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Costa FO, Esteves Lima RP, Costa AM, Costa AA, Mattos Pereira GH, Cortelli SC, Cortelli JR, Magalhães Cyrino R, Aparecida Silva T, Miranda Cota LO. Adjunctive effects of photodynamic therapy using indocyanine green in residual pockets during periodontal maintenance therapy: A split-mouth randomized controlled trial. J Periodontol 2023; 94:1100-1111. [PMID: 37051740 DOI: 10.1002/jper.22-0672] [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: 11/14/2022] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Prospective studies have reported conflicting results regarding the adjunctive effect of antimicrobial photodynamic therapy (aPDT) on clinical and microbiological parameters in individuals under periodontal maintenance therapy (PMT). This study aimed to evaluate the clinical and microbiological adjunctive effects of aPDT using indocyanine green (ICG) in residual sites with probing depth (PD) ≥5 mm during PMT in comparison with scaling and root planing (SRP) alone. METHODS A split-mouth randomized controlled clinical trial was conducted with 24 individuals in a PMT program. Contralateral quadrants with eligible residual sites were randomly assigned to either SRP + aPDT (test group) or SRP alone (control). aPDT included ICG dye and diode laser (909 nm) performed together with SRP and repeated 15 days after. Periodontal clinical parameters, periodontal inflamed surface area (PISA) index, and subgingival biofilm samples were collected at baseline (T1), 3 (T2), and 6 months later (T3). Microbiological analyses were performed by quantitative real-time polymerase chain reaction. RESULTS Significant improvements were observed in all clinical and microbiological parameters in both groups from T1 to T3. However, no significant differences were observed regarding plaque index, PD, and clinical attachment level. Test group showed significantly greater reductions in bleeding on probing (BOP), PISA index, and Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans levels, when compared with controls. CONCLUSIONS Both treatments resulted in significant clinical periodontal improvements, but with no significant differences between groups except from inflammation parameters. aPDT using ICG resulted in significant reductions in BOP and PISA index, as well as in P. gingivalis and A. actinomycetemcomitans levels.
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Affiliation(s)
- Fernando Oliveira Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Adriana Moreira Costa
- Department of Periodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Amanda Almeida Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Renata Magalhães Cyrino
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Costa FO, Costa AM, Cortelli JR, Cortelli SC, Costa AA, Lima RPE, Pereira GHM, Oliveira AMSD, Oliveira PAD, Cota LOM. Effect of supragingival plaque control on recurrent periodontitis and clinical stability among individuals under periodontal maintenance therapy: 10-year follow-up. J Periodontol 2023; 94:55-65. [PMID: 35904985 DOI: 10.1002/jper.22-0301] [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: 05/23/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of supragingival plaque control on the recurrence of periodontitis (RP) and the achievement of a stable periodontal clinical endpoint after 10 years of periodontal maintenance therapy (PMT). METHODS The present retrospective cohort study included 225 individuals in continuous PMT. The plaque index (PI) determining the oral hygiene (OH) status, periodontal clinical parameters, and other variables of interest were collected at three time points: T1 (prior to active periodontal therapy [APT]), T2 (after APT), and T3 (10 years after T2). According to PI records at T3, participants were categorized into: (1) good OH (GOH; PI ≤ 30%, n = 63); (2) fair OH (FOH; PI > 30% and ≤40%, n = 73); and (3) poor OH (POH; PI > 40%, n = 88). Data were analyzed using the chi-square and Student t tests, analysis of variance (ANOVA), and mediation and regression analyses. RESULTS Significant differences in all periodontal clinical parameters between the GOH, FOH, and POH groups were observed at T3. The POH group exhibited higher mean bleeding on probing (BOP), periodontal probing depth (PD), and clinical attachment level (CAL), as well as higher tooth loss (POH > FOH > GOH; P < .001). There was an increased risk for RP in the FOH (odds ratio [OR] 2.02; CI, 1.10-4.38) and POH (OR 4.33; CI, 2.17-8.65) groups. Moreover, the FOH and POH groups had an approximately 2.5 and 6.0 times greater chance of not achieving a stable periodontal clinical endpoint, respectively. CONCLUSIONS After 10 years of monitoring in PMT, individuals with higher PI scores (>30%) presented an unhealthier periodontal status, a higher risk for RP, and a lower chance of achieving ≤4 sites with PD ≥ 5 mm.
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Affiliation(s)
- Fernando Oliveira Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - José Roberto Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Sheila Cavalca Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Amanda Almeida Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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3
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Costa FO, Lages EJP, Cortelli SC, Cortelli JR, Mattos-Pereira GH, Lima RPE, Cota LOM. Association between cumulative smoking exposure, span since smoking cessation, and peri-implantitis: a cross-sectional study. Clin Oral Investig 2022; 26:4835-4846. [PMID: 35316410 DOI: 10.1007/s00784-022-04451-8] [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: 10/26/2021] [Accepted: 03/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate the association of cumulative smoking exposure and span since smoking cessation with the occurrence of peri-implantitis. METHODS A sample of 350 individuals aged ≥ 35 years, with the presence of at least one osseointegrated implant functioning for > 5 years, were enrolled in the study. According to smoking habits, participants were categorized into 3 groups: non-smokers (NS; n = 212), former smokers (FC; n = 66), and current smokers (CS; n = 72). Complete peri-implant and periodontal examinations were evaluated. Associations between the occurrence of peri-implantitis and smoking habits, as well as potential confounders, were evaluated through univariate and multivariate analyses. RESULTS The occurrence of peri-implantitis in the NS, FS, and CS groups was 18.2%, 19.7%, and 30.5%, respectively. A high prevalence of the overall number of cases with periodontitis (54.2%) was observed in the CS group when compared to the FS and NS groups. After adjusting for confounders, the odds ratio (OR) for the occurrence of peri-implantitis was 2.63 (1.39-6.77; p < 0.001) for CS compared to NS. There was a significant dose-response relationship between pack/year of smoking and the occurrence of peri-implantitis, as well as a significant decrease in the risk as the years of smoking cessation increased. CONCLUSIONS The occurrence of peri-implantitis among CS was high. The cumulative smoking exposure in an incremental manner and the shorter smoking cessation span was directly associated with a higher risk for peri-implantitis. CLINICAL RELEVANCE Educational and preventive strategies in general health services must attempt to reduce the adverse effects of cumulative smoking exposure and to explore the beneficial effects of smoking cessation on peri-implant status.
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Affiliation(s)
- Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Eugênio José Pereira Lages
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sheila Cavalca Cortelli
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Gustavo Henrique Mattos-Pereira
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rafael Paschoal Esteves Lima
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Costa FO, Cortelli JR, Cortelli SC, Costa AA, Esteves Lima RP, Costa AM, Pereira GHM, Cota LOM. The loss of molars in supportive periodontal care: a 10-year follow-up for tooth- and patient-related factors. J Clin Periodontol 2021; 49:292-300. [PMID: 34905803 DOI: 10.1111/jcpe.13585] [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: 07/09/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
AIM Determining the impact of the degree of furcation involvement (FI) on the longevity of molar teeth and assessing risk variables (tooth- and patients-related factors) associated with loss of molars (LM) in individuals treated for periodontitis and monitored in a private program of supportive periodontal care (SPC). MATERIALS AND METHODS The present retrospective cohort study included 222 individuals with 1,329 molars under a 10-year monitoring period in SPC. Periodontal clinical parameters, FI, type of molar, pulp vitality and other variables of interest were colleted at approximately 50 days after active periodontal therapy and after 10 years. The association of tooth- and patients-related factors with LM was assessed using a multilevel Cox regression analysis. RESULTS 235 molars were extracted during the SPC period of 12.4(±1.9) years. Age >50 years old, male gender, diabetes, smoking and no compliance were identified as relevant patient-related factors for LM during SPC (p<0.05). Significant tooth-related factors for LM were bleeding on probing (BOP) and probing depth (PD) ≥5mm, tooth non-vitality and class II and III FI (p<0.05). CONCLUSIONS Class III FI, tooth non-vitality, higher mean PD and BOP, age, male gender, diabetes and smoking all strongly influenced the prognosis of molars during SPC. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Fernando Oliveira Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Roberto Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Sheila Cavalca Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Amanda Almeida Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Cota LOM, Villar CC, Vettore MV, Campos JR, Amaral GCLSD, Cortelli JR, Cortelli SC. Periodontal diseases: is it possible to prevent them? A populational and individual approach. Braz Oral Res 2021; 35:e098. [PMID: 34586212 DOI: 10.1590/1807-3107bor-2021.vol35.0098] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 12/29/2022] Open
Abstract
Periodontal diseases are infectious inflammatory chronic diseases of a multifactorial nature. They are primarily caused by dysbiotic ecological changes in dental biofilm, which may be influenced by risk factors. The prevention of periodontal diseases may involve different strategies focused on reducing distal, intermediate, and proximal risk factors at both the population and individual levels. Effective prevention depends on interdisciplinary and common risk factor approaches. Also, patient-centered preventive models are more effective than professional-centered models in the management of periodontal diseases. Regular and periodic control of dental biofilm is an essential measure for the different levels of prevention of periodontal diseases. The effectiveness of periodontal disease prevention largely depends on positive modifications of behavior, knowledge, health literacy, patient empowerment, motivation, and compliance.
