Adriana de Fátima Vasconcelos Pereira

Association between osteoporosis and periodontal disease

PURPOSE to verify the association of osteoporosis with periodontal disease. METHODS the study has included 39 postmenopausal women divided in three groups according to bone mass categories, through evaluation of mineral bone density (MBD), measured by X-ray double emission absorbimetry in the lumbar area (L1-L4): ): normal bone; osteopenia and osteoporosis. In all the participants the Clinical Insertion Level (CIL) index has been determined at the research onset and after one year, by the same examiner. The periodontal situation data have been submitted to statistical analysis with the paired t-Student test. RESULTS the periodontal exam has shown that postmenopausal women in the osteopenia presented lower CIL at the initial periodontal clinical exam (2.1+/-1.1 mm), while the ones in the normal bone showed less teeth support tissue loss after one year (3.1+/-1.6 mm). The statistical analysis has shown that there was no significant difference for the periodontal situation in the normal bone, but there was significant statistical difference for the osteopenia and osteoporosis patients, when CIL values from both evaluation periods were compared. CONCLUSIONS it is concluded that postmenopausal osteoporosis may be a possible risk factor for periodontal disease.

Salivary IgA and periodontal treatment needs in diabetic patients

Salivary IgA can serve as a first line of defense against pathogens that colonize and invade mucosal surfaces and may be protective against periodontal disease. The aim of this study was to assess salivary immunoglobulin A levels in diabetic and non-diabetic patients with different periodontal treatment needs. The Periodontal Screening & Recording (PSR) system was used to evaluate the periodontal treatment needs of 41 diabetic and 42 non-diabetic patients. Unstimulated whole saliva was collected from each patient immediately before clinical examination and stored at -20 °C until analysis. Salivary immunoglobulin A (s-IgA) levels were determined using an enzyme-linked immunosorbent assay, and values were expressed as optical density. Diabetic and non-diabetic patients were compared using clinical and laboratory data. PSR data indicated that periodontal disease was more frequent and more severe in diabetic patients. A higher prevalence of codes 3 and 4 was observed in diabetics as compared with non-diabetics (odds ratio = 2, P < 0.05). Furthermore, non-diabetic patients had more healthy sextants (code 0) than did diabetic patients. Over half of diabetic patients (∼54%) presented with s-IgA levels that were lower than the normal range (optical density from 0.4 nm to 0.6 nm; P < 0.05). In addition, diabetic patients showed a higher variability in s-IgA levels as compared with non-diabetic patients. In conclusion, diabetic individuals had lower s-IgA levels, more-frequent and more-severe periodontal disease, and a greater need for periodontal treatment as compared with non-diabetic patients.

Oral manifestations as important symptoms for juvenile dermatomyositis early diagnosis: a case report

BACKGROUND Juvenile dermatomyositis (JDM) is an idiopathic inflammatory myopathy of childhood and adolescence, characterized by symmetrical weakness of proximal muscles and classical cutaneous features. Literature reports rarely describe or focus on oral lesions that are associated with this disease. CASE REPORT This case describes a 4-year-old girl in whom the oral lesions were the initial manifestations of JDM. Physical examination revealed characteristic skin manifestations, proximal muscle weakness, extensive calcinosis, necrotic ulceration, complicated erysipelas, and diffuse alopecia. The diagnosis was established based on the clinical, histological, electroneuromyography, and biochemical findings. CONCLUSION Recognition of gingival telangiectases as an important diagnostic marker of JDM leads us to suggest that identifying oral manifestations, which may be carried out by a paediatric dentist, contributes in establishing an early diagnosis and an immediate treatment of this condition.

DENSIDADE MINERAL ÓSSEA SISTÊMICA VS SITUAÇÃO CLÍNICA PERIODONTAL: ESTUDO TRANSVERSAL EM MULHERES NA PÓS-MENOPAUSA

OBJECTIVE To assess the systemic bone mineral density (BMD) and the periodontal situation in postmenopausal women, to understand the possible role of osteoporosis as a risk factor for periodontal disease. METHODS The sample was comprised of 47 postmenopausal women, divided into 3 groups: 14 patients with normal bones (G1), 17 with osteopenia (G2) and 16 patients with osteoporosis (G3). Data was obtained using bone mineral density (BMD), obtained by dual energy x-ray absorptiometry (DXA) in the lumbar area (L1-L4). Periodontal condition was evaluated by Gingival Index (GI), Plaque Index (PI) and Clinical Attachment Level (CAL). Results were analyzed and submitted to statistical treatment, through the One Way ANOVA: (alpha=0.05) test and the Pearsons Correlation test (alpha=0.01). RESULTS GI, PI and CAL variables did not disclose a significant difference in the periodontal situation of postmenopausal women A significant correlation between periodontal parameters GI, PI and CAL (p<0,001) was observed, however no significant correlation was detected between periodontal parameters (GI, PI and CAL) and systemic bone condition of postmenopausal women, evaluated by BMD (p>0.01). CONCLUSION The periodontal situation of postmenopausal women does not depend on the systemic bone mass and there is no significant correlation between BMD and periodontal parameters. However, further longitudinal surveys are required to understand osteoporosis as a risk factor of periodontal disease.

Relationship between periodontal status and degree of visual impairment in institutionalized individuals.

