RESUMO
Objetivo: La gingivitis espongiótica es una patología benigna poco común y una entidad clínica patológica poco frecuente que los odontólogos pueden observar durante la atención odontológica. Es importante conocer la misma para poder diagnosticarla adecuadamente, describir sus características clínicas y elaborar un plan para su tratamiento. El objetivo de este artículo es presentar un caso clínico de esta patología poco conocida, describir sus características y su manejo clínico. Caso clínico: Un niño de 7 años que ingresó derivado por su odontólogo a la cátedra de Estomatología de la Facultad de Odontología de la Universidad Nacional de Córdoba, Argentina, presentaba en la encía libre e insertada del maxilar superior una lesión con ausencia de sintomatología y evolución crónica, benigna y con cambios estéticos notorios. Se deriva a la cátedra de Periodoncia para realizar un tratamiento interdisciplinario. Tuvo una respuesta favorable al tratamiento de la lesión, y se realizó un seguimiento periódico de la misma evitando la técnica quirúrgica convencional para su tratamiento.(AU)
Aim: Spongiotic gingivitis is a rare benign pathology and a rare clinical pathological entity that dentists can observe during dental care. It is important to know it to be able to properly diagnose it, describe its clinical characteristics and develop a plan for its treatment. The aim of this article is to present a clinical case of this little-known pathology and describe its characteristics as well as its clinical management. Clinical case: A 7-yeard-old child who was referred by his dentist to the Department of Stomatology of the Faculty of Dentistry of the National University of Córdoba, Argentina, presented a lesion in the free and inserted gingiva of the upper jaw, with absence of symptoms and chronic, benign evolution with notable aesthetic changes. He is referred to the Periodontics department to perform interdisciplinary treatment. He had a favorable response to the treatment of the lesion, and a periodic follow-up was carried out, avoiding the conventional surgical technique for its treatment.(AU)
RESUMO
La gingivitis se ha definido como una inflamación de la encía caracterizada por edema, eritema, cambio de la morfología normal, exudado acuoso y hemorragia de interés mundial. El objetivo fue evaluar el efecto dos pastas dentales en pacientes jóvenes diagnosticados con gingivitis en la ciudad de Cusco-Perú en el año 2022. La investigación se realizó en alumnos de la Facultad de Economía de la Universidad Nacional San Antonio Abad del Cusco todos ellos diagnosticados con gingivitis en el mismo año. El estudio se desarrolló bajo un diseño experimental pre-test post-test con dos grupos experimentales cada uno con n=15. Evaluados con el índice de placa de Löe & Silness y el índice gingival de Löe & Silness (IG). Los participantes fueron orientados a cepillar los dientes con el dentífrico tres veces al día, por un periodo de 2 semanas. Se utilizó como instrumento de recolección de datos una matriz de registro para la medición antes y después de aplicado el tratamiento en la cual se plasmaron los índices de placa e índice gingival de Löe & Silness. Resultó que los sujetos del estudio en su gran mayoría presentaron gingivitis moderada y un estado de higiene oral regular. Con lo cual concluimos que la pasta dental aplicada en el Grupo I resultó más efectiva en la recuperación de pacientes con gingivitis. El dentífrico con contenido de Ratania fue bien tolerado por los participantes, no existiendo ningún tipo de alteración de tipo alérgica en los tejidos bucales, por lo tanto, no interrumpió el tratamiento.
Gingivitis has been defined as an inflammation of the gum characterized by edema, erythema, change in normal morphology, watery exudate, and bleeding of global interest. The aim was to evaluate the effect of two toothpastes on young patients diagnosed with gingivitis in the city of Cusco, Peru in 2022. The research was conducted on students from the Faculty of Economics at the National University of San Antonio Abad in Cusco, all diagnosed with gingivitis in the same year. The study was carried out under a pre-test post-test experimental design with two experimental groups, each with n=15. Evaluated using the Löe & Silness plaque index and the Löe & Silness gingival index (GI). Participants were instructed to brush their teeth with the toothpaste three times a day for a period of 2 weeks. A data collection instrument was used, a record matrix for measurement before and after treatment application, where the Löe & Silness plaque and gingival indices were recorded. The study subjects mostly presented moderate gingivitis and a regular oral hygiene status. Therefore, we conclude that the toothpaste applied in Group I was more effective in the recovery of patients with gingivitis. The toothpaste containing Ratania was well tolerated by the participants, with no allergic tissue alterations in the oral tissues, thus not interrupting the treatment.
A gengivite foi definida como uma inflamação da gengiva caracterizada por edema, eritema, alteração na morfologia normal, exsudato aquoso e sangramento de interesse mundial. O objetivo foi avaliar o efeito de duas pastas de dentes em pacientes jovens diagnosticados com gengivite na cidade de Cusco, Peru, em 2022. A pesquisa foi realizada em alunos da Faculdade de Economia da Universidade Nacional de San Antonio Abad em Cusco, todos diagnosticados com gengivite no mesmo ano. O estudo foi realizado sob um desenho experimental pré-teste pós-teste com dois grupos experimentais, cada um com n=15. Avaliados com o índice de placa de Löe & Silness e o índice gengival de Löe & Silness (IG). Os participantes foram orientados a escovar os dentes com a pasta de dentes três vezes ao dia, por um período de 2 semanas. Foi utilizado como instrumento de coleta de dados uma matriz de registro para medição antes e depois da aplicação do tratamento, na qual foram registrados os índices de placa e índice gengival de Löe & Silness. A maioria dos sujeitos do estudo apresentou gengivite moderada e um estado de higiene oral regular. Portanto, concluímos que a pasta de dentes aplicada no Grupo I foi mais eficaz na recuperação de pacientes com gengivite. A pasta de dentes com conteúdo de Ratania foi bem tolerada pelos participantes, não havendo nenhuma alteração alérgica nos tecidos bucais, portanto, não interrompendo o tratamento.
