Relationship Among Mothers' Glycemic Level, Periodontitis, and Birth Weight.

BACKGROUND: The aim of this study is to determine the influence of glycemic level on the relationship between periodontitis and low birth weight (LBW). METHODS: A case-control study was conducted with 372 females divided into cases (109 mothers of newborns with birth weight < 2,500 g) and controls (263 mothers of newborns with birth weight ≥ 2,500 g). The birth weight of children was obtained from medical records, whereas information on sociodemographic, lifestyle, and health characteristics of the participants was obtained through an interview. Glycated hemoglobin (HbA1c) levels were measured, and probing depth, clinical attachment levels, and bleeding on probing were used to determine the periodontal status. Results were analyzed using logistic regression. RESULTS: The likelihood of having children with LBW among the mothers with periodontitis was six times greater than that observed among mothers without periodontitis (adjusted odds ratio [OR adjusted] = 6.02, 95% confidence interval [CI] = 2.47 to 15.17), even after adjustment. There was also a strong, statistically significant relationship between periodontitis and LBW in both the normal glycemic-level group (HbA1c levels < 5.6%, unadjusted odds ratio [OR unadjusted] = 8.30, 95% CI = 3.56 to 19.35) and the high glycemic-level group (HbA1c levels ≥ 5.6% and < 6.5%, OR unadjusted = 5.73, 95% CI = 1.75 to 18.70). After adjustment for confounders, the magnitude of the association continued to be strong in the normal glycemic-level group (OR adjusted = 7.59, 95% CI = 2.7 to 24.28), an increase of 25% when compared to the main association measurement. In those with high glycemic levels (OR adjusted = 4.03, 95% CI = 0.81 to 19.96), the OR decreased almost 50%, and the association lost statistical significance. CONCLUSION: Periodontitis and glycemic levels appeared to have opposing influences on birth weight, with periodontitis being associated with LBW and the magnitude of the association being altered depending on maternal blood glucose level.

Longitudinal assessment of immunological and oral clinical conditions in patients undergoing anticancer treatment for leukemia.

OBJECTIVE: The aim of this study was to evaluate the evolution of the immunological and oral clinical conditions of children and adolescents undergoing anticancer treatment for leukemia (ATL). METHODS: Twenty patients aged 3-15 years undergoing chemotherapy seen at a referral center for cancer treatment in the State of Maranhão, Brazil, from 2008 to 2009, were evaluated at baseline (1st). Twenty-two controls were selected in public schools. Oral lesions, caries experience (deft and DMFT), plaque index (PI), gingival index (GI) and salivary IgA were analyzed. Patients and controls were evaluated after 6 months (2nd). The Shapiro Wilk, Mann-Whitney, Wilkoxon and Spearman correlation tests were carried out (alpha=5%). RESULTS: Gingivitis and mucositis were the most frequent manifestations in oral mucosae during the two phases. The mean DMFT index increased from 3.9 ± 4.2 (1st) to 4.4 ± 4.3 (2nd) (p = 0.04). The mean deft index was the same in the 1st (1.9 ± 2.7) and 2nd (1.9 ± 2.7) evaluation (p = 0.86). The GI also did not vary between assessments: 1st (1.3 ± 0.4) and 2nd (1.3 ± 0.3) - (p = 0.12), except on the lingual and distal surfaces, where increased from the 1st to 2nd evaluation (p < 0.01). The PI varied from 0.9 to 1.1, but this difference was not significant (p = 0.48), except for the lingual surface, where increased from 0.6 to 1.0 (p = 0.04). There was a reduction in salivary IgA levels from 2.9 to 1.9 µg/mL (p = 0.04), and mean IgA was significantly higher in the control group (5.4 µg/mL) if compared to cases (p < 0.01). CONCLUSION: The clinical and immunological oral conditions of children and adolescents undergoing ATL presented an unfavorable evolution. This study highlights the need for monitoring oral conditions during the ATL and draws attention to the additional responsibility of the otolaryngologist in referring ATL patients to the dentist, especially in the presence of clinical evidence of oral problems. We suggest that the planning of ATL take into account the oral health, in a multidisciplinary oncology team.

The interface between metabolic syndrome and periodontal disease

Introduction: Metabolic syndrome (MS) is a complex pathology that combines several risk factors for cardiovascular disease. It is defined by the presence of visceral obesity, elevated triglycerides, decreased HDL, elevated blood pressure and blood glucose. The presence of at least three of these factors characterizes the syndrome. Periodontal disease (PD) is a chronic infection that produces a local and systemic inflammatory response. PD has been suggested as a possible risk factor for some of the components of MS, such as diabetes, obesity and dyslipidemia. Objective: The aim of this study was to review the literature about the possible association between periodontal disease and metabolic syndrome and to identify the components of this syndrome that may contribute to this association. Literature review: PD in the body produces a subclinical inflammatory state characterized by the release of inflammatory cytokines. Conclusion: It is plausible that these substances may contribute to the development of metabolic syndrome.

