Periodontal status in adult patients with leukemia: a literature review / Condição periodontal em pacientes adultos com leucemia: revisão de literatura

Periodontal disease is a highly prevalent chronic inflammatory disease that affects the tissues that support the teeth, while leukemia is a type of malignous cancer that affects the production of blood cells. Recent studies suggest that immune response and microbial disbiosis related to periodontal disease may be associated with an increased risk of developing leukemia and may affect its prognosis, as well as leukemia type and treatment may also have effects on the periodontium, demanding a interdiscipinary approach of these patients. The aim of this study was to conduct a literature review to assess the association between periodontal disease and leukemia in adult patients. An electronic database serch using the descriptors was performed. Clinical studies with periodontal examination in adult individuals with leukemia were selected. After literature search, 9 studies were reviewed. Gingival bleeding and periodontal pockets were frequent findings. Periodontitis prevalence varied among studies, ranging from 29% to 82,4% in patients diagnosed with leukemia. The relationship between periodontal disease and leukemia is complex and multifaceted and there are few studies available in adults, with heterogeneous exam protocols. Still, the high prevalence of gingivitis and periodontitis found in the studies suggest that periodontal diagnosis and treatment could be a helpful tool to prevent further complications in leukemia treatment.

A doença periodontal é uma doença inflamatória crônica altamente prevalente e que afeta os tecidos que sustentam os dentes, enquanto a leucemia é um tipo de câncer maligno que afeta a produção de células sanguíneas. Estudos recentes sugerem que a resposta imune e a disbiose microbiana relacionada a doença periodontal podem estar associadas a um risco aumentado de desenvolver leucemia e pode afetar o prognóstico da doença, assim como o tipo de leucemia e o tratamento também podem ter efeitos no periodonto, exigindo uma abordagem interdisciplinar desses pacientes. O objetivo deste estudo foi realizar uma revisão de literatura para avaliar a associação entre doença periodontal e leucemia em pacientes adultos. Foi realizada uma busca eletrônica em bancos de dados utilizando os descritores. Foram selecionados estudos clínicos com exame periodontal em indivíduos adultos com leucemia. Após busca na literatura, 9 estudos foram revisados. Sangramento gengival e bolsas periodontais foram achados frequentes. A prevalência da periodontite variou entre os estudos, sendo de 29% a 82,4% em pacientes diagnosticados com leucemia. A relação entre doença periodontal e leucemia é complexa e multifacetada e existem poucos estudos disponíveis em adultos, com protocolos de exames heterogêneos. Ainda assim, a alta prevalência de gengivite e periodontite encontrada nos estudos sugere que o diagnóstico e o tratamento periodontal podem ser uma ferramenta útil para prevenir maiores complicações no tratamento da leucemia.

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

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

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

Nivel de higiene y prevalencia de Porphyromona gingivalis y Fusobacterium nucleatum en pacientes recuperados de SARS-CoV-2 / Hygiene level and prevalence of Porphyromona gingivalis and Fusobacterium nucleatum in recovered SARS-CoV-2 patients

Introducción: El SARS-CoV-2 afecta el sistema respiratorio en diferentes grados. La cavidad oral es el lugar más colonizado por bacterias, por lo tanto, al no tener una adecuada higiene pueden presentarse diferentes enfermedades secundarias, lo que ha causado alerta en el gremio odontológico, ya que puede contribuir a complicaciones posteriores en los pacientes. Material y métodos: El estudio fue conformado por 47 pacientes voluntarios recuperados de SARS-CoV-2, residentes de Montemorelos, Nuevo León, México, donde fueron atendidos en Bucalia Dent, consultorio dental. Después del consentimiento informado de cada paciente, se realizó una historia clínica para conocer los síntomas, enfermedades sistémicas, ausencia de dientes y nivel de inflamación gingival de acuerdo al índice de Loe y Silness. A continuación, se tomó una muestra de biofilm microbiano (placa dentobacteriana), la cual se suspendió en una solución buffer de fosfato, posteriormente fue llevada al Centro de Investigación y Desarrollo en Ciencias de la Salud (CIDICS), Monterrey, N.L, México. Se extrajo DNA y se purificó, después se realizó PCR para detectar los patógenos orales; la PCR se visualizó en gel de agarosa (1.5%) por tinción de bromuro de etidio. Resultados: Se detectó 80.85% Porphyromona gingivalis y 68.09% Fusobacterium nucleatum en pacientes recuperados de SARS-CoV-2; 23.4% presentaron inflamación leve de acuerdo al índice de Loe y Silness, 54.5% fueron masculinos y 45.5% femeninos. Por otro lado, 36.4% de los pacientes con inflamación leve tenían de cuatro a seis dientes ausentes. En estos pacientes se detectó 18.18% únicamente con Fusobacterium nucleatum y 27.27% sólo con Porphyromona gingivalis; el sexo masculino tuvo predisposición en 66.6% y el femenino en 33.33%. Se observó infección con los dos patógenos presentes en 45.45%; y 60% de estos pacientes fueron masculinos. Conclusiones: Los pacientes recuperados de SARSCoV- 2 analizados en esta investigación mostraron mala higiene oral y alta prevalencia de los patógenos mencionados altamente relacionados a inflamación gingival o enfermedad periodontal, lo que nos indica que es indispensable la intervención del odontólogo al finalizar el periodo de infección de cada paciente (AU)

