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Roth JVS, Guarenghi GG, Ferro RM, Valenga HM, Haas AN, Prates RC, Steffens JP. Gingival bleeding as a predictor of handgrip strength-an observational study and a pilot randomized clinical trial. Clin Oral Investig 2024; 28:109. [PMID: 38261106 DOI: 10.1007/s00784-024-05507-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
OBJECTIVE The aim of this study was to (i) assess the association between self-reported periodontal disease and gingival bleeding as predictors of handgrip strength (HGS) in the elderly and (ii) evaluate the impact of baseline periodontal clinical parameters on the improvement of HGS in trained or non-trained treated periodontitis patients. METHODS For (i), cross-sectional data from the Brazilian Longitudinal Study of Aging were retrieved and association between HGS (dependent variable) and self-reported gingival bleeding, periodontal disease, and missing teeth was analyzed using multiple linear regressions. For (ii), a pilot study was conducted with 17 patients randomly allocated to two groups-physical training or non-training-and followed for 45 days after subgingival instrumentation. Clinical parameters and HGS were recorded before and after treatment. RESULTS The observational study showed a significant association between HGS and tooth loss, edentulism and gingival bleeding. The clinical trial showed that baseline bleeding on probing, but not other parameters, was associated with delta HGS. CONCLUSION Taken together, our findings suggest that gingival bleeding could act as a predictor of handgrip strength and its improvement after non-surgical periodontal therapy. CLINICAL RELEVANCE Gingival bleeding, either as self-perceived or clinically detected, may impact handgrip strength, an important marker of muscle frailty and mortality.
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Affiliation(s)
| | | | - Rafael Milani Ferro
- School of Dentistry, Universidade Federal Do Paraná - UFPR, Curitiba, PR, Brazil
| | | | - Alex Nogueira Haas
- Department of Periodontology, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Rodolfo Coelho Prates
- Postgraduate Program in Health and Environment, Universidade da Região de Joinville - UNIVILLE, Joinville, SC, Brazil
| | - Joao Paulo Steffens
- Postgraduate Program in Dentistry, Universidade Federal Do Paraná - UFPR, Curitiba, PR, Brazil.
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2
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Daroit NB, Martins LN, Garcia AB, Haas AN, Maito FLDM, Rados PV. Oral cancer over six decades: a multivariable analysis of a clinicopathologic retrospective study. Braz Dent J 2023; 34:115-124. [PMID: 38133466 PMCID: PMC10759960 DOI: 10.1590/0103-6440202305264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 10/22/2023] [Indexed: 12/23/2023] Open
Abstract
Studies have reported changes in the epidemiological profile of patients with oral cancer in recent decades, especially regarding gender and age. This study aimed to evaluate a historical series of oral malignant lesions prevalence over six decades and define characteristics associated with the occurrence, mainly, of oral squamous cell carcinoma (OSCC). A retrospective review of histopathological records from 1953 to 2019 was conducted in three oral pathology laboratories in South Brazil about age, sex, anatomical site, clinical aspect, and histopathological diagnosis. Descriptive and analytical analyses were performed comparing the histopathological diagnoses with other variables. Multivariable logistic regression was applied to determine the associated predictors of OSCC. Of the 53,065 records available in the institutions, 986 were oral malignant tumors (including all malignant neoplasms), representing 1.86% of all diagnoses. The occurrence of OSCC in the 1960's was 80.0%, decreasing over time reaching the lowest percentage of cases in the 1990's (75.8%) and significantly increasing to 88.7% in the 2010s. Females had a lower chance than males of having OSCC independently of the decade (odds ratio=0.30, p<0.001). This was the same for older individuals compared to those younger than 40 years. No interactions between sex, age, and decade were observed. The number of diagnoses of oral malignant lesions increased over time, and the occurrence of OSCC varied. Older individuals and males had higher chances of having OSCC independently of the decade. Therefore, in this study sample, no changes were observed in the epidemiological profile over the years concerning these predictors.
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Affiliation(s)
- Natália Batista Daroit
- Oral Pathology - School of Dentistry, Atitus Educação, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas Nunes Martins
- School of Dentistry, Atitus Educação, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Alex Nogueira Haas
- Periodontology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fábio Luiz Dal Moro Maito
- Celular and Molecular Biology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Pantelis Varvaki Rados
- Oral Pathology - School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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3
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Oliveira VB, Costa FWG, Haas AN, Júnior RMM, Rêgo RO. Effect of subgingival periodontal therapy on glycaemic control in type 2 diabetes patients: Meta-analysis and meta-regression of 6-month follow-up randomized clinical trials. J Clin Periodontol 2023; 50:1123-1137. [PMID: 37257917 DOI: 10.1111/jcpe.13830] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/05/2023] [Accepted: 05/06/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Periodontitis worsens the hyperglycaemia in patients with type 2 diabetes mellitus (T2DM). Subgingival instrumentation, with or without surgical access, is the gold-standard treatment for periodontitis. The aim was to summarize the evidence on the effect of subgingival instrumentation (with or without open flap) on the reduction of glycosylated haemoglobin (HbA1c). METHODS Nine electronic databases were searched up to 15 February 2023. Twelve randomized controlled trials with at least 6 months of follow-up were included. Studies using systemic or local-delivery antimicrobial therapies were excluded. Meta-analyses were performed using the random-effects model. The sources of heterogeneity were assessed by applying linear meta-regression. Risk of bias was assessed by RoB 2, and certainty of evidence by GRADE. RESULTS Eleven studies were included in the quantitative analyses (1374 patients). Subgingival instrumentation resulted in 0.29% lower HbA1c (95% confidence interval: 0.10-0.47; p = .03) compared with non-active treatment. DISCUSSION None of the 12 studies were assessed as having low risk of bias. The percentage of females and the time of diabetes diagnosis significantly explained the high level of heterogeneity. Subgingival periodontal therapy results in a significant and clinically relevant improvement in glycaemic control over 6 months in patients with T2DM and periodontitis. The grade of evidence was moderate.
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Affiliation(s)
- Victor Bento Oliveira
- Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Fábio Wildson Gurgel Costa
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Alex Nogueira Haas
- Department of Conservative Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rodrigo Otávio Rêgo
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
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4
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Anjos SDD, Ferro RM, Laskawski BN, Haas AN, Prates RC, Steffens JP. Associations between physical activity domains and oral health: an analysis of a Brazilian population-based study. Braz Oral Res 2023; 37:e071. [PMID: 37436294 DOI: 10.1590/1807-3107bor-2023.vol37.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/17/2023] [Indexed: 07/13/2023] Open
Abstract
Physical activity comprises four domains (leisure, transportation, domestic, and work activities) that may be differently associated with oral health. The aim of this study was to assess the association between each physical activity domain and oral health conditions in Brazilian adults. A total of 38,539 participants in the 2019 Brazilian Health Survey aged 30 years or older were analyzed. The outcomes were self-perceived oral health (dichotomous) and self-reported number of missing teeth (counts). The presence, frequency, and time of activity in each domain and their combination were analyzed as main exposures. Odds ratios (OR) and mean ratios (MR) were estimated by fitting multivariable models. Higher leisure time physical activity was the only domain associated with better self-perception of oral health (OR = 1.32; 95%CI 1.26-1.38) and lower tooth loss (MR=0.88; 95%CI 0.86-0.90). Higher levels of work, transportation, and household activities were significantly associated with worse self-perception of oral health, while higher levels of work- and transportation-related physical activities were also associated with greater tooth loss. When the total recommended weekly physical activity time was analyzed, no significant associations were found. Sensitivity analysis suggested that this pattern persists in potential periodontitis-related cases, such as when selecting older age or excluding individuals with no tooth loss. In conclusion, leisure physical activity was the only domain with the potential of reflecting the benefits of physical activity on oral health. The inclusion of other domains can confound this association.
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Affiliation(s)
| | - Rafael Milani Ferro
- Universidade Federal do Paraná-UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | - Bernardo Novak Laskawski
- Universidade Federal do Paraná-UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | - Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul-UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre-RS-Brazil
| | - Rodolfo Coelho Prates
- Universidade da Região de Joinville-Univille, Postgraduate Program in Health and Environment, Joinville, SC, Brazil
| | - Joao Paulo Steffens
- Universidade Federal do Paraná-UFPR, Postgraduate Program in Dentistry, Curitiba, PR, Brazil
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5
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Rup AG, Izquierdo CDM, Rios FS, Costa RDSA, Jardim JJ, Haas AN, Alves LS, Maltz M. Classification of a patient's caries activity based on lesion activity assessment among adults: findings from a prospective cohort study. Clin Oral Investig 2023; 27:1123-1131. [PMID: 36121494 DOI: 10.1007/s00784-022-04702-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate whether the classification of a patient's caries activity based on lesion activity assessment can predict the increment and progression of coronal and root caries lesions among adults. METHODS This population-based prospective cohort study followed 413 individuals (mean age 54.1) from southern Brazil for 4 years. Data collection included a questionnaire and clinical examination to record coronal/root caries and gingival recession. The main outcomes were caries increment measured as decayed, missing and filled tooth surfaces (DMFS) and caries progression (surface-level analysis). The main predictor variable was patients' caries activity at baseline ("caries-inactive" or "caries-active"). Negative binomial regression models (unadjusted and adjusted) were used. RESULTS Caries-active individuals were more likely to present DMFS increment than caries-inactive ones when migrations among DMFS components were considered (IRR [incidence risk ratio] = 1.26, 95%CI [confidence interval] = 1.01-1.58). On the other hand, no such association was found when these migrations were disregarded. The risk for coronal caries progression on filled surfaces was 90% higher among caries-active patients (IRR=1.9; 95%CI=1.4-2.6). In addition, patient's caries activity was able to predict higher risk for root caries progression in newly exposed root surfaces (IRR=1.9; 95%CI=1.0-3.6). CONCLUSION The classification of a patient's caries activity based on lesion activity was able to foresee lesion progression on the coronal and root surfaces more susceptible to caries among adults. Clinical relevance Classifying a patient's caries activity is a useful tool for the clinical management of dental caries in adults.
