Silvia Regina Jamelli

Maternal periodontitis as a risk factor for prematurity.

Background:  The aim of this study was to investigate maternal periodontitis associated with prematurity.

Periodontitis-associated risk factors in pregnant women

OBJECTIVE: The main objective of this study was to investigate the risk factors associated with periodontitis in pregnant women. METHODS: This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and 720 without. A hierarchized approach to the evaluation of the risk factors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1) socio-demographic variables; 2a) variables related to nutritional status, smoking, and number of pregnancies; and 2b) variables related to oral hygiene. Periodontitis was defined as a probing depth ≥4 mm and an attachment loss ≥3 mm at the same site in four or more teeth. A logistic regression analysis was also performed. RESULTS: The prevalence of periodontitis in this sample was 11%. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque. CONCLUSION: The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene.

Persistência de hábitos de sucção não nutritiva: prevalência e fatores associados

OBJECTIVES: to identify the prevalence of nonnutritive sucking habits in preschoolers and verify factors associated with persistent habit. METHODS: a cross-sectional analytical study conducted in 17 public educational units of Recife/PE through questionnaire with 524 preschooler guardians. Dependent (digital and pacifier sucking) and independent variables, related to the children (sex, age, breastfeeding, bottle feeding, nocturnal enuresis, school period, caregiver, birth order, dentist visit) and to their mothers (schooling, age, familiar income, outside work, work shift, cohabitation, habits guidance), were associated by Pearson´s chi-square test, Fisher´s Exact test and Poisson´s regression. RESULTS: prevalence of nonnutritive sucking habits was 57%; 47,5% pacifier sucking, 5,7% digital sucking and 3,8% of both habits. After odds ratio adjustment, in a multivariate analysis, variables: breastfeeding and bottle feeding duration remained associated with pacifier sucking, while others variables as mother education, bottle feeding, and children´s age and sex were statistically significant with digital sucking. CONCLUSIONS: nonnutritive sucking habits showed high prevalence, being pacifier sucking most prevalent. Factors related to breastfeeding pattern (bottle feeding and breastfeeding duration) were explanatory factors to the habits persistence and psychosocial factors had relevant association.

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.

Oral health and perceptions regarding dental care in patients with mental disorders living in therapeutic residences.

Patients with mental disorders have considerable difficulty in access to dental care, including the refusal of oral health professionals to offer care to this clientele and the inadequate professional training of oral health professionals regarding this issue. The present study was carried out in therapeutic residences in order to assess the oral health conditions of the residents as well as their perceptions regarding the dental care they have received. Thirty-eight individuals participated in the study. Data were collected through clinical examinations and a semi-structured interview. Data analysis revealed a high number of caries and the need for dentures, with 42.5% of the individuals needing complete dentures and 30.3% needing partial dentures. Regarding periodontal conditions, 28.5% of the dental elements exhibited losses of over 4 mm of periodontal insertion. Data from the interviews were submitted to content analysis, which enabled the establishment of two categories: the association of pain with the presence of teeth and mutilating dental care. Oral health was associated to dental extraction, which was considered the only solution to oral health disturbances, indicating that, for this population, oral health signifies not having teeth.

Utilization of oral health services network among children and adolescents with leukemia: USE OF ORAL HEALTH SERVICES BY LEUKEMIC PATIENTS

AIM To evaluate the use of the network of oral health services by children and adolescents with leukemia, according to the phase of cancer treatment, type of dental treatment received, and access barriers. METHODS AND RESULTS An exploratory cross-sectional study carried out in a referral hospital in cancer in northeast of Brazil, with all children and adolescents (3-16 years old) with leukemia who used dental services and who attended the medical consultation in the outpatient clinic between March and August 2016. The analysis of the medical records and a structured interview with caregivers were performed. The majority who used only the specialized network were in a single phase of cancer treatment (49.1%), had oral mucositis treatment (79.2%), and had a time of displacement for oral health services greater than 40 minutes (92.6%). In addition, dental care was centered in the specialized network (76.8%) and during hospitalization (37.7%). CONCLUSIONS The findings suggest that the oral health care of these individuals is centered on tertiary care, reflecting a deficiency in communication between the network services, as well as the nonrecognition of the basic network as a caregiver source by its users. Despite this, more research is needed.