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Affiliation(s)
- Luís Otávio Miranda Cota
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Dental Clinics, Oral Surgery and Oral Pathology, Belo Horizonte, MG, Brazil
| | - Cristina Cunha Villar
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Mario Vianna Vettore
- University of Agder - UiA, Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, Kristiansand, Norway
| | - Julya Ribeiro Campos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Dental Clinics, Oral Surgery and Oral Pathology, Belo Horizonte, MG, Brazil
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Moura MF, Silva TA, Cota LOM, Oliveira SR, Cunha FQ, Ferreira GA, Cortelli JR, Cortelli SC, Costa FO. Nonsurgical periodontal therapy decreases the severity of rheumatoid arthritis and the plasmatic and salivary levels of RANKL and Survivin: a short-term clinical study. Clin Oral Investig 2021; 25:6643-6652. [PMID: 33954850 DOI: 10.1007/s00784-021-03950-4] [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: 02/03/2021] [Accepted: 04/16/2021] [Indexed: 01/02/2023]
Abstract
AIM To investigate the influence of nonsurgical periodontal treatment (NSPT) on clinical periodontal status, rheumatoid arthritis (RA) activity, and plasmatic and salivary levels of biomarkers through a controlled clinical trial on individuals with RA and periodontitis (PE). METHODS Sixty-six individuals from a convenience sample were considered eligible and consecutively allocated in 3 groups: (1) individuals without PE and RA (-PE-RA, n = 19); (2) individuals without PE and with RA (-PE+RA, n = 23), and (3) individuals with PE and RA (+PE+RA, n = 24). Full-mouth periodontal clinical examinations, Disease Activity Score (DAS-28) evaluations, and analysis in plasma and saliva of RANKL, OPG, RANKL/OPG, and Survivin were performed at baseline (T1) and 45 days after NSPT (T2). RESULTS NSPT in the +PE+RA group was very effective to improve periodontal condition. At T2, significant reductions in DAS-28 were observed in +PE+RA (p = 0.011). Significantly higher levels of Survivin and RANKL were observed in saliva and plasma from RA individuals (with and without PE) compared to controls. Additionally, Survivin e RANKL demonstrated positive correlations with DAS-28 and an expressively significant reduction in +PE+RA at T2 (p < 0.001). CONCLUSIONS NSPT was effective on improving both the periodontal and the RA clinical status and reducing the concentration of Survivin and RANKL in saliva and plasma. PRACTICAL IMPLICATIONS Nonsurgical periodontal treatment was effective on reducing the concentration of Survivin and RANKL and on improving both the periodontal and the RA clinical status of affected individuals. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (ReBEC) protocol #RBR-8g2bc8 ( http://www.ensaiosclinicos.gov.br/rg/RBR-8g2bc8/ ).
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Affiliation(s)
- Marcela Faria Moura
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Tarcília Aparecida Silva
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Sicilia Rezende Oliveira
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | | | - Gilda Aparecida Ferreira
- School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - José Roberto Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Sheila Cavalca Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil. .,Faculty of Dentistry, Department of Periodontology, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, Zip Code 31270-901, Brazil.
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Campos ISDO, de Freitas MR, Costa FO, Cortelli SC, Rovai ES, Cortelli JR. The Effects of Patient Compliance in Supportive Periodontal Therapy on Tooth Loss: A systematic Review and Meta-analysis. J Int Acad Periodontol 2021; 23:17-30. [PMID: 33512339] [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
BACKGROUND The present review aimed to assess the impact of being a complier to supportive periodontal therapy (SPT), when compared to not being a complier, on tooth loss in patients with periodontitis. METHODS Prospective and retrospective observational studies were included. MEDLINE, EMBASE, and LILACS databases were searched up to May 2019. The odds-ratio (OR) and standard error (SE) values of the studied groups (compliant or non-compliant) were converted to logOR, and the results of individual studies were grouped using a random effects model. RESULTS From a total of 1815 articles initially searched, 13 retrospective studies and one prospective study comparing tooth loss of complier and non-complier individuals in SPT were included. Meta-analysis of eight studies showed that non-compliers in SPT have an increased risk of tooth loss when compared with compliers. Overall meta-analysis demonstrated that non-compliant patients in SPT have a 26% increased risk of tooth loss when compared with compliant patients (OR = 1.26; 95% CI = 1.06 to 1.51, Heterogeneity: I2 = 0%, p = 0.008). CONCLUSIONS Patients with periodontitis who do not comply in SPT have a higher risk of tooth loss than compliant patients. Oral health professionals should implement measures to obtain optimal adherence by patients in SPT.
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Affiliation(s)
| | | | - Fernando O Costa
- School of Dentistry, Department of Periodontology, Federal University of Minas Gerais, Brazil
| | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil
| | - Emanuel Silva Rovai
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil. E-mail:
| | - José R Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil
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8
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Costa FO, Esteves Lima RP, Cortelli SC, Costa AM, Cortelli JR, Cota LOM. Effect of compliance during periodontal maintenance therapy on c-reactive protein levels: a 6-year follow-up. J Clin Periodontol 2020; 48:400-409. [PMID: 33259118 DOI: 10.1111/jcpe.13407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/28/2020] [Revised: 11/06/2020] [Accepted: 11/22/2020] [Indexed: 12/13/2022]
Abstract
AIMS To longitudinally evaluate the effects of compliance during periodontal maintenance therapy (PMT) on C-reactive protein (CRP) levels and its relation to periodontal status. MATERIALS AND METHODS A subsample comprising of 30 matched pairs was taken from a previous 6-year longitudinal study under PMT. Pairs were composed of one regular (RC) and one irregular (IC) compliers, matched by age and sex. Periodontal parameters and plasma samples were collected at 3 times: T1[prior to active periodontal therapy (APT)], T2(after APT), and T3(after 6 years). CRP plasma levels were quantified using ELISA. RESULTS RC presented better clinical periodontal status, lower recurrence of periodontitis (sites with PD ≥4 mm and CAL ≥3 mm, together with the persistence and/or presence of BOP and/or suppuration, during any of the subsequent recall evaluations) and significant reductions in CRP levels over time [(T1: RC = 3.64 ± 2.13 and IC = 3.92 ± 2.02 mg/L) and (T3: RC = 2.12 ± 1.39 mg/L and IC = 3.71 ± 1.82 mg/L)]. Logistic regression analysis demonstrated that individuals with periodontitis recurrence presented 2.19 higher chances of presenting altered CRP levels (values ≥3 mg/L- T2 to T3) than those without periodontitis recurrence (95%CI:1.16-3.27; p = 0.017). CONCLUSIONS Higher CRP plasma levels were associated with higher recurrence of periodontitis and worse clinical periodontal parameters among IC when compared to RC.