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Affiliation(s)
- Ariel Goulart Rup
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristina de Moraes Izquierdo
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Silva Rios
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Juliana Jobim Jardim
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alex Nogueira Haas
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luana Severo Alves
- Deparment of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Avenida Roraima, 1000, Prédio 26F, Santa Maria, RS, 97105-900, Brazil.
| | - Marisa Maltz
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Filgueiras LV, Konflanz W, Haas AN, Celeste RK. Assessment of the contextual effects on the prevalence of periodontitis: a systematic review. Braz Oral Res 2023; 36:e0125. [PMID: 36651384 DOI: 10.1590/1807-3107bor-2022.vol36.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/02/2021] [Indexed: 01/17/2023] Open
Abstract
This study reviews the influence of contextual factors on periodontitis based on a systematic search of studies recorded in the PubMed, Scopus, Web of Science, and EMBASE databases. Periodontitis was assessed by clinical attachment loss and probing depth for studies with data on the socioeconomic status (SES) of a specific area (area-level SES) or dental care service (service-level) in a catchment area among individuals aged 18 and over. Two independent reviewers performed study selection, data extraction, and assessment of methodological quality. Of the 646 articles identified, 13 were included in the systematic review, representing 101,362 individuals from five countries (USA, UK, Brazil, China, and Uruguay). A higher prevalence of periodontitis was described in lower SES neighborhoods, more deprived postcodes, and poorer provinces. Gini Index results were mixed and inconclusive. Three studies showed that higher coverage of primary dental care at the municipal level was associated with a lower prevalence of periodontitis. Contextual factors at the area-level SES and dental care service might influence periodontitis, but the existing evidence is unclear. The contextual effect is important for periodontal health and may contribute to the prevalence of periodontitis, independent of well-known risk factors and individual levels.
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Affiliation(s)
- Leonardo Vilar Filgueiras
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
| | - Willian Konflanz
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Roger Keller Celeste
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
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7
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Borgia GS, Pebé P, Barbot R, Haas AN. Immediate implants with buccal defects filled with bone from the tuberosity or a xenograft: 1-year randomized trial. Braz Oral Res 2022; 36:e102. [PMID: 35830145 DOI: 10.1590/1807-3107bor-2022.vol36.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/02/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to compare the use of autologous bone from tuberosity (TUBER) and deproteinized bovine bone mineral (DBBM) in immediate implants with buccal bone defects. A total of 31 patients with one single tooth in the upper anterior region indicated for extraction presenting tomographic buccal bone defect were analyzed. Immediate implantation was conducted for all patients. In one group, DBBM and a collagen membrane were inserted into the buccal defect; in the other group, a small block of bone from tuberosity was used. The primary outcome was facial-palatal ridge thickness (FPT) measured in casts 1 year after function. The implant success rate was 100% in both groups. FPT changes were <0.5 mm and did not differ significantly between groups. FPT reductions in the DBBM and TUBER groups were 1% and 0.6%, respectively, at the gingival margin and 5% and 2%, respectively, at 6 mm apical of the gingival margin (p > 0.05). No significant differences were observed between groups for patient's esthetic, satisfaction, pain and quality of life. Pink esthetic scores for the DBBM and TUBER were 11.5±1.7 and 10.8±1.9, respectively (p=0.37). It can be concluded that DBBM and TUBER did not differ in terms of ridge alterations, peri-implant clinical parameters and patient-reported outcomes.
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Affiliation(s)
- Gonzalo Stagnaro Borgia
- Universidad de la Republica del Uruguay, Faculty of Dentistry, Department of Oral and Maxillofacial Prosthesis, Montevideo, Uruguay
| | - Pablo Pebé
- Universidad de la Republica del Uruguay, Faculty of Dentistry, Department of Oral and Maxillofacial Prosthesis, Montevideo, Uruguay
| | - Roberto Barbot
- Universidad de la Republica del Uruguay, Faculty of Dentistry, Department of Oral and Maxillofacial Prosthesis, Montevideo, Uruguay
| | - Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Periodontology and Implantology, Porto Alegre, RS, Brazil
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8
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Martins JR, Wagner TP, Vallim AC, Konflanz W, Schwendicke F, Celeste RK, Haas AN. Comparison of the efficacy of different techniques to seal the alveolus during alveolar ridge preservation: Meta-regression and network meta-analysis. J Clin Periodontol 2022; 49:694-705. [PMID: 35451071 DOI: 10.1111/jcpe.13628] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/24/2022] [Accepted: 04/05/2022] [Indexed: 12/29/2022]
Abstract
AIM To evaluate the efficacy of different techniques to seal the alveolus (flap advancement [FA], open healing with barrier [OHB], and open healing without barrier [OHNB]) during alveolar ridge preservation (ARP) in terms of horizontal ridge width resorption. MATERIALS AND METHODS Randomized trials of at least 2 months duration comparing at least two techniques to seal the alveolus against each other or against spontaneous healing (SH) were eligible. Searches were conducted in MEDLINE via PubMed, EMBASE, Scopus, and Cochrane Central. Conventional meta-analysis, meta-regression, and network meta-analysis (NMA) were conducted, with clinical and tomographic ridge width changes as outcomes. Predictive intervals (95% PI) were reported. RESULTS Twenty-two studies were included, accounting for 52 study arms. Meta-regression identified that the socket sealing technique and publication year explained the observed heterogeneity. NMA showed that FA and OHB led to significantly lower ridge resorption than SH, resulting in 1.18 mm (95% PI 0.21-2.13) and 1.10 mm (95% PI 0.49-1.69) wide alveolar ridges, respectively. No significant difference between OHNB and SH was found (0.46 mm, 95% PI -0.70 to 1.64). The treatment with the largest probability for ARP was FA (52.7%), followed by OHB (39.1%) and OHNB (8.2%). CONCLUSIONS FA and OHB are efficacious techniques to seal the alveolus during ARP.
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Affiliation(s)
- João Roig Martins
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Tassiane Panta Wagner
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ana Carolina Vallim
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Willian Konflanz
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Falk Schwendicke
- Charité Centre for Dental Medicine, Department of Oral Diagnostics and Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Roger Keller Celeste
- Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alex Nogueira Haas
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Pereira KKY, Jara CM, Antunes GL, Gomes MS, Rösing CK, Cavagni J, Haas AN. Effects of periodontitis and periodontal treatment on systemic inflammatory markers and metabolic profile in obese and non-obese rats. J Periodontol 2022; 93:1411-1420. [PMID: 35289404 DOI: 10.1002/jper.21-0575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/03/2022] [Accepted: 02/14/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Little is known about a synergistic effect of periodontitis and obesity on systemic biomarkers and a possible effect periodontal treatment may exert. This study aimed to evaluate the impact of periodontitis and periodontal treatment on systemic inflammation and metabolic profile in obese and non-obese rats. METHODS 60 male Wistar rats were randomly divided in six groups differentiated by diet and periodontal status: no periodontitis (G1 and G4), untreated ligature-induced periodontitis (G2 and G5) and treated ligature-induced periodontitis (G3 and G6). Groups G4, G5 and G6 were exposed to cafeteria diet to induce obesity. Periodontitis was induced by silk ligatures over 4 weeks (G2, G3, G5, G6). Rats in G3 and G6 received scaling and root planning and were followed for additional 4 weeks. After sacrifice, serum levels of C-reactive protein (CRP), interleukin (IL)-1β, IL-6, IL-10, IL-17a, tumor necrosis factor alfa (TNF-α), glucose, triglycerides, and total cholesterol (TC) were compared between groups. RESULTS CRP was significantly higher in obese rats with than without periodontitis (G5 = 10.15μg/L vs. G4 = 4.47μg/L, p = 0.01). No beneficial effects of periodontal treatment were observed for CRP levels, IL-6, IL-1β, IL-17a, TNF-α, glucose and triglycerides. Treated periodontitis (G6) exhibited significantly lower TC than the periodontitis group (G5) in obese rats. CONCLUSION Periodontitis increased serum CRP in obese rats, indicating a synergistic role of periodontitis in the systemic inflammatory burden triggered by obesity. The treatment of induced periodontitis reduced TC levels in obese rats. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Karina Kimiko Yamashina Pereira
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cynthia Mireya Jara
- School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Faculty of Dentistry, National University of Assunción, Assunción, Paraguay
| | - Géssica Luana Antunes
- School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maximiliano Schünke Gomes
- School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Medical and Dental Center of the Military Police of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Juliano Cavagni
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alex Nogueira Haas
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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10
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Haas AN, Furlaneto F, Gaio EJ, Gomes SC, Palioto DB, Castilho RM, Sanz M, Messora MR. New tendencies in non-surgical periodontal therapy. Braz Oral Res 2021; 35:e095. [PMID: 34586209 DOI: 10.1590/1807-3107bor-2021.vol35.0095] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/31/2021] [Indexed: 12/11/2022] Open
Abstract
The aim of this review was to update the evidence of new approaches to non-surgical therapy (NSPT) in the treatment of periodontitis. Preclinical and clinical studies addressing the benefits of adjunctive antimicrobial photodynamic therapy, probiotics, prebiotics/synbiotics, statins, pro-resolving mediators, omega-6 and -3, ozone, and epigenetic therapy were scrutinized and discussed. Currently, the outcomes of these nine new approaches, when compared with subgingival debridement alone, did not demonstrate a significant added clinical benefit. However, some of these new alternative interventions may have the potential to improve the outcomes of NSPT alone. Future evidence based on randomized controlled clinical trials would help clinicians and patients in the selection of different adjunctive therapies.
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Affiliation(s)
- Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Flavia Furlaneto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Oral Surgery and Periodontology, Ribeirão Preto, SP, Brazil
| | - Eduardo José Gaio
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Sabrina Carvalho Gomes
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Daniela Bazan Palioto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Oral Surgery and Periodontology, Ribeirão Preto, SP, Brazil
| | - Rogerio Moraes Castilho
- Michigan University, School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, MI, USA
| | - Mariano Sanz
- Complutense University of Madrid, Etiology and Therapy of Periodontal and Peri-implant Diseases Research Group, Madrid, Spain
| | - Michel Reis Messora
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Oral Surgery and Periodontology, Ribeirão Preto, SP, Brazil
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Rodrigues JA, Santos NM, Azevedo CB, Haas AN, Lenzi TL. Non-invasive and micro-invasive treatments to arrest active occlusal carious lesions in erupting permanent molars: A randomized clinical trial. Braz Oral Res 2021; 35:e058. [PMID: 34346946 DOI: 10.1590/1807-3107bor-2021.vol35.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 11/25/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate the efficacy of non-invasive and micro-invasive treatments on the arrest of occlusal enamel carious lesions in erupting permanent molars. This two-arm randomized clinical trial included 27 subjects, aged 5-11 years, with 64 erupting permanent molars presenting active occlusal enamel carious lesions (as assessed by the International Caries Detection and Assessment System [ICDAS]; scores 1-3). The sample was randomly assigned into two treatment groups: 1) resin-modified glass ionomer cement sealant (Clinpro XT Varnish; 3M ESPE) and 2) 4-week topical fluoride varnish application (Duraphat; Colgate). All children and parents received oral hygiene and dietary instructions. Teeth were evaluated at baseline and 3, 6, 9, and 12 months regarding the eruption stage, biofilm accumulation, as well as severity and activity of the carious lesions. The Kaplan-Meier method was used to evaluate the survival estimates for inactivation of the carious lesions for both treatment groups. Multivariate Cox regression models with shared frailty were performed to identify factors associated with the outcome (p < 0.05). After 12 months, 22% and 3% of the lesions treated with topical fluoride varnish and sealant, respectively remained active. The adjusted model demonstrated that younger children had a higher probability of active enamel carious lesions arresting (hazard ratio [HR] 0.42, 95% confidence interval [CI] 0.22-0.78; p=0.01). However, the probability of active enamel carious lesions arresting after sealant application was 8.85 times higher compared with fluoride varnish applications (p=0.01). Sealing is a more effective approach than fluoride varnish for arresting occlusal enamel carious lesions in erupting permanent molars.
