RESUMO
Cardiovascular diseases (CVD) are highly prevalent non-communicable diseases worldwide. Periodontitis may act as a non-traditional cardiovascular risk (CVR) factor, linked by a low-grade systemic inflammation mediated by C-reactive protein (CRP). Patients with periodontitis reported higher serum CRP levels; however, a CRP systemic and periodontal correlation in gingival crevicular fluid (GCF) and its CVR impact have been barely studied. We aimed to assess the association between periodontal diseases and CVR in a group of adult women, based on serum high-sensitivity CRP (hs-CRP) levels; and secondly, to determine the association between serum and GCF CRP levels. Gingival crevicular fluid and blood samples were obtained from women with periodontitis, gingivitis, and healthy controls. Serum and GCF CRP were determined by turbidimetric method and Luminex technology, respectively. Data were analyzed and adjusted by CVR factors. All women presented moderate CVR, without an evident association between serum hs-CRP levels and periodontal diseases. While serum hs-CRP concentrations did not significantly differ between groups, patients with gingivitis and periodontitis showed higher CRP levels in GCF, which positively correlated to CRP detection in serum.
Assuntos
Proteína C-Reativa/biossíntese , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/complicações , Doenças Periodontais/sangue , Doenças Periodontais/complicações , Adolescente , Adulto , Estudos Transversais , Feminino , Gengiva/metabolismo , Líquido do Sulco Gengival/metabolismo , Gengivite/sangue , Gengivite/complicações , Humanos , Nefelometria e Turbidimetria , Periodontite/sangue , Periodontite/complicações , Medição de Risco , Fatores de RiscoRESUMO
The objective of the present study was to establish if individuals with Diabetes Mellitus (DM2) and periodontal diseases (gingivitis or periodontitis) presented an increase in the concentration of modified LDL (moLDL) and what is the influence of periodontal treatment on the decrease of moLDL particles with consequent improvement in the parameters of DM2. Twenty-four diabetic patients with periodontitis (Group 1) and twenty-four diabetic patients with gingivitis (Group 2) were followed up for a period of 12 months. Group 1 was treated with periodontal debridement, and Group 2 received supra-gingival scaling and prophylaxis. In both groups, periodontal clinical parameters: probing depth (PD), clinical attachment level (CAL), gingival resection (GR), bleeding on probing index (BOP) and plaque index; inflammatory serum markers (glycemia, A1c, total cholesterol, HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c), triglycerides and hs-CRP) and oxidized LDL (oxLDL) were measured at baseline, t = 6 and t = 12 months after treatment. Solutions of LDL were analyzed using the nonlinear optical Z-Scan and optical absorption techniques. The periodontal clinical parameters showed significant improvement (p < 0.05) in both Group after 12 months. For both groups, total cholesterol, HDL-c, LDL-c, triglycerides and A1c levels did not show significant reductions after periodontal therapy. hs-CRP levels in Group 1 presented a significant reduction after 12 months. The glycemic rate and the oxLDL concentrations did not show significant differences as a function of time. The optical measurements of LDL solutions revealed an improvement of the LDL-c quality in both groups. Periodontal debridement was able to improve periodontal parameters and the quality of LDL-c in diabetic patients but without changes in the oxLDL concentration in both groups. Considering the clinical relevance, the reduction of infectious and inflammatory sites present in the oral cavity through periodontal therapy may help with the control and prevention of hyperglycemia and precursors of cardiovascular diseases.
Assuntos
Glicemia/análise , Doenças Cardiovasculares/sangue , Colesterol/sangue , Diabetes Mellitus Tipo 2/complicações , Gengivite/complicações , Hemoglobinas Glicadas/análise , Lipoproteínas/sangue , Periodontite/complicações , Triglicerídeos/sangue , Biomarcadores/sangue , Doenças Cardiovasculares/prevenção & controle , Índice de Placa Dentária , Raspagem Dentária , Diabetes Mellitus Tipo 2/sangue , Gengivite/sangue , Gengivite/cirurgia , Gengivite/terapia , Humanos , Inflamação , Lipoproteínas LDL/sangue , Estresse Oxidativo , Perda da Inserção Periodontal/sangue , Perda da Inserção Periodontal/complicações , Desbridamento Periodontal , Índice Periodontal , Periodontite/sangue , Periodontite/terapiaRESUMO
Abstract Obesity is considered a risk factor for periodontal health due to the low- grade inflammation promoted by the increased adipose tissue. Objective: This study aimed to determine correlations and associations between gingival inflammation (Simplified Oral Hygiene Index, and Gingival Index), salivary immunoglobulin A (s-IgA), and salivary parameters (salivary flow and osmolality) in normal-weight and overweight/obese children. Material and Methods: Ninety-one children, aged 6 to 12 years old (8.6±1.9 years), were divided into two groups according to their body mass index (BMI), circumferences, skinfold measurements and body fat percentage: normal- weight group (NWG; n =50) and overweight/obese group (OG; n =41). A calibrated examiner performed the clinical examination using the Simplified Oral Hygiene Index, Gingival Index, and salivary collection. Data analysis included descriptive statistics and association tests ( p <0.05). Results: OG presented statistically higher s-IgA values compared with NWG, especially among the obese children ( p <0.05). Significant positive correlations between s-IgA and salivary osmolality in OG ( p <0.05), and between s-IgA and BMI values ( p <0.05) and body fat percentage ( p <0.05) were observed among all the children. Effect size varied from moderate for s-IgA values ( d =0.57) to large for BMI ( d =2.60). Conclusion: Gingival inflammation and salivary parameters were similar for NWG and OG; however, s-IgA presented higher values in OG, with correlations between BMI and body fat percentage.