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Affiliation(s)
| | | | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | | | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
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Cortelli SC, Costa FO, Lousana G, Quintairos PCR, Francisconi-Dos-Rios LF, Cortelli JR. Clinical trials sponsored by industry and other private organizations. Braz Oral Res 2020; 34 Suppl 2:e077. [PMID: 32785487 DOI: 10.1590/1807-3107bor-2020.vol34.0077] [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: 09/04/2019] [Accepted: 09/22/2019] [Indexed: 11/22/2022] Open
Abstract
The present manuscript discussed some relevant aspects related to private sponsored clinical trials in dentistry. For decades, the academy has been the major responsible for research in Brazil. Distant from the trade sector, academic research has not always provided clear benefits to society. A key aspect of making benefits clearer is the process of scientific knowledge transference to decision-makers, which is, in fact, the ground of evidence-based dentistry. Although private sponsoring of clinical research seems to be part of the research progress of the business rates, investment in Brazil is lower than those observed in other countries. It is particularly important to understand that instead of creating its own rules, dentistry imported the high-quality standards originally designed for pharmaceutical studies. Therefore, it is critical to understand the original rules and how dental items are classified by regulatory agencies. In fact, knowledge about international and local regulation is a basic assumption in industry-sponsored research. Despite globalization, the identification of industry-sponsored studies through open access databases is still very hard and time-demanding. A common concern when conducting industry-sponsored trials is study biases. Fortunately, many relevant organizations, academic and industry groups, have been working seriously against that. Finally, for less experienced researchers, many aspects related to industry-sponsored studies - such as confidentiality, authorship, budget - are deeply discussed until a final version of the trial agreement can be written and signed, protecting all sides. In short, the scenario should be improved, but it already represents a nice opportunity for dental research.
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Affiliation(s)
- Sheila Cavalca Cortelli
- Office of Graduate Studies and Scientific Affairs, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Fernando Oliveira Costa
- Periodontics Department, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | - José Roberto Cortelli
- Office of Graduate Studies and Scientific Affairs, Universidade de Taubaté, Taubaté, SP, Brazil
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Máximo PDM, Cortelli SC, Aquino DR, de Miranda TB, Costa FO, Cortelli JR. Preoperative Mouthwash in Subjects with Different Periodontal Status: A Randomised Controlled Clinical Trial. Oral Health Prev Dent 2020; 18:433-440. [PMID: 32515413 DOI: 10.3290/j.ohpd.a44308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The effects of three preoperative mouthwashes on salivary bacterial levels were evaluated and compared between subjects with differing periodontal status. MATERIALS AND METHODS Based on periodontal parameters, periodontally healthy individuals (n = 60) and those with gingivitis (n = 60) and periodontitis (n = 60) were randomly assigned to a single preoperative dose of chlorhexidine (CHX), essential oils (EO), cetylpyridinium chloride (CPC) or negative control mouthwashes. Saliva samples were collected between 8:00 and 11:00 a.m., before and after a single-dose rinse with the respective mouthwash. Total bacterial load and levels of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Streptococcus oralis were determined by qPCR. Data were statistically analysed using paired t- and Student's t-tests (p < 0.05). RESULTS CHX, EO and CPC showed greater antimicrobial efficacy than did the negative control. CHX [1226445.53] and EO [1743639.38] provided greater reductions in comparison to both CPC [106302.96] and negative control [37852.46]). CHX provided greater reductions of simultaneous levels of Pg [106326.00], Td [3335841] and Tf [61557.47] in the healthy group, as did EO in the diseased groups. CPC provided the greatest reduction [3775319.36] in the periodontitis group. CONCLUSION Periodontal status influenced the antimicrobial efficacy of preoperative mouthwashes. Therefore, periodontal status should be taken into consideration by clinicians. The antimicrobial efficacy differed among the agents tested. CHX and EO showed the greatest efficacy. The recognition of periodontal condition by clinicians is mandatory to select the most effective preoperative mouthwash.
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Peralta FDS, Cortelli SC, Rovai ES, Aquino DR, Miranda TB, Costa FO, Cortelli JR. Clinical and microbiological evaluation of non-surgical periodontal therapy in obese and non-obese individuals with periodontitis: a 9-month prospective longitudinal study. J Appl Oral Sci 2020; 28:e20190694. [PMID: 32428060 PMCID: PMC7213783 DOI: 10.1590/1678-7757-2019-0694] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 03/23/2020] [Indexed: 01/25/2023] Open
Abstract
Objective Obesity is a chronic disease that negatively affects an individual’s general and oral health. The present study aimed to compare the clinical and microbiological effects of non-surgical periodontal therapy with the full mouth disinfection (FMD) protocol on obese and non-obese individuals at 9 months post-therapy. Methodology This clinical study was first submitted and approved by the Ethics Committee. Fifty-five obese patients and 39 non-obese patients with periodontitis were evaluated. The full-mouth periodontal clinical parameters, clinical attachment level (CAL), probing depth (PD), gingival index (GI), and plaque index (PI), were monitored at baseline, 3, 6, and 9 months after periodontal treatment with full mouth disinfection (FMD) protocol. The mean count of
Tannerella forsythia
,
Porphyromonas gingivalis
,
Treponema Denticola
, and
Aggregatibacter actinomycetemcomitans
was determined by quantitative polymerase chain reaction on subgingival biofilm samples. Demographic data were assessed by Chi-square test. For clinical and microbiological parameters, two-factor repeated-measures ANOVA was used. Results In both groups, periodontal therapy using the one-stage full-mouth disinfection protocol significantly improved CAL, PD, GI, and PI (p<0.05). Obese and non-obese patients equally responded to non-surgical periodontal therapy (p>0.05). Microbial count found no major differences (p>0.05) between obese and non-obese individuals who had undergone non-surgical periodontal therapy. Conclusions Obesity did not affect the clinical and microbiological outcomes of non-surgical periodontal therapy.
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Affiliation(s)
| | | | - Emanuel Silva Rovai
- Departamento de Odontologia, Universidade de Taubaté, Taubaté, São Paulo, Brasil
| | - Davi Romeiro Aquino
- Departamento de Odontologia, Universidade de Taubaté, Taubaté, São Paulo, Brasil
| | - Taís Browne Miranda
- Departamento de Odontologia, Universidade de Taubaté, Taubaté, São Paulo, Brasil
| | - Fernando Oliveira Costa
- Departamento de Periodontia, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minhas Gerais, Brasil
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12
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Costa FO, Cortelli JR, Lima RPE, Costa AA, Cortelli SC, Cota LOM. Depressive disorders associated with the recurrence of periodontitis in periodontal maintenance. J Int Acad Periodontol 2020; 22:1-9. [PMID: 32224545] [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: 06/10/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the association between depressive disorders and periodontal condition and the recurrence of periodontitis, during periodontal maintenance therapy (PMT). METHODS From a 6-year prospective cohort study with 268 individuals under PMT, 124 individuals had complete periodontal clinical data recorded between T1 (baseline) and T2 (final data at the last PMT appointment). Individuals were divided into two groups, being 35 individuals with depressive disorders (DD) and 89 individuals without DD (NDD). Full-mouth periodontal examination was evaluated at T1 and T2. RESULTS The periodontal status of NDD was significantly better then DD at T2. In the NDD group, the recurrence of periodontitis was 50.6% whereas in the DD group was 62.8%. Moreover, the following variables were significantly associated with recurrence of periodontitis in final multivariate logistic regression model: DD, age, co-habitation status without companion, smoking and the interaction between DD and smoking. CONCLUSION Individuals with DD undergoing PMT presented higher rates of recurrence of periodontitis and tooth loss when compared to individuals without DD. Additionally, the interaction between DD and smoking significantly increased the risk for the recurrence of periodontitis.
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Affiliation(s)
- Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery,School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. E-mail:
| | - José Roberto Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté,Taubaté, São Paulo, Brazil
| | - Rafael Paschoal Esteves Lima
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Amanda Almeida Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sheila Cavalca Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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13
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Costa FO, Vieira TR, Cortelli SC, Cota LOM, Costa JE, Aguiar MCF, Cortelli JR. Effect of compliance during periodontal maintenance therapy on levels of bacteria associated with periodontitis: A 6-year prospective study. J Periodontol 2019. [PMID: 29537663 DOI: 10.1002/jper.17-0173] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND It is well established that regular compliance during periodontal maintenance therapy (PMT) maintains the stability of periodontal clinical parameters obtained after active periodontal therapy (APT). However, compliance during PMT has not yet been related to subgingival bacterial levels. Thus, this study followed individuals in PMT over 6 years and longitudinally evaluated the effects of compliance on periodontitis-associated bacterial levels and its relation to periodontal status. METHODS From a 6-year prospective cohort study with 212 individuals in PMT, 91 were determined to be eligible. From this total, 28 regular compliers (RC) were randomly selected and matched for age and sex with 28 irregular compliers (IC). Complete periodontal examination and microbiological samples were obtained 5 times: T1 (prior to APT), T2 (after APT), T3 (2 years), T4 (4 years), and T5 (6 years). Total bacteria counts and levels of Actinomyces naeslundii, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were evaluated through quantitative polymerase chain reaction. RESULTS RC had less tooth loss and better clinical and microbiological conditions over time when compared with IC. IC had higher total bacterial counts and higher levels of T. denticola. Moreover, among IC, total bacterial counts were positively associated with plaque index and bleeding on probing, while levels of A. naeslundii, T. forsythia, and T. denticola were negatively associated with clinical attachment loss (4 to 5 mm) among RC. CONCLUSIONS Compliance positively influenced subgingival microbiota and contributed to stability of periodontal clinical status. Regular visits during PMT sustained microbiological benefits provided by APT over a 6-year period.