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Affiliation(s)
- Jonas Almeida Rodrigues
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, Porto Alegre, RS, Brazil
| | - Nicole Marchioro Santos
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, Porto Alegre, RS, Brazil
| | - Claudia Brito Azevedo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, Porto Alegre, RS, Brazil
| | - Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Tathiane Larissa Lenzi
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, Porto Alegre, RS, Brazil
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12
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Goergen J, Albandar JM, Oppermann RV, Rösing CK, Susin C, Haas AN. Periodontitis stage and grade are associated with poor oral-health-related quality of life: Findings from the Porto Alegre cohort study. J Clin Periodontol 2021; 48:1333-1343. [PMID: 34296465 DOI: 10.1111/jcpe.13527] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/07/2021] [Indexed: 12/13/2022]
Abstract
AIM To determine the association between periodontitis stage and grade with oral-health-related quality of life (OHRQoL). MATERIALS AND METHODS This cohort was derived from the Porto Alegre study. The original sample was representative of more than 3 million inhabitants of a Brazilian urban area. Full-mouth periodontal examinations at six sites per tooth were performed at baseline and 5 years later. Periodontitis grade was determined by direct evidence of progression of attachment loss over the follow-up. Stage of periodontitis and OHRQoL, determined by the oral health impact profile version 14 (OHIP-14), were recorded at the follow-up examination. Mean ratios (MRs) and 95% confidence intervals (95% CIs) were estimated adjusting for age, sex, smoking, systemic diseases, tooth loss, and baseline periodontitis diagnosis. RESULTS Five-hundred and ninety-nine individuals were analysed. Individuals with periodontitis grade C + stage II (MR = 1.49; 95% CI = 1.08-2.04) and stages III/IV (MR = 1.83; 95% CI = 1.25-2.66) had significantly higher OHIP scores than those without periodontitis or with periodontitis stage I/grade B. Individuals with periodontitis stages II and III/IV + grade B did not differ from those without periodontitis or with periodontitis stage I/grade B. CONCLUSION Severity and progression rate of periodontitis are associated with poor OHRQoL.
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Affiliation(s)
- Joseane Goergen
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jasim M Albandar
- Periodontal Diagnostics Research Laboratory, Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, Pennsylvania, USA
| | - Rui Vicente Oppermann
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristiano Susin
- Division of Comprehensive Oral Health-Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alex Nogueira Haas
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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13
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Wagner TP, Pires PR, Rios FS, de Oliveira JAP, Costa RDSA, Cunha KF, Silveira HLD, Pimentel S, Casati MZ, Rosing CK, Haas AN. Surgical and non-surgical debridement for the treatment of peri-implantitis: a two-center 12-month randomized trial. Clin Oral Investig 2021; 25:5723-5733. [PMID: 33725166 DOI: 10.1007/s00784-021-03874-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare surgical (ST) and non-surgical (NST) debridement for the treatment of peri-implantitis in a two-center randomized trial. MATERIALS AND METHODS Forty-five individuals with 63 implants with probing depth (PPD) ≥5mm, bleeding on probing (BOP), and radiographic bone loss ≥2mm were included. In the NST (30 implants), submucosal debridement was performed. In the ST (33 implants), a mucoperiosteal flap was raised and surfaces were decontaminated only by debridement as performed in NST. Clinical parameters and radiographs were compared at baseline and after 12 months. Means and standard errors were reported. RESULTS PPD considering all implant sites reduced significantly in NST from 4.14±0.25 to 3.25±0.18mm. In ST, PPD also significantly changed (3.74±0.22 to 3.00±0.29mm). No significant differences were observed between the two groups. For deep sites (≥7mm), PPD was 7.82±0.20mm at baseline and reduced to 5.10±0.30mm in NST, while in ST group, it was 7.11±0.11mm and changed to 5.22±0.91mm (between-groups p value=0.51). BOP significantly reduced from ~60 to 35% of all sites in both groups, without significant differences between them. When sites with radiographic bone level ≥3mm at baseline were analyzed, there was a significant difference between groups in bone gain after 12 months in favor of ST (ST=0.78±0.30mm compared to NST=0.25mm±0.13; p=0.03). CONCLUSIONS Surgical and non-surgical debridement for the treatment of peri-implantitis present similar clinical outcomes. Bone levels were better improved in ST than NST for sites with higher initial bone loss. CLINICAL RELEVANCE The treatment of peri-implantitis is still a challenge in clinical practice, since less than half of affected implants achieve health after surgical or non-surgical debridement. Considering the lack of clinically relevant differences between these two treatments, non-surgical debridement should be considered the first therapeutic choice for peri-implantitis, mainly mild to moderate cases.
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Affiliation(s)
- Tassiane Panta Wagner
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | | | - Fernando Silva Rios
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | - Joao Augusto Peixoto de Oliveira
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | - Ricardo Dos Santos Araujo Costa
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | - Kelly F Cunha
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | | | - Suzana Pimentel
- Periodontology, Faculty of Dentistry, Paulista University, São Paulo, Brazil
| | - Marcio Zaffalon Casati
- Periodontology, Faculty of Dentistry, Paulista University, São Paulo, Brazil.,Periodontology, Faculty of Dentistry, University of Campinas, Piracicaba, Brazil
| | - Cassiano Kuchenbecker Rosing
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil
| | - Alex Nogueira Haas
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90030-035, Brazil.
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14
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Christofoli BR, Rios FS, Costa RSA, Wagner TP, Goergen J, Izquierdo C, Jardim JJ, Maltz M, Haas AN. Changes in gingivitis and protective factors among adults: A 4-year prospective population-based study. Community Dent Oral Epidemiol 2021; 49:437-444. [PMID: 33719061 DOI: 10.1111/cdoe.12619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES There are limited longitudinal data regarding gingival inflammation in adults. This study aimed to assess changes in gingivitis over 4 years and to determine protective factors. METHODS A representative sample of 1023 adults living in Porto Alegre, Brazil, was obtained in the Caries-Perio Collaboration Study. At follow-up, 402 individuals were re-examined. Gingivitis was assessed by the gingival bleeding index (GB) at both time points. Individuals were dichotomized into those showing reductions ≥ 15% and those showing reductions < 15% or increase in bleeding sites. Multivariable Poisson regression models were fitted with 11 possible risk factors, estimating relative risks (RR) and 95% confidence intervals (95% CI). RESULTS Percentage of individuals with GB ≥ 10% reduced from 72.4% to 53.8%. Bleeding sites significantly reduced (25.9%-20.1%), and in a higher magnitude in buccal/palatal sites (34.1%-24.0%). 31.0% of individuals presented GB reduction ≥ 15% in all sites. Toothbrushing ≥ 3 times/d increased 72% the probability of ≥15% GB reduction compared with ≤1/d (RR = 1.72; 95% CI 1.01-3.16). For each 10 pack-years smoked, the probability of ≥15% GB reduction was 3% higher (RR = 1.03; 95% CI: 1.01-1.04). At buccal/palatal sites, normal weight individuals had 26% higher probability of reducing GB than overweight-obese individuals (RR = 1.26; 95% CI: 1.01-1.62). A 5% higher decrease in GB sites was observed in the absence than the presence of periodontitis. Younger individuals had higher reduction in GB sites. CONCLUSIONS In the studied population, gingivitis reduced over time, with younger age, better oral hygiene, absence of periodontitis and normal weight being found to be protective factors. Smoking was associated with lower levels of gingivitis over time, probably due to its vasoconstrictive effect.
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Affiliation(s)
- Barbara R Christofoli
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando S Rios
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ricardo S A Costa
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Tassiane P Wagner
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Joseane Goergen
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristina Izquierdo
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana J Jardim
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Marisa Maltz
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alex Nogueira Haas
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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15
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Lucena IMD, Santos IDS, Daroit NB, Salgueiro AP, Cavagni J, Haas AN, Rados PV. Sun protection as a protective factor for actinic cheilitis: Cross-sectional population-based study. Oral Dis 2021; 28:1802-1810. [PMID: 33751725 DOI: 10.1111/odi.13837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/11/2021] [Accepted: 02/28/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine whether sun protection is associated with lower occurrence of actinic cheilitis in adults living in a city from southern Brazil. MATERIALS AND METHODS A multi-stage proportional sample of 404 individuals 18 years and older was obtained. Interviews and clinical examinations were conducted in participants' households. Four categories of self-reported use of sun protection were determined. Multivariable Poisson regression was used to assess the associations. RESULTS Prevalence of actinic cheilitis was 47.1%. In the first main-effects multivariable model, AC was significantly associated with sex, age, skin colour and duration of sun exposure, but not with sun protection. However, the association between sun protection and actinic cheilitis was modified by the time of sun exposure. Among those exposed ≥4 hr/day to sun, individuals using physical protection or physical + chemical protection were 33% (prevalence ratio = 0.67, 95% confidence interval [CI] 0.47-0.94, p = .02) and 36% (PR = 0.64, 95% CI 0.47-0.94, p = .02), respectively, less likely to have actinic cheilitis than those who did not use any sun protection, adjusting for sex, age and skin colour. CONCLUSIONS Physical and chemical sun protection were associated with lower occurrence of actinic cheilitis in individuals with greater exposure to sun.