Introduction: SARS-CoV-2 affects the respiratory system to different degrees. The oral cavity is a colonized place by bacterias, therefore, by not having good hygiene, different secondary diseases can occur; this has caused an alert in the dental industry, since it can contribute to later complications in patients. Material and methods: The study was conducted in 47 SARS-CoV-2 recovered volunteers from the Montemorelos city of the Nuevo León state, Mexico, who were attended at the Bucalia Dent dental clinic. An informed consent was obtained from each of the patients, then their clinical history was documented in order to know the symptoms, previous systemic diseases, absence of teeth and degree of gingival inflammation, as suggested by Loe and Silness. Subsequently, a dental plaque sample was taken from all patients, which was suspended in a phosphate buffered solution and shipped to The Center for Research and Development in Health Sciences (CIDICS), Monterrey, NL, Mexico for storage. DNA extraction and purification was performed and PCR was carried out for the oral pathogens detection. All PCR products were visualized on 1.5% agarose gel by ethidium bromide staining. Results: Porphyromona gingivalis and Fusobacterium nucleatum were detected in 80.85% and 68.09% of SARS-CoV-2 recovered patients, respectively. 23.4% showed mild inflammation based on the Loe and Silness criteria, 54.5% were male and 45.5% female. On the other hand, 36.4% of patients with mild inflammation had between 4 to 6 missing teeth. A single infection by Fusobacterium nucleatum was detected in 18.18% and by Porphyromona gingivalis in 27.27%; the male sex had a predisposition with 66.66% and 33.33% female; coinfection of both pathogens was observed in 45.45% where 60% were male. Conclusions: SARS-CoV-2 recovered patients show poor oral hygiene and a high prevalence of oral pathogens related to the development of inflammatory gingival or periodontal disease, this suggests the need for an odontological clinical intervention at the end of the course of infection or disease caused by SARS-CoV-2 (AU)

Condições periodontais e fatores associados a profundidade de sondagem em pacientes de uma faculdade do sul do Brasil / Periodontal conditions and factors associated with the probing depth in patients from a faculty in southern Brazil

RESUMO Objetivos: Verificar os sinais clínicos periodontais e investigar a os níveis de profundidade de sondagem (PS) e fatores associados em pacientes atendidos nas Clínicas da Faculdade IMED, localizada em um município do sul do Brasil. Metodologia: Os dados foram coletados em 193 prontuários de pacientes que buscaram atendimento odontológico, no período de 2017-2018, agrupados em sociodemográficos, hábitos de higiene bucal, hábitos nocivos e doenças crônicas. Os dados clínicos foram índice de placa dental visível (IPV), índice de sangramento gengival (ISG) e PS. Após realizadas análises descritivas foi construído um modelo de Regressão linear simples e múltiplo para verificar relações entre as variáveis ao p-valor<0,05. Resultados: A maioria dos pacientes são do sexo feminino (63,2%) com média de 40,8 anos (±14,58). Os resultados descritivos de IPV, ISG e PS foram 39,11±32,28%, 21,81 ±22,43% e 2,91 ±1,09mm, respectivamente. Após os ajustes no modelo de regressão múltiplo, os portadores de diabetes e a a quantidade de cigarros fumados por dia influenciaram no nível de PS. Conclusões: Os achados desta investigação mostram um alto IPV e de SG. Apesar da média da PS ter sido baixa, portadores de diabetes e fumo foram fatores preditivos de maiores níveis de PS.

ABSTRACT: Objectives: To evaluate periodontal clinical signs and investigate the probing depth levels (PD) and associated factors in patients attending the Dental Clinics of the Faculty IMED, located in a municipality in southern Brazil. Material and Methods: The data were collected of 193 records of patients who demand dental care in the Dental Clinics for periodontal treatment, in the period 2017- 2018: sociodemographic data, oral hygiene habits, tobacco use and chronic diseases. The clinical data were: gingival bleeding index (GBI), visible plaque index (VPI) and PD. The statistical analyzed the relationship between probing depth and exposure variables, using a linear regression linear model (p-value<0.05). Results: The majority of the patients attended were female (63.2%) and 40.8 years old on average (± 14.58). The descriptive results of VPI, GBI e PD were: 39.11 ± 32.28%, 21.81 ± 22.43%, and 2.91 ± 1.09mm, respectively. After adjustments in the multiple regression model, it was observed that diabetes and quantity of cigarettes smoked had an influence on PD. Conclusions: The results obtained in this research allowed to verify a high index of VPI and GBI in the patients. The mean PD of the individuals was low, however, it was possible to verify that having diabetes and smoking a large amount of cigarettes daily were predictive factors of higher levels of PD.

