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BACKGROUND: To assess the efficiency of periodontal treatment (PT) in improving diabetes-related outcomes in adults with type 2 diabetes mellitus (T2DM) and periodontitis, providing an updated and comprehensive synthesis from economic evaluations (EE). METHODS: Seven databases and one register were independently searched by two reviewers for articles published up to 8 May 2024. Studies that assessed the efficiency of PT versus no treatment or other dental treatments were included. Risk of bias was assessed using the Cochrane RoB 2, ROBINS-I and ECOBIAS tools for the first stage of EE and the CHEERS checklist and NICE quality appraisal tool for overall EE. Qualitative and quantitative syntheses of the articles were conducted and assessed using the GRADE approach. RESULTS: Eleven studies were included. PT reduces total healthcare costs, including inpatient and outpatient, diabetes-related costs and other drug costs (low to moderate certainty). A total incremental net benefit of USD 12 348 (2022 currency, 95% CI 12 195-12 500) was estimated from three high-quality model-based cost-utility analyses (high certainty). DISCUSSION: The inclusion of PT in the comprehensive treatment of patients with T2DM and periodontitis is cost-effective. Future research is required to ensure the transferability of these findings and inform decision makers from different countries. REGISTRATION: PROSPERO CRD42023443146.

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The aim of this study was to evaluate the impact of non-surgical periodontal treatment (NS-PT) on periodontal parameters and inflammatory biomarkers in the concentration and level of calprotectin (CLP) in women with periodontitis and rheumatoid arthritis (RA). In this quasi-experimental study, we evaluated 30 women (mean age: 52.0 ± 5.8 years) with periodontitis and RA who had been diagnosed and treated for RA for more than 3 years and whose activity markers remained at similar values without significant reduction over three consecutive months. Patients underwent NS-PT, which included plaque control, scaling, and root planing. Serum and saliva samples, periodontal indices, RA activity markers, Disease Activity Score-28 (DAS28), the erythrocyte sedimentation rate (ESR), and the C-reactive protein (CRP) and CLP contents were measured at the beginning of the study and 6 and 12 weeks after NS-PT. Parametric and nonparametric tests were used in the analysis. The mean age was 52.0 ± 5.8 years. Compared to the baseline results, all periodontal indices were significantly reduced 6 and 12 weeks after NS-PT (p < 0.001). DAS28 was also significantly reduced after 12 weeks (p < 0.0001). Similarly, the serum CLP concentration decreased 6 and 12 weeks after NS-PT (p < 0.0001). Of the patients, 100% presented lower levels of CRP and ESR (p < 0.0001). Overall, NS-PT reduced inflammation and disease activity, highlighting the importance of oral health in the control and treatment of systemic diseases such as RA and confirming that NS-PT effectively reduces periodontitis activity and plays a key role in modulating RA activity. Therefore, NS-PT should be considered as an adjunct treatment for RA.

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Objetivo: Avaliar e comparar duas técnicas de aplicação do laser de baixa potência ­ transgengival (LBPT) e intrasulcular (LBPI) ­ utilizado na Fotobiomodulação como adjuvante à TPB em pacientes com periodontite. Metodologia: Trata-se de um ensaio clínico, randomizado, boca dividida e duplo cego, no qual foram selecionados, de cada paciente, 3 sítios periodontais doentes, em diferentes quadrantes, para um dos três grupos de tratamento: grupo RAR (grupo controle), grupo RAR + LBPT (teste 1) e grupo RAR + LBPI (teste 2). A terapia com laser de baixa potência nos grupos teste foi realizada em três momentos, sendo 48 horas, 7 e 14 dias após a finalização da RAR de boca completa. Os parâmetros clínicos de profundidade à sondagem (PS), nível clínico de inserção (NIC) e sangramento à sondagem (SS) foram avaliados antes do tratamento (T0), e após 3 (T1) e 6 meses (T2). Além disso, radiografias periapicais padronizadas foram usadas para medir e comparar a densidade óssea radiográfica 6 meses após conclusão do tratamento. Foram realizados o teste ANOVA para medidas repetidas para as variáveis quantitativas e o teste qui-quadrado para a variável categórica utilizando um nível de significância ou p < 0,05 e intervalos de confiança de 95%. Resultados: Reduções estatisticamente significativas de PS (p < 0,001) e NIC (p < 0,001) foram observadas nos três grupos de tratamento em 3 e 6 meses de acompanhamento em comparação ao baseline, sem diferenças significativas entre os grupos. Nenhuma diferença significativa foi encontrada no sangramento à sondagem em 3 e 6 meses e na densidade óssea radiográfica em 6 meses de acompanhamento. Conclusão: Os resultados mostraram que, comparado à TPB isolada, a fotobiomodulação adjuvante não trouxe benefícios adicionais, independentemente da técnica de aplicação do laser utilizada (AU).

