Oral health status after orthodontic treatment: a retrospective study / Estado de salud bucal después del tratamiento de ortodoncia: un estudio retrospectivo

ABSTRACT: Orthodontic appliances in the oral cavity may cause problems such as white spot lesions, dental plaque, periodontal disease and root resorption. The aim of this study was to investigate the association between orthodontic treatment and oral health parameters including visible dental plaque, gingival recession and white spot lesions (WSLs). A total of 170 patients (86 females, 84 males) were randomly selected to determine visible dental plaque, gingival recession and white spot lesions by using pre-treatment and post-treatment oral photographs. Except of previously extracted teeth, maxillary and mandibular incisors, canine, 1st and 2nd premolars and 1st molar were evaluated. There was a significant difference between the T0 (before treatment) and T1 (after treatment) groups in visible plaque (P< 0.001). The distribution of gingival recession frequencies according to Miller classification before treatment did not differ from the after treatment (P=082). A statistically significant increase in the severity of WSL was detected between the two time points (P< 0.001). Males have been shown to have higher WSL incidence after treatment. In conclusion, the present study showed that visible dental plaque and white spot lesions significant increase after orthodontic treatment. Considering the relationship between oral health and orthodontic treatment, clinicians and patients should know the risks and take precautions.

RESUMEN: Los aparatos de ortodoncia en la cavidad oral puede causar problemas como lesiones de mancha blanca, placa dental, enfermedad periodontal y reabsorción radicular. El objetivo de este estudio fue investigar la asociación entre el tratamiento de ortodoncia y los parámetros de salud bucal, incluida la placa dental visible, la recesión gingival y las lesiones de mancha blanca (LMB). Un total de 170 pacientes (86 mujeres, 84 hombres) fueron seleccionados al azar para determinar la placa dental visible, la recesión gingival y las lesiones de manchas blancas mediante el uso de fotografías orales antes y después del tratamiento. Excepto los dientes extraídos previamente, se evaluaron incisivos maxilares y mandibulares, caninos, premolares y primeros molares. Hubo una diferencia significativa entre los grupos T0 (antes del tratamiento) y T1 (después del tratamiento) en la placa visible (P<0.001). La distribución de las frecuencias de recesión gingival según la clasificación de Miller antes del tratamiento no mostraron diferencias significativas con respecto al postratamiento (P=0.082). Se detectó un aumento estadísticamente significativo en la gravedad de LMB entre los dos puntos de tiempo (P<0.001). Se ha demostrado que los hombres tienen una mayor incidencia de LMB después del tratamiento. En conclusión, el presente estudio mostró que la placa dental visible y las lesiones de manchas blancas aumentaron significativamente durante el tratamiento de ortodoncia. Teniendo en cuenta la relación entre la salud bucal y el tratamiento de ortodoncia, los médicos y los pacientes deben conocer los riesgos y tomar precauciones.

Efecto antibacteriano de una pasta dental con xilitol sobre Streptococcus mutans en saliva de gestantes / Antibacterial effect of a toothpaste with xylitol on Streptococcus mutans in pregnant women's saliva

RESUMEN Introducción: Durante la gestación, algunos cambios fisiológicos en la mujer propician un incremento de la placa dental y de la microbiota cariogénica. Esta condición unida a una modificación de la dieta y a una inadecuada higiene bucal condicionarían desfavorablemente la salud oral tanto de la madre como del bebé. Objetivo: Determinar el efecto antibacteriano de una pasta dental con xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes. Métodos: Ensayo clínico, a doble ciego, que se realizó en el Centro de Salud "José Olaya" (Chiclayo Perú), en enero de 2017. Se trabajó con una población muestral de 50 gestantes en el segundo trimestre que cumplieron con los criterios establecidos. Se crearon dos grupos: 25 gestantes usaron dentífrico con 10 por ciento de xilitol y 25 gestantes usaron dentífrico sin xilitol. Se les tomó y proceso microbiológicamente una muestra de saliva antes del inicio del estudio y 14 días después del uso de las respectivas pastas. Se realizó el recuento de unidades formadoras de colonias de Streptococcus mutans en saliva con una confiabilidad altamente significativa mediante el coeficiente de correlación intraclase, calibración intra e interexaminador (1,000 y 0,999, respectivamente). El análisis de los datos se realizó mediante la prueba U de Mann-Whitney, considerando un nivel de significancia del 5 por ciento. Resultados: No se encontró diferencia significativa entre las gestantes que emplearon pasta dental con xilitol en comparación con las que utilizaron pasta dental sin xilitol (p= 0,062). Conclusiones: El efecto antibacteriano de la pasta dental comercial con xilitol es similar a una pasta dental sin xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes(AU)

