RESUMO
OBJECTIVE: To evaluate the existing evidence supporting or refuting the following questions: (i) Do patients with lower vitamin D levels have higher risk for periodontal disease? (ii) Are periodontal treatment outcomes improved by the adjuvant supplementation of vitamin D or by elevated serum vitamin D levels? MATERIAL AND METHODS: MEDLINE, SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched up to September 2017. Studies were included if they had measured serum vitamin D levels or vitamin D intake and any periodontal parameter. RESULTS: Overall, 27 studies were included (13 cross-sectional studies, 6 case-control studies, 5 cohort studies, 2 randomized clinical trials and 1 case series study). Sixty-five percent of the cross-sectional studies reported significant associations between low vitamin D levels and poor periodontal parameters. None of the observational longitudinal studies found that periodontal disease progression could be attributed to lower vitamin D levels. No interventional studies that evaluated the use of vitamin D supplementation as a solely adjuvant to periodontal treatment was found. No meta-analysis was performed due to high variability across studies. CONCLUSION: The data to support or refute the association between vitamin D levels and periodontal disease are inconclusive at the moment. More rigorously designed longitudinal studies with standardized definitions of periodontal disease and vitamin D are necessary.
Assuntos
Doenças Periodontais/sangue , Vitamina D/sangue , Bases de Dados Factuais , Suplementos Nutricionais , Humanos , Doenças Periodontais/epidemiologia , Doenças Periodontais/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Vitamina D/administração & dosagemRESUMO
BACKGROUND: The use of a toothbrush has a limited ability to control the dental biofilm in interproximal areas. Therefore, specialized devices, such as dental floss, may be useful for these specific areas. OBJECTIVE: This study aimed to investigate the efficacy of dental floss impregnated with 5% chlorhexidine gluconate on the reduction of the supragingival biofilm. METHODS: This research was parallel, single-blind, controlled and randomized, and contained a sample of thirty dental students from the Faculty of Pharmacy, Dentistry and Nursing of the Federal University of Ceará, Brazil, who were divided equally into three groups. The negative control group (NC) did not utilize any kind of interproximal cleaning; the positive control group (PC) used waxed floss without impregnation twice a day; and the test group (T) used the same dental floss, which was impregnated with 5% chlorhexidine gluconate, twice a day. For all groups, this study lasted for 15 days. The presence of a biofilm was evaluated on four surfaces (mesiobuccal, distobuccal, mesiolingual and distolingual) by the Quigley-Hein Index, resulting in four scores for each tooth. RESULTS: Group T had the lowest plaque scores, showing a significant difference compared to group NC (P < 0.001) and group PC (P < 0.001). Group PC also displayed a significant difference compared to NC (P < 0.001). CONCLUSION: It was concluded that the use of dental floss impregnated with 5% chlorhexidine gluconate resulted in additional reductions in the supragingival biofilm relative to the results achieved with conventional waxed floss on the anterior teeth of a well-motivated and well-instructed population.