RESUMO
BACKGROUND: Data on preemptive analgesia in periodontal surgeries are scarce and still diverse. The aim of this study was to evaluate and compare the analgesic effects of the preemptive administration of ibuprofen and nimesulide in open flap periodontal surgeries. METHODS: The present randomized controlled clinical trial comprised 40 individuals, divided into two groups (n = 20), according to the test drug (ibuprofen and nimesulide) to be administered 1 hour preoperatively. Participants underwent bilateral periodontal surgeries at two different times, and were randomly given the test drug or placebo in a split-mouth design. Postoperative pain and rescue medication were evaluated at different times. Comparisons between ibuprofen and nimesulide were performed through a Generalized Estimation Equation model, using test drug and evaluation times, along with an interaction between these two variables as predictors. RESULTS: In intergroup comparisons regarding pain control, ibuprofen showed better effects than placebo only at the first postoperative hour, whereas nimesulide showed better effects than placebo at 1, 6, 24, and 48 postoperative hours. In intergroup comparisons, nimesulide showed better effects than ibuprofen at 24, 48, and 72 postoperative hours, demonstrating a higher overall preemptive effect. No differences were observed in relation to the number of rescue medication. CONCLUSION: Preemptive administration of nimesulide showed better overall preemptive effects on postoperative pain control when compared with ibuprofen.
Assuntos
Ibuprofeno , Dor Pós-Operatória , Método Duplo-Cego , Humanos , Ibuprofeno/uso terapêutico , Boca , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Sulfonamidas , Extração DentáriaRESUMO
The effect of periodontal treatment on clinical, microbiological and serological parameters of patients with rheumatoid arthritis (RA) are scarce and controversial. The aim of this study was to investigate the influence of non-surgical periodontal treatment on clinical periodontal status, subgingival bacterial levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and RA activity through a controlled clinical trial on individuals with RA and periodontitis (PE). From a convenience sample, 107 individuals were considered eligible and consecutively allocated in four groups: (1) individuals without PE and RA (- PE-RA, n = 30); (2) individuals without PE and with RA (- PE + RA, n = 23); (3) individuals with PE and RA (+ PE + RA, n = 24); and (4) individuals with PE and without RA (+ PE-RA, n = 30). Full-mouth periodontal clinical examinations, microbiological analysis and Disease Activity Score (DAS-28) evaluations were performed at baseline (T1) and 45 days after non-surgical periodontal treatment (T2). At T1, individuals + PE + RA showed greater severity of PE than + PE-RA individuals. At T2, significant reductions were observed in all periodontal clinical parameters in both groups (p < 0.001) with a significant reduction in DAS-28 in + PE + RA (p = 0.011). Individuals + PE-RA and + PE-RA showed significant reductions for all bacteria (p < 0.001). Additionally, P. gingivalis demonstrated an expressively significant reduction in + PE + RA (p < 0.001). Non-surgical periodontal treatment was effective on improving the clinical periodontal condition, improving the RA clinical status and reducing the presence of periodontal pathogens. Brazilian Registry of Clinical Trials (ReBEC) protocol #RBR-8g2bc8 ( https://www.ensaiosclinicos.gov.br/rg/RBR-8g2bc8/ ).
Assuntos
Artrite Reumatoide , Treponema denticola , Aggregatibacter actinomycetemcomitans , Artrite Reumatoide/terapia , Brasil , Humanos , Porphyromonas gingivalis , Tannerella forsythiaRESUMO
OBJECTIVE: To evaluate the epidemiological and microbiological aspects of the potential association between bipolar affective disorder (BAPD) and periodontitis. METHODOLOGY: The present case-control study comprised 176 individuals with BAPD and 176 controls. All individuals underwent a complete full-mouth periodontal examination and microbiological sampling. Data on bleeding on probing, probing depth, and clinical attachment level in all present teeth were recorded. Quantification of total bacterial load and Aggregatibacter actinomycetemcomitans, Treponema denticola, and Porphyromonas gingivalis counts were performed through qPCR. Data were analyzed using univariate analysis, Spearman correlation and multivariate logistic regression. RESULTS: The prevalence of periodontitis was 39.7% among controls and 58.5% among individuals with BAPD (OR = 2.13; 95% CI 1.39-3.27). A. actinomycetemcomitans and P. gingivalis counts were significantly higher in individuals with BPAD and periodontitis. The final multivariate logistic regression revealed that periodontitis was strongly associated with the total bacterial load (OR = 1.91; 95% IC = 1.0-1.99; P < 0.001) and the depressive phase of BPAD (OR = 28.94; 95% IC = 4.44-177.27; P < 0.001). CONCLUSION: BAPD was associated with increased risk for periodontitis. Individuals with BPAD presented higher levels of A. actinomycetemcomitans and P. gingivalis, suggesting that periodontitis could be a co-morbidity frequently found in individuals with BAPD.