ABSTRACT Introduction: Some physiological changes occur in women during pregnancy which cause an increase in dental plaque and cariogenic microbiota. This situation, alongside a modification in the diet and inadequate oral hygiene, negatively affect the oral health of both the mother and the baby. Objective: Determine the antibacterial effect of a toothpaste with xylitol on the count of Streptococcus mutans in pregnant women's saliva. Methods: A double-blind clinical trial was conducted in José Olaya Health Center (Chiclayo, Peru) in January 2017. The sample population was 50 women in the second trimester of pregnancy who met the established inclusion criteria. Two groups were formed: 25 pregnant women used a toothpaste with 10 percent xylitol and the other 25 used a toothpaste without xylitol. A saliva sample was taken and processed microbiologically before the start of the study and 14 days after use of the two toothpastes. A count was performed of colony-forming units for Streptococcus mutans in saliva with highly significant reliability, using the intraclass correlation coefficient, and intra- and inter-rater calibration (1.000 and 0.999, respectively). Data analysis was based on the Mann-Whitney U Test, with a significance level of 5 percent. Results: No significant difference was found between the pregnant women who used the toothpaste with xylitol and those who used the toothpaste without xylitol (p= 0.062). Conclusions: The antibacterial effect of the commercial toothpaste with xylitol is similar to that of a toothpaste without xylitol in terms of the Streptococcus mutans count in pregnant women's saliva(AU)

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.

Modelo operativo de promoción de la salud y prevención de enfermedades bucales en preescolares de Cuautla, Morelos-México / Operational model of health promotion and prevention of oral diseases in preschool children in Cuautla, Morelos-Mexico

Las estrategias tradicionales para abordar la salud bucal en México han carecido de un enfoque integrado a la promoción de la salud y a los factores de riesgo en común con otras patologías, principalmente crónicas. De unir esfuerzos se aprovecharían mejor los limitados recursos sanitarios. Esta investigación tuvo como objetivo implementar un modelo operativo de promoción de la salud y prevención de las enfermedades bucales, usando un ciclo de mejora continua en el preescolar de la comunidad Peña-Flores, Cuautla, Morelos. Se realizó un estudio cuasi-experimental con 120 niños de ambos sexos. La implementación contempló: diagnóstico epidemiológico bucal y social, capacitación de actores clave, ejecución del programa de salud bucal, monitoreo, análisis y evaluación de resultados. Se levantaron datos mediante una guía de observación participante, de reuniones con madres de familia y maestras bajo la perspectiva participativa del triple diagnóstico de educación popular. Se determinó el índice de dientes cariados, a extraer y obturados. Se realizó la medición de la placa dento-bacteriana utilizando el índice de sedimento dental (DIS). Como resultado del control y sistematización del proceso de cepillado dental y del monitoreo de la placa dento-bacteriana, se identificó una disminución del DIS de 1,04 a 0,47. Con la implementación de un menú escolar, se mejoró la alimentación infantil. El modelo implementado constituye una posible solución a la problemática de salud bucal del preescolar de la comunidad Peña-Flores, situado en un contexto de desventaja social por factores como pobreza, migración y déficit de servicios públicos(AU)

Acesso à saúde bucal na primeira infância no município de Porto Alegre, Brasil / Access to oral health in early childhood in the city of Porto Alegre, Brazil

Resumo O objetivo foi avaliar o acesso e fatores associados à consulta odontológica em crianças de até 5 anos no município de Porto Alegre, Brasil. Estudo transversal realizado em 10 Unidades Básicas de Saúde, através de questionário e exame clínico em 560 crianças. Foram avaliadas variáveis clínicas (placa visível, sangramento gengival e ceo-s), sociodemográficas, e de acesso à consulta. Regressão de Poisson foi utilizada para cálculo de Razões de Prevalência (RP), com intervalo de confiança de 95%. Os resultados mostraram que 68,2% das crianças nunca haviam ido ao dentista. O principal motivo relatado para a não realização de consulta odontológica foi não ter sentido necessidade (48,7%) e dificuldade de acesso ao posto de saúde (15,8%). A procura pelo dentista teve como propósito a prevenção/revisão (55,8%) e os locais mais procurados para consultas foi o consultório particular (43,9%) e o posto de saúde (39,5%). O modelo multivariado final mostrou que a idade da criança (IC95%, RP = 1,03 (1,02-1,05)), a renda familiar (RP = 1,05; (1,01-1,08)) e a mãe ter concluído o ensino médio (RP = 1,69 (1,15-2,56)) estiveram associados com a procura por consulta odontológica. Assim, torna-se fundamental reconhecer a importância do contexto familiar durante os primeiros anos de vida.

Abstract The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.

Prevalencia de placa dentobacteriana y caries dental en el primer molar permanente en una población escolar del sur de la Ciudad de México / Prevalence of plaque and dental decay in the first permanent molar in a school population of south Mexico City