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Affiliation(s)
- Ieda Milani de Lucena
- Department of Conservative Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ingrid da Silva Santos
- Department of Conservative Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Natália Batista Daroit
- Department of Conservative Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Arthur Pias Salgueiro
- Department of Conservative Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliano Cavagni
- Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alex Nogueira Haas
- Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Pantelis Varvaki Rados
- Department of Conservative Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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16
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Konflanz W, Orth CC, Celeste RK, Muniz FWMG, Haas AN. Influence of Donor Site and Harvesting Technique of Connective Tissue Graft on Root Coverage Outcomes of Single Gingival Recessions: Systematic Review and Meta-analyses. J Int Acad Periodontol 2021; 23:79-98. [PMID: 33512344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To compare the outcomes of root coverage when the (1) donor site of connective tissue graft is the palate or tuberosity and (2) when connective tissue graft is harvested with intra- or extra-oral de-epithelization techniques. METHODS The primary outcome was patient satisfaction. Secondary outcomes included complete root coverage, percentage of root coverage and keratinized tissue width. Searches were conducted until December 2019 in PubMed, EMBASE, Scopus and CENTRAL. RESULTS 3275 studies were retrieved, but no randomized trials (randomized controlled trials) were found comparing tuberosity and palate. Data were extracted for one arm assessing any connective tissue graft technique from 56 randomized controlled trials to compare intra-oral de-epithelization and extra-oral de-epithelization outcomes. Among these studies, none have harvested connective tissue graft from tuberosity. Patient satisfaction for intra-oral de-epithelization and extra-oral de-epithelization ranged between 79% and 95%. Complete root coverage for intra-oral de-epithelization and extra-oral de-epithelization techniques was 55% (95%CI 46-65) and 70% (95%CI 63-77). Metaregression analyzes demonstrated that free gingival graft presented 4.41 higher chance of CRC [odds ratio (OR)=4.41, p=0.001] compared to single incision technique, followed by Bruno's (OR=4.39) and double-blade (OR=3.85) techniques. There were no differences between de-epithelization techniques for percentage of root coverage and keratinized tissue width. CONCLUSION No evidence was found to support the use of connective tissue grafts from the tuberosity. If complete root coverage is the major clinical goal, extra-oral deepithelization may be preferred over intra-oral de-epithelization techniques.
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Affiliation(s)
- Willian Konflanz
- Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cassio Cardona Orth
- Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil and Instituto Implanteperio, São Paulo, Brazil
| | - Roger Keller Celeste
- Department of Preventive and Social Denstitry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Alex Nogueira Haas
- Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
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17
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Vallim AC, Gaio EJ, Oppermann RV, Rösing CK, Albandar JM, Susin C, Haas AN. Obesity as a risk factor for tooth loss over 5 years: A population-based cohort study. J Clin Periodontol 2020; 48:14-23. [PMID: 33010056 DOI: 10.1111/jcpe.13378] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/18/2020] [Accepted: 09/24/2020] [Indexed: 12/12/2022]
Abstract
AIM To assess obesity as a risk factor for tooth loss over 5 years in an urban sample of Brazilian adults. MATERIALS AND METHODS A total of 1586 individuals were surveyed using a multistage probabilistic approach. Five years later, 635 individuals 14-64 years old were re-examined. An incident case of tooth loss was determined for a participant that had lost at least one tooth over time. Obesity was evaluated by calculating body mass index at baseline and by the change in obesity status over time. RESULTS Incident cases of tooth loss were significantly more frequent among obese (47.1%) than normal-weight individuals (32.4%) (p = .004). Obese individuals had 31% higher risk [relative risk (RR) =1.31; 95% confidence interval (95%CI) 1.04-1.65] for tooth loss than normal-weight individuals adjusting for age, socio-economic status, smoking, dental care and periodontitis. This association was significant for females (RR=1.47, 95%CI 1.08-2.01), but not for males. The risk for tooth loss was also modified by presence of periodontitis at baseline and lifetime smoking exposure. There was an increased risk for tooth loss for those that remained obese than those that remained normal weight. CONCLUSION Obesity is associated with higher risk for tooth loss. This association was modified by sex, periodontal status and smoking.
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Affiliation(s)
- Ana Carolina Vallim
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduardo José Gaio
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rui Vicente Oppermann
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Jasim M Albandar
- Periodontal Diagnostics Research Laboratory, Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA, USA
| | - Cristiano Susin
- Department of Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alex Nogueira Haas
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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18
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Liberman J, Franzon R, Guimarães LF, Casagrande L, Haas AN, Araujo FB. Survival of composite restorations after selective or total caries removal in primary teeth and predictors of failures: A 36-months randomized controlled trial. J Dent 2019; 93:103268. [PMID: 31881241 DOI: 10.1016/j.jdent.2019.103268] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/20/2019] [Accepted: 12/21/2019] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES The aim of this study was to assess the survival of composite restorations after selective (SCR) or total caries removal (TCR) and determine predictors of failures after 36 months. METHODS 120 teeth with deep occlusal or occlusal-proximal carious lesions were randomly divided into control (TCR; n = 54; 69% Class II) and test (SCR; n = 66; 63% Class II) groups. Clinical evaluation was applied using the USPHS criteria, and the presence of Charlie or Delta scores at the marginal integrity were considered as a failure. RESULTS The overall survival rate of restorations was 68% after 36 months, 81% for TCR and 57% for SCR (p = 0.004). The multivariable Cox Regression model demonstrated that restorations performed after SCR had 3.44 times greater probability of failure compared to TCR (p = 0.006). The other two predictors for failure of restorations were teeth with Class II cavities (hazard ratio = 3.3) and children with gingival bleeding over 20% (hazard ratio = 2.5). CONCLUSIONS Performing composite restorations after SCR in primary teeth had success rate significantly lower than restorations performed after TCR. Complex cavities and worst patient´s oral hygiene were found to be predictors of failure of restorations. CLINICAL SIGNIFICANCE Although SCR has been demonstrating high rates of pulp preservation, clinicians should consider that composite restorations fail in a higher frequency compared to TCR in primary teeth and, in some circumstances, may be preferable in terms of restoration longevity.
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Affiliation(s)
- J Liberman
- Department of Pediatric Dentistry, School of Dentistry, Universidad de la Republica, Montevideo, Uruguay
| | - R Franzon
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - L F Guimarães
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - L Casagrande
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - A N Haas
- Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - F B Araujo
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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19
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Schütz JDS, de Azambuja CB, Cunha GR, Cavagni J, Rösing CK, Haas AN, Thomé FS, Fiorini T. Association between severe periodontitis and chronic kidney disease severity in predialytic patients: A cross-sectional study. Oral Dis 2019; 26:447-456. [PMID: 31742816 DOI: 10.1111/odi.13236] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/22/2019] [Accepted: 11/10/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim of this cross-sectional study was to evaluate the association between periodontitis and different severities of chronic kidney disease (CKD) in predialytic patients. MATERIALS AND METHODS Demographic, socioeconomic, and medical data of 139 patients from the nephrology service of one university hospital in Porto Alegre, Brazil, were obtained through interview and clinical records. Full-mouth six-sites per tooth periodontal examinations were performed. Associations between periodontitis, stages of CKD, and estimated glomerular filtration rate (eGFR) were estimated by multivariable models adjusted for sex, smoking, vitamin D supplementation, physical activity, and renal treatment duration. CKD was classified based on eGFR (<60 ml/min/1.73 m2 ) estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. RESULTS Patients with severe periodontitis, compared to those without severe periodontitis, had 2.8 (95% CI: 1.25-6.62) and 3.4 (95% CI: 1.27-9.09) times higher risk of being in stages 4 and 5 of CKD, respectively. Having ≥ 2 teeth with clinical attachment loss (CAL) ≥6 mm increased 3.9 times the risk of being in stage 5 of CKD. Patients with severe periodontitis and ≥2 teeth with CAL ≥ 6 mm had 4.4 ml/min/1.732 and 5.2 ml/min/1.732 lower eGFR (p-values < .05), respectively. CONCLUSION Severe periodontitis was associated with poor renal conditions in predialytic CKD patients, strengthening the importance of periodontal evaluation in such patient population.
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Affiliation(s)
- Jasper da Silva Schütz
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina Barrera de Azambuja
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Juliano Cavagni
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alex Nogueira Haas
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Tiago Fiorini
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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20
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Nuernberg MAA, Ivanaga CA, Haas AN, Aranega AM, Casarin RCV, Caminaga RMS, Garcia VG, Theodoro LH. Periodontal status of individuals with Down syndrome: sociodemographic, behavioural and family perception influence. J Intellect Disabil Res 2019; 63:1181-1192. [PMID: 31062454 DOI: 10.1111/jir.12629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/09/2019] [Accepted: 03/26/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The aim of the present study was to assess the periodontal condition of individuals with Down syndrome and the association with sociodemographic and behavioural characteristics and family perception of oral health. METHODS This cross-sectional observational study was performed at a referral centre for dental assistance to disabled persons in Araçatuba, Brazil. Parents of the individuals were interviewed, and the visible plaque index, bleeding on probing, probing pocket depth and clinical attachment level were recorded by one periodontist in six sites per tooth of all teeth. The individual was the unit of analysis. The significance level was set at 5%. RESULTS Sixty-four subjects (23.8 ± 8.3 years old) were included. Eighteen (28.1%) were diagnosed with gingivitis and 46 (71.9%) with periodontitis. In the multiple logistic regression final model, age and self-reported oral hygiene practices were associated with the occurrence of periodontitis. The chance of having periodontitis was 4.7 times higher among individuals older than 20 years and approximately 4 times higher in patients whose oral hygiene was performed by themselves and their parents, compared with those who performed oral hygiene alone. Sex, follow-up time in the centre, education, degree of participants' dependence, flossing and family history of periodontal disease were not associated with the occurrence of periodontitis. Higher levels of plaque and bleeding were observed for participants with parents reporting bad gingival health (76.2% and 46.9%) and deficient oral hygiene (79.5% and 47.3%). The perception of parents regarding gingival bleeding was correlated with higher bleeding detected clinically (P = 0.01; 50.1%). CONCLUSIONS The prevalence of periodontitis in individuals with Down syndrome is high and increases with age, even in the face of the parents' perception about their children's oral condition.
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Affiliation(s)
- M A A Nuernberg
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - C A Ivanaga
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - A N Haas
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - A M Aranega
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - R C V Casarin
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - R M S Caminaga
- Department of Morphology, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - V G Garcia
- Post Graduate Program, Latin American Institute of Dental Research and Education (ILAPEO), Curitiba, Brazil
| | - L H Theodoro
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
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Rösing CK, Fiorini T, Haas AN, Muniz FWMG, Oppermann RV, Susin C. The impact of maintenance on peri-implant health. Braz Oral Res 2019; 33:e074. [PMID: 31576958 DOI: 10.1590/1807-3107bor-2019.vol33.0074] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 12/18/2022] Open
Abstract
Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.
