The absence of proximal contact point on periodontal parameters of teeth moved into extraction sites

Abstract The aim of study was to evaluate periodontal conditions of upper canines and second premolars with and without proximal contact of individuals undergoing orthodontic treatment associated to extractions of the upper first premolars. The study selected upper canines and premolars of individuals undergoing orthodontic treatment without extractions (30 hemiarches - control group), or with extraction of the upper first premolars and whose canines and second premolars had interproximal contact (16 hemiarches - group 1) or diastema (17 hemiarches - group 2). Clinical (plaque index, probing depth, gingival bleeding index, height of the gingival margin, clinical attachment loss and gingival clefts) and radiographic (crest height, bone height and bone-crest discrepancy) parameters of the distal surfaces of canines and mesial surfaces of premolars were evaluated. Group 1 had worse results when compared to the control group for the levels of plaque in canines and premolars and for probing depth in canines (distal and mean) and in premolars (lingual and mean), as well as increasing tendency of clinical attachment loss (lingual and mean) in premolars. Plaque level in canines in group 1 was also significantly higher than in group 2. There was no difference between group 2 and the control group. The lack of proximal contact between canines and second premolars did not significantly affect their periodontal characteristics.

Resumo A extração de dentes para obtenção de espaço nos arcos dentários é uma estratégia rotineiramente utilizada em Ortodontia, porém a movimentação de dentes para os locais de extrações pode estar associada à falhas na estabilidade dos dentes e abertura do ponto de contato, gerando prejuízo aos tecidos periodontais. Objetivo: Avaliar a condição periodontal de caninos e segundos pré-molares superiores com e sem ponto de contato entre si de indivíduos submetidos ao tratamento ortodôntico associado à extração dos primeiros pré-molares superiores. Foram selecionados caninos, primeiros e segundos pré-molares superiores de indivíduos submetidos ao tratamento ortodôntico sem extração (30 hemiarcos - grupo controle) ou com extração dos primeiros pré-molares superiores cujos caninos e os segundos pré-molares apresentavam contato interproximal (16 hemiarcos - grupo 1) ou diastema (17 hemiarcos - grupo 2). Nas superfícies distal dos caninos e mesial dos pré-molares foram avaliados parâmetros clínicos e radiográficos para determinar o efeito da movimentação dos dentes para o local de extração e da ausência de ponto de contato interproximal nos tecidos periodontais. Os grupos não apresentaram diferença significativa para a idade e o tempo de pós-tratamento. O grupo 1 apresentou valores mais desfavoráveis em relação ao grupo controle para o índice de placa em caninos e pré-molares e para a profundidade de sondagem em caninos (distal e média) e em pré-molares (lingual e média), além de uma tendência de maior perda de inserção clínica (lingual e média) nos pré-molares. O índice de placa nos caninos do grupo 1 também foi significativamente maior do que no grupo 2. Os grupos 2 e controle não apresentaram diferença significativa. A ausência de ponto de contato entre os caninos e os segundos pré-molares superiores não afetou significativamente a situação periodontal desses dentes.

Use and need of dental prosthesis among community dwelling elderly: a cross-sectional population-based study / Uso e necessidade de próteses dentárias em idosos domiciliados: um estudo transversal de base populacional

Abstract Background By the use of complete or partial dental prosthesis, function, esthetics, and phonetics are reestablished. Few population-based studies are available in the literature using an older adult population. Objective Evaluate the use of and need for dental prostheses and their associated factors. Method This study included a random sample of 287 elderly, in the city of Cruz Alta, Brazil. Use of and need for dental prostheses were the main outcomes, and two analytical models were constructed. Subgroup analyses were performed for individuals using fixed partial denture (FPD) and removable (partial and/or complete) dental prosthesis (RDP). Results Use of and need for dental prosthesis were identified in 83.6% (n=240) and 42.5% (n=122) of the elderly, respectively. Women presented a significantly higher prevalence ratio (PR) for use of dental prostheses (PR=1.15; 95%IC:1.02-1.28) and lower need (PR=0.70; 95%IC:0.54-0.91). No statistically significant difference was demonstrated for the use of FPD regarding the sex. Higher education level was associated with lower use of prostheses (PR=0.73; 95%IC:0.58-0.91) when compared to lower level of education. Medium level of education showed a significantly lower need for dental prostheses (PR=0.61 - 95%IC:0.39-0.94). Those that did not consume alcohol presented with a significantly lower use of FPD and RDP (PR=0.46; 95%IC:0.23-0.93 and 0.90;0.81-0.99, respectively). Conclusion The use of and need for dental prostheses were associated with sex, level of education, and behavioral factors.

