Periodontitis and its higher levels of severity are associated with the triglyceride/high density lipoprotein cholesterol ratio.

BACKGROUND: Periodontitis and the Triglyceride/High Density Lipoprotein Cholesterol (TG/HDL-C) ratio have both been associated with cardiovascular disease, metabolic syndrome, and obesity. Additionally, the ratio is a possible substitute for predicting insulin resistance. This study investigated the association between periodontitis, its severity levels (exposures), and the TG/HDL-C ratio (outcome). METHODS: A cross-sectional study of public health service users in Brazil considered socioeconomic-demographic characteristics, lifestyle behavior, and general and oral health conditions. Anthropometric measurements and blood pressure were also measured. Systemic biomarker data were obtained, as well as assessment of periodontal diagnosis and its severity. The TG/HDL-C ratio was calculated using the serum triglyceride level over HDL cholesterol and the cut-off point, TG/HDL-C ≥2.3 serving as the cutoff indicting dyslipidemia. Logistic and linear regressions were used to statistically analyze the data. RESULTS: A total of 1011 participants were included, with 84.17% having periodontitis and 49.85% having a TG/HDL-C ratio ≥2.3. For individuals with periodontitis, the odds of TG/HDL-C ratio ≥2.3 were 1.47 times greater than in those without periodontitis (ORAdjusted  = 1.47, 95% CI: 1.02-2.14). Similar results were found for those with moderate and severe periodontitis, with a slight increase in the measurement magnitude with disease severity. CONCLUSION: A positive relationship between periodontitis and the TG/HDL-C ratio ≥2.3 was found, suggesting a possible association with periodontal disease severity.

Severe and moderate periodontitis are associated with acute myocardial infarction.

BACKGROUND: An association between periodontitis and cardiovascular disease is now well documented; however, the effect of periodontitis severity levels on this outcome, specifically on acute myocardial infarction (AMI), remains unexplored. This study investigated the association between levels of periodontitis severity (exposure) and AMI (outcome). METHODS: This case-control study, matched by sex and age, was conducted with 621 participants, with 207 individuals treated in the emergency department of Santa Izabel and Ana Nery Hospitals in Salvador, Bahia, Brazil, diagnosed with a first AMI event, and compared to 414 individuals without a diagnosis of AMI. Levels of periodontitis severity followed two criteria: (1) Center for Disease Prevention and Control and American Academy of Periodontology; (2) Gomes-Filho et al. (2018) using criteria that also evaluated bleeding upon probing. Conditional logistic regression analysis was performed and odds ratios (ORs) and their 95% confidence intervals (CIs) were obtained. RESULTS: The adjusted association measurements showed a positive association between both severe (ORadjusted ranged from 2.21 to 3.92; 95% CI ranged from 1.03 to 10.05) and moderate periodontitis (ORadjusted ranged from 1.96 to 2.51; 95% CI ranged from 1.02 to 6.19), and AMI, for both periodontitis diagnostic criteria. It demonstrated that among those with moderate and severe periodontitis, the chance of having AMI was approximately two to four times greater than among those without periodontitis. CONCLUSION: The findings demonstrate that there is an association between the severity of the periodontal condition and AMI, suggesting a possible relationship among the levels of periodontitis severity and the cardiovascular condition.

Association between osteoporosis treatment and severe periodontitis in postmenopausal women.

OBJECTIVE: To estimate the association between osteoporosis treatment and severe periodontitis in postmenopausal women. METHODS: This cross-sectional study comprised of 492 postmenopausal women, 113 women in osteoporosis treatment, and 379 not treated. Osteoporosis treatment consisted of systemic estrogen alone, or estrogen plus progestin, and calcium and vitamin D supplements, for at least 6 months. Severe periodontitis was defined as at least two interproximal tooth sites with clinical attachment loss of at least 6 mm, and at least one interproximal site with probing depth of at least 5 mm; and dental caries experience was measured using the decayed, missing, and filled teeth (DMFT) index. Analysis included descriptive statistics and Poisson multivariate analysis with robust variance. RESULTS: Women receiving osteoporosis treatment had less periodontal probing depth, less clinical attachment loss, and less gingival bleeding than women not receiving treatment for osteoporosis (P ≤ 0.05). In the osteoporosis treatment group, the estimated mean DMFT index score was approximately 20, the most frequent component being the number of missing teeth, and in the nontreated group, the DMFT index was approximately 19. The prevalence of severe periodontitis was 44% lower in the osteoporosis treatment group than in the nontreatment group. The prevalence ratioadjusted was 0.56, 95% confidence interval was 0.31 to 0.99 (P = 0.05), after adjustments for smoking, age, family income, and visit to the dentist. CONCLUSIONS: The results suggest that women treated with estrogen for postmenopausal osteoporosis have a lower prevalence of severe periodontitis than women not receiving treatment.

