Gingival state and presence of red complex bacteria in 12-Year-Old schoolchildren / Estado gingival y presencia de bacterias del complejo rojo en escolares de 12 años

Abstract The objective of this study was to determine the gingival state and presence of red complex bacteria in saliva samples of 12-year-old schoolchildren. A calibrated periodontist evaluated biofilm index (BI) (Silness and Löe, 1964), presence of calculus, and gingival index (GI) (Silness and Löe, 1967) in sixty two 12-year-old students of Carmen Lyra School. Saliva samples were collected from each student. The DNA of each sample was extracted and amplified by the polymerase chain reaction (PCR) technique, using specific primers. The BI was 1.18. Calculus was present in 40.40% of the schoolchildren examined; 19.4% was supragingival calculus and 21% both supragingival and subgingival calculus. The GI was 0.97, which according to Silness and Löe is mild gingivitis. Gingivitis was present in 96.8% of the children examined. Regarding the PCR tests: 18 of the samples (31.58%) did not present any of the bacteria analyzed and the remaining 39 samples (68.42%) were positive for at least the presence of red complex bacteria. Within the limitations of this study, it is concluded that the prevalence of gingivitis and calculus is high in the sample examined, and the gingival state observed in the study population, may be related to the presence of red complex bacteria.

Resumen El objetivo de este estudio era determinar el estado gingival y la presencia de bacterias del complejo rojo en muestras de saliva de niños de 12 años de la Escuela Carmen Lyra. Una periodoncista calibrada evaluó en 62 estudiantes de 12 años de la Escuela Carmen Lyra, el índice de biofilme (IB) (Silness y Löe, 1964), la presencia de cálculo y el índice gingival (IG) (Silness y Löe, 1967). Se recolectaron muestras de saliva de cada estudiante. El ADN de cada muestra fue extraído y amplificado por medio de la prueba PCR, empleando primers específicos, para determinar la presencia de bacterias del complejo rojo. El IB fue de 1.18. El cálculo estuvo presente en el 40.40% de la muestra, se encontró 19.4% de cálculo en supragingival y 21% tanto en supragingival como en subgingival. El IG fue de 0.97, que de acuerdo con Silness y Löe es una gingivitis leve. La gingivitis estuvo presente en el 96.8 % de los niños examinados. Con respecto a las pruebas PCR: 18 de las muestras (31.58 %) no presentaron ninguna de las bacterias analizadas y las 39 muestras restantes (68.42%) fueron positivas por lo menos a la presencia de las bacterias del complejo rojo. Dentro de las limitaciones de este estudio, se concluye que la prevalencia de gingivitis y cálculo es alta en la muestra examinada y el estado gingival observado puede estar relacionado con la presencia de bacterias del complejo rojo.

Hipertensão arterial sistêmica autorrelatada em pacientes atendidos no curso de Odontologia da Unigranrio e sua relação com parâmetros periodontais e CPOD / Self-reported systemic arterial hypertension in patients treated at Unigranrio's Dentistry course and its relationship with periodontal parameters and DMFT

Objetivo: Avaliar a frequência de hipertensão arterial sistêmica e sua associação com parâmetros periodontais e do índice de dentes cariados, perdidos, obturados (CPOD) em indivíduos atendidos na clínica do Curso de Odontologia da Unigranrio. Materiais e métodos: Noventa e cinco indivíduos de ambos os sexos foram incluídos no estudo entre março e maio de 2021. Os participantes responderam a questionários anamnésicos, tiveram sua pressão arterial sistêmica aferida e foram examinados para obtenção do índice CPOD e de parâmetros periodontais. Resultados: A frequência de hipertensão arterial sistêmica na população estudada foi 23,15%. Em pacientes com periodontite, essa prevalência foi 27%, e, em pacientes com gengivite, 19%. Pacientes com periodontite tiveram médias superiores de pressão arterial sistólica (PAS) e diastólica (PAD) comparado ao grupo com gengivite (p<0,0001). Foram identificadas correlações significativas positivas entre PAS e bolsas periodontais moderadas (rho=0,356) e profundas (rho=0,342), perda de inserção avançada (rho=0,538), CPOD (rho=0,365) e quantidade de dentes ausentes (rho=0,477), p < 0,001. A PAD apresentou correlações significativas (p < 0,001) positivas com bolsas periodontais moderadas (rho=0,331) e profundas (rho=0,283), perda de inserção avançada (rho=0,465), CPOD (rho=0,361) e dentes ausentes (rho=0,348). Conclusões: A frequência de hipertensão arterial sistêmica autorrelatada é relativamente alta na população estudada e, em especialmente, dentre as pessoas com periodontite. Pressão arterial sistólica e diastólica são correlacionadas positivamente com parâmetros periodontais indicadores de severidade de doença, assim como piores escores do CPOD.