Resumo Introdução Pelo uso de próteses dentárias completas ou parciais, função, estética e fonética são reestabelecidas. Poucos estudos de base população estão disponíveis na literatura utilizando a população idosa. Objetivo Avaliar o uso e a necessidade de prótese dentária, bem como seus fatores associados. Método Esse estudo incluiu uma amostra randômica de 287 idosos da cidade de Cruz Alta, no Brasil. Uso e necessidade de prótese dentária foram os desfechos primários, e dois modelos analíticos foram construídos. No uso de prótese dentária, análises de subgrupos foram realizadas para Prótese Parcial Fixa (PPF) e Prótese Removível (parcial e/ou completa) (PR). Resultados Uso e necessidade de prótese dentária foram detectados em 83,6% (n=240) e 42,5% (n=122) dos idosos, respectivamente. Mulheres apresentaram significativa maior Razão de Prevalência (RP) para o uso de prótese dentária (RP:1,15; IC95%:1,02-1,28) e menor necessidade (RP:0,70; IC95%:0,54-0,91). Nenhuma associação significativa foi encontrada para o uso de PPF em relação aos gêneros. Alto nível educacional esteve associado ao menor uso de prótese (RP:0,73; IC95%:0,58-0,91), quando comparado com escolaridade baixa. Escolaridade média mostrou significativa menor necessidade de prótese dentária (RP:0,61 - IC95%:0,39-0,94). Aqueles que não utilizam álcool apresentaram um menor uso de PPF e PR (RP:0,46; IC95%:0,23-0,93 e 0,90;0,81-0,99, respectivamente). Conclusão Uso e necessidade de prótese dentária estão associados ao gênero, nível educacional e fatores comportamentais.

Investigation of oral and general health status and IL-1β gene polymorphism as risk factors for oral mucositis in hematopoietic stem cell transplantation patients

Abstract: The aim of the present study was to analyze the relationship of OM with possible risk factors such as oral health condition, immunological status and IL-1β profile in patients submitted to hematopoietic stem cell transplantation (HSCT). Fifty-four individuals submitted to HSCT were included. All patients received previous dental treatment and photobiomodulation (PBM) as the institutional OM preventive protocol. OM scores, immune status, and IL-1β levels were determined during the conditioning period and at D+3 and D+8 after HSC infusion. IL-1β gene polymorphism was also analyzed during conditioning. Possible associations of OM with risk factors were analyzed using conditional Fisher's exact test. OM was observed in 34 patients (62.9%) classified as Grade 1 (13 patients/24.1%), Grade 2 (14 patients/25.9%), Grade 3 (3 patients/5.5%), and Grade 4 (4 patients/7.4%). Allogeneic HSCT individuals exhibited a higher OM grade than autologous subjects. Moreover, an association was observed between severe OM and severe gingivitis (p = 0.01), neutropenia (p = 0.03), and leukopenia (p = 0.04). A significant association between OM and lower IL-1β levels was detected at three time points, i.e., conditioning (p = 0.048), D+3 (p = 0.01), and D+8 (p = 0.005). The results showed that IL-1β gene polymorphism was not associated with OM. Our study provided important insights into the scope of OM risk factors in the setting of HSCT. Patients submitted to HSCT with severe gingivitis prior to chemotherapy and with severe neutropenia and leukopenia exhibited a higher OM grade. Further investigation will be necessary to better understand the exact role of IL-1β in the context of OM pathobiology and to validate cytokine analysis in larger cohorts.

Self-reported periodontitis in cannabis club members in Montevideo, Uruguay. An exploratory study

In 2013, the Oriental Republic of Uruguay enacted a law regulating the cannabis market, and since then, an increasing number of users has been registered. Previous reports based on data from other countries link cannabis smokers to worse periodontal health status. The aim of this study is to describe self-reported gingival and periodontal health status and estimate the prevalence of periodontitis among Uruguayan cannabis club members. A cross-sectional study was conducted on a convenience sample of cannabis club members in Uruguay. A survey was used to gather sociodemographic data and information on oral hygiene, use of cannabis and other drugs, and self-reported gingival and periodontal health status. Eight questions validated in Spanish were used to estimate the prevalence of total periodontitis and severe periodontitis, based on two previously implemented predictive models. The survey was completed by 50 people, of whom 68% were male and 78% were in the 20-40 year age range. Based on the first model, estimated prevalence was 12% for total periodontitis and 10% for severe periodontitis. Based on the second model, estimated prevalence was 36% for total periodontitis and 12% for severe periodontitis. These findings suggest that smoking cannabis could potentially have a detrimental effect on oral health status.

En 2013 se aprobó la ley que regula el mercado del cannabis en la República Oriental del Uruguay y desde entonces se ha registrado un creciente número de consumidores. Reportes previos a partir de datos de otros países vinculan un peor estado de salud periodontal en fumadores de cannabis. El objetivo de este estudio es describir el estado gingivo-periodontal auto-reportado y estimar la prevalencia de periodontitis en participantes de clubes cannábicos uruguayos. Se realizó un estudio transversal a partir de una muestra por conveniencia de integrantes de clubes cannábicos en Uruguay. Mediante una encuesta se recolectaron datos socio-demográficos, de higiene oral, de consumo de cannabis y otras drogas, así como de auto-reporte del estado de salud gingivo-periodontal. A partir de 8 preguntas validadas en español se estimó la prevalencia de periodontitis total y severa a través de dos modelos predictivos previamente implementados. Un total de 50 personas completaron la encuesta. El 68% eran hombres y el 78% estaba dentro del rango de 20 a 40 años de edad. Con el primer modelo la prevalencia estimada de periodontitis total fue 12% y de periodontitis severa 10%. Con el segundo modelo fue 36% para periodontitis total y 12% para periodontitis severa. Estos hallazgos sugieren que fumar cannabis podría tener un potencial efecto deletéreo sobre las condiciones de salud bucal.

