Unvaccinated periodontal patients with a history of COVID-19: clinical findings in a Dental School setting

Abstract This study analyzed the periodontal clinical data of individuals with a history of COVID-19 treated in a dental school during the pandemic in 2021 before vaccination. Methods: This analysis included individuals older than 18 years with no history of systemic disorders other than systemic arterial hypertension. Individuals who had COVID-19 were classified according to the World Health Organization as asymptomatic, with mild, moderate, severe, or critical symptoms. Results: A total of 95 individuals were evaluated, which included 24 with a history of COVID-19. Seventeen percent had been asymptomatic, 21% had mild, 25% moderate, 21% severe, and 17% critical symptoms, including intubation. Individuals with no history of COVID-19 presented significantly lower measurements of probing depth (p=0.003; Mann-Whitney test) and clinical attachment level (p=0.002) compared to individuals with a history of COVID-19. A significant negative association was found between bleeding on probing and the severity of characteristics of COVID-19 (rho= -0.233; p=0.023). Conversely, positive associations between the values of probing depth (rho= 0.292; p=0.004) and mean clinical attachment level (rho= 0.300; p=0.003) and the characteristics of COVID-19 were found. Conclusions: The periodontal data shows that patients who had COVID-19 before vaccination may present a worse periodontal status when compared to patients in the same clinical setting with no history of COVID-19. However, a more extensive study should confirm it with more participants.

Resumo Este estudo analisou os dados clínicos periodontais de indivíduos com histórico de COVID-19 tratados em uma escola de odontologia durante a pandemia em 2021, antes da vacinação. Métodos: Essa análise incluiu indivíduos maiores de 18 anos sem histórico de distúrbios sistêmicos, exceto hipertensão arterial sistêmica. Os indivíduos que tiveram COVID-19 foram classificados de acordo com a Organização Mundial da Saúde como assintomáticos, com sintomas leves, moderados, graves ou críticos. Resultados: 95 indivíduos foram avaliados, incluindo 24 com histórico de COVID-19. 17% eram assintomáticos, 21% tinham sintomas leves, 25% moderados, 21% graves e 17% críticos, incluindo intubação. Os indivíduos sem histórico de COVID-19 apresentaram medidas significativamente mais baixas de profundidade de sondagem (p=0,003; teste de Mann-Whitney) e nível de fixação clínica (p=0,002) em comparação com indivíduos com histórico de COVID-19. Foi encontrada uma associação negativa significativa entre o sangramento à sondagem e a gravidade das características da COVID-19 (rho= -0,233; p=0,023). Por outro lado, foram encontradas associações positivas entre os valores de profundidade de sondagem (rho = 0,292; p = 0,004) e o nível médio de apego clínico (rho = 0,300; p = 0,003) e as características da COVID-19. Conclusão: Os dados periodontais mostraram que os pacientes que tiveram COVID-19 antes da vacinação podem apresentar um pior estado periodontal quando comparados a pacientes no mesmo ambiente clínico sem histórico de COVID-19. No entanto, um estudo mais extenso deve ser realizado para confirmar tal achado com maior número de participantes.

Tratamento de periodontite estágio III localizado grau C em um indivíduo fumante: um relato de caso / Treatment of periodontitis stage III localized grade C in smoker individual: a case report

Objetivo: A periodontite é uma doença infecto-inflamatória que acomete os tecidos de inserção periodontal, e ser fumante representa um risco modificável significativo para todos os graus da doença. Ainda, indivíduos fumantes apresentam uma resposta inflamatória alterada quando comparados a não fumantes. Nesse contexto, o objetivo deste estudo foi reportar um relato de caso de tratamento periodontal de paciente fumante pesado. Relato de caso: O paciente DRS, sexo masculino, 22 anos, foi encaminhado à Faculdade de Odontologia da Universidade Federal de Pelotas (UFPel) com a queixa principal de necessidade de "realização de uma limpeza dentária". Na anamnese, relatou fumar 20 cigarros ao dia, há 7 anos (7 maços-ano). Na consulta inicial, foi encontrado índice de placa visível (IPV) de 100% e índice de sangramento gengival (ISG) de 66,67%. Foi encontrado cálculo supragengival como fator retentivo de placa (FRP) em 46,30% dos sítios. Estabeleceu-se o diagnóstico de periodontite estágio III localizado grau C. Os exames periodontais foram realizados por um único pesquisador calibrado e optou-se pelo tratamento periodontal não cirúrgico. Ao exame de 12 meses, o paciente apresentou IPV de 23,45% e ISG de 22,83%. Houve ausência de FRP. De uma forma geral, foi possível constatar a diminuição significativa das bolsas periodontais, bem como o ganho significativo de inserção clínica periodontal. Considerações finais: Dessa forma, é possível concluir a efetividade da terapia periodontal não cirúrgica, aliada à manutenção periodontal e instruções de higiene para o tratamento de periodontite estágio III, grau C, em paciente fumante.(AU)