Aim: To assess and compare two techniques of low-level laser application - transgingival (LLLTT) and intrasulcular (LLLTI) - used in Photobiomodulation as an adjunct to BPT in patients with periodontitis. Methods: This is a randomized, split-mouth, double-blind clinical trial where, from each patient, 3 diseased periodontal sites in different quadrants were selected for one of three treatment groups: SRP group (control group), SRP + LLLTT group (test 1), and SRP + LLLTI group (test 2). Low-level laser therapy in the test groups was performed at three time points, 48 hours, 7 and 14 days after completing full-mouth SRP. Clinical parameters of probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were assessed before treatment (T0), and at 3 months (T1) and 6 months (T2). Additionally, standardized periapical radiographs were used to measure and compare radiographic bone density 6 months after treatment completion. Repeated-measures ANOVA was conducted for quantitative variables, and the chi-square test was used for the categorical variable, with a significance level of p < 0.05 and 95% confidence intervals. Results: Statistically significant reductions in PD (p < 0.001) and CAL (p < 0.001) were observed in all three treatment groups at 3 and 6 months follow-up compared to baseline, with no significant differences between the groups. No significant differences were found in bleeding on probing at 3 and 6 months and in radiographic bone density at 6 months of follow-up. Conclusion: The results indicated that, compared to isolated basic periodontal therapy (TPB), adjunctive photobiomodulation did not provide additional benefits, regardless of the laser application technique used (AU).

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OBJECTIVES: To (1) investigate dental anxiety (DA) and oral health-related quality of life (OHRQOL) before and after non-surgical periodontal treatment (NSPT) and (2) determine correlations between these patient-reported measures. MATERIALS AND METHODS: Demographics, smoking habits, dental pain, Modified Corah's Dental Anxiety Scale (MDAS), and Oral Health Impact Profile (OHIP-14) were assessed in eighty-two participants. RESULTS: Mean age was 48.3 years ± 11.5. At baseline, 8.5% reported being active smokers. Of non-smokers, 11% reported being an ex-smoker. After NSPT, 11.0% reported smoking. Patients' maximal pain in the last month decreased after therapy. Before treatment, participants reported higher DA. Extreme DA was observed in 8.5% of participants before therapy. Afterwards, 2.4% of participants reported extreme DA. Fear of having a foreign object in the mouth decreased after NSPT. All OHIP-14 scores, except functional limitation, improved post-treatment. Higher DA was associated with worse OHRQoL before treatment. After treatment, total MDAS score was associated with OHIP-14 global score, physical pain, psychological disability, and social disability. Worse MDAS sub-scores were associated with a higher OHIP-14 global score. Individuals with "normal/slight anxiety" had a significant improvement in OHRQoL, whereas people in the "moderate and extreme anxiety" group did not report a significant improvement. Patients diagnosed with generalized periodontitis (GP) stage III grade B and GP stage IV grade B reported less anxiety after NSPT. CONCLUSIONS: Associations of MDAS subcategories with OHIP-14 domain scores were found before and after therapy. DA decreases and OHRQoL enhances after NSPT in patients with "normal/slight" anxiety to dental treatment. Dental practitioners should plan strategies to cope with anxiety to dental treatment and prevent decreases in OHRQoL. CLINICAL RELEVANCE: Within the limitations of this study, DA and OHRQoL were positively correlated in patients with periodontitis, before and after NSPT, using the MDAS and OHIP-14 questionnaires. The results of our study suggest that treatment is effective in terms of alleviating DA and improving oral health, along with quality of life, in patients that report "normal/slight" anxiety to dental treatment. Nonetheless, results must be interpreted with caution since patients are generally anxious before any type of dental treatment. DA may not just be confined to NSPT per se. According to our results, evaluation of both outcomes should be an integral part of routine periodontal clinical evaluation and periodontal reevaluation of initial therapy. It is important that clinicians learn to identify patients that suffer from anxiety and take time to explain the treatment procedures to the patient, to strive for patient's emotional well-being before, during, and after dental care services. The use of specific questionnaires for both DA and OHRQoL may be more appropriate to demonstrate the psychological and quality of life differences due to periodontal disease and NSPT.

