Risk indicators for aggressive periodontitis in an untreated isolated young population from Brazil.

This study aimed to assess the prevalence of aggressive periodontitis (AgP), and to investigate the association between demographic, socioeconomic and behavioral risk indicators with AgP in an untreated and isolated young population in Southeastern Brazil. For this cross-sectional survey, 134 subjects aged 12-29 years were selected by a census. Of those eligible, 101 subjects received a full-mouth clinical examination, and were interviewed using a structured written questionnaire. Cases were defined as individuals with 4 or more teeth with attachment loss > 4 mm or > 5 mm in the age groups 12-19 and 20-29, respectively. Overall, 9.9% of the subjects presented AgP (10.3% of the 12-19-year-olds and 9.7% of the 20-29-year-olds). The only risk indicator significantly associated with AgP in this isolated population was a high proportion of sites (> 30%) presenting supragingival calculus [OR = 23.2]. Having experienced an urgency dental treatment was a protective factor for AgP [OR = 0.1]. The authors concluded that this isolated and untreated population from Brazil presented a high prevalence of AgP. Local plaque-retaining factors played a major role in the prevalence of AgP in this isolated population, and should be included in further studies evaluating this destructive periodontal disease form.

Tooth loss prevalence and risk indicators in an isolated population of Brazil.

OBJECTIVE: The aim of this study was to assess the prevalence, extent, and risk indicators of tooth loss in an isolated population of Brazil. MATERIAL AND METHODS: Two-hundred-and-forty-two subjects, ranging in age from 14 to 82 years (mean 36.2 years), were identified by census in an isolated population of Brazil. All consenting subjects received a full-mouth clinical (DFT index and information about missing teeth) and periodontal examination of 6 sites per tooth. Furthermore, they were interviewed using a structured written questionnaire in order to gather information about demographic, environmental, and biological variables. RESULTS: Of the 200 subjects (80% response rate), 19 (9.5%) were edentulous, 90% had lost at least one tooth, and 39% had lost more than 8 teeth. The mean number of teeth lost was 9.5 (95% CI = 8.2-10.8). First mandibular molars were the most commonly missing teeth. In a multiple logistic regression analysis based on a theoretical hierarchical model of tooth loss, having more than 8 teeth lost was strongly associated with adult age (OR = 18.3-17.3, 95% CIs = 4.8-69.7 and 4.0-75.1) and female gender (OR = 5.9, 95% CI = 1.9-18.2) in the final model. CONCLUSIONS: Tooth loss was highly prevalent and extensive in this isolated population. Demographic and behavioral factors played an important role in tooth loss prevalence in this population.

Risk indicators for aggressive periodontitis in an untreated isolated young population from Brazil

This study aimed to assess the prevalence of aggressive periodontitis (AgP), and to investigate the association between demographic, socioeconomic and behavioral risk indicators with AgP in an untreated and isolated young population in Southeastern Brazil. For this cross-sectional survey, 134 subjects aged 12-29 years were selected by a census. Of those eligible, 101 subjects received a full-mouth clinical examination, and were interviewed using a structured written questionnaire. Cases were defined as individuals with 4 or more teeth with attachment loss > 4 mm or > 5 mm in the age groups 12-19 and 20-29, respectively. Overall, 9.9 percent of the subjects presented AgP (10.3 percent of the 12-19-year-olds and 9.7 percent of the 20-29-year-olds). The only risk indicator significantly associated with AgP in this isolated population was a high proportion of sites (> 30 percent) presenting supragingival calculus [OR = 23.2]. Having experienced an urgency dental treatment was a protective factor for AgP [OR = 0.1]. The authors concluded that this isolated and untreated population from Brazil presented a high prevalence of AgP. Local plaque-retaining factors played a major role in the prevalence of AgP in this isolated population, and should be included in further studies evaluating this destructive periodontal disease form.

Risk indicators for increased probing depth in an isolated population in Brazil.

