Avaliação Morfométrica da Influência da Obesidade Sobre o Tecido Gengival de Ratos com Periodontite Experimental / Morphometric Evaluation of the Influence of Obesity on Gingival Tissue in Rats with Experimental Periodontitis

Objetivo: O objetivo desse trabalho foi avaliar o comportamento do tecido gengival de ratos após a indução experimental de obesidade e doença periodontal. Material e Métodos: Vinte e quatro ratos machos (n=24) foram divididos inicialmente em 2 grupos, que foram submetidos a injeções intradérmicas na região cervical de 4g/kg/dia de solução glutamato monossódico (MSG) (grupo OBS) e 1,25g/kg/dia de solução salina (grupo CTL), nos primeiros 5 dias de vida. Aos 70 dias foi induzida a doença periodontal com a colocação de ligadura nos dentes posteriores dos ratos, após esse procedimento 4 grupos, com 6 ratos cada, foram originados: grupo controle sem ligadura (CTL); grupo controle com ligadura (LIG); obeso sem ligadura (OBS), obeso com ligadura (OBSLIG). Aos 100 dias os ratos foram sacrificados, e a hemimandíbula direita de cada rato foi retirada para a análise morfométrica do tecido gengival. Resultados: A altura do epitélio da crista gengival foi significativamente (p<0,05) maior nos grupos com periodontite induzida (LIG 44,26±0,69; OBSLIG 43,30±1,23). A altura do tecido conjuntivo na região média mostrou-se menor nos grupos CTL (237,44±7,38) e OBS (238,17±0,73), sendo estas diferenças estatisticamente significativas (p<0,05) em relação aos demais grupos. Conclusão: A obesidade induzida pelo glutamato monossódico não alterou as características dos tecidos epitelial e conjuntivo da região gengival de ratos. (AU)

Objective: This study aimed to evaluate the behavior of gingival tissue upon experimentally-induced obesity and periodontitis in rats. Materials and Methods: Twenty-four male Wistar rats were initially divided into 2 groups. Animals were subjected to intradermal injections of 4 g/kg/day Monosodium Glutamate (MSG) and 1.25 g/kg/day saline solution (control group, CTRL) in the cervical region for their first 5 days of life. At 70 days, the groups were subdivided into 2 other groups. A ligature placed around their 1st mandibular molars was used to induce periodontitis. Accordingly, a total of 4 groups were formed, with 6 animals each: ligature-free control group (CTRL); control group with ligature (LIG); ligature-free obese group (OBS); obese group with ligature (OBSLIG). After 100 days, animals were sacrificed and their right hemi-jaws were dissected for morphometric analysis. Results: The height of the gingival crest epithelium was significantly higher (p<0.05) in the groups with induced periodontitis (LIG 44.26±0.69; OBSLIG 43.30±1.23). The height of the connective tissue in the middle region was found to be lower in CTRL (237.44±7.38) and OBS groups (238.17±0.73), with statistically significant differences (p<0.05) as compared to the other groups. Conclusion: MSG-induced obesity did not change the characteristics of the gingival epithelium and connective tissues in rats. (AU)

Effects of Initial Periodontal Treatment in Moderately Compensated and Decompensated Type 2 Diabetic Patients.

Objective: The objectives of this research were to evaluate the effect of periodontal therapy in moderately compensated and decompensated type 2 diabetic patients. Materials and Methods: 20 patients with type 2 diabetes mellitus (DM2) and periodontal disease were selected and divided into two groups (based on HbA1c level): Group 1: Moderately compensated; Group 2: Decompensated. The analyses including clinical periodontal parameters and the quantification of gingival crevicular fluid (GCF), the IL1-β expression in the GCF and Glycated hemoglobin (HbA1c) and fasting glucose (FG) from venous blood were performed at 0, 3, and 6 months. Results: Both groups presented improvement in all clinical periodontal parameters as well as quantification of gingival crevicular fluid and in the expression of IL-1ß present in the fluid after 6 months. However, no statistically significant difference was found in the levels of HbA1C in the group 1 after 6 months, although a significant increase was found after six months in the group 2. While in relation to the FG, a great improvement was found in the group 1 and a significant increase in the group 2 after six months. Conclusions: It was possible to observe that conventional periodontal treatment (scaling and root planning) is more effective for moderately compensated type 2 diabetic patients’ glycemic control rather than for the decompensated patients.

Efeito do tratamento periodontal de suporte no nascimento de bebês prematuros ou de baixo peso em mulheres grávidas com doença periodontal / Effect of supportive periodontal therapy in the preterm birth or low birth weight in pregnant women with periodontal disease

O agravamento da gengivite, durante a gravidez, é atribuído principalmente ao aumento dos níveis de progesterona, a qual produz dilatação e tortuosidade na microvascularização gengival, estase circulatória e susceptibilidade aumentada à irritação mecânica, todas as quais favorecem um extravasamento de fluido para os tecidos perivasculares. A gravidez afeta a severidade de áreas previamente inflamadas, mas não altera a gengiva saudável. Assim o objetivo do estudo foi avaliar a influência do tratamento periodontal de suporte sobre o nascimento de bebês prematuros ou de baixo peso em gestantes com doença periodontal. Foram selecionadas 20 pacientes com doença periodontal diagnosticada, periodontite crônica moderada ou severa. Aleatoriamente as pacientes foram separados em 2 grupos, com 10 gestantes cada, onde todas receberam tratamento periodontal básico, sendo um grupo recebendo também a terapia periodontal de suporte e outro recebendo instrução de higiene oral durante todo o acompanhamento da gestação. Os resultados demonstraram uma redução estatisticamente significativa em todos os parâmetros, com destaque maior para o grupo 2, onde ocorreram as maiores reduções nas variações das médias dentro dos parâmetros de Profundidade de Sondagem e Nível de Inserção Clínica (p<0.05). Assim, podemos sugerir que a terapia periodontal de suporte influenciou positivamente na prevenção do nascimento de bebês prematuros ou de baixo peso em gestantes com doença periodontal.

The aggravation of gingivitis during pregnancy is mainly attributed to the increased levels of progesterone , which produces dilation and tortuosity in gingival microvasculature , circulatory stasis and increased susceptibility to mechanical irritation , all of which favor a leakage of fluid into the perivascular tissue . Pregnancy affects the severity of previously inflamed areas , but does not change the gums healthy. Thus the aim of the study was to evaluate the influence of supportive periodontal treatment on preterm birth or low birth weight in women with periodontal disease. We selected 20 patients diagnosed with periodontal disease , moderate to severe chronic periodontitis . Patients were randomly divided into 2 groups , each with 10 pregnant women , where all received basic periodontal treatment , one group also receiving supportive periodontal therapy and the other receiving oral hygiene instruction throughout the monitoring of pregnancy . The results showed a statistically significant reduction in all parameters , especially higher for group 2 , which showed the largest reductions in variations of the medium within the parameters of Probing Depth and Clinical Attachment Level (p<0.05) . Thus, we suggest that periodontal therapy support positively influenced in the prevention of preterm birth or low birth weight in women with periodontal disease.