Efficacy of two soft-bristle toothbrushes in plaque removal. A randomized controlled trial / Eficácia de duas escovas de cerdas macias na remoção de Placa. Um ensaio clínico randomizado

ABSTRACT The aim of the present examiner-blind randomized controlled clinical study was to compare the efficacy two soft-bristle toothbrushes in terms of plaque removal. Seventy volunteers were randomly allocated to Group A (tapered-tip toothbrush) or Group B (end-rounded toothbrush). At baseline appointment (Day 0), volunteers underwent plaque examination using the Improved Plaque Identification Index. Under supervision, they brushed their teeth for 1 minute with their assigned toothbrushes and the plaque examination was repeated. Volunteers continued the oral hygiene regimen (assigned toothbrush and a regular dentifrice provided by the researchers) for 7 days. The experimental procedures of Day 0 were then repeated. Separate statistical analyses were performed for mean percent reduction of plaque in the whole-mouth, interproximal and gumline scores at both times, usingMann-Whitney test, p<0.05. After a single toothbrushing, on Day 0, mean percent plaque was significantly reduced in both groups (p<0.05), with statistically greater reductions of whole-mouth (21.39±12.44 vs. 11.40±11.17), gumline (6.32±7.37 vs. 2.89±4.57) and interproximal (10.82±10.49 vs. 5.21±7.68) for Group A as compared to Group B. However, on day 7, no significant difference was observed between groups for whole-mouth (29.94±20.91 vs. 26.58±18.64), gymline (14.04±18.82 vs. 13.78±17.63) and interproximal surfaces (26.41±22.77vs. 23.12±20.98) (p>0.05). In conclusion, on Day 0, Group A presented higher efficacy in supragingival plaque removal than Group B, as reflected by whole-mouth, gumline and interproximal plaque scores.

RESUMO O objetivo desse ensaio clínico, examinador-cego, randomizado e controle foi de comparadas a eficácia de duas escovas de cerdas macias em relagäo ao controle de placa. Setenta vo-luntários foram randomicamente alocados para Grupo A (es-cova com ponta cónica) ou Grupo B (escova com ponta arredondada). Na consulta inicial (dia 0), voluntarios receberam exame de placa utilizando o Índice de identificagäo de placa melhorado. Sob supervisäo, eles escovaram seus dentes por 1 minuto com as escovas designadas e o exame de placa foi repetido. Voluntarios continuaram seu regime de higiene oral (escova dental alocada e dentifrício comum fornecidos pelos pesquisadores) durante 7 dias. Os procedimentos da consulta inicial foram novamente repetidos. Análises estatísticas distintas foram realizadas para percentual de redugäo média de placa para os escores de boca toda, interproximal e linha gengi-val em ambos os momentos, utilizando teste de Mann-Whitney, p<0,05. Após único uso da escova, no dia 0, o percentual de redugäo média de placa foi significativamente reduzido em ambos os grupos (p<0,05), com reduções significativas para boca toda (21,39±12,44 vs. 11,40±11,17), linha gengival (6,32±7,37 vs. 2,89±4,57) e interproximal (10,82±10,49 vs. 5,21±7,68) no Grupo A quando comparada com o Grupo B. Entretanto, no dia 7, nenhuma diferenga significativa foi observada entre os grupos para boca toda (29,94±20,91 vs. 26,58±18,64), linha gengival (14,04±18,82 vs. 13,78±17,63) e interproximal (26,41±22,77 vs. 23,12±20,98) (p>0,05). Em conclusäo, no dia 0, a escova do Grupo A apresentou eficácia superior na remo-gäo de placa suprageng ival quando comparada com a escova do Grupo B, como demonstrado nos escores de placa de boca toda, linha gengival e interproximal.

Oral health-related quality of life and associated factors in the elderly: a population-based cross-sectional study / Qualidade de vida relacionada à saúde bucal e fatores associados em idosos: um estudo transversal com amostra representativa

Abstract This study aimed to evaluate the oral health-related quality of life (OHRQoL) and associated factors in the elderly. A cross-sectional study was conducted with 287 elderly of Cruz Alta, Brazil. The following variables were collected: age, sex, ethnicity, level of education, marital status, retirement, medical/dental history, smoking/alcohol exposure, oral hygiene habits, use and need of dental prosthesis, missing teeth, temporomandibular disorder symptoms (TMD), nutritional status, and halitosis. OHRQoL was assessed by Oral Health Impact Profile-14 (OHIP-14). The sample was categorized into low impact (sum scores ≤6) and high impact (sum scores ≥7). Associations were analyzed by Poisson regression with robust variation. Mean scores of OHIP-14 was 5.92±8.54. Divorced individuals and those who did not use dental floss presented 77% and 54%, respectively, higher prevalence ratio (PR) of having higher OHRQoL impact. Elderly that did not need dental prosthesis demonstrated a lower impact on OHRQoL (P<0.01). Elderly with TMD presented a higher PR of having higher OHRQoL impact (P<0.01). It was concluded that higher impact on OHRQoL was associated with marital status, non-users of dental floss and those with TMD. No need dental prosthesis were associated with lower impact on OHRQoL.