Evaluation of the genotoxicity and cytotoxicity of filling pastes used for pulp therapy on deciduous teeth using the micronucleus test on bone marrow from mice (Mus musculus).

Pulp therapy is the last resort for preserving deciduous teeth. However, the genotoxic and cytotoxic effects of many products used in this therapy are not well established. The aim of this study was to use the micronucleus test on bone marrow from mice to evaluate the genotoxic and cytotoxic effects of four filling pastes: zinc oxide, calcium hydroxide P.A., mineral trioxide aggregate and an iodoform paste (iodoform + camphorated + paramonochlorophenol + rifamycin + prednisolone). Male Swiss mice were divided into 4 groups of 10 animals, each exposed to one of the pastes, and were subdivided according to the dilutions tested: 1/10, 1/50, 1/500 and 1/1000 administered intraperitoneally (0.1ml/10g of weight). Cyclophosphamide was the positive control. The negative controls were dimethylsulfoxide and buffered saline solution. Five animals were killed 24h and five 48h after the treatment. The material was processed in accordance with Schmid (1976) and micronuclei were counted in 1000 polychromatic erythrocytes (PCE), under an optical microscope in a blinded test. Cytotoxicity was evaluated using the PCE/normochromatic erythrocyte (NCE) ratio in 200 erythrocytes. The micronucleus analysis results were evaluated using the conditional test for comparing proportions in situations of rare events. Analysis of variance and Tukey's test were used to evaluate the PCE/NCE ratio. There was significantly greater occurrence of micronuclei in the animals treated with iodoform paste at all the dilutions tested, at both sacrifice times. Greater occurrence of micronuclei was observed among the animals treated with zinc oxide and sacrificed 48h after the treatment, at the dilutions 1:50; 1:500 and 1:1000. Calcium hydroxide P.A. and mineral trioxide aggregate did not present any genotoxic or cytotoxic effects. The genotoxicity and cytotoxicity of zinc oxide and iodoform paste revealed here constitute an initial step towards their contraindication, but additional studies will be necessary in order to securely establish the risks involved in their use.

Genotoxic and cytotoxic effects of testosterone cypionate (deposteron(®)).

The indiscriminate use of anabolic androgenic steroids (AAS) has motivated researchers to investigate the mutagenic action of these substances. The present study, using the mouse bone marrow micronucleus test, evaluates the genotoxic potential of testosterone cypionate (deposteron). Male Swiss mice received intramuscular injections of deposteron at three doses. The animals were sacrificed 24, 48, or 72h after treatment and bone marrow was removed immediately, followed by scoring to count the micronuclei in 2000 polychromatic erythrocytes (PCE). Two hundred erythrocytes/animal were analyzed to determine the PCE-NCE (normochromatic erythrocyte) relationship and to determine the cytotoxic effects. The animals treated with deposteron at the highest dose presented greater numbers of micronuclei. The highest dose caused a decrease in the PCE/NCE relationship, indicating a cytotoxic effect. We conclude that deposteron is genotoxic and cytotoxic in mice.

Women with low bone mineral density and dental panoramic radiography.

