Renata Cimões

A systematic review on the critical size defect model

OBJECTIVES To systematically review the literature data regarding the critical size defect (CSD) in adult rat calvaria and to determine which defect dimensions could be considered as being critical size. MATERIAL AND METHODS A literature search was conducted at Ovid Medline and Embase up to July 2012. Studies presenting with at least one of the primary outcomes of interest (number of defects with complete closure and the percentage of new bone formation (%NBF) in rat calvaria) were included. Screening, data extraction and quality assessment were conducted independently and in duplicate. RESULTS From 1461 citations, 257 full-text papers were screened and 61 papers were included in the analysis. Fourteen of 937 evaluated defects presented complete closure. Only 7 and 6 untreated sites in 5.0- and 6.0-mm-diameter defects, respectively, showed complete closure. A great variability among the preclinical models was seen, and the meta-analysis result showed a high heterogeneity regarding the mean %NBF. The mean %NBF according to the defect dimension was as follows: 18.29% and 21.44% for 5.0 mm central single defects at 1 and 3 months, respectively; 17.55%, 20.24% and 22.65% for 5.0 mm bilateral defects; 9.81%, 12.56% and 7.96% for 8.0 mm single defect; 11.18%, 9.48% and 26.24% for 9.0 mm single defects at 1, 2 and 3 months, respectively. CONCLUSION Calvarial defects with a diameter of 5.0 mm could be considered as a CSD. However, there is a necessity for further standardization of the rat calvaria model to enable more accurate comparison among future studies.

Association between periodontal diseases and systemic diseases

Current evidence suggests that periodontal disease may be associated with systemic diseases. This paper reviewed the published data about the relationship between periodontal disease and cardiovascular diseases, adverse pregnancy outcomes, diabetes and respiratory diseases, focusing on studies conducted in the Brazilian population. Only a few studies were found in the literature focusing on Brazilians (3 concerning cardiovascular disease, 7 about pregnancy outcomes, 9 about diabetes and one regarding pneumonia). Although the majority of them observed an association between periodontitis and systemic conditions, a causal relationship still needs to be demonstrated. Further studies, particularly interventional well-designed investigations, with larger sample sizes, need to be conducted in Brazilian populations.

Influência da classe social nas razões clínicas das perdas dentárias

Com o objetivo de determinar a influencia da classe social nas razoes clinicas das perdas dentarias na cidade de Maceio, Alagoas, foi realizado um estudo transversal que envolveu 466 individuos adultos, com idade entre 18 a 76 anos. Foram coletados dados socioeconomicos e demograficos atraves de um formulario. O exame clinico determinou a razao pela qual o dente seria extraido e houve registro do CPO-D de todos os pacientes. Os pacientes foram incluidos em classes sociais com base nos dados coletados dos formularios. 54,1% dos individuos que participaram da pesquisa eram do sexo feminino, a idade teve media de 33,73 ± 13,68 anos, observou-se que 369 (79,2%) nao tinham completado o segundo grau e 385 (82,6) apresentaram renda familiar de ate quatro salarios minimos, com media de 3,4 ± 5,4. A principal razao das perdas dos dentes permanentes foi a carie dentaria. Os pacientes apresentaram em media 16,59 ± 6,96 dentes cariados, perdidos ou obturados, a maioria dos pacientes 219 (47,0%) apresentaram CPO-D entre onze a vinte dentes. Observou-se associacao estatisticamente significante entre a razao da perda e o grupo social a que pertencia o paciente (P<0,001). Concluiu-se que a classe social influenciou significativamente na razao clinica da perda dentaria.

Impacto do número de dentes presentes no desempenho de atividades diárias: estudo piloto

To establish the relation between the aspects associated to the number of the teeth and the impact on daily performance it was realized a pilot study with 75 voluntary patients that had been divided in three groups: short arch, complete and toothless. To evaluate the impact the IODD was used (Index of the Oral Impacts on Daily Performance). The results had evidenced that 16% of the participants had at least one daily activity affected. Although it have not been registered significant difference between the groups in relation to each one of the activities, the percentage that the complete arch group was less affected with the activity: to chew, to speak/to pronounce words and to smile clearly, on the other hand the activities that had less affected the toothless group were: to clean the mouth/teeth and to sleep. In relation to the mean of the IODD, that was lower in the group with complete arc and it was similar between the others two groups. The means of the variables: frequency and severity of the impacts were less in the group with the complete arch and had values approached in the others two groups. Based on the results, could be concluded that no significant differences were registered between the groups in relation to each one of the affected daily activities.

