Relación entre la enfermedad periodontal y complicaciones en el Embarazo / Relationship between periodontal disease and complications in pregnancy

Resumen La periodontitis es una enfermedad multifactorial caracterizada por una respuesta inflamatoria desarrollada por el huésped frente a los microorganismos de la biopelícula bacteriana. El proceso localizado en la cavidad oral puede influir en el huésped a nivel sistémico provocando resultados adversos en el embarazo como parto prematuro, hipertensión materna y bajo peso del niño al nacer. Objetivo: Analizar el estado actual del conocimiento sobre los mecanismos probables que vinculan la periodontitis con resultados adversos en el embarazo. Material y métodos: Se efectuó una revisión de la literatura y una búsqueda de artículos publicados durante el periodo comprendido entre los años 2016 y 2021 en las bases de datos MEDLINE, PUBMED, SciELO, LILACS, idioma inglés y/o español. Las búsquedas se realizaron utilizando los siguientes términos: Periodontitis, mediadores de inflamación, complicaciones del embarazo, parto prematuro. Resultados: Se analizaron un total de 24 publicaciones, incluidas revisiones de la literatura, revisiones sistemáticas, estudios de cohorte, estudios de casos y controles y estudio observacionales, que cumplieron con los criterios de inclusión. Conclusión: La periodontitis es un factor de riesgo evitable por lo que se recomienda intensificar las medidas de prevención y tratamiento, en embarazadas y en mujeres en edad fértil.

Abstract Periodontitis is a multifactorial disease characterized by an inflammatory response developed by the host against the microorganisms of the bacterial biofilm. The localized process in the oral cavity can influence the host systemically causing adverse pregnancy outcomes such as premature delivery, maternal hypertension, and low birth weight. Objective: To analyze the current state of knowledge about the probable mechanisms that link periodontitis with adverse pregnancy outcomes. Material and methods: A literature review and a search for articles published during the period between 2016 and 2021 was carried out in the MEDLINE, PUBMED, SciELO, LILACS, English and / or Spanish databases. Searches were conducted using the following terms: Periodontitis, inflammatory mediators, pregnancy complications, preterm delivery. Results: 24 publications were analyzed, including literature reviews, systematic reviews, cohort studies, case-control studies, and observational studies, which met the inclusion criteria. Conclusion: Periodontitis is an avoidable risk factor, therefore it is recommended to intensify prevention and treatment measures in pregnant women and women of childbearing age.

Guía clínica para el tratamiento de lesiones endoperiodontales sin compromiso radicular en pacientes periodontales / Clinical practice guide for the treatment of endoperiodontal lesions without root compromise in periodontal patients

La comunicación patológica entre la pulpa y el pe-riodonto se denomina lesión endoperiodontal. Puede presentarse de forma aguda o crónica, y su mani-festación más común es la presencia de un absceso acompañado de dolor. Es importante realizar una detenida evaluación clínica y radiográfica para esta-blecer un correcto diagnóstico y plan de tratamiento. Por este motivo, el objetivo de esta guía es presentar un protocolo consensuado entre las Cátedras de Pe-riodoncia y Endodoncia de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA), para su tratamiento (AU)

The pathological communication between the pulp and the periodontium is called Endoperiodontal Lesion. It can be presented in an acutely or chronically form and its most common manifestation is the presence of an abscess accompanied by pain. It is important to carry out a careful clinical and radiographic evaluation to establish a correct diagnosis, prognosis, and treatment plan. For this reason, the objective of this guide is to present a consensus protocol between Periodontics and Endodontics Departments of the Faculty of Dentistry of the University of Buenos Aires (FOUBA) for their treatment (AU)

Research progress in association of neurological disorders and periodontal diseases / 中华口腔医学杂志

Periodontal diseases are inflammatory diseases caused by oral pathogens around the periodontal supporting tissues, leading to systemic and chronic inflammatory conditions. The continuous chronic systemic inflammation may be a trigger of neuroinflammation, which is the prominent feature of a variety of neurological disorders. It implies that there may be a causal link between periodontal diseases and neurological disorders. This article presents epidemiological and biological evidences that periodontal diseases can induce or exacerbate neurological disorders, including Alzheimer's disease, Parkinson's disease, multiple sclerosis and major depressive disorder, and analyzes the possible mechanisms. The importance of maintaining oral health as well as preventing and treating periodontal diseases are emphasized. At the same time, this may provide novel approaches to study the relationship between periodontal diseases and neurological disorders in the prevention and treatment strategies of neurological disorders.

