Association between alcohol dependence and both periodontal disease and tooth loss: a cross-sectional study.

The impact of alcohol consumption on periodontal disease and tooth loss is still under debate. The aim of this cross-sectional study was to evaluate the association between alcohol dependence and both periodontal diseases and tooth loss in Brazilian native Indians. Full mouth periodontal examination was performed and tooth loss was clinically evaluated in a representative sample of 225 Indians (≥ 19 years). Sociodemographic, oral health-related data, and alcohol dependence were evaluated using structured questionnaires. The subjects were categorized as either alcohol-dependent or non-dependent according to the Alcohol Use Disorders Identification Test results. Severe periodontal disease was defined in individuals with ≥ 2 proximal sites with a clinical attachment level ≥ 6 mm, not on the same tooth, and ≥ 1 proximal site with a probing depth ≥ 5 mm. Tooth loss was categorized as one or more missing teeth, or no missing teeth. Bivariate models followed by logistic regression were used to assess the association between alcohol dependence and both periodontal disease and tooth loss. Prevalence ratio (PR) was calculated using Mantel-Haenszel analysis. Alcohol dependence increased 2.5 times the risk for tooth loss (prevalence ratio [PR] =2.49, 95% confidence interval [CI] = 1.01-9.04, p = 0.05). Severe periodontal disease was not associated with alcohol dependence (OR = 0.54, 95% CI = 0.22-1.31, p = 0.23). In conclusion, alcohol dependence was associated with tooth loss in the present population, but severe periodontal disease was not. Questions on alcohol dependence should be included in dental anamnesis questionnaires, and patients diagnosed with alcohol dependence should be referred for dental evaluation.

Interrelação dentística-periodontia: necessidade de restauração trans-cirurgicas / Inter-relationship between dentistry periodontologi: need for trans-surgery restorations

O sucesso dos procedimentos restauradores pode, a longo prazo, depende também da resposta dos tecidos periodontais, pois, na maioria destes procedimentos, há uma correlação direta do periodonto com os materiais restauradores. Assim sendo, é coerente afirmar que as restaurações dentária devem possuir características anátomo-morfo-funcionais adequadas e bem reproduzidas, de forma a proporcionar uma boa integridade entre o elemento dental-restauração-periodonto. Restaurações localizadas com margens intrasulculares podem favorecer o estabelecimento de lesões irreversíveis resultando em perda de inserção clínica com formação de bolsas periodontais e perdas ósseas, as quais comportam-se como contínuas agressões clínicas ao espaço biológico. Para a realização de tratamento restauradores que não agridam os tecidos periodontais, por vezes, é necessária intervenção cirúrgica periodontal. Muitas vezes, esta intervenção torna possível o acesso imediato à lesão cariosa e sua remoção, o que expõe supragengivalmente as margens do preparo, possibilitando a posterior reabilitação do elemento dental. este trabalho relata um caso clínico de restaurações transcirúrgica de classe V subgengival na face vestibular de um molar inferior direito.