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Affiliation(s)
- Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thaís Riberal Vieira
- Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Eustáquio Costa
- Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Cássia Ferreira Aguiar
- Department of Dental Clinics, Oral Pathology and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil
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Araújo MM, Albuquerque BN, Cota LOM, Cortelli SC, Cortelli JR, Costa FO. Periodontitis and Periodontopathogens in Individuals Hospitalized in the Intensive Care Unit: A Case-Control Study. Braz Dent J 2019; 30:342-349. [PMID: 31340223 DOI: 10.1590/0103-6440201902480] [Citation(s) in RCA: 1] [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: 10/27/2018] [Accepted: 03/13/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to compare periodontal conditions between intensive care unit (ICU) in-patients and non-ICU patients through clinical and microbiological periodontal parameters. This case-control study included 88 individuals hospitalized in ICU and 176 non-hospitalized controls. All individuals underwent a complete periodontal examination and microbiological sampling. The total bacterial load and counts of Porphyromonas gingivalis, Treponema denticola and Aggregatibacter actinomycetemcomitans were evaluated using qPCR. Data were analyzed through the Chi-square, Fisher exact, and t-Student tests, and the Spearman correlation, as appropriate. The prevalence of periodontitis was 39.7% among controls and 59.0% among ICU in-patients (OR=2.18; p=0.002). ICU in-patients had a significantly higher occurrence of cardiovascular disease (p=0.002; OR=2.20) and history of periodontal disease (p=0.031; OR=1.92) than controls. Bacterial counts of A. actinomycetemcomitans, T. denticola and P. gingivalis were significantly higher in ICU in-patients with periodontitis than in controls. The correlation between periodontal parameters and microbiological findings among cases and controls showed a significant and positive correlation between: total bacteria load and % of sites with probing depth (PD) ≥ 4 mm (cases: r=0.22 and controls: r=0.13) and P. gingivalis and % sites with bleeding on probing (BOP) (cases: r=0.22 and controls: r=0.23). Thus, ICU in-patients presented a higher prevalence of periodontitis and worse periodontal condition (higher mean plaque index, BOP, clinical attachment level ≥3 mm, and sites with PD 4 to 6 mm).
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Affiliation(s)
- Milena Moreira Araújo
- Department of Periodontology, UFMG Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Luís Otávio Miranda Cota
- Department of Periodontology, UFMG Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sheila Cavalca Cortelli
- Department of Periodontology, UFMG Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - José Roberto Cortelli
- Department of Periodontology, UFMG Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fernando Oliveira Costa
- Department of Periodontology, UFMG Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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15
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Costa FO, Cortelli SC, Costa AA, Cyrino RM, Cortelli JR, Miranda Cota LO. Impact of compliance during periodontal maintenance therapy on oral health-related quality of life: A 6-year follow-up. J Dent 2019; 83:50-55. [PMID: 30831209 DOI: 10.1016/j.jdent.2019.02.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To evaluate the effects of compliance during periodontal maintenance therapy (PMT) in the oral impact on daily performance (OIDP) measures, as well as to determine and compare the periodontal condition of acceptable and irregular compliers. MATERIAL AND METHODS From a 6-year prospective cohort study with 268 individuals under PMT, 232 individuals had complete periodontal clinical data and OIDP questionnaires completed between T1 (data was recorded after the first PMT appointment) and T2 (final data at the last PMT appointment), were determined to be eligible. Individuals were divided into two groups: 124 acceptable compliers (AC) and 108 irregular compliers (IC). Full-mouth periodontal examination and questionnaires were evaluated in 2 times, at T1 and T2. RESULTS At T2, the periodontal status of the AC group was significantly better than the IC group. The IC group also presented with higher OIDP scores (63.31 ± 19.11) compared to the AC group (57.72 ± 15.30, p = 0.005). On analyzing the OIDP dimensions independently, both groups (AC and IC) presented with high scores in the functional, psychological and social performances; however, the impacts were significantly higher in IC group. CONCLUSION The AC group presented with better periodontal conditions and lower OIDP, compared to the IC group. The discomfort and dissatisfaction with appearance, showed more influence on these daily impacts. CLINICAL SIGNIFICANCE Acceptable compliers showed lower scores of OIDP when compared to erratic ones. Thus, clinicians could take the chance to gain advantage from the positive impacts of acceptable compliance in the OHRQL for subsequent patient-centred motivation during PMT.
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Affiliation(s)
- Fernando Oliveira Costa
- Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, Brazil.
| | - Amanda Almeida Costa
- Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil; Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, Brazil.
| | - Renata Magalhães Cyrino
- Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, Brazil.
| | - Luís Otávio Miranda Cota
- Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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16
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Amaral SA, Pereira TSF, Brito JAR, Cortelli SC, Cortelli JR, Gomez RS, Costa FO, Miranda Cota LO. Comparison of miRNA expression profiles in individuals with chronic or aggressive periodontitis. Oral Dis 2018; 25:561-568. [PMID: 30350903 DOI: 10.1111/odi.12994] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 05/04/2018] [Revised: 09/17/2018] [Accepted: 10/03/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVES MicroRNAs (miRNAs) may play an important role in inflammatory response. However, the involvement of miRNAs in the pathogenesis of periodontitis is unclear. The present study aimed to compare the miRNA expression profiles in individuals with chronic (CP) or aggressive (AP) periodontitis. MATERIALS AND METHODS Eighteen non-smoker individuals (CP = 9 and AP = 9) without any history of systemic diseases or previous periodontal therapies were selected at the Clinics of Periodontology from the Federal University of Minas Gerais. Gingival tissue samples were collected during the initial periodontal therapy. miRNAs were isolated, and expression patterns of 754 miRNAs were assessed with a quantitative miRNA PCR array. miRNAs expression profiles were compared between CP and AP groups. RESULTS There were no differences observed in the miRNAs expression profiles between CP and AP (p > 0.05). According to the microarray analyses, the most expressed miRNAs in both groups were hsa-miR-1274b, hsa-let-7b-5p, hsa-miR-24-3p, hsa-miR-19b-3p, hsa-miR-720, hsa-miR-126-3p, hsa-miR-17-3p and hsa-miR-21-3p. CONCLUSION Findings suggested no differences in miRNAs expression profiles between chronic and aggressive forms of periodontitis. The overexpression of specific miRNAs could provide insights into the pathogenesis of both forms of the disease.
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Affiliation(s)
- Sérgio Antonucci Amaral
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thaís Santos Fontes Pereira
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - João Artur Ricieri Brito
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil
| | - Ricardo Santigo Gomez
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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17
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Costa FO, Ferreira SD, Cortelli JR, Lima RPE, Cortelli SC, Cota LOM. Microbiological profile associated with peri-implant diseases in individuals with and without preventive maintenance therapy: a 5-year follow-up. Clin Oral Investig 2018; 23:3161-3171. [DOI: 10.1007/s00784-018-2737-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 10/02/2018] [Indexed: 12/31/2022]
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Albuquerque BN, Araújo MM, Silva TA, Cota LOM, Cortelli SC, Costa FO. Periodontal Condition and Immunological Aspects of Individuals Hospitalized in the Intensive Care Unit. Braz Dent J 2018; 29:301-308. [PMID: 29972458 DOI: 10.1590/0103-6440201802034] [Citation(s) in RCA: 1] [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: 10/04/2017] [Accepted: 02/16/2018] [Indexed: 11/22/2022] Open
Abstract
There are few studies on the clinical and immunological periodontal status of intensive care unit (ICU) in-patients. The aim of the present study was to evaluate the periodontal condition among ICU in-patients through clinical and immunological periodontal parameters. From the sample of 373 hospitalized ICU patients, 182 were submitted' to a thorough clinical periodontal and immunological evaluation. Data on bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were collected and gingival sulcular fluid samples were quantified through ELISA on IL-1, IL-6, and MMP-2 for immunological evaluation. Data was statistically analyzed by Chi-square, Fisher's exact, Mann-Whitney tests, and Sperman's correlation and multivariate logistic regression analysis. A high dental plaque index and a high prevalence of periodontitis (48.3%), mostly in moderate and localized chronic form, were observed. Individuals with periodontitis presented higher levels of IL-1 and MMP-2, while individuals with cardiovascular disease (CVD) and individuals with two or more systemic diseases (MSD) presented higher levels of IL-1; diabetes mellitus (DM) and MSD individuals presented higher levels of IL-6. A positive association was found between the severity of periodontitis and CVD (OR 2.2; CI = 1.11-4.42). This study reported a 48.3% of the prevalence of periodontitis in ICU patients and a positive association between the severity of periodontitis and CVD. Additionally, higher levels of IL-1 and MMP-2 were found in individuals with periodontitis, higher levels of IL-6 were found in individuals with DM, and higher levels of IL-1 were found in individuals with CVD.
