Periodontitis and non-communicable diseases in a Brazilian population, a cross-sectional study, Vila Velha-ES, Brazil.

BACKGROUND: The objective of this study was to examine the hypothesis that periodontal disease is associated with chronic non-communicable diseases. METHODS: In this cross-sectional study, we evaluated the periodontal health condition of the population, based on the community periodontal index, as well as the number of missing teeth and the presence of systemic health conditions. We quantified the association between oral health and the presence of chronic diseases using simple logistic regression, adjusting for confounding factors including age, smoking, and overweight. RESULTS: The study population consisted of 334 volunteers, aged between 19 and 81 years. In patients over 45 years old, periodontal disease was found to be significantly associated with hypertension and diabetes. Furthermore, in female patients, periodontal disease was significantly associated with hypertension, diabetes, and cancer. CONCLUSION: Our findings indicate that periodontal disease is positively and significantly associated with both arterial hypertension and diabetes, independent of potential confounding factors.

Assessment of Subgingival Biofilm and its Relationship with the Status of Tumors in a Population with Breast Cancer

This study aimed to compare the subgingival microbiota of subjects with and without breast cancer (BC). Patients with BC (Group 1; n= 50) and without BC (Group 2; n=50) with periodontitis (A) and without periodontitis (B). The study was conducted in two phases (P1 and P2). One biofilm sample was collected from each subject and analyzed by DNA-DNA Hybridization (Checkerboard DNA-DNA). The relative abundance of the subgingival microbiota differed between the Case and Control groups. However, some species were higher in patients in the Case than in Control subjects and differed between the groups in both phases. Composition of the subgingival microbial community according to the Socransky complex was related to periodontal disease, followed by clinical attachment of level (CAL ≥4mm), age, and tooth loss, which were found to be abundant in Cases when compared with controls. Patients with Tumor Grade II and III had a higher prevalence of tooth loss and CAL≥4mm. It was concluded that in individuals with BC, the sub-gingival microbiota exhibited atypical changes, but they developed periodontal disease.

El objetivo de este estudio fue comparar la microbiota subgingival de sujetos con y sin cáncer de mama (CM). Pacientes con CM (Grupo 1; n= 50) y sin CM (Grupo 2; n=50) con periodontitis (A) y sin periodontitis (B). El estudio se realizó en das fases (P1 y P2). Se recogió una muestra de biopelícula de cada sujeto y se analizó mediante hibridación ADN-ADN (tablero de ajedrez ADN-ADN). La abundancia relativa de la microbiota subgingival difirió entre los grupos de Caso y Control. Sin embargo, algunas especies fueron más altas en los pacientes del Caso que en los sujetos del Control y difirieron entre los grupos en ambas fases. La composición de la comunidad microbiana subgingival según el complejo de Socransky se relacionó con la enfermedad periodontal, seguida por el nivel de inserción clínica (CAL≥4mm), la edad y la pérdida de dientes, que se mostró abundante en los casos en comparación con los controles. Los pacientes con Tumor Grado II y III tuvieron mayor prevalencia de pérdida dental y CAL≥4mm. Se concluyó que en individuos con CM la microbiota subgingival presentó cambios atípicos, pero sin embargo, desarrollaron enfermedad periodontal.

Efeitos clínicos da fotobiomodulação como terapia adjuvante não-cirúrgica na periodontite crônica: uma revisão integrativa da literatura / Clinical effects of photobiomodulation as non-surgical adjuvant therapy for chronic periodontitis: an integrative literature review

Introdução: A doença periodontal, de origem infecciosa, constitui diferentes quadros clínicos de caráter multifatorial e inflamatório. A fotobiomodulação é uma técnica não invasiva que tem demonstrado ser capaz de diminuir a inflamação e proporcionar alívio da dor. Estudos também demonstraram que a adoção da fotobiomodulação adjuvante à raspagem e alisamento radicular tem sido capaz de reduzir a carga bacteriana proveniente da periodontite crônica. Objetivos: Analisar os efeitos da fotobiomodulação como terapia adjuvante à raspagem e ao alisamento radicular no tratamento da periodontite crônica publicados nos últimos cinco anos. Métodos: Trata-se de uma revisão integrativa da literatura, realizada no período de setembro a novembro de 2021, mediante a utilização dos seguintes descritores: "Periodontitis", "Photobiomodulation" e "Therapy, selecionando artigos publicados em inglês durante o período entre 2016 a 2021. Resultados: Foram identificados 47 trabalhos. Destes, foram excluídos 39 estudos que se dispersaram do tema e 2 que se encontravam indisponíveis para o acesso, resultando em 6 artigos que foram consultados integralmente. Foi consenso entre os artigos consultados que a prática da fotobiomodulação tornou-se um potencial agente terapêutico no tratamento da periodontite crônica contribuindo para a redução da contagem de periodontopatógenos e que atua de maneira coadjuvante às raspagens radiculares. Conclusão: A fotobiomodulação mostrou-se uma ferramenta promissora na área odontológica. Entretanto, a grande variedade nos parâmetros de tratamentos e protocolos utilizados na fotobiomodulação impossibilita uma comparação e uma análise mais crítica e rigorosa dos resultados obtidos nos trabalhos analisados.