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We assessed the level of evidence for the presence of new periodontal pathogens by (i) comparing the occurrence of non-classical periodontal taxa between healthy vs. periodontitis patients (Association study); (ii) assessing the modifications in the prevalence and levels of these species after treatments (Elimination study). In the Association study, we compared the prevalence and levels of 39 novel bacterial species between periodontally healthy and periodontitis patients. In the Elimination study, we analyzed samples from periodontitis patients assigned to receive scaling and root planing alone or with metronidazole+ amoxicillin TID/ 14 days. Levels of 79 bacterial species (39 novel and 40 classic) were assessed at baseline, 3 and 12 months post-therapy. All samples were analyzed using Checkerboard DNA-DNA hybridization. Out of the 39 novel species evaluated, eight were categorized as having strong and four as having moderate association with periodontitis. Our findings suggest strong evidence supporting Lancefieldella rimae, Cronobacter sakazakii, Pluralibacter gergoviae, Enterococcus faecalis, Eubacterium limosum, Filifactor alocis, Haemophilus influenzae, and Staphylococcus warneri, and moderate evidence supporting Escherichia coli, Fusobacterium necrophorum, Spiroplasma ixodetis, and Staphylococcus aureus as periodontal pathogens. These findings contribute to a better understanding of the etiology of periodontitis and may guide future diagnostic and interventional studies.

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Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there is a growing trend in the indications for implants, which seems attributable not only to their clinical success but also to arguments such as a more "simplified approach" based on convenience or the belief that dental implants are as good as natural teeth. Therefore, the objective of this critical literature review of observational studies was to discuss the evidence concerning the long-term survival rates and treatment outcomes, comparing endodontically or periodontally treated teeth with dental implants. Altogether, the evidence suggests that the decision between keeping a tooth or replacing it with an implant should carefully consider the condition of the tooth (e.g., amount of remaining tooth and degree of attachment loss and mobility), systemic disorders, and patient preference. Although observational studies revealed high success rates and long-term survival of dental implants, failures and complications are common. For this reason, attempts should be made to first save maintainable teeth over the long-term, instead of immediately replacing teeth with dental implants.

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Introducción: El efecto del tratamiento no quirúrgico periodontal en los pacientes con artritis reumatoide es escaso y controversial. Objetivo: Evaluar el efecto de la terapia periodontal no quirúrgica en la actividad de la artritis reumatoide. Métodos: Se realizó un estudio cuasi experimental de intervención terapéutica en 30 pacientes de ambos sexos entre 35 y 70 años de edad con diagnóstico clínico de artritis reumatoide y periodontitis. Fueron incluidos en este estudio los pacientes con más de ocho dientes presentes y aprobación escrita para participar en la investigación y excluidos las embarazadas, fumadores y los que recibieron terapia periodontal o antibiótica. Los parámetros clínicos-serológicos y periodontales fueron evaluados antes y 30 días después de la terapia periodontal. Las variables estudiadas fueron: formas de periodontitis y actividad de la enfermedad reumática (DAS-28/VSG). Se utilizaron frecuencias absolutas, relativas, chi-cuadrado y correlación de Spearman al 95 % de confianza. Resultados: El grupo de edad de 45-54 años y el sexo femenino fueron predominantes. La periodontitis incipiente y moderada fue la más prevalente antes del tratamiento periodontal y estuvo asociada a los niveles de actividad moderada de la AR. Tras el tratamiento periodontal se confirmó disminuciones en el estado periodontal y en la actividad de la afección reumática en el 73.3 % de los pacientes. Conclusiones: La terapia periodontal no quirúrgica mejoró el estado periodontal y redujo la actividad de la artritis reumatoide.