Objective: Periodontitis is an infect-inflammatory diseases that affects the periodontal attachment tissues, and being smoker represents a significant modifiable risk for all degrees of the disease. Moreover, smokers have an altered inflammatory response when compared to non-smokers. Therefore, the aim of this study was to report a case report of periodontal treatment of a heavy smoker. Case report: A patient DRS, male, 22 years old, was referred to the School of Dentistry of the Federal University of Pelotas (UFPel) with the main complaint of the need to "perform a dental cleaning". During the anamnesis, he reported smoking 20 cigarettes a day for 7 years (7 pack-years). In the initial appointment, a visible plaque index (VPI) of 100% and a gingival bleeding index (GBI) of 66.67% were found. Supragingival calculus was found as a plaque retentive factor (PRF) in 46.30% of the sites. The diagnosis of periodontitis stage III localized grade C was established. Periodontal examinations were performed by a single calibrated researcher and non-surgical periodontal treatment was chosen. At the 12-month appointment, the patient had an VPI of 23.45% and an GBI of 22.83%. There was absence of PRF. In general, it was possible to observe a significant decrease in periodontal pockets, as well as a significant gain in periodontal clinical attachment. Final considerations: Thus, it is possible to conclude the effectiveness of non-surgical periodontal therapy, combined with periodontal maintenance and hygiene instructions for the treatment of periodontitis stage III localized grade C in a smoker.(AU)

Análisis Microbiológico del Fluido Crevicular para Determinar Presencia de Candida albicans en Bolsas Periodontales de Sujetos Adultos

RESUMEN: El objetivo de este trabajo fue establecer la asociación entre la profundidad de bolsa periodontal y la presencia de Candida albicans en el fluido crevicular de sujetos adultos con salud gingival y periodontitis, recibidos en el área de la Maestría en Periodoncia de un Centro Odontológico. El estudio estuvo conformado por 81 muestras de fluido crevicular obtenidas con un cono de papel Nº 40. Fueron distribuidas en tres grupos: G1: 20 muestras del grupo control (salud gingival), G2: 32 muestras de bolsas con profundidad de 4-6 mm y G3: 29 muestras de bolsas con profundidad >6mm; que fueron colocadas en Caldo Sabouraud Dextrosa para su trasporte al laboratorio, donde fue cultivado en Agar Sabouraud Dextrosa por 48 h a 37 ºC. Posteriormente se realizó tinción a las colonias y prueba de tubo germinal para la confirmación de la presencia de Candida albicans. Del total de muestras, 12 (14,8 %) evidenciaron presencia de Candida albicans, de las cuales 6 (18,8 %) pertenecían al grupo de bolsas con profundidad de 4-6 mm y las otras 6 (20,7 %) pertenecían al grupo de bolsas con profundidad >6mm. En el grupo control, no se observó presencia de Candida albicans. Los pacientes con salud gingival no presentaron Candida albicans. Sin embargo, la Candida albicans estuvo presente en pacientes con bolsas periodontales de 4-6 mm y >6 mm (14,8 %). No se encontró diferencia estadísticamente significativa entre presencia de Candida albicans con profundidad de bolsa periodontal (p=0,849).

ABSTRACT: The aim of this work was to establish the association between the depth of the periodontal pocket and the presence of Candida albicans in the crevicular fluid of adult subjects with gingival health and periodontitis, received in the area of the Master in Periodontology of a Dental Center. The study consisted of 81 samples of crevicular fluid obtained with a No. 40 paper cone. They were distributed into three groups: G1: 20 samples from the control group (gingival health), G2: 32 samples from pockets with depth of 4-6 mm and G3: 29 samples from pockets with depth >6 mm; which were placed in Sabouraud Dextrose Broth for transport to the laboratory, where it was cultivated in Sabouraud Dextrose Agar for 48h at 37 ºC. Subsequently, colony staining and a germ tube test were performed to confirm the presence of Candida albicans. Of the total samples, 12 (14.8 %) showed the presence of Candida albicans, of which 6 (18.8 %) belonged to the group of pockets with depth of 4-6 mm and the other 6 (20.7 %) belonged to the group of bags with depth> 6mm. In the control group, no presence of Candida albicans was observed. The patients with gingival health did not present Candida albicans. However, Candida albicans was present in patients with periodontal pockets of 4-6 mm and >6 mm (14.8 %). No statistically significant difference was found between the presence of Candida albicans with depth of the periodontal pocket (p=0.849).