Assuntos
Humanos , Animais , Masculino , Feminino , Criança , Saliva/metabolismo , Índice de Massa Corporal , Sobrepeso/sangue , Obesidade Infantil/sangue , Gengivite/sangue , Valores de Referência , Estudos de Casos e Controles , Modelos Lineares , Índice Periodontal , Tecido Adiposo/metabolismo , Estudos Transversais , Fatores de Risco , Estatísticas não Paramétricas , Sobrepeso/complicações , Obesidade Infantil/complicações , Gengivite/etiologiaRESUMO
Obesity is considered a risk factor for periodontal health due to the low- grade inflammation promoted by the increased adipose tissue. OBJECTIVE: This study aimed to determine correlations and associations between gingival inflammation (Simplified Oral Hygiene Index, and Gingival Index), salivary immunoglobulin A (s-IgA), and salivary parameters (salivary flow and osmolality) in normal-weight and overweight/obese children. MATERIAL AND METHODS: Ninety-one children, aged 6 to 12 years old (8.6±1.9 years), were divided into two groups according to their body mass index (BMI), circumferences, skinfold measurements and body fat percentage: normal- weight group (NWG; n =50) and overweight/obese group (OG; n =41). A calibrated examiner performed the clinical examination using the Simplified Oral Hygiene Index, Gingival Index, and salivary collection. Data analysis included descriptive statistics and association tests ( p <0.05). RESULTS: OG presented statistically higher s-IgA values compared with NWG, especially among the obese children ( p <0.05). Significant positive correlations between s-IgA and salivary osmolality in OG ( p <0.05), and between s-IgA and BMI values ( p <0.05) and body fat percentage ( p <0.05) were observed among all the children. Effect size varied from moderate for s-IgA values ( d =0.57) to large for BMI ( d =2.60). CONCLUSION: Gingival inflammation and salivary parameters were similar for NWG and OG; however, s-IgA presented higher values in OG, with correlations between BMI and body fat percentage.
Assuntos
Índice de Massa Corporal , Gengivite/sangue , Imunoglobulina A/análise , Sobrepeso/sangue , Obesidade Infantil/sangue , Saliva/metabolismo , Tecido Adiposo/metabolismo , Animais , Estudos de Casos e Controles , Criança , Estudos Transversais , Feminino , Gengivite/etiologia , Humanos , Modelos Lineares , Masculino , Sobrepeso/complicações , Obesidade Infantil/complicações , Índice Periodontal , Valores de Referência , Fatores de Risco , Estatísticas não ParamétricasRESUMO
OBJECTIVES: To analyze the association between periodontal conditions and inflammation, nutritional status and calcium-phosphate metabolism disorders in hemodialysis (HD) patients. MATERIAL AND METHODS: We analyzed 128 HD patients divided into two groups: dentate (n = 103) and edentulous (n=25). The following items were assessed: baseline characteristics, age at the start and duration of HD, biochemical data: C-reactive protein (CRP), serum albumin, calcium, phosphorus, alkaline phosphatase, parathormone. A single dentist performed a complete dental/periodontal examination, including parameters of oral hygiene and gingival bleeding. RESULTS: One person had healthy periodontium, 62.14% of the patients had gingivitis, and 36.9% had moderate or severe periodontitis. The age at HD onset had a positive impact on periodontal status and negatively correlated with the number of teeth. A positive correlation between age and CRP level and negative correlations between age and serum albumin and phosphorus were found. Pocket depth (PD) was negatively correlated with serum albumin. The number of teeth was negatively correlated with serum CRP. CONCLUSIONS: High prevalence and severity of periodontal disease are observed in hemodialysis patients. There is a high probability that periodontal disease may be present at the early stages of chronic kidney disease (CKD) before the hemodialysis onset.