Periodontal disease distribution, risk factors, and importance of primary healthcare in the clinical parameters improvement / Distribución de la enfermedad periodontal, factores de riesgo e importancia de la atención primaria en salud en la mejora de los parámetros clínicos

The objective of this study is to show the distribution of periodontal disease, risk factors, and importance of primary healthcare, for the improvement of clinical parameters. Two phases study transversal and nonrandomized trial (before - after), with educational intervention and conservative treatment, were carried out at Dental School of the Universidad Autónoma de Guerrero México, in 161 subjects who met the inclusion criteria. Oral healthcare education was carried out as well as conservative periodontal treatment, with six months follow up. Clinical measurements were performed with a Williams probe, O'Leary plaque index, calculus index and dental mobility Miller method. Periodontal disease was found on 82 % of all participants. Multinomial logistic regression analysis showed an odds ratio of 14.3 (95 % CI: 2.5, 82.1), 13.4 (95 % CI: 1.7, 103.5), 29.2 (95 % CI: 3.2, 260.9) and 68 (95 % CI: 6.6, 711.0) plaque in gingivitis, mild, moderate and severe chronic periodontitis, respectively. The longitudinal panel data analysis showed a significant effect (p <0.001) in the mean decrease of the clinical parameters after intervention, probing depth 0.4 mm (95 % CI: -0.5, -0.3), pockets depth 1.1 mm (95 % CI: -1.3, -0.9), amount of pockets 4.5 (95 % CI: -5.2, -3.7), bleeding 5.2 (95 % CI: -5.9, -4.5) and dental mobility 0.6 degrees (95 % CI: -0.7, -0.5). Primary healthcare is still the best option to improve the periodontal health in population who do not have access to specialty services. Dentists can achieve significant clinical improvement at very low cost, if they are aware of primary health care.

El objetivo del estudio fue mostrar la distribución de la enfermedad periodontal, los factores de riesgo y la importancia de la atención primaria de salud, para la mejora de los parámetros clínicos. Material y método: Estudio de dos fases transversal y no aleatorizado (antes - después), con intervención educativa y tratamiento conservador, realizado en la Facultad de Odontología de la Universidad Autónoma de Guerrero México, en 161 sujetos que cumplieron con los criterios de inclusión. Se llevó a cabo una educación sanitaria oral, así como un tratamiento periodontal conservador, con un seguimiento de seis meses. Las mediciones clínicas se realizaron con una sonda Williams, el índice de placa O'Leary, el índice de cálculo y el método Miller de movilidad dental. Resultados: se encontró enfermedad periodontal en el 82 % de todos los participantes. El análisis de regresión logística multinomial mostró un odds ratio de 14.3 (IC 95 %: 2.5, 82.1), 13.4 (IC 95 %: 1.7, 103.5), 29.2 (IC 95 %: 3.2, 260.9) y 68 (IC 95 %: 6.6, 711.0) placa en gingivitis, periodontitis crónica leve, moderada y grave, respectivamente. El análisis de datos del panel longitudinal mostró un efecto significativo (p <0.001) en la disminución media de los parámetros clínicos después de la intervención, profundidad de sondeo 0.4 mm (IC 95 %: -0.5, -0.3), profundidad de bolsillos 1.1 mm (IC 95 %: -1.3, -0.9), cantidad de bolsillos 4.5 (IC 95 %: -5.2, -3.7), hemorragia 5.2 (IC 95 %: -5.9, -4.5) y movilidad dental 0.6 grados (IC 95 %: -0.7, - 0.5). Conclusiones: la atención primaria de salud sigue siendo la mejor opción para mejorar la salud periodontal en la población que no tiene acceso a servicios especializados. Relevancia clínica: los dentistas pueden lograr una mejora clínica significativa a un costo muy bajo, si conocen la atención primaria de salud.

Gingivitis influences oral health-related quality of life in adolescents: findings from a cohort study / A gengivite influencia a qualidade de vida relacionada à saúde bucal de adolescentes: achados de um estudo de coorte

ABSTRACT: Introduction: Oral health-related quality of life (OHRQoL) is affected by different clinical conditions. The aim of this study was to evaluate the impact of gingivitis on OHRQoL in adolescents. Methodology: This cohort study consisted of a random sample of 1,134 schoolchildren enrolled during 2012, in Santa Maria, Brazil. After two years, 743 adolescents were follow-up (response rate: 65.5%). Clinical, socioeconomic and OHRQoL data were collected. OHRQoL was assessed by the short Brazilian version of the Child Perceptions Questionnaire 11-14 (CPQ11-14), and gingival bleeding through Community Periodontal Index. Gingivitis was considered with the presence of 15% or more bleeding sites. Poisson regression models were used to evaluate the association between gingivitis and overall and domain-specific CPQ11-14 scores. Prevalence of gingivitis at baseline was considered the main predictor for the OHRQoL at follow-up. Results: Gingivitis at baseline was associated with higher overall CPQ 11-14 score (RR = 1.07; 95%CI 1.01 - 1.14), and emotional well-being (RR = 1.17; 95%CI 1.04 - 1.31), independently of other oral conditions and socioeconomic variables. Conclusions: The findings indicate that gingivitis negatively impacts the adolescents' OHRQoL. Moreover, gender, maternal schooling and household income were also associated with OHRQoL.