Applications of diode laser in periodontal therapy ­ clinical guidelines and tips / Aplicações do laser de diodo na terapia periodontal ­ Orientações e dicas clínicas

Os lasers de diodo tornaram-se ferramentas clínicas populares devido ao seu tamanho compacto, acessibilidade, facilidade de uso e versatilidade. O objetivo deste artigo é apresentar as diversas aplicações de um laser de diodo na prática diária e destacar os aspectos técnicos do uso do laser de diodo para o mesmo. Esta série de casos relata o manejo de seis diferentes situações clínicas com laser de diodo: anquiloglossia, bolsa periodontal, zênites gengivais desiguais, mucocele, hipersensibilidade dentinária e gengiva hiperpigmentada. Os pacientes foram tratados com laser de diodo de 940 nm com potência de 0,5 W a 2 W dependendo do caso. A cicatrização pós-operatória transcorreu sem intercorrências na maioria dos casos e foram observados resultados favoráveis. O laser de diodo ofereceu vantagens cirúrgicas como ­ campo seco, desinfecção do sítio cirúrgico e cirurgia sem sutura. Além disso, os autores observaram melhor satisfação do paciente devido à mínima dor ou edema pós-operatório e alívio imediato em caso de hipersensibilidade dentinária. Este artigo apresenta as aplicações cirúrgicas e não cirúrgicas do laser de diodo juntamente com os aspectos técnicos. Embora a literatura disponível não forneça evidências substanciais para comparação direta do laser de diodo com as técnicas convencionais, é seguro concluir que o laser de diodo é uma ferramenta eficiente para uso rotineiro em odontologia.(AU)

The diode lasers have become popular clinical tools because of their compact size, affordability, ease of use and versatility. The aim of this paper is to put forth the various applications of a diode laser in day to day practice and highlight the technical aspects of diode laser use for the same. This case series reports management of six different clinical situations with diode laser namely ­ ankyloglossia, periodontal pocket, unequal gingival zeniths, mucocele, dentinal hypersensitivity and hyper-pigmented gingiva. The patients were treated with 940 nm diode laser with power settings from 0.5 W to 2 W depending on the case. The post-operative healing was uneventful in most cases and favourable outcomes were observed. The diode laser offered surgical advantages like ­ dry field, disinfection of surgical site and suture-less surgery. In addition, the authors observed better patient satisfaction owing to minimal post-operative pain or swelling and immediate relief in case of dentinal hypersensitivity. This paper presents both surgical and non-surgical applications of diode laser along with the technical aspects. Even though the available literature does not lend substantial evidence for direct comparison of diode laser with conventional techniques, it is safe to conclude that diode laser is an efficient tool for routine use in dentistry.(AU)

Investigation of dental caries and periodontal conditions in maintenance hemodialysis patients / 口腔疾病防治

Objective@#To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease.@*Methods @#A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss.@*Results@#The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05).@*Conclusion@#The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.

Clinical application of molar uprighting for impacted mandibular second molars / 口腔疾病防治

Objective @#To investigate the effect of the clinical application of molar uprighting in the treatment of impacted mandibular second molars.@*Methods@# A total of 16 cases of impacted mandibular second molars were chosen, and the impacted molars were treated with straight wire appliances and molar uprighting. Before and after treatment, the vertical angle of the molar, the height of the distal buccal tip, the height of the distal buccal tip of the anchorage molar, the depth of the periodontal pocket and the height of the alveolar bone were measured. Moreover, the treatment cycles of the third molar extraction group, the premolar group and the nonextraction group were compared.@*Results @#All impacted molars responded well to treatment. The vertical time of impacted molars was (1.34 ± 0.45) months, (2.20 ± 0.57) months, and (2.30 ± 0.45) months in the third molar extraction group, the premolar extraction group and the nonextraction group, respectively. The treatment time of the third molar extraction group was shorter than that of the other two groups, and the difference was statistically significant (P < 0.05). After treatment, the inclination of impacted second molars increased by (25.94 ± 8.85)°, the elongated distal buccal tip was depressed by (1.00 ± 1.48) mm, the depth of the proximal and middle periodontal pocket of impacted molars decreased by (1.21 ± 1.03) mm, and the height of the alveolar bone of the proximal and middle adjacent surfaces of impacted second molars increased by (4.57 ± 1.45) mm; these differences were statistically significant (P < 0.05). There was no significant difference in the height of the distal buccal tip of the first molar before and after treatment (P > 0.05).@*Conclusion @#Molar uprighting is an efficient, reliable, and convenient method that can shorten the treatment period. Extraction of crowded third molars is beneficial for the vertical and periodontal health of impacted second molars.