Assuntos
Distúrbios do Metabolismo do Cálcio/etiologia , Gengivite/etiologia , Estado Nutricional/fisiologia , Periodontite/etiologia , Distúrbios do Metabolismo do Fósforo/etiologia , Diálise Renal/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Fosfatase Alcalina/sangue , Proteína C-Reativa/análise , Cálcio/sangue , Distúrbios do Metabolismo do Cálcio/sangue , Índice de Placa Dentária , Feminino , Gengivite/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Hormônio Paratireóideo/sangue , Índice Periodontal , Periodontite/sangue , Fósforo/sangue , Distúrbios do Metabolismo do Fósforo/sangue , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Fatores de Risco , Albumina Sérica/análise , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Association between periodontal disease and dyslipidemia was recently reported in healthy adults. However, a systematic evaluation of concomitant periodontal diseases and lipid profile was not carried out in juvenile dermatomyositis (JDM). A cross-section study was performed in 25 JDM patients and 25 healthy controls, assessing demographic data, periodontal evaluation, fasting lipoproteins and anti-lipoprotein lipase antibodies. Disease parameters, laboratorial tests and treatment were also evaluated in JDM patients. RESULTS: The mean current age was similar in patients and controls (11.5 ± 3.75 vs. 11.2 ± 2.58 years,p = 0.703). Regarding lipid profile, the median triglycerides [80(31-340) vs. 61(19-182)mg/dL,p = 0.011] and VLDL[16(6-68) vs. 13(4-36)mg/dL,p = 0.020] were significantly higher in JDM patients versus controls. Gingival vasculopathy pattern was significantly higher in the former group (60% vs. 0%,p = 0.0001), as well as the median of gingival bleeding index (GBI) [24.1(4.2-69.4) vs. 11.1(0-66.6)%,p = 0.001] and probing pocket depth (PPD) [1.7(0.6-2.4) vs.1.4(0-2.12)mm,p = 0.006]. Comparison between JDM patients with and without dyslipidemia revealed that the median of dental plaque index (PI) [100(26.7-100) vs. 59(25-100)%,p = 0.022], PPD[1.9(0.6-2.4) vs. 1.4(1.2-1.8)mm,p = 0.024] and clinical attachment level (CAL) [1.31(0.7-1.7) vs. 0.8(0.6-1.7)mm,p = 0.005] were significantly higher in patients with dyslipidemia. Further analysis between JDM patients with and without gingivitis revealed that the median of current age [12.4 (8.3-18.4) vs. 9.2 (5.5-17.5) years, p = 0.034] and disease duration [7.09 ± 3.07 vs. 3.95 ± 2.1 years, p = 0.008] were significantly higher in the former group. CONCLUSION: Our study showed that gingival inflammation seems to be related to dyslipidemia in JDM patients, suggesting underlying mechanisms for both complications.
Assuntos
Dermatomiosite/complicações , Dislipidemias/complicações , Doenças Periodontais/complicações , Adolescente , Estudos de Casos e Controles , Criança , Estudos Transversais , Índice de Placa Dentária , Dermatomiosite/sangue , Dislipidemias/sangue , Feminino , Hemorragia Gengival/sangue , Hemorragia Gengival/complicações , Hemorragia Gengival/diagnóstico , Bolsa Gengival/sangue , Bolsa Gengival/diagnóstico , Gengivite/sangue , Gengivite/complicações , Gengivite/diagnóstico , Humanos , Lipase Lipoproteica/antagonistas & inibidores , Lipoproteínas VLDL/sangue , Masculino , Doenças Periodontais/sangue , Doenças Periodontais/diagnóstico , Triglicerídeos/sangueRESUMO
Abstract Objectives To analyze the association between periodontal conditions and inflammation, nutritional status and calcium-phosphate metabolism disorders in hemodialysis (HD) patients. Material and Methods We analyzed 128 HD patients divided into two groups: dentate (n = 103) and edentulous (n=25). The following items were assessed: baseline characteristics, age at the start and duration of HD, biochemical data: C-reactive protein (CRP), serum albumin, calcium, phosphorus, alkaline phosphatase, parathormone. A single dentist performed a complete dental/periodontal examination, including parameters of oral hygiene and gingival bleeding. Results One person had healthy periodontium, 62.14% of the patients had gingivitis, and 36.9% had moderate or severe periodontitis. The age at HD onset had a positive impact on periodontal status and negatively correlated with the number of teeth. A positive correlation between age and CRP level and negative correlations between age and serum albumin and phosphorus were found. Pocket depth (PD) was negatively correlated with serum albumin. The number of teeth was negatively correlated with serum CRP. Conclusions High prevalence and severity of periodontal disease are observed in hemodialysis patients. There is a high probability that periodontal disease may be present at the early stages of chronic kidney disease (CKD) before the hemodialysis onset.
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Periodontite/etiologia , Distúrbios do Metabolismo do Fósforo/etiologia , Distúrbios do Metabolismo do Cálcio/etiologia , Estado Nutricional/fisiologia , Diálise Renal/efeitos adversos , Gengivite/etiologia , Higiene Bucal , Hormônio Paratireóideo/sangue , Periodontite/sangue , Distúrbios do Metabolismo do Fósforo/sangue , Fósforo/sangue , Índice de Gravidade de Doença , Distúrbios do Metabolismo do Cálcio/sangue , Proteína C-Reativa/análise , Albumina Sérica/análise , Índice Periodontal , Índice de Placa Dentária , Cálcio/sangue , Fatores de Risco , Fosfatase Alcalina/sangue , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Gengivite/sangue , Pessoa de Meia-IdadeRESUMO
This study aimed to assess the impact of hyperlipidemia on healthy and diseased periodontal tissue by evaluating oxidative stress biomarkers in gingival crevicular fluid (GCF). Clinical periodontal parameters and blood serum lipid, GCF malondialdehyde (MDA), protein carbonyl (PC), and total antioxidant capacity (TAOC) levels were evaluated in six age and sex-matched groups (n = 15 each) of normolipidemic and hyperlipidemic individuals as follows: normolipidemic + periodontally healthy (H), normolipidemic + gingivitis (G), normolipidemic + chronic periodontitis (CP), hyperlipidemic + periodontally healthy (HH), hyperlipidemic + gingivitis (HG), and hyperlipidemic + CP (HCP). GCF MDA, and PC levels varied among groups, with patients with periodontitis having the highest MDA and PC levels [CP > G > H (p < 0.01) and HCP > HG > HH (p < 0.01)] and the lowest TAOC levels [CP < G < H (p < 0.01) and HCP < HG < HH (p < 0.01)]. Furthermore, paired comparisons showed MDA and PC levels to be higher and TAOC levels to be lower in HCP compared with NCP (p < 0.01). In patients with hyperlipidemia, GCF, MDA, and PC levels positively correlated with clinical assessments and serum triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) levels and negatively correlated with serum high-density lipoprotein cholesterol (HDL) levels, whereas GCF TAOC levels negatively correlated with clinical assessments and serum TG, TC, and LDL levels, but positively correlated with serum HDL levels (p < 0.01). In normolipidemic patients, GCF, MDA, and PC levels positively correlated with clinical assessments and serum TG levels and negatively correlated with serum HDL levels, whereas GCF TAOC levels negatively correlated with clinical assessments and serum TG levels and positively correlated with serum HDL levels (p < 0.01). In conclusion, abnormal serum lipid subfractions could be considered a risk factor for enhancing oxidative stress in GCF in the presence of periodontal disease.
