RESUMEN
Este trabalho associa graus de severidade de periodontite agressiva e crônica ao hábito de fumar e à ocorrência de doenças sistêmicas. Selecionaram-se 83 pacientes com periodontite agressiva e crônica, classificados segundo parâmetros clínicos e radiográficos. A periodontite agressiva apresentou forte associação estatística com o hábito de fumar e moderada associação com doenças sistêmicas e a coexistência de ambas as variáveis. A periodontite crônica associou-se a ambos os fatores de modo independente. Hábito de fumar e doenças sistêmicas associaram-se fortemente aos diagnósticos de periodontite moderada e severa, tanto para periodontite agressiva como crônica. Quando coexistiram ambos os fatores, a severidade da doença relacionou-se ao número de cigarros e à complicação sistêmica.
This article addresses the association of the severity of aggressive, chronic periodontitis and smoking habits, and the establishment of systemic diseases. Eighty-three patients presenting aggressive, chronic periodontitis were selected, according to clinical and radiographical parameters. It has been established a strong correlation between the periodontitis and smoking, and a moderate correlation to the establishment of systemic diseases and the presence of both variables. Chronic periodontitis was associated to both factors independently. Smoking habit and systemic diseases have been strongly associated to moderate and severe periodontitis, regardless they were aggressive or chronic. When both factors were present, the severity of the disease was related to the number of cigarettes and systemic complications.
Asunto(s)
Periodontitis Agresiva , Periodontitis Crónica , Enfermedades Periodontales , FumarRESUMEN
Periodontitis is a chronic inflammatory disease characterized by tissue destruction which is usually diagnosed through clinical and radiographic signs. The detection of changes in the chemical composition of saliva could be used to reflect gingivo- periodontal alterations. The aim of this study was to identify salivary parameters that could identify different stages of the periodontal disease. The study group included 118 adults, 89 of them with mild, moderate or severe chronic periodontitis. The remaining participants comprised the control group. Total saliva was analyzed for physical and chemical properties. Dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) was used for protein detection and zymography for type IV collagenase identification. Salivary flow rate, pH and buffer capacity showed similar values in all groups. Proteins were augmented in severe periodontitis, as also shown by SDS-PAGE. Hydroxyproline rose significantly in all periodontal groups as secretory Immunoglobulin A significantly diminished compared with the control group. An increase in peroxidase was detected in moderate and severe periodontitis. All salivary samples contained 200-116-92 kDa gelatinases; minor bands at 66-31 kDa were also present in all periodontitis groups. Calcium levels showed significant differences between all periodontitis groups compared with the control group. Quantitative changes in the chemical composition of the saliva of patients with periodontal disease could be of significance in the diagnosis and progression of periodontal disease.
La Periodontitis es una enfermedad inflamatoria crónica caracterizada por destrucción tisular que se diagnostica generalmente a través de signos clínicos y radiográficos. Sin embargo la detección de cambios en la composición química de la saliva podrían ser empleados para reflejar alteraciones gingivo-periodontales. El objetivo de este estudio fue encontrar parámetros salivales que pudieran identificar diferentes estadios de la enfermedad periodontal. El grupo de estudio incluyo 118 adultos, 89 de los cuales con enfermedad periodontal crónica leve, moderada o severa El resto constituyo el grupo control. Se analizaron las propiedades físicas y químicas de la saliva total. La separación de proteínas fue realizada empleando la electroforesis en geles de poliacrilamida conteniendo dodecil sulfato de sodio y la identificación de colagenasa tipo IV se realizo empleando la zimografia. Flujo salival, pH y capacidad bufferante mostraron valores similares en todos los grupos. Las proteínas estuvieron aumentadas en la periodontitis grave lo cual también se mostró por medio de la electroforesis. Hidroxiprolina aumento significativamente en todos los grupos de pacientes con enfermedad periodontal, mientras IgA secretoria se encontró significativamente disminuida respecto al grupo control. Un incremento en los valores de peroxidasa se detecto en las periodontitis moderada y grave. Todas las muestras contenían gelatinasas de 200-116-92 kDa; sin embargo todos los grupos de pacientes con enfermedad periodontal también presentaron bandas de peso molecular menor (66-31 kDa). Los niveles de calcio mostraron diferencias significativas entre todos los grupos de pacientes con periodontitis cuando se los comparo con el grupo control. Cambios cuantitativos en la composición química de la saliva de pacientes con enfermedad periodontal podrían tener significancia en el diagnostico y progresión de la enfermedad periodontal.