RESUMO: Introdução: Qualidade de vida relacionada à saúde bucal (QVRSB) é afetada por diferentes condições clínicas. O objetivo deste estudo foi avaliar o impacto da gengivite na QVRSB de adolescentes. Metodologia: Este estudo de coorte consistiu em uma amostra aleatória de 1.134 escolares iniciado em 2012, na cidade de Santa Maria, Brasil. Após dois anos, 743 adolescentes foram acompanhados (taxa de resposta: 65,5%). Dados clínicos, socioeconômicos e de QVRSB foram coletados. A QVRSB foi avaliada pela versão brasileira curta do Child Perceptions Questionnaire 11-14 (CPQ11-14) e o sangramento gengival foi coletado através do Índice Periodontal Comunitário. Gengivite foi considerada com o indivíduo apresentando 15% ou mais locais de sangramento. Os modelos de regressão de Poisson foram utilizados para avaliar a associação entre gengivite e os escores total e específico do domínio do CPQ11-14. A prevalência de gengivite na primeira avaliação foi considerada o preditor principal para a QVRSB no acompanhamento. Resultados: A gengivite no baseline foi associada à maior pontuação geral do CPQ 11-14 (RR = 1,07; IC95% 1,01 - 1,14) e ao domínio de bem-estar emocional (RR = 1,17; IC95% 1,04 - 1,31), independentemente das outras condições orais e variáveis socioeconômicas. Conclusão: Os achados indicam que a gengivite impacta negativamente a QVRSB de adolescentes. Além disso, sexo, escolaridade materna e renda familiar mensal também foram associados à QVRSB.

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

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

Periodontal disease and its impact on general health in Latin America. Section II: Introduction part II

Abstract: The epidemiological data on gingivitis and periodontitis in Latin America are scarce, as the majority of the Latin American studies have analyzed probing depth instead of clinical attachment loss. Reported data have shown high variations in results between different Latin American countries, with the main causes of these differences being the clinical case definition and methodological strategies used. In general, data have revealed that the prevalence of periodontal disease is higher in Latin Americans than in populations in the USA or Europe. Regarding its relations with other diseases and conditions, some Latin American studies have focused on the association between periodontitis and adverse pregnancy outcomes, or poor glycemic control in diabetic patients; however, these studies have reported controversial results. In Chile, reports have indicated that periodontal treatment significantly reduced the preterm birth rate; however, no association between periodontitis and perinatal outcome was found in Brazil. For diabetes mellitus, Brazilian studies have reported controversial findings; however, a Chilean interventional study reported significant reductions in the glycosylated hemoglobin levels after periodontal treatment. Although epidemiological data for Latin America are scarce, the information available at present is useful for establishing national policies on health promotion, prevention, and treatment of periodontal disease. Therefore, dental schools must play a key role in educating professionals who are highly trained in the promotion, prevention, early diagnosis and treatment of periodontal disease, with an approach to risk, and strong biopsychosocial and ethical components. Thus, future Latin American dentists would be able to face the challenge of decreasing the prevalence of periodontal diseases by leading interdisciplinary health teamwork.

Condiciones de salud oral, higiene oral y estado nutricional en niños que acuden a un establecimiento de salud de la Región Huánuco, Perú / Oral health and oral hygiene conditions and nutritional status in children attending a health facility in the Huánuco Region, Peru

RESUMEN Con el objetivo de determinar la asociación entre las condiciones de salud oral e higiene oral y el estado nutricional en niños usuarios de un establecimiento de salud en la región Huánuco se realizó un estudio transversal descriptivo en 118 niños que acudieron al control de crecimiento y desarrollo (CRED) del Puesto de Salud «La Esperanza¼. Las condiciones de salud e higiene oral fueron evaluados mediante los índices de placa bacteriana visible, higiene bucal simplificado, hemorragia simplificado e inflamación gingival. El estado nutricional se obtuvo del último control de CRED registrado en la historia clínica. La desnutrición aguda (DA) fue el estado nutricional más frecuente. Entre los niños con DA la proporción de inflamación gingival severa fue 60,3%, sangrado de encías 61,5%, presencia de placa dentobacteriana 59,3% e higiene oral deficiente 60,3%. Se evidencia una mayor afectación de la salud oral e higiene oral en niños con desnutrición, principalmente aguda.

ABSTRACT In order to determine the association between oral health and oral hygiene conditions and nutritional status in children using a health facility in the Huánuco region, a cross-sectional descriptive study was conducted in 118 children who attended the Growth and Development Control (CRED) of the health clinic "La Esperanza." Oral health and hygiene conditions were evaluated by visible bacterial plaque, simplified oral hygiene, simplified bleeding, and gingival inflammation indices. Nutritional status was obtained from the last CRED control recorded in the clinical history. Acute malnutrition (AM) was the most common nutritional status. Among children with AM, the proportion of severe gingival inflammation was 60.3%; gum bleeding, 61.5%; dentobacterial plaque presence, 59.3%; and poor oral hygiene, 60.3%. There is evidence of a greater impact of oral health and oral hygiene on children with malnutrition, mainly acute.