Autoavaliação da saúde bucal e fatores associados entre adultos em áreas de assentamento rural, Estado de Pernambuco, Brasil

The aim of this study was to estimate prevalence of negative self-rated oral health and associated factors among adults in rural settlements. The probabilistic sample consisted of 557 adults 20 to 59 years of age in rural settlements in Pernambuco State, Brazil. The dependent variable was self-rated oral health, with the following independent variables: demographic characteristics, predisposition and availability of resources, oral health-related behavior, objective oral health conditions, and subjective oral health conditions. Crude and adjusted prevalence ratios were estimated using a Poisson regression model. Prevalence of negative self-rated oral health was 70.5%. Negative self-rated oral health was associated with younger age, lower schooling, female gender, and black or brown skin color. Predictors of negative self-rated oral health included skin color, self-defined need for dental care, and the impact of oral health problems on quality of life.O objetivo deste estudo foi estimar a prevalencia de autoavaliacao negativa de saude bucal e fatores associados entre adultos em areas de assentamento rural. A amostra probabilistica consistiu de 557 adultos entre 20 a 59 anos em areas de assentamento rural no Estado de Pernambuco, Brasil. A variavel dependente foi autoavaliacao da condicao de saude bucal e as independentes foram: caracteristicas demograficas, de predisposicao/disponibilidade de recursos, comportamentos relacionados a saude bucal, condicoes objetivas e subjetivas relacionadas a saude bucal. Foram estimadas as razoes de prevalencia bruta e ajustada por meio de regressao de Poisson. A prevalencia de autopercepcao negativa da saude bucal foi de 70,5%. A autoavaliacao negativa da saude bucal foi mais prevalente em individuos mais jovens, de baixa escolaridade, entre as mulheres, e entre os de cor preta e parda. Os preditores da autoavaliacao negativa da saude bucal foram a cor da pele, a necessidade autorreferida de tratamento odontologico e o impacto das condicoes de saude bucal na qualidade de vida.

Occurrence of periodontal pathogens among patients with chronic periodontitis

The aim of the present study was to evaluate the presence of the periodontal pathogens that form the red complex (Tannerella forsythia, Porphyromonas gingivalis and Treponema denticola) and Aggregatibacter actinomycetemcomitans in patients with chronic periodontitis. The sample consisted of 29 patients with a clinical and radiographic diagnosis of chronic periodontitis based on the criteria of the American Academy of Periodontology (3). Samples for microbiological analysis were collected from the four sites of greatest probing depth in each patient, totaling 116 samples. These samples were processed using conventional polymerase chain reaction, which achieved the following positive results: 46.6% for P. gingivalis, 41.4% for T. forsythia, 33.6% for T. denticola and 27.6% for A. actinomycetemcomitans. P. gingivalis and T. forsythia were more prevalent (p < 0.05) in periodontal pockets ≥ 8 mm. The combinations T. forsythia + P. gingivalis (23.2%) and T. forsythia + P. gingivalis + T. denticola (20.0%) were more frequent in sites with a probing depth ≥ 8 mm. Associations with the simultaneous presence of A. actinomycetemcomitans + P. gingivalis, A. actinomycetemcomitans + T. forsythia, P. gingivalis + T. forsythia and T. forsythia + T. denticola were statistically significant (p < 0.05). It was concluded that the red complex pathogens are related to chronic periodontitis, presenting a higher occurrence in deep periodontal pockets. Moreover, the simultaneous presence of these bacteria in deep sites suggests a symbiotic relationship between these virulent species, favoring, in this way, a further progression of periodontal disease.