Assuntos
Transtorno Bipolar/epidemiologia , Índice Periodontal , Periodontite/epidemiologia , Periodontite/microbiologia , Adulto , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Carga Bacteriana , Estudos de Casos e Controles , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Reação em Cadeia da Polimerase , Porphyromonas gingivalis/isolamento & purificação , Prevalência , Risco , Treponema denticola/isolamento & purificaçãoRESUMO
OBJECTIVES: Patients with diabetes have a poor oral health-related quality of life (OHRQoL). It is not clear if this situation could be changed with effective periodontal treatment. This study examined both patients with diabetes and systemically healthy individuals to discover the impact of a gingivitis treatment protocol on OHRQoL and its relation to objective periodontal parameters. DESIGN: After ultrasonic debridement, patients were randomly assigned to an essential-oils (EO) or placebo mouthwash group. At baseline and 3 months, OHRQoL was assessed with the Oral Health and Quality of Life-United Kingdom questionnaire (OHQoL-UK) along with clinical, halitometric, microbiological and inflammatory objective parameters. The primary outcome was a change in OHQoL-UK scores. A factor analysis was performed and the impact of the extracted quality of life factor (QLF) and its interactions with diabetes, treatment, and time on the objective parameters, were tested by multiple linear regression models (p < 0.05). Chi-Square test compared questionnaire-answering profiles (p<0.05). RESULTS: Combined treatment with EO provided OHQoL improvements in both systemic conditions. Positive effect of oral health status on quality of life increased in EO groups but not in placebo groups. Question I (self-confidence) showed the greatest factorial weight, while Question A (food intake) showed the lowest factorial weight. All patients who showed OHRQoL improvements and used the EO rinse showed the lowest plaque and gingival indices and lower levels of bacteria and volatile sulfur compounds. CONCLUSIONS: OHRQoL positively changed overtime. Most effective treatment protocols would provide better improvements in OHRQoL which is related to periodontal objective measures.
Assuntos
Diabetes Mellitus , Gengivite/tratamento farmacológico , Antissépticos Bucais/uso terapêutico , Óleos Voláteis/uso terapêutico , Qualidade de Vida , Adulto , Brasil , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: There are few studies on periodontal status related to microbiologic and immunologic profiles among individuals not or occasionally using alcohol and those with alcohol dependence. The aim of this study is to determine the effect of alcohol consumption on the levels of subgingival periodontal pathogens and proinflammatory cytokines (interleukin [IL]-1ß and tumor necrosis factor [TNF]-α) in the gingival fluid among individuals with and without periodontitis. METHODS: This observational analytic study includes 88 volunteers allocated in four groups (n = 22): individuals with alcohol dependence and periodontitis (ADP), individuals with alcohol dependence and without periodontitis (ADNP), individuals not or occasionally using alcohol with periodontitis (NAP), and individuals not or occasionally using alcohol without periodontitis (NANP). Levels of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Eikenella corrodens, and Fusobacterium nucleatum were determined by real-time polymerase chain reaction on the basis of the subgingival biofilm, and IL-1ß and TNF-α were quantified by enzyme-linked immunosorbent assay in gingival fluid samples. RESULTS: Individuals with alcohol dependence showed worse periodontal status and higher levels of P. intermedia, E. corrodens, F. nucleatum, and IL-1ß than non-users. No significant correlations between TNF-α and bacterial levels were observed. However, in the ADP group, higher levels of E. corrodens were correlated with higher levels of IL-1ß. CONCLUSION: A negative influence of alcohol consumption was observed on clinical and microbiologic periodontal parameters, as well as a slight influence on immunologic parameters, signaling the need for additional studies.