Resumen Introducción: El primer molar permanente (PMP) es susceptible de caries a partir de su erupción por su anatomía y porque ha estado expuesto antes que otros dientes. Métodos: Estudio observacional, prolectivo, transversal, comparativo, en 194 escolares con una media de edad de 9.9 ± 1.8 años. La valoración de la placa dentobacteriana (PDB) se realizó con el índice de O'Leary, y la experiencia de caries con los índices CPOS (suma de superficies dentales cariadas, perdidas/extraídas y obturadas) y CPOD (suma de dientes cariados, perdidos/extraídos y obturados). Resultados: La prevalencia de PDB en el PMP fue del 99.4%, y la de caries, del 57.2%. El valor del CPOD fue de 1.4 ± 1.4. La experiencia de caries por superficie dental en los niños de 7.10 años de edad fue de 2.2 ± 2.3 y son 7.9 veces más susceptibles a desarrollar lesiones (razón de momios: 8.9; intervalo de confianza al 95%: 4.1-19.5; p < 0.0001) que los menores de esa edad. Se detectó asociación con la variable edad y los valores de los índices de experiencia de caries; aun cuando estas son débiles en el caso del CPOS (r = 0.439), el modelo permitió explicar el 19% de la asociación, y el 22% para el CPOD (r = 0.464). Conclusiones: La caries dental se desarrolla rápidamente en los PMP. En general, no se le da la importancia debida porque se desconoce que se presenta en un diente permanente.

Abstract Background: The first permanent molar is susceptible to acquire tooth decay since its eruption, due to its anatomy and because it has been exposed before other teeth. Method: An observational, prolective, transversal and comparative study in 194 students, with an average age of 9.9 ± 1.8 years. The evaluation of the dentobacterial plate (DBP) was analyzed using the O'Leary index and the tooth decay experience with the DMFS (sum of decayed, missing, extracted and filling dental surfaces) and DMFT (sum of decayed, missing, extracted and filling per tooth) indexes. Results: The prevalence of DBP in the first permanent molar was of 99.4% and tooth decay of 57.2%. The value of DMFT was 1.4 ± 1.4. The tooth decay experience was higher in children from 7.10 years old with a value of 2.2 ± 2.3, who are 7.9 times more likely to develop lesions than younger children (odds ratio: 8.9; 95% confidence interval: 4.1-19.5; p < 0.0001). We found an association between age and the values of the tooth decay experience indexes; even though these were weak in the case of DMF (r = 0.439), the model allowed to explain 19% of the association, and 22% for DMFT (r = 0.464). Conclusions: Tooth decay develops rapidly in the first permanent molars; however, it does not receive the necessary care because it is usually unknown that it is a permanent tooth.

Associação entre fatores socioeconômicos, comportamentais, saúde geral e condição da mucosa bucal em idosos / Association between socioeconomic factors, behavioral, general health and oral mucosa status in elderly

Resumo O objetivo deste estudo foi investigar a associação entre fatores socioeconômicos, comportamentais, saúde geral, saúde bucal e os desfechos de acúmulo de placa e condição de mucosa bucal em idosos. Este estudo transversal, conduzido entre 2004 e 2005, incluiu 785 idosos de Carlos Barbosa, RS. Questionários foram utilizados para coleta de dados socioeconômicos, comportamentais e estado de saúde. O exame físico das estruturas bucais e o Índice de Mucosa e de Placa de Henriksen (MPS) foram utilizados para categorizar os desfechos. Observou-se maior prevalência de acúmulo de placa moderado/grave entre os idosos mais velhos, do sexo masculino e com menor escolaridade. O uso de prótese dental total superior e renda de até 1 salário mínimo foram fatores de proteção para acúmulo de placa moderado/grave. Apenas as variáveis do primeiro bloco da estrutura conceitual, sexo masculino (OR = 2,13; IC95% = 1,26-3,61) e menor escolaridade (OR = 1,37; IC95% = 1,06-1,78) permaneceram associados como risco à presença de escore inaceitável do MPS. Os achados sugerem que idosos do sexo masculino e com menor escolaridade têm maior chance de saúde bucal precária, conforme o MPS.

Abstract This study aimed to investigate the association between socioeconomic and behavioral factors, general health, oral health, and plaque accumulation and oral mucosa condition outcomes in the elderly. This is a cross-sectional study conducted from 2004 to 2005 with 785 elderly dwellers of the city of Carlos Barbosa (RS), Brasil. We used questionnaires to collect socioeconomic, behavior and health status data. The physical examination of the oral structures comprised the Mucosal-Plaque Index proposed by Henriksen (MPS). A higher prevalence of moderate/severe plaque accumulation was observed in the elderly group, in less educated male elderly. The use of full upper dentures and income under one minimum wage were protective factors for moderate/severe plaque accumulation. Only the variables of the first block of the conceptual structure, male gender (OR = 2.13; 95% CI 1.26-3.61) and lower education (OR = 1.37; 95% CI 1.06-1.78) remained associated with an unacceptable MPS score. The findings suggest that, as per MPS, less educated male elderly are more likely to have poor oral health.

