Fabiano Araújo Cunha

Association between depression and periodontitis: a systematic review and meta-analysis.

AIM The aim of this systematic review and meta-analysis was to assess the scientific evidence on the association between depression and periodontitis. METHODS An electronic search was conducted in three databases until October 2015 (PROSPERO-CRD42014006451). Hand searches and grey literature were also included. Search retrieved 423 potentially studies. Two independent reviewers selected the studies, extracted data and assessed risk bias through a modified version of Newcastle-Ottawa scale. Meta-analysis was performed for the presence/absence of periodontitis (dichotomic). Summary effect measures and odds ratio (OR) 95% CI were calculated. RESULTS After selecting the studies, 15 were included in the systematic review (eight cross-sectional, six case-control and one cohort study). Six studies reported that depression was associated with periodontitis, whereas nine studies did not. The majority of studies had low risk of bias by methodological quality assessment. Meta-analysis of seven cross-sectional studies showed no significant association between depression and periodontitis (OR = 1.03, 95% CI = 0.75-1.41). CONCLUSION Findings from the present systematic review showed a great heterogeneity among the studies and the summary effect measure of the meta-analysis cannot affirm an association between depression and periodontitis. Future studies with different designs in distinct populations should be conducted to investigate this association.

Acellular dermal matrix and gingival connective in the treatment of periodontal recessions – comparative clinical evaluation in humans

Different periodontal surgical techniques have been proposed for the treatment of periodontal recessions. Among these, the graft of gingival connective tissue stands out for the high predictability of success. This work compared the clinical outcomes of treatment of periodontal recessions, using the gingival connective tissue grafts and acellular dermal matrix. A total of 72 recessions constituted the sample, divided equally into 2 groups. Group 1: treated with acellular dermal matrix graft (MDA) associated with the displaced: Group 2: treated with gingival connective tissue graft, also associated with the flap offset coronally. We evaluated the clinical parameters of probing depth, insert, clinical periodontal recession towards coronal-apical diameter mesio-distal of recessions, keratinized and mucosa thickness flap and influence of grafts in relation to root coverage. The initial measures were compared to those obtained with 45, 90 and 120 days after surgery. No statistically significant differences were found between the groups in terms of reduction of periodontal recessions, keratinized and mucosa flap thickness and of grafts in relation to root coverage. The Group 2 (CG) showed statistically significant reduction in the depth of drilling and clinical level of insertion, compared to group 1 (MDA). However, these differences were not clinically relevant. It was concluded that both the gingival connective tissue graft as the acellular dermal matrix can be used in the treatment of periodontal recessions, with a high predictability of success.