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Affiliation(s)
| | | | | | | | - Sheila Cavalca Cortelli
- UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,UNITAU - Universidade de Taubaté, Taubaté, SP, Brazil
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19
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Balejo RDP, Cortelli JR, Costa FO, Cyrino RM, Aquino DR, Cogo-Müller K, Miranda TB, Moura SP, Cortelli SC. Effects of chlorhexidine preprocedural rinse on bacteremia in periodontal patients: a randomized clinical trial. J Appl Oral Sci 2018; 25:586-595. [PMID: 29211279 PMCID: PMC5701528 DOI: 10.1590/1678-7757-2017-0112] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/27/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Single dose of systemic antibiotics and short-term use of mouthwashes reduce bacteremia. However, the effects of a single dose of preprocedural rinse are still controversial. This study evaluated, in periodontally diseased patients, the effects of a pre-procedural mouth rinse on induced bacteremia. MATERIAL AND METHODS Systemically healthy individuals with gingivitis (n=27) or periodontitis (n = 27) were randomly allocated through a sealed envelope system to: 0.12% chlorhexidine pre-procedural rinse (13 gingivitis and 13 periodontitis patients) or no rinse before dental scaling (14 gingivitis and 15 periodontitis patients). Periodontal probing depth, clinical attachment level, plaque, and gingival indices were measured and subgingival samples were collected. Blood samples were collected before dental scaling, 2 and 6 minutes after scaling. Total bacterial load and levels of P. gingivalis were determined in oral and blood samples by real-time polymerase chain reaction, while aerobic and anaerobic counts were determined by culture in blood samples. The primary outcome was the antimicrobial effect of the pre-procedural rinse. Data was compared by Mann-Whitney and Signal tests (p<0.05). RESULTS In all sampling times, polymerase chain reaction revealed higher blood bacterial levels than culture (p<0.0001), while gingivitis patients presented lower bacterial levels in blood than periodontitis patients (p<0.0001). Individuals who experienced bacteremia showed worse mean clinical attachment level (3.4 mm vs. 1.1 mm) and more subgingival bacteria (p<0.005). The pre-procedural rinse did not reduce induced bacteremia. CONCLUSIONS Bacteremia was influenced by periodontal parameters. In periodontally diseased patients, pre-procedural rinsing showed a discrete effect on bacteremia control.
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Affiliation(s)
| | - José Roberto Cortelli
- Universidade de Taubaté, Departamento de Odontologia, Núcleo de Pesquisa Periodontal, Taubaté, SP, Brasil
| | | | | | - Davi Romeiro Aquino
- Universidade de Taubaté, Departamento de Odontologia, Núcleo de Pesquisa Periodontal, Taubaté, SP, Brasil
| | - Karina Cogo-Müller
- Universidade Estadual de Campinas, Faculdade de Ciências Farmacêuticas, Piracicaba, SP, Brasil
| | | | - Sara Porto Moura
- Universidade de Taubaté, Departamento de Odontologia, Taubaté, SP, Brasil
| | - Sheila Cavalca Cortelli
- Universidade de Taubaté, Departamento de Odontologia, Núcleo de Pesquisa Periodontal, Taubaté, SP, Brasil
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20
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Lynch MC, Cortelli SC, McGuire JA, Zhang J, Ricci-Nittel D, Mordas CJ, Aquino DR, Cortelli JR. The effects of essential oil mouthrinses with or without alcohol on plaque and gingivitis: a randomized controlled clinical study. BMC Oral Health 2018; 18:6. [PMID: 29321067 PMCID: PMC5763666 DOI: 10.1186/s12903-017-0454-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 12/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The efficacy of several variants of essential oil mouthrinses has been studied extensively. This is the first study to compare the anti-plaque and anti-gingivitis efficacy of two marketed essential oil mouthrinses: one is an alcohol containing mouthrinse and the other one is an alcohol-free mouthrinse. METHODS This examiner-blind, parallel-group study randomized subjects to three groups: 1) Mechanical Oral Hygiene (MOH) only; 2) MOH plus Alcohol-Containing essential oil Mouthrinse (ACM); 3) MOH plus Alcohol-Free essential oil Mouthrinse (AFM). Primary endpoint was whole-mouth mean Modified Gingival Index (MGI) at six months. Secondary endpoints included whole-mouth mean MGI at one and three months, and whole-mouth mean Plaque Index (PI) and whole-mouth mean Bleeding Index (BI) at one, three and six months. Safety assessments were conducted at all time points. RESULTS A total of 370 subjects were enrolled; 348 subjects completed the study. After six months, subjects using essential oil mouthrinses with or without alcohol showed significant reduction (p < 0.001) in gingivitis (28.2% and 26.7%, respectively) and significant reduction (p < 0.001) in plaque (37.8% and 37.0%, respectively), compared to those performing MOH only. Significant reductions in MGI, PI, and BI (p < 0.001) were observed at one and three months and also at six months for mean BI. No statistically significant differences were observed for all measured indices between ACM and AFM groups at any time point. Both mouthrinses were well tolerated. CONCLUSIONS No significant differences were observed in the efficacy of ACM and AFM to reduce plaque and gingivitis, when used in addition to MOH, over six months. TRIAL REGISTRATION The trial was registered on clinicaltrials.gov on November 30, 2016. The registration number is NCT02980497 .
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Affiliation(s)
- Michael C Lynch
- Johnson & Johnson Consumer Inc.,, 199 Grandview Road, Skillman, New Jersey, 08558, USA
| | - Sheila Cavalca Cortelli
- Nucleus of Periodontal Research, Dental School, University of Taubate, Taubaté, São Paolo, Brazil
| | - James A McGuire
- Johnson & Johnson Consumer Inc.,, 199 Grandview Road, Skillman, New Jersey, 08558, USA
| | - Jane Zhang
- Johnson & Johnson Consumer Inc.,, 199 Grandview Road, Skillman, New Jersey, 08558, USA.
| | - Danette Ricci-Nittel
- Johnson & Johnson Consumer Inc.,, 199 Grandview Road, Skillman, New Jersey, 08558, USA
| | - Carolyn J Mordas
- Johnson & Johnson Consumer Inc.,, 199 Grandview Road, Skillman, New Jersey, 08558, USA
| | - Davi Romeiro Aquino
- Nucleus of Periodontal Research, Dental School, University of Taubate, Taubaté, São Paolo, Brazil
| | - Jose Roberto Cortelli
- Nucleus of Periodontal Research, Dental School, University of Taubate, Taubaté, São Paolo, Brazil
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21
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Dutra BC, Oliveira AMSD, Oliveira PAD, Manzi FR, Cortelli SC, Cota LODM, Costa FO. Effect of 1% sodium alendronate in the non-surgical treatment of periodontal intraosseous defects: a 6-month clinical trial. J Appl Oral Sci 2017; 25:310-317. [PMID: 28678950 PMCID: PMC5482254 DOI: 10.1590/1678-7757-2016-0252] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 12/06/2016] [Indexed: 12/04/2022] Open
Abstract
Background and objectives Few studies have evaluated the effect of the topical application of sodium alendronate (ALN) on the treatment of intrabuccal bone defects, especially those caused by periodontitis. This 6-month randomized placebo controlled clinical trial aimed at evaluating the effect of non-surgical periodontal treatment associated with the use of 1% ALN, through clinical evaluations and cone-beam computed tomography (CBCT). Material and Methods Twenty individuals with chronic periodontitis underwent periodontal examination at the baseline as well as 3 and 6 months after periodontal treatment, registering clinical attachment level (CAL), periodontal probing depth (PPD), and bleeding on probing (BOP) as the clinical outcomes. After manual scaling and root planing, 40 bilateral sites with interproximal vertical bone defects were randomly treated with either 1% ALN gel or a placebo. Bone defects were evaluated through CBCT at the baseline and 6 months post-treatment. The clinical and CBCT parameters were compared using the Wilcoxon and Friedman tests (p<0.05). Results Although ALN produced a greater CAL gain when compared to the placebo at 6 months post-treatment (p=0.021), both treatments produced similar effects on the PPD, BOP, and bone height. Significant differences in bone fill were observed only in patients of the ALN group (4.5 to 3.8 mm; p=0.003) at 6 months post-treatment. Conclusions Topical application of 1% ALN might be a beneficial adjuvant to non-surgical periodontal therapy.