Objective: Periodontal disease is a set of inflammatory infections that affect the supporting structures of the dentition. Patients with visual impairment (VI) may have more difficulty in cleaning and maintaining oral health. The purpose of this study was to investigate the possible relationship between periodontal status and degree of VI in institutionalized individuals. Materials and Methods: Fifty-two visually impaired individuals were included in this cross-sectional study. The periodontal parameters assessed were clinical attachment level (CAL), probing depth (PD), and visible plaque index. The degree of VI was established as: Group 1 (mild or moderate VI), Group 2 (severe or profound VI), and Group 3 (completely blind); and the types of VI were considered as congenital and acquired. Fisher′s exact, Kruskal-Wallis, Mann-Whitney, and Spearman correlation coefficient test were used. The level of significance was set at 5%. Result: Only plaque index was higher on proximal surfaces of subjects with mild/moderate VI when compared to the other degrees of VI (P = 0.01). Furthermore, we observed higher values for interproximal CAL (P = 0.01), total PD (P = 0.04), and interproximal PD in subjects with acquired VI when compared to subjects with congenital VI (P = 0.01). Conclusions: These findings suggest that periodontal status may be more related to the type of disability than with the degree of VI. Acquired VI people presented a worse periodontal health than the group with congenital VI.

Is depression associated with periodontal status in elderly

Aim: To examine whether the depression is associated with periodontitis in elderly and to evaluate oral hygiene of these patients. Methods: One hundred and ninety one individuals aged 60 years or more were randomly selected. Periodontal examination was performed in full mouth by probing depth and clinical attachment loss in 6 sites for each tooth. The Simplified Oral Hygiene Index (OHI-S) per individual was also obtained. Depression was assessed by the Geriatric Depression Scale (GDS-15) to show how the elderly have been feeling during the last week. Results: Only SOHI was statistically significant (t = 4.7169, p<0.001), which better explains the variance in periodontal status. The variable GDS-15 revealed no significant values (t=0.3901, p=0.6971). Conclusions: There was no association between periodontitis and depression in elderly, but there was association between periodontitis and oral hygiene.

Avaliação de lesões cervicais não-cariosas em adultos: estudo piloto

Resumen pt: Objetivo: determinar as caracteristicas clinicas e a prevalencia de lesoes cervicais nao-cariosas (LCNCs) em pacientes adultos. Metodos: a coleta dos dad...

A Doença Periodontal Como Fator de Risco Para os Acidentes Cerebrovasculares

Introduction: The cardiovascular diseases, among them the brain vascular accidents, are responsible for 20% of the deaths annually. Studies have proved ass...

Conhecimentos e práticas de saúde bucal de gestantes usuárias dos serviços de saúde em São Luís, Maranhão, 2007-2008

Resumo OBJETIVO: descrever as caracteristicas dos cuidados de saude bucal durante o acompanhamento pre-natal e o conhecimento sobre saude bucal entre gestantes usuarias de servicos de saude publico e privado em Sao Luis, Maranhao, Brasil. METODOS: estudo descritivo com 300 gestantes entrevistadas em servico publico e 300 em servico privado, no periodo de agosto de 2007 a julho de 2008. RESULTADOS: a frequencia de escovacao dentaria foi similar entre as usuarias dos servicos publico e privado (p=0,156), enquanto o uso de fio dental (64,0% e 47,0%; p<0,001) e de colutorios (39,7% e 27,0%; p=0,001) foi mais frequente no servico privado, em relacao ao publico; a maioria das usuarias, tanto do servico publico (60,3%) como do privado (65,7%), desconheciam a associacao entre saude bucal e gravidez. CONCLUSAO: a frequencia de escovacao dentaria foi similar entre gestantes dos servicos publico e privado; os efeitos da gestacao sobre a saude bucal eram pouco conhecidos.OBJECTIVE to describe characteristics of oral health care during prenatal check-ups and knowledge about oral health among pregnant women using public and private health services in São Luís, Maranhão, Brazil. METHODS this is a descriptive study of 300 women interviewed in public health services and a further 300 interviewed in private health services between August 2007 and July 2008. RESULTS tooth brushing frequency was similar among users of public and private services (p=0.156), while flossing (64.0% and 47.0%; p<0.001) and mouthwashing (39.7% and 27.0%; p=0.001) was more frequent among private service users in relation to public service users; most users of public services (60.3%) and private services (65.7%) were unaware of the association between oral health and pregnancy. CONCLUSION frequency of tooth brushing was similar among pregnant women in public and private services; the effects of pregnancy on oral health were not well known.

Periodontal Disease as a Risk Factor for Cerebrovascular Accidents

Introducao: As doencas cardiovasculares, entre elas os acidentes vasculares cerebrais, sao responsaveis por 20% de todas as mortes anualmente. Estudos tem evidenciado a associacao das doencas periodontais com fatores inerentes ao hospedeiro como fumo, doencas sistemicas, estresse, obesidade e outros. Recentemente, a doenca periodontal tem sido estudada como fator de risco para a ocorrencia de acidentes vasculares cerebrais. Objetivo: Analisar a relacao existente entre acidente vascular cerebral e doencas periodontais, atraves de evidencias da literatura uma vez que ambas as doencas sao de grande prevalencia na sociedade atual. Conclusao: Apesar de estudos mostrarem evidencias da doenca periodontal como fator de risco para os acidentes vasculares cerebrais, os mecanismos biologicos que ligam as duas doencas ainda nao estao totalmente esclarecidos. Estudos adicionais devem ser realizados para esclarecer esta associacao, bem como medidas preventivas devem ser realizadas, visando prevenir a ocorrencia de ambas as doencas.