Condición periodontal y pérdida dental en pacientes diabéticos del Hospital Universitario San Vicente de Paúl / Periodontal condition and tooth loss in diabetic patients

Introducción. La diabetes es una enfermedad sistémica que afecta el metabolismo de la glucosa y se ha relacionado con el desarrollo de enfermedad periodontal. Objetivo. El objetivo de este estudio fue determinar la condición periodontal y la pérdida dental de un grupo de pacientes diabéticos del Hospital Universitario San Vicente de Paúl. Materiales y métodos. A 117 sujetos con diabetes de tipo 1 y 2 se les practicó un examen periodontal completo, determinación de valores de la hemoglobina A1C (glycosilated hemoglobin) y radiografías periapicales, y se les indagó sobre hábitos de higiene oral e historia de diabetes. Los datos se analizaron de forma descriptiva y comparativa entre los parámetros clínicos, pérdida dental y tipo de diabetes. Resultados. La prevalencia de gingivitis fue de 27,4 % y la de periodontitis de 72,6 %. La complicación sistémica más frecuente fue la hipertensión arterial (51,3 %). Los dientes más frecuentemente perdidos fueron los molares y, en promedio, los sujetos habían perdido siete dientes. El control de placa bacteriana fue pobre (55,4 %). No hubo diferencias en los parámetros clínicos entre pacientes diabéticos de tipo 1 y de tipo 2. El promedio de profundidad con sonda fue 2,62 mm, siendo los molares los dientes más afectados. El promedio de pérdida de inserción fue de 3,03 mm. Los dientes 17, 16, 27, 37 y 47 presentaron los valores más altos de pérdida de inserción. Conclusiones. En conclusión, la condición periodontal en pacientes diabéticos fue mala, y presentaban periodontitis en la mayoría de los casos. Esto puede ser una causa importante de pérdida dental en sujetos diabéticos y requiere de especial atención por parte de los odontólogos y médicos.

Introduction. Diabetes is a systemic disease which affects the metabolism of glucose,and it has been associated with the development of periodontal disease. Objective. The periodontal condition and tooth loss was evaluated in diabetic subjects. Materials and methods. At the San Vicente de Paúl Hospital (Medellín, Colombia), 117 subjects with type 1 and 2 diabetes mellitus were examined. Patients underwent a comprehensive periodontal evaluation, glycosylated hemoglobin analysis, oral hygiene habits and history of diabetes. A descriptive and comparative analysis between the clinical parameters, tooth loss and type of diabetes was performed. Results. The prevalence of gingivitis was 27.4% and periodontitis 72.6%. The most frequent systemic complication was hypertension (51.3%). The most frequently lost teeth were molars and in general, the subjects had lost an average of 7 teeth and had a poor plaque control (55.4%). No differences were seen in clinical parameters between type 1 and 2 diabetes patients. The mean probing depth was 2.6 mm. The first and second upper and lower molars showed the highest values of PD. The mean clinical attachment loss was 3.3 mm . Maxillary teeth 17, 16, and mandibular 37, 47 showed the highest values of clinical attachment loss. Conclusions. In conclusion, the periodontal condition in diabetic patients was poor, presenting periodontitis in most cases. This can be a major cause of tooth loss in diabetic subjects and requires special attention by clinicians.

Assessment of periodontal status among dental fluorosis subjects using community periodontal index of treatment needs.

Aim: To determine the periodontal status and treatment needs among dental fluorosis subjects residing in Ennore, Chennai, using Community Periodontal Index of Treatment Needs (CPITN). Materials and Methods: All the subjects with dental fluorosis above 15 years of age, permanent residents of Ennore, were included in the study. Subjects with known systemic diseases and subjects with other intrinsic dental stains were excluded from the study. Periodontal status was estimated using CPITN and Dental fluorosis was recorded using Dean's Dental Fluorosis Index. Results: The total number of study subjects was 1075, of which 489 were males and 586 were females. Males were predominantly affected with periodontal disease than females. This was found to be statistically significant (P=0.000). The association between Degree of Fluorosis and Periodontal Status is statistically significant (P=0.000). There was statistically significant difference in mean number of sextants between the degree of fluorosis in each of the periodontal status (P=0.000). Conclusion: The finding that the lower prevalence of shallow pockets in the study area, where the fluoride level in the drinking water ranges from 1.83 to 2.01 ppm, indicates that the use of fluoride in water is beneficial to the periodontal tissues.