RESUMO
La gingivitis se ha definido como una inflamación de la encía caracterizada por edema, eritema, cambio de la morfología normal, exudado acuoso y hemorragia de interés mundial. El objetivo fue evaluar el efecto dos pastas dentales en pacientes jóvenes diagnosticados con gingivitis en la ciudad de CuscoPerú en el año 2022. La investigación se realizó en alumnos de la Facultad de Economía de la Universidad Nacional San Antonio Abad del Cusco todos ellos diagnosticados con gingivitis en el mismo año. El estudio se desarrolló bajo un diseño experimental pre-test post-test con dos grupos experimentales cada uno con n=15. Evaluados con el índice de placa de Löe & Silness y el índice gingival de Löe & Silness (IG). Los participantes fueron orientados a cepillar los dientes con el dentífrico tres veces al día, por un periodo de 2 semanas. Se utilizó como instrumento de recolección de datos una matriz de registro para la medición antes y después de aplicado el tratamiento en la cual se plasmaron los índices de placa e índice gingival de Löe & Silness. Resultó que los sujetos del estudio en su gran mayoría presentaron gingivitis moderada y un estado de higiene oral regular. Con lo cual concluimos que la pasta dental aplicada en el Grupo I resultó más efectiva en la recuperación de pacientes con gingivitis. El dentífrico con contenido de Ratania fue bien tolerado por los participantes, no existiendo ningún tipo de alteración de tipo alérgica en los tejidos bucales, por lo tanto, no interrumpió el tratamiento.
Gingivitis has been defined as an inflammation of the gum characterized by edema, erythema, change in normal morphology, watery exudate, and bleeding of global interest. The aim was to evaluate the effect of two toothpastes on young patients diagnosed with gingivitis in the city of Cusco, Peru in 2022. The research was conducted on students from the Faculty of Economics at the National University of San Antonio Abad in Cusco, all diagnosed with gingivitis in the same year. The study was carried out under a pre-test post-test experimental design with two experimental groups, each with n=15. Evaluated using the Löe & Silness plaque index and the Löe & Silness gingival index (GI). Participants were instructed to brush their teeth with the toothpaste three times a day for a period of 2 weeks. A data collection instrument was used, a record matrix for measurement before and after treatment application, where the Löe & Silness plaque and gingival indices were recorded. The study subjects mostly presented moderate gingivitis and a regular oral hygiene status. Therefore, we conclude that the toothpaste applied in Group I was more effective in the recovery of patients with gingivitis. The toothpaste containing Ratania was well tolerated by the participants, with no allergic tissue alterations in the oral tissues, thus not interrupting the treatment.
A gengivite foi definida como uma inflamação da gengiva caracterizada por edema, eritema, alteração na morfologia normal, exsudato aquoso e sangramento de interesse mundial. O objetivo foi avaliar o efeito de duas pastas de dentes em pacientes jovens diagnosticados com gengivite na cidade de Cusco, Peru, em 2022. A pesquisa foi realizada em alunos da Faculdade de Economia da Universidade Nacional de San Antonio Abad em Cusco, todos diagnosticados com gengivite no mesmo ano. O estudo foi realizado sob um desenho experimental pré-teste pós-teste com dois grupos experimentais, cada um com n=15. Avaliados com o índice de placa de Löe & Silness e o índice gengival de Löe & Silness (IG). Os participantes foram orientados a escovar os dentes com a pasta de dentes três vezes ao dia, por um período de 2 semanas. Foi utilizado como instrumento de coleta de dados uma matriz de registro para medição antes e depois da aplicação do tratamento, na qual foram registrados os índices de placa e índice gengival de Löe & Silness. A maioria dos sujeitos do estudo apresentou gengivite moderada e um estado de higiene oral regular. Portanto, concluímos que a pasta de dentes aplicada no Grupo I foi mais eficaz na recuperação de pacientes com gengivite. A pasta de dentes com conteúdo de Ratania foi bem tolerada pelos participantes, não havendo nenhuma alteração alérgica nos tecidos bucais, portanto, não interrompendo o tratamento.
Assuntos
Doenças PeriodontaisRESUMO
Background: Gingivitis is an inflammation of the gums that is the initial cause of the development of periodontal disease by the activity of Nuclear Factor-kappa B (NF-κB), Interleukin-1ß (IL-1ß), Interleukin-6 (IL-6), p38, and Tumor Necrosis Factor-α (TNF-α). Unaddressed chronic inflammation can lead to persistent disturbances in other parts of the body. Brazilin is a naturally occurring plant chemical that may have antibacterial and anti-inflammatory effects. Treatment based on the natural plant compound, brazilin, is developed in the form of a topical cream for easy application. Objective: The aim is to develop the natural compound brazilin in the form of a topical cream as an anti-inflammatory agent to reduce NF-κB expression through Imunohistochemistry (IHC) methods, and the expression of pro-inflammatory genes IL-1ß, IL-6, p38, and TNF-α. Methods: Male Sprague-Dawley rats were induced with gingivitis using P. gingivalis bacteria. The observed groups included rats treated with a single application of brazilin cream and rats treated with two applications of brazilin cream. The treatment was administered for 15 days. On days 3, 6, 9, 12, and 15, anatomical wound observations and wound histology using hematoxylin-eosin and Masson's Trichrome staining were performed. NF-κB protein expression was analyzed using the IHC method. Gingival inflammation gene expression of NF-κB, IL-1ß, IL-6, p38, and TNF-α was measured using q-RTPCR. Results: Single and double applications of brazilin cream increased angiogenesis and decreased NF-κB protein expression, in addition to the IL-1ß, IL-6, p38, and TNF-α gene expressions. Conclusion: In a rat gingivitis model, Brazilin cream may function as an anti-inflammatory agent in the gingival tissue.