Assuntos
Periodontite Crônica/sangue , Líquido do Sulco Gengival/metabolismo , Gengivite/sangue , Hiperlipidemias/sangue , Estresse Oxidativo/fisiologia , Adulto , Análise de Variância , Estudos de Casos e Controles , Colesterol/sangue , Periodontite Crônica/etiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Gengivite/etiologia , Humanos , Hiperlipidemias/complicações , Masculino , Malondialdeído/sangue , Pessoa de Meia-Idade , Carbonilação Proteica/fisiologia , Valores de Referência , Estatísticas não Paramétricas , Triglicerídeos/sangueRESUMO
Las enfermedades gingiviales y perodontales son un conjunto de enfermedades producidas por microorganismos que afectan las estructuras que sostienen los dientes como; encía, ligamentos, huesos alveolar, hay dos grandes grupos de enfermedad de la encías: 1. La gingivitis, afecta solo la encía 2. La periodontitis,además de la inflamación de la encía, produce una destrucción profunda e irreversibles, que afecta al hueso alveolar, al cemento del diente y al ligamento periodontal.
Assuntos
Humanos , Adulto , Higiene Bucal , Periodontia/métodos , Assistência Odontológica , Guias como Assunto/análise , Doenças da Gengiva , Gengivite , Periodontite , Relatos de Casos , Fluoretação , Testes de Atividade de Cárie Dentária , Profilaxia Dentária , Doenças da Gengiva/complicações , Gengivite/sangueRESUMO
Abstract: This study aimed to assess the impact of hyperlipidemia on healthy and diseased periodontal tissue by evaluating oxidative stress biomarkers in gingival crevicular fluid (GCF). Clinical periodontal parameters and blood serum lipid, GCF malondialdehyde (MDA), protein carbonyl (PC), and total antioxidant capacity (TAOC) levels were evaluated in six age and sex-matched groups (n = 15 each) of normolipidemic and hyperlipidemic individuals as follows: normolipidemic + periodontally healthy (H), normolipidemic + gingivitis (G), normolipidemic + chronic periodontitis (CP), hyperlipidemic + periodontally healthy (HH), hyperlipidemic + gingivitis (HG), and hyperlipidemic + CP (HCP). GCF MDA, and PC levels varied among groups, with patients with periodontitis having the highest MDA and PC levels [CP > G > H (p < 0.01) and HCP > HG > HH (p < 0.01)] and the lowest TAOC levels [CP < G < H (p < 0.01) and HCP < HG < HH (p < 0.01)]. Furthermore, paired comparisons showed MDA and PC levels to be higher and TAOC levels to be lower in HCP compared with NCP (p < 0.01). In patients with hyperlipidemia, GCF, MDA, and PC levels positively correlated with clinical assessments and serum triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) levels and negatively correlated with serum high-density lipoprotein cholesterol (HDL) levels, whereas GCF TAOC levels negatively correlated with clinical assessments and serum TG, TC, and LDL levels, but positively correlated with serum HDL levels (p < 0.01). In normolipidemic patients, GCF, MDA, and PC levels positively correlated with clinical assessments and serum TG levels and negatively correlated with serum HDL levels, whereas GCF TAOC levels negatively correlated with clinical assessments and serum TG levels and positively correlated with serum HDL levels (p < 0.01). In conclusion, abnormal serum lipid subfractions could be considered a risk factor for enhancing oxidative stress in GCF in the presence of periodontal disease.
Assuntos
Humanos , Masculino , Feminino , Adulto , Líquido do Sulco Gengival/metabolismo , Estresse Oxidativo/fisiologia , Periodontite Crônica/sangue , Gengivite/sangue , Hiperlipidemias/sangue , Valores de Referência , Triglicerídeos/sangue , Ensaio de Imunoadsorção Enzimática , Estudos de Casos e Controles , Colesterol/sangue , Análise de Variância , Estatísticas não Paramétricas , Carbonilação Proteica/fisiologia , Periodontite Crônica/etiologia , Gengivite/etiologia , Hiperlipidemias/complicações , Malondialdeído/sangue , Pessoa de Meia-IdadeRESUMO
Adipokines are present in inflammatory processes and may be directly related to periodontal disease. Moreover, their activities may be regulated by fatty acids. The goal of this study was to quantify the concentrations of the main adipokines, leptin, adiponectin and resistin, and the docosahexaenoic (DHA), docosapentaenoic (DPA), eicosapentaenoic (EPA) and arachidonic (AA) fatty acids, in patients with generalized chronic periodontitis. As a secondary objective, the ratios of these substances in the blood of these patients were evaluated. The study included 15 systemically healthy patients with generalized chronic periodontitis (test group) and 15 patients with gingivitis (control group). Medical and periodontal parameters and blood samples were collected. Serum concentrations of fatty acids were analyzed by gas chromatography and adipokines by multiplex bead immunoassay. There was no significant difference in adipokines between groups. However, there was a tendency for lower values of adiponectin in periodontitis patients. Regarding the fatty acids, they were significantly higher in the test group compared with controls. The res/DHA, res/AA, adipon/DHA, adipon/AA and adipon/DPA ratios were significantly lower in the test group. There was no significant correlation between adipokines and clinical parameters and between adipokines and fatty acids levels. It was concluded that generalized chronic periodontitis patients showed significantly higher levels of fatty acids in comparison to gingivitis; adiponectin revealed a trend to lower values in the periodontitis group, even after Ancova correction. The ratios suggest a minor proportion of adiponectin and resistin in relation to the fatty acids in patients with generalized chronic periodontitis.