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Affiliation(s)
- Bernardo Carvalho Dutra
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Patologia e Cirurgia. Belo Horizonte, MG, Brasil
| | | | | | - Flavio Ricardo Manzi
- Pontífica Universidade Católica of Minas Gerais, Departamento de Periodontia. Belo Horizonte, MG, Brasil
| | - Sheila Cavalca Cortelli
- Universidade de Taubaté, Departamento de Odontologia, Divisão de Pesquisa Periodontal. Taubaté, SP, Brasil
| | - Luís Otávio de Miranda Cota
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Patologia e Cirurgia. Belo Horizonte, MG, Brasil
| | - Fernando Oliveira Costa
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Patologia e Cirurgia. Belo Horizonte, MG, Brasil
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Esteves Lima RP, Cota LOM, Silva TA, Cortelli SC, Cortelli JR, Costa FO. Periodontitis and type 2 diabetes among women with previous gestational diabetes: epidemiological and immunological aspects in a follow-up of three years. J Appl Oral Sci 2017; 25:130-139. [PMID: 28403353 PMCID: PMC5393533 DOI: 10.1590/1678-77572016-0367] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/06/2016] [Accepted: 09/22/2016] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The aim of this study was to verify the incidence on the development of type 2 diabetes in women with previous gestational diabetes with and without periodontitis after a three-year time interval. MATERIAL AND METHODS Initial sample of this follow-up study consisted of 90 women diagnosed with gestational diabetes who underwent periodontal examination. After three years, 49 women were subjected to new periodontal examination and biological, behavioral, and social data of interest were collected. Additionally, the quantification of the C-reactive protein in blood samples was performed. Fasting glucose and glycated hemoglobin levels were requested. Saliva samples were collected for quantification of interleukin 6 and 10, tumor necrosis factor α, matrix metalloproteinase 2 and 9. RESULTS The incidence of type 2 diabetes mellitus was 18.4% and of periodontitis was 10.2%. There was no significant difference in the incidence of type 2 diabetes mellitus among women with and without periodontitis. It was observed impact of C-reactive protein in the development of type 2 diabetes mellitus. However, it was not observed impact of periodontitis on the development of type 2 diabetes mellitus among women with previous gestational diabetes. CONCLUSIONS It was not observed impact of periodontitis on the development of type 2 diabetes among women with previous gestational diabetes. The impact of C-reactive protein in the development of type 2 diabetes mellitus highlights the importance of an inflammatory process in the diabetes pathogenesis.
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Affiliation(s)
- Rafael Paschoal Esteves Lima
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Periodontologia e Patologia, Belo Horizonte, MG, Brasil
| | - Luis Otávio Miranda Cota
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Periodontologia e Patologia, Belo Horizonte, MG, Brasil
| | - Tarcília Aparecida Silva
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Periodontologia e Patologia, Belo Horizonte, MG, Brasil
| | | | | | - Fernando Oliveira Costa
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Periodontologia e Patologia, Belo Horizonte, MG, Brasil
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Pataro AL, Cortelli SC, Abreu MHNG, Cortelli JR, Franco GCN, Aquino DR, Cota LOM, Costa FO. Frequency of periodontal pathogens and Helicobacter pylori in the mouths and stomachs of obese individuals submitted to bariatric surgery: a cross-sectional study. J Appl Oral Sci 2016; 24:229-38. [PMID: 27383704 PMCID: PMC5019838 DOI: 10.1590/1678-775720150534] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/15/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES This cross-sectional study compared the frequency of oral periodontopathogens and H. pylori in the mouths and stomachs of obese individuals with or without periodontitis submitted to bariatric surgery. MATERIAL AND METHODS One hundred and fifty-four men and women aged 18-65 were conveniently distributed into four groups. Two groups were composed of individuals who underwent bariatric surgery with (BP) (n=40) and without (BNP) (n=39) periodontitis and two obese control groups with (CP) (n=35) and without (CNP) (n=40) periodontitis. The oral pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Parvimonas micra, Treponema denticola, Tannerella forsythia, Campylobacter rectus, and Helicobacter pylori were detected by a polymerase chain reaction technique using saliva, tongue and stomach biopsy samples. RESULTS Statistical analysis demonstrated that periodontopathogens were highly frequent in the mouth (up to 91.4%). In the bariatric surgically treated group, orally, P. gingivalis, T. denticola and T. forsythia were more frequent in periodontitis, while C. rectus was more frequent in non-periodontitis subjects. Stomach biopsies also revealed the high frequency of five oral species in both candidates for bariatric surgery (91.6%) and the bariatric (83.3%) groups. H. pylori was frequently detected in the mouth (50.0%) and stomach (83.3%). In the stomach, oral species and H. pylori appeared in lower frequency in the bariatric group. CONCLUSIONS Obese individuals showed high frequencies of periodontopathogens and H. pylori in their mouths and stomachs. Bariatric surgery showed an inverse microbial effect on oral and stomach environments by revealing higher oral and lower stomach bacterial frequencies.
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Affiliation(s)
- André Luiz Pataro
- - Universidade Federal de Minas Gerais, Departamento de Periodontia, Belo Horizonte, Minas Gerais, Brasil
| | - Sheila Cavalca Cortelli
- - Universidade de Taubaté, Núcleo de Pesquisa Periodontal, Departamento de Odontologia, Taubaté, São Paulo, Brasil
| | | | - José Roberto Cortelli
- - Universidade de Taubaté, Núcleo de Pesquisa Periodontal, Departamento de Odontologia, Taubaté, São Paulo, Brasil
| | - Gilson Cesar Nobre Franco
- - Universidade de Taubaté, Núcleo de Pesquisa Periodontal, Departamento de Odontologia, Taubaté, São Paulo, Brasil.,- Universidade Estadual de Ponta Grossa, Laboratório de Fisiologia e Patofisiologia, Departamento de Biologia Geral, Ponta Grossa, Paraná, Brasil
| | - Davi Romeiro Aquino
- - Universidade de Taubaté, Núcleo de Pesquisa Periodontal, Departamento de Odontologia, Taubaté, São Paulo, Brasil
| | - Luis Otavio Miranda Cota
- - Universidade Federal de Minas Gerais, Departamento de Periodontia, Belo Horizonte, Minas Gerais, Brasil
| | - Fernando Oliveira Costa
- - Universidade Federal de Minas Gerais, Departamento de Periodontia, Belo Horizonte, Minas Gerais, Brasil
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Abstract
OBJECTIVE Sense of Coherence (SOC) has been associated with perceived oral health measures, but the contribution of SOC to clinical measures is still unclear. The aim of the present cross-sectional study was to evaluate the potential association between periodontal health outcomes, such as periodontal clinical parameters and perceived periodontal health, and SOC. MATERIALS AND METHODS The study sample comprised 276 individuals, aged 18-60 years, from Belo Horizonte, Brazil. Participants answered questionnaires covering sociodemographic variables, self-perceived periodontal health and SOC. Full-mouth periodontal examinations were performed. The sample was divided into three groups according to SOC score: (a) SOC1 = weak (24-46); (b) SOC2 = moderate (47-51); (c) SOC3 = strong (52-65). Multivariate analyses including appropriate logistic or linear regression models were performed to evaluate the association between periodontal health outcomes and biological, sociodemographic and behavioural variables. RESULTS Perceived general oral health was associated with family income bracket (p = 0.010), smoking (p = 0.004), dental flossing (p = 0.017) and SOC (weak SOC: p = 0.005). Perceived gum disease and perceived periodontal disease were associated with SOC (weak SOC: p = 0.001 and p = 0.015, respectively). CONCLUSIONS Overall, perceived periodontal health outcomes were associated with SOC. However, no association between clinical periodontal health outcomes and SOC were observed.