Assuntos
Benzopiranos , Caesalpinia , Gengivite , NF-kappa B , Ratos Sprague-Dawley , Animais , Caesalpinia/química , Masculino , Ratos , Benzopiranos/farmacologia , Benzopiranos/administração & dosagem , Benzopiranos/uso terapêutico , NF-kappa B/metabolismo , Gengivite/tratamento farmacológico , Gengivite/patologia , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Doenças Periodontais/tratamento farmacológico , Interleucina-1beta/metabolismo , Interleucina-1beta/genética , Modelos Animais de Doenças , Fator de Necrose Tumoral alfa/metabolismo , Fator de Necrose Tumoral alfa/genética , Interleucina-6/metabolismo , Interleucina-6/genética , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismoRESUMO
Background: This study aimed to systematically review the literature regarding the inflammatory profiles, measured by cytokines and chemokines, of individuals with different diagnoses of weight, but with the similar periodontal condition. Materials and Methods: Searches were performed in five databases (Scopus, EMBASE, PubMed, Web of Science, and Cochrane-Central). Studies that compared the inflammatory profile of normal-weight individuals to those with obesity and evaluated the same cytokine, collection method, and periodontal diagnosis (periodontal health, gingivitis, or periodontitis) were included. Cross-sectional studies underwent evaluation by independent researchers using the Joanna Briggs Institute Critical Appraisal Checklist. The GRADE (Grades of Recommendation, Assessment, Development and Evaluation) system assessed evidence certainty. Results: Twelve studies were included. The diagnosis of obesity was done on the basis of body mass index, waist circumference, and waist-hip ratio. Pro-inflammatory cytokines (interleukin-6 [IL-6], tumor necrosis factor-α [TNF]-α, IL-1ß, IL-31, and IL-34) were analyzed in serum, saliva, gingival crevicular fluid (GCF), and plasma. Periodontal diagnoses varied across studies. TNF-α expression was significantly higher in individuals with obesity and periodontal health or periodontitis. Serum IL-1ß levels showed mixed results, but salivary IL-1ß levels were elevated in obese individuals. IL-6 levels were higher in obese individuals, regardless of periodontal status. IL-34 and IL-10 showed no significant differences across groups. Monocyte chemoattractant protein-4 (MCP-4) levels were higher in obese individuals with periodontitis or periodontal health. IL-31 and IL-34 in GCF showed no significant differences between obese and nonobese individuals, without periodontitis. Conclusions: Heterogeneous results were noted for IL-6, IL-1ß, IL-31, IL-34, TNF-α, and MCP-4, hindering conclusions on weight's impact on inflammatory profiles in periodontal patients.
RESUMO
OBJECTIVE: To explore the association between hygiene knowledge and habits and gingivitis in Puerto Rican school children. METHODS: Questionnaires on oral health knowledge and hygiene habits were provided to almost half of the 12-year-olds who participated in an island-wide cross-sectional oral health study. The evaluations included gingival examinations in 2 quadrants. Odds ratios (ORs) (with 95% CIs) were computed using logistic regression models and oral health-related knowledge and hygiene habits to gingivitis. RESULTS: Of the 823 participants who completed the questionnaire 53.43% were female, and 81% had gingivitis. Most reported having received instructions on brushing (98%), flossing (89.5%), and using mouthwash (90%). The majority (75%) rated their gums as healthy, and 44.68% agreed that oral health affects general health. Nearly half (44%) reported brushing their teeth at least 2 times a day, and 80.25%, flossing daily. In multivariate analysis, not having been instructed on how to brush was related to greater odds of having gingivitis (OR: 7.32; 95% CI: 1.5-35.67). Flossing more than once a day was associated with half the odds of gingivitis (OR: 0.50; 95% CI: 0.29-0.88). CONCLUSION: The children had knowledge of oral hygiene methods but were mostly unaware that gingival health could affect systemic health. Fewer than half reported brushing 2 or more times a day. Not having been instructed on how to brush was associated with higher odds of gingivitis.
Assuntos
Gengivite , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino , Saúde Bucal , Higiene Bucal , Humanos , Estudos Transversais , Feminino , Criança , Masculino , Higiene Bucal/estatística & dados numéricos , Gengivite/epidemiologia , Saúde Bucal/estatística & dados numéricos , Inquéritos e Questionários , Hispânico ou Latino/estatística & dados numéricos , Porto Rico , Escovação Dentária/estatística & dados numéricos , Modelos LogísticosRESUMO
OBJECTIVES: To evaluate, (i) if subjects submitted to a structured oral hygiene training program (OHt) maintain adopted habits over 180 days without professional guidance; and (ii) in perspective whether flossing provides additional benefits to toothbrushing on gingival health. MATERIALS AND METHODS: Seventy-five adult subjects showing approximately 40% proximal gingival bleeding were randomized to receive OHt (1 session weekly over 8 weeks) using toothbrush and dental floss or toothbrush alone. The subjects were then followed over 180 days without professional guidance. Primary outcomes were mean interproximal Gingival Index (GI) and GI = 2 (gingival bleeding). Mixed linear models were used for the comparison between groups (p < 0.05). RESULTS: 68 subjects received OHt, 48 subjects completed the 180-day follow-up. Subjects maintained adequate oral hygiene routines. Besides a reduction in gingival inflammation, no alterations in gingival status were observed among groups, subjects additionally instructed to use dental floss showing a mean interproximal GI = 2 of 12.8 ± 2.5 compared with 19.8 ± 2.2 for subjects limited to tooth brushing alone. CONCLUSIONS: OHt intensive training promotes gingival health and maintenance lasting at least 6 months without professional supervision reinforcing important principles: (i) dental health professionals should dedicate time training and motivating their patients to reach adequate self-performed plaque control; and (ii) the adjunctive use of dental floss appears essential to reduce interproximal gingival inflammation in subjects with intact interdental papillae. CLINICAL RELEVANCE: Dentists need to invest time in training/motivating/engage their patients to achieve adequate OH; adjunct flossing in subjects with papilla filling the interdental space appears essential to reach and maintain gingival health. CLINICALTRIALS: GOV : (53831716.5.0000.5346). TRIAL REGISTRATION: The protocol registration was filed May 9, 2018 (# 538,311,716.5.0000.5346) on ClinicalTrials.gov. An NCT number (NCT04909840) was generated upon completed registration.
Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Humanos , Feminino , Masculino , Adulto , Seguimentos , Higiene Bucal/educação , Índice Periodontal , Escovação Dentária , Pessoa de Meia-Idade , Gengivite/prevenção & controle , Gengivite/terapia , Resultado do TratamentoRESUMO
Periodontal disease is a highly prevalent chronic inflammatory disease that affects the tissues that support the teeth, while leukemia is a type of malignous cancer that affects the production of blood cells. Recent studies suggest that immune response and microbial disbiosis related to periodontal disease may be associated with an increased risk of developing leukemia and may affect its prognosis, as well as leukemia type and treatment may also have effects on the periodontium, demanding a interdiscipinary approach of these patients. The aim of this study was to conduct a literature review to assess the association between periodontal disease and leukemia in adult patients. An electronic database serch using the descriptors was performed. Clinical studies with periodontal examination in adult individuals with leukemia were selected. After literature search, 9 studies were reviewed. Gingival bleeding and periodontal pockets were frequent findings. Periodontitis prevalence varied among studies, ranging from 29% to 82,4% in patients diagnosed with leukemia. The relationship between periodontal disease and leukemia is complex and multifaceted and there are few studies available in adults, with heterogeneous exam protocols. Still, the high prevalence of gingivitis and periodontitis found in the studies suggest that periodontal diagnosis and treatment could be a helpful tool to prevent further complications in leukemia treatment.
A doença periodontal é uma doença inflamatória crônica altamente prevalente e que afeta os tecidos que sustentam os dentes, enquanto a leucemia é um tipo de câncer maligno que afeta a produção de células sanguíneas. Estudos recentes sugerem que a resposta imune e a disbiose microbiana relacionada a doença periodontal podem estar associadas a um risco aumentado de desenvolver leucemia e pode afetar o prognóstico da doença, assim como o tipo de leucemia e o tratamento também podem ter efeitos no periodonto, exigindo uma abordagem interdisciplinar desses pacientes. O objetivo deste estudo foi realizar uma revisão de literatura para avaliar a associação entre doença periodontal e leucemia em pacientes adultos. Foi realizada uma busca eletrônica em bancos de dados utilizando os descritores. Foram selecionados estudos clínicos com exame periodontal em indivíduos adultos com leucemia. Após busca na literatura, 9 estudos foram revisados. Sangramento gengival e bolsas periodontais foram achados frequentes. A prevalência da periodontite variou entre os estudos, sendo de 29% a 82,4% em pacientes diagnosticados com leucemia. A relação entre doença periodontal e leucemia é complexa e multifacetada e existem poucos estudos disponíveis em adultos, com protocolos de exames heterogêneos. Ainda assim, a alta prevalência de gengivite e periodontite encontrada nos estudos sugere que o diagnóstico e o tratamento periodontal podem ser uma ferramenta útil para prevenir maiores complicações no tratamento da leucemia.
Assuntos
Doenças Periodontais , Periodontite/epidemiologia , Leucemia , Adulto , Gengivite/epidemiologiaRESUMO
Introducción: La odontología holística es parte de la medicina biológica o neurofocal, dirigida a la prevención, el diagnóstico y el tratamiento relacionados con las enfermedades del sistema estomatognático en correlación con otras estructuras anatómicas, a fin de tratar al paciente de manera integral, en cuerpo, mente y alma. Objetivo: Identificar la presencia de gingivitis crónica y de otros campos de interferencia en pacientes con artritis del hombro. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 24 pacientes con artritis del hombro, pertenecientes al área de salud del Policlínico Docente Carlos Juan Finlay en Santiago de Cuba, quienes fueron atendidos en la Clínica Estomatológica Provincial Docente Mártires del Moncada, desde noviembre del 2021 hasta mayo del 2022. Resultados: En la serie predominaron el sexo femenino (62,5 %) y el grupo etario de 35-59 años (75,0 %). De igual modo, la mayoría de los pacientes padecía gingivitis crónica (87,5 %), en tanto, los otros campos de interferencia mayormente hallados fueron la placa dentobacteriana (100 %) y la caries dental (58,3 %), que figuraron en todos los molares según el holograma del microsistema de dientes alemán. Conclusiones: Los campos de interferencia identificados con más frecuencia en la casuística fueron la gingivitis crónica grave, la placa dentobacteriana y la caries dental, los cuales estuvieron asociados a la artritis del hombro que aquejaba a los pacientes.