Prevalence and Molecular Analysis of Novel Newly Identified Periodontal Pathogens in Subgingival Plaque Samples of Saudi Patients with Chronic Periodontitis

Objective: To evaluate the prevalence of novel newly identified periodontal pathogenic strains in subgingival plaque samples and relate it with bleeding on probing, probing pocket depth and age. Material and Methods: 268 chronic periodontitis patients with a mean age of 46.0 ± 6.0 years were included. The following microorganisms were evaluated: Campylobacter gracilis (Cg), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), and Tannerella forsythia (Tf). Full mouth examination was registered; the probing pocket depth and clinical attachment level were assessed at six sites per tooth. Dental subgingival plaque samples were taken in the deepest pocket per arch in the maxilla and mandible. DNA analysis was performed using DNA-strip technology. Pearson's correlation coefficient was used for statistical analysis. Results: Porphyromonas gingivalis and Tannerella forsythia were detected at high level of 80% and 82% respectively. F nucleatum revealed a rate of 94%. Bacterial load significantly increased by increasing mean probing depth of the examined sites. Pearson's coefficient was the highest for Pg (r=0.62, p=0.0001) and the lowest for Cg (r=0.08, p=0.04). The bacterial load significantly increased by increasing the number of bleeding sites; Pearson's coefficient varied from r= 0.14 for Pg (p=0.01) to r=0.39 for Tf (p=0.001). Conclusion: It was confirmed the presence of main putative periodontal pathogens detectable in Saudi periodontal subjects, also providing a comprehensive view for correlation of these putative periodontal pathogens with the increase in probing pocket depth to the presence and load of all the bacterial species.

Scaling and Root Planing Effect to mRNA Expression of Matrix Metalloproteinase-9 and Periodontal Clinical Parameters on Chronic Periodontitis

Abstract Objective: To evaluate the relationship between the mRNA transcription level of Matrix Metalloproteinase-9 (MMP-9) and the selected clinical periodontal healing at one month of scaling and root planing. Material and Methods: A total of six chronic periodontitis patients and one periodontally healthy subject were recruited. The gingival crevicular fluid was collected from all subjects, and the expression level of MMP-9 mRNA was measured by quantitative real-time PCR. Pocket depth, papilla bleeding index, and clinical attachment loss were measured on day 1 at baseline and day 30. Scaling and root planing was performed on day 1. Data were analyzed using SPSS 22.0 software Results: In comparison to the control, periodontal clinical parameters in the treatment group were significantly reduced after scaling and root planing. MMP-9 mRNA expression did not show a significant change after the 30th day. A weak correlation was noted between the MMP-9 mRNA transcription level and the changed PBI measurement Conclusion: Scaling and root planing is clinically effective for chronic periodontitis with a 4-6 mm pocket, whereas the expression of MMP-9 mRNA was not altered. Further studies with a more extended observation period are needed to confirm or reject the present findings.

Enfermedad periodontal en niños y adolescentes. A propósito de un caso clínico / Periodontal disease in children and adolescents. Case report

RESUMEN: Dentro de las enfermedades gingivales en niños y adolescentes el cuadro clínico más prevalente es la gingivitis asociada a la placa bacteriana; más aún, es la afección más prevalente dentro de todas las enfermedades periodontales. El progreso de la gingivitis a la periodontitis implica la interrelación de una serie de factores de riesgo y factores contribuyentes que progresarán en la pérdida de la inserción periodontal. El presente artículo tiene como objetivo resumir las principales características de la enfermedad periodontal en niños, así como mostrar la secuencia clínica del diagnóstico y tratamiento de un paciente niño con enfermedad periodontal localizada a quien se realizó el tratamiento periodontal básico para revertir los efectos causados en el periodonto de inserción y de soporte. Resultados: El seguimiento del caso clínico mostró una reducción del índice de sangrado, índice de placa bacteriana e índice de higiene oral. Conclusión: Se concluye que la evaluación periodontal de pacientes pediátricos y adolescentes debe ser parte rutinaria del examen odontológico, y que un tratamiento conservador permite revertir los efectos de la enfermedad periodontal en este tipo de pacientes.