Introduction: Periodontal disease, which has an infectious origin, constitutes a multifactorial and inflammatory different clinical condition of multifactorial, inflammatory, and infectious origin. Photobiomodulation is a non-invasive technique that has been shown to decrease inflammation and provide pain relief. Studies also have shown that the choosing of photobiomodulation as adjuvant therapy to scaling and root planing has been able to reduce the bacterial load from chronic periodontitis. Objectives: To analyze the effects of photobiomodulation as an adjuvant therapy to scaling and root planing in the treatment of chronic periodontitis in the studies published in the last five years. Methods: This is an integrative literature review, carried out from September to November 2021, using the following descriptors: "Periodontitis", "Photobiomodulation" and "Therapy, from selected articles published in English during the period between 2016 to 2021. Results: From the research and selection of studies to compose this integrative literature review, 47 studies were initially identified based on the descriptors. From those, 39 papers that were outside from the topic and 2 papers that were unavailable for access were excluded from the present review. Then remained, 6 articles that were fully consulted. The practice of photobiomodulation has become a potential therapeutic agent in the treatment of chronic periodontitis reducing the count of periodontopathogens and as an adjunct therapy to root scaling. Conclusion: Photobiomodulation therapy has become a promising tool in the dental field, however, the great variety in the treatment parameters and protocols used for photobiomodulation makes impossible to compare and perform a more critical and rigorous analysis of the results collected in the present work.

O papel da saliva na pandemia por COVID-19: alternativa diagnóstica para um problema de saúde pública global / The role of saliva in the COVID-19 pandemic: diagnostic alternative for a global public health problem

O objetivo desse estudo foi relatar as evidências disponíveis sobre o papel da saliva no diagnóstico da Covid-19. Trata-se de uma revisão narrativa da literatura de cunho qualitativo com buscas realizadas a partir das bases de dados eletrônicas PubMed, Google Acadêmico e Scielo, nos idiomas português e inglês utilizando os termos "Covid-19", "Diagnóstico" e "Saliva". Foi observado a utilização da saliva com a finalidade de se monitorar o estado de saúde e da doença de uma pessoa cujo objetivo tem se tornado extremamente desejável quanto à promoção da saúde e à pesquisa de cuidados em saúde. Nesse sentido, amostras de saliva podem ser usadas no diagnóstico da Covid-19. Um obstáculo crítico para o diagnóstico salivar pode ser a validação de amplo espectro em pacientes com Covid-19 durante o período de incubação, a fase de resposta viral e a fase inflamatória do hospedeiro de indivíduos assintomáticos e sintomáticos. Conclui-se que a saliva pode ter aplicações potenciais no contexto da Covid-19, mas, são necessários mais estudos para investigar o potencial diagnóstico da Covid-19 na saliva e seu impacto na transmissão desse vírus.

The aim of this study was to review the available evidence on the role of saliva in the diagnosis of Covid-19. This is a narrative review of the literature of a qualitative nature whose search was carried out from the digital databases PubMed, Academic Google and Scielo, in Portuguese and English, using the terms "Covid-19", "Diagnosis" and "Saliva". It was observed that the use of saliva in order to monitor a person's state of health and illness it became an objective extremely desirable in terms of health promotion and health care research. In this sense, saliva samples can be used in the diagnosis of Covid-19. A critical obstacle for salivary diagnosis may be broad-spectrum validation in patients with Covid-19 during the incubation period, the viral response phase, and the host inflammatory phase in asymptomatic and symptomatic patients. It is concluded that saliva may have potential applications in the context of Covid-19, but further studies are needed to investigate the diagnostic potential of Covid-19 in saliva and its impact on the transmission of this virus.