Comportamiento de la enfermedad periodontal inmunoinflamatoria crónica. Jovellanos. Matanzas / Behavior of the chronic immunoinflammatory periodontal disease. Jovellanos. Matanzas

RESUMEN Introducción: Para la Organización Mundial de la Salud, la enfermedad periodontal representa un problema de salud pública en países industrializados y en los que están en vías de desarrollo. Afecta la calidad de vida de quienes las sufren. Este término agrupa una serie de entidades que afectan los tejidos de protección e inserción del diente, dentro de las cuales se encuentra la periodontitis, proceso inmunoinflamatoria crónico. Objetivo: estimar la prevalencia de la enfermedad periodontal inmunoinflamatoria crónica en el municipio de Jovellanos, provincia de Matanzas. Materiales y métodos: con el objetivo de estimar la prevalencia de la enfermedad periodontal inmunoinflamatoria crónica, en el municipio de Jovellanos, provincia de Matanzas se realizó un estudio observacional, descriptivo transversal, en el período comprendido entre el mes junio del 2009 a junio del 2010. Resultados: el 54,5 % de la población no presentó la enfermedad estudiada. El grupo de 5 a 11 años fue el que más aportó a este resultado. La enfermedad fue diagnosticada en el 45,5 % de la población examinada, la cual comenzó a manifestarse a partir del grupo de edad de 15 a 18 años. El 92,9 % de los individuos de 60 a 74 años fueron los más afectados. Conclusiones: en cuanto a la enfermedad periodontal inmuno inflamatoria la cantidad de pacientes sanos, desde el punto de vista periodontal, estuvo entre un 49,4 % y un 59,6 % del total de la población. La incidencia de la enfermedad aumenta con la edad. La presencia de bolsas resultó mayor a partir de los 35 años y causó gran afectación en los individuos de 60 a 74 años.

ABSTRACT Introduction: According to the World Health Organization, periodontal disease represents a public health problem in the developed countries and in the developing ones. It affects the life quality of people suffering it. This term groups together several entities affecting the tooth´s insertion and protection tissues; periodontitis, a chronic immunoinflammatory process, is found among them. Objective: estimate the prevalence of periodontal disease inmunoinflamatoria chronic in the municipality of Jovellanos, province of Matanzas. Materials and methods: a cross-sectional descriptive, observational study was carried out in the municipality of Jovellanos, province of Matanzas from June 2009 to June 2010 for the sake of estimating the prevalence of the chronic immunoinflammatory periodontal disease. Results: 54.5 % of the population did not present the studied disease. The 5-11-years-old group was the one contributing more to these results. The disease was diagnosed in 45.5 % of the studied population, and started to manifest beginning from the 15-18-years-old age group. 92.9 % of the individuals aged 60 to 74 years were the most affected ones. Conclusions: from the periodontal point of view, the quantity of healthy patients oscillated between 49.4 % and 59.6 % of the total population. The disease incidence increases with age. The presence of pockets was higher from the age of 35 years on, and caused great affectation in individuals aged 60-74 years.

Prevalence of periodontitis in a population of patients on dialysis in Colombia

The aim of this study is to establish the prevalence of Chronic Periodontitis (CP) in patients with Chronic Kidney Disease (CKD) and to ascertain its relationship with several factors or indicators of micro inflammation. One hundred and thirtyfive CKD patients on dialysis treatment were included. Biochemical parameters, clinical attachment level and pocket depth were recorded according of the American Academy of Periodontology and the CDC (CDCAAP). Gingivitis and CP were recorded based on the biofilmgingival interface (BGI) periodontal diseases classification. The rate of nonresponse to the survey was 10 percent. A total 2,636 teeth in 135 patients were examined, of whom 52.5% were males. Average age was 55.7 years (SD ± 1.32); 41.4% had a smoking history; 78/135 patients were on hemodialysis and 57/135 on peritoneal dialysis; 55.5% had been on dialysis for more than three years. Prevalence of gingivitis and periodontitis was 14.8%, 95% CI (9.721.9) and 82.2%, 95% CI (74.7 ­ 87.8), respectively; according to the BGI Index. Severity of CP was: No periodontitis, 14.0% 95% CI (9.1 21.1) ; mild, 11.1% 95% CI (6.7 17.7) ; moderate, 28.8% 95% CI (21.7 37.1) ; and severe, 45.9% 95% CI (31.654.47). Peritoneal dialysis and time on dialysis > 3 years increase the chance of having periodontitis, OR 11.0 95% CI (2.253.8) and OR 7.6 95% CI (1.150.2), respectively. In view of the high prevalence of CP in this population, programs designed to ensure better periodontal and gingival care in the population on dialysis need to be established (AU)