Periodontal disease and the risk of prostate cancer: a meta-analysis of cohort studies

ABSTRACT Background: Periodontal disease is reportedly associated with the risk of various systemic diseases, including pancreatic and lung cancers. However, its association with prostate cancer remains inconclusive. Herein, we explored the association of periodontal disease with the risk of prostate cancer through a meta-analysis. Materials and Methods: MEDLINE, Embase, Web of Sciences and Cochrane Library databases were searched for eligible publications up to April 2020. Multivariate adjusted risk estimates with corresponding 95% confidence intervals (CIs) were extracted and calculated using random- or fixed-effect models. Results: Nine cohort studies involving 3.353 prostate cancer cases with 440.911 participants were identified and included in the meta-analysis. We found that periodontal disease significantly increased the risk of prostate cancer by 1.40-fold (hazard ratio [HR]=1.40, 95% CI: 1.16-1.70; P=0.001; I2=76.1%) compared with normal condition. Interestingly, the risk of developing prostate cancer was not significant in patients treated with periodontal therapy (HR=1.22, 95% CI: 0.86-1.73; P=0.272; I2=65.2%). The results of subgroup analyses were also consistent and significant when stratified by study design and follow-up period, whereas conflicting results were observed in periodontal disease ascertainment stratification. These findings were robust as indicated by sensitivity analyses. Conclusions: Periodontal disease was associated with the increased risk of prostate cancer, whereas no significant association was observed in patients treated with periodontal therapy. Hence, the awareness and importance for maintaining oral health should be improved, and the underlying mechanisms linking periodontal disease and prostate cancer should be fully explored in future research.

Periodontal disease and its complications in cats from a shelter in the Central Region of Rio Grande do Sul / Doença periodontal e suas complicações em gatos de um abrigo na Região Central do Rio Grande do Sul

Periodontal disease is the most common infectious disease that occurs in feline patients. Although it occurs in both sexes, different age groups, and any breeds, the prevalence and severity seem much higher in cats living in animal shelters. This paper aimed to describe the clinical, radiological, cytopathological, and virological aspects of periodontal disease and its complications in cats, based on these aspects and, consequently, on the importance it brings to cat feline medicine in shelter cats. For this, nine cats with periodontal disease from a single animal shelter were evaluated. These cats demonstrated a disease characterized by halitosis, excessive salivation, and oral discomfort. Lymphadenomegaly of the mandibular and retropharyngeal lymph nodes was observed in 44.4% of the cases. Oral lesions consisted of varying degrees of gingival hyperemia, complete loss of free gingival margins, and consequently gingival retraction, dental calculus deposition, dental mobility, complete exposure of the furcation of premolars and molars, and dental roots of canines and incisors, loss of bone radiopacity due to alveolar bone resorption and tooth loss. Complications included chronic ulcerative paradental stomatitis (22.2%), faucitis (22.2%), and chronic gingivostomatitis (11.1%). None of the cats affected by periodontal disease was positive for FIV or FeLV. In 33.3% of the cases, cats were carriers of feline calicivirus, but not feline herpesvirus.(AU)

Doença periodontal é a mais comum doença infecciosa que ocorre em pacientes felinos. Embora ocorra em gatos de ambos os sexos, diferentes faixas etárias e quaisquer raças, a prevalência e a gravidade parece muito maior em gatos que vivem em abrigos para animais. Baseado nesses aspectos e, consequentemente, na importância que ela traz para a medicina felina de gatos de abrigos, o objetivo desse artigo é descrever os aspectos clínicos, radiológicos, citopatológicos e virológicos da doença periodontal e suas complicações em gatos. Para isso, nove gatos com doença periodontal oriundos de um único abrigo de animais foram avaliados. Esses gatos demonstraram uma doença caracterizada por halitose, salivação excessiva e desconforto oral. Linfadenomegalia dos linfonodos mandibulares e retrofaríngeos foi observada em 44,4% dos casos. As lesões orais consistiam de graus variados de hiperemia gengival, perda completa das margens gengivais livres e, consequentemente, retração gengival, deposição de cálculo dental, mobilidade dentária, exposição completa da furca dos pré-molares e molares e das raízes dentárias dos caninos e incisivos, perda de radiopacidade óssea devido à reabsorção de osso alveolar e perda dentária. Complicações incluíram estomatite paradental ulcerativa crônica (22,2%), faucite (22,2%) e gengivoestomatite crônica (11,1%). Nenhum dos gatos afetados pela doença periodontal foi positivo para FIV ou FeLV. Em 33,3% dos casos, os gatos eram portadores do calicivírus felino, mas não do herpesvírus felino.(AU)

Etiologia e fatores associados à halitose: uma revisão integrativa da literatura / Etiology and factors associated with halitosis: an integrative literature review

Objetivo: avaliar quais as possíveis causas e quais são os fatores associados ao surgimento da halitose. Métodos: foi realizada uma revisão nos bancos de dados PubMed e SciELO, utilizando os descritores e sinônimos MeSH organizados em lógica booleana: 'Halitosis' AND 'Risk Factors' OR 'Association' OR 'Etiologies', com as seguintes etapas: identificação dos artigos, triagem, elegibilidade e inclusão. Apenas artigos publicados entre os anos de 2015-2020, ensaios clínicos randomizados, estudos transversais ou de coorte foram incluídos na revisão. Foram excluídos protocolos de estudos e os artigos que não estavam nos critérios e objetivo desta revisão. Resultados: de 240 artigos encontrados, 22 foram inclusos. Desses, 50% demonstraram que a falta ou a deficiência dos hábitos de higiene oral se relacionam com a halitose. Ainda, 40,9% deles se referem à saburra lingual como um forte fator etiológico e 36,4% demonstram que a doença periodontal está diretamente associada com o mau hálito. Além disso, em relação a outras condições locais e sistêmicas, xerostomia (13,6%), doença gastrointestinal e refluxo laringofaríngeo (9,1%), rinite e diabetes (4,5%) também demonstraram associação. Considerações finais: a halitose pode estar associada com higiene bucal, saburra lingual, doença periodontal, alguns hábitos e quadros sistêmicos.(AU)

