Impact of periodontal disease on late morbimortality (10 years) of pacientes with acute coronary syndrome / Impacto da doença periodontal na morbimortalidade tardia (10 anos) de pacientes com síndrome coronariana aguda

Background: It is known that predisposing factors for periodontal disease (PD) and cardiovascular diseases are similar, just as dissemination of oral flora pathogens can induce the development of cardiovascular diseases, which play a direct role on the morbimortality of patients. Objective: To assess the impact of periodontal disease in the presence of acute coronary syndrome on late morbimortality after long-term follow-up of patients (10 years). Methods: The historical prospective study of continuous assessment was based on the evaluation of 345 medical records of patients hospitalized for acute coronary syndrome, divided into 3 groups: edentulous, with periodontal disease and without periodontal disease. The patients studied were in the ICU, in 2006, with a clinical picture of acute coronary syndrome submitted to invasive stratification with coronary angiography on the basis of clinical indication and were reassessed over the next 10 years. The qualitative variables were compared using the Chi-square test. Long-term mortality was assessed using the Kaplan-Meier curves, quantified with the hazard ratio (HR) and a confidence interval of 95% and compared through Cox regression. P values of less than or equal to 0.05 were regarded as statistically significant. Results: Of the 345 patients, 233 had at least one coronary obstruction greater than or equal to 50%, being the main group for comparison according to the different status of periodontal disease (without periodontal disease, with periodontal disease and edentulous). In his cardiovascular condition, we found a difference in mortality among edentulous patients compared to those free of periodontal disease, with a p = 0.004 and a hazard ratio of 10.496 (95% CI: 4.988-22.089). A is ignificant difference was also noted between edentulous patients and patients with periodontal disease, with a p = 0.0017 and a hazard ratio of 2.512 (95% CI: 1.491-4.234). Conclusion: A significant increase in mortality was found according with the progression of periodontal disease, which justifies its classification as an important risk factor for the development of cardiovascular diseases, as well as the need for prevention and treatment of oral diseases

Caracterização mecânica e microestrutural da y-tzp sinterizada por micro-ondas e degradada em meio bucal / Mechanical and microstructural characterization of Y-TZP sintered by microwave and degraded in the buccal medium

Neste estudo avaliou-se por caracterização mecânica e microestrutural, a degradação em meio bucal e in vitro da cerâmica Y-TZP sinterizada por energia de micro-ondas em comparação ao método convencional. Foram confeccionados noventa e seis discos por CAD-CAM (ISO 6872), sinterizados de modo convencional (C) 1530°C/120 minutos e por energia de micro-ondas (M) 1450°C/15 minutos. E submetidos à degradação hidrotérmica em reator pressurizado (E) (1,5h/150°C/3 bar) e à degradação in situ (B) (240 horas em meio bucal), formando-se 8 grupos (n = 12): M, C, ME, CE, MB, CB, MEB e CEB. Foram realizadas análises de contração volumétrica, difração de raios-X (DRX), rugosidade superficial (Ra e Rz), ângulo de contato, microscopia eletrônica de varredura (MEV), quantificação do biofilme por UFC/mL e análise de resistência mecânica por flexão biaxial. Os resultados obtidos foram analisados estatisticamente por t-Student, Anova dois e três fatores, e teste de Tukey (5%). Por DRX observou-se transformação de fase tetragonal para monoclínica (t-m) nos grupos envelhecidos, exceto para o grupo MB. Não foram observadas diferenças significantes na contração volumétrica (p=0,274), na rugosidade Ra (p=0,137) e Rz (p=0,187), assim como nos valores de ângulo de contato entre os métodos de sinterização (p=0,669). Por MEV observou-se a presença de formação de biofilme inicial e na contagem de Unidades Formadoras de Colônias (UFC/mL) foi maior quando os espécimes foram previamente envelhecidos in vitro (p=0,001). No ensaio de resistência à flexão biaxial foi observado o efeito interação (p=0,005) para as três variáveis, sinterização, envelhecimento in vitro e envelhecimento in situ, com aumento da resistência para os grupos sinterizados pelo método convencional após os envelhecimentos, devido ao aumento de tensão de transformação superficial. E houve equivalência estatística entre todos os grupos micro-ondas comparados aos grupos controle. Concluiu-se que o método de envelhecimento in situ por 240 horas foi capaz de transformar a fase t-m da superfície da cerâmica, sendo que a sinterização por energia de micro-ondas influenciou positivamente a resistência à degradação hidrotérmica à baixa temperatura (LTD), além da redução no tempo de sinterização em mais de 80%(AU)