El objetivo de este estudio fue establecer la prevalencia de Periodontitis Crónica (PC) en pacientes con enfermedad renal crónica (ERC) en diálisis y determinar la relación de su presencia con algunos indicadores de micro inflamación. Un total de 135 pacientes con ERC en terapia dialítica fueron incluidos en este estudio. Se evaluaron parámetros bioquímicos, nivel de inserción clínica (NIC) y profundidad de sondaje (PS), de acuerdo con la Asociación Americana de Periodoncia y el CDC de Atlanta (CDCAAP). También fue evaluada, la gingivitis y la PC de acuerdo con la clasificación interface biopeliculaencia (BGI). La tasa de no respuesta a la encuesta fue del 10%. Un total de 2636 dientes en 135 pacientes fueron evaluados, (52.5% hombres, edad promedio 55.7 ± 1.32), 56% con antecedente de tabaquismo. 78/135 en hemodiálisis y 57/135 en diálisis peritoneal, el 55.5 % con un tiempo en diálisis mayor a tres años. La prevalencia de gingivitis por la clasificación BGI fue del 14.8% IC 95% (9.7 21.9) y de periodontitis 82.2% IC 95% (74.7 ­ 87.8). La severidad de la PC fue: sin periodontitis 14.0% 95% IC (9.1 21.1) ; leve 11.1% 95% IC (6.7 17.7) ; moderada 28.8% 95% IC (21.7 37.1) y severa 45.9% 95% IC (31.654.47) La diálisis peritoneal y el tiempo en diálisis aumentaron la chance de tener PC: OR 11.0 95% IC (2.253.8) y OR 7.6 95% CI (1.150.2) respectiva mente. Por la alta prevalencia de PC en esta población, es necesario establecer programas para asegurar el cuidado de la salud periodontal en esta población en diálisis (AU)

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.

Occurrence and predictors of gingivitis and supragingival calculus in a population of Brazilian adults

Abstract: The aim of this study was to determine the occurrence of gingivitis and calculus and their predictors in a population of adults in Brazil. A representative sample of 758 adults from 35 to 59 years of age from Porto Alegre city was examined. A structured questionnaire was applied. The Gingival Bleeding Index and the presence of calculus were measured at 4 sites/tooth. Multivariable logistic models were fitted to determine the predictors for gingival bleeding at >20% of sites. Overall, 96.5% (95% confidence interval [CI]=95.1-98.0) of individuals had ≥ 1 bleeding site. The mean percentages of sites with gingivitis and calculus were 26.1% and 44.6%, respectively. The odds of gingivitis decreased by ∼45% for individuals ≥40 years old compared to younger adults. Individuals that never performed interproximal cleaning and non-whites had an approximately two times higher chance of gingivitis. Smokers had lower chances of gingivitis than never-smokers (odds ratio=0.40; 95% CI=0.24-0.68). Higher numbers of missing teeth were associated with higher chances of gingivitis. The percentage of calculus was significantly associated with skin color, education, proximal cleaning, smoking exposure, dental visits, and tooth loss. It can be concluded that the occurrence of gingivitis and calculus was high in this Brazilian population, and it was associated with age, skin color, education, self-reported proximal cleaning, smoking, dental care, and tooth loss.

Manifestaciones bucales de la diabetes mellitus tipo 2 en el adulto mayor / Oral manifestations of type 2 diabetes mellitus in the elderly

Introducción: La diabetes mellitus tipo 2 favorece la aparición de enfermedades bucales en el adulto mayor. Objetivos: Identificar las alteraciones bucales y factores de riesgo más frecuentes en pacientes con diabetes mellitus tipo 2. Métodos: Se realizó un estudio observacional, descriptivo y transversal. El universo lo conformaron 52 pacientes pertenecientes al consultorio # 13 del Policlínico Héroes del Corynthia, atendidos desde 2016 a 2017 en la Clínica Estomatológica Docente H y 21, municipio Plaza de la Revolución. Las variables analizadas fueron: edad, sexo, estado de salud bucal, factores de riesgo y manifestaciones bucales. Resultados: 55,7 por ciento de los adultos mayores pertenecieron al grupo de 60-69 años y el 59,4 por ciento del total de los pacientes involucrados en el estudio fueron mujeres. El 44,2 por ciento presentó un estado de salud bucal medianamente favorable. Por caries dental fueron afectados 34 pacientes, 31 por periodontitis y 25 por gingivitis. La obesidad se evidenció en el 59,6 por ciento de los pacientes. Conclusiones: El factor de riesgo predominante fue la obesidad. Las alteraciones bucales más observadas fueron la caries dental, la periodontitis y la gingivitis(AU)

Introduction: Type 2 diabetes mellitus fosters the appearance of oral diseases in the elderly. Objectives: Identify the most common oral alterations and risk factors among patients with type 2 diabetes mellitus. Methods: A cross-sectional observational descriptive study was conducted. The study universe was 52 patients from Consultation Office No. 13 of Héroes del Corynthia polyclinic cared for from 2016 to 2017 at H and 21st University Dental Clinic in the municipality of Plaza de la Revolución. The variables analyzed were age, sex, oral health status, risk factors and oral manifestations. Results: 55.7 percent of the elderly patients were in the 60-69 age group, and 59.4 percent of the total patients involved in the study were women. 44.2 percent had a fairly favorable oral health status. 34 had dental caries, 31 periodontitis and 25 gingivitis. 59.6 percent were obese. Conclusions: Obesity was the prevailing risk factor. The oral alterations most commonly found were dental caries, periodontitis and gingivitis(AU)