Objective: to evaluate the possible causes and what are the factors associated with the onset of halitosis. Methods: a review was performed in the PubMed and SciELO databases, using the descriptors and synonyms MeSH organized in Boolean logic: 'Halitosis' AND 'Risk Factors' OR 'Association' OR 'Etiologies', with the following steps: identification of articles, screening, eligibility and inclusion. Only articles published between 2015- 2020; randomized clinical trials; cross-sectional or cohort studies were included in the review. Study protocols and articles that were not in the criteria and objective of this review were excluded. Results: Of 240 articles found, 22 were included. Of those, 50% showed that the lack or deficiency of oral hygiene habits are related to halitosis. Furthermore, 40.9% of them refer to tongue coating as a strong etiological factor and 36.4% demonstrate that periodontal disease is directly associated with bad breath. Moreover, in relation to other local and systemic conditions, xerostomia (13.6%), gastrointestinal disease and laryngeal reflux (9.1%), rhinitis and diabetes (4.5%) also demonstrated an association. Final considerations: Halitosis may be associated with oral hygiene, lingualcoating, periodontal disease, some habits and systemic conditions.(AU)

Diagnóstico y tratamiento de la sinusitis maxilar odontogénica / Diagnosis and treatment of odontogenic maxillary sinusitis

RESUMEN Introducción: La patología sinusal inflamatoria e infecciosa puede comprometer la mucosa sinusal maxilar, etmoidal, esfenoidal o frontal, y su etiología es variada. Se ha observado que la patología odontológica es uno de los factores causales de la sinusitis maxilar, con una incidencia del 10% al 40% según diversas series de casos. El diagnóstico y tratamiento se debe realizar de manera interdisciplinaria entre las especialidades de otorrinolaringología y de cirugía maxilofacial. Se elaboró un documento descriptivo sobre la sinusitis odontogénica y orientador sobre su manejo, de acuerdo a una revisión de la literatura. Se realizaron búsquedas en las bases de datos PubMed, Lilacs y Google Académico, utilizando términos relevantes para la sinusitis odontogénica, con el fin de elaborar el documento. Se utilizaron 43 artículos, todos publicados desde el año 1986 hasta la fecha. Se concluye que la sinusitis odontogénica difiere tanto en la clínica como en la microbiología de otras enfermedades sinusales. El tratamiento se basa en el trabajo interdisciplinario e incluye cirugía endoscópica funcional, realizada por el otorrinolaringólogo, en conjunto con el tratamiento odontológico, siendo fundamental la buena comunicación entre ambos equipos.

ABSTRACT Introduction: Infectious and inflammatory sinus diseases have a varied etiology and can be associated to the maxillary, ethmoidal, sphenoidal and frontal sinuses. Dental pathology can be one of the etiological factors associated to maxillary sinus disease, with frequency rates of 10-40%. Diagnosis and treatment require interdisciplinary work, with participation of otorhinolaryngology and oral and maxillofacial surgery. The development of a descriptive document on odontogenic sinusitis and management guidelines according to literature review. Pubmed, Lilacs and Google Academic database were searched using terms relevant to odontogenic sinusitis, in order to prepare the document. 43 articles were used, all published from 1986 onwards. We conclude that odontogenic sinusitis differs clinically and microbiologically from other sinus pathologies. Treatment modalities are based upon interdisciplinary surgery, including functional endoscopic surgery done by otolaryngologists and dental treatment, being fundamental close communication between the two teams.

Enfermedad periodontal como factor de riesgo adicional asociado con nacimiento pretérmino en México: un estudio de casos y controles / Periodontal disease as an additional risk factor associated with preterm birth in Mexico: a case-control study