BACKGROUND: The aim of this study was to assess the prevalence, extent, and severity of probing depth (PD) and to investigate the associations between demographic, socioeconomic, and behavioral risk indicators and PD in a periodontally untreated and isolated population in Brazil. METHODS: The target population consisted of all individuals aged > or =12 years as identified by a census. Consenting participants were submitted to a full-mouth clinical examination of six sites per tooth and were interviewed using a structured written questionnaire. RESULTS: Among the 214 subjects who were interviewed and clinically examined, PD > or =4 mm was observed in 54% to 83% of the subjects, depending on age, whereas the age-dependent prevalence of PD > or =6 mm ranged from 5% among 12- to 19-year-olds to 50% among 40- to 49-year-olds, decreasing to 40% among subjects > or =50 years of age. Multivariate analyses identified supragingival calculus (odds ratio [OR] = 5.4 to 10.3; 95% confidence intervals [CIs]: 2.5 to 11.6 and 4.0 to 26.2 for 20% to 50% and >50% of the sites, respectively) as a risk indicator for PD > or =4 mm, whereas age > or =40 years (OR = 9.0; 95% CI: 1.7 to 48.5), being a moderate/heavy smoker (OR = 3.7; 95% CI: 1.4 to 10.1), and having supragingival calculus in 20% to 50% of sites (OR = 6.8; 95% CI: 1.4 to 32.4) or in >50% of sites (OR = 15.3; 95% CI: 3.2 to 73.6) were risk indicators for PD > or =6 mm. Having undergone urgency dental treatment was a protective factor for PD > or =4 and > or =6 mm (OR = 0.4; 95% CI: 0.2 to 0.8). CONCLUSIONS: Increased PD is highly prevalent in this isolated population. Behavioral factors played a significant role as risk indicators for increased PD in this isolated population.

Periodontal attachment loss in an untreated isolated population of Brazil.

BACKGROUND: The aim of this study was to assess the prevalence, extent, and severity of clinical attachment loss (CAL) and to investigate the association of demographic, socioeconomic, and behavioral risk indicators with CAL in an untreated isolated population in Brazil. METHODS: All subjects aged > or =12 years were identified by a census. Participants were submitted to a full-mouth clinical examination of six sites per tooth and were interviewed using a structured, written questionnaire. RESULTS: Among the 214 subjects who were interviewed and examined clinically, CAL > or =5 mm in at least one site was observed in 8% of the 12- to 19-year-olds and in all dentate subjects > or =50 years of age; the age-dependent prevalence of CAL > or =7 mm in at least one site ranged from 5% among 12- to 19-year-olds to 83% among subjects > or =50 years old. Multivariate analysis identified plaque (odds ratio [OR] = 2.8), supragingival calculus (OR = 2.9 to 10.6), age > or =30 years (OR = 11.4), and smoking (OR = 2.4) as risk indicators for CAL > or =5 mm and smoking (OR = 8.2) as a risk indicator for CAL > or =7 mm. CONCLUSIONS: CAL is highly prevalent in this isolated population. The high occurrence of CAL in young age groups and the confirmation of traditional risk indicators for CAL in this study suggest that other factors, such as host susceptibility, may be needed to explain the high levels of CAL found. Age and behavioral factors were risk indicators associated significantly with the CAL found in this population and may be useful indicators of high-risk subjects for periodontal diseases.

Relationship of subgingival and salivary microbiota to gingival overgrowth in heart transplant patients following cyclosporin A therapy.

BACKGROUND: Severe gingival overgrowth (GO) is induced in patients taking cyclosporin A (CsA) following organ transplantation. Determining which patient will develop GO is still not possible. The purpose of this study was to establish an association between CsA and gingival overgrowth in heart transplant patients taking into account periodontal and microbiological conditions. METHODS: Thirty patients (10 female, 20 male; range: 13 to 67 years; mean age: 44.89) undergoing CsA treatment were evaluated using the gingival index (GI), plaque index (PI), probing depth (PD), and clinical attachment level (CAL). Subgingival samples collected from the deepest site of each quadrant and saliva samples were submitted to microbial analysis. All patients had at least 12 teeth. Exclusion criteria were the use of antibiotics and/or having undergone periodontal treatment 6 months prior to the study. Patients were divided in two groups: with gingival (GO+) and without gingival overgrowth (GO-). RESULTS: There were no statistically significant differences between the GO+ and GO- groups when CsA dosage, time since transplant, GI, PI, PD, and CAL were compared. Microbiological examination of the subgingival samples detected the following microorganisms: Actinobacillus actinomycetemcomitans (23%), Porphyromonas gingivalis (36%), Prevotella intermedia (93%), Fusobacterium sp. (66%), Campylobacter rectus (30%), Micromonas micros (66%), enteric rods (0%), and yeasts (30%). A positive association between M. micros and the GO+ group was found (P < 0.001). Yeasts were detected in 30% of the subgingival and saliva samples. CONCLUSIONS: Clinical parameters were not sufficient to determine which patients would develop GO. However, colonization by M. micros might play a role in the etiology of GO.