Introduction: Holistic dentistry is part of the biological or neurofocal medicine, directed to the prevention, diagnosis and treatment related to the diseases of the stomatognatic system in correlation with other anatomical structures, in order to treat the patient in an integral way, in body, mind and soul. Objective: To identify the presence of chronic gingivitis and other interference fields in patients with shoulder arthritis. Methods: An observational, descriptive and cross-sectional study of 24 patients with shoulder arthritis was carried out, who belonged to the health area of Carlos Juan Finlay Teaching Polyclinic in Santiago de Cuba. They were assisted in Mártires del Moncada Teaching Provincial Stomatological Clinic, from November, 2021 to May, 2022. Results: In the series there was a prevalence of the female sex (62.5%) and the 35-59 age group (75.0%). In a same way, most of the patients suffered from chronic gingivitis (87.5%), as long as the other mostly found interference fields were the dentobacterial plaque (100%) and dental cavity (58.3%) that were in all the molars according to the hologram of the German teeth microsystem. Conclusions: Severe chronic gingivitis, dentobacterial plaque and dental cavity were the most frequently identified interference fields in the case material, which were associated to the shoulder arthritis in patients.
RESUMO
El objetivo del artículo es reportar el desempeño clínico en el control y disminución de la placa bacteriana en pacientes adolescentes mediante un gel y barniz con partículas S-PRG. Se realizaron tratamientos con materiales bioactivos con tecnología GIOMER en 2 pacientes. En el primer caso se realizó una profilaxis con Pro Care Gel (S-PRG) en un paciente de 15 años con problemas neuromotores para eliminar la placa y posteriormente, se aplicó un barniz con partículas de S-PRG para prevenir la formación de biofilm. En el segundo caso, un adolescente de 15 años normoreactivo con inflamación gingival recibió el tratamiento profilaxis con PRG Pro Care Gel.Se observó una disminución de placa bacteriana tras la profilaxis con el gel Pro Care y la aplicación del barniz en el primer caso. Además, existió una baja incidencia de biofilm incluso después de 11 meses de la aplicación del barniz. En el segundo caso, a las 2 horas de aplicación, se observó una disminución total de la placa. Clínicamente se observó el bueno desempeño clínico de los materiales con partículas de S-PRG, como lo demuestra la literatura científica en cuanto a la reducción de la formación de placa bacteriana en las estructuras dentarias, la desinflamación gingival, proporciona bienestar a los pacientes y restaura la salud bucal de forma menos invasiva.
The objective of the article is to report the clinical performance in the control and reduction of bacterial plaque in adolescent patients using a gel and varnish with S-PRG particles. Treatments with bioactive materials with GIOMER technology were performed in two patients. In the first case, prophylaxis was performed with Pro Care Gel (S-PRG) in a 15-year-old patient with neuromotor problems to eliminate plaque and subsequently, a varnish with S-PRG particles was applied to prevent biofilm formation. In the second case, a normal 15-year-old adolescent with gingival inflammation received prophylaxis treatment with PRG Pro Care Gel. A decrease in bacterial plaque was observed after prophylaxis with the Pro Care gel and the application of the varnish in the first case. Furthermore, there was a low incidence of biofilm even after 11 months of varnish application. In the second case, after 2 hours of application, a total decrease in plaque was observed. The good clinical performance of materials with S-PRG particles was clinically perceived, as demonstrated by the scientific literature in terms of reducing the formation of bacterial plaque in dental structures, gingival disinflammation, providing well-being to patients and restoring oral health in a less invasive way.
RESUMO
OBJECTIVE: To compare dental caries, oral hygiene, periodontal status, bruxism, malocclusion, tooth loss, and salivary alterations between autistic and typical developing individuals. MATERIAL AND METHODS: Observational studies presenting clinical measures of oral outcomes between autism spectrum disorder (ASD) individuals and controls. EMBASE, LILACS, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 26, 2023. Pairs of reviewers independently conducted study selection, data extraction, and assessments of methodological quality and certainty of evidence. Meta-analyses of standardized mean differences (SMD) and risk ratio (RR) were performed. RESULTS: A total of 47 studies comprising 6885 autistic individuals were included in the review. Autistic individuals had significantly higher severity of dental-caries experience in primary teeth (SMD 0.29, 95%CI 0.02, 0.56), of dental plaque presence (SMD 0.59, 95%CI 0.24, 0.94), and of gingivitis (SMD 0.45, 95%CI 0.02, 0.88). Autistic individuals showed higher probability of occurrence of gingivitis (RR 1.34, 95%CI 1.08, 1.66,), bruxism (RR 4.23, 95%CI 2.32, 7.74), overjet (RR 2.16, 95%CI 1.28, 3.64), overbite (RR 1.62, 95%CI 1.02, 2.59), crossbite (RR 1.48, 95%CI 1.02, 2.13), and openbite (RR 2.37, 95%CI 1.46, 3.85), when compared to neurotypical individuals. Most estimates showed a small effect size with very low certainty of evidence. CONCLUSION: Autistic individuals show worse oral health status than controls. CLINICAL RELEVANCE: The findings reported herein can help to build health policies to better serve autistic individuals including prevention actions and access to specialized dental care.
Assuntos
Estudos Observacionais como Assunto , Humanos , Saúde Bucal , Má Oclusão , Cárie Dentária/epidemiologia , Transtorno do Espectro Autista , Bruxismo , Higiene Bucal , Perda de DenteRESUMO
BACKGROUND: Down syndrome (DS) is distinguished by cognitive disability, a concave profile, and systemic complications. Oral diseases have been reported to be common in DS patients. OBJECTIVE: To investigate the association between DS and periodontal diseases. METHODS: Two independent reviewers searched six bibliographic databases up to January 2023 and used additional search methods to identify published studies on gingivitis or periodontitis in people with and without DS. Meta-analysis, risk of bias, sensibility analysis, publication bias, and evidence grading were all carried out. RESULTS: Twenty-six studies were included for analysis. There was a tendency for increased plaque accumulation, periodontal probing, periodontal attachment level, bleeding on probing and indices in DS individuals. Meta-analysis of 11 studies showed a significant association between DS and periodontitis (OR 3.93; 95% CI 1.81-8.53). Probing depth was significantly high in individuals with DS as compared to controls (mean difference 0.40 mm; 95% CI 0.09-0.70). Gingivitis was significantly associated (OR 1.93; 95% CI 1.09-3.41) with DS in four studies. The evidence was classified as 'moderate certainty'. CONCLUSION: Medium/low-quality studies demonstrate that Down syndrome is strongly associated with periodontitis and moderately associated with gingivitis.