Relação entre dentes mal posicionados e a condição dos tecidos periodontais

OBJECTIVE: To identify malpositioned teeth in patients referred to periodontal treatment in the Brazilian Association of Dentistry, Pernambuco Division and evaluate the association of these irregularities with periodontal health. METHODS: The sample comprised 90 individuals aged 15 to 69 years. First, each participant was examined to identify the types of abnormal tooth positions by means of visual inspection. After that, their periodontal health was assessed according to the following clinical parameters: gingival bleeding on probing, periodontal attachment loss, and probing depth. In bivariate analysis, a chi-square test was used to calculate significance of the associations. RESULTS: Several types of changes in tooth position were detected in the participants, and the most significant were: rotated teeth (86.7%); crowding (52.2%); and mesially tipped molar (48.9%). All participants had periodontal changes associated with these abnormalities: 100% had gingival bleeding; 67.8%, gingival recession; 54.4%, gingival enlargement; and 28.9%, chronic periodontitis. There were significant associations between gingival recession and the variables buccally tipped tooth and excessive proclination of maxillary incisors, and also between chronic periodontitis and mesially tipped molar, crowding, excessive proclination of maxillary and mandibular incisors, and diastema (p<0.05). The need of multidisciplinary treatment was clear in all the cases. CONCLUSIONS: Malpositioned teeth negatively affected the health of periodontal tissues, which draws attention to the importance of a multidisciplinary approach that includes, primarily, periodontal and orthodontic care to improve the oral health of patients.

Non‐surgical treatment of gingival overgrowth induced by nifedipine: a case report on an elderly patient

Drug-induced gingival overgrowth (DIGO) is a significant problem for periodontologists and this side effect is frequently associated with three particular drugs: phenytoin, cyclosporin A and nifedipine. A case report of gingival overgrowth induced by nifedipine in an elderly patient treated with non-surgical periodontal therapy is described. A 75-year-old male with generalised gingival overgrowth reported the problem of oral malodour and significant gingival bleeding. The medical history revealed a controlled hypertensive state and Cerebral Vascular Accident (CVA) 3 years prior to consultation. The diagnosis was gingival overgrowth associated with nifedipine, no other risk factors being identified. The patient had been taking nifedipine for 18 months, but after the consultation with the patients doctor, nifedipine was suspended, as the hypertension was controlled. Treatment consisted of meticulous oral hygiene instruction, scaling, root surface instrumentation and prophylaxis. Six months after the first intervention, clinical parameters revealed a significant improvement with a considerable reduction in gingival overgrowth, demonstrating the effect of non-surgical periodontal therapy in severe cases of gingival overgrowth. Non-surgical treatment of DIGO is a far less invasive technique than surgical approaches and has demonstrated an impressively positive treatment response. It should therefore be considered as a first treatment option for DIGO.

Condição Periodontal e Marcadores do Controle Metabólico em Pacientes Diabéticos

Resumen pt: Objetivo: Avaliar a condicao periodontal dos pacientes diabeticos tipo 2, relacionando com o controle de marcadores metabolicos. Metodo: Para este estudo...

Polymorphisms of Il-10 (-1082) and RANKL (-438) Genes and the Failure of Dental Implants

Background. Genetic polymorphisms in certain cytokines and chemokines have been investigated to understand why some individuals display implant flaws despite having few risk factors at the time of implant. Purpose. To investigate the association of genetic polymorphisms in interleukin- (IL-) 10 [-1082 region (A/G)] and RANKL [-438 region (A/G)] with the failure of dental implants. Materials and Methods. This study included 90 partially edentulous male and female patients who were rehabilitated with a total of 245 Straumann dental implants. An implant was considered a failure if any of the following occurred: mobility, persistent subjective complaint, recurrent peri-implant infection with suppuration, continuous radiolucency around the implant, probing depth ≥ 5 mm, and bleeding on probing. Buccal mucosal cells were collected for analysis of RANKL438 and IL-10. Results. The implant success rate in this population was 34.4%. The mutant allele (G) in RANKL had an incidence of 52.3% and mutant allele (A) in IL-10 was observed in 37.8%. No statistically significant difference was detected between the failure of the implant and the genotypes and allelic frequencies. Conclusion. No association was detected between the genetic polymorphisms of RANKL (-438) and IL-10 (-1082) and the failure of dental implants in the population studied.