Assuntos
Adipocinas/sangue , Periodontite Crônica/sangue , Ácidos Graxos/sangue , Adulto , Biomarcadores/sangue , Cromatografia Gasosa , Feminino , Gengivite/sangue , Humanos , Imunoensaio , Masculino , Pessoa de Meia-IdadeRESUMO
Adipokines are present in inflammatory processes and may be directly related to periodontal disease. Moreover, their activities may be regulated by fatty acids. The goal of this study was to quantify the concentrations of the main adipokines, leptin, adiponectin and resistin, and the docosahexaenoic (DHA), docosapentaenoic (DPA), eicosapentaenoic (EPA) and arachidonic (AA) fatty acids, in patients with generalized chronic periodontitis. As a secondary objective, the ratios of these substances in the blood of these patients were evaluated. The study included 15 systemically healthy patients with generalized chronic periodontitis (test group) and 15 patients with gingivitis (control group). Medical and periodontal parameters and blood samples were collected. Serum concentrations of fatty acids were analyzed by gas chromatography and adipokines by multiplex bead immunoassay. There was no significant difference in adipokines between groups. However, there was a tendency for lower values of adiponectin in periodontitis patients. Regarding the fatty acids, they were significantly higher in the test group compared with controls. The res/DHA, res/AA, adipon/DHA, adipon/AA and adipon/DPA ratios were significantly lower in the test group. There was no significant correlation between adipokines and clinical parameters and between adipokines and fatty acids levels. It was concluded that generalized chronic periodontitis patients showed significantly higher levels of fatty acids in comparison to gingivitis; adiponectin revealed a trend to lower values in the periodontitis group, even after Ancova correction. The ratios suggest a minor proportion of adiponectin and resistin in relation to the fatty acids in patients with generalized chronic periodontitis.
As adipocinas estão presentes em processos inflamatórios e podem estar diretamente relacionadas à doença periodontal. Além disso, suas atividades podem ser reguladas pelos ácidos graxos. Este estudo teve como objetivo quantificar as concentrações das principais adipocinas, leptina, adiponectina e resistina, e dos ácidos graxos: ácido docosahexaenóico (DHA), ácido docosapentaenóico (DPA), ácido eicosapentaenóico (EPA) e ácido araquidônico (AA), em pacientes com periodontite crônica generalizada. Como objetivo secundário, avaliar as proporções destas substâncias no sangue desses pacientes. O estudo incluiu 15 pacientes sistemicamente saudáveis com periodontite crônica generalizada (grupo teste) e 15 com gengivite (grupo controle). Foram coletados parâmetros médicos e periodontais e amostras de sangue. As concentrações séricas dos ácidos graxos foram analisadas por cromatografia gasosa e as das adipocinas foram analisadas pelo método multiensaio multiplex. Não houve diferença significativa entre os níveis de adipocinas entre os grupos. No entanto, houve uma tendência para menores valores nos níveis da adiponectina nos pacientes com periodontite. Com relação aos ácidos graxos, os valores foram significativamente maiores no grupo teste em comparação com os controles. As razões entre res/DHA, res/AA, adipon/DHA, adipon/AA e adipon/DPA foram significativamente menores no grupo teste. Não houve correlação significativa entre as adipocinas e os parâmetros clínicos e entre os níveis de adipocinas e ácidos graxos. Conclui-se que pacientes com periodontite crônica generalizada apresentaram níveis significativamente maiores de ácidos graxos em relação à gengivite, adiponectina apresentou uma tendência a valores menores no grupo periodontite, mesmo após a correção de Ancova. Os resultados das razões sugerem uma menor proporção de adiponectina e resistina em relação aos ácidos graxos em pacientes com periodontite crônica generalizada.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adipocinas/sangue , Biomarcadores/sangue , Periodontite Crônica/sangue , Ácidos Graxos/sangue , Cromatografia Gasosa , Gengivite/sangue , ImunoensaioRESUMO
BACKGROUND: The aim of this study was to evaluate the endothelial function, systemic inflammatory biomarkers and subgingival microbial profile associations in patients with and without periodontal disease. METHODS: Forty-four patients, half with chronic moderate to severe periodontitis (cases) and half gingivitis and incipient periodontitis (controls) were recruited. Anthropometric, clinical, biochemical parameters, endothelial function, subgingival microbiota, and eight plasma biomarkers of cardiovascular disease were assessed in both groups. RESULTS: Both groups were comparable in anthropometric parameters, blood pressure, and number of positive metabolic syndrome components. Univariate analyses demonstrated significantly higher plasma levels of E-selectin (64.5 ± 30.9 vs 43.8 ± 22.2; P = 0.026) and myeloperoxidase (MPO) (103 ± 114.5 vs 49.1 ± 35.6; P = 0.032) in cases than controls. In addition, significantly higher levels of E-selectin, MPO and ICAM-1 were found in periodontitis patients after adjustment by age and waist circumference. Red complex microorganisms were more frequently detected by culture and polymerase chain reaction in patients with severe to moderate periodontitis. CONCLUSIONS: Subgingival red complex bacteria and important cardiovascular risk markers were increased in untreated chronic moderate to severe periodontitis cases. Periodontitis seems to be associated with systemic inflammation that could increase the risk of cardiovascular events. The causal relation between periodontal infections and cardiovascular disease requires further research.