Resumo O estudo avaliou a qualidade de vida relacionada à saúde bucal (QVRSB) e fatores associados em idosos. Estudo transversal foi realizado em 287 idosos de Cruz Alta, Brasil. As seguintes variáveis foram coletadas: idade, sexo, etnia, nível educacional, estado civil, aposentadoria, histórico médico/odontológico, exposição ao fumo/álcool, hábitos de higiene oral, uso e necessidade de prótese, dentes ausentes, sintomas de desordem temporomandibular (DTM), estado nutricional e halitose. QVRSB foi avaliada pelo OHIP-14 (Perfil de Impacto de Saúde Bucal) e categorizado em baixo impacto (soma dos escores ≤6) e alto impacto (soma dos escores ≥7). Associações foram avaliadas por regressão de Poisson com variância robusta. A média OHIP-14 foi 5,92±8.54. Indivíduos divorciados e aqueles que reportaram não usar fio dental apresentaram 77% e 54%, respectivamente, maior razão de prevalência (RP) de terem maior impacto na QVRSB. Idosos que não necessitam próteses dentárias demonstraram menor impacto na QVRSB (P<0,01). Além disso, idosos com DTM apresentaram maior RP de terem maiores escores de OHIP-14 (P<0,01). Foi concluído que maiores impactos na QVRSB estão associados com estado civil, não uso de fio dental e DTM. Não necessitar de prótese dentária esteve associado com menores impactos na QVRSB.

Effect of Obesity and/or Ligature-induced Periodontitis on Aortic Wall Thickness in Wistar Rats / Efeito da obesidade e/ou periodontite induzida por ligadura na espessura da parede da aorta em ratos wistar

ABSTRACT The purpose of this study was to evaluate aortic wall thickness after periodontal disease and/or obesity induction in a Wistar rat model. Sixty male Wistar rats were randomly divided into four groups: control (CT), periodontal disease (PD), obesity (OB), and obesity plus periodontal disease (OB+PD). Groups OB and OB+PD received cafeteria diet for 17 weeks. After they had acquired obesity (week 12), periodontal disease was induced by placing a silk ligature on the maxillary right second molar of groups PD and OB+PD. During the experimental period, body weight and Lee index were assessed. Mean alveolar bone loss (ABL) was evaluated, and aortas were prepared for histometric analysis of the aortic wall by ImageJ software. Body weight and Lee index increased in rats exposed to cafeteria diet. Mean ABL was higher in Groups PD and OB+PD than in control and OB (p<0.05). ABL was 18% higher in Group OB+PD than in Group PD, with statistically significant difference (p<0.001). Aortas were thicker in Groups OB and OB+PD than in control and PD groups, respectively (2.31mm ± 0.28 and 2.33 ± 0.29 vs. 2.18 ± 0.26 and 2.14 ± 0.27). Group OB differed significantly from the control group (p=0.036), and OB+PD and OB differed significantly from PD (p=0.004 and p= 0.001, respectively). Obesity alters aortic wall thickness in Wistar rats. However, the presence of periodontal disease did not affect the aortic wall thickness under the conditions of the present study.

RESUMO O objetivo deste estudo foi avaliar a espessura da parede da aorta após modelos de indução de doença periodontal e/ou obesidade em ratos Wistar. Sessenta ratos Wistar machos foram aleatoria mente divididos em quatro grupos: controle (CT), doença periodontal (DP), obesidade (OB), obesidade mais doença periodontal (OB+DP). Os grupos OB e OB+DP rece beram dieta de cafeteria por 17 semanas. Após de adquirirem obesidade, (semana 12), doença periodontal foi induzido pela colocação de ligaduras de seda no segundo molar superior direito dos grupos DP e OB+DP. Durante o período experi mental, o peso corporal e índice de Lee foram obtidos. Média de perda óssea alveolar (POA) foi avaliada e as aortas preparadas para análise histométrica da parede aórtica (em mm) pelo software ImageJ. Ratos expostos a dieta de cafeteria demonstraram um aumento do peso corporal e do índice de Lee. Uma POA media maior foi observada nos grupos DP e OB+DP comparado aos grupos controle e OB (p<0.05). O grupo OB+DP, quando comparado ao grupo DP, apresentou POA 18% maior e essa diferença foi estatisticamente significativa (p<0.001). Os grupos OB e OB+DP exibiram uma espessura de aorta maior comparado aos grupos DP e controle, respectivamente (2.31 ± 0.28 e 2.33 ± 0.29 vs. 2.18 ± 0.26 e 2.14 ± 0.27). Diferenças significativas foram observadas nas comparações dos grupos OB e controle (p=0,036), e OB+DP e OB comparado ao grupo DP (p=0.004 e p= 0.001, respectivamente). A obesidade parece afetar a espessura da parede da aorta em ratos Wistar. Entretanto, a presença de doença periodontal não afetou a espessura da parede da aorta sob as condições do presente estudo.