OBJECTIVE: The aim of this study was to investigate whether some mandibular measurements on panoramic radiographs are associated with low bone mineral density in postmenopausal women. METHODS: A sample of 122 panoramic dental radiographs and bone density tests from women 50 years or older were examined. Bone mineral density was measured in the lumbar spine and proximal femur regions through dual-energy x-ray absorptiometry. The mandibular cortical bone thickness below the mental foramen, mandibular alveolar bone resorption, and panoramic mandibular index were measured. RESULTS: The mandibular cortical thickness and mandibular alveolar bone resorption showed the highest specificity (lumbar spine: 89.8% vs 73.5%, proximal femur: 83.6% vs 71.2%, respectively). The panoramic mandibular index demonstrated the highest sensitivity (lumbar spine: 43.8%; proximal femur: 40.8%). The association between the mandibular cortical thickness and bone mineral density was statistically significant even after adjustment for hormonal treatment, smoking, age at menopause, and body mass index (P = 0.04). CONCLUSIONS: It is suggested that panoramic radiography may be useful for confirming individuals who present with low bone mineral density.

Periodontal therapy and low birth weight: preliminary results from an alternative methodologic strategy.

BACKGROUND: The purpose of this study is to present the use of a non-randomized experimental design with multiple controls, with emphasis on a historical control group, as an alternative methodologic resource for studies on the association between periodontal disease and prematurity/low birth weight. METHODS: The sample consisted of 234 pregnant women: 54 in the Test Group (treatment of periodontal disease); 68 in Control Group I (without periodontal disease); and 112 in Control Group II (historical control group, with untreated periodontal disease). The diagnosis of periodontal disease was established by means of a complete clinical examination, using measurements of probing depth, gingival recession, clinical attachment loss, and bleeding index. The women in the Test Group were treated for periodontitis and followed-up with periodontal support therapy throughout their pregnancies. After delivery, they were reevaluated regarding their periodontal condition, and information on the newborn's birth weight was obtained. This was also done for Control Groups I and II. Descriptive analyses on the study variables were performed using the χ(2) and Fisher exact tests. Association measurements (relative risk) were obtained using a significance level of 5%. RESULTS: The frequency of low birth weight among the Test Group was similar to Control Group I and lower than Control Group II. CONCLUSION: The results suggest that successful periodontal therapy in pregnant women suffering from periodontitis is a protective factor promoting the birth of children with normal weight.

Contribution of periodontal disease in pregnant women as a risk factor for low birth weight.

UNLABELLED: Starting in the 1990s, several authors sought to investigate the hypothesis that periodontitis during pregnancy may contribute towards the birth of low-weight children. However, this relationship is still not well established. The aim of this study was to evaluate whether this oral infection is associated with this gestational event. METHODS: This was a case-control study among 548 puerperae, of whom 164 were the mothers of low-weight live births (case group) and 384 were the mothers of live births of normal gestational weight (control group). They were selected at two public hospital units in two municipalities in the State of Bahia. From interviews and data gathered using live birth cards or birth certificates, information was obtained regarding age, height, previous diseases, marital status, socioeconomic situation, smoking and alcohol use. Mothers who presented at least four teeth on which one or more sites had a probing depth of greater than or equal to 4 mm, clinical attachment loss of greater than or equal to 3 mm and bleeding on probing, at the same site, were deemed to present periodontal disease. The data were analysed by stratification from logistic regression. RESULTS: Periodontal disease was diagnosed in 42.7% of the case group and 30% of the control group. A statistically significant association was found between periodontal disease and low birth weight (unadjusted OR = 1.74; 95% CI: 1.19-2.54), particularly among mothers with low schooling levels (adjusted OR = 2.30; 95% CI: 1.14-4.6). CONCLUSION: The findings suggest an association between periodontal disease and low birth weight among mothers with low education levels.