Assuntos
Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Periodontite Crônica/sangue , Gengivite/sangue , Adulto , Análise de Variância , Bactérias/isolamento & purificação , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , Periodontite Crônica/microbiologia , Colômbia , Selectina E/sangue , Feminino , Gengivite/microbiologia , Humanos , Molécula 1 de Adesão Intercelular/sangue , Masculino , Peroxidase/sangue , Reação em Cadeia da Polimerase , Espécies Reativas de Oxigênio/sangue , Fatores de RiscoRESUMO
BACKGROUND: Long-chain polyunsaturated fatty acids omega-3 and omega-6 (LC-PUFA n-3 and n-6) can function as important inflammatory modulators and also have a strong effect in the proresolving inflammatory processes. The aim of the authors is to analyze the serum levels of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and arachidonic acid (AA) in patients with generalized chronic periodontitis (GCP) and compare these results with serum levels of patients with gingivitis only. METHODS: Twenty-one patients with untreated GCP (mean age: 46.0 ± 8.8 years) and 16 patients with gingivitis only (mean age: 31.5 ± 7.5 years) were investigated. The clinical examination included probing depth (PD), clinical attachment level, bleeding on probing, and plaque index. Blood samples were analyzed for the presence of DHA, EPA, DPA, and AA using gas chromatography. RESULTS: Significantly higher levels of DHA, DPA, EPA, and AA were observed in patients with GCP when compared with patients with gingivitis (P = 0.007, P = 0.004, P = 0.033, and P = 0.001, respectively). The differences were still significant even after the adjustments for age and sex. The PD showed a significant positive correlation with DHA (r = 0.5; P = 0.003), DPA (r = 0.6; P <0.001), and AA (r = 0.6; P <0.001). CONCLUSION: The present findings suggest that serum levels of LC-PUFA n-3 and n-6 may be affected by the severity of periodontal disease.
Assuntos
Periodontite Crônica/sangue , Periodontite Crônica/metabolismo , Ácidos Graxos Insaturados/sangue , Ácidos Graxos Insaturados/metabolismo , Adulto , Análise de Variância , Cromatografia Gasosa , Periodontite Crônica/patologia , Dieta , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-3/metabolismo , Ácidos Graxos Ômega-6/sangue , Ácidos Graxos Ômega-6/metabolismo , Feminino , Produtos Pesqueiros , Gengivite/sangue , Gengivite/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Estatísticas não ParamétricasRESUMO
Leukemia has been associated with oral manifestations. However, the available literature on this topic consists of mostly reports of cases, without data about the periodontal parameters that may be under the influence of hematologic factors. The aim of this cross-sectional study was to assess the correlation between the Gingival Index and Bleeding on Probing with the platelet count in patients with leukemia. Patients with diagnosis of any kind of leukemia, at any stage of treatment, having a minimum age of 14 years, treated at the Department of Hematology-Oncology of the University Hospital of Santa Maria, Brazil, between December 2009 and March 2010, were assessed. Excluded patients were: edentulous, with orthodontic appliances, with psychomotor disturbances, requiring antibiotic prophylaxis for the examinations, or those using medications associated with gingival swelling. Two trained and calibrated examiners evaluated the Plaque Index, Gingival Index (GI), Probing depth, Bleeding on Probing (BOP), and Clinical Attachment Loss. Hematologic data were collected from a blood test performed on the same day as the periodontal examination. Thirty-seven patients (26 males), aged between 15 and 80 years (mean age 41.7 ± 18.31) were evaluated. Correlation between platelet count and BOP (p > 0.05), or between platelet count and GI (p > 0.05), were both weak (Pearson's correlation coefficient r = 0.171 and r = -0.003, respectively) and not statistically significant. It can be concluded from the preliminary results that the low platelet count was not correlated with the higher prevalence of gingival and periodontal bleeding in patients with leukemia.