Dental and Periodontal Conditions in Alcoholics from a Brazilian Recovery Centera

ABSTRACT: The aim of this study was to evaluate the dental and periodontal condition of alcohol-dependents from a Brazilian Recovery Center. Sixty male individuals (30 alcoholic and 30 non-alcoholic) and aged between 32 and 72 years old were clinically evaluated. Interviews, dental and periodontal clinical examinations were obtained from all participants. The Pearson Chi-Square Test and Exact Fisher test were used to compare categorical data. The t-Student's test was adopted for non-categorical data. Multiple logistic regressions were used to evaluate the association of variables in the groups. The alcoholics were younger, consumed more tobacco, had lower frequency of tooth brushing and dental flossing, higher number of missing and decayed teeth, more residual root, and more teeth with presence of visible plaque index (OR = 0.5, 95 % Cl = 4.4 to 5.5), when compared to the non-alcoholics. Alcoholics at the Recovery Center performed poor oral hygiene, had higher number of sites with periodontal disease, and worse oral hygiene than non-alcoholic individuals. As regards professional follow-up, there was similarity between the groups evaluated.

RESUMEN: El objetivo de este estudio fue evaluar las condiciones dentales y periodontales de los alcohólicos de un Centro de Recuperación de Brasil. Sesenta hombres (30 alcohólicos y 30 no alcohólicos) y con edades comprendidas entre 32 y 72 años fueron evaluados clínicamente. Se obtuvieron entrevistas, exámenes clínicos dentales y periodontales de todos los participantes. La prueba de Chi-cuadrado de Pearson y la prueba exacta de Fisher se utilizaron para comparar datos categóricos. La prueba de t-Student se adoptó para datos no categóricos. Se utilizaron regresiones logísticas múltiples para evaluar la asociación de variables en los grupos. Los alcohólicos eran más jóvenes, consumían más tabaco, tenían menor frecuencia de cepillado dental y uso de hilo dental, mayor número de dientes perdidos y cariados, más raíz residual y más dientes con presencia de índice de placa visible (OR = 0,5, 95 % Cl = 4,4 a 5,5), en comparación con los no alcohólicos. Los alcohólicos en el Centro de Recuperación realizan una mala higiene bucal, tenían un mayor número de sitios con enfermedad periodontal y una peor higiene bucal que los no alcohólicos. En cuanto al seguimiento profesional, hubo similitud entre los grupos evaluados.

Tratamento cirúrgico em fratura de mandíbula atrófica: uma revisão de literatura / Surgical treatment of atrophic jaw fracture: a literature review

Analisar o manejo de fraturas em mandíbula atrófica voltado para a abordagem cirúrgica com ênfase na melhor técnica indicada. A perda óssea alveolar tem sido uma das consequências do edentulismo, que tem o potencial de levar a atrofia óssea. As fraturas de mandíbulas atróficas, normalmente são consideradas um procedimento desafiador, devido ser encontrada em pacientes idosos ou em virtude da perda dentária precoce resultando em um reparo dessas fraturas mais complexo. Os principais fatores etiológicos têm sido os acidentes automobilísticos, seguidos de queda e agressão. Geralmente, as causas das quedas decorrem de desequilíbrio, fraqueza muscular, tontura, e uso crônico de medicamentos como sedativos. As opções terapêuticas objetivam restaurar forma, função e imobilização apropriada desse possível evento. A individualização do tratamento de escolha é de grande importância, pois geralmente o paciente apresenta alterações fisiológicas decorrentes do envelhecimento e ossos mais fragilizados com potencial osteogênico reduzido, que dificultam a abordagem cirúrgica. Entretanto, deve ser considerado para o manejo dessas fraturas, a idade do paciente, as condições e quantidade de tecido ósseo e tecido mole. Porém, vale ressaltar que o envelhecimento não apresenta contraindicação, apenas exige condições especiais que devem ser consideradas. Nesse sentido, quando há oportunidade de dispositivos tecnológicos, como os biomodelos que contribuem significativamente para procedimentos cirúrgicos bucomaxilofaciais, esses fornecem maior previsibilidade de resultados, bem como redução do tempo cirúrgico.

To analyze the management of fractures in atrophic mandible aimed at the surgical approach, emphasizing which technique is best indicated. Alveolar bone loss has been one of the consequences of edentulism, which has the potential to lead to bone atrophy. Atrophic jaw fractures are usually considered a challenging procedure, as they are found in elderly patients or due to early tooth loss, resulting in a more complex repair of these fractures. The main etiological factors have been described as car accidents, followed by falls and aggression. Commonly, the causes of falls stem from imbalance, muscle weakness, dizziness, and chronic use of medications such as sedatives. The therapeutic options aim to restore form, function and appropriate immobilization of this possible event. The individualization of the treatment of choice is of great importance, as the patient usually presents physiological changes resulting from aging and more brittle bones and a reduced osteogenic potential, which makes the surgical approach difficult. However, the patient's age, conditions and amount of bone and soft tissue must be taken into consideration for the management of these fractures. However, it is noteworthy that aging has no contraindication, it only requires special conditions that must be considered. In this sense, when there is an opportunity for technological devices, such as biomodels that significantly contribute to maxillofacial surgical procedures, it provides greater predictability of results, as well as reduced surgical time.

