Luiz Eduardo Montenegro Chinellato

Periodontal disease and diabetes mellitus

Periodontal disease (PD) is one of the most commonly known human chronic disorders. The relationship between PD and several systemic diseases such as diabetes mellitus (DM) has been increasingly recognized over the past decades. Objective: The purpose of this review is to provide the reader with knowledge concerning the relationship between PD and DM. Many articles have been published in the english and Portuguese literature over the last 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of DM, PD and different clinical criteria were applied to determine the prevalence, extent and severity of PD, levels of glycemic control and diabetes-related complications. Methods: This paper provides a broad overview of the predominant findings from research conducted using the BBO (Bibliografia Brasileira de Odontologia), MEDLINE, LILACS and PubMed for Controlled Trials databases, in english and Portuguese languages published from 1960 to October 2012. Primary research reports on investigations of relationships between DM/DM control, PD/periodontal treatment and PD/DM/diabetes-related complications identified relevant papers and meta-analyses published in this period. Results: This paper describes the relationship between PD and DM and answers the following questions: 1- The effect of DM on PD, 2- The effects of glycemic control on PD and 3- The effects of PD on glycemic control and on diabetes-related complications. Conclusions: The scientific evidence reviewed supports diabetes having an adverse effect on periodontal health and PD having an adverse effect on glycemic control and on diabetes-related complications. Further research is needed to clarify these relationships and larger, prospective, controlled trials with ethnically diverse populations are warranted to establish that treating PD can positively influence glycemic control and possibly reduce the burden of diabetes-related complications.

Condições periodontais e diabetes mellitus na população nipo-brasileira

OBJECTIVE To evaluate the relationship between diabetic status and periodontal conditions in the Japanese-Brazilian population. METHODS The sample consisted of 1,315 subjects, of both sexes, first (Issei) and second (Nisei) generations, aged 30 to 92 years, living in Bauru, Brazil. Edentulism and presence of 6 null sextants were the exclusion criteria for the sample. The Community Periodontal Index and Periodontal Attachment Loss Index were determined using the probing of 10 teeth in a sample of 831 subjects. The diagnosis of diabetes mellitus was based on fasting blood sugar and blood sugar 2 hours after 75 mg of glucose overload. Statistical analysis was conducted using Kappa test and Chi-square test. RESULTS Regarding periodontal conditions, 25.5% of the sample were healthy people, 12.5% showed bleeding on probing, 49.4% calculus, 10.4% pockets of 4-5 mm deep, and 2.2% pockets deeper than 6 mm. The percentage of subjects with an attachment loss of 0-3 mm was 24.2%; 4-5 mm, 36.7%; 6-8 mm, 23.7%; 9-11 mm, 11.3%; and up to 12 mm or more, 4.1%. The association between the periodontal condition and diabetes mellitus showed no statistical significance (p<0.05), although diabetic subjects have a higher percentage of deeper pockets and attachment loss >6 mm than non-diabetics, as tested by Chi-square test. CONCLUSIONS Epidemiological studies relating oral health and systemic disease, such as diabetes mellitus, can provide important contributions for preventing the worsening of such diseases.

Contribution of radiographs to the diagnosis of naso-alveolar cyst

Eight cases of nasoalveolar cyst are reported; seven of these cases demonstrated radiographically identifiable changes. The literature is reviewed, and clinical and cytologic characteristics of the lesions are discussed. The importance of radiographs in the diagnosis of nasoalveolar cysts is emphasized.

Comparison of radiographic measurements obtained with conventional an indirect digital imaging during endontic treatment

The aims of this study were to evaluate the quality of indirect digitized radiographic images taken during endodontic procedures and to compare the measurements recorded with this technique to those obtained from conventional radiographs. Two-hundred conventional periapical radiographs taken at the undergraduate Endodontics Clinic of the Dental School of Bauru were digitized. The conventional and indirect digitized images were compared by three examiners as to the quality and accuracy of the measurements recorded during endodontic treatment, in canal length determination, gutta-percha adaptation, lateral condensation and final obturation. The conventional radiographs were observed on a film viewer, surrounded by a dark card, and measured with magnifying glass and a millimeter ruler; the indirect digitized images were evaluated on the Digora® for Windows software, with free utilization of the bright/contrast tool. Unlike the conventional radiographic images, all indirect digitized images were considered as having a high quality. The distance between the filling material and the root apex was 0.117 mm larger, on average, for the Digora® system (p<0.01). The measurements achieved by the investigated radiographic methods were clinically similar and they are thus equivalent. Changes in brightness and contrast of the images using Digora® software improved the diagnosis.