Resumen Introducción: Las sustancias relacionadas con los microorganismos involucrados en la enfermedad periodontal puedan llegar a la interfaz materno-fetal por vía hematógena y estimular la contractilidad uterina. Objetivo: Determinar la asociación entre enfermedad periodontal con nacimiento pretérmino. Método: Estudio de casos y controles de 343 embarazadas pretérmino y 686 de término. Se calculó la edad gestacional por fecha de último periodo menstrual y se confirmó con los métodos de Capurro y Ballard. La enfermedad periodontal se diagnosticó por la profundidad del espacio entre la raíz dental y la encía. La asociación fue medida con regresión logística. Resultados: La edad de las madres en los casos fue de 23.8 ± 6.7 años y en los controles de 23.2 ± 6.7 años. La enfermedad periodontal estuvo presente en 66.8 % de los casos y 40.5 % de los controles. Los factores asociados con nacimiento pretérmino fueron enfermedad periodontal (RM = 2.26), antecedente de nacimiento pretérmino (RM = 4.96), embarazo no planeado (RM = 2.15), control prenatal deficiente (RM = 2.53), infección de vías urinarias (RM = 2.22), preeclampsia (RM = 4.49), ruptura prematura de membranas amnióticas (RM = 2.59) y nacer por cesárea (RM = 9.15). Conclusión: La enfermedad periodontal en el embarazo constituyó un factor de riesgo independiente para nacimiento pretérmino.

Abstract Introduction: Substances related to microorganisms involved in periodontal disease can reach the maternal-fetal interface via the hematogenous route and stimulate uterine contractility. Objective: To determine the association between periodontal disease and preterm birth. Method: Case-control study in 343 preterm and 686 full-term pregnant women. Gestational age was calculated based on the date of the last menstrual period and confirmed with Capurro and Ballard methods. Periodontal disease was diagnosed according to the depth of the space between the tooth root and the gum. The association was measured with logistic regression. Results: Maternal age of the cases was 23.8 ± 6.7 years, and 23.2 ± 6.7 in the controls. Periodontal disease was present in 66.8% of cases and 40.5% of controls. The factors associated with preterm birth were periodontal disease (Odds ratio [OR] = 2.26), history of preterm birth (OR = 4.96), unplanned pregnancy (OR = 2.15) poor prenatal control (OR = 2.53), urinary tract infection (OR = 2.22), preeclampsia (OR = 4.49), premature rupture of membranes (OR = 2.59) and caesarean section delivery (OR = 9.15). Conclusion: Periodontal disease in pregnancy was an independent risk factor for preterm birth.

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

Efeitos do campo eletromagnético pulsátil (CEMP) na doença peridontal induzida em ratas ovariectomizadas: análises histomorfométrica, imunoistoquímica e microtomografia computadorizada MicroCT / Effects of the pulsed electromagnetic field (PEMF) on induced peridontal disease in ovariectomized rats: histomorphometric, immunohistochemical and computerized microtomography (microCT) analyzes

A doença periodontal (DP) resulta de uma infecção polimicrobiana complexa, levando à destruição dos tecidos periodontais, como consequência da perturbação da homeostase entre a microbiota subgengival e os mecanismos de defesas do hospedeiro em indivíduos suscetíveis. A deficiência estrogênica (DE) é a causa mais comum de osteoporose. A osteoporose é definida como uma doença crônica, multifatorial, provenientes de uma desordem esquelética que promove fragilidade óssea pela redução de sua massa. Vários estudos experimentais têm demonstrado que a estimulação com Campo Eletromagnético Pulsátil (CEMP) pode promover a osteogênese e potencialmente aumentar a mineralização óssea e também, reduzir a inflamação aguda e crônica em tecidos moles e duros. Frente a isso, este estudo teve como objetivo, avaliar por meio da histomorfometria, imunoistoquímica e microtomografia computadorizada (MicroCT), a influência do CEMP na DP induzida em ratas ovariectomizadas e Sham. Para a pesquisa, foram utilizadas 60 ratas adultas (Rattus norvegicus, variação albinus, Wistar) com 3 meses de idade, pesando em torno de 300 gramas e em todos os animais a DP foi induzida. As ratas foram randomizadas em dois grupos experimentais, contendo 30 animais cada, classificados em ovariectomia simulada (Sham) e Ovariectomizada (Ovz), respectivamente. Os grupos foram divididos em dois subgrupos com 15 animais cada: Sham-S (n=15): não receberam terapia com CEMP e este foi nosso grupo controle. Sham-CEMP (n=15): receberam terapia com CEMP. Ovz­O (n=15): não receberam terapia com CEMP. Ovz­CEMP (n=15): receberam terapia com CEMP. As análises histomorfométrica, e MicroCT foram realizadas e os dados obtidos foram submetidos à análise de variância (ANOVA) e teste de Tukey, ambos com nível de significância convencional de 95% e não apresentaram nenhuma diferença estatisticamente significante. Na análise semiquantitativa para os biomarcadores RANKL e OPG, o subgrupo Ovz-O apresentou maior expressão do biomarcador RANKL e menor expressão do biomarcador OPG em relação aos outros subgrupos. Na análise quantitativa da expressão do biomarcador TRAP não foi encontrado nenhuma diferença estatisticamente significante. Apesar de não encontramos evidências significativas da terapia com CEMP na DP em ratas ovariectomizadas, o presente estudo nos sugere que o CEMP pode apresentar um efeito benéfico na remodelação óssea(AU)