Assuntos
Placa Dentária , Síndrome de Down , Gengivite , Doenças Periodontais , Periodontite , Humanos , Síndrome de Down/complicações , Síndrome de Down/epidemiologia , Doenças Periodontais/complicações , Doenças Periodontais/epidemiologia , Gengivite/complicações , Gengivite/epidemiologiaRESUMO
INTRODUCTION: Studies evaluating smoking and periodontal status show controversial results regarding the impact on oral health-related quality of life (OHRQol). The aim was to evaluate the association between OHRQol and periodontal status in patients according to their smoking habit. METHODS: Cross-sectional study with a total of 100 patients (31.44 ± 8.50 years, 55% females) answered the short version of Oral Health Impact Profile (OHIP-14) and underwent a periodontal examination. Associations between periodontal status and total mean OHIP-14 scores related with smoking habit were analysed with Kruskal-Wallis test. RESULTS: Mean percentage of sites with Bleeding on Probing (BOP), Clinical Attachment Loss (CAL) and Number of Teeth were significantly different between current smokers (n = 53) and never (n = 40) or former smokers (n = 7; p < 0.05). There was no significant difference for Periodontal Probing Depth (PPD) in relation to smoking status. A total mean OHIP-14 score of 13.07 was observed for the entire sample. The corresponding total mean OHIP-14 scores, for current smokers, never smokers and former smokers, were 15, 10 and 13 (p = 0.280), respectively. The domains social disability and handicap of the OHIP-14 were worse in current smokers (p = 0.028 and p = 0.026, respectively). CONCLUSION: Current smoking was associated with a negative influence on OHRQoL in the domain of social disability and handicap. In addition, smokers have worse periodontal status, related to less BOP, greater CAL and fewer teeth than never and former smokers.
Assuntos
Qualidade de Vida , Fumar , Feminino , Humanos , Masculino , Estudos Transversais , Inquéritos e Questionários , Saúde BucalRESUMO
AIM: To compare individuals with a periodontitis background (Grade C, stage III/IV-formerly generalized aggressive periodontitis) (H-GAP) with periodontally healthy subjects (H-Health) in terms of molecular changes (immunological/microbiological) accompanying experimental peri-implant mucositis and gingivitis. MATERIALS AND METHODS: H-GAP and control (H-Health) subjects were recruited, and experimental mucositis/gingivitis was induced around a single screw-retained implant and one contralateral tooth. Participants refrained from oral hygiene for 21 days in the selected areas, followed by professional prophylaxis and hygiene instructions for 21 days. Clinical parameters, immunological markers (multiplex analysis) and microbial data (16S rRNA gene sequencing) were collected at baseline, during induction (7, 14 and 21 days) and following remission (42 days). RESULTS: Clinically, no significant differences were observed between the groups (n = 10/each group) (H-GAP vs. H-Health) (p > .05, Mann-Whitney test) and the type of site (tooth vs. implant) (p > .05, Wilcoxon test) at the time of onset and resolution, or severity of gingival/mucosal inflammation. H-GAP displayed lower concentrations of the cytokines interleukin (IL)-1B, IL-4, IL-17, tumor necrosis factor-α and interferon-γ around implants than H-Health at baseline and during induction of mucositis (p < .05, Mann-Whitney test). In both groups, implants showed significantly higher inflammatory background at baseline and all subsequent visits when compared with teeth (p < .05, Wilcoxon test). Alpha and ß-diversity metrics showed a significant shift in the microbiome composition and abundances of core species during induction and resolution of peri-implant mucositis and gingivitis (p < .05, restricted maximum likelihood method of Shannon and Bray-Curtis indices, respectively). Differences were not significant for these parameters between the H-Health and H-GAP groups when the periodontal and peri-implant microbiomes were compared separately; however, at each time point, the peri-implant microbiome differed significantly from the periodontal microbiome. CONCLUSIONS: Within the limitations of this pilot study (e.g. low power), it can be concluded that different microbial shifts contribute to the onset and progression of inflammatory responses around teeth and implants and that history of periodontal disease experience plays an additional role in modulating the immune response of peri-implant and periodontal tissues to biofilm accumulation.
Assuntos
Periodontite Agressiva , Implantes Dentários , Gengivite , Mucosite , Peri-Implantite , Humanos , Mucosite/etiologia , Projetos Piloto , RNA Ribossômico 16S/genética , Implantes Dentários/efeitos adversos , Implantes Dentários/microbiologia , Peri-Implantite/microbiologia , Gengivite/microbiologiaRESUMO
BACKGROUND: Periodontal disease is a biofilm-dependent chronic inflammatory condition triggered by a host response. Several factors impact systemic inflammation and could lead to changes in disease pathogenesis. Recently, studies have assessed the influence of nutritional patterns on the development of periodontitis. In the present cross-sectional study, we evaluated the dietary inflammatory profile on periodontal conditions, focusing on clinical, subgingival microbial, and cytokine assessment of individuals with periodontal health or gingivitis. METHODS: One hundred patients with periodontal health or gingivitis were included. Plaque index (PI), Bleeding on probing (BoP), the probing depth (PD), and the clinical attachment level (CAL) for each patient were assessed. Nutritional data and the Dietary Inflammatory Index (DII) were recorded by two 24-h food recalls on non-consecutive days. Biofilm and gingival crevicular fluid (GCF) to assess the microbiome profile and inflammatory biomarkers were collected. Multiple regressions focused on the DII, age, and sex as predictors of periodontal conditions were done. RESULTS: Age and moderate DII scores increased the risk of gingivitis by 1.64 and 3.94 times, respectively. Males with an elevated DII score had 27.15 times higher odds of being diagnosed with gingivitis and BoP (ß = 6.54; p = 0.03). Elderly patients with a moderate or high DII score were less prone to gingivitis and increased BoP (p < 0.04) compared with younger subjects. Considering the DII, there were no differences in microbial alpha and beta diversity; however, distinct species abundance and a higher concentration of monocyte-chemoattractant protein-1 and interleukin 33 were seen in patients with a higher DII. CONCLUSION: A pro-inflammatory diet significantly contributes to periodontal inflammation, modulating inflammatory biomarkers and affecting the subgingival microbial community in healthy individuals.