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Affiliation(s)
- Renata Magalhães Cyrino
- Department of Periodontology School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fernando Oliveira Costa
- Department of Periodontology School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Luís Otávio Miranda Cota
- Department of Periodontology School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Santuchi CC, Cortelli JR, Cortelli SC, Cota LOM, Fonseca DC, Alencar CO, Costa FO. Scaling and Root Planing per Quadrant Versus One-Stage Full-Mouth Disinfection: Assessment of the Impact of Chronic Periodontitis Treatment on Quality of Life — A Clinical Randomized, Controlled Trial. J Periodontol 2016; 87:114-23. [DOI: 10.1902/jop.2015.150105] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Porto AN, Cortelli SC, Borges AH, Matos FZ, Aquino DR, Miranda TB, Oliveira Costa F, Aranha AF, Cortelli JR. Oral and endotracheal tubes colonization by periodontal bacteria: a case-control ICU study. Eur J Clin Microbiol Infect Dis 2016; 35:343-51. [PMID: 26810057 DOI: 10.1007/s10096-015-2518-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
Abstract
Periodontal infection is a possible risk factor for respiratory disorders; however, no studies have assessed the colonization of periodontal pathogens in endotracheal tubes (ET). This case-control study analyzed whether periodontal pathogens are able to colonize ET of dentate and edentulous patients in intensive care units (ICU) and whether oral and ET periodontal pathogen profiles have any correlation between these patients. We selected 18 dentate and 18 edentulous patients from 78 eligible ICU patients. Oral clinical examination including probing depth, clinical attachment level, gingival index , and plaque index was performed by a single examiner, followed by oral and ET sampling and processing by quantitative polymerase chain reaction (total bacterial load, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia). Data were statistically analyzed by Mann-Whitney U, two-way analysis of variance (p < 0.05). Among dentate, there was no correlation between clinical parameters and ET bacterial levels. Both dentate and edentulous patients showed similar ET bacterial levels. Dentate patients showed no correlation between oral and ET bacterial levels, while edentulous patients showed positive correlations between oral and ET levels of A. actinomycetemcomitans, P. gingivalis, and T. forsythia. Periodontal pathogens can colonize ET and the oral cavity of ICU patients. Periodontal pathogen profiles tend to be similar between dentate and edentulous ICU patients. In ICU patients, oral cavity represents a source of ET contamination. Although accompanied by higher oral bacterial levels, teeth do not seem to influence ET bacterial profiles.
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Affiliation(s)
- A N Porto
- Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil.
| | - S C Cortelli
- Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil
| | - A H Borges
- Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil
| | - F Z Matos
- Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil
| | - D R Aquino
- Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil
| | - T B Miranda
- Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil
| | - F Oliveira Costa
- Periodontal Department, Dental School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - A F Aranha
- Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil
| | - J R Cortelli
- Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil
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Fonseca DC, Cortelli JR, Cortelli SC, Miranda Cota LO, Machado Costa LC, Moreira Castro MV, Oliveira Azevedo AM, Costa FO. Clinical and Microbiologic Evaluation of Scaling and Root Planing per Quadrant and One-Stage Full-Mouth Disinfection Associated With Azithromycin or Chlorhexidine: A Clinical Randomized Controlled Trial. J Periodontol 2015; 86:1340-51. [DOI: 10.1902/jop.2015.150227] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Santuchi CC, Cortelli SC, Cortelli JR, Cota LOM, Alencar CO, Costa FO. Pre- and post-treatment experiences of fear, anxiety, and pain among chronic periodontitis patients treated by scaling and root planing per quadrant versus
one-stage full-mouth disinfection: a 6-month randomized controlled clinical trial. J Clin Periodontol 2015; 42:1024-31. [DOI: 10.1111/jcpe.12472] [Citation(s) in RCA: 9] [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] [Accepted: 10/07/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Camila Carvalho Santuchi
- Department of Dental Clinics, Oral Pathology, and Dental Surgery; Dentistry School; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Sheila Cavalca Cortelli
- Periodontics Research Division; Department of Dentistry; University of Taubaté; Taubaté São Paulo Brazil
| | - José Roberto Cortelli
- Periodontics Research Division; Department of Dentistry; University of Taubaté; Taubaté São Paulo Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Dental Surgery; Dentistry School; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Camila Oliveira Alencar
- Periodontics Research Division; Department of Dentistry; University of Taubaté; Taubaté São Paulo Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Dental Surgery; Dentistry School; Federal University of Minas Gerais; Belo Horizonte Brazil
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Costa FO, Cota LOM, Cortelli JR, Cortelli SC, Cyrino RM, Lages EJP, Oliveira APL. Surgical and Non-Surgical Procedures Associated with Recurrence of Periodontitis in Periodontal Maintenance Therapy: 5-Year Prospective Study. PLoS One 2015; 10:e0140847. [PMID: 26496187 PMCID: PMC4619675 DOI: 10.1371/journal.pone.0140847] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 10/01/2015] [Indexed: 12/23/2022] Open
Abstract
Background and Objective Prospective studies that investigated the influence of surgical and nonsurgical procedures in the recurrence of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs have not been previously reported. The objective of this study was to evaluate longitudinally the recurrence of periodontitis in regular compliers (RC) and irregular compliers (IC) individuals undergoing surgical and non-surgical procedures over 5 years in a program of PMT. Materials and Methods A total of 212 individuals participated in this study. Full-mouth periodontal examination including bleeding on probing, probing depth, and clinical attachment level were determined at all PMT visits over 5 years. The recurrence of periodontitis was evaluated in RC and IC individuals undergoing surgical and non-surgical procedures in PMT. The influences of risk variables of interest were tested through univariate analysis and multivariate logistic regression. Results Recurrence of periodontitis was significantly lower among RC when compared to IC. Individuals with recurrence of periodontitis and undergoing surgical procedures showed higher probing depth and clinical attachment loss than those who received non-surgical procedures. Recurrence of periodontitis was higher in individual undergoing surgical procedures and irregular compliance during PMT. Conclusions Irregular compliance and surgical procedures in individuals undergoing PMT presented higher rates of recurrence of periodontitis when compared to regular compliant patients undergoing non-surgical procedures.
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Affiliation(s)
- Fernando Oliveira Costa
- Department of Periodontology, Dentistry School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail: (FOC); (APLO)
| | - Luís Otávio Miranda Cota
- Department of Periodontology, Dentistry School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Renata Magalhães Cyrino
- Department of Periodontology, Dentistry School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Eugênio José Pereira Lages
- Department of Periodontology, Dentistry School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Paula Lima Oliveira
- Department of Periodontology, Dentistry School, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
- * E-mail: (FOC); (APLO)
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de Araujo Neris M, Cortelli SC, Aquino DR, de Miranda TB, Costa FDO, Cortelli JR. A. actinomycetemcomitans profile and red complex bacterial species of an Afro-Brazilian community: A comparative study. Arch Oral Biol 2015; 60:753-9. [DOI: 10.1016/j.archoralbio.2015.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 11/18/2014] [Accepted: 01/31/2015] [Indexed: 11/29/2022]
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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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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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Cortelli SC, Cortelli JR, Shang H, Costa R, Charles CA. Gingival health benefits of essential-oil and cetylpyridinium chloride mouthrinses: a 6-month randomized clinical study. Am J Dent 2014; 27:119-126. [PMID: 25208357] [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 This randomized, single center, examiner-blind, controlled, parallel-group, 6-month clinical study compared the antiplaque/antigingivitis potential of an essential oil (EO) versus a 0.07% cetylpyridinium chloride (CPC)-containing mouthrinse. A 5% hydroalcohol solution was included as a control group. METHODS 354 healthy volunteers (18-71 years of age) were enrolled in this clinical trial; 338 subjects completed the study. At baseline, 1-, 3-, and 6-month visits, subjects received an oral examination, gingivitis (MGI), gingival bleeding (BI) and plaque assessments (PI). Following randomization, subjects received a prophylaxis and began brushing twice daily with the provided fluoride toothpaste and rinsing twice daily with 20 mL of the assigned mouthrinse for 30 seconds. RESULTS All rinses were well tolerated by the subjects, with the exception of extrinsic tooth stain complaints in 13 subjects in the CPC group between the 3- and 6-month exams. Statistically significant reductions in gingivitis, bleeding and plaque were observed for both EO and CPC at all post-baseline time-points when compared to the negative control. At 6 months MGI and PI were reduced by 42.6% and 42.0% for EO and by 17.1% and 13.9% respectively, for CPC vs. control. When compared to CPC, EO was statistically significantly superior at all post-baseline time-points. EO showed increasing reductions in MGI of 10.5%, 20.3% and 30.7% as well as reductions in PI of 12.7%, 23.7% and 32.6% at 1, 3 and 6 months, respectively. When analyzing the number of healthy sites (MGI scores of 0 or 1), the beneficial effect of the EO-containing mouthrinse is 45.8% greater than using a CPC-containing mouthrinse and 59.8% greater than placebo.