Fatores associados ao histórico de prática de atividade física em gestantes / Factors associated with a history of practicing physical activity among pregnant women

A necessidade do conhecimento dos fatores externos que podem influenciar na causalidade de eventos deletérios à gestação é de grande relevância, pois podem determinar a morbi-mortalidade infantil. Sabe-se que a prática de atividade física orientada, ao contrário, executada durante a gestação, traz benefícios. O objetivo deste estudo foi avaliar descritivamente os aspectos sociodemográficos, de saúde, estilo de vida em gestantes com histórico de prática de atividade física (PAF). Um estudo exploratório do tipo corte transversal foi composto por 164 grávidas, divididas em dois grupos: o GRUPO 01, de mulheres com histórico de prática de atividade física, e o GRUPO 02, de mulheres sem histórico de prática de atividade física. Todas responderam a um questionário para coletar dados sociodemográficos e de estilo de vida, além de informações acerca do histórico de prática de atividade física. Inicialmente, foram estimadas as freqüências das variáveis estudadas e então obtidas as medidas de associação (RP e IC 95%) entre o histórico de PAF e as variáveis em questão. Os resultados demonstraram uma precariedade no acesso aos serviços básicos de saúde, renda e escolaridade baixas, e a falta de prática de atividade física regular antes e durante a gestação.

Exposure measurement in the association between periodontal disease and prematurity/low birth weight.

AIM: To compare the use of different definitions for exposure measurement in cases of association between periodontal disease (PD) and prematurity and/or low birth weight (PLBW). MATERIAL AND METHODS: A database from a previous case-control study was used to compare four different definitions for periodontitis: at least one site with probing depth > or =4 mm (1); at least one site with clinical attachment loss (CAL)> or =3 mm (2); at least four teeth with one or more sites presenting probing depth > or =4 mm, with CAL> or =3 mm at the same site (3); and at least four teeth with one or more sites with probing depth > or =4 mm, with CAL> or =3 mm at the same site and presence of bleeding on probing (4). The PD frequency, diagnostic values and adjusted association measurements were calculated. RESULTS: PD frequency ranged from 33.1% to 94.7%. Odds ratio(adjusted) varied slightly according to the exposure measurement used. CONCLUSIONS: The association between PD and PLBW weight was consistent, except for exposure measurement 1, i.e. using at least one site with CAL> or =3 mm for periodontitis diagnosis, while the magnitude of this varied according to the definition established.

Periodontal status as predictor of prematurity and low birth weight.

OBJECTIVE: The objective was to verify the relation between periodontal status and prematurity/low birth weight. METHODS: a case control study of 211 women, 44 being mothers of children born with weight below 2.500g or gestational age of less than 37 weeks (case group) and 177 mothers of children born with weight of over 2.500g or more and gestational age of 37 weeks or more (control group). The women were invited to reply to a questionnaire during the interview. A single dentist performed a complete periodontal exam in the oral cavity of each participant, including: probing depth, recession, plaque index, bleeding on probing, and clinical attachment loss measurements. Descriptive analysis of the study variables was performed and the statistical significance was calculated at 5%, using the chi-squared test. RESULTS: There was no statistically significant difference in the clinical parameters between the groups. CONCLUSIONS: The findings showed no association between periodontal status and prematurity/low birth weight.

Sobrepeso e obesidade infantil: influência de fatores biológicos e ambientais em Feira de Santana, BA / Childhood overweight and obesity: influence of biological and environmental factors in Feira de Santana, BA

Sobrepeso e obesidade infantil apresentam prevalência elevada e caráter multifatorial. Com o objetivo de determinar a influência de fatores biológicos e ambientais no seu desenvolvimento, foi realizado corte transversal com 699 crianças, de 5 a 9 anos, da rede de ensino público e privado da zona urbana de Feira de Santana, BA. Sobrepeso e obesidade foram definidos como índice de massa corpórea > aos percentis 85 e 95 para idade e sexo, respectivamente. A análise de entrevistas com os responsáveis determinou a influência dos fatores em questäo. Observados como de significância estatística para o desenvolvimento de ambas as condiçöes: nível elevado de escolaridade e renda familiar, ser unigênito, freqüentar escola privada, possuir ele trodomésticos e utilizar computador. O grupo étnico branco relacionou-se apenas ao sobrepeso. Repetência escolar e realizaçäo de atividade física sistemática mostraram associaçäo inversa. O odds ratio mostrou associaçäo preditiva independente com o fato de estudar em escola privada e ser unigênito. Em conclusäo, há influência de fatores biológicos e ambientais no desenvolvimento de sobrepeso e obesidade infantil, confirmando o caráter multifatorial