Aim: The study evaluated the prevalence of systemic arterial hypertension and its association with periodontal parameters and decayed-missing-filled teeth (DMFT) index in individuals treated in a Dental School clinic. Material and methods: Ninety-five individuals of both genders were included in the study in the period between March and May 2021. All participants answered anamnestic questionaries, had their systemic blood pressure measured, and were examined to obtain the DMFT and periodontal parameters. Results: The prevalence of systemic arterial hypertension in the study population was 23.15%. In periodontitis individuals, that prevalence was 27%, and, in gingivitis patients, 19%. Patients with periodontitis have higher mean systolic (SBP) and diastolic (DBP) blood pressure compared with gingivitis individuals (p<0.0001). Significant positive correlations were found between SBP and moderate (rho=0.356) and deep (rho=0.342) periodontal pockets, severe attachment loss (rho=0.538), DMFT (rho=0.365), and amount of missing teeth (rho=0.477), p ? 0.001. The DBP showed significant (p?0.001) positive correlations with moderate (rho=0.331) and (rho=0.283) deep periodontal pockets, severe attachment loss (rho=0.465), DMFT (rho=0.361), and missing teeth (rho=0.348). Conclusions: The prevalence of systemic arterial hypertension is relatively high in the study population and, in particular, among individuals with periodontitis. Systolic and diastolic blood pressure are positively correlated with periodontal parameters that indicate the severity of disease, as well as with worse DMFT scores.

Concentración de mucina salival en pacientes con enfermedad periodontal / Concentração de mucina salivar em pacientes com doença periodontal / Salivary mucin concentration in patients with periodontal disease

Resumen El objetivo de este trabajo fue estudiar la relación entre la concentración de mucina salival y la enfermedad periodontal. La muestra se dividió en tres grupos de 20 individuos cada uno: Grupo 1 sin enfermedad periodontal; Grupo 2 con gingivitis; y Grupo 3 con periodontitis. En todas las muestras salivales se confirmó la presencia de mucina, el Grupo 1 presentó un valor promedio de 1,27 mg/ml. En el Grupo 2 se registró un promedio de 1,93 mg/ml. En el Grupo 3 se observó un promedio de 3,01 mg/ml. El Análisis de la Variancia y posterior prueba de F (F = 25,01, p < 0,0001) confirman diferencias significativas en los contenidos de mucina entre grupos. El aumento de la concentración de mucina salival en pacientes periodontales podría representar un marcador químico de utilidad como coadyuvante en el diagnóstico clínico de esta enfermedad.

Resumo O objetivo deste trabalho foi estudar a relação entre a concentração de mucina salivar e a doença periodontal. A amostra foi dividida em três grupos de 20 indivíduos cada: Grupo 1 sem doença periodontal; Grupo 2 com gengivite; e Grupo 3 com periodontite. Em todas as amostras salivares foi confirmada a presença de mucina, o Grupo 1 apresentou valor médio de 1,27 mg / ml. No Grupo 2, foi registrada uma média de 1,93 mg / ml. No Grupo 3 foi observada uma média de 3,01 mg / ml. A Análise de Variância e o teste F subsequente (F = 25,01, p <0,0001) confirmam diferenças significativas nos conteúdos de mucina entre os grupos. O aumento da concentração de mucina salivar em pacientes periodontais pode representar um marcador químico útil como adjuvante no diagnóstico clínico desta doença.

Abstract This work aimed to study the relationship between salivary mucin concentration and periodontal disease. The sample was divided into three groups of 20 individuals each: Group 1 with no periodontal disease, Group 2 with gingivitis, and Group 3 with periodontitis. Mucin was detected in all the saliva samples. Group 1 had an average value of 1.27 mg/ml. Group 2 had an average value of 1.93 mg/ml. Group 3 had an average value of 3.01 mg/ml. The analysis of variance and subsequent F test (F = 25.01, p < 0.0001) confirmed significant differences in mucin content between the groups. Increased salivary mucin concentration in periodontal patients could be a useful chemical marker for the clinical diagnosis of periodontal disease.

Tratamiento del agrandamiento gingival inducido por placa bacteriana asociado a factores locales: Reporte de un caso clínico / Treatment of Gingival Enlargement Induced by Dental Plaque Associated with Local Factors: Case Report

Resumen Los agrandamientos gingivales inducidos por placa bacteriana asociados a factores locales como el uso de aparatología ortodóntica, son frecuentemente observados en pacientes jóvenes, con un inadecuado control del biofilm dental. Dentro de la terapéutica recomendada para tratar dicha condición se encuentra la fase higiénica periodontal y el abordaje quirúrgico. Se presenta un caso clínico de un paciente de 16 años con agrandamiento gingival y su respectivo tratamiento.

Absytract Dental plaque-induced gingival enlargements associated with local factors such as the use of orthodontic appliances are frequently observed in young patients, with inadequate dental biofilm control. Among the recommended therapeutics to treat this condition is the Nonsurgical phase and the surgical approach. A clinical case of a 16-year-old patient with a gingival enlargement and its respective treatment is presented.

Periodontal disease and its impact on general health in Latin America: LAOHA Consensus Meeting Report

Abstract: Periodontal diseases are considered a worldwide public health problem, owing to their high prevalence in developed and developing countries. Periodontitis may lead to tooth loss, which can impact oral health-related quality of life. Gingivitis and periodontitis have been extensively studied regarding their etiopathogenesis, epidemiology, prevention and treatment outcomes. However, most of these aspects are studied and discussed globally, which may hamper a clear interpretation of the findings and the design of effective plans of action for specific regions or populations. For example, in Latin America, epidemiological data about the distribution of periodontal diseases is still scarce, mainly when it comes to nationwide representative samples. This Consensus aimed to address the following topics related to periodontal diseases in Latin America: a) The impact of the global burden of periodontal diseases on health: a global reality; b) Periodontal diseases in Latin America; c) Strategies for the prevention of periodontal diseases in Latin America; d) Problems associated with diagnosis of periodontal conditions and possible solutions for Latin America; e) Treatment of Periodontitis. This consensus will help to increase awareness about diagnosis, prevention and treatment of periodontal diseases, in the context of Latin American countries.

