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INTRODUCTION: Concomitance of chronic periodontitis (CP) in patients with chronic kidney disease (CKD) have been associated with adverse outcomes. Vitamin D (25(OH)D) deficiency my play a role in CP and inadequate vitamin D status is common among patients with CKD. OBJECTIVE: To examine the relationship between vitamin 25(OH)D and CP in patients with CKD not yet on dialysis. METHOD: A case-control study was conducted. Cases and controls were defined as patients with CKD with and without CP, respectively. The demographic, clinical and laboratory data were obtained when the patient was attended in the outpatient clinic. CKD was defined and staged according to the NKF QDOKI TM. Serum 25(OH) D levels were measured by chemiluminescence when assessing the CP, which was definined according to the American Academy of Periodontoly (1999). Serum 25(OH)D levels were stratified into deficient (< 14 ηg/mL), insufficient (15-29 ηg/mL) and sufficiency (> 30 ηg/ mL). RESULTS: A total of 15 cases were compared with 14 controls. Cases had lower median 25(OH)D levels than controls (22.6 versus 28.6 ηg/mL, p < 0.01) and were more likely to be categorized as vitamin D insufficiency/deficiency (93,3% versus 57,1%, p < 0,004). On the other hand, the percentage of controls with vitamin D sufficiency was higher then cases (42,9% versus 6,7%, p < 0,004). CONCLUSION: In patients with CKD not yet on dialysis, vitamin D deficiency is associated with CP.

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INTRODUÇÃO A concomitância de periodontite crônica (PC) em pacientes com doença renal crônica (DRC) tem sido associada a desfechos adversos. A deficiência de vitamina D (25(OH)D) parece desempenhar papel importante na PC e níveis inadequados de vitamina D têm sido descritos em pacientes com DRC. OBJETIVO: Examinar a relação entre níveis séricos de vitamina D e PC em pacientes com DRC pré-dialítica. MÉTODO: Estudo de caso-controle, definidos, respectivamente, como pacientes com DRC e PC e DRC sem PC. Os dados demográficos, de exame físico e laboratoriais foram obtidos no dia da consulta. A DRC foi definida e estagiada segundo a NKF QDOKI TM. Os níveis séricos de 25(OH) D foram dosados por quimioluminescência quando da avaliação da PC, a qual foi caracterizada segundo os critérios de Academia Americana de Periodontologia (1999). Os resultados de 25(OH)D foram estratificados em deficiência (< 14 ηg/mL), insuficiência (15-29 ηg/mL) e suficiência (> 30 ηg/mL). RESULTADOS: Um total de 29 pacientes foram estudados, 15 no grupo caso e 14 no grupo controle. Os pacientes casos apresentaram mediana de 25(OH) D inferior a dos pacientes controles (22,6 vs. 28,6 ηg/mL; p < 0,01). A frequência de pacientes casos com insuficiência/deficiência de vitamina D foi maior do que entre os pacientes controles (93,3% vs. 57,1%, p < 0,004). Por outro lado, o percentual de pacientes com suficiência de vitamina D foi maior entre os controles se comparados aos integrantes do grupo casos (42,9% vs. 6,7%, p < 0,004). CONCLUSÃO: Em pacientes com DRC, a deficiência de vitamina D se associa com PC.

INTRODUCTION: Concomitance of chronic periodontitis (CP) in patients with chronic kidney disease (CKD) have been associated with adverse outcomes. Vitamin D (25(OH)D) deficiency my play a role in CP and inadequate vitamin D status is common among patients with CKD. OBJECTIVE: To examine the relationship between vitamin 25(OH)D and CP in patients with CKD not yet on dialysis. METHOD: A case-control study was conducted. Cases and controls were defined as patients with CKD with and without CP, respectively. The demographic, clinical and laboratory data were obtained when the patient was attended in the outpatient clinic. CKD was defined and staged according to the NKF QDOKI TM. Serum 25(OH) D levels were measured by chemiluminescence when assessing the CP, which was definined according to the American Academy of Periodontoly (1999). Serum 25(OH)D levels were stratified into deficient (< 14 ηg/mL), insufficient (15-29 ηg/mL) and sufficiency (> 30 ηg/ mL). RESULTS: A total of 15 cases were compared with 14 controls. Cases had lower median 25(OH)D levels than controls (22.6 versus 28.6 ηg/mL, p < 0.01) and were more likely to be categorized as vitamin D insufficiency/deficiency (93,3% versus 57,1%, p < 0,004). On the other hand, the percentage of controls with vitamin D sufficiency was higher then cases (42,9% versus 6,7%, p < 0,004). CONCLUSION: In patients with CKD not yet on dialysis, vitamin D deficiency is associated with CP.

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INTRODUCTION: Recent studies have identified periodontal disease (PD) as a risk factor for chronic kidney disease (CKD). The aim of this study was to assess the general knowledge about, attitudes toward, and behaviors/practices concerning PD among physicians and nurses who work with CKD patients. METHODS: An 8-question questionnaire was distributed to participants of the XXV Brazilian Congress of Nephrology (2010) and the Minas Gerais Nephrology Congress (2011). The questions covered the following aspects of PD: epidemiology, clinical presentation, predisposing factors, systemic expression, inclusion of oral examination during routine physical examination, and the frequency of referral for dental treatment. RESULTS: Most physicians and nurses interviewed correctly answered the questions on general knowledge about PD. 42.2% of the physicians and 38% of the nurses did not routinely examine the oral cavity of their patients. Most patients seen by nephrologists (59.4%) and nurses (61.5%) were referred to dental care in less than 30% of the consultations. CONCLUSION: Nephrologists and nurses demonstrated good self-reported general knowledge about PD, albeit with limited clinical experience, as evidenced by the low rates of examination of the oral cavity and referral for specialist treatment. These findings suggest the need of theoretical and practical training in oral health at both, undergraduate (medicine and nursing) and postgraduate levels (medical and multiprofessional residency programs).