In this study ir was evaluated the effect of in situ low temperature degradation of yttrium oxide stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics sintered by microwave energy in comparison to the conventional method. Ninety-six discs milled by CAD/CAM (ISO 6872) were divided in: conventionally sintered (C) at 1530 ° C / 120 minutes and microwave energy (M) 1450°C / 15 minutes. Specimens were submitted to hydrothermal degradation in a pressurized reactor (E) (1.5h / 150°C / 3 bar) and in situ degradation (B) (240 hours in the buccal medium), forming eight groups (n=12): M, C, ME, CE, MB, CB, MEB and CEB. Specimens were evaluated through analysis of volumetric contraction, X-ray diffraction (XRD), surface roughness (Ra and Rz), contact angle, scanning electron microscopy (SEM), biofilm quantification by CFU / mL and biaxial flexural strength. Results were statistically analyzed through t-Student, two, three-way Anova and Tukey tests (5%). By XRD, tetragonal to monoclinic phase transformation (t-m) was observed in the aged groups, except for the MB group. No significant differences were observed in the volumetric contraction (p = 0.274), Ra roughness (p = 0.137) and Rz (p = 0.187), as well as contact angle values between sintering methods (p = 0.669). SEM images showed that the initial biofilm formation was observed after 8 hours in situ, an increase of CFU / mL occurred when the specimens were previously aged in vitro (p = 0.001). Regarding biaxial flexural strength, the interaction effect (p = 0.005) for the three variables, sintering method, hydrothermal aging and in situ aging was observed, with increased resistance for the sintered groups by the conventional method after aging, and statistical equivalence for the microwave groups, aged or not, compared to the control groups. The in situ aging method for 240 hours was induced the t-m phase transformation the surface of the ceramic, and sintering by microwave energy had a positive effect on the resistance to low temperature hydrothermal degradation (LTD), besides reduction in sintering time by more than 80%(AU)

Cárie dentária e presença de placa visível em dentes ântero-superiores em crianças de 0 a 5 anos / Dental caries and presence of visible plaque on anterior teeth on 0 to 5 years old children

Objetivo: Identificar a associação entre cárie dentária e placa dental em função do estágio da primeira infância. Materiais e Métodos: Foram examinadas clinicamente 183 crianças de 8 a 69 meses de idade em dois Centros Municipais de Educação Infantil de Curitiba. As crianças foram divididas em dois grupos, de acordo com o estágio da primeira infância, G1 (até 36 meses)e G2 (37 a 69 meses). Experiência de cárie (ceo-d > 0) e presença de placa visível (em pelo menos um incisivo superior) foram avaliadas por um único pesquisador previamente calibrado (Kappainter e intraexaminador> 0,80). As mães responderam a um questionário sobre condições socioeconômicas, hábitos de higiene e alimentação. Os dados foram submetidos à análise bivariada,por meio dos testes de Qui-quadrado de Pearson e Exato de Fisher. Resultados: No grupo G1houve tendência de associação entre experiência de cárie e placa visível (p = 0,053), enquanto no grupo G2 esta associação apresentou-se significativa (p = 0,006). Houve associações entre o padrão de higienização após a alimentação durante a noite e placa visível (p= 0,026) no grupoG1; e entre estado civil das mães e placa visível no grupo G2 (p= 0,043). Conclusão: Dentro da primeira infância, a relação entre cárie dentária e placa visível em dentes anteriores torna-semais evidente com o aumento da idade.