Concern with dental appearance and associated factors among the elderly of two southern Brazilian cities: a cross-sectional study

Aim: This study aimed to evaluate the prevalence of concern with dental appearance (DA) and associated factors among the elderly of two southern Brazilian cities. Methods: A cross-sectional study was conducted in the cities of Cruz Alta and Veranópolis, Brazil. Oral health examination and a structured questionnaire were applied. Questions from the PCATool-SB Brasil tool and the Questionnaire about Teeth Appearance, both validated to Brazilian samples, were used. The collected independent variables were: sex, age, ethnicity, education level, marital status, retirement, health problem, use of medication, smoking exposure, alcohol exposure, access to the dentist, toothbrushing frequency, use of dental floss, edentulism, use of and need for dental prosthesis. Concern with DA was dichotomized into yes/no. Associations between dependent and independent variables were assessed by Chi-square or Mann-Whitney tests. Moreover, uni- and multivariate analyses were conducted by Poisson regression with robust variance. Level of significance was established as p<0.05. Results: The prevalence of concern with DA was 18.8% (n=107). The prevalence ratio (PR) of concern with DA decreased 5.8% for each year increase (PR:0.942; 95% confidence interval [95%CI]:0.911­0.973). Elderly without access to the dentist in the last 12 months presented 62.5% (p=0.006) higher PR of concern with DA when compared to those with access to dental care. Dentate elderly showed 219% higher PR for concern with DA (PR:2.197; 95%CI:1.364­3.539) in comparison to edentulous individuals. Conclusion: Prevalence of concern with DA was low and associated with demographics, access to dental care and edentulism

Dental Care and the COVID-19 Pandemic: The Precautionary Principle and the Best Available Evidence

Abstract The precautionary principle is part of evidence-based healthcare and is used both preventively and therapeutically when there is no available evidence about how to manage problems/diseases/conditions that are especially life-threatening. However, since it is not always based in the most qualified evidence, it is frequently questioned. The emergence of a highly contagious disease, with increased levels of morbimortality, an acute respiratory syndrome, the so called Coronavirus Disease 2019 (COVID-19), led health professionals to look for the best alternatives to save lives. In this sense, the precautionary principle was evocated. The aim of this paper is to make a reflection about the precautionary principle, the dental profession and COVID-19. It is important to have in mind that in such a disease, guidelines, protocols and approaches can change very fast, since a continuous evaluation of all policies is mandatory. During the pandemic, elective procedures may be restricted, but international organizations removed the recommendation to postpone elective procedures. Clinicians are advised to be updated about their local current policies. On the other hand, there are cases in which in-office dental care is unavoidable, such as individuals with pain, spontaneous bleeding and dental trauma. Biosafety is upmost importance when seeking patients during pandemic. In this sense, it was concluded that precautionary principle should be, therefore, used. However, caution needs to be taken and continuous surveillance necessary.

Brazilian dentistry research productivity: state level socioeconomic, educational and structural factors

Aim: To explore socioeconomic, educational and research factors associated with dental research productivity at the state level in Brazil. Methods: The authors used the Scopus database to identify dental articles published from 2006 to 2016 associated with Brazilian universities at the state level. Several social, economic, educational and research structure variables were obtained from the census and National Research Council to predict the rate of articles per 100 thousand inhabitants among the 27 Brazilian states. Rates were fitted in linear weighted least-squared regression with stepwise technique. Twenty-two variables were grouped in six blocks (social, economic, general education, dental education, research workforce and structure). Results: A total of 21189 articles were published, and the state of São Paulo accounted for 46%, followed by Rio Grande do Sul with 9.4%; four states did not publish any articles. There were an average (± standard deviation) of 2.6 (±1.98) published articles per 100 researchers and 13.4 (±9.6) articles per 100 thousand inhabitants. Research structure and workforce explained 92.4% and 87.2% of state variability, respectively, while the final model explained 94.5%. One extra PhD and one extra undergraduate researcher per 100 thousand inhabitants were associated with 11.3 more and 3.5 fewer articles, respectively, while every 10 points (range 0-100) on the Human Development Index (Education Component) was associated with 3.3 more articles. Conclusion: State scientific output has several associated factors, but research workforce and general education variables seem to be good predictors. Large disparities among state research outputs have been described and must be addressed by research and development policies

Self-reported dentin hypersensitivity in south brazilian adolescents: occurrence and risk indicators / Hipersensibilidade dentinária autorreportada em adolescentes do sul do Brasil: ocorrência e indicadores de risco