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Affiliation(s)
- Cassiano Kuchenbecker Rösing
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Tiago Fiorini
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | | | - Rui Vicente Oppermann
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Cristiano Susin
- University of North Carolina, School of Dentistry, Department of Periodontology, Chapel Hill, NC, USA
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22
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Christofoli BR, Silva NC, Oliveira JAP, Fernandes MI, Haas AN. Predictors of dental plaque and gingivitis in patients receiving integrated dental treatment—a longitudinal retrospective study. Clin Oral Investig 2019; 23:651-659. [DOI: 10.1007/s00784-018-2485-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/02/2018] [Indexed: 11/24/2022]
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23
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Haas AN, Prado R, Rios FS, Costa RDSA, Angst PDM, Moura MDS, Maltz M, Jardim JJ. Occurrence and predictors of gingivitis and supragingival calculus in a population of Brazilian adults. Braz Oral Res 2019; 33:e036. [DOI: 10.1590/1807-3107bor-2019.vol33.0036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/21/2019] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Renan Prado
- Universidade Federal do Rio Grande do Sul, Brazil
| | | | | | | | | | - Marisa Maltz
- Universidade Federal do Rio Grande do Sul, Brazil
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24
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Schütz JDS, Flores MF, Montenegro MM, Furtado MV, Polanczyc CA, Haas AN, Rösing CK. CONDIÇÕES BUCAIS DE PACIENTES CARDIOPATAS CRÔNICOS. R Fac Odontol Porto Alegre 2018. [DOI: 10.22456/2177-0018.53809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo: Descrever as condições de saúde bucal e hábitos comportamentais relacionados à saúde de indivíduos com doença arterial coronariana crônica (DAC) em acompanhamento em uma unidade de atendimento cardiológico do Hospital de Clínicas de Porto Alegre.
Materiais e Métodos: Foram avaliados 100 pacientes consecutivos que frequentaram a unidade entre junho de 2011 e março de 2012. Dados demográficos, socioeconômicos e comportamentais foram obtidos. Um exame bucal foi realizado avaliando os índices de placa visível (IPV) e sangramento gengival (ISG), recessão gengival (RG), profundidade de sondagem (PS), sangramento à sondagem (SS) e perda de inserção (PI), além do índice CPO-D.
Resultados: Observou-se um predomínio de indivíduos do gênero masculino, sendo que a faixa etária predominante foi a partir de 60 anos na amostra do estudo. Cerca de metade dos indivíduos era ex-fumante. Mais de três quartos da amostra relatou visitas ao dentista de maneira irregular. Os parâmetros relacionados ao biofilme supragengival apresentaram médias elevadas, contabilizando índices de placa e sangramento médios de cerca de 68% e 47%, respectivamente. Mais da metade dos dentes examinados possuíam PS ≥4 mm, e o sangramento subgengival (SS) esteve presente em aproximadamente três quartos dos sítios examinados. A maior parte dos dentes examinados apresentou PI ≥6 mm. Em média, os indivíduos do presente estudo apresentaram 13,2 dentes perdidos. O CPO-D médio encontrado foi de 10,9 dentes.
Conclusão: A presente amostra apresentou condições de saúde bucal compatíveis com a epidemiologia das doenças bucais mais prevalentes na população brasileira. Porém, esta condição é alarmante no contexto de saúde, uma vez que cada vez mais tem-se associado perda dentária e doenças periodontais a maiores riscos de eventos cardiovasculares.
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25
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Pinto JPNS, Goergen J, Muniz FWMG, Haas AN. Vitamin D levels and risk for periodontal disease: A systematic review. J Periodontal Res 2018; 53:298-305. [PMID: 29492977 DOI: 10.1111/jre.12531] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the existing evidence supporting or refuting the following questions: (i) Do patients with lower vitamin D levels have higher risk for periodontal disease? (ii) Are periodontal treatment outcomes improved by the adjuvant supplementation of vitamin D or by elevated serum vitamin D levels? MATERIAL AND METHODS MEDLINE, SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched up to September 2017. Studies were included if they had measured serum vitamin D levels or vitamin D intake and any periodontal parameter. RESULTS Overall, 27 studies were included (13 cross-sectional studies, 6 case-control studies, 5 cohort studies, 2 randomized clinical trials and 1 case series study). Sixty-five percent of the cross-sectional studies reported significant associations between low vitamin D levels and poor periodontal parameters. None of the observational longitudinal studies found that periodontal disease progression could be attributed to lower vitamin D levels. No interventional studies that evaluated the use of vitamin D supplementation as a solely adjuvant to periodontal treatment was found. No meta-analysis was performed due to high variability across studies. CONCLUSION The data to support or refute the association between vitamin D levels and periodontal disease are inconclusive at the moment. More rigorously designed longitudinal studies with standardized definitions of periodontal disease and vitamin D are necessary.
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Affiliation(s)
- J P N S Pinto
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - J Goergen
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - F W M G Muniz
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - A N Haas
- Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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26
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Gaio EJ, Haas AN, Rösing CK, Oppermann RV, Albandar JM, Susin C. Effect of obesity on periodontal attachment loss progression: a 5-year population-based prospective study. J Clin Periodontol 2016; 43:557-65. [DOI: 10.1111/jcpe.12544] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 01/09/2023]
Affiliation(s)
- Eduardo José Gaio
- Faculty of Dentistry - Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Alex Nogueira Haas
- Faculty of Dentistry - Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | | | - Rui Vicente Oppermann
- Faculty of Dentistry - Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Jasim M. Albandar
- Department of Periodontology; Temple University School of Dentistry; Philadelphia PA USA
| | - Cristiano Susin
- Departments of Periodontics and Oral Biology; The Dental College of Georgia; Augusta University; Augusta GA USA
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27
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Franzon R, Opdam NJ, Guimarães LF, Demarco FF, Casagrande L, Haas AN, Araujo FB. Randomized controlled clinical trial of the 24-months survival of composite resin restorations after one-step incomplete and complete excavation on primary teeth. J Dent 2015; 43:1235-41. [PMID: 26231301 DOI: 10.1016/j.jdent.2015.07.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 06/30/2015] [Accepted: 07/24/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This randomized clinical trial aimed to compare the 24-months survival of composite restorations in primary molars after partial caries removal (PCR) and total caries removal (TCR). METHODS Forty-eight children aged 3-8 years with at least one molar with a deep carious lesion were included (PCR; n=66; TCR; n=54). For PCR, excavation was stopped when dentine with a leathery consistency was achieved; in the TCR group, total absence of carious tissue was confirmed using a blunt-tipped probe. Pulpotomy was performed in cases of pulp exposure. Success was assessed by modified USPHS criteria with Alpha and Bravo scores recorded as success. RESULTS Pulp exposure occurred in 1 and 15 of the teeth treated with PCR and TCR respectively (p<0.01). The restorations survival rate after 24 months was 66% (PCR) and 86% (TCR) (p=0.03). When teeth that received pulpotomy were analyzed separately, the survival rate was 92% (p=0.09). PCR performed in occlusoproximal restorations demonstrated the lowest success rate (p=0.002). PCR increases 2.90 times the probability of having a restorative failure compared to TCR (p=0.03), after adjusting for cavity type. When pulp exposure and restoration failure were considered as the outcome, there was no significant difference between the two groups (p=0.10) with success rates of 64% (PCR) and 61% (TCR). CONCLUSION Collectively, deciduous teeth submitted to PCR prevented pulp exposure and, consequently, more invasive treatments; otherwise, PCR yielded lower longevity for composite restoration compared to TCR, suggesting that PCR restorations need to be followed over time, especially when multi-surface restorations are involved. CLINICAL SIGNIFICANCE Composite restorations on carious remaining tissue require monitoring over time, especially those performed in more than one surface. Even if the restorations present shortcomings over the time, the majority of them are subject to repair, allowing more conservative approaches for teeth with deep caries lesions.
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Affiliation(s)
- R Franzon
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - N J Opdam
- Department of Preventive and Restorative Dentistry, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - L F Guimarães
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - F F Demarco
- Post-Graduate Program in Dentistry and Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - L Casagrande
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - A N Haas
- Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - F B Araujo
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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28
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Haas AN, Gaio EJ, Wagner MC, Rios FS, Costa RDSA, Rösing CK, Oppermann RV, Albandar J, Susin C. A population-based cohort study of oral health in South Brazil: The Porto Alegre Study. Rev Bras Epidemiol 2015; 18:515-9. [PMID: 26083520 DOI: 10.1590/1980-5497201500020018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 04/25/2014] [Indexed: 11/22/2022] Open
Abstract
Few population-based cohort studies have been established in Dentistry and this is especially true for Latin America. We conducted a population-based prospective study focusing on oral health in Porto Alegre, south Brazil, and herein we describe its methodology and discuss directions for further research. The cohort was established in 2001 using a multistage probability sample of 1,465 toothed and 121 edentulous subjects. A 5-year follow-up was performed in 2006 that included 755 individuals. The main aim of this study was to determine the pattern and risk factors for periodontal disease progression and tooth loss incidence. A full-mouth protocol was used including periodontal assessments at six sites per tooth. Primary outcomes were periodontal attachment loss and tooth loss. Oral mucosal lesions, dental plaque, gingivitis, supragingival calculus, probing depths, gingival recession, and dental caries were also assessed. This is the first population-based cohort study to focus on periodontal disease in Latin America. Findings will contribute to our understanding of the epidemiology of periodontal disease and provide valuable data for the planning and implementation of preventive and therapeutic strategies.
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Affiliation(s)
- Alex Nogueira Haas
- Department of Periodontics, Scholl of dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eduardo José Gaio
- Department of Periodontics, Scholl of dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marcius Comparsi Wagner
- Department of Periodontics, Scholl of dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Silva Rios
- Department of Periodontics, Scholl of dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Cassiano Kuchenbecker Rösing
- Department of Periodontics, Scholl of dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rui Vicente Oppermann
- Department of Periodontics, Scholl of dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Jasim Albandar
- Periodontal Diagnostics Research Laboratory, Department of Periodontology and Oral Implantology, Temple University, Philadelphia, Pennsylvania, USA
| | - Cristiano Susin
- Laboratory for Applied Periodontal and Craniofacial Regeneration, Departments of Periodontics and Oral Biology, College of Dental Medicine, Georgia Regents University, Augusta, Georgia, USA
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29
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Saffi MAL, Furtado MV, Polanczyk CA, Montenegro MM, Ribeiro IWJ, Kampits C, Haas AN, Rösing CK, Rabelo-Silva ER. Relationship between vascular endothelium and periodontal disease in atherosclerotic lesions: Review article. World J Cardiol 2015; 7:26-30. [PMID: 25632316 PMCID: PMC4306203 DOI: 10.4330/wjc.v7.i1.26] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/26/2014] [Accepted: 12/19/2014] [Indexed: 02/06/2023] Open
Abstract
Inflammation and endothelial dysfunction are linked to the pathogenesis of atherosclerotic disease. Recent studies suggest that periodontal infection and the ensuing increase in the levels of inflammatory markers may be associated with myocardial infarction, peripheral vascular disease and cerebrovascular disease. The present article aimed at reviewing contemporary data on the pathophysiology of vascular endothelium and its association with periodontitis in the scenario of cardiovascular disease.