Assuntos
Consumo de Bebidas Alcoólicas , Líquido do Sulco Gengival/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Interleucina-1beta/análise , Periodontite/microbiologia , Fator de Necrose Tumoral alfa/análise , Adulto , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Consumo de Bebidas Alcoólicas/imunologia , Alcoolismo/imunologia , Alcoolismo/microbiologia , Carga Bacteriana , Biofilmes , Estudos Transversais , Eikenella corrodens/isolamento & purificação , Feminino , Fusobacterium nucleatum/isolamento & purificação , Líquido do Sulco Gengival/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/imunologia , Porphyromonas gingivalis/isolamento & purificação , Prevotella intermedia/isolamento & purificaçãoRESUMO
BACKGROUND: Nitrite is a biologic factor relevant to oral and systemic homeostasis. Through an oral bacteria reduction process, it was suggested that periodontal therapy and chlorhexidine (CHX) rinse could affect nitrite levels, leading to negative effects, such as an increase in blood pressure. This 6-month randomized clinical trial evaluated the effects of periodontal therapeutic protocols on salivary nitrite and its relation to subgingival bacteria. METHODS: One hundred patients with periodontitis were allocated randomly to debridement procedures in four weekly sections (quadrant scaling [QS]) or within 24 hours (full-mouth scaling [FMS]) in conjunction with a 60-day CHX (QS + CHX and FMS + CHX), placebo (QS + placebo and FMS + placebo), or no mouthrinse (QS + none and FMS + none) use. Real-time polymerase chain reaction determined total bacterial, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Streptococcus oralis, and Actinomyces naeslundii levels. Salivary nitrite concentration was determined with Griess reagent. Data were analyzed statistically at baseline and 3 and 6 months by analysis of variance, Kruskal-Wallis, Mann-Whitney U, and Spearman correlation tests (P <0.05). RESULTS: Nitrite concentrations did not tend to change over time. Regarding CHX use, there was a negative correlation between nitrite and total bacterial load at 6 months (FMS + CHX) and one positive correlation between P. gingivalis and nitrite at baseline (QS + CHX). Independently of rinse type, in the FMS group, nitrite correlated negatively with several microbial parameters and also with a higher percentage of deep periodontal pockets. CONCLUSIONS: The relationship between nitrite and bacterial levels appears weak. Short-term scaling exhibited a greater influence on nitrite concentrations then long-term CHX use.
Assuntos
Bactérias/metabolismo , Periodontite Crônica/terapia , Nitritos/análise , Saliva/microbiologia , Actinomyces/efeitos dos fármacos , Adulto , Aggregatibacter actinomycetemcomitans/efeitos dos fármacos , Anti-Infecciosos Locais/uso terapêutico , Carga Bacteriana/efeitos dos fármacos , Clorexidina/uso terapêutico , Raspagem Dentária/métodos , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/uso terapêutico , Desbridamento Periodontal/métodos , Placebos , Porphyromonas gingivalis/efeitos dos fármacos , Saliva/química , Streptococcus oralis/efeitos dos fármacos , Tannerella forsythia/efeitos dos fármacos , Treponema denticola/efeitos dos fármacosRESUMO
BACKGROUND: Although patients with diabetes are frequently affected by periodontitis, only a few investigations have focused on gingivitis in this at-risk population. This randomized placebo-controlled clinical trial compared the response to a gingivitis treatment protocol that combined mechanical procedures and daily use of an essential oil (EO) mouthrinse between patients with and without diabetes. METHODS: The whole-mouth periodontal probing depth (PD), gingival index (GI), and plaque index (PI) were monitored in gingivitis cases among systemically healthy patients (n = 60) or those with diabetes (n = 60) at baseline and 3 months after treatment. Levels of Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, and total bacterial load were determined by a real-time polymerase chain reaction in intrasulci plaque samples. The volume of gingival crevicular fluid (GCF) was quantified, and interleukin-1ß (IL-1ß) levels were determined in GCF samples. After a full-mouth ultrasonic debridement, patients were randomly assigned to an EO or a placebo rinse for 90 days (40 mL/day). The data were analyzed through repeated-measures analysis of variance and multiple comparisons Tukey tests (P <0.05). RESULTS: GI was more severe in the diabetes group. Diabetes impaired GI and reduced GCF volume. PD, bacterial levels, and IL-1ß improved similarly in both systemic conditions. The adjunctive use of EO provided greater reductions of PI, GI, total bacterial load, T. forsythia, A. actinomycetemcomitans, and GCF volume. CONCLUSIONS: Response to gingivitis treatment in patients with diabetes can slightly differ from that in patients without diabetes. Daily use of an EO mouthrinse after ultrasonic debridement benefited patients with and without diabetes.