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

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

Índice de higiene oral comunitario en escolares de 12 años / Oral hygiene index in students of 12 years old

Objetivos: El objetivo de esta investigación fue determinar el índice de higiene oral en escolares de 12 años de la parroquia El Vecino en la ciudad de Cuenca - Ecuador, 2016. Material y Métodos: Se realizó un estudio descriptivo, documental, retrospectivo, cuantitativo a partir de los datos epidemiológicos de 185 escolares de 12 años, de la parroquia El Vecino, aplicando el IHO-S de Greene y Vermillion. Se utilizaron fichas epidemiológicas que cuentan con consentimientos y asentimientos debidamente firmados, las cuales reposan en el archivo del departamento de investigación de la carrera de Odontología de la UCACUE. Los valores pesquisados fueron vertidos en fichas digitales, que se almacenaron en una base de datos en el programa EPI INFO ver 7.2 y posteriormente se tabularon en el programa Excel. Resultados: El IHO-S parroquial promedio se estableció en 1,09, donde el 61,62% (114 escolares) mostró un nivel bueno, no existiendo diferencia estadísticamente significativa entre los géneros. El 84,32% (156 escolares) presentó un nivel bueno de placa bacteriana blanda, mientras que el 61,08% (113 escolares) mostró ausencia de placa bacteriana calcificada. Las unidades educativas presentaron un IHO-S promedio entre 0,93 ­ 1,29. Conclusiones: La mayoría de los escolares presentan un buen nivel de higiene oral, no encontrándose diferencia estadísticamente significativa entre los géneros. El nivel bueno predominó en el índice de placa bacteriana blanda, mientras que en la placa bacteriana calcificada prevaleció su ausencia. Casi la totalidad de las unidades educativas presentaron un nivel bueno de Índice de Higiene Oral. (AU)

Objetives: The aim of this study was to determine the Oral Hygiene Index in students of 12 years old at parish El Vecino in Cuenca, Ecuador, 2016. Material and Methods: A descriptive, documentary, retrospective, quantitative study was done from epidemiological data of 185 students of 12 years old at parish El Vecino, applying the IHO-S Greene and Vermillion. Epidemiological records with duly signed consents and approvals by legal representative and students respectively were used, which are stored on the Research Department files of the career of Dentistry, UCACUE. The obtain data were typed into digital files, which were stored in a database in the EPI INFO program, version 7.2 and tabulated in Excel program. Results: The community's average of OHI-S was established in 1.09, where 61.62% (114 students) showed a good level, there was no statistically significant difference between sexes. The 84.32% (156 students) presented a good level of dental plaque, while 61.08% (113 students) showed no calcified plaque. The educational unit's average of OHI-S was determinate between 0,93­1,29. Conclusions: Most of the students have a good level of oral hygiene, not found statistically significant difference between gender. The good level predominated in the dental plaque index, while in the calcified plaque prevailed absence. Almost all of the schools showed a good level of Oral Hygiene Index. (AU)

Caries Dental su Asociación con el Índice de Masa Corporal en una Población Joven Adulta / Dental Caries its Association with Body Mass Index in a Young Adult Population

RESUMEN: Este estudio tiene como objetivo determinar la distribución del Índice de Masa Corporal y su asociación con la caries dental en estudiantes de primer ingreso período 2016 de la carrera de Cirujano Dentista de la Facultad de Estudios Superiores Zaragoza UNAM. El estudio fue transversal, descriptivo y observacional, en una muestra por conveniencia de 335 estudiantes que entregaron su consentimiento firmado para participar en este estudio. El bajo peso, sobrepeso y obesidad se midió a través del Índice de Masa Corporal (IMC), e interpretado por los criterios establecidos en la Norma Oficial Mexicana NOM-008-SSA3-2010, para el tratamiento integral del sobrepeso y la obesidad y la caries dental por el indicador epidemiológico de Dientes cariados, perdidos y obturados (CPOD). La información se capturó en el Programa Estadístico SPSS versión 17.0. El 3,3 % de esta población presentó bajo peso con un promedio de caries dental de 6,3±5. El 54 % normal con un CPOD de 7,6±4,8. El 31 % con sobrepeso y un promedio de caries de 7,0±5,1. El 9,3 % con obesidad grado 1 y 7,3±3,6 dientes cariado y el 2,4 % con obesidad grado 2 y 5,2±4,1 con historia de caries dental. El 31 % de los estudiantes que participaron en este estudio presentaron sobrepeso, por lo que existe un riesgo muy elevado si no se actúa con medidas preventivas y de promoción de la salud, de que estos alumnos en un futuro se conviertan en obesos y con ello tener repercusiones en su salud general.

ABSTRACT: The objective of this study is to determine the body mass index and its association with dental caries, in first-year students of the dental surgeon degree program for the 2016 school term, Zaragoza College for Higher Education, UNAM. This was a cross, descriptive and observational study, in a sample of 335 students. Low weight, overweight and obesity were measured through body mass index and interpreted with the official Mexican Norm NOM008-SSA3-2010, for integral treatment of overweight, obesity and dental caries. The measures were taken according to the epidemiologic indicator of decayed, lost and sealed teeth (dlst). We used statistical program SPSS version 17.0 for the information. In the studied population, 3.3 % presented low weight, with an average of dental caries of 6.3±5; 54 % presented normal weight with a DLST of 7.6±4.8; 31 % presented with overweight and an average of caries of 7.0±5.1; 9.3 % with obesity grade 1 and 7.3±3.6 tooth decay and lastly 2.4 % with obesity grade 2 and 5.2±4.1 with a history of dental caries. Of the students participating in this study, 31 % presented overweight, indicating a high risk of poor oral health. If preventive measures in their overall health are not implemented early on, these students are at risk of obesity and general health repercussions in the future.