Antimicrobial activity against oral pathogens and immunomodulatory effects and toxicity of geopropolis produced by the stingless bee Melipona fasciculata Smith.

BACKGROUND: Native bees of the tribe Meliponini produce a distinct kind of propolis called geopropolis. Although many pharmacological activities of propolis have already been demonstrated, little is known about geopropolis, particularly regarding its antimicrobial activity against oral pathogens. The present study aimed at investigating the antimicrobial activity of M. fasciculata geopropolis against oral pathogens, its effects on S. mutans biofilms, and the chemical contents of the extracts. A gel prepared with a geopropolis extract was also analyzed for its activity on S. mutans and its immunotoxicological potential. METHODS: Antimicrobial activities of three hydroalcoholic extracts (HAEs) of geopropolis, and hexane and chloroform fractions of one extract, were evaluated using the agar diffusion method and the broth dilution technique. Ethanol (70%, v/v) and chlorhexidine (0.12%, w/w) were used as negative and positive controls, respectively. Total phenol and flavonoid concentrations were assayed by spectrophotometry. Immunotoxicity was evaluated in mice by topical application in the oral cavity followed by quantification of biochemical and immunological parameters, and macro-microscopic analysis of animal organs. RESULTS: Two extracts, HAE-2 and HAE-3, showed inhibition zones ranging from 9 to 13 mm in diameter for S. mutans and C. albicans, but presented no activity against L. acidophilus. The MBCs for HAE-2 and HAE-3 against S. mutans were 6.25 mg/mL and 12.5 mg/mL, respectively. HAE-2 was fractionated, and its chloroform fraction had an MBC of 14.57 mg/mL. HAE-2 also exhibited bactericidal effects on S. mutans biofilms after 3 h of treatment. Significant differences (p < 0.05) in total phenol and flavonoid concentrations were observed among the samples. Signs toxic effects were not observed after application of the geopropolis-based gel, but an increase in the production of IL-4 and IL-10, anti-inflammatory cytokines, was detected. CONCLUSIONS: In summary, geopropolis produced by M. fasciculata can exert antimicrobial action against S. mutans and C. albicans, with significant inhibitory activity against S. mutans biofilms. The extract with the highest flavonoid concentration, HAE-2, presented the highest antimicrobial activity. In addition, a geopropolis-based gel is not toxic in an animal model and displays anti-inflammatory effect.

The potential use of propolis as a cariostatic agent and its actions on mutans group streptococci.

Propolis is a resinous substance made by bees. It possesses many biological activities, and many studies have reported its potential application in the control of dental caries. However, variability in the chemical composition of propolis is a potential problem in its quality control, especially since propolis has already been incorporated into products for oral use. Therefore, a critical analysis of the available data on propolis is warranted. The present review discusses the in vitro and in vivo studies published in the period between 1978 and 2008 regarding the effects of propolis on Streptococcus mutans growth, bacterial adherence, glucosyltransferase activity, and caries indicators. Several investigations carried out with crude propolis extracts, isolated fractions, and purified compounds showed reductions in Streptococcus mutans counts and interference with their adhesion capacity and glucosyltransferase activity, which are considered major properties in the establishment of the cariogenic process. Data from in vivo studies have demonstrated reductions in Streptococcus mutans counts in saliva, the plaque index, and insoluble polysaccharide formation. These findings indicate that propolis and/or its compounds are promising cariostatic agents. However, the variation in the chemical composition of propolis due to its geographical distribution is a significant drawback to its routine clinical use. Thus, further studies are needed to establish the quality and safety control criteria for propolis in order for it to be used in accordance with its proposed activity.

Avaliação clínica de placa, gengivite e superfície dentária em usuários de prótese parcial removível / Clinical evaluation of dental plaque, gingivitis and dental surface of removable partial dentures

O objetivo desta pesquisa foi avaliar clinicamente os dentes pilares (148), não pilares (163) e antagonistas (226), de 30 pacientes usuários de prótese parcial removível, num total de 537 dentes. Calculou-se em cada grupo a freqüência dos escores 0, 1 e 2-3 de placa, gengivite na face vestibular e lingual e a freqüência de dentes cariados, restaurados e hígidos. Com relação à freqüência dos escores, o teste qui-quadrado mostrou haver significância apenas na face lingual, sendo o escore 2-3 o mais freqüente do índice de placa (46,62 por cento) e do índice gengival (23,65 por cento). Com relação à análise de superfície, houve significância estatística, sendo os dentes pilares os que apresentam mais freqüentemente cárie (22,97 por cento) e restauração (51,35 por cento), já os antagonistas foram os dentes com maior percentual de higidez (49,56 por cento). Os autores concluíram que os dentes em contato com a prótese (pilares) apresentam maior probabilidade de acumular placa, de apresentar gengivite marginal, bem como predispor à cárie e que a face lingual destes dentes apresentaram maior freqüência de acúmulo de placa e gengivite marginal