Assuntos
Complicações do Diabetes , Gengivite/terapia , Adulto , Aggregatibacter actinomycetemcomitans/efeitos dos fármacos , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Carga Bacteriana/efeitos dos fármacos , Bacteroides/efeitos dos fármacos , Bacteroides/isolamento & purificação , Placa Dentária/microbiologia , Índice de Placa Dentária , Complicações do Diabetes/imunologia , Complicações do Diabetes/microbiologia , Método Duplo-Cego , Feminino , Seguimentos , Líquido do Sulco Gengival/química , Líquido do Sulco Gengival/imunologia , Gengivite/imunologia , Gengivite/microbiologia , Humanos , Interleucina-1beta/análise , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/uso terapêutico , Óleos Voláteis/uso terapêutico , Desbridamento Periodontal/métodos , Índice Periodontal , Bolsa Periodontal/classificação , Placebos , Porphyromonas gingivalis/efeitos dos fármacos , Porphyromonas gingivalis/isolamento & purificação , Adulto JovemRESUMO
BACKGROUND: To assess changes in gingival status of renal transplant subjects under immunosuppressive regimens based on cyclosporine (CsA), tacrolimus (Tcr), and sirolimus (Sir). METHODS: From a sample of 135 subjects (baseline examination [BE]), 89 without periodontal treatment, who maintained the immunosuppressive regimen based on the same main agent (CsA=23, Tcr=31, and Sir=35), were reexamined after 44 months (follow-up examination [FE]). Demographic, pharmacologic, and periodontal variables were collected and gingival overgrowth (GO) was assessed by visual examination. RESULTS: In Tcr and CsA groups, although not significant, occurrence of GO decreased (CsA [BE=56.5% and FE=34.8%; P=0.063] and Tcr [BE=19.4% and FE=12.9%; P=0.500]). In addition, the severity of GO decreased significantly in CsA group (mean score BE=10.29 ± 7.70 and mean score FE=0.78 ± 1.38; P=0.003). In Sir group, GO decreased from 17.1% (BE) to 0.0% (FE) (P=not applicable). In total sample, GO was associated with papillary bleeding index (P=0.001) and concomitant use of calcium channel blockers (P=0.029); in CsA and Tcr groups, GO was associated with papillary bleeding index (P=0.029 and 0.033, respectively). CONCLUSIONS: There was no incidence of GO, and a decrease in the occurrence and severity of GO was significant in total sample. This decrease can be attributed to changes in pharmacologic and periodontal variables over this period of time.
Assuntos
Crescimento Excessivo da Gengiva/epidemiologia , Rejeição de Enxerto/tratamento farmacológico , Imunossupressores/efeitos adversos , Transplante de Rim , Adulto , Brasil/epidemiologia , Feminino , Seguimentos , Crescimento Excessivo da Gengiva/induzido quimicamente , Crescimento Excessivo da Gengiva/diagnóstico , Humanos , Imunossupressores/uso terapêutico , Incidência , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Fatores de Tempo , Adulto JovemRESUMO
OBJECTIVE: Investigate the association between the frequency of alcohol consumption and periodontitis. Moreover, evaluate the influence of biological, behavioural, and social risk variables in this association. METHODS: Sample was comprised by 542 subjects of both genders, 35-55 years of age, who underwent a complete periodontal examination, and was divided into four groups according to the frequency of alcohol use, based on alcohol use disorders identification test (AUDIT) and Cut-down, Annoyed, Guilty, Eye-opener (CAGE) instruments: (1) no or occasional alcohol use (NA), (2) moderate alcohol use (MA), (3) intense alcohol use (IA) and (4) alcohol dependence (DA). Associations between the occurrence of periodontitis and potential risk variables were analysed by univariate and multivariate logistic regression stratified by smoking status when appropriate. RESULTS: The prevalence of periodontitis in NA, MA, IA and DA groups were 17.2%, 24.0%, 29.6% and 53%, respectively. Alcohol odds ratio (OR) estimates significantly increased with an increase in consumption frequency (DA>IA>MA>NA) and were approximately two times higher in smokers (OR = 3.43 to 7.91) compared to non-smokers (OR = 1.22 to 3.02). CONCLUSION: Occurrence of periodontitis among alcohol users were high and the frequency of alcohol consumption increased the odds of periodontitis incrementally mainly in smokers.