Incidence of Fracture in Single Ceramic Crowns in Patients with Chronic Tooth Wear: A Clinical Follow-up

ABSTRACT: The aim of this study was to identify the incidence of fractures in single crowns placed in individuals with chronic tooth wear. The sample selection was performed based on the evaluation of 218 patient records rehabilitated with single crowns placed by the same professional from a private clinic. After exclusion criteria, 43 individuals (18 males and 25 females) were included and a total of 112 single crowns distributed in both jaws. Three ceramic systems were evaluated: 34 feldspathic all-ceramic, 38 metal-ceramic with a core in gold electropositive alloy, and 40 In-Ceram Alumina. The intraoral photograph analysis adopted a diagnosis method of tooth wear according to the morphological variations of the teeth. Of the 112 crowns evaluated, 47 were placed in male and 65 in female patients, aged between 21 to 74 years (mean 27.5 years old). The variables gender (p = 0.83), presence of chronic tooth wear (p = 0.91), ceramic system (p = 0.24) and crown location (p = 0.86) did not present a statistically difference. However, the variables pulp vitality (p = 0.04) and survi val time (p = 0.01) presented a statistically significant difference. The evaluated ceramic systems can be considered as alternativ es of restorative material, even in individuals with clinical characteristics suggestive of chronic tooth wear.

RESUMEN: El objetivo de este estudio fue identificar la incidencia de fracturas en coronas individuales colocadas en individuos con desgaste dental crónico. La selección de la muestra se realizó en base a la evaluación de 218 registros de pacientes rehabilitados con coronas individuales colocadas entre 1999 y 2009 por el mismo profesional de una clínica privada. Después de analizar los criterios de exclusión, se incluyeron 43 individuos (18 hombres y 25 mujeres) y un total de 112 coronas individuales distribuidas en ambas mandíbulas. Este estudio evaluó coronas hechas de tres sistemas cerámicos: 34 de cerámica totalmente feldespática, 38 de cerámica de metal con un núcleo de aleación electropositiva de oro y 40 de alúmina enceram. El análisis de la fotografía intraoral adoptó un método de diagnóstico del desgaste dental de acuerdo con las variaciones morfológicas de los dientes. De las 112 coronas evaluadas, 47 se colocaron en hombres y 65 en mujeres, con edades comprendidas entre 21 y 74 años (media de 27,5 años). Con respecto a las coronas individuales, las variables género (p = 0,83), presencia de desgaste dental crónico (p = 0,91), sistema cerámico (p = 0,24) y ubicación de la corona (p = 0,86) no presentaron una diferencia estadísticamente significativa. Sin embargo, las variables vitalidad pulpar (p = 0.04) y tiempo de supervivencia (p = 0.01) presentaron una diferencia estadísticamente significativa. Los sistemas cerámicos evaluados pueden considerarse como alternativas de material restaurador, incluso en individuos con características clínicas que sugieren desgaste dental crónico.

Evaluation of peri-implant condition in periodontally compromised patients.

AIMS: The aim of the study is to evaluate the profile of peri-implant tissues in periodontally compromised patients. SETTINGS AND DESIGN: In vivo - cross sectional study design. MATERIALS AND METHODS: Fifty-eight implants were evaluated, clinically and radiographically, installed in seven individuals treated by the same team of professionals, during the years 1997 and 2005 in a private dental clinic in Vitória, ES, Brazil; that time of data collection, all implants were at least 10 years of functional loading. The variables related to the dental implants evaluated were: visible Plaque Index, Gingival Bleeding Index (GBI), probing pocket depth, bleeding on probing, and bone level, to relate them to the classification of dental implants. STATISTICAL ANALYSIS USED: The Chi-square and Kruskal-Wallis test were adopted. RESULTS: The total of 58 implants were classified: 11 (18.9%) as healthy and 12 (20.7%) as clinically stable. The other 35 implants (60.4%) had some type of peri-implant inflammation, 20 of them (34.5%) were diagnosed with peri-implant mucositis and 15 (25.9%) with peri-implantitis. Among the variables studied, the results showed statistically significant differences for implant location (P = 0.001) and GBI (P = 0.03). Most of the maxillary implants (85.7%) were classified for some type of peri-implant disease. For the implants which resulted in Score 1 for GBI, most of them (75.0%) were also classified for some type of peri-implant disease. CONCLUSIONS: Dental implants placed in periodontally compromised patients may have high long-term survival rates. However, most implants were classified with some type of peri-implant inflammation.