Prevalence and Severity of Plaque-Induced Gingivitis in Three Latin American Cities: Mexico City-Mexico, Great Metropolitan Area-Costa Rica and Bogota-Colombia / Prevalencia y severidad de gingivitis inducida por placa en tres ciudades de Latinoamérica: Ciudad de México-México, Gran Área Metropolitana-Costa Rica y Bogotá- Colombia

Abstract Plaque-induced gingivitis is the most common form of periodontal disease and can affect 100% of the population. Gingivitis prevalence in Latin American population is not well documented, therefore the aim of this study was to determine the prevalence and severity of plaque-induced gingivitis in adult populations of three Latin American cities. Methods: This cross sectional multicenter study included 1650 participants, 550 from the Great Metropolitan Area of Costa Rica (GAM), 550 from Mexico City, Mexico (CDMX) and 550 from Bogota City, Colombia (BC). Subjects completed a questionnaire about their medical history and oral hygiene. Clinical assessment included recording of missing teeth, visible plaque index, calculus recording and gingival index (GI, Loe-Silness index). Results: Average GI was 1.36. No statistical difference was found between GAM (1.45) and BC (1.48); however, GI in CDMX was significantly lower (1.16). Average gingival bleeding on probing was 43%. Total plaque index was 0.76 showing the highest accumulation at interproximal sites (p=0.0001). A positive correlation was found between plaque and gingivitis (r=0.59). Dental calculus was present in at least one of the 18 evaluated sites per subject with no statistical difference between cities. There was no statistical difference in GI between smokers, former smokers and non- smokers. Conclusion: Gingivitis prevalence was 99.6%. Moderate Gingivitis was the predominant form, with no statistically significant difference between cities or gender. Dental plaque accumulation was the most important risk factor associated with the establishment of the disease.

Resumen La gingivitis inducida por placa es la forma más común de enfermedad periodontal y puede afectar al 100% de la población. La prevalencia de gingivitis en Latinoamerica no está bien documentada, por lo tanto, el objetivo de este estudio fue determinar la prevalencia y severidad de la gingivitis inducida por placa en poblaciones adultas de tres ciudades latinamericanas. Metodología: Este estudio transversal multicéntrico incluyó 1650 sujetos, 550 del Gran Área Metropolitana de Costa Rica (GAM), 550 de la Ciudad de México, México (CDMX) y 550 de la Ciudad de Bogotá, Colombia (BC). Los sujetos completaron un cuestionario sobre su historia médica y hábitos de higiene oral. El examen clínico incluyó el registro de piezas dentales ausentes, el índice de placa visible, el registro de cálculo y el índice gingival (GI, Índice de Silness y Loe). Resultados: El GI promedio fue de 1.36. No se encontró diferencia estadísticamente significativa entre GAM (1.45) y BC (1.48); sin embargo, el índice gingival en CDMX fue menor (1.16). El promedio de sangrado al sondaje fue de 43%. El índice de placa total fue 0.76, mostrando la mayor acumulación en sitios interproximales (p=0.0001). Se encontró una correlación positiva entre placa y gingivitis (r=0.59). Hubo presencia de cálculo dental en al menos uno de los 18 sitios evaluados por cada sujeto sin diferencia estadística entre ciudades. No se encontró diferencia estadísticamente significativa en cuanto al índice gingival entre fumadores, ex fumadores y no fumadores. Conclusión: La prevalencia de Gingivitis fue del 99.6%. La Gingivitis Moderada fue la forma predominante, sin diferencia estadísticamente significativa por ciudad o sexo. La acumulación de placa fue el principal factor de riesgo asociado con el establecimiento de la enfermedad.

Prevalence of caries and gingivitis in 2- to 4-year-old children attending daycare centers managed by the chilean national kindergartens board (JUNJI) and municipal schools, Valdivia

Objective: to determine the prevalence of carious lesions and gingivitis in 2- to 4-year-old children attending JUNJI daycare centers and urban municipal schools in the city of Valdivia, Chile. material and method: descriptive cross-sectional study. a population of 182 two-year-old children and 285 four-year-old children were examined. subjects were selected by stratified random sampling. all subjects were enrolled in daycare centers managed by JUNJI and municipal schools in the city of Valdivia. an oral examination was performed to measure the DMFT and hemorrhagic indexes according to the WHO diagnostic criteria. the presence of cavitated carious lesions and gingivitis was determined, resulting in descriptive statistics according to age and gender. results: the prevalence of caries was 12.6 percent in two-year-old children and 41 percent in four-year-olds, respectively. the prevalence of gingivitis was 36.8 percent at 2 years of age and 70.5 percent at 4 years. there were no significant differences by gender at 2 years of age (p=1) or at 4 years (p=0.37). two year-old children have significantly fewer carious lesions and gingivitis less frequently than four-year-olds (p=<.001). conclusion: two year-old children have a lower prevalence of carious lesions and gingivitis than four-year-old ones. no relationship between the variables and gender was found.