Introduction: The effect of nonsurgical periodontal treatment in patients with rheumatoid arthritis is limited and controversial. Objective: To evaluate the effect of non-surgical periodontal therapy on the activity of rheumatoid arthritis. Methods: a quasi-experimental study of therapeutic intervention was carried out in 30 patients of both sexes between 35 and 70 years of age with a clinical diagnosis of rheumatoid arthritis and periodontitis. Patients with more than eight teeth present and written approval to participate in the research and excluded were included in this study: pregnant women, smokers and those who received periodontal or antibiotic therapy. The clinical - serological rheumatoid and periodontal parameters were evaluated: before and 30 days after periodontal therapy. The variables studied were: forms of periodontitis and activity of the arthritic disease. Absolute and relative frequencies, chi-square and Spearman's correlation at 95 % confidence were used. Results: The age group of 45-54 years and the female sex were predominant. Early and moderate periodontitis was the most prevalent before periodontal treatment and was associated with moderate levels of rheumatoid activity. After periodontal treatment, decreases in periodontal status and rheumatic disease activity were confirmed in 73.3 % of patients. Conclusions: Non-surgical periodontal therapy improved the periodontal status and activity levels of rheumatoid arthritis.

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This article honors Dr. Anne Haffajee's career, her highest research standards, scholarly integrity, and inspirational mentorship. Anne-as she liked to be called-was one of the most productive clinical scientists of her time. Gifted with the unique combination of knowledge in the fields of clinical research, oral ecology, data analysis, and computer programing, her work triggered unprecedented advances in the diagnosis, progression, and treatment of periodontitis. Anne's pivotal clinical trials elucidated the effects of non-surgical and surgical periodontal therapies. In addition to her scholarly achievements, Anne played an important role in mentoring young scientists, many of whom have developed independent leadership careers in periodontal research. She always found time to help her mentees, and ultimately became a warm-hearted friend to many of them, including myself. Anne was consistently devoted to contributing to the future of clinical investigation, and more specifically concerned about the lack of interest by (1) funding agencies in supporting such studies and by (2) the new generation of investigators in pursuing a career in the area. She passed away prematurely, in 2013, at the age of 65. Undoubtedly, her work and legacy assured the continuity of high-standard clinical studies in periodontics and the survival of a whole generation of clinical researchers.

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OBJECTIVE: To evaluated the relationship between serum vitamin D levels and periodontal healing outcomes in patients with mild or moderate periodontitis. METHODS: Serum vitamin D levels and periodontal pockets and gingival bleeding were evaluated in 51 patients before and 6 months after non-surgical periodontal treatment. A t-test and chi-square test were used to analyse the data (p ≤ 0.05). RESULTS: The mean reduction of periodontal pocket depth was statistically significant higher in patients with vitamin D ≥30 ng/ml than those with <30 ng/ml (CI = -0.23-0.42, p = 0.05), but not clinically significant. Vitamin D level was not associated with the percentage of sites of gingival bleeding on probing at the final evaluation (OR = 0.58, 95% CI = 0.17-1.99, p = 0.39). CONCLUSION: Lower serum vitamin D level was associated with a slightly reduced periodontal healing after non-surgical periodontal therapy, which should be further investigated in a larger population.

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Objetivo: evaluar la evidencia del láser como coadyuvante en el tratamiento quirúrgico de lesiones de furca grado II y reflejar la importancia clínica de los hallazgos para la toma de decisiones. Materiales y métodos: se realizó una búsqueda bibliográfica manual, se consultaron las siguientes bases de datos: PORTAL TIMBO FOCO, PUBMED, BVS, SciELO y GOOGLE SCHOOLAR. Esta búsqueda fue restringida a los últimos 15 años y los artículos seleccionados están en inglés. Resultados: Se seleccionaron 105 artículosque abordan la temática y se completó la búsqueda con el rastreo y la lectura de la bibliografía referenciada en esos artículos. Conclusiones: El láser de baja potencia tanto para la bioestimulación así como su efecto anti-inflamatorio, solo ha mostrado hasta ahora resultados positivos a corto plazo como coadyuvante del tratamiento periodontal regenerativo en lesiones de furca grado II. Sin embargo, sus resultados a largo plazo no son claros debido a la debilidad metodológica y al número insuficente de estudios existentes. Por otro lado, la terapia fotodinámica podría ser una alternativa para el control de pérdida ósea en lesiones de furca causadas por periodontitis. Por lo tanto, hacen falta más estudios para dilucidar la acción del la terapia fotodinámica y de la fotobiomodulación coadyuvantes del tratamiento de las lesiones de furca.