Prevalence, severity, and risk indicators of gingival inflammation in a multi-center study on South American adults: a cross sectional study

ABSTRACT Objectives: The aim of this study is to investigate the prevalence and severity of gingival inflammation and associated risk indicators in South American adults. Material and Methods: Multi-stage samples totaling 1,650 adults from Porto Alegre (Brazil), Tucumán (Argentina), and Santiago (Chile) were assessed. The sampling procedure consisted of a 4-stage process. Examinations were performed in mobile dental units by calibrated examiners. A multivariable logistic regression model was utilized for associating variables as indicators of gingival inflammation (GI) (Gingival Index ≥0.5). Statistical significance was set at 0.05. Results: A total of 96.5% of the adults have GI. Regarding the severity of GI, 22.5% of participants examined have mild GI, 74.0% have moderate GI, and 3.6% have severe GI. The multivariate analyses identify the main risk indicators for GI as adults with higher mean of Calculus Index (OR=18.59); with a Visible Plaque Index ≥30% (OR=14.56); living in Santiago (OR=7.17); having ≤12 years of schooling (OR=2.18), and females (OR=1.93). Conclusions: This study shows a high prevalence and severity of gingival inflammation, being the first one performed in adult populations in three cities of South America.

Epidemiología del estado de salud periodontal en la VII Región del Maule, Chile / Epidemiology of periodontal status in the Maule Region, Chile

Antecedentes Pese a que la enfermedad periodontal es una patología altamente prevalente, en Chile la información regional es escasa y limitada, especialmente en lo referente a la realidad de la población rural. Objetivo Dada la falta de datos locales y el alto índice de ruralidad de la Región del Maule, el objetivo de este estudio fue determinar el estado periodontal de la población de 6, 12, 15, 35 a 44 y 65 a 74 años que vive en la Región del Maule. Metodología Se llevó a cabo un estudio transversal (EpiMaule) con 2.414 personas, agrupadas según las edades de vigilancia epidemiológica señaladas por la Organización Mundial de la Salud (OMS) para estudios poblacionales, sexo y zona de procedencia. Se midió el índice de placa bacteriana de Silness y Löe (IP), el índice gingival de Löe y Silness (IG) y el índice periodontal comunitario (IPC). Se analizaron los datos mediante estadística descriptiva y analítica con un nivel de significancia del 5%. Resultados La gran mayoría de la población presentó niveles moderados de placa bacteriana y de inflamación gingival, tanto los niños como los adultos y los adultos mayores. Los adolescentes de 15 años mostraron la mayor prevalencia de sangramiento al sondaje en todas las edades examinadas. Los adultos mayores mostraron los valores más altos de IP (1,75) e IG (1,62) entre todos los grupos estudiados, afectando mayormente a los mayores que viven en zonas rurales. Los hombres y la población rural presentan los valores más altos para el IP como para el IG (p < 0,05). Con un 77,2% de la población de 35 a 44 años, el código 2 del IPC fue el más frecuentemente detectado. Por su parte, el 28,8% de los participantes de 65-74 años tenían profundidades al sondaje ≥ 4 mm, representando el grupo etario con mayor prevalencia de este nivel de IPC (p < 0,05). Conclusiones La población de la Región del Maule presenta importantes diferencias en el estado periodontal según edad, sexo y ruralidad, siendo los más afectados los adultos mayores. Estos datos sugieren la necesidad de implementar políticas de salud bucal que aborden diferencialmente las distintas necesidades de las personas.

Background Despite periodontal disease being highly prevalent in Chile, information from the regions is scarce and limited, particular as regards the situation in the rural population. Objective Given the lack of local data and the high rurality index of the Maule Region, the aim of this study was to determine the periodontal status of the 6, 12, 15, 35 to 44, and 65 to 74 year-old population that lives in the Region. Methodology A cross-sectional study (EpiMaule) was conducted on 2,414 individuals, grouped according to the epidemiological surveillance ages indicated by the World Health Organisation (WHO) for population studies, sex and area of study. The measurements made include the Silness-Löe bacterial plaque index (IP), Silness-Löe gingival index (IG), and the community periodontal index (IPC). The data were analysed using descriptive and analytical statistics with a significance level of 5%. Results The large majority of the population, including children, adults and the elderly, had moderate levels of bacterial plaque and gingival inflammation. Adolescents of 15 years showed the highest prevalence of bleeding on probing in all the ages examined. The older adults had the highest IP (1.75) and IG values among all the groups studied, mainly affecting the older ones that lived in rural areas. Males and the rural population had the highest values for IP as well as for IG (P < .05). A CPI level of 2 was most frequently detected in 77.2% of the 35 to 44 years population. On the other hand, more than one-quarter (28.8%) of the 65-74 year-old participant had probe depths ≥ 4 mm, being the age group with a high prevalence at this CPI level (P < .05). Conclusions The population of the Maule Region show significant differences in periodontal status, according to age, sex, and rurality, with the elderly being the most affected. These data suggest the need to implement oral health policies that differentially approach the individual needs of the population.