Interfaces between bariatric surgery and oral health: a longitudinal survey / Interface entre cirurgia bariátrica e saúde bucal: estudo longitudinal

PURPOSE: To evaluate oral changes, such as dental caries, periodontal disease, dental wear and salivary flow in bariatric patients. Fifty four obese patients who underwent bariatric surgery were studied before (n=54), up after 3 months (n=24) and 6 months (n=16). METHODS: Indices for evaluating oral conditions were: DMFT, CPI, DWI and salivary flow. OIDP questionnaire was used to assess the impact of oral health on quality of life. ANOVA and Spearman correlation were used (p<0.05). RESULTS: DMFT was 17.6±5.7, 18.4±4.1 and 18.3±5.5 (P>0.05), presence of periodontal pockets in 50 percent, 58 percent and 50 percent of patients (p>0.05), tooth wear in dentin present in 81.5 percent, 87.5 percent and 87.5 percent before, 3 and 6 months after surgical treatment respectively. There were differences between the three periods for prevalence and severity of dental wear (p = 0.012). Salivary flow was 0.8±0.5 ml/min before surgery, 0.9±0.5 ml/min for 3 months and 1.1±0.5m/min for 6 months (p>0.05). The impact of oral health on quality of life decreased with time after bariatric surgery (p= 0.029). CONCLUSION: The lifestyle changes after bariatric surgery and these changes may increase the severity of pre-existing dental problems. However, these alterations in oral health did not influence the quality of life.

OBJETIVO: Avaliar alterações bucais, como cárie dentária, doença periodontal, desgaste dentário e fluxo salivar, em pacientes bariátricos. MÉTODOS: Cinquenta e quatro pacientes obesos, submetidos à cirurgia bariátrica, tiveram suas condições bucais avaliadas antes (n=54), aos 3 meses (n=24) e aos 6 meses (n=16) após a cirurgia bariátrica. Os índices para avaliação das condições bucais foram: CPOD, IPC, IDD e o volume de fluxo salivar. O questionário OIDP foi utilizado para verificar o impacto da saúde bucal na qualidade de vida. ANOVA e correlação de Spearman foram utilizados para análise estatística (p<0,05). RESULTADOS: CPOD foi 17,6±5,7, 18,4±4,1 e 18,3±5,5 (p>0,05), bolsa periodontal foi encontrada em 50 por cento, 58 por cento e 50 por cento dos pacientes (p>0,05) e o desgaste dentário em dentina em 81,5 por cento, 87,5 por cento e 87,5 por cento dos pacientes, respectivamente antes, 3 meses e 6 meses após a cirurgia bariátrica. Houve diferença significativa entre os três períodos estudados, quanto à prevalência e à severidade do desgaste dentário (p=0,012). O fluxo salivar foi 0,8±0,5 ml/min antes, 0,9±0,5 ml/min aos 3 e 1,1±0,5 ml/min aos 6 meses após cirurgia (p>0,05). O impacto da saúde bucal na qualidade de vida diminuiu com o tempo decorrido após cirurgia bariátrica (p=0,029). CONCLUSÕES: As mudanças no estilo de vida após a cirurgia bariátrica podem aumentar a gravidade de problemas bucais pré-existentes. Entretanto, esta alteração na condição bucal pode não influenciar a qualidade de vida.

Oral health conditions among the elderly in Southeastern São Paulo State

Objective: This study aimed to asses oral health conditions in a population aged 60 years and over living in Botucatu, Southeastern Brazil. A cross-sectional population-based study was carried out using a random sample (N=372) of the urban population aged 60 years and over from the city of Botucatu, in 2005. World Health Organization criteria and codes for oral health epidemiological surveys were used. Re-examination was carried out in 10% of individuals aiming to evaluate intra-examiner agreement. Statisticalanalysis was performed by one-way ANOVA or Kruskal-Wallis ANOVA, as applicable. Also, the t-test was used in the absence of homoscedasticity. Fisher’s exact test was used for situations where the categories with less than five units were observed. Adjusted residuals and multiple-comparison analysis were conducted to identify associations between variable categories and subgroups. The intra-examiner agreement was 98% and Kappa statistics result was 0.95. Loss component represented 90.68% of DMF-T index, which was 29.85. The prevalence of edentulism was 63.17%. Upper and lower dentures were found in 80% and 58% respectively, with complete denture as the most commonly used. In those studied, 15% required upper and 38% lower dentures. There was more need for complete denture in both jaws. Approximately 20% had soft tissue alterations. For periodontal conditions, most sextants were excluded (81.81%). Periodontal pockets (4 – 5 mm) were seen in 11.29% of the examined individuals. The oral health status of the elderly population in Botucatu is poor, as well as in other Brazilian cities. The results of this study may help planning collective health actions, giving an accurate description of the oral problems among the elderly.