Objetivo: avaliar a evidência do laser como adjuvante no tratamento cirúrgico das lesões de furca grau II e refletir a importância clínica dos achados para a tomada de decisão. Materiais e métodos: foi realizada busca bibliográfica manual, consultadas as seguintes bases de dados: PORTAL TIMBO FOCO, PUBMED, BVS, SciELO e GOOGLE SCHOOL. Esta busca foi restrita aos últimos 15 anos e os artigos selecionados estão no idioma inglês. Resultados: foram selecionados 105 artigos que abordam o assunto e a busca foi concluída por meio de busca e leitura da bibliografia referenciada nesses artigos. Conclusões: O laser de baixa potência, tanto para a bioestimulação como para o seu efeito anti-inflamatório, apenas apresentou resultados positivos a curto prazo como adjuvante do tratamento periodontal regenerativo em lesões de furca grau II. No entanto, seus resultados a longo prazo não são claros devido a deficiências metodológicas e número insuficiente de estudos existentes. Por outro lado, a terapia fotodinâmica pode ser uma alternativa para controlar a perda óssea em lesões de furca causadas por periodontite. Portanto, mais estudos são necessários para elucidar a ação da Terapia Fotodinâmica e da fotobiomodulação como adjuvantes no tratamento da lesões de furca.

Objective: to evaluate the evidence of the efficacy of the adjuvant use of laser in the surgical treatment of grade II furcation lesions and to demonstrate the clinical importance of the findings for decision making. Materials and methods: a manual bibliographic search was carried out where the following databases were consulted: PORTAL TIMBO FOCO, PUBMED, SciELO, BVS and GOOGLE SCHOOL. This search was restricted to the last 15 years and the selected articles are in English. Results: 105 articles that addressed the subject were selected and the search was completed by searching and reading the referenced bibliography in those articles. Conclusions: Low-power laser, both for biostimulation and as an anti-inflammatory has so far only shown positive short-term results as an adjunct to regenerative periodontal treatment in grade II furcation lesions. However, its long-term results are not clear due to methodological weaknesses and the insufficient number of existing studies. On the other hand, photodynamic therapy could be an alternative to control bone loss in furcation lesions caused by periodontitis. However, more studies are needed to elucidate the action of photodynamic therapy and photobiomodulation as adjuvants in the treatment of furcation lesions.

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OBJECTIVES: To evaluate the cost-effectiveness of the nonsurgical periodontal treatment (NSPT) compared with supragingival therapy in type II diabetics with periodontitis. METHODS: A decision tree analysis was used to estimate the costs and health outcomes of two periodontal therapies in a hypothetical cohort of type II diabetics with periodontitis. The analysis was developed from the perspective of a third-party payer at 1 year and 5 years. Probabilities were derived from two systematic reviews. The costs and resource use were validated by a Delphi expert panel. All costs were expressed in USD, using the 25 May 2021 Colombian pesos market exchange rate (USD 1 = COP 3,350). RESULTS: NSPT was a dominant alternative compared with subsidized supragingival therapy in type II diabetics with periodontitis, generating savings of USD 87 and 400, during the first year or up to 5 years, respectively, and improving dental survival from 32 to 69 percent. CONCLUSIONS: NSPT can generate savings by reducing the complications derived from uncontrolled periodontitis and tooth loss.

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AIM: To evaluate the frequency of side effects associated with intake of metronidazole (MTZ) + amoxicillin (AMX) in periodontal treatment, and to explore associations between these events and patients' features. MATERIALS AND METHODS: Data of five randomized clinical trials testing MTZ + AMX adjunctive to mechanical therapy were evaluated. Volunteers answered an adverse event questionnaire. RESULTS: Information from 656 subjects was assessed. The frequency of side effects in the antibiotic- and placebo-treated groups ranged from 1.0% to 17.7% and 0.9% to 13.7%, respectively. The events more frequently observed in the antibiotic than in the placebo group were diarrhoea and metallic taste (p < .05). Diabetes significantly raised the odds of a patient reporting discomfort (odds ratio [OR] = 2.6), diarrhoea (OR = 4.0), weakness (OR = 6.0) and excessive sleepiness (OR = 2.9). In systemically healthy volunteers, using antibiotics 3 months post-mechanical treatment (healing phase) (OR = 3.0), being a woman (OR = 3.9) and aged ≤49 (OR = 4.5) significantly increased the chances of reporting adverse events. CONCLUSIONS: The occurrence of side effects during MTZ + AMX treatment ranged from uncommon (1%) to very common (17.7%). The main factors raising the chances of a patient reporting adverse events were diabetes and taking antibiotics in the healing phase, instead of in the active phase of treatment. Patients ≤ 49 years old and females also tend to report more side effects.