Black stains and dental caries in Brazilian schoolchildren: a cross-sectional study

Abstract The aim of this study was to assess the prevalence of black stains (BS) and factors associated with their occurrence and to investigate the association of BS with caries experience after adjusting for other risk indicators. A school-based, cross-sectional study using multistage sampling of children aged 10-12 years from 20 private and public schools in Pelotas/Southern Brazil was conducted (n = 706). Children were evaluated for BS and dental caries (DMFT/dmft index) and socioeconomic information was collected by questionnaire. Univariate and multivariate Poisson regressions were used to assess variables associated with the prevalence of BS and with caries experience. The prevalence of BS was 5.81%. The mean DMFT/dmft was 1.54 (±1.91), with a maximum value of 10. Among the children with BS, mean dmft/DMFT was 1.22 (SD 1.68), with a maximum value of 6. After adjustments for demographics and socioeconomic variables, dental plaque and tooth brushing habits, prevalence of BS was associated with lower caries experience (RR 0.67; 95%CI 0.49-0.92). In conclusion, the presence of BS showed an association with lower dental caries experience in the evaluated population. Future studies should investigate the mechanisms behind this association.

Propiedades anti-placa dental bacteriana de los principales materiales dentales empleados en consultas estomatológicas / Effect of the main materials used in dental practice against the formation of bacterial dental plaque

Introducción: la placa dental bacteriana y las biopelículas se forman tanto en tejidos dentales duros como en los blandos; constituye la mayor causa de formación de caries dental y de enfermedades periodontales en los pacientes afectados. Objetivo: identificar las propiedades anti-placa dental bacteriana de los materiales dentales más empleados en consultas estomatológicas a través de una revisión bibliográfica. Métodos: se realizó una revisión bibliográfica sobre las propiedades anti-biopelícula de los principales materiales dentales utilizados en consultas estomatológicas. Los criterios de inclusión fueron: las propiedades de inhibición, formación y/o desarrollo de placa dental bacteriana en la superficie de los cementos dentales empleados en endodoncia, cementos dentales de uso frecuente como el óxido de zinc, Policarboxilato e ionómero vítreo; materiales de restauración definitiva como resinas compuestas y aleaciones de plata. Los buscadores de información y plataformas empleados fueron: SciELO, HINARI, y MEDLINE. Se revisaron 21 revistas de impacto relacionadas con el tema. Se obtuvo aproximadamente 899 artículos de los cuales solo 39 fueron incluidos en el estudio. El 52,6 por ciento de los artículos fue de los últimos 5 años. Análisis e integración de los resultados: se expone el mecanismo del efecto y propiedades anti-placa dental bacteriana de algunos cementos dentales, de materiales empleados en endodoncia y de materiales de restauración permanente. Conclusiones: la revisión de la literatura indica que de los materiales dentales que se emplean, las resinas compuestas resultaron ser las que más favorecen la formación de placa dental bacteriana seguidas de la amalgama de plata. Los cementos para tratamientos endodónticos presentaron cualidades favorables para la inhibición de la formación de biopelícula dental y los cementos con compuestos de zinc, pH elevado y liberadores de flúor mostraron cualidades óptimas en la inhibición y no formación de biopelícula(AU)

Introduction: bacterial dental plaque and biofilms are formed in hard and soft dental tissue alike. They are the main cause of dental caries and periodontal disease in the patients affected. Objective: identify the effect of the materials most commonly used in dental practice against the formation of bacterial dental plaque. Methods: a bibliographic review was conducted about the antibiofilm properties of the main materials used in dental practice. The inclusion criteria were the following: inhibitory properties, formation and/or development of bacterial dental plaque on the surface of dental cements used in endodontics, commonly used dental cements such as zinc oxide, polycarboxylate and glass ionomer, permanent restoration materials such as composite resins and silver amalgam. Data were obtained from the search engines and platforms SciELO, HINARI and MEDLINE. A review was conducted of 21 high impact journals dealing with the topic. About 899 papers were obtained, of which only 39 were included in the study. 52.6 percent of the papers had been published in the last five years. Integration of results: a description is provided of the effect of several dental cements, materials used in endodontics and permanent restoration materials against the formation of bacterial dental plaque. Conclusions: according to the bibliographic review conducted, the materials that most commonly enable the formation of bacterial dental plaque are composite resins, followed by silver amalgam. Cements used in endodontic treatment were found to have antifilm properties, whereas cements with zinc compounds, high pH and fluoride releasing capacity exhibited optimal inhibitory and antifilm properties(AU)

Prevalence of eight putative periodontal pathogens in atherosclerotic plaque of coronary artery disease patients and comparing them with noncardiac subjects: A case–control study.