Assuntos
Gengivite/sangue , Leucemia/sangue , Índice Periodontal , Adolescente , Adulto , Idoso , Estudos Transversais , Índice de Placa Dentária , Feminino , Humanos , Leucemia/complicações , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/sangue , Contagem de Plaquetas , Adulto JovemRESUMO
Objetivo: Determinar si la condición clínica periodontal materna, el índice de masa corporal (IMC) y su variación durante el embarazo, se asocian con marcadores de inflamación sistémica: interleuquina-6 (IL-6), factor de necrosis tumoral alfa (TNF-) y proteína C reactiva (PCR) a nivel plasmático. Material y Método: Estudio clínico que analizó una cohorte de 56 embarazadas entre 18 y 38 años de edad (promedio 27.9 +/- 7.04 años), derivadas de la unidad de medicina perinatal en el centro de salud docente asistencial (CESA) de la Universidad de los Andes. Todas ellas consintieron voluntariamente su participación en el estudio. En cada trimestre de embarazo, se les realizó un examen periodontal completo, consistente en la determinación de los niveles de inserción clínica, profundidad al sondaje, índice de higiene y sangrado en seis sitios por cada pieza dentaria, excluyendo terceros molares. Adicionalmente, en cada control se obtuvieron muestras de sangre periférica para la determinación de los mediadores proinflamatorios mediante técnica de ELISA. El diagnóstico periodontal y los niveles de mediadores inflamatorios fueron relacionados con la variación del IMC durante el embarazo. Resultados: Las embarazadas con periodontitis crónica presentaron una mayor variación y aumento del índice de masa corporal (p=0.039) y niveles de IL-6 (p=0.026) en comparación con las mujeres embarazadas con gingivitis. Conclusiones: En esta serie de pacientes, se demostró una asociación entre el diagnóstico clínico de periodontitis durante el embarazo con un aumento plasmático de IL-6, así como también una asociación entre un aumento del IMC con los niveles plasmáticos de PCR.
Objective: To determine if maternal periodontal clinical status, body mass index (BMI) and its variation during pregnancy are associated with increased levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-) and C-reactive protein (CRP) in plasma. Material and Methods: This clinical study included a total of 56 pregnant women between 18 and 38 years old (mean 27.9 +/- 7.04 years), referred from perinatal medicine unit at health care center Universidad de los Andes. All pregnant patients consented to voluntarily participate in the study. In each trimester of pregnancy, they underwent a complete periodontal examination, involving the determination of clinical attachment levels, probing depth, bleeding and hygiene index at six sites of each tooth, excluding third molars. Additionally, in each clinical check, peripheral blood samples were taken for determination of pro-inflammatory mediators with ELISA immunoassay. Periodontal diagnosis and inflammatory mediators were the variables analyzed in relation to changes in BMI during pregnancy. Results: Pregnant women with chronic periodontitis had an increase and more variation of BMI (p=0.039) and higher levels of IL-6 (p=0.026) in comparison with pregnant women with gingivitis. Conclusions: In this series of pregnant patients the clinical diagnosis of periodontitis, with an increase in BMI are associated with increased plasma levels of IL-6 and CRP.
Assuntos
Gravidez , Índice de Massa Corporal , Complicações na Gravidez/sangue , /sangue , Periodontite Crônica/sangue , Estudos de Coortes , Ensaio de Imunoadsorção Enzimática , Fator de Necrose Tumoral alfa/sangue , Gengivite/sangue , Estado Nutricional , Proteína C-Reativa/análiseRESUMO
Leukemia has been associated with oral manifestations. However, the available literature on this topic consists of mostly reports of cases, without data about the periodontal parameters that may be under the influence of hematologic factors. The aim of this cross-sectional study was to assess the correlation between the Gingival Index and Bleeding on Probing with the platelet count in patients with leukemia. Patients with diagnosis of any kind of leukemia, at any stage of treatment, having a minimum age of 14 years, treated at the Department of Hematology-Oncology of the University Hospital of Santa Maria, Brazil, between December 2009 and March 2010, were assessed. Excluded patients were: edentulous, with orthodontic appliances, with psychomotor disturbances, requiring antibiotic prophylaxis for the examinations, or those using medications associated with gingival swelling. Two trained and calibrated examiners evaluated the Plaque Index, Gingival Index (GI), Probing depth, Bleeding on Probing (BOP), and Clinical Attachment Loss. Hematologic data were collected from a blood test performed on the same day as the periodontal examination. Thirty-seven patients (26 males), aged between 15 and 80 years (mean age 41.7 ± 18.31) were evaluated. Correlation between platelet count and BOP (p > 0.05), or between platelet count and GI (p > 0.05), were both weak (Pearson's correlation coefficient r = 0.171 and r = -0.003, respectively) and not statistically significant. It can be concluded from the preliminary results that the low platelet count was not correlated with the higher prevalence of gingival and periodontal bleeding in patients with leukemia.
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Gengivite/sangue , Leucemia/sangue , Índice Periodontal , Estudos Transversais , Índice de Placa Dentária , Leucemia/complicações , Contagem de Plaquetas , Perda da Inserção Periodontal/sangueRESUMO
BACKGROUND: The purpose of the present study is to verify a possible association between herpesviruses and periodontal pathogens in individuals with human immunodeficiency virus (HIV) and periodontitis. METHODS: Twenty-seven patients with HIV and chronic periodontitis and 23 patients with HIV and gingivitis were included in the study. Probing depth, clinical attachment loss, gingival index, and plaque index were recorded. Blood, saliva, and subgingival plaque were processed for viral and bacterial identification. Bacteria were identified by 16S rRNA-based polymerase chain reaction and viruses by the nested polymerase chain reaction. RESULTS: For the chronic periodontitis group, Epstein-Barr (EBV)-1 (70.4%) and Tannerella forsythia (Tf) (51.8%) presented higher detection in subgingival plaque and saliva (81.5% and 40.7%, respectively) than in blood (22% and 0%, respectively) (P <0.005 and P <0.0001, respectively). Porphyromonas gingivalis (Pg) was more frequent in subgingival plaque (77.7%; P <0.0001). In the gingivitis group, Pg and human cytomegalovirus (HCMV) presented higher frequency in subgingival plaque (95.6% and 91.3%, respectively; P <0.0001 and P = 0.004). Tf and EBV-1 were detected more frequently in subgingival plaque (47.8% and 78.3%, respectively) and saliva (52.2% and 52.2%, respectively; P = 0.004 and P <0.005) than in blood. EBV-1, EBV-1-HCMV, and presence of different viruses presented an association with periodontitis in saliva. CONCLUSIONS: No association was detected for herpesviruses and periodontal pathogens in patients who are HIV-positive with periodontitis. EBV-1 and coinfection (EBV-1-HCMV) were associated with patients who are HIV-positive with periodontitis.