Objective: To identify the association between dental caries and plaque in the different stages of the early childhood. Materials and Methods: 183 children 8-69 months of age from two Municipal Centers of Children Education, in Curitiba, were clinically examined for cariesand visible plaque. Children were divided in two groups according to the different stages ofthe early childhood, G1 (up to 36 months), G2 (37 to 69 months). Caries experience (ceo-d>0)and visible plaque on at least one upper incisor were evaluated by one previously calibrated examiner (kappa>0,80). Mothers were invited to answer a questionnaire about socioeconomic aspects, dental hygiene and feeding habits. Data were submitted to bivariate analysis using Pearson´s chi-square and Fisher´s exact tests. Results:G1 showed a tendency of association between caries experience and visible plaque (p=0,053), while in G2 a significant association wasfound (p=0,006).Association was found in G1 between dental hygiene after feeding during thenight and visible plaque (p=0,026), and between mother´s marital status and visible plaque onG2 (p=0,043). Conclusion: The association between dental caries and visible plaque on anteriorteeth becomes more evident on the late stages of early childhood.

Periodontal status of Pakistani orthodontic patients

The objective of this study was to evaluate and compare the periodontal status of orthodontic patients and non-orthodontic patients, aged 15–28 years, of both genders. The cross-sectional study included 100 orthodontic and 100 non-orthodontic patients evaluated using a Community Periodontal Index for Treatment Need (CPITN) probe on the index teeth. A questionnaire was distributed to the participants to assess and evaluate the use of oral hygiene aids. The data were analyzed using SPSS version 17, and various comparisons were performed using the chi-square test. The study revealed that there was a statistically significant association in CPITN scores between the orthodontic and non-orthodontic patients (p < 0.01). The study showed that patients undergoing orthodontic treatment have increased plaque accumulation and probing depth resulting in periodontal tissue destruction. Proper oral hygiene practices and interdental aids should be employed to control plaque.

Prevalence and severity of plaque-induced gingivitis in a Saudi adult population

To evaluate the prevalence and severity of plaque-induced gingivitis among a Saudi adult population in Riyadh region. Three hundred and eighty-five eligible participants in this cross-sectional study were recruited from routine dental patients attending the oral diagnosis clinic at Al-Farabi College in Riyadh, Saudi Arabia from June 2013 to December 2013. A clinical examination was performed by 2 dentists to measure the gingival and plaque indices of Loe and Silness for each participant. The prevalence of gingivitis was 100% among adult subjects aged between 18-40 years old. Moreover, the mean gingival index was 1.68 +/- 0.31, which indicates a moderate gingival inflammation. In fact, males showed more severe signs of gingival inflammation compared with females [p=0.001]. In addition, the mean plaque index was 0.875 +/- 0.49, which indicates a good plaque status of the participants. Interestingly, the age was not related either to the gingival inflammation [p=0.13], or to the amount of plaque accumulation [p=0.17]. However, males were more affected than females [p=0.005]. The results of this study show that plaque accumulation is strongly associated with high prevalence of moderate to severe gingivitis among Saudi subjects

In adults: 47.2% have periodontitis! How about in orthodontic patients? / Em adultos: 47,2% apresentam periodontite! E nos pacientes ortodônticos?

The occurrence of chronic inflammatory periodontal disease due to dental plaque in adults over 30 years of age was noticed in 47.2% of the 3,742 subjects studied, representing a 64.7 million people population in the 50 states of the U.S. and the District of Columbia. The methods used by the authors were uniquely precise and the results brought us to great insight on the correlation between orthodontic treatment and periodontal health, which is described below.

A prevalência de 47,2% da doença periodontal inflamatória crônica induzida pela placa dentobacteriana em adultos com mais de 30 anos foi detectada em 3.742 adultos, que representaram estatisticamente 64,7 milhões de pessoas de 50 estados e do distrito federal dos Estados Unidos da América. O método foi preciso e os resultados induzem a alguns insights quanto à relação entre o tratamento ortodôntico e a saúde dos tecidos periodontais, que foram expostos no texto desse trabalho.

Relationship between overweight-obesity and periodontal disease in Mexico

The aim of this study was to examine the association between overweight-obesity and periodontal disease in subjects who attended the clinic of Periodontics, Faculty of Dentistry, San Luis de Potosi, Mexico. This was cross-sectional study involving 88 subjects - 60 without overweight-obesity and 28 with overweight-obesity. The following clinical parameters were evaluated: dental bacterial plaque, index of calculus, gingivitis, probing depth and periodontal disease index (PDI). When comparing the group of subjects with overweight-obesity to the control, there were statistically significant differences in the variables calculus (p=0.0015), gingivitis (p=0.0050) and periodontal disease (p=0.0154). Regarding the logistic regression analysis, the dependent variable was subjects with and without overweight-obesity and the independent variables were sex, age and periodontal disease. We found statistically significant differences (p=0.0162) with OR=3.16 in periodontal disease. Periodontal disease showed statistically significant differences in the group of subjects with overweight-obesity. The oral health of subjects with overweight- obesity should be supervised and checked in order to prevent oral alterations.