Endocardite infecciosa por aggregatibacter actinomycetemcomitans em pacientes predispostos / Infective endocarditis by aggregatibacter actionomycetemcomitans in predisposed patients

A endocardite infecciosa (EI) corresponde a uma infecção microbiana do endocárdio com presença de coágulo de plaquetas e fibrina em seu interior. Quando é de origem periodontal, a Aggregatibacter actinomycetemcomitans (Aa) é a bactéria mais relacionada com a ocorrência dessa doença. Foi avaliada a presença de Aa em gengivites e periodontites de pacientes hospitalizados e sua associação na predisposição à EI. Métodos: Realizou-se a sondagem periodontal em 15 pacientes de um hospital de Itajaí, SC com gengivites e periodontites, entre 18 a 75 anos de idade, de ambos os sexos, considerados em risco de EI. Usou-se um dente de cada paciente como amostra, coletado em cones de papel esterilizado, transferência em recipientes e processamento no laboratório. As amostras foram homogeneizadas e alíquotas de 0,1 ml foram semeadas em duplicata em placas de ágar sangue, incubadas por cinco dias em microaerofilia a 37 O C. Depois da visualização das colônias bacterianas características, foram realizadas provas bioquímicas e reação de catalase. O diagnóstico de EI foi realizado seguindo os critérios de Duke modificado. Conclusão: Não houve incidência de pacientes com risco de EI relacionada com presença da Aa nos participantes avaliados

Objective: Infective endocarditis (IE) corresponds to a microbial infection of the endocardium with the presence of platelet and fibrin clotting in its interior. When it is of periodontal origin, Aggregatibacter actinomycetemcomitans (Aa) is the bacterium most often related to the occurrence of this disease. The presence of Aa in the gingivitis and periodontitis of hospitalized patients and its association with predisposition to IE were evaluated. Methods: Periodontal probing was performed in 15 patients with gingivitis and periodontitis, aged 18 and 75 years, of both genders, and considered at risk for IE at a hospital in Itajaí ­ SC. One tooth of each patient was used for the sample, which was collected in cones of sterilized paper, transferred in containers, and processed in the laboratory. The samples were homogenized and aliquots of 0.1 ml were seeded in duplicate in blood agar plates, incubated for five days in microaerophylia at 37ºC. Following visualization of characteristic bacterial colonies, biochemical and catalase reaction tests were conducted. The diagnosis of IE was performed following the modified Duke criteria. Conclusion: There was no incidence of patients at risk of IE related to the presence of Aa in the participants evaluated

Utilidad del oleozón tópico en la gingivitis crónica fibroedematosa / Usefulness of topic Oleozón® in chronic fibro-edematous gingivitis

RESUMEN Introducción: La constante y diversa disponibilidad de nuevos fármacos, nos ofrece opciones alternativas de tratamiento. El oleozón tópico es un medicamento aun en experimento y validación de sus indicaciones. Existen suficientes evidencias de su efecto antimicrobiano y cicatrizante. Objetivo: evaluar la eficacia del oleozón tópico en el tratamiento de la gingivitis crónica fibroedematosa. Materiales y métodos: se realizó un estudio experimental y aleatorizado. El período de estudio fue de septiembre de 2015 a junio de 2017. Se tomó una muestra de 60 pacientes pertenecientes al municipio de Palmira, entre 18 y 35 años, con diagnóstico de gingivitis crónica fibroedematosa que acudieron a los servicios en el período comprendido, luego de cumplir los criterios de inclusión y consentimiento informado, se dividieron de forma aleatorizada simple en dos grupos: estudio y control. Se utilizaron métodos del nivel teórico, histórico- lógico, documental en la revisión bibliográfica y teórica del tema de investigación, inducción - deducción para el análisis de los propósitos y pasos lógicos de la investigación. Resultados: a pesar de no encontrar diferencias significativas entre los grupos de pacientes tratados con oleozón tópico y clohexidina, recomendamos su inclusión en las Guías Prácticas de Estomatología, como tratamiento alternativo de la gingivitis crónica fibroedematosa. Conclusiones: no se encontraron diferencias significativas respecto a la eficacia del oleozón tópico y clohexidina en el tratamiento de la gingivitis crónica fibroedematosa, ambos tratamientos fueron resolutivos por igual en la mayoría de los casos.

ABSTRACT Introduction: the constant and diverse availability of new drugs offers alternative options of treatment. The topic Oleozón® is a drug that is still being tested and validated. There are evidences enough of its antimicrobial and healing effect. Objective: to evaluate the efficacy of topic Oleozón® in the treatment of chronic fibro-edematous gingivitis. Material and method: an experimental randomized study was carried out. The studied period was September 2015-June 2017. The sample were 60 patients living in the municipality of Palmira, aged 18-35 years old, with diagnosis of chronic fibro-edematous gingivitis who assisted the dental services in the before mentioned period and fulfilled the inclusion criteria and gave their informed consent. They were randomly divided into two groups: the study and the control groups. There were used methods of the theoretic, logic-historical and documental level in the bibliographic and theoretical review of the research theme, the induction-deduction method for the analyses of the purposes and logical steps of the research. Results: although there were not found significant differences between the groups of patients treated with topic Oleozón® and clorhexidine, the authors recommend their inclusion in Guias Prácticas de Estomatología as an alternative treatment of the chronic fibro-edematous gingivitis. Conclusions: there were not found significant differences between the groups of patients treated with topic Oleozón® and clorhexidine in the treatment of chronic fibro-edematous gingivitis; both treatments were decisive at the same level in most of the cases.