Periodontal disease (PD) results from a complex polymicrobial infection, leading to the destruction of periodontal tissues as a consequence of the disturbance of homeostasis between the subgingival microbiota and the host defense mechanisms in susceptible individuals. Estrogen deficiency is the most common cause of osteoporosis. Osteoporosis is defined as a chronic, multifactorial disease from a skeletal disorder that promotes bone fragility by reducing its mass. Several experimental studies have shown that Pulsed Electromagnetic Field (PEMF) stimulation can promote osteogenesis and potentially increase bone mineralization and also reduce acute and chronic inflammation in soft and hard tissues. The aim of this study was to evaluate, through histomorphometry, immunohistochemistry and computerized microtomography (MicroCT), the influence of PEMF on PD induced in ovariectomized and Sham rats. For the research, 60 adult rats (Rattus norvegicus, albinus variant, Wistar) at 3 months of age, weighing around 300 grams were used and in all animals PD was induced. The rats were randomized into two experimental groups, containing 30 animals each, classified as simulated ovariectomy (Sham) and Ovariectomized (Ovz), respectively. The groups were divided into two subgroups with 15 animals each: Sham-S (n = 15): did not receive PEMF therapy and this was our control group. Sham-PEMF (n = 15): received PEMF therapy. Ovz-O (n = 15): did not receive PEMF therapy. Ovz-PEMF (n = 15): received PEMF therapy. The histomorphometric and MicroCT analyzes were performed and the data were submitted to analysis of variance (ANOVA) and Tukey's test, both with a 95% significance level and did not present any statistically significant difference. In the semiquantitative analysis for RANKL and OPG biomarkers, the Ovz-O subgroup showed higher expression of the RANKL biomarker and lower expression of the OPG biomarker in relation to the other subgroups. In the quantitative analysis of TRAP biomarker expression no statistically significant difference was found. Although we did not find significant evidence of PEMF therapy in PD in ovariectomized rats, the present study suggests that PEMF may have a beneficial effect on bone remodeling(AU)

Associação entre saúde bucal e acidente vascular encefálico isquêmico (AVEI) - uma revisão da literatura / Association between oral health and ischemic stroke (IS) - a literature review

A associação entre saúde bucal e desfechos de saúde geral vem sendo estudada de modo crescente nas últimas décadas, com ênfase na relação entre doenças inflamatórias crônicas bucais e doenças cardiovasculares (DCV) de origem aterosclerótica. OBJETIVO: revisar a literatura, atualizando os conhecimentos sobre a associação entre parâmetros de saúde bucal (doença periodontal (DP), periodontite apical (PA) e perda dentária) e a ocorrência de acidente vascular encefálico isquêmico (AVEI). METODOLOGIA: foram pesquisadas as seguintes bases eletrônicas, sem restrições de idiomas ou data: PubMed/ MEDLINE, LILACS, Scielo e ISI Web of Science e Schoolar Google, além de buscas manuais. Estudos realizados em animais ou in vitro, relatos e séries de casos foram excluídos. RESULTADOS: a presente revisão identificou e incluiu 11 estudos clínicos observacionais avaliando a associação entre diferentes indicadores de saúde bucal e AVEI, além de uma meta-analise sobre o assunto. Nenhum estudo de intervenção foi identificado. CONCLUSÃO: a evidência disponível, oriunda de estudos observacionias, sugere que as principais doenças inflamatórias crônicas bucais (DP e PA) estão associadas de modo independente com DCV de origem aterosclerótica. A relação entre DP e AVEI parece consistente, porém há carência de estudos analisando a associação entre AVEI e outros parâmetros de saúde bucal, especialmente cárie e PA. Até o momento, uma relação de causalidade entre DP, PA e AVEI não pode ser confirmada ou rejeitada, em face à ausência de estudos de intervenção. Futuros estudos deverão contribuir para o esclarecimento dos mecanismos biológicos que embasam a associação entre as doenças crônicas bucais e o AVEI.

The association between oral health and general health has been under study for decades, with emphasis on the relationship between chronic oral inflammatory diseases and atherosclerotic cardiovascular diseases (ACVD). OBJECTIVE: to review the literature, updating the knowledge about the association between oral health (periodontal disease (PD), apical periodontitis (AP) and tooth loss) and the occurrence of ischemic stroke (IS). METHODOLOGY: the following electronic databases were searched, without language or date restrictions: PubMed/MEDLINE, LILACS, Scielo, ISI Web of Science and Schoolar Google, as well as manual searches. Studies in animals or in vitro, reports and series of cases were excluded. RESULTS: the present review identified and included 11 clinical observational studies evaluating the association between different indicators of oral health and IS, and one meta-analysis on the field. No interventional studies were identified. CONCLUSION: the available evidence from observational studies suggests that the main chronic oral inflammatory diseases (PD and PA) are independently associated with ACVD. In addition, the relationship between PD and IS seems consistent, but there is a lack of studies analyzing the association between IS and other oral health parameters, such as caries and AP. To now, a causal relationship between DP, PA and IS cannot be confirmed or rejected, considering the lack of interventional studies on the area. Future studies should contribute to the comprehension of the biological mechanisms underlying the association between the main chronic oral diseases and IS.