Assuntos
Periodontite Crônica/complicações , Periodontite Crônica/virologia , Gengivite/complicações , Infecções por HIV/complicações , Infecções por HIV/virologia , Herpesviridae/isolamento & purificação , Adulto , Bacteroides/isolamento & purificação , Distribuição de Qui-Quadrado , Periodontite Crônica/sangue , Periodontite Crônica/microbiologia , Coinfecção , Citomegalovirus/isolamento & purificação , DNA Bacteriano/análise , DNA Viral/análise , Placa Dentária/microbiologia , Placa Dentária/virologia , Feminino , Gengivite/sangue , Gengivite/microbiologia , Gengivite/virologia , Infecções por HIV/sangue , Infecções por HIV/microbiologia , Herpesvirus Humano 4/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Porphyromonas gingivalis/isolamento & purificação , Saliva/microbiologia , Saliva/virologia , Carga ViralRESUMO
BACKGROUND: Inhibitory signals mediated via molecules such as programmed death-1 (PD-1) play a critical role in downmodulating immune responses and maintaining peripheral tolerance. We investigated the involvement of cytokines and PD-1 engagement in mediating the T-cell unresponsiveness to bacterial and ubiquitous antigens in periodontal diseases. METHODS: Gingival and peripheral blood samples from healthy individuals and patients with chronic periodontitis were collected and used for the subsequent assays. Leukocytes in the lesion site and blood were evaluated using flow cytometry. The production of interferon-gamma, interleukin-10, and transforming growth factor-beta proteins was evaluated by enzyme-linked immunosorbent assay (ELISA), and the presence of PD-1+ cells in the inflamed gingiva was confirmed by immunofluorescence confocal microscopy for CD4 and PD-1 colocalization. RESULTS: T cells from patients with chronic periodontitis proliferated poorly in response to Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) antigen. T-cell unresponsiveness was not associated with imbalanced cytokine production. However, T cells from patients with chronic periodontitis expressed significantly higher levels of PD-1 either upon isolation or after culture with antigens. Moreover, PD-1 blocking did not result in significant T-cell proliferation in cells cultured with phytohemagglutinin or bacterial antigens. The blockade of PD-1 resulted in the increased production of IFN-gamma. In addition, CD4+ and CD8+ T cells expressing PD-1 accumulated in lesions with chronic periodontitis. CONCLUSION: These data show that PD-1 engagement could be involved in the modulation of IFN-gamma production by T cells in patients with chronic periodontitis.
Assuntos
Antígenos CD/imunologia , Proteínas Reguladoras de Apoptose/imunologia , Periodontite Crônica/imunologia , Ativação Linfocitária/imunologia , Linfócitos T/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Aggregatibacter actinomycetemcomitans/imunologia , Perda do Osso Alveolar/imunologia , Antígenos de Bactérias/imunologia , Antígenos CD/análise , Proteínas Reguladoras de Apoptose/análise , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Estudos de Casos e Controles , Periodontite Crônica/sangue , Regulação para Baixo/imunologia , Feminino , Gengiva/patologia , Gengivite/sangue , Gengivite/patologia , Humanos , Interferon gama/análise , Interferon gama/imunologia , Interleucina-10/análise , Interleucina-10/imunologia , Leucócitos/patologia , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/imunologia , Bolsa Periodontal/imunologia , Receptor de Morte Celular Programada 1 , Subpopulações de Linfócitos T/imunologia , Fator de Crescimento Transformador beta/análise , Fator de Crescimento Transformador beta/imunologiaRESUMO
AIM: The objective of this study was to compare the frequency of herpes simplex virus type 1 (HSV-1), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in subgingival plaque, saliva and peripheral blood of HIV-positive and-negative patients with periodontal disease. MATERIAL AND METHODS: Fifty HIV-positive subjects (23 with gingivitis, 27 with periodontitis) and 50 healthy HIV-negative patients with chronic periodontitis were included in the study. Parameters of probing depth (PD), clinical attachment level (CAL), gingival index and plaque index were recorded. The samples were processed for viral identification by the nested polymerase chain reaction technique. RESULTS: HCMV was the most prevalent virus in HIV-positive (82%) and-negative patients (84%), and the detection in the three samples was similar (p>0.05). HSV-1 was the least prevalent virus in both groups, being detected in similar frequencies in oral sites and in peripheral blood. EBV-1 was found more frequently in saliva and subgingival plaque of HIV-positive patients than in HIV-negative patients (p< or =0.05). CONCLUSIONS: EBV-1 was more frequently recovered in oral sites of HIV-positive patients than in HIV-negative patients.