Programa educativo dirigido a la prevención de la enfermedad periodontal en adolescentes / Educative program for preventing periodontal disease in teenagers

RESUMEN Introducción: constituye un reto modificar hábitos y conductas perjudiciales para la salud bucal de los adolescentes, a través de programas educativos. Objetivo: elaborar un programa educativo para la prevención de la enfermedad periodontal en adolescentes. Materiales y métodos: se realizó un estudio descriptivo transversal, en el período comprendido de noviembre del 2016 a abril del 2017, en los adolescentes de séptimo grado de la Escuela Secundaria Básica Urbana "13 de Marzo", de Placetas. Enfermedad periodontal, sexo, nivel de información sobre la enfermedad periodontal constituyeron las variables del estudio. A partir de la información obtenida se diseñó el programa educativo. La investigación se efectuó teniendo presente las normas éticas internacionales para la investigación biomédica. Se utilizaron frecuencias absolutas y porcentajes. Resultados: el 69,2 % de los adolescentes estaban enfermos, el 64 % de las féminas y el 50 % de los varones presentaron gingivitis leve. Solamente el 10,3 % padecían gingivitis moderada. El 65,8 % de los adolescentes tenían un nivel de información insuficiente. El programa abordó temas como: prevención de la enfermedad periodontal, realización del cepillado dental, efecto del tabaco en el periodonto y la importancia de una dieta balanceada. Se tuvo en cuenta el nivel y la edad de los alumnos a quienes estuvo dirigido el programa. Se realizaron múltiples técnicas participativas para motivar a los estudiantes sobre el tema. Conclusiones: el programa educativo fue valorado por criterios de especialistas como positivo por el nivel de pertinencia para resolver las carencias detectadas (AU).

ABSTRACT Introduction: it is a challenge to modify harmful habits and behaviours for the oral health of teenagers through educative programs. Objective: to prepare an educative program for preventing periodontal disease in teenagers. Materials and methods: a cross-sectional, descriptive study was carried out in the period from November 2016 to April 2017 in 7th grade teenagers from the Urban Junior High School "13 de Marzo", of Placetas. The variables of the study were periodontal disease, sex, and information level on periodontal disease. The educative program was prepared on the basis of the gathered information. The research was carried out taking into account the international ethic norms for the biomedical research. Absolute frequencies and percentages were used for the analysis of the results. Results: 69,2 % of the patients suffered the disease; 64 % of the female students and 50 % of the male ones had mild gingivitis. Only 10,3 % suffered moderated gingivitis. 65,8 % of the patients had an inadequate information level. The program dealt with themes like periodontal disease prevention; teeth brushing; effects of smoking in the periodontium and importance of a balanced diet. The educational level and age of the students to which the program was directed at were taken into account. Many participative techniques were applied to motivate the students on the theme. Conclusions: the educative program was valued as positive according to the criteria of specialists due to the level of relevance to solve the deficiencies that were found (AU).

Prevalencia y gravedad de la enfermedad periodontal en pacientes diabéticos / Prevalence and severity of the periodontal illness diabetic patients

RESUMEN Introducción: la enfermedad periodontal es el conjunto de enfermedades inflamatorias que afectan los tejidos de soporte del diente. Se considerada un problema de salud, que se comporta como indicador de riesgo que influye en enfermedades sistémicas como la diabetes mellitus. Objetivo: determinar el comportamiento de la enfermedad periodontal en pacientes diabéticos. Materiales y métodos: se realizó estudio observacional, descriptivo, transversal, en policlínico "Juan Gualberto Gómez" Los Arabos, Matanzas, de enero a mayo 2016 en un universo conformado por 12 pacientes diabéticos mayores de 20 años, sin distinción de sexo y color de piel, con plenitud de sus facultades físicomotoras. Se estudiaron variables demográficas, prevalencia y gravedad de la enfermedad periodontal y áreas bucales con afectación periodontal. Resultados: resaltó la edad 61 y más años con 50 %. Predominó sexo femenino con un 75 %, el 66,6 % presentó enfermedad periodontal. La gingivitis de leve a moderada se presentó en 25 %. El 41,6 % presentó formas benévolas de periodontitis. Las superficies vestibulares se afectaron en el 75 %, el área de incisivos inferiores destacó sobre los superiores al igual que los molares superiores ambas con 50 %. Conclusiones: la enfermedad periodontal mostró una alta prevalencia en la población estudiada, resaltaron las féminas en la edad de 61 y más año en correspondencia con el envejecimiento poblacional actual. Predominó la gingivitis de tipo leve y la periodontitis moderada. Las zonas vestibulares de incisivos inferiores y molares superiores se afectaron por enfermedad periodontal (AU).