ABSTRACT: Gingivitis is the most prevalent clinical condition in the gum diseases presented in children and adolescents, as well as being the most prevalent of all periodontal diseases. The progression of gingivitis to periodontitis involves the interplay of a number of risk and contributing factors that will progress into loss of periodontal attachment. This article aims to summarise the main characteristics of periodontal disease in children and to present the clinical diagnosis and treatment of a patient with localised periodontal disease on whom the basic periodontal treatment was performed to reverse the effects caused by the loss of periodontal attachment. Results: The monitoring of the case showed a reduction in bleeding index, plaque index, and oral hygiene index. Conclusion: It is concluded that periodontal evaluation of children and adolescents should be part of the routine dental examination as a conservative treatment can reverse the effects of periodontal disease in these patients.

Relaciones endoperiodontales: una frontera transitable / Endoperiodontal relationships: a passable border

La existencia de una íntima conexión entre el conducto radicular y el ligamento periodontal, ha dado lugar a lo que se conoce como relaciones endoperiodontales. Esto se debe a la presencia de varias vías anatómicas de comunicación entre ambas entidades: el foramen apical, los forámenes laterales pertenecientes a conductos accesorios y conductillos dentinarios en zonas de ausencia del cemento dentario protector. Los microorganismos y sus agentes tóxicos tienen la capacidad de afectar ambos tejidos en esa interrelación física y biológica. El diagnóstico diferencial entre enfermedad endodóntica y periodontal es de vital importancia para la elección del tratamiento y el pronóstico a distancia.

The intimate connection between the root canal and theperiodontal ligament generates a concept that is known asendo-periodontal relationships. This is due to the presence ofseveral anatomical communications between them: apical foramen,lateral foramina and dentinal tubules denuded of theircementum coverage. Microorganisms and their toxic agentscan affect both tissues due to this physical and biological interrelation.Proper differential between endodontic and periodontaletiology is vital to the accurate choice of treatment andfor the long term prognosis.

Presencia de bacilos negro pigmentantés en bolsas periodontales de pacientes diabéticos tipo 2 y su relación con el control glicémico / Presence of bacilli black pigments in periodontal pockets of patients with type 2 diabetes and its relationship with the glycemic level

Objetivos: El estudio tuvo como objetivo identificar la presencia de bacilos negro pigmentantés (BNP) en bolsas periodontales de pacientes diabéticos tipo 2 y determinar una relación con su control glicémico. Material y métodos: Se evaluó un número total de 46 pacientes que cumplían con los criterio de inclusión en el estudio, de los cuales quedaron 20 por haber concluido con todas las pruebas realizadas en el estudio, como el estudio microbiológico de sus muestras de placa subgingival y las pruebas de hemoglobina glicosilada que se realizó en forma periódica en los 3 meses que se evaluó a los pacientes. Resultados: De los 20 pacientes evaluados que completaron todas sus pruebas, 14 eran mujeres y 6 varones, con un rango de edad de 40 a 68 años, pudiéndose identificar estos bacilos negro pigmentantés (BNP) en el 20 % de casos con diagnóstico de periodontitis moderada a severa (periodontitis moderada: bolsa periodontal de 6 a 7 mm y Periodontitis severa: bolsa periodontal mayor de 7 mm), presentando estos pacientes un control glicémico de condición bueno a moderado (control bueno: = 6.9 % HbAc1y control moderado: 7 a 7.9 % HbAc1). La prueba estadística realizada para valorar la relación presencia BNP y el control glicémico fue de Chi cuadrado el cual no determino significancia de la relación (P > 5 %). Conclusiones: Se identificó la presencia de BNP en pacientes diabéticos tipo 2 pero más relacionado a pacientes con cuadros de periodontitis moderada a severa y con un control glicémico de bueno a moderado, no presentando significancia estadística.