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30
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Cortelli SC, Costa FO, Rode SDM, Haas AN, Andrade AKPD, Pannuti CM, Escobar EC, Almeida ERD, Cortelli JR, Pedrazzi V. Mouthrinse recommendation for prosthodontic patients. Braz Oral Res 2014; 28 Spec No:S1806-83242014000200201. [PMID: 25003786 DOI: 10.1590/1807-3107bor-2014.vol28.0020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 04/16/2014] [Indexed: 11/21/2022] Open
Abstract
Different reasons can contribute to classifying dental prosthesis wearers as high-risk individuals in relation to dental biofilm accumulation. These include a past history of oral disease, age and additional retentive areas. Other common complaints include inflammation and halitosis. Moreover, prosthesis replacement and prosthetic pillar loss are generally associated with caries and periodontal disease recurrence. Therefore, the present study undertook to make a critical review of the literature, aiming at discussing the main aspects related to chemical agent prescriptions for dental prosthesis wearers. Most of the articles were selected based on relevance, methods and availability in regard to the specific subject under investigation, without considering publication year limitations. Different types of prostheses and their impact on teeth and other oral tissues were reported. It was demonstrated that there is greater biofilm buildup and increased inflammatory levels in the presence of different types of prostheses, suggesting that additional measures are required both on population-wide and individual levels in order to control these factors. Mechanical control consists of a combination of manual or electric toothbrush and toothpaste, as well as specific devices for interdental cleaning. Although many chemical agents exhibit antimicrobial benefits when used for prosthesis disinfection, only a few agents can be used safely without causing damage. Regarding the selection of antiseptics by the overall population, chlorhexidine is the most indicated in the short term and in sporadic cases. The most indicated adjuncts to overcome the deficiencies and limitations of daily mechanical biofilm control are products containing essential oils as active ingredients.
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Affiliation(s)
- Sheila Cavalca Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Fernando Oliveira Costa
- Periodontology Department, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sigmar de Mello Rode
- Dental Materials and Prosthesis Department, Instituto de Ciência e Tecnologia, Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | - Alex Nogueira Haas
- Periodontology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, RS, Brazil
| | | | - Claudio Mendes Pannuti
- Periodontology Department, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Elaine Cristina Escobar
- Periodontology Department, School of Dentistry, Faculdades Metropolitanas Unidas, São Paulo, SP, Brazil
| | - Eliete Rodrigues de Almeida
- Epidemiology and Pediatric Dentistry Department, School of Dentistry, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
| | - José Roberto Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Vinicius Pedrazzi
- Endodontics and Prosthesis Department, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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31
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Rösing CK, Junges R, Haas AN. Publication rates of editorial board members in oral health journals. Braz Oral Res 2014; 28:S1806-83242014000100251. [PMID: 25166764 DOI: 10.1590/1807-3107bor-2014.vol28.0042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 05/16/2014] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to measure the publication rate of editorial board members in their board journals and to evaluate associated variables. We evaluated the ten highest-ranked journals according to the 5-year impact factor under 'Dentistry, Oral Surgery & Medicine' subject category for 2010, 2011, and 2012. All original research papers with at least one member of the editorial board as author were counted. Final analyses assessed associated variables such as size of the editorial board, number of papers published each year, and each journal's impact factor. Overall, there was an increase in the average number of articles published from 2010 (115.2 ± 52.2) to 2012 (134.7 ± 47.4). The number and percentage of articles published with editorial board members as authors over the three years did not follow the same pattern, with a slight decrease from 2010 to 2011 and an increase in 2012. The number of articles with editorial board members as authors was significantly higher for journals with impact factors ≥4.0. Journals with a higher impact factor and larger editorial board were associated with higher chances of editorial board members publishing in their respective journals. Participation of editorial board members as authors in publishing varies significantly among journals.
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Affiliation(s)
- Cassiano Kuchenbecker Rösing
- Department of Periodontology, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Roger Junges
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Alex Nogueira Haas
- Department of Periodontology, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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32
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Cortelli SC, Costa FO, Rode SDM, Haas AN, Andrade AKPD, Pannuti CM, Escobar EC, Almeida ERD, Cortelli JR, Pedrazzi V. Mouthrinse recommendation for prosthodontic patients. Braz Oral Res 2014. [PMID: 25003786 DOI: 10.1590/1807-3107bor-2014.vol28.0020.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Different reasons can contribute to classifying dental prosthesis wearers as high-risk individuals in relation to dental biofilm accumulation. These include a past history of oral disease, age and additional retentive areas. Other common complaints include inflammation and halitosis. Moreover, prosthesis replacement and prosthetic pillar loss are generally associated with caries and periodontal disease recurrence. Therefore, the present study undertook to make a critical review of the literature, aiming at discussing the main aspects related to chemical agent prescriptions for dental prosthesis wearers. Most of the articles were selected based on relevance, methods and availability in regard to the specific subject under investigation, without considering publication year limitations. Different types of prostheses and their impact on teeth and other oral tissues were reported. It was demonstrated that there is greater biofilm buildup and increased inflammatory levels in the presence of different types of prostheses, suggesting that additional measures are required both on population-wide and individual levels in order to control these factors. Mechanical control consists of a combination of manual or electric toothbrush and toothpaste, as well as specific devices for interdental cleaning. Although many chemical agents exhibit antimicrobial benefits when used for prosthesis disinfection, only a few agents can be used safely without causing damage. Regarding the selection of antiseptics by the overall population, chlorhexidine is the most indicated in the short term and in sporadic cases. The most indicated adjuncts to overcome the deficiencies and limitations of daily mechanical biofilm control are products containing essential oils as active ingredients.
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Affiliation(s)
- Sheila Cavalca Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Fernando Oliveira Costa
- Periodontology Department, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sigmar de Mello Rode
- Dental Materials and Prosthesis Department, Instituto de Ciência e Tecnologia, Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | - Alex Nogueira Haas
- Periodontology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, RS, Brazil
| | | | - Claudio Mendes Pannuti
- Periodontology Department, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Elaine Cristina Escobar
- Periodontology Department, School of Dentistry, Faculdades Metropolitanas Unidas, São Paulo, SP, Brazil
| | - Eliete Rodrigues de Almeida
- Epidemiology and Pediatric Dentistry Department, School of Dentistry, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
| | - José Roberto Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Vinicius Pedrazzi
- Endodontics and Prosthesis Department, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Pedrazzi V, Escobar EC, Cortelli JR, Haas AN, Andrade AKPD, Pannuti CM, Almeida ERD, Costa FO, Cortelli SC, Rode SDM. Antimicrobial mouthrinse use as an adjunct method in peri-implant biofilm control. Braz Oral Res 2014; 28 Spec No:S1806-83242014000200301. [PMID: 25003787 DOI: 10.1590/1807-3107bor-2014.vol28.0022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/11/2014] [Indexed: 01/23/2023] Open
Abstract
Great possibilities for oral rehabilitation emerged as a result of scientific consolidation, as well as a large number of dental implant applications. Along with implants appeared diseases such as mucositis and peri-implantitis, requiring management through several strategies applied at different stages. Biofilm accumulation is associated with clinical signs manifest by both tooth and implant inflammation. With this in mind, regular and complete biofilm elimination becomes essential for disease prevention and host protection. Chemical control of biofilms, as an adjuvant to mechanical oral hygiene, is fully justified by its simplicity and efficacy proven by studies based on clinical evidence. The purpose of this review was to present a consensus regarding the importance of antimicrobial mouthrinse use as an auxiliary method in chemical peri-implant biofilm control. The active ingredients of the several available mouthrinses include bis-biguanide, essential oils, phenols, quaternary ammonium compounds, oxygenating compounds, chlorine derivatives, plant extracts, fluorides, antibiotics and antimicrobial agent combinations. It was concluded that there is strong clinical evidence that at least two mouthrinses have scientifically proven efficacy against different oral biofilms, i.e., chlorhexidine digluconate and essential oils; however, 0.12% chlorhexidine digluconate presents a number of unwanted side effects and should be prescribed with caution. Chemical agents seem beneficial in controlling peri-implant inflammation, although they require further investigation. We recommend a scientifically proven antiseptic, with significant short and long term efficacy and with no unwanted side effects, for the prevention and/or treatment of peri-implant disease.