ABSTRACT The aim of this study was to assess the occurrence of selfreported dentin hypersensitivity (DH) and its risk indicators in adolescents from a southern Brazilian city. 736 students (1519 years old) were randomly selected from 20 public and private schools in the city of Passo Fundo, Brazil. DH was assessed through the answers on a Likert scale to the question: "Do you have tooth sensitivity?".Participants underwent a clinical examination in which present teeth were counted, and answered an interview based on a structured questionnaire on sociode mographic information, history of dental bleaching, orthodontic treatment and oral health habits. The dependent variable (DH) was dichotomized at the point where hypersen sitivity occurs fairly often or always. Data were analyzed by multivariable logistic regression, including demographic, health history, socioeconomic and behavioral variables. Results: 556 (75.5%) subjects reported having sensitive teeth never, rarely or sometimes, while 180 (24.5%) reported having sensitive teeth fairly often or always. In the final model, number of present teeth, age, skin color, flossing, smoking, bleaching and orthodontic history were not associated with selfreported DH. Females showed significantly greater chance of having DH than males [odds ratio (OR)=1.91; 95% confidence interval (95%CI) 1.342.72]. The likelihood of DH in students at public schools was 63% higher than in those at private schools (OR=1.63 95%, CI 1.012.75). DH is a common perception among adolescents and is associated with female gender and studying at public schools.

RESUMO O objetivo deste estudo foi determinar a ocorrência de hipersensibilidade dentinária (HD) autorreportada e seus indicadores de risco de uma cidade do sul do Brasil. 736 estudantes (1519 anos) foram selecionados aleatoriamente em 20 escolas públicas e privadas da cidade de Passo Fundo, Brasil. HD foi aferida pela resposta em escala Likert à pergunta: "Você tem sensibilidade nos dentes?". O exame clínico incluía a contagem de dentes presentes e um questionário estruturado foi aplicado incluindo dados sociodemográficos, história de clareamento dental, tratamento ortodôntico e hábitos de saúde bucal.A variável de pendentes (HD) foi dicotomizada no ponto que a hipersensibilidade ocorria repetidamente ou sempre. Os dados foram analisados por meio de regressão logística multivariada, incluindo variáveis demográficas, histórico de saúde, dados socioeconômicos e comportamentais. Nos resultados 556 (75.5%) indivíduos reportaram experiência de sensibilidade dentinária, nunca raramente ou às vezes, enquanto 180 (24.5%) reportaram ter sensibilidade repetidamente ou sempre. No modelo final, número de dentes presentes, idade, raça, uso do fio dental, tabagismo, histórico de clareamento dental e tratamento ortodôntico não foram associados com HD autorreportada. Mulheres mostraram uma chance significativamente maior de ter HD comparado aos homens [odds ratio (OR)=1,90; 95% intervalo de confiança (95%CI) 1.332.71]. Frequentar escolas públicas aumentou a chance de HD em 63% comparado com escolas particulares (OR=1,63 95%IC 1.012.75). HD é uma percepção comum entre adolescentes e está associada com gênero feminino e estudar em escolas públicas.

Effects of low molecular weight heparin on alveolar bone loss in wistar rats

Abstract This study aimed to assess the effects of low molecular weight heparin (LMWH) on alveolar bone loss (ABL), blood count, and counting of megakaryocytes and adipocytes in male Wistar rats. Forty male 60-day Wistar rats were randomly divided into four groups: Control (C), Periodontal Disease (PD), Heparin (Hp) and Heparin + Periodontal Disease (Hp+PD). LMWH was applied for 60 days at doses of 1 ml/kg/day. Blood samples were collected at baseline, 30 and 60. On day-49, PD and Hp+PD groups were subjected to ligature-induced periodontitis around second upper right molar. The left side was assessed as spontaneous alveolar bone loss. Mean ABL in the side with ligature showed significantly different between C (0.35±0.07 mm) and Hp+DP (0.49±0.09 mm) groups (p<0.001), between PD (0.55±0.11 mm) and Hp (0.32±0.06 mm) groups (p<0.001) and between Hp and Hp+DP groups (p<0.001). No significant differences were found among groups for ABL in the side without ligature. Animal weight, food intake, and water consumption showed no statistically significant difference among groups. Megakaryocytes and adipocytes were counted using optical microscopy and no statistically significant differences were found. Within-groups, there were an increase and a decrease, respectively, in the counting of lymphocytes (p=0.005 for C and p=0.009 for Hp+PD groups only) and leukocytes (p=0.003 for C, p=0.001 for PD, p=0.002 for Hp, and p<0.001 for Hp+PD groups). There was no decrease in the number of platelets in the three collection periods. LMWH was not able to affect ABL, but it may change the blood counting, especially increasing lymphocytes.