Superinfecting microorganisms in patients under treatment with cyclosporin-A and its correlation to gingival overgrowth.

The aim of this study was to identify the presence of superinfecting microorganisms (Gram-negative enteric rods and Candida sp.) in heart transplant patients and correlate this with gingival overgrowth. Thirty patients (10 females, 20 males--mean age 45 years) were examined. All were under cyclosporin-A (CsA) therapy. Patients who had taken any antibiotics 3 months prior the study or had been submitted to periodontal therapy were not enrolled. Patients were required to have at least 6 teeth. The plaque index (PI), gingival index (GI), pocket depth (PD) and clinical attachment level (CAL) were recorded. Microbiological samples were taken from sulcus/pocket (s/p) and from stimulated saliva (ss) and submitted to analysis. Patients were divided into two groups: the ones with gingival overgrowth (GO) and those without gingival overgrowth (WGO). After statistical analysis (chi-square test, Student's t-test, Fisher test, p < or = 0.05), we concluded that there was no statistical difference between groups in the parameters of gender, CsA dosage, time since transplantation, PI, GI, PD and CAL. Gram-negative rods from either the sulcus/pocket or saliva samples were not found. Candida sp. was detected (s/p-30% and ss-30%). Stimulated saliva samples analysis determined that the presence of Candida sp. was associated with patients without gingival overgrowth.

Superinfecting microorganisms in patients under treatment with cyclosporin-A and its correlation to gingival overgrowth

A proposta deste trabalho foi identificar a presença de microrganismos superinfectantes (bastonetes entéricos Gram-negativos e Candida spp.) em pacientes transplantados cardíacos e correlacionar com a presença de crescimento gengival. Foram examinados 30 pacientes (10 mulheres e 20 homens - média 45 anos). Todos os pacientes estavam sob terapia com ciclosporina-A (CsA) sem ter sido submetidos a antibioticoterapia e nem a tratamento periodontal prévio, por pelo menos três meses do início do estudo. O paciente deveria ter, no mínimo, seis dentes. Foram registrados os índices de placa bacteriana (IP), índice gengival (IG), valores de profundidade clínica de sondagem (PCS) e nível clínico de inserçäo (NCI). Análise microbiológica foi realizada a partir de amostras coletadas do sulcobolsa (sb) gengival e da saliva estimulada (se). Os pacientes foram divididos em dois grupos: com crescimento gengival (CCG) e sem crescimento gengival (SCG). Após análise estatística (Teste do Qui-quadrado; teste t de Student; Prova exata de Fisher; p0,05), concluiu-se que näo houve diferença entre os dois grupos de pacientes com relaçäo ao sexo dos pacientes, dosagem de CsA, tempo decorrido após o transplante, IP, IG, PCS e NCI. O exame microbiológico das amostras coletadas mostrou a ausência de bastonetes entéricos Gram-negativos. Foi possível a detecçäo de Candida spp. (sb-30 por cento e se-30 por cento), na amostra de saliva estimulada e a presença deste microrganismo estava associada aos pacientes SCG

Propolis extract as an adjuvant to periodontal treatment.

PURPOSE: The aim of this study was to evaluate the effect of subgingival irrigation with propolis extract by clinical and microbiological parameters. MATERIALS AND METHODS: Twenty patients diagnosed with chronic periodontitis presenting three non-adjacent teeth with deep pockets were selected. After scaling and root planing, the selected periodontal sites were submitted to one of the following treatments: irrigation with a hydro alcoholic solution of propolis extract twice/week for two weeks (group A); irrigation with a placebo twice/week for two weeks (group B); or no additional treatment (C). Subgingival plaque sampling and scaling and root planing were performed two weeks after clinical data recording. Two weeks later irrigation procedures were started (Baseline). Microbiological and clinical data were collected at baseline, and after 4, 6 and 24 weeks. RESULTS: A decrease in total viable counts of anaerobic bacteria (p=0.007), an increase in the proportion of sites with low levels (< or = 10(3) cfu/mL) of Porphyromonas gingivalis (p=0.005), and a decrease in the number of sites with detectable presence of yeasts (p=0.000) were observed in group A sites when compared to group B and C sites. Propolis treatment did not lead to an increase in organisms such as coagulase positive Staphylococci and Pseudomonas spp. 24 weeks after treatment there was an increased proportion of sites showing probing depth (PD) < or = 3 mm in Group A sites. CONCLUSION: Subgingival irrigation with propolis extract as an adjuvant to periodontal treatment was more effective than conventional treatment both by clinical and microbiological parameters.