ABSTRACT Introduction: The periodontal diseases are the joint of the inflammatory diseases that affect the supporting tissues of the tooth. It´s considered health problem that behave as a risk factor that influences upon systemic conditions like diabetes mellitus. Objective: Determine behave of the periodontal diseases in diabetic patients. Materials and methods: An observant, descriptive and transversal studied was carried out in the policlinic Juan Gualberto Gomez from Los Arabos Matanzas provinces from January to May 2016 in a universe of 12 diabetic patients older than 20 years, of both sex, without distinction in the color of the skin and in a full physical and motor conditions. They were analyzed variables than: age, sex, prevalence and severity of the periodontal disease also oral areas with periodontal affection. Results: The more significant age from 61 years old and more. The female sex prevailed with 75 %; the 66 % had periodontal disease. Gingivitis was presented from mild to moderate in a 25 %. The 41,6 % presented moderate levels of periodontitis. Thebuccalareas were affected in a 75 %. The area of the lower incisors was the most significant compared with theupper incisors and upper molars with 50 %. Conclusions: The periodontal disease showed a high prevalence in the population studied. The female with 61 years old and more prevailed in correspondence with the current aging in population mild gingivitis and moderate periodontitis prevailed. Buccal areas of lower incisors and upper molars were affected by periodontal disease (AU).

Manifestación oral del pénfigo vulgar. Reporte de un caso / Oral manifestation of vulgar pemphigus. A case report

RESUMEN El pénfigo es una enfermedad autoinmune potencialmente mortal, que causa ampollas y erosiones en la piel y en la membrana mucosa. Las lesiones epiteliales son el resultado de autoanticuerpos que reaccionan con las glicoproteínas desmosomales y están presentes en la superficie celular del queratinocito. La reacción autoinmune contra estas glicoproteínas causa una pérdida de adhesión celular, resultando en la formación de ampollas intraepiteliales. Del 80 al 90 % de los pacientes con pénfigo vulgar, desarrollan trastornos cutáneos y en el 60 % de los casos alteraciones en la mucosa que es el primer o único signo. El diagnóstico de las lesiones en cavidad bucal es fundamental, ya que pueden prevenir su afectación a la piel. Si se establece el tratamiento en su etapa inicial, la enfermedad es más fácil de controlar y aumenta la posibilidad de una remisión temprana del trastorno y mejor calidad de vida. Este reporte de caso mostró a una paciente de 35 años, la que comenzó a presentar lesiones ulceradas en toda la orofaringe, con sensación de ardor e incapacidad para la ingestión de alimentos. El diagnóstico fue pénfigo vulgar (AU).

ABSTRACT Pemphigus is a potentially deadly autoimmune disease causing blisters and erosions in the skin and the mucous membrane. The epithelial lesions are the result of antibodies reacting to desmosomal glycoproteins, and are present in the keratinocytes cellular surface. The autoimmune reaction to these glycoproteins causes a cellular adhesion loss resulting in the formation of intraepithelial blisters. From 80 to 90 % of the patients with vulgar pemphigus develop skin disorders, and 60 % of the cases show mucosa changes as the first or unique sign. The diagnosis of the lesions in oral cavity is essential because it could prevent the skin damage. If the treatment begins in an initial stage, it is easier to control the disease and the possibility of the disorder's early remission and a better life quality increases. This is the report of the case of a female patient, aged 35 years, who presented ulcerated lesions in the entire oropharyngeal region, with itching sensation and inability for food consumption. The diagnosis was vulgar pemphigus (AU).

Efficacy of Mouthwash from Aloe vera Juice after Scaling Treatment on Patient with Gingivitis: A Clinical Study

Objective: To determine the effectiveness effectivity of mouthwash from Aloe vera juice after scaling treatment on patient with gingivitis. Material and Methods: This was an experimental research using pretest and posttest design with control group. The number of samples of 30 people selected using sampling method quota sampling. Samples were divided into two groups: test (n = 15 skeletons with Aloe vera juice) and control (n = 15 just scaling). Gingival inflammation is measured using a gingival index according to Loe and Sillness on the first day before scaling treatment and 7th day after scaling. Data analysis was conducted using SPSS version 20. Independent-samples t-test and paired-samples t-test were used for data analysis. The statistical test performed has a significance level of 0.05 (p = 0.05) and confidence level of 95% (α = 0,05). Results: There was a significant decrease in the mean score of the gingival index in the control group (1.1 to 0.5) and the test group (1.2 to 0.4) significantly (p<0.05). Conclusion: The use of mouthwash from Aloe vera juice can decrease gingival inflammation, which can be seen from the gingival index score on all test subjects. The decrease in gingival index in the test group using the Aloe vera juice was greater than that of the control group, which was not given the mouthwash.

Development of a self-report questionnaire designed for population-based surveillance of gingivitis in adolescents: assessment of content validity and reliability

Abstract The major infectious diseases in Chile encompass the periodontal diseases, with a combined prevalence that rises up to 90% of the population. Thus, the population-based surveillance of periodontal diseases plays a central role for assessing their prevalence and for planning, implementing, and evaluating preventive and control programs. Self-report questionnaires have been proposed for the surveillance of periodontal diseases in adult populations world-wide. Objective This study aimed to develop and assess the content validity and reliability of a cognitively adapted self-report questionnaire designed for surveillance of gingivitis in adolescents. Material and Methods Ten predetermined self-report questions evaluating early signs and symptoms of gingivitis were preliminary assessed by a panel of clinical experts. Eight questions were selected and cognitively tested in 20 adolescents aged 12 to 18 years from Santiago de Chile. The questionnaire was then conducted and answered by 178 Chilean adolescents. Internal consistency was measured using the Cronbach's alpha and temporal stability was calculated using the Kappa-index. Results A reliable final self-report questionnaire consisting of 5 questions was obtained, with a total Cronbach's alpha of 0.73 and a Kappa-index ranging from 0.41 to 0.77 between the different questions. Conclusions The proposed questionnaire is reliable, with an acceptable internal consistency and a temporal stability from moderate to substantial, and it is promising for estimating the prevalence of gingivitis in adolescents.