Background: The study was aimed to assess the prevalence of periodontal pathogens namely Tannerella forsythia (T.f), Campylobacter rectus (C.r), Eikenella corrodens (E.c), Porphyromonas gingivalis (P.g), Treponema denticola (T.d), Prevotella nigrescens (P.n) ,Aggregatibacter actinomycetemcomitans (A.a), P.g (fi mA gene) and Prevotella intermedia (P.i), in the subgingival and the atheromatous plaque of patients with coronary artery disease (CAD), and comparing them with the noncardiac subjects thereby indicating the role of periodontal pathogenic bacteria in the progression of atherosclerosis in south Indian population. Materials and Methods: 51 cardiac and non cardiac subjects within the age group of 40–80 years,who met the eligibility criteria, were selected and categorized as the experimental and control group respectively. Total number of teeth was recorded, and oral hygiene was evaluated using Plaque Index and Oral Hygiene Index (OHI). Periodontal pocket depth and clinical attachment level were also assessed as a part of periodontal examination. Subgingival plaque samples were collected with the help of with Gracey’s curette in both the groups. In experimental group, biopsy was obtained from the atherosclerotic plaque during Coronary artery bypass grafting CABG procedure. Both, subgingival and the coronary atherosclerotic plaque samples were subjected to polymerase chain reaction (PCR) analysis for identification of the periodontal bacteria. Statistical Analysis: Mean, standard deviation and test of significance of quantitative variables such as periodontal parameters were compared between experimental group and control group. Kappa measures of agreement was done to analyze the relationship between the presence/absence of microorganisms in the subgingival and atherosclerotic plaque samples in the experimental group. Results: The mean Plaque Index, Gingival Index, Russel’s Periodontal Index, OHI, clinical attachment level, Pocket Depth Index was statistically significant in both the groups. Association of T.f, E.c, C.r, P.g, P.g (fi mA), T.d, P.i, P.n was significantly associated. A.a was absent in the control group, whereas only one patient in the experimental group was positive for the bacteria. Kappa analysis showed the significant association of periodontal bacteria T.f, C.r, P.g, P.g (fi mA), P.i and P.n in subgingival plaque and atherosclerotic plaque of the same patients of the experimental group. Conclusion: It is concluded that CAD subjects had higher prevalence of periodontal pathogens in subgingival biofilms as compared to the non cardiac subjects. Further, the number of bacteria was significantly associated between the subgingival and atherosclerotic plaques of the cardiac patients in south Indian population.

Avaliação clínica da cavidade bucal de pacientes internados em unidade de terapia intensiva de um hospital de emergência / Clinical assessment of the oral cavity of patients hospitalized in an intensive care unit of an emergency hospital

Objetivo: Descrever a condição bucal de pacientes hospitalizados em uma unidade de terapia intensiva. Métodos: A avaliação clínica da cavidade bucal foi realizada em 35 pacientes em dois momentos (até 48 horas após a internação e em 72 horas após a primeira avaliação), e anotada em fichas de coleta de dados. Foram observados: índice de placa, condição da mucosa, presença ou não de prótese dentária, número de dentes presentes e índice de saburra lingual. Resultados: A prevalência de infecção hospitalar foi de 22% (oito pacientes), sendo 50% de infecções do aparelho respiratório. Foi constatado que todos os pacientes apresentavam biofilme bucal, sendo que 20 (57%) apresentavam biofilme por meio da simples visão e, em 24 pacientes (69%), a saburra estava presente em mais de dois terços da língua, sendo espessa na maioria dos casos. Após 72 horas houve aumento significativo do índice de placa (p=0,007), no entanto, o índice de saburra quanto à área foi de p<0,001 e quanto à espessura de p=0,5. Conclusão: O índice de placa e a saburra lingual aumentaram de acordo com o tempo de internação na unidade de terapia intensiva. .

Objective: To describe the oral health status of patients hospitalized in an intensive care unit. Methods: Clinical assessment of the oral cavity was performed in 35 patients at two time-points (up to 48 hours after admission and 72 hours after the first assessment) and recorded in data collection forms. The following data were collected: plaque index, condition of the mucosa, presence or absence of dental prosthesis, number of teeth present, and tongue coating index. Results: The prevalence of nosocomial infection was 22% (eight patients), with 50% respiratory tract infections. All patients exhibited oral biofilm, and 20 (57%) showed biofilm visible to the naked eye; tongue coating was present on more than two thirds of the tongue in 24 patients (69%) and was thick in most cases. A significant increase in plaque index (p=0.007) occurred after 72 hours, although the tongue coating index was p<0.001 regarding the area and p=0.5 regarding the thickness. Conclusion: The plaque and tongue coating indices increased with the length of hospital stay at the intensive care unit. .

Risk factors associated with denture stomatitis in healthy subjects attending a dental school in Southeast Iran

There is scant information regarding the multifactorial aetiology of denture stomatitis [DS] in the world and, despite its frequency, associated factors are not completely understood. The aim of this study was to investigate the risk factors that may be associated with this lesion. A total of 70 edentulous patients, all wearing removable dentures, were divided into two groups. The test group comprised 43 patients with DS and the control group comprised 27 subjects with clinically healthy palatal mucosa. A thorough history-taking and physical examination were carried out; the subjects also answered a questionnaire. The serum level of vitamin A for each subject was assayed from a blood sample taken after the examination. This study showed a significant relationship between the incidence of DS and three major factors: denture age [in terms of years], the practitioner manufacturing the dentures [general dental practitioner versus dental hygienist], and the nightlong wearing of dentures. Also, the vitamin A serum level was low in 94.29% of all subjects [cases and controls]. Although many predisposing conditions were related to this situation, the most important risk factor was the continuous use of the dentures

