Periodontitis and identification of undiagnosed hyperglycemia / Periodontite e identificação da hiperglicemia não diagnosticada

Introduction Individuals with pre-diabetes have altered glycemic levels, are generally asymptomatic, and are at increased risk for developing type 2 diabetes mellitus. Objective Identify the prevalence of periodontal individuals with undiagnosed hyperglycemia and associated impact factors. Material and method Fifty-six patients with periodontitis and without diabetes self-report, users of dental clinic services at Federal University of Juiz de Fora were included in this research, during one year and a half of experimental evaluation. Socioeconomic and demographic data, anthropometric patterns, fasting capillary blood glucose, and complete periodontal examination (six sites per tooth) were evaluated. Result The sample consisted of 58.9% female, mean age 53 years old, 58.9% obese/overweight and 45.3% had a low level of education. A total of 28.6% (n=16) participants had undiagnosed hyperglycemia (between 100 to 160 mm / dL), of which 81.3% were obese/overweight, 25% were smokers, 56.3% reported having a history of diabetes in the family, 93.8% had a family income up to 2 brazilian´s minimum wages. BMI values ​​were higher in the group of patients with hyperglycemia (29.8 ± 5.7, p = 0.03) compared to the group without hyperglycemia (26.6 ± 5.6). Patients with hyperglycemia had a greater number of sites with clinical attachment loss (CAL) between 4 and 6 mm (p = 0.04) when compared with the normoglycemic group. Conclusion Undiagnosed CAL attachment loss between 4 and 6 mm due to periodontitis than normoglycemic individuals.

Introdução Indivíduos com pré-diabetes apresentam níveis glicêmicos alterados, geralmente são assintomáticos e apresentam risco aumentado para desenvolver diabetes mellitus tipo 2. Objetivo Identificar a prevalência de indivíduos periodontais com hiperglicemia não diagnosticada e os fatores de impacto associados. Material e método Cinquenta e seis pacientes com periodontite e sem autorrelato de diabetes, usuários de serviços de clínica odontológica da Universidade Federal de Juiz de Fora foram incluídos nesta pesquisa, durante um ano e meio de avaliação experimental. Foram avaliados dados socioeconômicos e demográficos, padrões antropométricos, glicemia capilar de jejum e exame periodontal completo (seis sítios por dente). Resultado A amostra foi composta por 58,9% do sexo feminino, média de idade de 53 anos, 58,9% obesidade / sobrepeso e 45,3% com baixa escolaridade. Um total de 28,6% (n=16) participantes tinham hiperglicemia não diagnosticada (entre 100 a 160 mm / dL), dos quais 81,3% eram obesos / com sobrepeso, 25% eram fumantes, 56,3% relataram ter histórico de diabetes na família, 93,8% tinham renda familiar de até 2 salários mínimos brasileiros. Os valores de IMC foram maiores no grupo de pacientes com hiperglicemia (29,8 ± 5,7, p = 0,03) em comparação ao grupo sem hiperglicemia (26,6 ± 5,6). Pacientes com hiperglicemia apresentaram maior número de sítios com perda clínica de inserção (CAL) entre 4 e 6 mm (p = 0,04) quando comparados ao grupo normoglicêmico. Conclusão A perda de inserção de CAL não diagnosticada entre 4 e 6 mm devido à periodontite do que indivíduos normoglicêmicos.

Occlusal device with extraoral retention: An occlusal technique for patients with Down syndrome.

Temporomandibular disorders associated with bruxism have a high prevalence rate in the overall population, including individuals with Down syndrome (DS). Occlusal devices have been prescribed for the treatment of temporomandibular disorders and prevention of tooth wear due to bruxism. Patients with DS have restrictions concerning treatment with occlusal devices, with an increased risk of swallowing and asphyxia, because of limitations with cognitive ability and motor deficiency. Therefore, an occlusal device with extraoral retention was developed to improve the safety for a patient with DS. An extraoral transverse rod was connected to the occlusal device to prevent it from being swallowed. The patient used the device safely for 4 weeks.

Systemic antibiotics in the treatment of aggressive periodontitis. A systematic review and a Bayesian Network meta-analysis.