Mapping of adolescents with gingivitis and dental calculus / Mapeamento de adolescentes com gengivite e cálculo dental / Mapeo de adolescentes con gingivitis y cálculo dental

Objective: The aim of this study was to map the distribution of periodontal disease in adolescents in the Jequitinhonha Valley. Methods: We constructed maps with varying Community Periodontal Index (CPI). The cities were selected based on population size and performance of oral health services. The sampling plan was composed of 450 individuals between 15 and 19 years, randomly selected in number corresponding to the proportion of the adolescent population in each municipality. Results: Of the 450 adolescents examined were 16 (3.5%) code 0 (Healthy), 232 (51.5%) of the code 1 (bleeding), 38 (8.44%) code 2 (Calculus) and 164 (36.44%) code 6 (bleeding and calculus). The pattern of mosaic maps was kind and may indicate that the worst periodontal conditions of adolescents were distributed throughout the region. Conclusion: maps described the oral health status of adolescents and can provide information for planning oral health.

Objetivo: Este estudo foi mapear a distribuição da doença periodontal nos adolescentes do Vale do Jequitinhonha. Métodos: Foram construídos mapas com variáveis do Índice Periodontal Comunitário (IPC). Os municípios foram selecionados com base no porte populacional e no desempenho do serviço de saúde bucal. O plano amostral foi composto por 450 indivíduos entre 15 e 19 anos, selecionados aleatoriamente, em número correspondente à proporção da população adolescente de cada município. Resultados: Dos 450 adolescentes examinados foram 16 (3,5%) de código 0 (Saudável), 232 (51,5%) do código 1 (sangramento), 38 (8,44%) de código 2 (Calculus) e 164 (36,44%) de código 6 (sangramento e cálculo). O padrão dos mapas foi do tipo mosaico e pode indicar que as piores condições periodontais dos adolescentes estavam distribuídas por toda a região. Conclusão: Mapas descreveram a condição de saúde bucal de adolescentes e pode fornecer subsídios para o planejamento em saúde bucal.

Objetivo: Este estudio fue determinar la distribución de la enfermedad periodontal en adolescentes del Valle de Jequitinhonha. Métodos: Se construyeron mapas con diferentes Índice Periodontal Comunitario (IPC). Las ciudades fueron seleccionadas en base al tamaño de la población y el desempeño de los servicios de salud oral. El plan de muestreo estuvo compuesto por 450 personas entre 15 y 19 años, seleccionados al azar en el número correspondiente a la proporción de la población adolescente en cada municipio. Resultados: De los 450 adolescentes examinados fueron 16 (3,5%) de código 0 (sano), 232 (51,5%) del código 1 (sangrado), 38 (8,44%) Código 2 (cálculo) y 164 (36,44%) de código 6 (sangrado y cálculo). El patrón de mapas mosaico era amable y puede indicar que las peores condiciones periodontales de los adolescentes se distribuyeron en toda la región. Conclusión: Los mapas describen el estado de salud bucal de los adolescentes y pueden proporcionar información para la planificación de la salud oral.

Enfermedad periodontal en adolescentes / Periodontal disease in teenagers

Introducción: durante mucho tiempo se creyó que la enfermedad periodontal era una afección de la adultez, sin embargo la falta de motivación en la práctica de la higiene oral en la etapa de la adolescencia condiciona su aparición. Objetivo: identificar el estado periodontal en adolescentes de la escuela Secundaria Básica Urbana ¨Raúl Pujols¨, en la ciudad de Santiago de Cuba, en el periodo de septiembre 2014 hasta marzo 2015. Materiales y Métodos: se realizó un estudio observacional, descriptivo transversal. El universo estuvo constituido por los 75 adolescentes, entre 11 a 14 años de edad de ambos sexos. Se utilizó el índice periodontal de Russell revisado por la Organización Mundial de la Salud y el índice de Love. Se confeccionó una planilla de recolección de datos para los resultados del examen físico y como medidas de resumen se usó el porcentaje. Resultados: prevaleció la gingivitis leve en el 66,7 % de los adolescentes, relacionado a la existencia de una higiene bucal deficiente. Predominó el sexo femenino y los factores de riesgo más encontrados fueron el apiñamiento dentario y los hábitos deletéreos. Conclusiones: la mayoría de los adolescentes del estudio presentaron gingivitis leve con una higiene bucal deficiente (AU).