El objetivo fue asociar el sobrepeso-obesidad con la enfermedad periodontal en sujetos que asistieron a la clinica de Periodoncia de la Facultad de Estomatologia de la Universidad Autonoma de San Luis Potosi (UASLP) Mexico. Se realizo un estudio transversal con un total de 88 sujetos, 60 con sobrepeso-obesidad y 28 sin sobrepeso-obesidad. Los siguientes parametros clinicos fueron evaluados en el estudio: placa dentobacteriana, indice de calculo, profundidad de bolsa y enfermedad periodontal (PDI). Al comparar el grupo de sujetos con sobrepeso-obesidad con el control se encontraron diferencias estadisticamente significativas en las variables calculo (p=0.0015), gingivitis (p=0.0050) y enfermedad periodontal (p=0.0154). En relacion con el analisis de regresion logistica, la variable dependiente fue sujetos sin y con sobrepeso-obesidad y las independientes fueron: sexo, edad y enfermedad periodontal. Encontramos diferencias estadisticamente significativa (p=0.0162) con un OR=3.16 en enfermedad periodontal. La enfermedad periodontal mostro diferencias al comparar el grupo de sujetos con sobrepeso-obesidad con el control. Es necesario la prevencion, supervision y revision del estado de salud bucal de los pacientes con sobrepeso y obesidad para prevenir alteraciones bucales.

16S rRNA-based detection of oral pathogens in coronary atherosclerotic plaque.

Background: Atherosclerosis develops as a response of the vessel wall to injury. Chronic bacterial infections have been associated with an increased risk for atherosclerosis and coronary artery disease. The ability of oral pathogens to colonize in coronary atheromatous plaque is well known. Aim: The aim of this study was to detect the presence of Treponema denticola, Porphyromonas gingivalis and Campylobacter rectus in the subgingival and atherosclerotic plaques of patients with coronary artery disease. Materials and Methods: Fifty-one patients in the age group of 40-80 years with coronary artery disease were selected for the study. DNA was extracted from the plaque samples. The specific primers for T. denticola, C. rectus and P. gingivalis were used to amplify a part of the 16S rRNA gene by polymerase chain reaction. Statistical Analysis Used: Chi-square analysis, correlation coefficient and prevalence percentage of the microorganisms were carried out for the analysis. Results: Of the 51 patients, T. denticola, C. rectus and P. gingivalis were detected in 49.01%, 21.51% and 45.10% of the atherosclerotic plaque samples. Conclusions: Our study revealed the presence of bacterial DNA of the oral pathogenic microorganisms in coronary atherosclerotic plaques. The presence of the bacterial DNA in the coronary atherosclerotic plaques in significant proportion may suggest the possible relationship between periodontal bacterial infection and genesis of coronary atherosclerosis.

Effect of oil pulling on plaque induced gingivitis: a randomized, controlled, triple-blind study.

BACKGROUND: Oil pulling has been used extensively as a traditional Indian folk remedy for many years for strengthening teeth, gums, and the jaw and to prevent decay, oral malodor, bleeding gums, dryness of the throat, and cracked lips. AIMS: The aim of this study was to evaluate the effect of oil pulling with sesame oil on plaque-induced gingivitis and to compare its efficacy with chlorhexidine mouthwash. MATERIALS AND METHODS: A total of 20 age-matched adolescent boys with plaque-induced gingivitis were selected for this study. They were divided randomly into the study or oil pulling group (Group I) and the control or chlorhexidine group (Group II) with 10 subjects in each group. Plaque index and modified gingival index scores were recorded for the 20 subjects and baseline plaque samples were also collected. The plaque samples were used to identify the microorganisms and to measure the total colony count of the aerobic microorganisms present. The study group was subjected to oil pulling with sesame oil and the control group was given chlorhexidine mouthwash everyday in the morning before brushing. Reassessment of the index scores and collection of plaque for measuring the colony count of the aerobic microorganisms was done after 10 days. RESULTS: There was a statistically significant reduction of the pre- and post-values of the plaque and modified gingival index scores in both the study and control groups (P < 0.001 in both). There was a considerable reduction in the total colony count of aerobic microorganisms present in both the groups. CONCLUSION: The oil pulling therapy showed a reduction in the plaque index, modified gingival scores, and total colony count of aerobic microorganisms in the plaque of adolescents with plaque-induced gingivitis.