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RESUMEN: La diabetes mellitus y la enfermedad periodontal son patologías con una alta prevalencia en la población, y su frecuencia va en aumento. Ambas presentan mecanismos comunes de progresión y se manifiestan en términos de comorbilidad. El objetivo de esta revisión fue explicar los mecanismos de asociación bidireccional entre la diabetes mellitus y la enfermedad periodontal. Para ello se desarrolló una búsqueda sistematizada de la información en las bases de datos PubMed, ScienceDirect, Scoopus y EBSCO de los últimos tres años y se seleccionaron aquellos en idioma inglés que incluían las vías de asociación entre la diabetes mellitus y la enfermedad periodontal o viceversa de manera unidireccional o bidireccional. La diabetes mellitus corresponde a un desorden metabólico, el cual se caracteriza por una hiperglucemia producto del defecto en la producción o acción de la insulina, o ambas. En los últimos tiempos se ha hecho énfasis en la influencia que tiene la condición periodontal en el control glucémico de los pacientes diabéticos Esta revisión concluyó que existe una asociación bidireccional de la diabetes mellitus y la enfermedad periodontal, así como la existencia de limitaciones de los estudios para explicar esta relación en términos de causalidad.

ABSTRACT: Diabetes mellitus and periodontal disease are pathologies with a high prevalence in the population, and their frequency is increasing. Both present common mechanisms of progression and manifest themselves in terms of comorbidity. The aim of this review was to explain the mechanisms of two-way association between diabetes mellitus and periodontal disease. For this purpose, a systematic search of the information in PubMed databases wasdeveloped, ScienceDirect, Scoopus and EBSCO of the last three years and selected those in English that included the pathways of association between diabetes mellitus and periodontal disease or viceversa in a unidirectional or bidirectional manner. Diabetes mellitus corresponds to a metabolic disorder, which is characterized by a hyperglycemia product of the defect in the production or action of insulin, or both. In recent times, emphasis has been placed on the influence of the periodontal condition on the glycemic control of diabetic patients. This review concluded that there is a bidirectional association of diabetes mellitus and periodontal disease, as well as the existence of limitations of studies to explain this relationship in terms of causality.

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Background: The development and progression of periodontal diseases is a result of the dynamic interaction of microorganisms within their habitat, and changes in this habitat generate a dysbiotic state. Fusobacterium nucleatum and Prevotella intermedia are bridging microorganisms between the pioneer communities and other microorganisms responsible for periodontitis such as Porphyromonas gingivalis. Tetracycline hydrochloride (TTC-HCl) is commonly used as a coadjutant in periodontal treatment in the form of an antiseptic. However, there are no clear dilution or concentration protocols. Objective: This study aimed to evaluate the in vitro antimicrobial activity of TTC-HCl diluted in sterile water, saline solution, and 2% lidocaine with epinephrine 1:80,000 at concentration of 125, 250, and 500 mg, at three time points- 30, 60, and 120 s - on P. intermedia, F. nucleatum, and P. gingivalis using the Kelsey-Maurer technique. Materials and Methods: The antimicrobial activity of TTC-HCl was evaluated at the proposed concentrations and times, dissolved in the different vehicles at pH 1.9 and 7.0, on F. nucleatum, P. intermedia, and P. gingivalis. The Kelsey-Maurer test was used to verify the presence or absence of colony-forming units. Each test was performed in triplicates with its respective viability controls. Results: Inhibition of F. nucleatum, P. intermedia, and P. gingivalis was achieved with TTC-HCl at all concentrations, dissolved in distilled water, saline solution, and 2% lidocaine with epinephrine 1:80,000 for all times. Conclusions: The results show that TTC-HCl is a good antimicrobial alternative against F. nucleatum, P. intermedia, and P. gingivalis regardless of the vehicle in which it was dissolved, concentration, pH, or time used in this investigation.

