ABSTRACT
BACKGROUND: The crevicular fluid contains biomarkers that allow the identification of periodontal disease, anticipation of its risk, and prediction of its progression. PURPOSE: The purpose of this study is to correlate interleukin-1ß (IL-1ß) and matrix metalloproteinase-1 (MMP-1) levels in crevicular fluid with periodontal disease severity in schoolchildren. METHODS: A cross-sectional study was conducted in 82 schoolchildren between 9 and 12 years. The biofilm percentage, attachment level, gingival recession, dental calculus, and bleeding on probing were measured in the teeth 16, 26, 36, 41, and 46. These five parameters obtained were considered to propose a disease score between 0 and 10 points. In crevicular fluid from the tooth with the highest score, IL-1ß and MMP-1 levels were measured. RESULTS: According to the proposed score, mild gingivitis was identified in 20 schoolchildren, moderate gingivitis in 30, and severe gingivitis in 32. Biofilm percentage, IL-1ß, and MMP-1 levels increased as the severity of the disease increase. The mean and 95% confidence interval were 23.2 pg/µl (18.6-27.7), 37.3 pg/µl (27.8-46.9), and 44.6 pg/µl (34.4-58.8) (P = 0.01) for IL-1ß and 2.69 mol/min (2.51-2.87), 4.43 mol/min (3.9-4.95), and 5.59 mol/min (4.81-6.38) (P < 0.001) for MMP-1 in each group, respectively. The proposed clinical score correlated with biofilm percentage (r = 0.63), IL-1ß (r = 0.50), and MMP-1 (0.45) levels, P < 0.001 in all cases. CONCLUSIONS: The proposed clinical score for periodontal disease in children correlated with percentage of biofilm, IL-1ß, and MMP-1 levels.
ABSTRACT
OBJECTIVES: To determine the effectiveness of a motivational interviewing-based educational program in reducing the number and intensity of new caries and bacterial dental plaque levels at 6 months post randomization. STUDY DESIGN: A randomized and single blind clinical trial in 100 schoolchildren between 6-10 years of age presenting the highest risk score of caries according to the Caries Management by Risk Assessment (CAMBRA) criteria was performed. These patients were randomized to two groups: control (in which the mothers initially received an oral prevention informative session) and experimental (in which the mothers received the initial informative session, followed by individual motivational interviewing sessions during a period of 6 months). The International Caries Detection and Assessment System (ICDAS) scores and bacterial plaque were evaluated at baseline, at 6 and 12 months. RESULTS: After 12 months, children in the experimental group had 2.12 ± 0.8 new caries versus 3.5 ± 0.9 in the control group (t=7.39; p<0.001). Caries in the experimental group was seen to be limited to the enamel, with a median intensity of 2 (range 0-3) versus 3 (0-6) in the control group (U=1594; p<0.0001). Bacterial plaque determined by the O'Leary index decreased in both groups; however, it decreased more in the experimental than in the control group (34.3 vs. 20.6; t=-3.12, p= 0.002) respectively. CONCLUSIONS: Motivational interviewing is better than traditional educational programs in preventing caries and decreasing bacterial plaque. Key words:Health educational, motivational interviewing, caries risk.