Subgingival microbial profile of women with breast cancer: a cross-sectional study

Background: Some prospective studies have observed associations between periodontal disease and breast cancer. Therefore, the aim of the present study was to investigate the composition of the subgingival biofilm of women diagnosed with breast cancer, who also presented with chronic periodontitis. Methods: All subjects underwent clinical and microbiological assessment. Subgingival biofilm samples were taken from at least three sites of 44 women who had breast cancer. The mean levels and proportions of 40 bacterial species were determined by checkerboard DNA-DNA hybridization. Spearman correlation was used to assess possible associations between the mean levels of bacterial species and clinical conditions. Results: The five species found at the highest levels were Prevotella nigrescens, Actinomyces gerencseriae, Neisseria mucosa, Porphyromonas gingivalis and Tannerella forsythia. The species detected in the lowest counts were Propionibacterium acnes, Streptococcus constellatus, Streptococcus intermedius, Eubacterium saburreum and Streptococcus anginosus. No significant association between levels and proportion of bacterial species and clinical parameters were found. Conclusion: In conclusion, the results of the present study found no direct association between the subgingival microbiota and breast cancer and an indirect pathway should be addressed in further studies.

Condição bucal e qualidade de vida em pacientes alcoolistas e não alcoolistas ­ estudo caso-controle / Buccal condition and quality of life in alcoholic and non-alcoholic patients ­ case-control study

Objetivo: estudar as concepções dos pacientes alcoolistas, alcoolistas cirróticos e cirróticos não alcoolistas quanto à percepção de qualidade de vida, condição periodontal, perda dentária e uso ou não de prótese dentária. Material e métodos: estudo caso-controle com 194 pacientes, com idades entre 25 e 73 anos, atendidos no Serviço de Gastroenterologia do Hospital Universitário Cassiano Antônio de Moraes (Hucam/Ufes), quanto aos parâmetros: profundidade de sondagem, nível de inserção clínica, índice de placa visível, sangramento gengival, sangramento a sondagem, supuração, mobilidade dentária, lesões de furca e questionário OHIP-14. Resultados: a condição clínica dos pacientes mostrou predomínio de má qualidade de vida marcada por perda dentária extrema. Foram observadas perdas de inserção periodontais, predominância de placa dentária (p=0,002) e bolsas periodontais profundas (< 6 mm) no grupo-caso (p=0,035). Alguns parâmetros do OHIP-14 com significância (p < 0,001) foram observados com a condição clínica médica, especialmente nas categorias dos problemas ao falar, sentimento de constrangimento social e mastigação. Uma comparação foi realizada para avaliar a percepção dos pacientes alcoolistas e desdentados em relação ao OHIP-14, utilizando apenas as primeiras (nunca) e as últimas (sempre) respostas. A resposta "nunca" apresentou maiores percentuais nas questões 1 (91,8%); 2 (82,7%); 6 (69,4%); 7 (70,7%); 8 (88,3%); 9 (80,0%); 12 (90,4%); 13 (69,2%); e 14 (89,8%). A pergunta 5 obteve a resposta "sempre" como a maior porcentagem (73,3%) para o mesmo grupo. Conclusão: a condição clínica dos pacientes mostra efeitos significativos ao se correlacionar os parâmetros do OHIP-14 com a condição periodontal deteriorada e ausência considerável de próteses dentárias.

Objective: in the present study we studied the conceptions of alcoholic, cirrhotic alcoholic and non-alcoholic cirrhotic patients regarding perception of quality of life, periodontal condition, tooth loss and use of dental prosthesis. Material and methods: we evaluated 194 patients aged 25-73 years, attending the Gastroenterology Department of the University Hospital Cassiano Antônio de Moraes (Hucam/Ufes), regarding the parameters: probing pocket depth, clinical attachment loss, visible plaque, marginal gingival bleeding, bleeding on probing, suppuration, dental mobility, furcation lesions, and OHIP-14 questionnaire. Results: the clinical condition of the patients showed a predominance of poor quality of life marked by extreme dental loss. Periodontal attachment losses, predominance of dental plaque (p=0.002) and signifi cant deep pockets ( 6 mm) were observed in the case group (p=0.035). Some OHIP-14 parameters with signifi cance (p < 0.001) were also observed with the medical clinical condition, especially in the categories of speech problems, feeling of social embarrassment and chewing. A comparison was made to evaluate the perception of alcoholic and edentulous patients in relation to OHIP-14 using the fi rst (never) and the last (always) answers. The answer "never" presented higher percentages in questions 1 (91.8%); 2 (82.7%); 6 (69.4%); 7 (70.7%); 8 (88.3%); 9 (80.0%); 12 (90.4%); 13 (69.2%); and 14 (89.8%). Question 5 obtained the answer "always" as the highest percentage (73.3%) for the same group. Conclusion: the clinical condition of patients shows signifi cant effects when correlating with OHIP-14 parameters with the medical clinical condition, deteriorated periodontal condition and considerable absence of dental prostheses.