Assuntos
Biofilmes , Dieta , Líquido do Sulco Gengival , Gengivite , Índice Periodontal , Humanos , Masculino , Feminino , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Líquido do Sulco Gengival/química , Fatores Etários , Índice de Placa Dentária , Microbiota , Citocinas/análise , Perda da Inserção Periodontal , Fatores Sexuais , Bolsa Periodontal , Biomarcadores/análise , Inflamação , Idoso , Adulto JovemRESUMO
Introducción: Existen datos controversiales y pocas revisiones acerca del efecto de los enjuagues herbales como complemento en la higiene bucal de pacientes con enfermedad periodontal. La reducción en costos y efectos secundarios de estos enjuagues, en comparación con los convencionales, los colocan en una posición prometedora para el cuidado de la salud. Objetivo: Comparar el efecto de los enjuagues bucales convencionales con los enjuagues herbales en la mejora de los siguientes parámetros periodontales: índice gingival, de placa, sangrado al sondaje, profundidad al sondaje y nivel de adherencia clínica en pacientes adultos con gingivitis o periodontitis. Métodos: Se realizó la revisión en las bases de datos MEDLINE/PubMed, Scopus, Web of Science, BVS y EBSCO, para identificar ensayos clínicos donde se comparen enjuagues bucales comerciales vs. herbales, publicados entre 2018 y 2022. Siguiendo las recomendaciones PRISMA, se utilizó el sistema PICO para determinar la pregunta clínica y una ecuación de búsqueda con criterios de elegibilidad. Resultados: De 485 estudios identificados inicialmente se analizaron 25 ensayos clínicos, de los cuales la mayoría se realizaron en la India (11) y en pacientes sin problemas sistémicos (23). Las muestras evaluadas fueron desde 19 hasta 318 sujetos, con edades comprendidas entre 18 y 74 años. El menor tiempo de seguimiento fue de siete días y el mayor de 180 días. Con respecto a los enjuagues evaluados, 20 ensayos usaron clorhexidina y 18 enjuagues a base de plantas herbáceas. Así mismo, seis estudios reportaron efectos adversos y tres reportaron conflictos de interés. Conclusiones: Los aceites esenciales combinados con curcumina redujeron el índice de placa en mayor medida que el enjuague de clorhexidina, que es el estándar dorado. Así mismo, la mayoría de los enjuagues herbales estudiados tuvieron un efecto similar a este último para mejorar los parámetros periodontales(AU)
Introduction: There are controversial data and few reviews about the effect of herbal rinses as an adjunct in oral hygiene in patients with periodontal disease. The reduction in costs and side effects of these rinses, in comparison with conventional rinses, place them in a promising position for health care. Objective: To compare the effect of conventional mouthwashes with herbal rinses in the improvement of the following periodontal parameters: gingival index, plaque index, bleeding on probing, probing depth and level of clinical adherence in adult patients with gingivitis or periodontitis. Methods: A review was performed in MEDLINE/PubMed, Scopus, Web of Science, BVS and EBSCO databases to identify clinical trials comparing commercial vs. herbal mouthrinses, published between 2018 and 2022. Following PRISMA recommendations, the PICO system was used to determine the clinical question and a search equation with eligibility criteria. Results: Out of 485 studies initially identified, 25 clinical trials were analyzed, of which the majority were conducted in India (11) and in patients without systemic problems (23). The samples evaluated ranged from 19 to 318 subjects, aged 18-74 years. The shortest follow-up time was seven days and the longest was 180 days. Regarding the rinses evaluated, 20 trials used chlorhexidine and 18 used herbal rinses. Also, six studies reported adverse effects and three reported conflicts of interest. Conclusions: Essential oils combined with curcumin reduced plaque index to a greater extent than the gold standard chlorhexidine rinse. Most of the herbal rinses studied had a similar effect to the latter in improving periodontal parameters(AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Higiene Bucal , Doenças Periodontais , Óleos Voláteis , Atenção à Saúde , Gengivite , Antissépticos Bucais , Padrões de Referência , Índice Periodontal , Custos e Análise de CustoRESUMO
Abstract This study aimed to estimate the prevalence and extent of bleeding on probing and calculus in 12-year-old schoolchildren of Quito, Ecuador, and evaluate the associated factors. We conducted an epidemiological survey with a representative sample of 1,100 12-year-old schoolchildren from public schools in the urban area of Quito, Ecuador. We assessed the periodontal health using the Community Periodontal Index (CPI). The prevalence and extent of the periodontal condition was based on the presence of at least one site with bleeding on probing (BOP), and the presence of dental calculus was also evaluated. We used univariate and multiple multilevel Poisson regression analyses to verify the association between the independent variables and the number of sextants with BOP and calculus. The prevalence of BOP and calculus was 92% and 69.9%, respectively. The adjusted mean of the affected sextants was 4.3 and 2.2 for BOP and calculus, respectively. The mother's schooling and malocclusion were associated with the number of sextants with bleeding. The mother's schooling and dental caries experience were associated with calculus. Gingival bleeding and the presence of dental calculus are highly prevalent in 12-year-old schoolchildren from Quito. Gingival bleeding is associated with maternal education and malocclusion, and dental calculus is associated with maternal education and dental caries.