Análisis biomecánico en la marcha deportiva entre deportistas de iniciación y alto rendimiento / Biomechanical analysis in sports walk among beginners and high performance athletes

Introducción: La relación causa / efecto entre el embarazo y la enfermedad periodontal resulta muy contradictorio en la literatura. Algunos autores niegan que exista esta relación, mientras otros la afirman. Objetivo: Identificar la presencia de Enfermedad Periodontal en gestantes del primer y tercer trimestre, teniendo en cuenta la edad y la higiene bucal de las mismas. Métodos: La muestra estuvo integrada por 106 gestantes del primer y tercer trimestre del embarazo. Las mismas fueron reunidas de acuerdo a los siguientes grupos de edades: Adolescentes, adultas jóvenes y adultas de más de 35 años. A todas las gestantes de la muestra se les efectuó un examen estomatológico para diagnosticar las pacientes portadoras de Enfermedad Periodontal, las formas clínicas presentadas, así como evaluar la calidad de la higiene bucal. Resultados: Se comprobó que 36 de las gestantes eran portadoras de Enfermedad Periodontal: 34 presentaban gingivitis y dos periodontitis. La forma clínica más abundante fue la gingivitis fibro-edematosa. De las 36 gestantes enfermas, 33 eran adultas jóvenes y tres, mayores de 35 años. Ninguna de las adolescentes presentó EP. Del total de gestantes, 20 se encontraban en el primer trimestre y 16 en el tercero. De las 36 pacientes enfermas 29 presentaron higiene bucal deficiente para un 80,55 por ciento y sólo siete mostraban una higiene bucal eficiente para un 19,44 por ciento. Conclusiones: La Enfermedad Periodontal es frecuente entre las gestantes del primer y tercer trimestre a lo cual contribuye la mala higiene bucal, la edad, como también la elevación de las hormonas durante el embarazo(AU)

Introduction: The cause / effect relationship between pregnancy and periodontal disease is very contradictory in the literature. Some authors deny that this relationship exists, while others affirm it. Objective: To identify the presence of Periodontal Disease in first and third trimester pregnant women, taking into account their age and oral hygiene. Methods: The sample consisted of 106 pregnant women from the first and third trimesters of pregnancy. They were collected according to the following age groups: Adolescents, young adults and adults over 35 years of age. All the pregnant women in the sample underwent a stomatological examination to diagnose the patients carrying Periodontal Disease, the presented clinical forms, as well as to evaluate the quality of the oral hygiene. Results: It was found that 36 of the pregnant women were carriers of Periodontal Disease: 34 had gingivitis and two periodontitis. The most abundant clinical form was fibro-edematous gingivitis. Of the 36 pregnant women, 33 were young adults and three were over 35 years old. None of the adolescents presented EP. Of the total of pregnant women, 20 were in the first quarter and 16 in the third. Of the 36 sick patients, 29 had poor oral hygiene for 80.55 percent and only seven showed efficient oral hygiene for 19.44 percent. Conclusions: Periodontal disease is common among pregnant the first and third quarter which contributes to poor oral hygiene, age, as well as elevated hormones during pregnancy(AU)

Enfermedad periodontal en gestantes del primer y tercer trimestre del embarazo / Periodontal disease in pregnant women of the first and third trimesters of pregnancy

Introducción: La relación causa / efecto entre el embarazo y la enfermedad periodontal resulta muy contradictorio en la literatura. Algunos autores niegan que exista esta relación, mientras otros la afirman. Objetivo: Identificar la presencia de Enfermedad Periodontal en gestantes del primer y tercer trimestre, teniendo en cuenta la edad y la higiene bucal de las mismas. Métodos: La muestra estuvo integrada por 106 gestantes del primer y tercer trimestre del embarazo. Las mismas fueron reunidas de acuerdo a los siguientes grupos de edades: Adolescentes, adultas jóvenes y adultas de más de 35 años. A todas las gestantes de la muestra se les efectuó un examen estomatológico para diagnosticar las pacientes portadoras de Enfermedad Periodontal, las formas clínicas presentadas, así como evaluar la calidad de la higiene bucal. Resultados: Se comprobó que 36 de las gestantes eran portadoras de Enfermedad Periodontal: 34 presentaban gingivitis y dos periodontitis. La forma clínica más abundante fue la gingivitis fibro-edematosa. De las 36 gestantes enfermas, 33 eran adultas jóvenes y tres, mayores de 35 años. Ninguna de las adolescentes presentó EP. Del total de gestantes, 20 se encontraban en el primer trimestre y 16 en el tercero. De las 36 pacientes enfermas 29 presentaron higiene bucal deficiente para un 80,55 por ciento y sólo siete mostraban una higiene bucal eficiente para un 19,44 por ciento Conclusiones: La Enfermedad Periodontal es frecuente entre las gestantes del primer y tercer trimestre a lo cual contribuye la mala higiene bucal, la edad, como también la elevación de las hormonas durante el embarazo(AU)