Inter-relação entre insuficiência renal crônica em hemodiálise e doença periodontal / Interrelation among chronic renal failure in hemodialysis and periodontal disease

A insuficiência renal crônica (IRC) apresenta, como resultado do seu desenvolvimento ou do tratamento, várias alterações sistêmicas, como hiperparatireoidismo secundário, anemia, desnutrição, diabetes, alterações cardiovasculares e alterações imunológicas. Seus principais fatores de morbidade e mortalidade são a infecção e as doenças cardiovasculares. A doença periodontal é uma doença infecciosa multifatorial, de causa bacteriana essencial associada à resposta imunológica do hospedeiro e também considerada um fator de risco para várias doenças sistêmicas. Pacientes com IRC em tratamento de hemodiálise apresentam alterações e deficiências imunológicas, assim, o acúmulo de placa bacteriana pode ser um fator de risco à doença periodontal (DP), bem como a DP pode ser um fator de risco à infecção sistêmica, através da disseminação de bactérias e de seus produtos bacterianos pela corrente sanguínea, com a possibilidade de afetar locais e órgãos distantes, como o rim, sendo inclusive motivo de impedimento ou rejeição ao transplante renal. O objetivo deste estudo é estabelecer a possível inter-relação entre essas duas doenças, através da interação causa-efeito dos seus fatores em comum.

Chronic renal insufficiency (CR) presents several systemic alterations as resulta of its development or treatment, such as secondary hyperparathyroidism, anemia, malnutrition, diabetes, cardiovascular alterations, and immunological alterations. Its main of morbidity and mortality are infections and cardiovascular diseases. Periodontal disease es an infective multifactorial disease, essentially caused by bacteria associated with hos immunological response, and it is also considered a risk factor several systemic diseases. Patients with CRI treated with hemodialysis presents immunological alterations and deficiencies, therefore, bacterial plaque accumulation may be a risk factor to periodontal disease (PD), as PD may a risk factor to systemic infection, when dissemination of bacteria and their products occurs through bloodstream, with the possibility of affecting distant places and organs, such as the kidney, and it could even be the reason for the impediment or the rejection of a renal transplant. The objective of this study is to establish a potential interrelation between these two diseases through cause-effect interaction of their common factors.

Pneumonia por aspiração associada à doença periodontal / Aspiration pneumonia associated with periodontal disease

O presente trabalho analisou os fatores etiológicos da pneumonia, relacionando-os com o acúmulo de placa bacteriana e com a doença periodontal, e concluiu que a via nais frequente de desenvolvimento da enfermidade é a aspiração de conteúdos da orofaringe, sendo de extrema importância a manutenção da saúde oral para que os microrganismos orais, presentes na placa bacteriana, na doença periodontal e nas lesões cariosas não colonizem o trato respiratório e também para que a placa bacteriana não atue como reservatório de patógenos e respiratórios

"Cariogenic potential of homemade weaning diet v/s commercial formula feeds" an in-vitro study.

The universal phenomenon of introducing weaning diet to the growing child sets its onset by the age of 4-6 months. This preliminary diet of the child governs his or her dental health in the long run. The main objective of this study is to investigate the histopathological and clinical invasion of deciduous teeth exposed to both the homemade weaning diet and commercial formula feeds. The study also aims at motivating the consumption of the most appropriate diet for the weaning baby. Extracted deciduous teeth were incubated with the test solutions of homemade diet and commercial formula feeds for the period of 6 weeks. Fewer carious invasion both clinically and histopathologically were seen in homemade feeds. Thus, homemade diet can be a strong candidate for the status of 'THE IDEAL WEANING FOOD'.