Saliva and tongue coating pH before and after use of mouthwashes and relationship with parameters of halitosis

Objectives The aim of this work was to evaluate saliva and tongue coating pH in oral healthy patients with morning bad breath before and after use of different oral mouthrinses. Material and Methods aliva and tongue coating pH of 50 patients allocated in 5 groups were measured respectively by a digital pHmeter and color pH indicators, before, immediately after and 30 min after rinsing 5 different mouthrinses: cetilpiridine chloride associated with sodium chloride, triclosan, enzymatic solution, essential oil and distilled water. Results Only triclosan and essential oil increased salivary pH immediately after rising. The enzymatic solution decreased salivary and tongue coating pH immediately after rinsing. Conclusion Salivary pH tended to be acidic while tongue coating pH tended to be alkaline, even after rising. Triclosan and essential oil mouthrinses increased salivary pH immediately after rinsing. Enzymatic solution decreased saliva and tongue coating pH immediately after rising.

Eosinophilic granuloma of mandible: Report of a case with a 7-year follow-up

Abstract We have presented a case of eosinophilic granuloma of bone in the region of the angle of mandible which was diagnosed through biopsy and successfully treated with radiotherapy. There was no recurrence after 7 years.

Oral health of building construction workers: an epidemiological approach

This cross-sectional study aimed at evaluating the oral health conditions of building construction workers from a city in the mid-west region of São Paulo, Brazil. This study involved 219 male subjects, aged 17 to 72. The definition of a random sample utilized the functional number of each worker as a criterion to the raffle, which took into account all 450 subjects registered in the Working Accidents Prevention Program. The examination of oral health conditions by DMFT index and need of treatment were carried out according to WHO criteria (1997). This paper reports the prevalence of caries according to age, occupation, and educational level. Among the 219 workers examined, the mean DMFT was 16.9. Amongst the younger workers (<25 years-old), 21.3 teeth showed no need of treatment, while the older ones showed increasing treatment needs (p<0.001). The DMFT values were 15.6 for the administrative duties and 21.7 for foremen and bricklayers, although the differences were not statistically significant. The DMFT index showed an increase with age for all groups (p<0.001). The self-reported need of treatment was associated with a smaller DMFT for people that reported a positive response when compared with subjects that did not report these needs (p<0.05). These differences were statistically significant, as tested by ANOVA and Student t test. Among the building construction workers, in this study, important oral lesions were not observed, despite the daily exposition to some risk factors for oral cancer.

Evaluation of oral and nasal odor in patients with and without cleft lip and palate: preliminary report.

Objective To evaluate oral and nasal halitosis parameters in patients with and without clefts. Design Randomized and prospective study. Patients with and without clefts were evaluated as to oral and nasal halitosis. Setting University of São Paulo, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, Brazil. Patients Twelve patients with clefts and 12 without clefts were evaluated, and no exclusion criteria were followed. Interventions Nasal and oral halitosis were measured with the use of a portable sulfide monitor during a single visit. Results One hundred percent of the patients with clefts had altered values for volatile sulfur compounds. Only 33.3% of the patients without clefts had at least one strong value for nasal halimeter measurements, and 58.3% of these patients showed alteration in the nasal values. Statistical evaluation, made using the Mann-Whitney U test, classifying the nasal halimeter values as normal, weak, and strong, showing a statistical significant group difference (p = .003). There was no significant difference in the oral halimeter values between the two groups. Conclusions Patients with cleft lip and palate had a tendency to present higher values for the nasal halimeter measurements, when compared with patients without clefts.

Condições de saúde bucal e diabetes mellitus na população nipo-brasileira de Bauru-SP

The aim of this cross-sectional study was to determine the oral health condition in a Japanese population aged 40 to 79, in Bauru, Brazil as well as its association with the occurrence of diabetes mellitus and impaired glucose tolerance. It involved 530 subjects, from both sexes. All persons of first generation (Issei) and a random sample of one third of second generation (Nisei) were submitted to a home interview. A clinical examination, oral glucose tolerance test, and examination of oral health conditions took place at the Hospital of Rehabilitation of Craniofacial Anomaly - USP. The data were processed by Epi-Info program and 22.9% of the individuals presented diabetes mellitus (group I), 15.1% impaired glucose tolerance (group II), and 61.9% were considered normoglycemics (group III). The percentage of edentulous subjects was 45.9% for the total sample, and values of 58.4%, 46.7%, and 41.2% were observed for groups I, II, and III, respectively. Among the edentulous subjects, no one showed necessity of making a total prothesis. These data indicate that tooth loss showed significant association with the occurrence of diabetes mellitus, but there was no significant association with glucose intolerance.

Atypical Lesion on Soft Palate: A Curious Case

El objetivo de este trabajo es presentar un caso de un hombre de 39 anos de edad, con un tejido de 2 cm pediculado color purpura en el paladar blando, junto al area retromolar superior derecha, asintomatico, con un dia de evolucion y de aspecto vascular. No habia historia de trauma o enfermedades sistemicas. Con base en los hallazgos clinicos nuestro diagnostico previo fue granuloma traumatico, hemangioma o la formacion de coagulos sanguineos, despues de un traumatismo local. Luego de una semana, el examen intraoral revelo ausencia de la lesion, la que desaparecio por completo. Este caso ilustra que la ausencia de historia de trauma y las caracteristicas clinicas atipicas, puede ser un desafio diagnostico en la rutina clinica.