Resumo O presente estudo objetivou verificar o efeito da heparina de baixo peso molecular (HBPM) sob a perda óssea alveolar (POA), contagem de células sanguíneas, megacariócitos e adipócitos em ratos Wistar machos. Quarenta ratos Wistar de 60 dias foram randomicamente divididos em quatro grupo: Controle (C), Doença Periodontal (DP), Heparina (Hp) e Heparina + Doença Periodontal (Hp+DP). HBPM foi aplicada durante 60 dias em doses de 1 mL/kg/dia. Coletas sanguíneas foram realizadas nos dias 0, 30 e 60. No dia 49, os grupos DP e Hp+DP receberam indução de doença periodontal por ligadura ao redor do segundo molar superior direito. No lado esquerdo, verificou-se perda óssea alveolar espontânea. A média de POA no lado com ligadura mostrou-se estatisticamente diferente entre os grupos C (0,35±0,07 mm) e Hp+PD (0,49±0,09 mm) (p<0,001), entre os grupos DP (0,55±0,11 mm) e Hp (0,32±0,06 mm) (p<0,001) e entre os grupos Hp e Hp+DP (p<0,001). Nenhuma diferente significativa foi observada entre os grupos no lado sem ligadura. Peso dos animais, consumo de ração e ingestão de água não mostraram diferenças significativas entre os grupos. Megacariócitos e adipócitos foram contados por microscopia óptica e nenhuma diferença significativa foi encontrada. Dentro dos grupos, houve um aumento e uma diminuição, respectivamente, na contagem de linfócitos (p=0,005 no grupo C e p=0,009 no grupo Hp+DP somente) e leucócitos (p=0,003 no grupo C, p=0.001 no grupo DP e p=0,002 no grupo Hp e Hp+DP). Não houve diminuição no número de plaquetas nos três períodos de coleta. HBPM não foi capaz de modificar a POA, porém modificou a contagem de células sanguíneas, especialmente aumentando o número de linfócitos.

Impact of smoking on gingival inflammation in representative samples of three South American cities

Abstract The aim of this study was to investigate the impact of smoking on gingival inflammation in a representative sample of 1,650 adults from Santiago (Chile), Porto Alegre (Brazil), and Tucumán (Argentina). A questionnaire was administered to participants to gather demographic and behavioral characteristics, including smoking habits. The participants were clinically examined to obtain gingival index (GI), gingival bleeding index (GBI), visible plaque index (VPI), and calculus presence values. Gingival inflammation was defined as a mean GI > 0.5. Heavy smokers presented significantly lower levels of gingival inflammation, as reflected by both GI and GBI, than both light and moderate smokers, despite their having increased amounts of plaque and calculus. Being 50 years old or older [odds ratio (OR), 1.93], a VPI ≥ 30% (OR, 28.1), and self-reported diabetes (OR, 2.79) were positively associated with detection of gingival inflammation. In conclusion, the occurrence of clinically detectable gingival inflammation was lower in heavy smokers than light and moderate smokers. Older age, diabetes, and visible plaque emerged as risk indicators of gingivitis. Plaque and gingival indices are significantly associated regardless of the smoking status.

The impact of maintenance on peri-implant health

Abstract Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.

Tooth loss and associated factors in adolescents ­ impact of extractions for orthodontic reason

Aim: To investigate tooth loss and its determinants in adolescents, considering the effect of extractions due to orthodontics reasons. Methods: This cross-sectional study was performed in students from public and private schools aged 15-19 years old from Passo Fundo, Brazil. The proportional randomly chosen sample included 736 adolescents. Clinical examinations and interviews were performed. Associations between prevalence of tooth loss and exposure variables studied were analysed by Poisson Regression with uni- and multivariate robust variance in two models. One model comprised students who had experienced tooth loss without orthodontic reasons and the other with all of the subjects presenting tooth loss. Results: Prevalence of tooth loss was 21.1% (mean of 0.42). Higher chances for tooth loss were found in the following features: non-whites (PR=1.72; CI95%:1.15-2.60), poorly schooling mothers (PR=2.2; CI95%:0.96-5.02), from public schools (PR=4.16; CI95%:0.98-17.59), smokers (PR=1.91; CI95%:1.15-3.17). Conclusion: Demographic, socioeconomic and behavioural conditions were strongly associated with tooth loss. These associations were more evident when extractions for orthodontic reasons were not included in the analytical models

Association between history of orthodontic treatment and sociodemographic factors in adolescents / Associação entre histórico de tratamento ortodôntico e fatores sociodemográficos em adolescentes

The aim of this study was to assess history of orthodontic treatment and its determinants in adolescents. This was a crosssectional study conducted in the city of Passo Fundo, Brazil, on a representative sample of adolescents aged 15 to 19 years, regularly enrolled in 20 high schools. A structured questionnaire was applied to assess demographic, behavioral and health variables. The association between history of orthodontic treatment and the dependent variables was analyzed by the chisquare test or Fisher's exact test. Additionally, multivariate regression with robust variance was performed. A total 736 students were examined and interviewed, of whom 57.6% had undergone orthodontic treatment, while 42.4% had not. In the multivariable analysis, the following variables were significantly associated with history of orthodontic treatment: female (PR= 1.26; 95% CI: 1.11 ­ 1.43), white (PR= 1.32; 95% CI: 1.11 ­ 1.56), mothers with higher level of education (PR=1.49; 95% CI: 1.28 ­ 1.74), tooth loss (PR=1.21; 95% CI: 1.06 ­ 1.39), and concern about oral health (PR=0.69; 95% CI: 0.61 ­ 0.78). Attending a private school was not significantly associated with history of orthodontic treatment (p>0.05). This study found a high rate for history of orthodontic treatment among adolescents, associated with gender, ethnicity, adolescent's mother with higher education, and tooth loss. Concern about oral health was a protective factor for orthodontic treatment (AU)