Introduction: The cause / effect relationship between pregnancy and periodontal disease is very contradictory in the literature. Some authors deny that this relationship exists, while others affirm it. Objective: To identify the presence of Periodontal Disease in first and third trimester pregnant women, taking into account their age and oral hygiene. Methods: The sample consisted of 106 pregnant women from the first and third trimesters of pregnancy. They were collected according to the following age groups: Adolescents, young adults and adults over 35 years of age. All the pregnant women in the sample underwent a stomatological examination to diagnose the patients carrying Periodontal Disease, the presented clinical forms, as well as to evaluate the quality of the oral hygiene. Results: It was found that 36 of the pregnant women were carriers of Periodontal Disease: 34 had gingivitis and two periodontitis. The most abundant clinical form was fibro-edematous gingivitis. Of the 36 pregnant women, 33 were young adults and three were over 35 years old. None of the adolescents presented EP. Of the total of pregnant women, 20 were in the first quarter and 16 in the third. Of the 36 sick patients, 29 had poor oral hygiene for 80.55 percent and only seven showed efficient oral hygiene for 19.44 percent. Conclusions: Periodontal disease is common among pregnant the first and third quarter which contributes to poor oral hygiene, age, as well as elevated hormones during pregnancy(AU)

Periodontal condition and immunological aspects of individuals hospitalized in the intensive care unit

Abstract There are few studies on the clinical and immunological periodontal status of intensive care unit (ICU) in-patients. The aim of the present study was to evaluate the periodontal condition among ICU in-patients through clinical and immunological periodontal parameters. From the sample of 373 hospitalized ICU patients, 182 were submitted' to a thorough clinical periodontal and immunological evaluation. Data on bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were collected and gingival sulcular fluid samples were quantified through ELISA on IL-1, IL-6, and MMP-2 for immunological evaluation. Data was statistically analyzed by Chi-square, Fisher's exact, Mann-Whitney tests, and Sperman's correlation and multivariate logistic regression analysis. A high dental plaque index and a high prevalence of periodontitis (48.3%), mostly in moderate and localized chronic form, were observed. Individuals with periodontitis presented higher levels of IL-1 and MMP-2, while individuals with cardiovascular disease (CVD) and individuals with two or more systemic diseases (MSD) presented higher levels of IL-1; diabetes mellitus (DM) and MSD individuals presented higher levels of IL-6. A positive association was found between the severity of periodontitis and CVD (OR 2.2; CI = 1.11-4.42). This study reported a 48.3% of the prevalence of periodontitis in ICU patients and a positive association between the severity of periodontitis and CVD. Additionally, higher levels of IL-1 and MMP-2 were found in individuals with periodontitis, higher levels of IL-6 were found in individuals with DM, and higher levels of IL-1 were found in individuals with CVD.

Resumo Existem poucos estudos sobre o estado clínico periodontal e imunológico de pacientes em unidade de terapia intensiva (UTI). O objetivo do presente estudo foi avaliar a condição periodontal entre os pacientes internados na UTI através de parâmetros clínicos periodontais e imunológicos. De uma amostra inicial de 373 pacientes internados em UTI, 183 foram submetidos a exame periodontal completo e análise imunológica. Os dados sobre o sangramento na sondagem (BOP), profundidade de sondagem (PD) e nível clínico de inserção (CAL) foram coletados e as amostras de fluido sulcular gengival foram quantificadas para avaliação imunológica através de ELISA para IL-1, IL-6 e MMP-2. Os dados foram analisados estatisticamente pelos testes de Qui-quadrado, exato de Fischer, Mann-Whitney, correlação de Sperman e análise de regressão logística multivariada. Foi observado um alto índice de placa dental e uma alta prevalência de periodontite (48,3%), principalmente na forma crônica moderada e localizada. Os indivíduos com periodontite apresentaram níveis mais altos de IL-1 e MMP-2, enquanto indivíduos com doença cardiovascular (CVD) e com mais de duas doenças sistêmicas (MSD) apresentaram níveis mais altos de IL-1 e os com diabetes mellitus (DM) e MSD apresentaram níveis mais elevados de IL-6. Foi encontrada associação positiva entre a gravidade da periodontite e CVD (OR 2.2; IC = 1,11-4,42). Este estudo reportou uma prevalência de periodontite em 48.3% dos pacientes em UTI e uma associação positiva entre ocorrência de periodontite e CVD. Além disso, níveis mais elevados de IL-1 e MMP-2 foram encontrados em indivíduos com periodontite, de IL-6 em indivíduos com DM e de IL-1 em indivíduos com CVD.