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Affiliation(s)
- Vinicius Pedrazzi
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Elaine Cristina Escobar
- Periodontology Department, School of Dentistry, Faculdades Metropolitanas Unidas, São Paulo, SP, Brazil
| | - José Roberto Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Alex Nogueira Haas
- Periodontology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, RS, Brazil
| | | | - Claudio Mendes Pannuti
- Periodontology Department, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Eliete Rodrigues de Almeida
- Epidemiology and Pediatric Dentistry Department, School of Dentistry, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
| | - Fernando Oliveira Costa
- Periodontology Department, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sheila Cavalca Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Sigmar de Mello Rode
- Dental Materials and Prosthesis Department, Instituto de Ciência e Tecnologia, Univ Estadual Paulista, São José dos Campos, SP, Brazil
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Haas AN, Wagner MC, Oppermann RV, Rösing CK, Albandar JM, Susin C. Risk factors for the progression of periodontal attachment loss: a 5-year population-based study in South Brazil. J Clin Periodontol 2014; 41:215-23. [DOI: 10.1111/jcpe.12213] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Alex Nogueira Haas
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Marcius Comparsi Wagner
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Rui Vicente Oppermann
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Jasim M. Albandar
- Periodontal Diagnostics Research Laboratory; Department of Periodontology and Oral Implantology; Temple University School of Dentistry; Philadelphia PA USA
| | - Cristiano Susin
- Department of Periodontics and Oral Biology; College of Dental Medicine; Georgia Regents University; Augusta GA USA
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Saffi MAL, Furtado MV, Montenegro MM, Ribeiro IWJ, Kampits C, Rabelo-Silva ER, Polanczyk CA, Rösing CK, Haas AN. The effect of periodontal therapy on C-reactive protein, endothelial function, lipids and proinflammatory biomarkers in patients with stable coronary artery disease: study protocol for a randomized controlled trial. Trials 2013; 14:283. [PMID: 24010954 PMCID: PMC3844458 DOI: 10.1186/1745-6215-14-283] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 09/03/2013] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Scarce information exists regarding the preventive effect of periodontal treatment in the recurrence of cardiovascular events. Prevention may be achieved by targeting risk factors for recurrent coronary artery disease (CAD) in patients with previous history of cardiovascular events. The aim of this trial is to compare the effect of two periodontal treatment approaches on levels of C-reactive protein, lipids, flow-mediated dilation and serum concentrations of proinflammatory and endothelial markers in stable CAD patients with periodontitis over a period of 12 months. METHODS/DESIGN This is a randomized, parallel design, examiner blinded, controlled clinical trial. Individuals from both genders, 35 years of age and older, with concomitant diagnosis of CAD and periodontitis will be included. CAD will be defined as the occurrence of at least one of the following events 6 months prior to entering the trial: documented history of myocardial infarction; surgical or percutaneous myocardial revascularization and lesion >50% in at least one coronary artery assessed by angiography; presence of angina and positive noninvasive testing of ischemia. Diagnosis of periodontitis will be defined using the CDC-AAP case definition (≥2 interproximal sites with clinical attachment loss ≥6 mm and ≥1 interproximal site with probing depth ≥5 mm). Individuals will have to present at least ten teeth present to be included. One hundred individuals will be allocated to test (intensive periodontal treatment comprised by scaling and root planing) or control (community periodontal treatment consisting of one session of supragingival plaque removal only) treatment groups. Full-mouth six sites per tooth periodontal examinations and subgingival biofilm samples will be conducted at baseline, 3, 6 and 12 months after treatment. The primary outcome of this study will be C-reactive protein changes over time. Secondary outcomes include levels of total cholesterol, LDL-C, HDL-C, triglycerides, IL-1β, IL-6, TNFα, fibrinogen, ICAM-1, VCAM-1 and E-selectin. These outcomes will be assessed at all time points over 12 months. Flow-mediated dilation will be assessed at baseline, 1, 3 and 6 months after periodontal therapy. DISCUSSION This trial will provide new evidence regarding the effect of periodontal treatment on risk markers for recurrence of cardiovascular events in stable coronary artery disease patients. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifier, NCT01609725.
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Affiliation(s)
- Marco Aurélio Lumertz Saffi
- Hospital de Clínicas de Porto Alegre, Cardiology Division, School of Medicine, Federal University of Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, Brazil
| | - Mariana Vargas Furtado
- Hospital de Clínicas de Porto Alegre, Cardiology Division, School of Medicine, Federal University of Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, Brazil
- Institute for Health Technology Assessment (IATS-CNPq), Ramiro Barcelos 2350, Porto Alegre, Brazil
| | - Márlon Munhoz Montenegro
- Faculty of Dentistry, Periodontology, Federal University of Rio Grande do Sul, Ramiro Barcelos 2492, Porto Alegre 90035-003, Brazil
| | - Ingrid Webb Josephson Ribeiro
- Faculty of Dentistry, Periodontology, Federal University of Rio Grande do Sul, Ramiro Barcelos 2492, Porto Alegre 90035-003, Brazil
| | - Cassio Kampits
- Faculty of Dentistry, Periodontology, Federal University of Rio Grande do Sul, Ramiro Barcelos 2492, Porto Alegre 90035-003, Brazil
| | - Eneida Rejane Rabelo-Silva
- Hospital de Clínicas de Porto Alegre, Cardiology Division, School of Medicine, Federal University of Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, Brazil
| | - Carisi Anne Polanczyk
- Hospital de Clínicas de Porto Alegre, Cardiology Division, School of Medicine, Federal University of Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, Brazil
- Institute for Health Technology Assessment (IATS-CNPq), Ramiro Barcelos 2350, Porto Alegre, Brazil
| | - Cassiano Kuchenbecker Rösing
- Faculty of Dentistry, Periodontology, Federal University of Rio Grande do Sul, Ramiro Barcelos 2492, Porto Alegre 90035-003, Brazil
| | - Alex Nogueira Haas
- Faculty of Dentistry, Periodontology, Federal University of Rio Grande do Sul, Ramiro Barcelos 2492, Porto Alegre 90035-003, Brazil
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Montenegro MM, Flores MF, Colussi PRG, Oppermann RV, Haas AN, Rösing CK. Factors associated with self-reported use of mouthwashes in southern Brazil in 1996 and 2009. Int J Dent Hyg 2013; 12:103-7. [DOI: 10.1111/idh.12052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2013] [Indexed: 11/27/2022]
Affiliation(s)
- MM Montenegro
- Department of Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - MF Flores
- Department of Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - PRG Colussi
- Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Department of Periodontology; University of Passo Fundo; Passo Fundo Brazil
| | - RV Oppermann
- Department of Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - AN Haas
- Department of Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - CK Rösing
- Department of Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
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Bressani AEL, Mariath AAS, Haas AN, Garcia-Godoy F, de Araujo FB. Incomplete caries removal and indirect pulp capping in primary molars: a randomized controlled trial. Am J Dent 2013; 26:196-200. [PMID: 24693629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To compare the effect of incomplete caries removal (ICR) and indirect pulp capping (IPC) with calcium hydroxide (CH) or an inert material (wax) on color, consistency and contamination of the remaining dentin of primary molars. METHODS This double-blind, parallel-design, randomized controlled trial included 30 children presenting one primary molar with deep caries lesion. Children were randomly assigned after ICR to receive IPC with CH or wax. All teeth were then restored with resin composite. Baseline dentin color and consistency were evaluated after ICR, and dentin samples were collected for contamination analyses using scanning electron microscopy. After 3 months, restorations were removed and the three parameters were re-evaluated. In both groups, dentin became significantly darker after 3 months. RESULTS No cases of yellow dentin were observed after 3 months with CH compared to 33.3% of the wax cases (P < 0.05). A statistically significant difference over time was observed only for CH regarding consistency. CH stimulated a dentin hardening process in a statistically higher number of cases than wax (86.7% vs. 33.3%; P = 0.008). Contamination changed significantly over time in CH and wax without significant difference between groups. It was concluded that CH and wax arrested the carious process of the remaining carious dentin after indirect pulp capping, but CH showed superior dentin color and consistency after 3 months.
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Greggianin BF, Oliveira SC, Haas AN, Oppermann RV. The incidence of gingival fissures associated with toothbrushing: crossover 28-day randomized trial. J Clin Periodontol 2013; 40:319-26. [DOI: 10.1111/jcpe.12072] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 10/18/2012] [Accepted: 12/27/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Bruna Frizon Greggianin
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Sara Cioccari Oliveira
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Alex Nogueira Haas
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Rui Vicente Oppermann
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
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Haas AN, Seleme F, Segatto P, Susin C, Albandar J, Oppermann RV, Fontanella VR, Rösing CK. Azithromycin as an adjunctive treatment of aggressive periodontitis: radiographic findings of a 12-month randomized clinical trial. Am J Dent 2012; 25:215-219. [PMID: 23082385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE To compare the 12-month radiographic outcomes following the use of azithromycin or placebo as adjuncts to non-surgical periodontal treatment of AgP. METHODS 17 aggressive periodontitis (AgP) subjects 13-26 years old were randomly assigned to receive scaling and root planing (SRP) with systemic azithromycin or placebo. Standardized radiographs were taken at baseline and 12 months postoperatively. Recall visits consisting of oral prophylaxis and oral hygiene instructions were performed during the 12 months. Digital image subtraction analysis and linear bone measurements were conducted by a blinded and calibrated examiner. Student t-tests were used for within and between-groups comparisons. ANCOVA was applied for between-group comparisons of changes in linear bone level adjusting for baseline values. RESULTS There were significant gains in linear bone levels in the azithromycin (0.55 +/- 0.10 mm) and placebo (0.42 +/- 0.07 mm) groups between the baseline and 12-month postoperative visits. There were also significant gains in bone density in the two treatment groups. No significant differences were observed between the two treatments in the amount of linear bone gain or bone density during the follow-up period. The use of azithromycin as an adjunct to SRP in the treatment of AgP did not result in significant radiographic bone level changes compared to placebo.
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Affiliation(s)
- Alex Nogueira Haas
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
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Haas AN, Silva-Boghossian CM, Colombo AP, Susin C, Albandar JM, Oppermann RV, Rösing CK. Adjunctive azithromycin in the treatment of aggressive periodontitis: Microbiological findings of a 12-month randomized clinical trial. J Dent 2012; 40:556-63. [DOI: 10.1016/j.jdent.2012.03.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 03/12/2012] [Accepted: 03/13/2012] [Indexed: 10/28/2022] Open
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Mendez M, Carrard VC, Haas AN, Lauxen IDS, Barbachan JJD, Rados PV, Sant'Ana Filho M. A 10-year study of specimens submitted to oral pathology laboratory analysis: lesion occurrence and demographic features. Braz Oral Res 2012; 26:235-41. [DOI: 10.1590/s1806-83242012000300009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 02/15/2012] [Indexed: 11/22/2022] Open
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Colussi PRG, Haas AN, Oppermann RV, Rösing CK. Factors associated with changes in self-reported dentifrice consumption in a brazilian group from 1996 and 2009. Braz Dent J 2012; 23:737-45. [DOI: 10.1590/s0103-64402012000600019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 12/05/2012] [Indexed: 11/22/2022] Open
Abstract
The aim of the study was to determine factors associated with changes in self-reported dentifrice consumption in an urban population group over 13 years. This study evaluated two surveys of 671 and 688 households sampled in the urban area of a city from Southern Brazil in 1996 and 2009, respectively. The mother of the family was asked to answer a structured questionnaire about demographics, socioeconomic and behavioral variables. The primary outcome was obtained by questioning "how long does a dentifrice tube last in your house?" The cut-off point of duration was less than 1 month. It was used to determine high consumption of dentifrice (HCD). Associations between HCD and independent variables were evaluated by multivariable Poisson regression. There was a significant decrease of 20% (81.2% to 61.2%) in the prevalence of HCD between 1996 and 2009, resulting in a crude annual decrease of 1.54%. Mother's age, family income, dental assistance, mother's brushing frequency and number of household members that use a toothbrush were significantly associated with HCD independent from the year of survey. The prevalence ratio (PR) of HCD for the year of survey was 0.75, indicating an overall decrease of 25% in the probability of HCD from 1996 to 2009. Probabilities of HCD also decreased over the 13 years among the strata of education, number of household members and reason for choice of dentifrice. It may be concluded that the factors associated with the observed decrease were higher educational levels, larger number of household members and reasons for choosing a dentifrice related to preventive/therapeutic effects.