Radiographic Bone Evaluation after Periodontal Full Mouth Disinfection Treatment in Women Undergoing Chemotherapy or Hormone Therapy with Tamoxifen

Objective: To radiographically evaluate the alveolar bone level after periodontal full mouth disinfection (FMD) treatment in women during chemotherapy (CHE) and hormone therapy with Tamoxifen (TAM). Material and Methods: This is an uncontrolled clinical trial with a convenience sample of women in antineoplastic treatment (CHE and TAM) and non-surgical periodontal FMD treatment. The Radiographic examination consisted of four bitewing radiographs and six periapical radiographs of the upper and lower anterior teeth, acquired according to the parallelling standard technique at three times: before (T0), 3 (T3) and 6 (T6) months after periodontal treatment. The alveolar crest level in the interproximal area of each tooth was measured by two calibrated observer using magnifying glass and digital caliper. Statistical analysis was performed for evaluation of the three times in each experimental group using the Friedman test (p < 0.05) and between groups, the Mann Whitney test (p <0.05). Results: Overall, 14 women undergoing treatment for breast cancer participated in this study. A follow-up loss of five (35.71%) women occurred during the study and the final sample size was composed of nine women divided into two groups: CHE (n = 4) and TAM (n = 5). A total of 330 sites were evaluated: 126 (CHE) and 204 (TAM). The alveolar bone level showed statistically significant reduction after 6 months of FMD therapy (p <0.05), but there was no difference between antineoplastic treatment type (p> 0.05). Conclusion: Patients undergoing chemotherapy and hormone therapy with Tamoxifen showed better alveolar bone levels after six months of periodontal FMD treatment. The current antineoplasic therapy did not influence the results obtained with periodontal treatment.

Association between periodontal condition and subgingival microbiota in women during pregnancy: a longitudinal study

Objectivo In this study, the gingival conditions and the quantitative detection for Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis and Prevotella intermedia in pregnant women were determined. Material and Methods Quantitative determinations of periodontal bacteria by using a SyBr green system in women during pregnancy were performed. Women at the 2nd and 3rd trimesters of pregnancy and non-pregnant women were included in this study. A. actinomycetemcomitans was observed in high numbers in women at the 2nd and 3rd trimesters of pregnancy with a significant difference (p<0.05). F. nucleatum and P. intermedia were also observed in high levels. Results and Conclusion Our results show that pregnant women are more susceptible to gingivitis, and the presence of A. actinomycetemcomitans in subgingival biofilm might be taken into account for the treatment of periodontal disease. .

Association between periodontal condition and subgingival microbiota in women during pregnancy: a longitudinal study.

OBJECTIVE: In this study, the gingival conditions and the quantitative detection for Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis and Prevotella intermedia in pregnant women were determined. MATERIAL AND METHODS: Quantitative determinations of periodontal bacteria by using a SyBr green system in women during pregnancy were performed. Women at the 2nd and 3rd trimesters of pregnancy and non-pregnant women were included in this study. A. actinomycetemcomitans was observed in high numbers in women at the 2nd and 3rd trimesters of pregnancy with a significant difference (p<0.05). F. nucleatum and P. intermedia were also observed in high levels. RESULTS AND CONCLUSION: Our results show that pregnant women are more susceptible to gingivitis, and the presence of A. actinomycetemcomitans in subgingival biofilm might be taken into account for the treatment of periodontal disease.