Análise da placa bacteriana subgengival em pacientes de risco à doença periodontal e sua capacidade previsora de perda de inserçäo periodontal / Microbiological analysis of subgingival plaque in risk patients of periodontal diseases and its predictive value for periodontal attachment loss

Examinou-se 104 amostras de placa bacteriana subgengival de 25 pacientes adultos com 18 a 45 anos, considerados de risco à doença periodontal, quanto à presença de bactérias periodontopáticas e valor previsor de perda de inserçäo, usando-se a técnica "slot immunoblot". As bactérias analisadas foram: P.g., P.i., T.d., A.v., S.sg. Dos 104 sítios amostrados, apenas 12 apresentaram perda de inserçäo quando este critério foi avaliado com intervalo de 6 meses, utilizando-se sonda computadorizada (Florida Probe) e um critério de "cohort" de 0,9 mm. A partir da análise dos resultados, vê-se que poucos sítios tiveram perda de inserçäo e que a quantidade de bactérias detectadas parece ter pouco ou nenhum valor previsor positivo de perda de inserçäo. O método de análise por "slot immunoblot" é pouco sensível e altamente específico para detectar perda de inserçäo em funçäo da presença de bactérias. Parece que, os métodos de análise microbiológica ainda näo säo suficientemente seguros para serem utilizados sozinhos como método de diagnóstico para prever perda de inserçäo periodontal

Hiperplasia gingival inducida por medicamentos antihipertensivos e inmunosupresores / Gingival hyperplasia induced by antihypertensive and immunosupressor drugs

El agrandamiento o hiperplasia gingival es uno de los hallazgos más frecuente en las patologías gingivales, debido principalmente a la exposición crónica de los tejidos a los factores irritantes de la placa bacteriana, y se asocia comunmente a la ingesta de medicamentos como los antihipertensivos, inmunosupresores y anticonvulsivos. En este artículo se revisará principalmente la hiperplasia inducida por el consumo de antihipertensivos e inmunosupresores, pues actualmente son drogas muy usadas, por las altas tasas de hipertensión encontradas en la población, el auge de los trasplantes de órganos y el tratamiento de múltiples enfermedades relacionadas con problemas inmunológicos. Los medicamentos más usados en esas patologías son la ciclosporina A (CsA) y la Nifedipina (NIF)

Efeito do uso contínuo de soluçäo para bochecho sobre o pH e o conteúdo mineral da placa bacteriana / Effects of the continuous use of a mouthrinsing solution on the pH and mineral content of dental plaque

Foi realizado um estudo com o objetivo de avaliar os efeitos do uso contínuo por 14 dias de uma soluçäo experimental para bochecho quanto ao pH e ao conteúdo inorgânico da placa bacteriana. Vinte e dois voluntários, alunos da FOUSP, com idade média de 19 (ñ 1,3) anos, receberam raspagem e polimento coronários, assim como orientaçöes de higiene e dieta. Em três ocasiöes, precedidas por um período de 48 horas sem higiene bucal, foram coletadas amostras de placa (3 mg) das superfícies lisas dos dentes posteriores 2 horas após o café da manhä. O pH das amostras incubadas com sacarose foi mensurado in vitro com um microeletrodo. O teor de minerais foi analisado por espectrometria de emissäo atômica. Os dados foram analisados através de testes t-pareados e de Wilcoxon. Foram observadas reduçöes significativas no pH médio de alguns minerais (P, Zn e Fe)

Programa de saúde em Odontologia: breves consideraçöes básicas / The health programs in dentistry a short basics considerations

Muitos freqüentam consultórios odontológicos ao longo da vida, gastando tempo, dinheiro, acumulando frustaçöes, como se isso fosse inevitável. Näo o é. A Odontologia atual, verdadeiramente moderna - aquela que cumpre sua real finalidade, enquanto profissäo de saúde -, coloca seus pacientes em um programa que lhes permite: 1) previnir cáries e doenças periodontais; 2) preservar, em saúde, os dentes e os trabalhos realizados; 3) evitar que novos trabalhos tenham que ser executados periodicamente, libertando o paciente de uma jornada cara, angustiante e ineficaz