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Objective: Mouthwash is effective in maintaining oral hygiene in patients; however, there is concern that it may adversely affect human oral mucosa. We evaluated a pH-neutral electrolyzed super-oxidized solution (ESS, tradename OxOral®) combined with dental scaling in periodontitis patients. This longitudinal study was conducted with 34 patients divided into three groups. The control group treated with scaling plus saline, the second with scaling plus ESS mouthwash, and another with scaling plus ESS mouthwash and gel. The plaque index (PI), gingival index (GI), and probing depth (PD) were determined before and after periodontal treatment. Results: The final PI and GI decreased compared with the initial measurements in the three treatment groups (p < 0.05). Scaling plus ESS mouthwash and gel significantly reduced the final PI, GI, and DP compared to the control group (p < 0.05). Conclusion: Our study shows the antiseptic properties of ESS with mouthwash and gel. Further studies are needed to verify the results.

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Objetivo: Comparar la salud periodontal de embaraza- das y no embarazadas mediante la aplicación del Índice de Periodontal Comunitario (IPC). Materiales y métodos: Se realizó un estudio ob- servacional de corte transversal. Se reclutaron 100 mujeres embarazadas (EMB) y 50 no embarazadas (NoEMB) que concurrieron al Hospital Materno Provincial de la Ciudad de Córdoba, Dr. Raúl F. Lucini. En todas se registró el IPC con la sonda periodontal WHO 621 en los 6 sextantes de la boca. Los datos se analizaron con el software Infostat/SP; el nivel de significación establecido fue de P <0,05. Resultados: El 70% de las pacientes presentó edades de entre 18 y 25 años. En las EMB el código 3 del IPC fue el más frecuente presente en 240 sextantes (40,1%) y en las NoEMB el código 2 fue el más frecuente con 39 sextantes (43%). A ambos grupos de estudio les corresponde el trata- miento de instrucción de higiene bucal, instrumentación supra y/o subgingival, y/o regularización de obturaciones. Conclusiones: El código 3 fue el más frecuente entre las EMB, a quienes les corresponde un Código de tratamiento periodontal (CTP) 2; las NoEMB presentaron un IPC de 1 y 2 como los más frecuentes y se vinculan con un CTP 1 y 2. Nos encontramos frente a una situación clínica periodontal posible de resolver con terapia básica que puede ser realizada por odontólogos generalistas (AU)

Aim: To compare the periodontal health of pregnant and non-pregnant women by applying the Community Periodontal Index (CPI). Materials and methods: In an observational, cross-sec- tional study, 100 pregnant women (PREG) and 50 non-preg- nant women (NonPREG) were recruited at the Dr. Raúl F. Lu- cini Provincial Maternity Hospital in Córdoba City. The CPI was determined in the 6 sextants of the mouth using a WHO 621 periodontal probe. The data were analyzed with Infostat SP software. P <0.05 was considered significant. Results: 70% of the patients were 18 to 25 years old. In the PREG group, CPI Code 3 was the most frequent, present in 240 sextants (40.1%), while in the non-PREG group, CPI Code 2 was the most frequent, with 39 sextants (43%). Treat- ment needs in both study groups are oral hygiene instruction, supra- and/or subgingival instrumentation, and/or correction of plaque retentive margins. Conclusions: Code 3 was the most frequent among preg- nant women, which corresponded to Periodontal Treatment Code (CTP) 2. CPI 1 and 2 were the most frequent in non-pregnant women, corresponding to CTP 1 and 2. This periodontal clinical condition can be treated with initial dental hygiene therapy, which can be performed by general dentists (AU)

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OBJECTIVE: To evaluate how chronic gingivitis treatment impacts the oral and circulating cytokine expressions after six-month follow-up in patients with juvenile systemic lupus erythematosus (jSLE) and also to evaluate the circulating expression of anti-Porphyromonas gingivalis peptidylarginine deiminase antibodies (anti-PPAD) before and after treatment. BACKGROUND: Juvenile systemic lupus erythematosus patients present a worse periodontal condition associated with higher gingival crevicular fluid (GCF) levels of interleukin (IL)-1ß, IL-8, granulocyte colony-stimulating factor (G-CSF), interferon-γ and monocyte chemoattractant protein (MCP)-1. MATERIALS AND METHODS: Twenty-one adolescents with jSLE (mean age: 16.2 ± 1.5 years) were recruited. Participants were rheumatologically and periodontally examined. All individuals were clinically diagnosed with gingival inflammation. Chronic gingivitis treatment consisted of supragingival scaling, prophylaxis and oral hygiene instructions. The cytokine levels were determined by bead-based multiplex assays and the anti-PPAD levels by ELISA. Gingival crevicular fluid (GCF) and serum samples were collected at baseline and 6 months after treatment. RESULTS: We observed a reduction in attachment loss, SLE Disease Activity Index (SLEDAI), IL-1ß, IL-10 and MCP-1 GCF levels, and the IL-4 and IL-5 serum levels 6 months after periodontal treatment. On the contrary, a significant increase in GCF expression of IL-4, IL-12, IL-17, IFN-γ and serum levels of anti-PPAD antibody was observed. CONCLUSION: Juvenile systemic lupus erythematosus patients seem to positively benefit from periodontal treatment by a significantly reduced CAL, a GCF reduction of pro-inflammatory cytokines and an increasing of anti-inflammatory ones. However, an increase in the GCF expression of IL-17 and the serum expression of anti-PPAD antibody 6 months after periodontal treatment might negatively affect the treatment outcome of such patients in the long term.