Assuntos
Transtornos Relacionados ao Uso de Álcool/complicações , Periodontite/complicações , Adulto , Consumo de Bebidas Alcoólicas , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Perda da Inserção Periodontal/complicações , Índice Periodontal , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , FumarRESUMO
Different periodontitis definitions have been used in periodontal research. This study assessed the impact of case definition on the prevalence and extent rates of periodontitis. A data set including 340 periodontal records, collected in Belo Horizonte, Brazil, was used. Periodontitis was defined as: 1) one site with probing depth (PD) >or= 4 mm; 2) clinical attachment level (CAL) >or= 5 mm in >or= 4 sites + one site with PD >or= 4 mm; 3) CAL >or= 6 mm in >or= 2 teeth + one site with PD >or= 5 mm; 4) >or= 4 teeth with >or= 1 sites with PD >or= 4 mm + CAL >or= 3 mm; 5a) interproximal CAL or PD >or= 4 mm at >or= 2 sites, not on the same tooth; and 5b) interproximal CAL of >or= 6 mm at >or= 2 sites, not on the same tooth + PD >or= 5 mm at >or= 1 proximal site. Definition 5 was determined to be the gold standard and the definitions were compared by means of agreement, sensitivity, specificity, and positive and negative predictive values. Prevalence and extent rates greatly varied, from 13.8% to 65.3% and from 9.7% to 55.6%, respectively. The use of different case definitions has a great impact on the prevalence and extent rates of periodontitis.
Assuntos
Pesquisa em Odontologia , Periodontite/classificação , Periodontite/epidemiologia , Adulto , Viés , Diagnóstico Bucal/normas , Etnicidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/patologia , Periodontite/patologia , Prevalência , Sensibilidade e Especificidade , Classe Social , Terminologia como AssuntoRESUMO
Susceptibility to and development of periodontal disease have been associated with psychological conditions. Previous studies have associated the presence of polymorphism in the promoter region of the serotonin transporter with several behavioral traits and psychological conditions such as depression, anxiety, and stress. The short allele S has a reduced transcriptional efficiency and is associated with lowered serotonin expression and uptake. The purpose of the present study was to investigate the association between 5-HTTLPR polymorphism and aggressive periodontitis in a sample of Brazilian individuals. This study involved 61 individuals affected by aggressive periodontitis and 71 without periodontitis. Genomic DNA was obtained from oral swabs, amplified by polymerase chain reaction (PCR), and genotyped at 5-HTTLPR. The Chi-square test and multivariate logistic regression were used for statistical analysis. The aggressive periodontitis group displayed a significantly higher occurrence of genotype SS (P < 0.01) and of allele S (P < 0.01). After adjustment for gender and age, it was observed that genotype SS occurred 8 times more frequently in this group. Our findings suggest that 5-HTTLPR polymorphism might be associated with aggressive periodontitis in the Brazilian population.
Assuntos
Periodontite/metabolismo , Polimorfismo Genético/genética , Regiões Promotoras Genéticas/genética , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Adolescente , Adulto , Fatores Etários , Alelos , DNA/genética , Feminino , Amplificação de Genes , Frequência do Gene , Genótipo , Hemorragia Gengival/genética , Hemorragia Gengival/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/genética , Perda da Inserção Periodontal/metabolismo , Bolsa Periodontal/genética , Bolsa Periodontal/metabolismo , Periodontite/genética , Reação em Cadeia da Polimerase , Fatores SexuaisRESUMO
BACKGROUND: The results from reports analyzing the occurrence of gingival overgrowth (GO) induced by tacrolimus are controversial. In addition, the role of pharmacological and periodontal variables on the development and severity of GO have not been well-established. Therefore, the aim of the present study was to determine the effect of potential risk variables for GO in a Brazilian population comprising renal transplant recipients medicated with tacrolimus in the absence of calcium channel blockers. MATERIALS AND METHODS: Demographic, pharmacological, and periodontal data, recorded from 125 subjects selected to participate in the study, was analyzed with the use of the independent sample t test, the chi-squared statistic, or Mann-Whitney test. The effects of risk variables on GO scores were subsequently examined using multivariate regression analysis and general linear model. RESULTS: The prevalence of clinically significant GO (> or =30%) in the study population was of 7.25%. These subjects showed greater averages of plaque scores (P=0.0043) as well as papillary bleeding index (P=0.0026) when compared to subjects with GO <30%. Papillary bleeding index, time since transplant and azathioprine dosage were significant in the univariate and multivariate models (adjusted R=43.8%), whereas plaque index was significant only in the univariate model. CONCLUSIONS: This study revealed that, in the absence of calcium channel blockers, gingival inflammation, represented by the papillary bleeding index, was a variable associated with Tcr-induced GO, indicating the importance of periodontal maintenance of subjects under Tcr immunosuppressive regimens.