AIM: The aim of this study was to assess the effect of systemic antibiotic therapy on the treatment of aggressive periodontitis (AgP). METHODS: This study was conducted and reported in accordance with the PRISMA statement. The MEDLINE, EMBASE and CENTRAL databases were searched up to June 2014 for randomized clinical trials comparing the treatment of subjects with AgP with either scaling and root planing (SRP) alone or associated with systemic antibiotics. Bayesian network meta-analysis was prepared using the Bayesian random-effects hierarchical models and the outcomes reported at 6-month post-treatment. RESULTS: Out of 350 papers identified, 14 studies were eligible. Greater gain in clinical attachment (CA) (mean difference [MD]: 1.08 mm; p < 0.0001) and reduction in probing depth (PD) (MD: 1.05 mm; p < 0.00001) were observed for SRP + metronidazole (Mtz), and for SRP + Mtz + amoxicillin (Amx) (MD: 0.45 mm, MD: 0.53 mm, respectively; p < 0.00001) than SRP alone/placebo. Bayesian network meta-analysis showed additional benefits in CA gain and PD reduction when SRP was associated with systemic antibiotics. CONCLUSIONS: SRP plus systemic antibiotics led to an additional clinical effect compared with SRP alone in the treatment of AgP. Of the antibiotic protocols available for inclusion into the Bayesian network meta-analysis, Mtz and Mtz/Amx provided to the most beneficial outcomes.

Análise transversal do ensino da implantodontia no curso de graduação / Cross-sectional study of implant dentistry teaching in the undergraduate course

O objetivo deste trabalho foi avaliar o ensino da Implantodontia na graduação nas faculdades brasileiras. Realizamos estudo transversal baseado em questionários enviados aos coordenadores de todas as faculdades brasileiras regularmente inscritas no Conselho Federal de Odontologia,5 para avaliar o conhecimento da ciência Implantodontia disponibilizado aos alunos de graduação. Constatamos que a disciplina Implantodontia está presente em 56,96% das faculdades de Odontologia pesquisadas e, nas faculdades onde a disciplina inexiste, os conhecimentos sobre a Implantodontia são ministrados, na maioria das vezes, na disciplina de cirurgia buco-maxilo-facial, o que poderia trazer ao aluno uma visão fragmentada predominantemente cirúrgica da Implantodontia; a carga horária de conhecimentos teóricos e práticos sobre Implantodontia são expressivamente maiores nas faculdades onde a disciplina existe, comparada às faculdades onde os conhecimentos são ministrados como parte de outras disciplinas; não houve comprovação da associação entre o fato da disciplina não ser ofertada e carga horária total do curso; os professores responsáveis pelo ensino da Implantodontia, em mais de dois terços das faculdades não possuem especialidade em Implantodontia, podendo ser a falta de corpo docente qualificado o motivo da ausência da disciplina em quase metade das escolas brasileiras. Diante dos resultados, sugerimos a incorporação da disciplina Implantodontia na grade curricular promovendo melhor embasamento científico para os futuros profissionais (AU).

The objective of this study was to evaluate the teaching of implant dentistry in colleges in Brazil. We conducted a cross-sectional study based on questionnaires sent to the coordinators of all the Brazilian colleges regularly enrolled in the Federal Council of Dentistry,5 to assess the level of knowledge of the science of implant dentistry available to undergraduate students. We found that the academic subject of implant dentistry was found in 56.96% of the dental schools and colleges surveyed. In those colleges where the discipline does not exist, implant dentistry is mostly taught in the course on maxillofacial surgery. This approach could give the student a fragmented, predominantly surgical view of implant dentistry. The workload of theoretical and practical dental implant subject matter is significantly higher in schools where the discipline is offered, compared to the colleges where the subject matter is taught as part of other disciplines. There was no evidence of an association between the fact that the course is not offered and the total hours of the course. The teachers responsible for teaching implant dentistry in more than two thirds of Brazilian colleges have no expertise in this field. The reason why this discipline does not exist in almost half of Brazilian schools may be because of a lack of a qualified teaching staff. In view of these results, we suggest that the subject of implant dentistry be included in the curriculum of dental schools to establish a better scientific basis for future professionals (AU).