Objectives: The study aimed to identify the presence of bacilli black pigments in periodontal pockets of type 2 diabetic patients and determine a relationship with glycemic control. Material and methods: A total of 46 patients who met the criteria for inclusion in the study, of which were 20 for having completed all tests in the study, such as microbiological analysis of samples of subgingival plaque and evaluated glycosylated hemoglobin tests held periodically in the 3 months patients were assessed. Results: Of the 20 patients evaluated, 14 were women and 6 men, with an age range of 40 to 68 years, being able to identify these black bacilli pigments (BNP) in 20% of cases diagnosed with moderate to severe periodontitis (periodontitis. moderate: periodontal pocket of 6 to 7 mm and severe periodontitis: greater periodontal pocket of 7 mm), presenting these patients glycemic control in good condition to moderate (good control: = 6,9 % HbAc1 and moderate control: 7 to 7,9 % HbAc1) . The statistical test performed to assess the presence relationship BNP and glycemic control was Chi square which does not determine significance of the relationship (P> 5%). Conclusions: It was possible to identify the presence of BNP in patients with type 2 diabetes but more related to patients with moderate to severe pictures periodontitis and with good glycemic control to moderate, showing no statistical significance.

Improved accuracy in periodontal pocket depth measurement using optical coherence tomography

PURPOSE: The purpose of this study was to examine whether periodontal pocket could be satisfactorily visualized by optical coherence tomography (OCT) and to suggest quantitative methods for measuring periodontal pocket depth. METHODS: We acquired OCT images of periodontal pockets in a porcine model and determined the actual axial resolution for measuring the exact periodontal pocket depth using a calibration method. Quantitative measurements of periodontal pockets were performed by real axial resolution and compared with the results from manual periodontal probing. RESULTS: The average periodontal pocket depth measured by OCT was 3.10±0.15 mm, 4.11±0.17 mm, 5.09±0.17 mm, and 6.05±0.21 mm for each periodontal pocket model, respectively. These values were similar to those obtained by manual periodontal probing. CONCLUSIONS: OCT was able to visualize periodontal pockets and show attachment loss. By calculating the calibration factor to determine the accurate axial resolution, quantitative standards for measuring periodontal pocket depth can be established regardless of the position of periodontal pocket in the OCT image.

Estado periodontal y su posible relación con variables funcionales de la oclusión / Periodontal state and its possible relationship to functional occlusal variables

Entre noviembre del 2010 y septiembre del 2011 se realizó un estudio descriptivo transversal para caracterizar la posible relación del factor oclusal con el estado periodontal de pacientes atendidos en el servicio de Periodoncia de la Clínica Estomatológica «Victoria de Santa Clara¼. Constituyeron unidades de análisis 40 pacientes y 1 112 dientes. Se determinó el estado periodontal al aplicar los índices periodontal de Russell y de movilidad de Miller, la medición de la profundidad de las bolsas periodontales y la presencia o no de pérdidas óseas. Se estudiaron variables oclusales funcionales seleccionadas. No se obtuvo correlación entre la profundidad de las bolsas y las alteraciones funcionales oclusales, excepto en el contacto exagerado. Las pérdidas angulares presentaron mayor profundidad de bolsas. La distribución de los dientes afectados en su función oclusal, según los códigos del índice periodontal, no siguió una tendencia única. La mayoría de los dientes con alteraciones funcionales presentaron movilidad dentaria.

Periodontal Status in Accordance with the Daily Stress and Coping and Control Effect of Oral Health Behavior / 치위생과학회지

In this study, 110 adults aged 40 to 69 years were surveyed from April 28, 2016, to May 28, 2016 to analyze their periodontal status according to daily stress, coping methods, and oral health behavior. The collected data were analyzed using the t-test, one-way analysis of variance, and hierarchical multiple regression. Daily stress levels of all subjects were most frequent potential risk 64.5% of the subjects, the high risk 19.1% and 16.4% of the health group. Regarding stress coping methods, active methods recorded 2.46, passive methods recorded 2.32. Regarding oral health behaviors, subjects brushed an average of 2.45 times daily, for an average of 2 minutes. Futhermore, 69.1% of subjects brushed before bedtime and 89.1% practiced scaling. Regarding periodontal status, the O'Leary index was 73.45, gingivitis index was 1.30, an average of 2.83 quadrants possessed a periodontal pocket. The hierarchical multiple regression analysis identified, type of employment (β=−0.348), scaling (β= −0.253), and age (β=0.244) as factors that influence the number of quadrants possessing a periodontal pocket. These results confirmed that the oral health behavior of scaling, but not stress levels of coping methods, strongly influenced periodontal status.

