Johelle de Santana Passos

Chronic periodontitis and C-reactive protein levels.

BACKGROUND This study aims to analyze the relationship between chronic periodontitis and C-reactive protein (CRP) by considering associated variables in individuals with or without cardiovascular disease. METHODS A sample of 359 individuals of both sexes (aged ≥40 years) was assessed. Among these individuals, 144 subjects were admitted to the hospital because of a first occurrence of acute myocardial infarction; 80 subjects were in the hospital for reasons other than acute myocardial infarction; and 135 subjects were living in the community. A questionnaire was applied to obtain demographic and lifestyle characteristics. Complete clinical periodontal examinations and anthropometric assessments were performed. CRP levels, plasma glucose levels, lipid profiles, and blood tests were performed to investigate any conditions that might have suggested infection and/or inflammation. CRP evaluations were performed using nephelometry. Individuals were considered to have periodontal disease if they simultaneously presented at least four teeth with one or more sites with probing depth ≥4 mm, clinical attachment loss ≥3 mm, and bleeding on probing. Procedures for descriptive analyses and logistic regression were used. RESULTS In the chronic periodontitis group, mean CRP levels were higher than those in the group without chronic periodontitis (2.6 ± 2.6 mg/L versus 1.78 ± 2.7 mg/L, respectively). The final model showed that individuals with chronic periodontitis were more likely to have high CRP levels (adjusted odds ratio: 2.26; 95% confidence interval: 1.30 to 3.93) considering the effects of age, schooling level, sex, smoking, high-density lipoprotein cholesterol, and diabetes. CONCLUSION In this study, chronic periodontitis is associated with elevated plasma CRP levels, even after controlling for several potential confounders.

Contribution of periodontal disease in pregnant women as a risk factor for low birth weight

UNLABELLED Starting in the 1990s, several authors sought to investigate the hypothesis that periodontitis during pregnancy may contribute towards the birth of low-weight children. However, this relationship is still not well established. The aim of this study was to evaluate whether this oral infection is associated with this gestational event. METHODS This was a case-control study among 548 puerperae, of whom 164 were the mothers of low-weight live births (case group) and 384 were the mothers of live births of normal gestational weight (control group). They were selected at two public hospital units in two municipalities in the State of Bahia. From interviews and data gathered using live birth cards or birth certificates, information was obtained regarding age, height, previous diseases, marital status, socioeconomic situation, smoking and alcohol use. Mothers who presented at least four teeth on which one or more sites had a probing depth of greater than or equal to 4 mm, clinical attachment loss of greater than or equal to 3 mm and bleeding on probing, at the same site, were deemed to present periodontal disease. The data were analysed by stratification from logistic regression. RESULTS Periodontal disease was diagnosed in 42.7% of the case group and 30% of the control group. A statistically significant association was found between periodontal disease and low birth weight (unadjusted OR = 1.74; 95% CI: 1.19-2.54), particularly among mothers with low schooling levels (adjusted OR = 2.30; 95% CI: 1.14-4.6). CONCLUSION The findings suggest an association between periodontal disease and low birth weight among mothers with low education levels.

Respiratory disease and the role of oral bacteria

Abstract The relationship between oral health and systemic conditions, including the association between poor oral hygiene, periodontal disease, and respiratory disease, has been increasingly debated over recent decades. A considerable number of hypotheses have sought to explain the possible role of oral bacteria in the pathogenesis of respiratory diseases, and some clinical and epidemiological studies have found results favoring such an association. This review discusses the effect of oral bacteria on respiratory disease, briefly introduces the putative biological mechanisms involved, and the main factors that could contribute to this relationship. It also describes the role of oral care for individuals who are vulnerable to respiratory infections.

Outcome measurements in studies on the association between osteoporosis and periodontal disease.