RESUMO
Abstract The prevalence of gingivitis is substantial within the general population, necessitating rigorous oral hygiene maintenance. Objective This study assessed a Garcinia indica (GI) fruit extract-based mouthrinse, comparing it to a 0.1% turmeric mouthrinse and a 0.2% Chlorhexidine (CHX) mouthrinse. The evaluation encompassed substantivity, staining potential, antimicrobial efficacy and cytocompatibility. Methodology The study employed 182 tooth sections. For antimicrobial analysis, 64 extracted human teeth coated with a polymicrobial biofilm were divided into four groups, each receiving an experimental mouthrinse or serving as a control group with distilled water. Microbial reduction was assessed through colony forming units (CFU). Substantivity was evaluated on 54 human tooth sections using a UV spectrophotometer, while staining potential was examined on 64 tooth sections. Cytocompatibility was tested using colorimetric assay to determine non-toxic levels of 0.2% GI fruit extract, 0.1% Turmeric, and 0.2% CHX. Results Data were analysed with one-way ANOVA (α=0.05). Cell viability was highly significant (p<0.001) in the 0.2% GI group (64.1±0.29) compared to 0.1% Turmeric (40.2±0.34) and 0.2% CHX (10.95±1.40). For antimicrobial activity, both 0.2% GI (20.18±4.81) and 0.2% CHX (28.22±5.41) exhibited no significant difference (P>0.05) at end of 12 hours. However, 0.1% Turmeric showed minimal CFU reduction (P<0.001). Substantivity results at 360 minutes indicated statistically significant higher mean release rate in 0.1%Turmeric (12.47±5.84 ) when compared to 0.2% GI (5.02±3.04) and 0.2% CHX (4.13±2.25) (p<0.001). The overall discoloration changes (∆E) were more prominent in the 0.2% CHX group (18.65±8.3) compared to 0.2% GI (7.61±2.4) and 0.1% Turmeric (7.32±4.9) (P<0.001). Conclusion This study supports 0.2% GI and 0.1% Turmeric mouth rinses as potential natural alternatives to chemical mouth rinses. These findings highlight viability of these natural supplements in oral healthcare.
RESUMO
BACKGROUND: Probiotics can compete with periodontal pathogens in the formation of dental biofilm, and they are able to modulate local and systemic immune responses. Thus, its use in diabetic patients with periodontal disease (PD) can overcome the limitations of conventional periodontal treatment. OBJECTIVE: This scoping review aimed to understand the extent and type of evidence in relation to the effects of probiotic therapy on periodontal and glycaemic parameters of diabetic patients with PD. METHODS: An electronic search was performed in the following databases: Cochrane Library, EMBASE, Virtual Health Library (including LILACS and BBO), PubMed (including Medline), Scopus, Web of Science, and Google Scholar. The review included clinical trials on patients with type 2 diabetes, diagnosed with gingivitis or periodontitis, who received probiotic therapy as a single therapy or adjuvant to scaling and root planning, and on whom the analyses of clinical periodontal, immunological, microbiological, or glycaemic parameters were performed. RESULTS: The electronic search yielded a total of 1165 articles. After removing duplicate titles and performing systematic screening, 6 studies were included in the qualitative summary. Probiotic administration improved clinical periodontal parameters (bleeding on probing and probing depth), oxidative stress markers, and inflammatory cytokines (IL-8, IL-10, and TNF-α) in relation to control groups. Experimental groups were also more advantageous in reducing the frequency of periodontopathogenic bacteria. However, the evidence of probiotics in decreasing glycated hemoglobin is still uncertain. CONCLUSION: Probiotics may provide safe additional benefits to periodontal parameters of patients with type 2 diabetes and periodontal disease.
RESUMO
BACKGROUND: Oral care regimens can be explored to improve oral health in patients with gingivitis. This study aimed to evaluate the efficacy of a multicomponent oral care regimen with a dual zinc plus arginine (DZA) toothpaste and cetylpyridinium chloride with zinc lactate (CPC + Zn) mouthwash in reducing gingival bleeding in patients with gingivitis. METHODS: This randomized clinical trial included 94 participants with gingivitis who were randomized into two groups: the DZA/CPC + Zn group, which used a 1450-ppm fluoride toothpaste containing 0.96% zinc plus 1.5% arginine and a fluoride-containing mouthwash with 0.075% CPC and 0.28% zinc lactate, and the control group, which used a 1450-ppm fluoride toothpaste and a placebo mouthwash for 6 months. All participants were examined by a blinded examiner who measured the gingival index, plaque index, and gingival severity index. Data were analyzed using paired t test, independent t test, and analysis of covariance (ANCOVA). RESULTS: Both groups presented statistically significant reductions in all clinical parameters compared to baseline. The DZA/CPC + Zn group exhibited significantly greater reductions in gingival index, gingival severity index, proximal gingival index, plaque index and proximal plaque index compared to the control group at 1, 3, and 6 months. Furthermore, DZA/CPC + Zn significantly decreased the percentage of patients with generalized gingivitis over a 6-month follow-up period. However, differences between the DZA/CPC + Zn and the control groups were not maintained after both groups established similar regimens with fluoride toothpaste. CONCLUSION: The multicomponent oral care regimen consisting of DZA toothpaste and CPC + Zn mouthwash is effective in reducing gingival inflammation and supragingival biofilm in patients with gingivitis.