Introduction: during many time it was believed that periodontal disease was adulthood affection, but lack of motivation in the practice of oral hygiene in the adolescence induces its beginning. Aim: to identify the periodontal status in teenagers from the Urban Secondary School “Raul Pujols”, in the city of Santiago de Cuba, in the period September 2014-March 2015. Materials and Methods: A cross-sectional, descriptive, observational study was carried out. The universe was formed by 75 both-sexes teenagers, aged 11-14 years. Russell’s periodontal index, up-dated by the Word Health Organization, and Love’s index were used. A form of data collection for the results of the physical examination was elaborated, and percentage was used as a summarizing measure. Results: mild gingivitis prevailed in 66.7 % of the teenagers, related with the deficient oral health. Female sex prevailed and the most commonly found risk factors were dental crowding and deleterious habits. Conclusions: most of the teenagers participating in the study had mild gingivitis and deficient oral health (AU).

Factors Associated with Gingivitis in Children with Developmental Disabilities

Objective: To investigate factors associated with gingivitis in children aged one to 13 years with developmental disabilities. Material and Methods: A total of 408 dental records were used to recover the data. Gingivitis was measured based on the Modified Gingival Index. Other variables were also analysed: gender, age, International Classification of Diseases (ICD) code, mouth breathing, history of gastroesophageal reflux, use of psychotropic drugs, reports of dry mouth, history of asthma, use of medications to treat asthma, oral hygiene, dental caries, and filled or missing teeth in deciduous or permanent dentition. For the purposes of this analysis, the individuals were categorized as with and without gingivitis. Variables with a p-value < 0.25 in the bivariate analysis were incorporated into the logistic regression models (ICD, reflux, oral hygiene, primary tooth decay or filling, mouth breathing, dry mouth and use of psychotropic drugs). Results: We found a 14.67% prevalence of gingivitis. Individuals with mouth breathing had a 2.574-fold (95% CI: (1.113-5.950) greater chance of exhibiting gingivitis. Individuals with moderate oral hygiene had a 2.763-fold (95% CI: 1.066 to 7.160) greater chance of exhibiting gingivitis, and individuals with poor oral hygiene had a 15.029-fold (95% CI: 3.705-60.965) greater chance of exhibiting gingivitis than those with good oral hygiene. Conclusion: Moderate or poor oral hygiene and mouth breathing are factors associated with gingivitis in a group of patients with developmental disabilities at a dental service in Belo Horizonte.

Dental flossing as a diagnostic method for proximal gingivitis: a validation study

ABSTRACT This study evaluated the clinical diagnosis of proximal gingivitis by comparing two methods: dental flossing and the gingival bleeding index (GBI). One hundred subjects (aged at least 18 years, with 15% of positive proximal sites for GBI, without proximal attachment loss) were randomized into five evaluation protocols. Each protocol consisted of two assessments with a 10-minute interval between them: first GBI/second floss, first floss/second GBI, first GBI/second GBI, first tooth floss/second floss, and first gum floss-second floss. The dental floss was slid against the tooth surface (TF) and the gingival tissue (GF). The evaluated proximal sites should present teeth with established point of contact and probing depth ≤ 3mm. One trained and calibrated examiner performed all the assessments. The mean percentages of agreement and disagreement were calculated for the sites with gingival bleeding in both evaluation methods (GBI and flossing). The primary outcome was the percentage of disagreement between the assessments in the different protocols. The data were analyzed by one-way ANOVA, McNemar, chi-square and Tukey's post hoc tests, with a 5% significance level. When gingivitis was absent in the first assessment (negative GBI), bleeding was detected in the second assessment by TF and GF in 41.7% (p < 0.001) and 50.7% (p < 0.001) of the sites, respectively. In the absence of gingivitis in the second assessment (negative GBI), TF and GF detected bleeding in the first assessment in 38.9% (p = 0.004) and 58.3% (p < 0.001) of the sites, respectively. TF and GF appears to be a better diagnostic indicator of proximal gingivitis than GBI.

Guidelines proposal for clinical recognition of mouth breathing children

INTRODUCTION: Mouth breathing (MB) is an etiological factor for sleep-disordered breathing (SDB) during childhood. The habit of breathing through the mouth may be perpetuated even after airway clearance. Both habit and obstruction may cause facial muscle imbalance and craniofacial changes.OBJECTIVE: The aim of this paper is to propose and test guidelines for clinical recognition of MB and some predisposing factors for SDB in children.METHODS: Semi-structured interviews were conducted with 110 orthodontists regarding their procedures for clinical evaluation of MB and their knowledge about SDB during childhood. Thereafter, based on their answers, guidelines were developed and tested in 687 children aged between 6 and 12 years old and attending elementary schools.RESULTS: There was no standardization for clinical recognition of MB among orthodontists. The most common procedures performed were inefficient to recognize differences between MB by habit or obstruction.CONCLUSIONS: The guidelines proposed herein facilitate clinical recognition of MB, help clinicians to differentiate between habit and obstruction, suggest the most appropriate treatment for each case, and avoid maintenance of mouth breathing patterns during adulthood.