BACKGROUND The present study aims to compare different diagnostic criteria for periodontal disease that were used to study the association between periodontal disease and osteoporosis. METHODS A database from a case-control study was used. The present study included sociodemographic, lifestyle, and health-condition data; panoramic radiographs; and clinical measurements on periodontal conditions from 139 postmenopausal women. Each participant was classified with regard to the diagnosis of periodontal disease using five different criteria for the outcome measurement (OM) found in the literature in studies on the association between osteoporosis and periodontal disease (OM1 through OM5). The frequency of periodontal disease and diagnostic values were calculated taking OM5 as the gold standard and the main association measurement for all criteria using odds ratios. RESULTS The frequency of periodontal disease varied from 24.5% to 98.6% depending on the OM used. OM4 and OM3 presented the highest specificity (98.9% and 94.5%, respectively), whereas OM2 and OM1 presented the highest sensitivity (100% and 77.1%, respectively). The association measurements with adjustments for age and smoking varied significantly according to the OM over a range from 1.87 to 3.75, and there were also variations in the statistical significance of the associations found. CONCLUSIONS The results of this study emphasize that the frequency of periodontal disease may be influenced by different OMs and indicated variations outside of the association between osteoporosis and periodontal disease. Therefore, there is a need for prior selection of a precise measurement of periodontal disease in investigations on this topic.

Periodontitis and nosocomial lower respiratory tract infection: preliminary findings.

AIM To evaluate the possible association between periodontitis and nosocomial lower respiratory tract infection (LRTI). MATERIAL AND METHODS A case-control study was conducted at a General Hospital in Feira de Santana, Bahia, Brazil. The sample consisted of 103 individuals: 22 cases (presence of nosocomial LRTI) and 81 controls (absence of nosocomial LRTI). The diagnosis of periodontitis was based on probing depth, gingival recession, clinical attachment loss and bleeding on probing. The diagnosis of nosocomial LRTI was made in accordance with established medical criteria. RESULTS Invasive ventilation was much more frequent in cases (95.5%) than in controls (7.4%). An orotracheal tube was used in 81.8% of cases and in 7.4% of controls; bronchoaspiration was suspected in 81.8% of cases and in 6.2% of controls. There was no statistically significant difference in any of the clinical periodontal parameters between cases and controls. The crude odds ratio (OR) value for individuals with periodontitis having LRTI was not statistically significant [OR(crude)=1.70; 95% confidence interval:(0.60-4.87)]. After including age, smoking and duration of hospitalization in the logistic regression, the adjusted OR for individuals with periodontitis having LRTI was statistically significant [OR(adjusted)=3.67 (1.01-13.53); p=0.049]. CONCLUSIONS A marginal association between periodontitis and LRTI was found when smoking, age and length of hospitalization were included as covariates. Patients with LRTI had a high frequency of suspected bronchoaspiration and this could explain the possible association of periodontal disease and LRTI found in this and other studies. Additional studies are needed to further clarify the possible relationship between periodontal disease and LRTI.

Periodontal therapy for pregnant women and cases of low birthweight: An intervention study

Background:  Over the past decade, strong evidence for an association between maternal periodontitis and low birthweight has started to appear. However, few intervention studies have been proposed for investigating this hypothesis. The aim of this study was to evaluate whether periodontal therapy among pregnant women would reduce the incidence of low birthweight.

Effect of osteoporosis on periodontal therapy among post-menopausal women

OBJECTIVE This intervention study aimed to investigate the effect of osteoporosis on periodontal condition among 48 post-menopausal women undergoing periodontal therapy. MATERIAL AND METHODS The experimental group, which underwent non-surgical periodontal therapy, was composed of 16 women with periodontitis to be treated, and the control group was formed by 32 women without periodontitis. Oral condition was assessed on three occasions: at the start of the treatment (first examination), 1 month (first re-examination) and 4 months after the end of the therapy (second re-examination). In the second re-examination, recurrence of periodontal disease was evaluated by comparing the clinical measurements obtained pre- and post-treatment. The diagnosis of osteoporosis was made by investigating densitometry reports obtained previously. Descriptive analysis, analysis of variance and the Bonferroni post hoc test were applied to the data gathered, with statistical significance level of 5%. RESULTS The frequency of periodontitis was 50% in the treated group and 25% in the group without periodontitis. In both groups, this recurrence was greater in subjects with osteoporosis (37.5 and 18.75%, respectively) than in the individuals without osteoporosis (12.5 and 6.25%, respectively). CONCLUSIONS The preliminary results indicate that osteoporosis possibly has an influence on periodontal condition among individuals undergoing non-surgical periodontal treatment.