Prevalencia de pérdida de inserción periodontal en una muestra de adolescentes de 15-19 años en Medellín, Colombia / Prevalence of periodontal attachment loss in a sample of adolescents aged 15-19 in Medellin, Colombia

Resumen Introducción y objetivo: La información epidemiológica acerca de la prevalencia de las enfermedades periodontales en adolescentes en Suramérica es escaza. Un estudio en Chile reportó que el 69,2% de los estudiantes adolescentes entre 12 y 21 años, tenían pérdida del nivel de inserción clínico > 1mm, el 16% > 2mm y el 4,5% >3mm. El objetivo de este estudio fue determinar las características epidemiológicas de la pérdida de inserción clínica de una muestra de adolescentes del Municipio de Medellín. Materiales y métodos: Se realizó un estudio transversal como parte de un estudio multicéntrico sobre prevalencia de pérdida de inserción en Suramérica. Se seleccionaron aleatoriamente estudiantes entre 15 y 19 años de escuelas públicas y privadas del municipio de Medellín. Se evaluaron el nivel clínico de inserción (NIC), el sangrado al sondaje (BoP) y la profundidad clínica de sondaje. Resultados: Se evaluaron 73 estudiantes con un predominio del género masculino del 52,1%. El sangrado al sondaje y el índice de placa en mujeres fue de 11,1±10,8 y 54,2±26,1 respectivamente, mientras que en los hombres fue de 15,1±15 y 44,2±21,1. Se encontró que el 65% de los hombres y el 60 % de las mujeres tenían pérdida de inserción > 1mm. La prevalencia de pérdida de inserción >3 mm fue de 14 % en mujeres. Conclusión: La prevalencia de pérdida de inserción leve en estudiantes de 15-19 años de colegios públicos y privados de la ciudad de Medellín es alta.

Abstract Introduction and objetive: The epidemiological information on the prevalence of periodontal disease in adolescents in South America is scarce. A study in Chile reported that 69.2% of teenage students between 12 and 21 years, had loss of clinical attachment level > 1 mm, 16% had > 2 mm loss and 4.5% >3mm. The aim of this study was to determine the epidemiological characteristics of the loss of a clinical sample of adolescents from Medellin insertion. Materials and method: A cross-sectional study was conducted as part of a multicenter study in South America. Students between 15 and 19 years were randomized to public and private in the city of Medellin. Clinical attachment level (NIC), bleeding on probing (BOP) and clinical probing depth were evaluated. Results: 73 students were evaluated with a prevalence of 52.1% male. Bleeding on probing and plaque index in women was 11.1 ± 10.8 and 54.2 ± 26.1respectively, while in men was 15.1 ± 15 and 44.2 ± 21, 1, respectively. It was found that 65% of men and 60% of women had insertion loss > 1mm. The prevalence of attachment loss >3 mm was 14% in women. Conclusion: The prevalence of incipient clinical attachment loss is high in this sample of students aged 15-19.

Periodontal status of Pakistani orthodontic patients

The objective of this study was to evaluate and compare the periodontal status of orthodontic patients and non-orthodontic patients, aged 15–28 years, of both genders. The cross-sectional study included 100 orthodontic and 100 non-orthodontic patients evaluated using a Community Periodontal Index for Treatment Need (CPITN) probe on the index teeth. A questionnaire was distributed to the participants to assess and evaluate the use of oral hygiene aids. The data were analyzed using SPSS version 17, and various comparisons were performed using the chi-square test. The study revealed that there was a statistically significant association in CPITN scores between the orthodontic and non-orthodontic patients (p < 0.01). The study showed that patients undergoing orthodontic treatment have increased plaque accumulation and probing depth resulting in periodontal tissue destruction. Proper oral hygiene practices and interdental aids should be employed to control plaque.

