André Luiz Pataro

Influence of obesity and bariatric surgery on the periodontal condition.

BACKGROUND Recent studies have shown that being overweight or obese is associated with a higher risk of periodontitis. However, the literature offers an insufficient number of published reports regarding the effect of bariatric surgery on oral health. As such, the present study aims to determine the association between periodontal status and being overweight/obese in prebariatric and postbariatric surgery populations of Brazil. METHODS Three hundred forty-five participants between 18 and 60 years of age, from both sexes, were grouped according to prebariatric or postbariatric surgery and underwent a complete periodontal examination. Biologic, demographic, and behavioral variables were analyzed in a Poisson regression model. RESULTS Considering the timing of bariatric surgery, the sample was divided into three groups: PRE-OP (preoperative, n = 133), POS-OP1 (postoperative ≤6 months, n = 72), and POS-OP2 (post-surgery >6 months, n = 140). Regardless of the type of surgery (PRE-OP, POS-OP1, POS-OP2), the prevalence of periodontitis proved to be high (81.45%). There was a statistically significant difference in the prevalence of periodontitis among the PRE-OP, POS-OP1, and POS-OP2 groups (P = 0.040). In the Poisson regression model, after adjusting for biologic, demographic, and behavioral risk variables, only bleeding on probing remained significantly associated with the prevalence of periodontitis (P <0.001). CONCLUSION Differences in periodontal condition were observed in individuals at different times of the bariatric surgery, showing a high prevalence of periodontitis in both preoperative and postoperative follow-up.

Surface effects and desorption of tetracycline supramolecular complex on bovine dentine

The aim of this in vitro study was to evaluate the antimicrobial activity, the substantivity, and surface effects of the inclusion compound tetracycline: beta-cyclodextrin on bovine roots. The antimicrobial activity was assessed by dentine slabs which had been immersed in the inclusion complex in concentrations 8.0%, 4.0%, 2.0%, 1.0%, 0.5% and 0.25% for 5min compared to a control of tetracycline hydrochloride. Each slab was tested in a broth of overnight culture of Actinobacillus actinomycetemcomitans (Y4-FDC). The inclusion complex significantly inhibited the A. actinomycetemcomitans (p<0.01) verified at concentrations from 1.0% to 8.0%. The substantivity of tetracycline was evaluated by the measure of desorption from the slabs previously immersed in solution samples and removed at 24h intervals. The tetracycline encapsulated in beta-cyclodextrin showed a flow rate near to zero order in comparison to free tetracycline. The surface morphology determined by SEM showed a more homogeneous and integrated layer with the complex compared to the effect of free tetracycline. We concluded that the root surfaces treated with tetracycline: beta-cyclodextrin release lower concentrations of active drug over 5 days at inhibitory concentrations against A. actinomycetemcomitans with enhanced disponibility in comparison to tetracycline.

Halitosis in obese patients and those undergoing bariatric surgery

BACKGROUND Patients undergoing bariatric surgery often complain of bad breath. However, the relationship between bariatric surgery and halitosis is relatively unknown. The purpose of the present study was to evaluate and compare the occurrence of halitosis among patients before and after a specific type of bariatric surgery, Roux-en-Y gastric bypass, and its relationship with the tongue coating index, plaque index, and salivary flow rate. METHODS A total of 62 patients with good oral health and in treatment for obesity at the walk-in clinic of Santa Casa Hospital, Belo Horizonte, Brazil, were selected. Of this sample, 31 were bariatric surgery candidates (control group) and 31 had already undergone Roux-en-Y gastric bypass surgery (case group). After completing a questionnaire, all patients underwent an oral clinical examination. Halitosis was measured using an organoleptic scale and a portable sulfide monitor. RESULTS The Spearman correlation demonstrated a strong positive relation between the organoleptic rates and the concentration of volatile sulfur compounds determined using the sulfide monitor (rs = .58; P = .0001). No difference was found in the prevalence of halitosis between the 2 groups (P = .48). Only the salivary flow rate was significantly reduced in the control group compared with the case group (P = .02). In the case group, the concentration of volatile sulfur compounds correlated negatively with the salivary flow rate (P = .04) and positively with the tongue coating index (P = .005). The tongue coating index was significantly increased in those patients who did not brush the tongue (P < .04) and who had had episodes of vomiting (P = .02). CONCLUSION These data suggest that no significant association exists between halitosis and Roux-en-Y gastric bypass. However, they do highlight the possible effect of this surgery on the oral cavity.

Frequency of periodontal pathogens and Helicobacter pylori in the mouths and stomachs of obese individuals submitted to bariatric surgery: a cross-sectional study

ABSTRACT Objectives This cross-sectional study compared the frequency of oral periodontopathogens and H. pylori in the mouths and stomachs of obese individuals with or without periodontitis submitted to bariatric surgery. Material and Methods One hundred and fifty-four men and women aged 18-65 were conveniently distributed into four groups. Two groups were composed of individuals who underwent bariatric surgery with (BP) (n=40) and without (BNP) (n=39) periodontitis and two obese control groups with (CP) (n=35) and without (CNP) (n=40) periodontitis. The oral pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Parvimonas micra, Treponema denticola, Tannerella forsythia, Campylobacter rectus, and Helicobacter pylori were detected by a polymerase chain reaction technique using saliva, tongue and stomach biopsy samples. Results Statistical analysis demonstrated that periodontopathogens were highly frequent in the mouth (up to 91.4%). In the bariatric surgically treated group, orally, P. gingivalis, T. denticola and T. forsythia were more frequent in periodontitis, while C. rectus was more frequent in non-periodontitis subjects. Stomach biopsies also revealed the high frequency of five oral species in both candidates for bariatric surgery (91.6%) and the bariatric (83.3%) groups. H. pylori was frequently detected in the mouth (50.0%) and stomach (83.3%). In the stomach, oral species and H. pylori appeared in lower frequency in the bariatric group. Conclusions Obese individuals showed high frequencies of periodontopathogens and H. pylori in their mouths and stomachs. Bariatric surgery showed an inverse microbial effect on oral and stomach environments by revealing higher oral and lower stomach bacterial frequencies.