Periodontal Therapy and Low Birth Weight: Preliminary Results From an Alternative Methodologic Strategy

BACKGROUND The purpose of this study is to present the use of a non-randomized experimental design with multiple controls, with emphasis on a historical control group, as an alternative methodologic resource for studies on the association between periodontal disease and prematurity/low birth weight. METHODS The sample consisted of 234 pregnant women: 54 in the Test Group (treatment of periodontal disease); 68 in Control Group I (without periodontal disease); and 112 in Control Group II (historical control group, with untreated periodontal disease). The diagnosis of periodontal disease was established by means of a complete clinical examination, using measurements of probing depth, gingival recession, clinical attachment loss, and bleeding index. The women in the Test Group were treated for periodontitis and followed-up with periodontal support therapy throughout their pregnancies. After delivery, they were reevaluated regarding their periodontal condition, and information on the newborns birth weight was obtained. This was also done for Control Groups I and II. Descriptive analyses on the study variables were performed using the χ(2) and Fisher exact tests. Association measurements (relative risk) were obtained using a significance level of 5%. RESULTS The frequency of low birth weight among the Test Group was similar to Control Group I and lower than Control Group II. CONCLUSION The results suggest that successful periodontal therapy in pregnant women suffering from periodontitis is a protective factor promoting the birth of children with normal weight.

SP4-33 Risk factors for low birth weight in the municipalities of Juazeiro and Petrolina (Brazil): a case-control study

The aim of this study was to evaluate the association between maternal characteristics and low birth weight (LBW). An exploratory case-control investigation was conducted in two hospital that provide attendance through SUS in neighbouring municipalities: Petrolina (Pernambuco) and Juazeiro (Bahia), Brazil. The sample consisted of 588 puerperae, of whom 136 were in the case group (women with low-weight children) and 452 in the control group (mothers of normal-weight children). In the data analysis procedures, the distribution of the variables was evaluated using the χ2 test at the significance level of 5%. This study was approved by the Research Ethics Committee of UEFS (CAAE: 0151.0.0590.000-08). The results demonstrated that LBW was associated with the mothers occupation during pregnancy (p=0.04), fathers schooling level (p=0.01), mothers race/colour (p=0.00), municipality of origin (p=0.01), mothers age (p=0.00), number of prenatal consultations (p=0.00), presence of pregnancy card at time of delivery (p=0.00), number of consultations with a medical professional (p=0.04), number of pregnancies (p=0.01) and gestational age (p=0.00). However, there were no statistically significant associations with the other variables. The findings reaffirm that having quality prenatal care is of utmost importance, with greater efforts made towards identifying factors that are associated with LBW, with a view to reducing the occurrence of this undesirable gestational outcome.

P2-45 Periodontal disease contributes to the occurrence of cardiovascular events? A meta-analysis of case control studies

Introduction We carried out a meta-analysis to determine the association between exposure to PD and ischaemic CDH. Material and methods Studies published case-control between 1999 and 2009 were obtained from the search site PUBMED/MEDLINE, Lilacs e Google. The articles included report results of observational studies, case-control on the association between PD and DCVI, where the DP should have been diagnosed by clinical parameters that included probing depth (PD) and clinical attachment level (NIC) DCVI and was represented by one of the following outcomes: Coronary Artery Disease (CAD), Myocardial Infarction (AMI) with or without angina pectoris, or Acute Coronary Syndrome (ACS). The quality of the articles was assessed using criteria recommended in “The Strengthening the Reporting of Observational Studies in Epidemiology-STROBE”. In addition, compliance with the guidelines of the guide to meta-analysis for observational studies-MOOSE. Results Of the 23 studies, case-control eligible, 16 had their results combined using the methodology of meta-analysis. The overall OR was approximately 2.52 (95% CI 2109 to 3009, p<0.001), indicating that individuals with PD have an increased chance of developing ischaemic CDH as compared to those without PD. Conclusion Observational case-control suggest that individuals with PD are more likely to develop ischaemic CDH, however, further studies are needed for more definitive conclusions.