Influence of head and linear growth on the development of malocclusion at six years of age: a cohort study

The aim of this article was to evaluate the influence of biological and sociobehavioral factors on the development of malocclusions in children. This is a cross-sectional study nested in a cohort of 350 children who participated in a community intervention study. After six years, an active search identified 290 children with occlusal abnormalities. Socioeconomic status, linear growth, and nutritional status of the child at birth and at the time of measurement, as well as dietary and sucking habits, were investigated. Malocclusions were evaluated across three spatial planes - anteroposterior, vertical, and transverse. The prevalence of these anomalies was 64.5%, primarily in the anteroposterior plane. The logistic regression analysis revealed that pacifier use for 60 months or more, stunting as measured at age six, and reduced gain in head circumference from birth to six years of age, were significantly associated with the development of malocclusion in childhood. Head circumference and linear growth are associated with occlusal anomalies in infants, independent of pacifier sucking.

Desenvolvimento da fala e alimentação infantil: possíveis implicações

Objetivo: identificar a associacao entre habito alimentar e desenvolvimento da fala em criancas pre-escolares. Metodos: estudo do tipo caso-controle, com amostra constituida por 273 criancas matriculadas nos Centros Municipais de Educacao Infantil da cidade do Recife. Foi pesquisada a associacao do desfecho com variaveis referentes a caracteristicas socioeconomicas, habitos de succao nutritiva e nao nutritiva e desenvolvimento do sistema estomatognatico. Foram utilizados os softwares STATA/SE 9.0 e Excel 2007 para calcular a medida de risco, OddsRatio, o intervalo de confianca de 95% e o valor de p≤0,05. Para verificar a existencia de associacao, aplicou-se o teste qui-quadrado para variaveis categoricas. Resultados: no que se refere as alteracoes de fala, verificou-se associacao significante no sexo masculino. Ja os habitos de succao nao se associaram significantemente com o desfecho estudado. Com relacao ao sistema estomatognatico, registra-se associacao significante as alteracoes de fala, principalmente no que concerne a postura habitual de labios e lingua, assim como com a presenca de oclusopatias. Nao houve associacao significante entre a variavel de consistencia alimentar e o evento estudado. Conclusao: a consistencia alimentar demonstrou associacao significante com variaveis que impactam na fisiologia adequada do sistema estomatognatico, em termos de orgaos fonoarticulatorios e desempenho de funcoes, podendo-se inferir que padrao alimentar e fala constituem ponto de convergencia na saude infantil.

Avaliação periodontal clínica e microbiológica em mães de prematuros: estudo caso-controle

Objetivo: Determinar os parâmetros clinicos periodontais e a frequencia de bacterias periodontopatogenicas no biofilme subgengival de maes de prematuros comparativamente as maes de bebes a termo. Metodo: Foi realizado um estudo caso-controle envolvendo 40 mulheres. Foram incluidas 20 maes de prematuros no grupo caso, enquanto no grupo controle foram incluidas 20 maes de bebes a termo. Em ate 48 horas apos o parto, as participantes do estudo foram submetidas a uma entrevista, contendo dados de identificacao, sociodemograficos, habitos de vida, historia gestacional atual e pregressa, e um exame periodontal, onde foram coletados dados de profundidade de sondagem, sangramento a sondagem, Indice de placa e perda de insercao periodontal. Na analise microbiologica do biofilme subgengival foram analisadas as bacterias Tannerella forsythia, Treponema denticola, Porphyromonas gingivalis e Aggregatibacter actinomycetemcomitans, realizada atraves da tecnica da PCR convencional. Resultados: As medias da perda de insercao clinica e sangramento a sondagem mostraram-se significativamente superiores nas maes de bebes prematuros (p=0,049; p= 0,031, respectivamente). A Porphyromonas gingivalis mostrou-se significativamente mais frequente no grupo caso (p= 0,044). Conclusao: Sugere-se que a inflamacao e perda de insercao periodontal bem como a presenca da Porphyromonas gingivalis no biofilme subgengival possam estar associados a prematuridade. Objective: The aim of this research was to determine periodontopathogens samples frequency in subgingival biofilm of pre-term delivery newborn mothers in comparison to women who experienced full-term delivery. Method: Twenty pre-term delivery newborn mothers and 20 women with full-term pregnancy were included in groups case and control, respectively. Up to forty-eight hours after the delivery, the patients were submitted to an interview, including identification, actual and late pregnancy history , life habits and a periodontal examination, which included probing depth, bleeding on probing, plaque index and clinical attachment loss. Microbiological analysis of the subgingival biofilm was carried out by conventional PCR technique to evaluate Tannerella forsythia, Treponema denticola, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Results: Clinical attachment loss and bleeding on probing means were significantly higher at case group (p=0.049; p = 0.031, respectively). Porphyromonas gingivalis was most frequent at the same group, with a significant difference (p=0.044). Periodontal disease was not associated to pre-term delivery. Conclusion: It can be suggested that periodontal tissues inflammation and the clinical attachment loss, as well as Porphyromonas gingivalis presence in subgingival biofilm may be associated to prematurity.