Relationship between alcoholism addiction and periodontitis. an in vivo study using drinking-in-darkness protocol in rats

Periodontal disease (PD) has been considered a probable risk factor for several systemic diseases. among them, PD is presumed to be one of the possible etiologies of chronic illness of the central nervous system. In this context, poor oral health and PD is associated with substance abuse in humans. however, if periodontal lesions can produce addiction is unknown. this paper aims to evaluate the possibility that chronic periodontal injury (CPL) can cause ethanol binge intake in drink-in-darkness (DID) protocol in rats. in CPL group (n=10) experimental damage was done to the periodontal tissue of the second maxillary molar, the control group (n=9) received sham injury. forty-three days after CPL the intake of ethanol was assessed using several concentrations in DID experiment. during the DID experiment, we observed significant differences between the binge-type consumption of ethanol at the lowest concentration of 10 percent (p=0.01). differences in consumption of 20 percent ethanol are observed during a few days (p=0.04), and there are no differences in consumption at 40 percent concentration of ethanol (p=0.2). it is concluded that chronic periodontal lesion leads to alcoholism in wistar rats.

Association between periodontal disease and polycystic ovary syndrome: a scoping review

Background: polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine disorders in women. it is believed that sex hormones play a role in the maintenance of bone mass and directly or indirectly influence several cell types, including periodontal cells. objective: to evaluate the association between periodontal disease and PCOS according to the evidence reported in the last decade. material and method: a search was made in the biomedical databases: Pubmed, Embase, Scopus, SciELO, Science Direct and SIGLE for the 2007-2017 period. selection criteria: prospective and retrospective studies reporting the relationship between periodontal disease and PCOS. the methodological quality of the studies was analyzed using the critical appraisal skills program scale. results: 10 articles were found: 1 clinical trial and 9 case-control studies. the number of patients ranged from 48 to 196, mean age between 23.3 and 28.1 years, age range between 15 and 45 years. studies were conducted in Turkey, India and Iran. all the studies presented good methodological quality and a positive association between PCOS and periodontal disease. conclusion: PCOS shows a positive and significant association with the clinical and molecular parameters of periodontal diseases.

Efeitos terapêuticos do uso de produtos derivados da romã (punica granatum) como coadjuvante no tratamento das doenças periodontais: uma revisão de literatura / Therapeutic effects of the use of pomegranate products (Punica granatum) as adjuvant in the treatment of periodontal diseases: a review of the literature

A romã (Punica granatum) possui uma vasta história médica conhecida por sua ação antibacteriana, antioxidante e anti-inflamatória. A presente revisão teve como objetivo verificar os potenciais efeitos terapêuticos do uso de produtos derivados da P. granatum como coadjuvante no tratamento das doenças periodontais. Descritores em inglês e português dos termos: "romã", "doença periodontal", "gengivite", "periodontite" e "punica granatum", foram utilizados para consulta nas bases de dados Pubmed, Lilacs e Scielo. Para avaliação dos efeitos anti-inflamatórios, antimicrobianos e clínicos da romã foram incluídos trabalhos clínicos e pré-clínicos, sem restrições de data. Os diferentes estudos selecionados avaliaram P. granatum em diferentes formulações, incluindo bochechos, géis, infusão, dentifrícios, e chips biodegradáveis. Os resultados demostraram que os componentes fitoquímicos de P. granatum, como polifenóis flavonoides, punicalaginas, ácido punícico e antocinas apresentam propriedades relevantes pró-saúde periodontal, que incluem efeitos anti-inflamatórios, antioxidantes, hemostáticos e imunoregulatórios. Estudos in vivo utilizando diferentes formulações da romã em participantes acometidos por gengivite ou periodontite apresentaram reduções nos índices de placa, sangramento gengival e profundidade de sondagem em graus variados. Conclui-se que P. granatum pode ser uma promissora alternativa à terapia antimicrobiana padrão, para auxílio do controle mecânico de placa, com melhora dos sinais clínicos das doenças periodontais. Contudo, mais estudos clínicos ainda são necessários. (AU)

The pomegranade (Punica granatum) has a vast medical history know by its antibacterial, antioxidant and antiinflammatory action. The presente review aimed at verifying the potential therapeutic effects of products derived from P. granatum as adjuvant in the treatment of periodontal diseases. English and Portugueses descriptors of the terms "pomegranate", "periodontal disease", "gingivitis", "periodontitis" and "Punica granatum" were used for search in Pubmed, Lilacs and Scielo databases. To assess the anti-inflammatory, antimicrobial and clinical effects of pomegranate, clinical and preclinical were included, with no date restrictions. The different studies evaluated P. granatum in different formulations, including mouthwash, gels, infusion, dentifrices, and biodegradable chips. Results showed that the phytochemical components of P. granatum, such as polyphenois flavonoids, punicalagins, punicic acid and antocines, demonstrated relevant periodontal prohealth properties, including anti-inflammatory, antioxidant, hemostatic and immunoregulatory effects. In vivo studies, using different pomegranade formulations in individuals affected by gingivitis or periodontitis, showed reductions in plaque index, gingival bleeding and probing depth in different levels. It was concluded that P. granatum could be a promising alternative to the standard antimicrobial therapy in order to aid the mechanical control of plaque, with improvement of clinical signs of periodontal diseases. However, more clinical studies are still necessary. (AU)