Condición periodontal y pérdida dental en pacientes diabéticos del Hospital Universitario San Vicente de Paúl / Periodontal condition and tooth loss in diabetic patients

Introducción. La diabetes es una enfermedad sistémica que afecta el metabolismo de la glucosa y se ha relacionado con el desarrollo de enfermedad periodontal. Objetivo. El objetivo de este estudio fue determinar la condición periodontal y la pérdida dental de un grupo de pacientes diabéticos del Hospital Universitario San Vicente de Paúl. Materiales y métodos. A 117 sujetos con diabetes de tipo 1 y 2 se les practicó un examen periodontal completo, determinación de valores de la hemoglobina A1C (glycosilated hemoglobin) y radiografías periapicales, y se les indagó sobre hábitos de higiene oral e historia de diabetes. Los datos se analizaron de forma descriptiva y comparativa entre los parámetros clínicos, pérdida dental y tipo de diabetes. Resultados. La prevalencia de gingivitis fue de 27,4 % y la de periodontitis de 72,6 %. La complicación sistémica más frecuente fue la hipertensión arterial (51,3 %). Los dientes más frecuentemente perdidos fueron los molares y, en promedio, los sujetos habían perdido siete dientes. El control de placa bacteriana fue pobre (55,4 %). No hubo diferencias en los parámetros clínicos entre pacientes diabéticos de tipo 1 y de tipo 2. El promedio de profundidad con sonda fue 2,62 mm, siendo los molares los dientes más afectados. El promedio de pérdida de inserción fue de 3,03 mm. Los dientes 17, 16, 27, 37 y 47 presentaron los valores más altos de pérdida de inserción. Conclusiones. En conclusión, la condición periodontal en pacientes diabéticos fue mala, y presentaban periodontitis en la mayoría de los casos. Esto puede ser una causa importante de pérdida dental en sujetos diabéticos y requiere de especial atención por parte de los odontólogos y médicos.

Introduction. Diabetes is a systemic disease which affects the metabolism of glucose,and it has been associated with the development of periodontal disease. Objective. The periodontal condition and tooth loss was evaluated in diabetic subjects. Materials and methods. At the San Vicente de Paúl Hospital (Medellín, Colombia), 117 subjects with type 1 and 2 diabetes mellitus were examined. Patients underwent a comprehensive periodontal evaluation, glycosylated hemoglobin analysis, oral hygiene habits and history of diabetes. A descriptive and comparative analysis between the clinical parameters, tooth loss and type of diabetes was performed. Results. The prevalence of gingivitis was 27.4% and periodontitis 72.6%. The most frequent systemic complication was hypertension (51.3%). The most frequently lost teeth were molars and in general, the subjects had lost an average of 7 teeth and had a poor plaque control (55.4%). No differences were seen in clinical parameters between type 1 and 2 diabetes patients. The mean probing depth was 2.6 mm. The first and second upper and lower molars showed the highest values of PD. The mean clinical attachment loss was 3.3 mm . Maxillary teeth 17, 16, and mandibular 37, 47 showed the highest values of clinical attachment loss. Conclusions. In conclusion, the periodontal condition in diabetic patients was poor, presenting periodontitis in most cases. This can be a major cause of tooth loss in diabetic subjects and requires special attention by clinicians.

Avaliação periodontal e de adaptabilidade após utilização de dois modelos de contenção ortodôntica fixa / Evaluation of the periodontium and of the adaptability after using two models of fixed orthodontic retainers

O objetivo desta pesquisa foi comparar dois tipos de contenções ortodônticas fixas correntemente usadas na clínica ortodôntica. As contenções avaliadas foram a contenção convencional (reta) e a contenção modificada (com livre acesso do fio dental). Essas contenções foram comparadas em relação ao acúmulo de placa e à ocorrência de inflamação gengival. Também foram avaliados o conforto e a adaptabilidade do paciente quanto ao uso das mesmas. Para tanto, foram selecionados 19 voluntários que haviam concluído o tratamento ortodôntico e, portanto, apresentavam bom alinhamento dos dentes anteriores inferiores, bem como ausência de doença periodontal. Após as orientações de higiene, as contenções avaliadas nesse estudo foram coladas nos dentes, sendo que uma metade da contenção tinha o desenho convencional e a outra metade, o desenho da contenção higiênica. Nos períodos de três e seis meses de uso dessas contenções, os pacientes preencheram um questionário para avaliar-se a adaptação e o conforto delas, a facilidade de higienização e qual desenho de contenção favoreceu um maior acúmulo de alimentos. Nesses períodos, foram aferidos os parâmetros clínicos periodontais dos sítios próximos às respectivas contenções. Os resultados mostraram que não houve diferença estatisticamente significativa — para o índice de placa e para o sangramento gengival nos períodos de três e seis meses — entre os grupos de contenção convencional e modificada. Os pacientes se adaptaram melhor ao uso da contenção convencional. Quanto à higienização, a contenção modificada foi a escolhida, sendo que grande diferença foi notada durante a higienização com o fio dental.