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INTRODUÇÃO: estudos recentes apontam a doença periodontal (DP) como fator de risco para doença renal crônica (DRC). O objetivo do presente estudo foi avaliar o grau de conhecimento, atitude e prática de médicos e enfermeiros que atuam na nefrologia relativos à DP. MÉTODOS: um questionário foi aplicado a médicos e a enfermeiros participantes do XXV Congresso Brasileiro de Nefrologia (2010) e IX Congresso Mineiro de Nefrologia (2011), abrangendo os seguintes aspectos da DP: epidemiologia, apresentação clínica, fatores predisponentes, repercussão sistêmica, a inclusão do exame da cavidade bucal no exame clínico dos pacientes com DRC e a frequência de encaminhamento para o dentista. RESULTADOS: a maioria dos médicos e enfermeiros responderam corretamente às perguntas que abordaram os conhecimentos gerais sobre a DP. À pergunta referente à inclusão do exame da cavidade bucal no exame físico do paciente, 42,2 por cento dos médicos e 38 por cento dos enfermeiros responderam não fazê-la (p > 0,05). Contudo, a maioria dos pacientes vistos por nefrologistas (59,4 por cento) e enfermeiros (61,8 por cento) são encaminhados ao dentista em menos de 30 por cento das consultas (p > 0,05). CONCLUSÃO: A amostra de nefrologistas e de profissionais de enfermagem participantes do estudo demonstrou conhecimento autorrelatado sobre DP considerado bom, embora com prática clínica limitada, expressada pelo baixo percentual de encaminhamento para tratamento especializado da doença. Os achados sinalizam para a necessidade da instituição de treinamento teórico-prático em saúde bucal nos cursos de graduação (medicina e enfermagem) e pós-graduação (residência médica e multiprofissional).

INTRODUCTION: Recent studies have identified periodontal disease (PD) as a risk factor for chronic kidney disease (CKD). The aim of this study was to assess the general knowledge about, attitudes toward, and behaviors/practices concerning PD among physicians and nurses who work with CKD patients. METHODS: An 8-question questionnaire was distributed to participants of the XXV Brazilian Congress of Nephrology (2010) and the Minas Gerais Nephrology Congress (2011). The questions covered the following aspects of PD: epidemiology, clinical presentation, predisposing factors, systemic expression, inclusion of oral examination during routine physical examination, and the frequency of referral for dental treatment. RESULTS: Most physicians and nurses interviewed correctly answered the questions on general knowledge about PD. 42.2 percent of the physicians and 38 percent of the nurses did not routinely examine the oral cavity of their patients. Most patients seen by nephrologists (59.4 percent) and nurses (61.5 percent) were referred to dental care in less than 30 percent of the consultations. CONCLUSION: Nephrologists and nurses demonstrated good self-reported general knowledge about PD, albeit with limited clinical experience, as evidenced by the low rates of examination of the oral cavity and referral for specialist treatment. These findings suggest the need of theoretical and practical training in oral health at both, undergraduate (medicine and nursing) and postgraduate levels (medical and multiprofessional residency programs).

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O objetivo desta revisão fundamentou-se em pesquisar o efeito do efeito cluster em implantes dentários osseointegráveis visando obter informações clínicas e científicas sobre este fenômeno. Implantes dentais osseointegráveis têm demonstrado uma ascensão em sua utilização clínica nos últimos anos. Trata-se de uma opção para reabilitar pacientes que apresentam dentes ausentes, considerando os aspectos funcionais e estéticos. Altos índices de falha de implantes dentais parecem estar concentrados em grupos específicos de indivíduos, sugerindo que a resposta do hospedeiro pode modular o sucesso dos implantes. A concentração das perdas de implantes, denominada clusterização, pode indicar uma resposta imunoinflamatória do hospedeiro. Falhas relacionadas aos implantes dentais é um traço complexo que pode envolver vários fatores etiológicos. O conhecimento da etiologia e de fatores associados à falha de implantes pode ajudar no reconhecimento nos pacientes de risco e auxiliar o desenvolvimento de um tratamento adequado em conjunto com estratégias de prevenção

This review was based on research the effect of cluster effects in osseointegrated dental implants in order to obtain clinical and scientific information about this phenomenon. Osseointegrated dental implants have shown a rise in its clinical use in recent years. This is an option to rehabilitate patients with missing teeth, considering the functional and aesthetic aspects. High rates of failures of dental implants seem to be concentrated in specific groups of individuals, suggesting that the host response may modulate the success of implants. The concentration of lost implants, called clustering, may indicate a host immunoinflammatory response. A failure related to dental implants is a complex trait that can involve multiple etiological factors. The knowledge of the etiology and factors associated with implant failure can help us in recognizing patients at risk and help develop an appropriate treatment in conjunction with strategic prevention

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