Principais manifestações bucais em pacientes pediátricos HIV positivos e o efeito da terapia antirretroviral altamente ativa / Most common oral manifestations in pediatric patients HIV positive and the effect of highly active antiretroviral therapy

Resumo Esta revisão integrativa da literatura tem por objetivo identificar as principais lesões bucais que afetam pacientes pediátricos com HIV, bem como descrever o efeito da terapia antirretroviral altamente ativa (HAART) sobre essas lesões, comparando-a com a terapia antirretroviral (ART). Foi feita uma busca nas bases de dados PubMed e Scielo, seguindo critérios de inclusão e exclusão pré-determinados. Foram selecionados dezenove artigos científicos e extraídas as informações principais sobre prevalência e a frequência das manifestações bucais em pacientes pediátricos HIV positivos e o efeito da terapêutica aplicada. As lesões mais frequentes foram candidíase oral, gengivite, aumento das parótidas e eritema gengival linear. O uso da HAART mostrou diminuir a prevalência das manifestações bucais nos pacientes pediátricos com HIV e ser mais eficaz que a ART. Os achados deste estudo sugerem que a manifestação bucal mais frequente em pacientes pediátricos com HIV é a candidíase oral, seguida de alterações como gengivite e aumento das glândulas parótidas. O uso de HAART parece reduzir a prevalência dessas lesões orais, apresentando resultados mais eficazes que os da ART.

Abstract This integrative literature review aims to identify the main oral lesions affecting pediatric patients with HIV, and describe the effect of highly active antiretroviral therapy (HAART) on these injuries, comparing it to antiretroviral therapy (ART). A search was conducted in PubMed and Scielo databases, following predetermined inclusion and exclusion criteria. 19 papers were selected and the main information on the prevalence and frequency of oral manifestations in HIV-positive pediatric patients and effect of therapy applied were extracted. The most frequent injuries were oral candidiasis, gingivitis, parotid gland enlargement and linear gingival erythema. The use of HAART shown to reduce the prevalence of oral manifestations in pediatric patients with HIV and be more effective than ART. The findings of this study suggest that the most frequent oral manifestation in HIV-infected children is oral candidiasis, followed by changes such as gingivitis and enlargement parotid glands. The use of HAART appears to reduce the prevalence of these oral lesions, showing more effective results than ART.

Edema and gingival bleeding in anterior region have a negative influence on quality of life of adolescents

Abstract The aim of the present study was to verify if clinical signs of gingivitis such as color changes, edema, and bleeding in the anterior region influence the OHRQoL of adolescents. We followed a cross-sectional convenience sample of 67 adolescents aged 11 to 16 years receiving dental treatment at the Federal University of Santa Maria (UFSM), in southern Brazil. The participants were evaluated for the following clinical variables: edema, gingival color alteration, and marginal bleeding of the gingival tissues, collected at 6 sites per tooth in the anterior region of the mouth. Socioeconomic variables were collected through questionnaires and OHRQoL was evaluated through the Brazilian version of the Children Perception Questionnaire (CPQ 11-14) short form. A Poisson regression model was used to verify associations between clinical variables and general CPQ11-14 scores. In the unadjusted analysis, edema, color alterations, and marginal bleeding in the anterior region were associated with worse scores of OHRQoL. Edema and marginal bleeding remained associated after adjusting for clinical and sociodemographic variables. Adolescents with higher levels of marginal bleeding and edema in the anterior region had higher mean CPQ11-14 scores. Therefore, the presence of bleeding and gingival edema in the anterior region can be considered clinical signs of gingivitis that are associated with a worse OHRQoL in adolescents.

Caracterización clinicoepidemiológica de pacientes especiales con gingivitis crónica / Clinical and epidemiological characterization of special patients with chronic gingivitis

Se realizó un estudio descriptivo y transversal de 59 pacientes especiales con gingivitis crónica, atendidos en el Policlínico Docente Julián Grimau García de Santiago de Cuba, desde marzo de 2016 hasta enero de 2017, con vistas a caracterizarles según variables clínicas y epidemiológicas de interés. Entre los resultados principales prevalecieron el sexo masculino (72,9 por ciento), el grupo etario de 10-14 años (64,4 por ciento), la primaria terminada como nivel escolar (40,7 por ciento), así como la higiene bucal deficiente (81,3 por ciento) como factor de riesgo; entre estos últimos, la mayoría presentaron gingivitis crónica edematosa (79,2 por ciento) e inflamación severa (76,2 por ciento). La práctica inadecuada del cepillado dental, dada por la incapacidad intelectual de este tipo de paciente, favoreció la aparición de esta enfermedad.

A descriptive and cross-sectional study of 59 special patients with chronic gingivitis, assisted in Julián Grimau García Teaching Polyclinic was carried out in Santiago de Cuba, from March, 2016 to January, 2017, aimed at characterizing them according to clinical and epidemiologic variables of interest. Among the main results, there was a prevalence of the male sex (72.9 percen), 10-14 age group (64.4 percen), primary school level (40.7 percent), as well as the inadequate oral hygiene (81.3 percen) as risk factor; among the latter, most of them presented chronic edematous gingivitis (79.2 percen) and severe inflammation (76.2 percen). The inadequate practice of dental brushing, due to the intellectual incapacity of this type of patient, favored the emergence of this disease.

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

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