Prevalence of periodontal disease in endemically flourosed areas of Davangere Taluk, India.

Success of fluoride in combating dental caries led to study of fluoride on periodontal disease, but studies are less reported in literature and results are varied in nature. To address this issue, the study was conducted to assess severity of periodontal disease among (n = 283) 36-45 years old adults residing in area of different concentration of fluoride in drinking water. The villages selected were having fluoride concentration in their drinking water are Shamnur (0.5 PPMF), Kundawada (1.1 ppmF) and Halebathi (3.17 ppm). Ion Selective Electrode Method (OrionUSA) estimated fluoride in drinking water. Community Periodontal Index (WHO, 1997) and Plaque Index (Silness and Loe, 1967) was used to assess periodontal status. There was consistent decrease in mean plaque score from 1.45+ _0.024 at 0.51 ppm, 1.21+ _0.009 at 1.1 ppm, and 1.12+ _0.08 at 3.17 ppm fluoride area. This difference was significant statistically (P < 0.001). As the fluoride concentration in drinking water increased there was decrease in severity of prevalence of periodontitis. This difference in observation was significant statistically (P < 0.05). There were no effects of fluoride on calculus, since little variability was found in three different fluoride areas. Thus it was concluded from the study results that the increase in fluoride concentration decreased the plaque accumulation. decreased the shallow and deep pockets. Hence lower prevalence and severity of periodontal disease.

Condiçöes gengivais e periodontais associadas a fatores socioeconômicos / Gingival and periodontal conditions associated with socioeconomic factors

OBJETIVO: Conhecer a prevalência de sangramento gengival, cálculo dentário e de bolsas periodontais, em jovens de 18 anos do sexo masculino, verificando as associações com variáveis socioeconômicas. MÉTODOS: Foi realizado um estudo transversal em uma amostra de jovens de 18 anos de idade (n=300), alistandos do Exército Brasileiro em Florianópolis, SC. Foram aplicadas entrevistas estruturadas com questões sobre o número de anos de escolaridade do alistando e de seus pais e sobre a renda familiar. Um cirurgião-dentista realizou os exames odontológicos para a detecção de sangramento gengival, presença de cálculo dentário, bolsas periodontais rasas (entre 3,5 mm a 5,5 mm) e profundas (5,5 mm e mais). Verificaram-se as associações entre as condições periodontais e as variáveis socioeconômicas pelo teste qui-quadrado. RESULTADOS: A taxa de resposta foi de 100,0 por cento, entretanto, 4,7 por cento dos indivíduos foram excluídos do estudo devido à impossibilidade de exame. A concordância diagnóstica intra-examinador foi alta (kappa=0,73). As prevalências de sangramento gengival, cálculo dentário, bolsas rasas e profundas foram de 86 por cento, 50,7 por cento, 7,7 por cento e 0,3 por cento, respectivamente. O sangramento gengival foi negativamente associado a todas as variáveis socioeconômicas estudadas (p<0,001). O cálculo dentário associou-se negativamente à menor escolaridade do pai do alistando e do alistando (p<0,05) e com menor escolaridade da mãe do alistando (p<0,01). Bolsas periodontais associaram-se à menor escolaridade do pai do alistando (p<0,05). CONCLUSÕES: Bolsas periodontais foram raramente observadas na amostra estudada, enquanto a presença de sangramento e cálculo dentário apresentou altas prevalências, sendo estas maiores nos indivíduos com piores condições socioeconômicas. A condição de saúde periodontal da população estudada pode ser considerada boa

Evaluación del índice periodontal. Tratamiento de la comunidad / Evaluation of periodontal index. Community treatment

El objetivo de este estudio fue hacer un análisis de los resultados obtenidos a través de la evaluación del Indice Periodontal de Necesidades de Tratamiento de la Comunidad (IPNTC) en ciento cincuenta pacientes, concurrentes al servicios de urgencias del Hospital Central de Odontología de la Ciudad de Resistencia. Si bien este índice es comunmente utilizado en los países en vía de desarrollo, presenta varias limitaciones clínicas, los datos obtenidos son de una significación cuestionable y con detalles inadecuados. Esto indica que no tendría que ser usado como índice rutinario en estudios periodontales