Esse estudo objetivou verificar o histórico de tratamento ortodôntico e seus fatores associados. Esse estudo transversal foi conduzido na cidade de Passo Fundo, Brasil, com uma amostra representativa dos adolescentes regularmente matricu lados no ensino médio, com idades entre 15 e 19 anos, de 20 escolas. Um questionário estrutura foi aplicado para acessar variáveis demográficas, comportamentais e de saúde. As associações entre histórico de tratamento ortodôntico e as variáveis independentes foram analisadas pelos testes de quiquadrado ou exato de Fisher. Além disso, regressão multivariada com variância robusta foi realizada. 736 estudantes foram examinados e entrevistados. Tratamento ortodôntico foi reali zado por 57,6% dos adolescentes, enquanto que 42,4% dos participantes não o mencionaram. Na análise multivariada, as seguintes variáveis estiveram significativamente associadas com histórico de tratamento ortodôntico: sexo feminino (PR= 1,26; 95%CI: 1,11 ­ 1,43), branco (PR= 1,32; 95%CI: 1,11 ­ 1,56), mães com alto nível educacional (PR=1,49; 95%CI: 1,28 ­ 1,74), perda dentária (PR=1,21; 95%CI: 1,06 ­ 1,39) e preocupação com a saúde bucal (PR=0,69; 95%CI: 0,61 ­ 0,78). Ir a uma escola privada não esteve significativamente associado com histórico de tratamento ortodôntico (p>0,05). Esse estudo demonstrou que altos níveis de histórico de tratamento ortodôntico são encontrados em adolescentes e isso está associado com sexo, etnia, alta escolaridade da mãe do adolescente e perda dentária. Preocupação com a saúde bucal mostrouse como um fator protetor para o tratamento ortodôntico (AU)

Oral health related quality of life among pregnant women: a randomized controlled trial

Abstract: The aim of the present study was to compare negative impacts of oral conditions in Oral Heath Related Quality of Life (OHRQoL) assessed by the Oral Health Impact Profile-14 (OHIP-14) scores in pregnant women receiving or not comprehensive periodontal treatment. This randomized controlled clinical trial included pregnant women aged between 18 and 35 years old. Participants were randomized in a test group with 96 and a control group with 114 women. Patients in the test group received comprehensive periodontal treatment, supra and subgingival scaling and root-planning and periodontal maintenance appointments. The OHIP-14 was applied before and after treatment. The primary outcome was changes in OHIP-14 scores after follow-up period. The impact of having received or not comprehensive periodontal treatment on the change of the OHIP-14 scores was also investigated. Both groups showed significant reduction in OHIP-14 scores and effect size for the test group was 0.60 and 0.36 for the control group. Multinomial logistic regression analysis showed that participants of the control group had 5.9-fold odds (CI 95% 1.88-18.52) of worsening in OHIP-14 scores and their perception of oral conditions in relation to test group. Comprehensive periodontal treatment during pregnancy can reduce the negative impacts in OHRQoL.

A multicenter study of oral health behavior among adult subjects from three South American cities

Abstract The aims of this study were to describe the self-reported oral hygiene habits, dental visit frequency, and gingival bleeding perception in adult populations from three South American cities, and also to assess the association of these variables with sociodemographic data and with the clinical presence of plaque and gingival inflammation. Five-hundred and fifty adult subjects from each city (Porto Alegre, Brazil; Tucumán, Argentina; Santiago, Chile) received full mouth examinations to determine visible plaque and gingival index. A structured questionnaire on demographics, habits, attitudes and knowledge of oral health was also administered. The data were analyzed according to dental visit frequency, toothbrushing frequency, interproximal tooth cleaning frequency, subjects' perception of gum bleeding, and proportion of subject sites with VP and bleeding sites. Analysis of the association among the variables was performed using either a chi-square test or Fischer's exact test. Toothbrushing twice a day or more was reported by 84.2% of the subjects, but only 17.7% reported daily interdental cleaning, and 60.2% reported visiting a dental clinic only in an emergency. Only 2.97% had no bleeding sites, whereas 33.7% had 50% or more bleeding sites. Regular interdental self-cleaning and a dental visit every 3-6 months was associated with less plaque and less gingival bleeding. More than 12 years of education was associated with healthier habits, less bleeding and plaque scores. In conclusion, the oral health behavior of South American adult subjects from these cities is below the international recommendations, especially in relation to interdental cleaning and regular dental visits.