Detection and sampling methods for isolation of Candidaspp. from oral cavities in diabetics and non-diabetics

The purpose of this study was to detect Candida spp. on the tongue and in the subgingival sites in healthy and type 2 diabetes (T2D) patients with chronic periodontitis (CP), and to compare the accuracy of sampling methods. This study included 131 patients divided into four groups: healthy control (group A), nondiabetics + CP (Group B), diabetics with good metabolic control + CP (group C) and diabetics with poor glycoregulation + CP (Group D). Cotton swab samples from tongue and subgingival samples were obtained from each patient with help of sterile paper points and a sterile curette. Swab cultures were made on Sabouraud dextrose agar. The number of CFUs was counted. The sampling methods for subgingival plaque were compared by Receiving Operator Curve (ROC). The presence of Candida spp. on the tongue was statistically significant among groups (group D vs. others three groups: χ2: p < 0.005 for each group). Positive findings of subgingival Candida spp. did not differ among the groups. There were no significant differences in the quantification ofCandida spp., neither on the tongue, nor in the subgingival samples. 17.2% of diabetic patients revealed the presence ofCandida spp. in the subgingival samples, with negative finding on tongue. There was a significant difference in the sampling methods for subgingival plaque (p = 0.000). Candidaspp. is more prevalent on the tongue of diabetics. The sampling of subgingival plaque by a sterile curette is more accurate than with paper points. Subgingival plaque may represent a reservoir of commensals. It is necessary to standardize the sampling of subgingival plaque.

Effect of root planing on the reduction of probing depth and the gain of clinical attachment depending on the mode of interproximal bone resorption

PURPOSE: The purpose of the present study was to evaluate the effect of root planing on the reduction of probing pocket depth and the gain of clinical attachment depending on the pattern of bone resorption (vertical versus horizontal bone loss) in the interproximal aspect of premolar teeth that showed an initial probing pocket depth of 4-6 mm. METHODS: In this study, we analyzed 68 teeth (15 from the maxilla and 53 from the mandible) from 32 patients with chronic periodontitis (17 men and 15 women; mean age, 53.6 years). The probing pocket depth and clinical attachment level at all six sites around each tooth were recorded before treatment to establish a baseline value, and then three months and six months after root planing. RESULTS: The reduction in interdental pocket depth was 1.1 mm in teeth that experienced horizontal bone loss and 0.7 mm in teeth that experienced vertical bone loss. Interdental attachment was increased by 1.0 mm in teeth with horizontal bone loss and by 0.7 mm in teeth with vertical bone loss. The reduction of probing pocket depth and the gain of clinical attachment occurred regardless of defect patterns three and six months after root planing. CONCLUSIONS: The reduction of pocket depth and gain in the clinical attachment level were significantly larger in horizontally patterned interproximal bone defects than in vertical bone defects.

Microbiological aspects of endoperiodontal lesion

Introduction: The endoperiodontal lesion occurs when a tooth undergoing endodontic disease is united to a periodontal lesion with apical progression. Many times, the differential diagnosis between the endodontic and periodontal disease can be of difficult execution and the correct diagnosis and planing of the treatment is of main importance for a good prognosis. Objective: To identify the main microorganisms within the lesion of endodontic and periodontal origin and correlate them with the endoperiodontal lesion. Literature review: The search strategy comprised the electronic studies of databases such as PubMed and Cochrane on the microbiology of the endodontic and periodontal systems through employing the following keywords: microbiology, endodontics, periodontal pocket. Results: There were similarities in the endodontic and periodontal microflora. However, the number of microorganisms within the cross infection is limited, including Bacteroides, Eubacteria, Fusobacteria, spirochaetes, Wolinella. The bacterias forming the red complex are closely related to the severity of the periodontal disease and can also participate in the pathogenesis of the periradicular abscesses. Conclusion: There are many communication routes between the periodontium and pulpal tissue, therefore the contamination from um tissue to another can occur, existing a microbiological inter-relationship between these tissues.

Apicoectomy after conventional endodontic treatment failure: case report

Introduction: Paraendodontic surgery is a safe and adequate alternative when teeth are not responding to conventional treatment and endodontic re-treatment. It must only be applied in specific situations. Endodontic treatment failures can be related to: extraradicular infections such as periapical actinomycosis; to foreign body reactions that can be caused by endodontic material extrusion; to endogenous cholesterol crystal accumulation in apical tissues; and unresolved cystic lesion. Paraendodontic surgery comprehends a set of procedures recommended in periapical diseases treatment, when traditional endodontic therapy does not obtain favorable outcomes. Objective: To report a clinical case where an apicoectomy was indicated due to failure in conventional endodontic treatment. Case report and Conclusion: Clinical case report of a tooth with unsatisfying conventional endodontic treatment history, due to lack of treatment in fourth root canal and an unsuccessful apicoectomy, since the lesion and the fistula had persisted. It was chosen to retreat tooth #26 and perform a new apicoectomy in the mesiobuccal root. The treatment was successful due to absence of fistula and painful symptoms and due to periapical bone repair.