Periodontopatógenos e riscos de complicações na gravidez / Periodontopathogens and risks of pregnancy complications. A review of the literature

A doença periodontal é um processo inflamatório crônico dos tecidos periodontais, causada por bactérias gram-negativas anaeróbicas presentes no biofilme dentário. Esse foco infeccioso pode manifestar-se em sítios corporais distantes ou sistêmicos, quando essas bactérias alcançam a corrente sanguínea. Os objetivos desse estudo de revisão são: demonstrar a relação entre doença periodontal e prematuridade, o efeito do tratamento periodontal sobre o nascimento de prematuros, e se microrganismos periodontopatogênicos são capazes de induzir efeitos adversos na gravidez quando os mesmos são encontrados na placenta. Esse estudo constituiu-se de uma revisão da literatura com artigos científicos selecionados através de bancos de dados Scielo, Bireme, Medline e Lilacs, publicados nos anos de 1980 a 2013. Entre os estudos selecionados, todos relacionaram a doença periodontal como sendo um fator de risco importante a ser considerado na gravidez, pois a presença de patógenos orais associou-se à prematuridade, baixo peso fetal ao nascer e infecções perinatais. Portanto, segundo a literatura consultada, a infecção periodontal em mulheres grávidas não deve ser negligenciada pois, se essa doença favorece complicações gestacionais, a atenção à saúde periodontal das gestantes deve estar incluída nas ações de cuidados do pré-natal.

Periodontal disease is a chronic inflammatory process of periodontal tissues caused by gram- negative anaerobic bacteria present in the biofilm. This infection may occur in distant or systemic body sites, when these bacteria reach the bloodstream. The aims of this review study are to demonstrate the relationship between periodontal disease and preterm birth, the effect of the periodontal treatment on preterm birth, and whether periodontopathogenic microorganisms can induce adverse effects on pregnancy when they are found in the placenta. This study is a literature review with scientific papers selected through Scielo Bireme, Medline and Lilacs databases and published between 1980 and 2013. All selected studies considered the periodontal disease as an important risk factor for the pregnancy, since the presence of oral pathogens was associated with premature birth, low birth weight and perinatal infections. Therefore, according to the literature, periodontal infection in pregnant women should not be underestimated, because it favors pregnancy complications, and periodontal health care to pregnant women should be included in the prenatal care.

Enxerto livre epitelizado em paciente HIV soropositivo / Free epithelium graft in HIV-positive patient: case report

0 indivíduo HIV positivo, atualmente, busca qualidade de vida e saúde, já que com os avanços da terapia antirretroviral houve um aumento na sobrevida deste perfil de paciente. Diversas manifestações orais podem ser vistas nestes pacientes, sendo a doença periodontal uma patologia constantemente encontrada. 0 tratamento da periodontite busca a homeostasia dos tecidos periodontais por meio do controle de biofilme dentário e raspagem supra e subgengival. Uma frequente consequência desta terapia é a ocorrência de recessão gengival nos dentes acometidos pela doença. A presença de recessão gengival associada à ausência de gengiva inserida pode dificultar a higienização correta do elemento dentário, prejudicando desta maneira o controle do paciente periodontal. Uma análise meticulosa do portador do HIV deve ser feita previamente a realização de procedimentos cirúrgicos, visto que pela depleção de seu sistema imune este pode apresentar uma série de complicações trans e pós-operatórias. 0 objetivo deste estudo foi relatar um caso clínico onde foi realizada uma cirurgia de enxerto epitelial livre para aumento da faixa de gengiva inserida em paciente HIV soropositivo.

Terapia periodontal com desinfecção total da boca ou tratamento convencional em quadrantes: considerações da literatura / Periodontal therapy performed with full mouth disinfection or conventional quadrant-wise treatment: literature considerations

A doença periodontal é principalmente causada por bactérias periodontopatogênicas presentes no sulco gengival em decorrência do crescimento e maturação do biofilme dentário. O tratamento para a periodontite crônica consiste na eliminação de biofilme, cálculo e cemento contaminado por meio de debridamento mecânico, junto com o correto e eficaz controle diário do biofilme realizado pelo paciente. Entretanto, estes sítios são posteriormente recontaminados em menores quantidades por patógenos periodontais presentes nas mucosas, língua, tonsilas ou podem ser remanescentes da doença tratada. A terapia periodontal convencional em quadrantes, geralmente, é o tratamento mais utilizado pelos profissionais. Esta modalidade, porém, demanda um tempo maior de tratamento, envolvendo quatro ou mais sessões. A terapia de desinfecção total da boca visa acelerar o procedimento, aumentar a aceitação do paciente e evitar que locais não tratados contaminem os que já o foram. Este trabalho teve como objetivo revisar a literatura científica relacionada às terapias que podem ser empregadas para o tratamento da periodontite crônica, comparando os resultados obtidos por meio do tratamento convencional em quadrantes e a desinfecção total da boca com o uso ou não de auxiliares químicos.

Comparative proteomic analysis of whole saliva from chronic periodontitis patients.