INTRODUÇÃO: a respiração bucal (RB) é um fator etiológico para os distúrbios respiratórios do sono (DRS) na infância. O hábito de respirar pela boca pode ser perpetuado mesmo depois da desobstrução das vias aéreas. Tanto o hábito quanto a obstrução podem causar desequilíbrios da musculatura facial e alterações craniofaciais. O objetivo deste trabalho é propor e testar uma diretriz para o reconhecimento clínico da RB e de alguns fatores predisponentes aos DRS em crianças.MÉTODOS: entrevistas semiestruturadas foram realizadas com 110 ortodontistas, com relação aos seus procedimentos para avaliação clínica da RB e aos seus conhecimentos sobre DRS na infância. A partir daí, com base nas respostas obtidas, uma diretriz foi desenvolvida e testada em 687 crianças, com 6 a 12 anos, oriundas de escolas de ensino fundamental.RESULTADOS: não existe padronização para o reconhecimento clínico da RB pelos ortodontistas. Os procedimentos mais comumente realizados foram ineficientes para reconhecer a diferença entre a RB por hábito e a por obstrução.CONCLUSÕES: a diretriz proposta facilita o reconhecimento clínico da RB, diferencia entre RB por hábito e por obstrução, sugere o tratamento mais adequado para cada caso, e evita a manutenção do padrão de respiração bucal na idade adulta.

Lack of associaiion between herpesvirus detectin in saliva and gingivitis in hhiv‑infected children / Ausência de associação entre a detecção de herpesvírus na saliva e gengivite em crianças infectadas pelo HIV

The aims of this study were to compare the detection of human herpesviruses (HHVs) in the saliva of HIV-infected and healthy control children, and to evaluate associations between viral infection and gingivitis and immunodeficiency. Saliva samples were collected from 48 HIV-infected and 48 healthy control children. Clinical and laboratory data were collected during dental visits and from medical records. A trained dentist determined gingival indices and extension of gingivitis. Saliva samples were tested for herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella zoster virus (VZV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) by nested polymerase chain reaction assays. Thirty-five HIV-infected and 16 control children had gingivitis. Seventeen (35.4%) HIV-infected children and 13 (27%) control children were positive for HHVs. CMV was the most commonly detected HHV in both groups (HIV-infected, 25%; control, 12.5%), followed by HSV-1 (6.2% in both groups) and HSV-2 (HIV-infected, 4.2%; control, 8.3%). The presence of HHVs in saliva was not associated with the presence of gingivitis in HIV-1-infected children (p = 0.104) or healthy control children (p = 0.251), or with immunosuppression in HIV-infected individuals (p = 0.447). Gingivitis was correlated with HIV infection (p = 0.0001). These results suggest that asymptomatic salivary detection of HHVs is common in HIV-infected and healthy children, and that it is not associated with gingivitis.

Os objetivos deste estudo foram detectar a presença de herpesvírus humanos (HHVs) na saliva de crianças infectadas pelo HIV, em comparação com controles saudáveis e avaliar a associação entre infecção viral, gengivite e imunodeficiência. Para este fim, foram colhidas amostras de saliva de 48 crianças HIV-positivas e 48 controles saudáveis. O índice gengival e extensão de gengivite foram determinados por um dentista treinado. Informações clínicas e laboratoriais foram obtidas durante a consulta odontológica e dos registros médicos. As amostras de saliva foram testadas para detecção de vírus herpes simplex tipos 1 e 2 (HSV-1 e HSV-2), vírus da varicela-zoster (VVZ), vírus Epistein-Barr (EBV) e citomegalovírus (CMV) através de nested-PCR. Trinta e cinco crianças HIV-positivas e 16 crianças do grupo controle apresentavam gengivite. Dezessete (35,4%) crianças HIV-positivas e 13 (27%) crianças controle testaram positivo para a presença de HHVs. CMV foi o vírus mais comum detectado em ambos os grupos (25% HIV-positivas e 12,5% de controle), seguido por HSV-1 (6,2% de ambos os grupos) e HSV-2 (4,2% HIV-positivas e 8,3% de controle). Não houve associação entre a detecção de HHVs na saliva e a presença de gengivite em ciranças HIV-positivas (p = 0.104) ou crianças saudáveis (p = 0,251), ou com imunossupressão em indivíduos HIV-positivos (p = 0,447). Foi observada uma correlação entre a infecção por HIV e a presença de gengivite (p = 0,0001). Os resultados sugerem que a detecção salivar assintomática de HHVs é comum entre crianças HIV-positivas e crianças saudáveis, e não está associada à gengivite.

Chemical salivary composition and its relationship with periodontal disease and dental calculus

Aim: To determine the relationship between the chemical composition of saliva, periodontal disease and dental calculus. Methods: An observational analytical cross-sectional study was conducted with patients over 55 years of age. Ethical principles of autonomy and risk protection were applied according to the international standards. Sociodemographic and diagnosis variables (presence of dental calculus and periodontal status) were considered to measure salivary concentrations of glucose (by the glucose oxidase/peroxidase method, amylase (by the colorimetric test), urea (by the amount of indophenol), total protein (by the Bradford method) and albumin (by the nephelometric method). Patients chewed a sterile rubber band and 3 mL of stimulated saliva were collected. The samples were stored at -5 °C, centrifuged at 2,800 rpm for 10 min, and the supernatant was removed and stored at -20 °C. Data were presented as frequencies and proportions for qualitative variables and measures of central tendency and dispersion for quantitative variables. Data were analyzed by either analysis of variance or Kruskal Wallis test . A p value <0.05 was considered statistically significant. Results: Significant relationships were observed between the concentration of salivary urea and periodontal status (p = 0.03) and the presence of dental calculus and urea (p = 0.04) was demonstrated. Conclusions: A relationship between the salivary urea concentration and the presence of periodontal disease and dental calculus is suggested.