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ABSTRACT: Drug-influenced gingival enlargement is considered to be an important side effect related to the use of some medications and often produces important esthetic changes for patients, as well as clinical symptoms such as pain, bleeding, abnormal tooth movement and occlusion problems. Anticonvulsants, immunosuppressants and antihypertensive drugs have been reported as the main inducers of these periodontal disorders. This case report describes the 4-year clinical follow-up of a young patient with a history of excessive gingival enlargement as a consequence of drug therapy for epilepsy (phenytoin and phenobarbital); the nonsurgical periodontal treatment of the excessive gingival enlargement was associated with the replacement of the patient's epilepsy medications with valproic acid. We conclude that intensive mechanical control of bacterial biofilms, instruction on oral hygiene guidelines and behaviors and the substitution of alternative anticonvulsant medications are the best way to control the drug-influenced gingival enlargement.

Assuntos

RESUMO

AIMS: The purpose of the present systematic review and meta-analysis was to assess the impact of periodontal treatment on the glomerular filtration rate (GFR) of individuals with chronic kidney disease (CKD). METHODS: Searches were conducted in five databases. Restrictions on publication date or language were not imposed. Studies reporting the GFR of CKD individuals before and after periodontal treatment were included. Studies' selection, extraction of data and assessment of risk of bias were performed by two reviewers independently. The Methodological Index for non-randomized studies was employed for risk of bias assessment. Meta-analysis was carried out. RESULTS: One hundred ninety-two references were retrieved and three studies were included. In all studies included, the periodontal intervention performed was non-surgical therapy. The three studies together assessed 77 individuals. The follow-up of participants after periodontal treatment varied between 3 and 6 months. Meta-analysis demonstrated that the GFR of individuals with CKD increased (improvement) after periodontal treatment (mean difference = 7.01, confidence interval = 0.66 - 13.36, I2  = 0%). Overall, included studies presented low risk of bias. CONCLUSION: Despite the limited evidence of this systematic review and meta-analysis, periodontal treatment seems to improve the GFR of CKD individuals, with positive repercussions on their renal function.

Assuntos

RESUMO

BACKGROUND: The aim of this cross-sectional study was to assess the analgesic consumption and the frequency and intensity of pain after nonsurgical periodontal therapy, as well as to associate these factors with the extent and severity of periodontitis and with the degree of anxiety before the procedure. MATERIALS AND METHODS: Fifty-one patients with chronic periodontitis were recruited. The degree of previous anxiety was assessed with the dental anxiety scale questionnaire. Periodontal data were obtained by means of clinical examination and circumferential probing performed by undergraduate students, supervised by a clinical lecturer. The teeth submitted to treatment in the session were registered. Analgesic consumption was recorded 7 days after periodontal intervention. To measure pain, a visual analog scale was used. The patient was instructed to record the pain intensity at 2, 4, 8, 24, and 48 h after subgingival scaling. Differences in pain intensity between periods after nonsurgical periodontal therapy were performed using Anova test. P < 0.05 was statistically significant. RESULTS: There was no relevant difference between groups in all variables used in the study (P > 0.05). The use of analgesics was significantly more frequent among individuals who had reported higher levels of pain. The degree of anxiety before treatment was similar among groups (P > 0.05). Most individuals reported no pain or mild pain (P < 0.05). CONCLUSION: Nonsurgical periodontal therapy is associated with low pain or absent pain.