Chronic periodontal disease is a chronic inflammatory process affecting tooth supporting tissues in the presence of pathogenic bacterial biofilm. There is some evidence for changes in the protein composition of whole saliva from chronic periodontitis patients, but there have been no studies using a proteomic approach. Hence, the aim of this study was to compare the protein profiles of unstimulated whole saliva from patients with periodontitis and healthy subjects by two complementary approaches (2D-gel electrophoresis and liquid chromatography). Protein spots of interest were analyzed by MALDI-TOF-TOF, and the data was complemented by an ESI-Q-TOF experiment. The analyses revealed that subjects with periodontal disease have increased amounts of blood proteins (serum albumin and hemoglobin) and immunoglobulin, and they have a lower abundance of cystatin compared to the control group. A higher number of protein spots were observed in the periodontitis group, of which most were identified as alpha-amylase. This higher number of alpha-amylase variants seems to be caused by hydrolysis by cysteine proteases under such inflammatory conditions. This approach gives novel insights into alterations of salivary protein in presence of periodontal inflammation and may contribute to the improvement of periodontal diagnosis.

Quantitative detection of periodontopathic bacteria in atherosclerotic plaques from coronary arteries.

Oral pathogens, including periodontopathic bacteria, are thought to be aetiological factors in the development of cardiovascular disease. In this study, the presence of Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum-periodonticum-simiae group, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens and Tannerella forsythia in atheromatous plaques from coronary arteries was determined by real-time PCR. Forty-four patients displaying cardiovascular disease were submitted to periodontal examination and endarterectomy of coronary arteries. Approximately 60-100 mg atherosclerotic tissue was removed surgically and DNA was obtained. Quantitative detection of periodontopathic bacteria was performed using universal and species-specific TaqMan probe/primer sets. Total bacterial and periodontopathic bacterial DNA were found in 94.9 and 92.3 %, respectively, of the atheromatous plaques from periodontitis patients, and in 80.0 and 20.0 %, respectively, of atherosclerotic tissues from periodontally healthy subjects. All periodontal bacteria except for the F. nucleatum-periodonticum-simiae group were detected, and their DNA represented 47.3 % of the total bacterial DNA obtained from periodontitis patients. Porphyromonas gingivalis, A. actinomycetemcomitans and Prevotella intermedia were detected most often. The presence of two or more periodontal species could be observed in 64.1 % of the samples. In addition, even in samples in which a single periodontal species was detected, additional unidentified microbial DNA could be observed. The significant number of periodontopathic bacterial DNA species in atherosclerotic tissue samples from patients with periodontitis suggests that the presence of these micro-organisms in coronary lesions is not coincidental and that they may in fact contribute to the development of vascular diseases.

Fratura de implante: revisão de literatura e relato de caso clínico / Implant fracture: literature review and case report

O objetivo deste trabalho é apresentar um caso clínico de fratura de implante osseintegrável e discutir as possíveis causas de fraturas do implante, ajudando o implantodontista a identificar os sinais que normalmente precedem as fraturas. As fraturas de implante felizmente não são acidentes freqüentes, mas quando ocorrem trazem aborrecimentos e desgastepara o paciente e grandes dificuldades para o cirurgião-dentista. No caso clínico aqui apresentado a porção fraturada do implante que se encontra no osso foi removida e uma nova prótese foi confeccionada para o paciente

The aim of this paper is to present a case report of dental implant fracture and to discuss its possible causes, helping clinicians to identify the signs that usually precede the fractures. The implant fractures happily are not frequent accidents, but when they happen they bring upset and waste for the patient and great difficulties for dentists. This case report presented the fractured portion of the implants that met in the bone was removed and a new prosthesis was made

Implante unitário com carga imediata: relato de 2 casos clínicos / Unitary conical implant with immediate load: report of two clinical cases

A instalação de uma coroa imediatamente após a instalação do implante pode ajudar a preservar a arquitetura gengival e o osso alveolar, permitindo uma redução significativa do tempo e custo de tratamento. Este trabalho descreve dois casos clínicos onde uma coroa acrílica provisória foi instalada imediatamente após a instalação do implante e as pacientes acompanhados por 6 (seis) e 4 (quatro) meses respectivamente , não apresentando neste período qualquer complicação. Embora o tempo de acompanhamento seja curto, acreditamos que esta pode ser uma técnica a ser utilizada quando bem indicada e executada

The installation of a crown immediately after the installation of its implant can help to preserve the architecture of gum and the alveolar bone, allowing a significant reduction of the time and treatment cost. This work describes two clinical cases where a temporary acrylic crown was installed immediately after the installation of its implant and the patient accompanied by 6 (six) and 4 (four) months, not presenting in this period any complication. Although the time of accompaniment is short, we believed that this could be a technique to be used when very suitable and executed