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Haas AN, Gaio EJ, Oppermann RV, Rösing CK, Albandar JM, Susin C. Pattern and rate of progression of periodontal attachment loss in an urban population of South Brazil: a 5-years population-based prospective study. J Clin Periodontol 2011; 39:1-9. [PMID: 22093104 DOI: 10.1111/j.1600-051x.2011.01818.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2011] [Indexed: 12/13/2022]
Abstract
AIM The aim of this 5-years longitudinal study was to investigate the pattern and rate of periodontal attachment loss (PAL) progression in an urban population in South Brazil. METHODS In 2001, a multistage probability sampling strategy was used to derive a representative sample of 1,465 dentate individuals from Porto Alegre, Brazil. Five years later, 697 dentate individuals (294M/403F, mean age: 37.9 ± 13.3) were available for follow-up. PAL was assessed by calibrated examiners using a full-mouth protocol. Estimates of proximal PAL progression and standard errors (SE) are reported. RESULTS Fifty-six per cent (SE: 1.9) and 36% (SE: 1.8) of subjects showed PAL progression ≥3 mm affecting ≥2 and ≥4 teeth respectively. PAL progression ≥3 mm was mostly localized affecting 3.8 (SE: 0.2) teeth and 5.7 (SE: 0.3) sites. Annual PAL progression was, on average, 0.3 mm (SE: 0.01). Significant differences in PAL progression were observed according to age, gender, race and socioeconomic status. PAL progression increased with age reaching the highest progression rate in the 40-49 years cohort, and then decreased in older age groups. PAL progression was consistently higher among males and non-Whites than females and whites. CONCLUSION A large proportion of this urban Brazilian sample was affected by PAL progression underscoring the need for health promotion initiatives aiming at preventing progression of destructive periodontal disease.
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Affiliation(s)
- Alex Nogueira Haas
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
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Colussi PRG, Haas AN, Oppermann RV, Rösing CK. Consumo de dentifrício e fatores associados em um grupo populacional brasileiro. CAD SAUDE PUBLICA 2011; 27:546-54. [DOI: 10.1590/s0102-311x2011000300014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 01/17/2011] [Indexed: 11/21/2022] Open
Abstract
Este estudo transversal avaliou o consumo de dentifrício fluoretado e fatores associados em Passo Fundo, Rio Grande do Sul, Brasil. Seiscentos e oitenta e oito domicílios foram selecionados. Um questionário estruturado foi respondido pela mãe para obter dados demográficos, hábitos e consumo de dentifrício. O consumo foi avaliado por intermédio da duração de um tubo de dentifrício e considerado baixo (duração > 1 mês) e alto (duração < 1 mês). Modelos de regressão logística avaliaram a associação do consumo com variáveis independentes. Foi observado que 61,2% dos domicílios apresentaram alto consumo de dentifrício. No modelo multivariado, idade da mãe > 50 anos (OR = 1.62; IC95% 1,02-2,61), frequência de escovação da mãe (OR = 2,53; IC95%: 1,53-4,16), número de moradores que utilizam escova (OR = 5,69; IC95%: 3,68-8,81) e motivo cosmético para escolha do dentifrício (OR = 1,64; IC95%:1,03-2,61) representaram maior chance de alto consumo de dentifrício. Conclui-se que a maioria dos domicílios apresenta consumo elevado de dentifrício, associado com idade e frequência de escovação da mãe, número de moradores e motivos de escolha.
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Oppermann RV, Haas AN, Villoria GEM, Primo LG, Serra-Negra JM, Ferreira EFE, Pannuti CM. Proposal for the teaching of the chemical control of supragingival biofilm. Braz Oral Res 2011; 24 Suppl 1:33-6. [PMID: 20857073 DOI: 10.1590/s1806-83242010000500006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 07/15/2010] [Indexed: 11/22/2022] Open
Abstract
The mechanical control of supragingival biofilm is accepted as one of the most important measures to treat and prevent dental caries and periodontal diseases. Nevertheless, maintaining dental surfaces biofilm-free is not an easy task. In this regard, chemical agents, mainly in the form of mouthwashes, have been studied to help overcome the difficulties involved in the mechanical control of biofilm. The aim of this paper was to discuss proposals for the teaching of supragingival chemical control (SCC) in order to improve dentists' knowledge regarding this clinical issue. Firstly, the literature regarding the efficacy of antiseptics is presented, clearly showing that chemical agents are clinically effective in the reduction of biofilm and gingival inflammation when used as adjuvant agents to mechanical control. Thus, it is suggested that the content related to SCC be included in the curricular grid of dental schools. Secondly, some essential topics are recommended to be included in the teaching of SCC as follows: skills and competencies expected of a graduate dentist regarding SCC; how to include this content in the curricular grid; teaching-learning tools and techniques to be employed; and program content.
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Affiliation(s)
- Rui Vicente Oppermann
- Department of Periodontics, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Carrard VC, Haas AN, Rados PV, Filho MS, Oppermann RV, Albandar JM, Susin C. Prevalence and risk indicators of oral mucosal lesions in an urban population from South Brazil. Oral Dis 2010; 17:171-9. [DOI: 10.1111/j.1601-0825.2010.01712.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mariath AAS, Haas AN, Fischer CM, de Araujo FB, Rösing CK. Professional toothbrushing as a method for diagnosing gingivitis in 3- to 6-year-old preschool children. Oral Health Prev Dent 2009; 7:315-321. [PMID: 20011748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE The aim of the present crossover study was to evaluate professional toothbrushing as a method for diagnosing gingivitis in children. MATERIALS AND METHODS Thirty-four preschool children who had gingival bleeding > or = 10% and without proximal restorations/carious lesions were included in the study. Examinations comprised two gingival indices recorded at a 15-min interval, in the following sequences: the Ainamo and Bay gingival bleeding index (GBI1) followed by the brushing index (BI2) and vice versa (BI1-GBI2). Half of the children started the study in the first sequence and the other half in the second. After a 3- to 4-day washout period, the indices were again recorded with individuals changing the sequences. Data analysis considered GBI as the gold standard, and sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) were also calculated. RESULTS The overall mean value of gingival bleeding at the first examination was 18.85 +/- 9.24%. Validation of toothbrushing performed after GBI (BI2) resulted in values for SE, SP, PPV and NPV of 0.59 (95% CI, 0.55 to 0.63), 0.92 (95% CI, 0.91 to 0.93), 0.64 (95% CI, 0.60 to 0.69) and 0.90 (95% CI, 0.89 to 0.92), respectively. BI performed before GBI (BI1) resulted in similar SE, SP, PPV and NPV. Percentage agreement of GBI1-BI2 and BI1-GBI2 was 83.5% and 85.9%, respectively. CONCLUSIONS Professional toothbrushing can be suggested as a method for the diagnosis of gingival inflammatory status in children, especially as an indicator of gingival health.
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Mariath AAS, Bressani AEL, Haas AN, Araujo FBD, Rösing CK. Professional flossing as a diagnostic method for gingivitis in the primary dentition. Braz Oral Res 2008; 22:316-21. [DOI: 10.1590/s1806-83242008000400006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2006] [Accepted: 08/03/2007] [Indexed: 11/21/2022] Open
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Haas AN, Silveira EMV, Rösing CK. Effect of tongue cleansing on morning oral malodour in periodontally healthy individuals. Oral Health Prev Dent 2007; 5:89-94. [PMID: 17722433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
PURPOSE The aim of this randomised single-blind, cross-over trial was to assess the effect of tongue cleansing on morning oral malodour in periodontally healthy subjects. MATERIALS AND METHODS Ten systemically healthy non-smoker subjects (6 males, 4 females), 24-38 years of age, completed two 4-day periods of oral hygiene cessation with a 7-day wash-out period. In one of these test periods, subjects were instructed to clean their tongues with a tongue scraper 2-3 times a day. Participants presented at least 20 teeth, without cavities, overhanging restorations/prostheses or periodontitis, and had no history of previous periodontal therapy or use of antibiotics in the 3 months prior to the study. Volatile sulphur compounds (VSC; Interscan Halimeter) and organoleptic scores were measured in exhaled mouth air once a day, early in the morning, by one examiner. Comparisons were performed using Wilcoxon's signed rank test and Friedman's test (alpha = 0.05). RESULTS VSC levels at baseline were 206.3 ppb (SD 139.8) and 191.4 ppb (SD 127.7) for periods of usage and non-usage of the scraper respectively (p > 0.05). VSC levels did not change significantly during the 4 days, independent of tongue cleansing (Friedman, p > 0.05). Only at day 3 did the use of the tongue scraper lead to a significantly lower level of VSC compared with controls (131.1 ppb and 199.3 ppb respectively). No significant differences in organoleptic scores were observed between groups at baseline. During the whole experimental period, there were also no significant changes in organoleptic scores when individuals used or did not use the tongue scraper. CONCLUSION Tongue cleansing with a scraper was unable to prevent morning oral malodour in the absence of tooth cleaning in periodontally healthy individuals.
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Affiliation(s)
- Alex Nogueira Haas
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Abstract
OBJECTIVE This case-control study investigated the association between life events, anxiety, and depression with periodontitis. METHODOLOGY The study counted with 165 individuals, both sexes, 35-60 years of age. Case group included 96 individuals suffering from periodontal disease; and in control group 69 subjects with no history of periodontitis. Clinical examinations were performed by a single examiner. Psychological assessment included four inventories: Life Events Scale, Beck Anxiety Inventory, State-Trait Anxiety Inventory and Beck Depression Inventory. Bivariate and multivariate logistic regression analyses were performed to compare cases and controls. RESULTS Mean probing depth and clinical attachment level were 3.44+/-0.80 and 4.01+/-1.61 in the case group and 1.96+/-0.19 and 0.95+/-0.50 in the control group, respectively (p<0.05). Positive association of periodontitis with age (odds ratio (OR)=1.15 95% confidence interval (CI): 1.06-1.24), male gender (OR=2.71, CI: 1.13-6.49), smoking (OR=6.05, CI: 1.67-21.94) and educational level (OR=6.49, CI: 1.14-36.95) was confirmed. Bivariate analysis did not demonstrate significant mean differences in life events, anxiety symptoms, trait or state of anxiety, or depression symptoms between cases and controls. Multivariate logistic regression, controlling for confounding factors, demonstrated no significant association between psychosocial factors and periodontal disease. CONCLUSIONS Within the limits of this study it is possible to conclude that there was no significant association between periodontitis and the psychosocial factors analysed.
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Affiliation(s)
- G D C Castro
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
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