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Charles CA, Lisante TA, Revankar R, Cortelli JR, Cortelli SC, Aquino D, Goyal CR, Amini P. Early benefits with daily rinsing on gingival health improvements with an essential oil mouthrinse--post-hoc analysis of 5 clinical trials. J Dent Hyg 2014; 88 Suppl 1:40-50. [PMID: 25071149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The aim of this investigation through post-hoc analyses was to determine the ability to achieve gingival health in the short term with daily rinsing with an essential oil containing antimicrobial mouthrinse. METHODS Conventional Analysis of Covariance (ANCOVA) on whole mouth mean plaque and gingivitis scores were originally conducted to demonstrate efficacy of adjunctive use of Cool Mint® LISTERINE® Antiseptic (EO) compared to negative control [brushing (B) or brushing/flossing (BF)] in each of 5 studies containing a 4 week evaluation. The Modified Gingival Index (MGI) was split into 2 categories: healthy (scores 0, 1) and unhealthy (≥2). Data, reflecting subjects that completed 4 weeks of treatment from 5 studies, were evaluated to determine the mean percent of healthy sites and mean percent of more inflamed "affected" areas (MGI≥3). RESULTS At baseline, the mean percent healthy gingival sites ranged from 0.1 to 3.2%. At 4 weeks, up to 29.3% and 16.1% of sites were healthy for the EO group and negative control group, respectively. Three and 6 month data from 2 of the 5 studies resulted in up to 39.6% and 62% at 3 and 6 month mean percent healthy sites per subject for EO and up to 17.2% and 15.6% at 3 and 6 months, respectively, for negative control. Virtually plaque free sites (PI=0, 1) at 4 weeks ranged up to 34.3% and 8.1% for EO and control groups, respectively. CONCLUSION Significantly more healthy gingival sites and virtually plaque free tooth surfaces can be achieved as early as 4 weeks with use of an essential oil antimicrobial mouthrinse. This finding continues through 6 months twice daily use as part of oral care practices compared to mechanical oral hygiene alone.
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Cortelli JR, Castro MVMD, Balejo RDP, Alencar COD, Gargioni Filho AC, Cortelli SC, Costa FO. Clinical and microbiological evaluation of one-stage full-mouth disinfection: a short-term study. Rev odontol UNESP 2013. [DOI: 10.1590/s1807-25772013000400010] [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] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Patients seem to adhere better to short-term periodontal treatment schemes. Besides, time-reduced treatments are more cost-effective. However, the degree of benefits related to this type of treatment still requires additional investigations. AIM: The present short-term study evaluated clinical and microbiological outcomes, from baseline to 3-months, of chronic periodontitis subjects treated by the one-stage full-mouth disinfection protocol. MATERIAL AND METHOD: Sixteen chronic periodontitis subjects (mean-age 49.87 ± 8.22) who met inclusion/exclusion criteria were included. A calibrated examiner measured whole-mouth plaque and gingival indices, periodontal pocket depth and clinical attachment level at baseline and at 3-months. Subgingival samples were also collected from the 5 most diseased periodontal sites to determine total bacterial load and levels of P. gingivalis and S. oralis by real time qPCR. Periodontal treatment consisted of full-mouth manual debridement plus wide intraoral use of chlorhexidine in gel and solution. Additionally, after debridement, individuals rinsed 0.12% chlorhexidine at home twice a day for the following 2 months. Data monitored were compared by paired Student-t test (p<0.05). RESULT: Statistical analysis revealed that, in general, one-stage full-mouth disinfection treatment provided significant clinical and microbiological improvements at 3-months. Total bacterial load showed one of the most pronounced reductions from baseline to 3-months (p=0.0001). Also, subgingival levels P. gingivalis and S. oralis reduced overtime. CONCLUSION: After a short period of monitoring, chronic periodontitis subjects showed clinical and microbial improvements following one-stage full-mouth disinfection treatment.
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Porto AN, Borges AH, Semenoff-Segundo A, Semenoff TA, Pedro FLM, Bandeca MC, Cortelli SC. Lipid Profile Parameters under influence of Periodontitis Associated with Chronic Stress: An Animal Model Study. J Int Oral Health 2013; 5:8-14. [PMID: 24155613 PMCID: PMC3780372] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 06/01/2013] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND The present study compared the effect of two chronic stress models associated with periodontitis induced in rats on partial lipid profile parameters. MATERIALS & METHODS Forty-eight rats were divided into 4 groups: physical stress+periodontitis, variable stress+periodontitis, periodontitis and control. Physical stress and variable stress occurred over 60 days. After the first ten days of the stress test, periodontitis was induced by ligature. After 60 days of experimentation, the animals underwent incision and visualization of the posterior vena cava, and blood punctures were performed under a vacuum. Impartial and trained examiners performed the analysis of the parameters: low-density lipoprotein, high density lipoprotein, triglycerides and cholesterol. RESULTS The lipid parameters and cholesterol were significantly lower in the variable stress group than in the ligature and control groups. The physical stress group was not statistically different from the other groups. The triglyceride level was highest for the control group and statistically different from the levels in groups variable stress and physical stress. The physical stress group had the lowest triglyceride level, which was statistically different from that of the control group. There was no statistical difference between physical stress and variable stress with respect to low-density lipoprotein; a similar finding was obtained for ligature and control. The variable stress group had the lowest low-density lipoprotein level, which was statistically different from those of the ligature and control groups. High density lipoprotein levels showed no statistical differences between groups. CONCLUSION Despite the limitations of the methodology, it seems that the stress model variable associated with periodontitis improved lipid parameters in the study. How to cite this article:Porto AN, Borges AH, Segundo AS, Semenoff TA, Pedro FL, Bandeca MC, Cortelli SC. Lipid profile parameters under influence of periodontitis associated with chronic stress: an animal model study. J Int Oral Health 2013; 5(4):8-14.
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Affiliation(s)
| | | | - Alex Semenoff-Segundo
- Masters Program in Integrated Dental Sciences, University of Cuiaba Cuiaba, MT, Brazil
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Cortelli SC, Cortelli JR, Shang H, McGuire JA, Charles CA. Long-term management of plaque and gingivitis using an alcohol-free essential oil containing mouthrinse: a 6-month randomized clinical trial. Am J Dent 2013; 26:149-155. [PMID: 23986962] [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: 06/02/2023]
Abstract
PURPOSE This 6-month, examiner-blind, single center, randomized, parallel group, controlled clinical trial compared the antiplaque/antigingivitis effects of an alcohol-free EO mouthrinse (LISTERINE Zero) to a negative control (5% flavored, colored hydroalcohol) and to an alcohol-free CPC-containing mouthrinse (Colgate Plax). METHODS 337 gingivitis subjects were clinically examined to determine Modified Gingival Index (MGI) and Plaque Index (PI) at baseline, 3 and 6 months. The primary efficacy variables were mean MGI and mean PI at 6 months (statistically analyzed by ANCOVA). After professional dental prophylaxis, subjects were randomly assigned to 6-month twice daily unsupervised use of alcohol-free EO, alcohol-free CPC or a negative control rinse, in conjunction with normal brushing and flossing. Safety was monitored throughout the study. RESULTS 311 subjects completed the study. After 6 months of use, EO significantly reduced plaque (31.6%) and gingivitis (24.0%) compared to negative control. At 6 months, CPC also significantly reduced plaque (6.4%) and gingivitis (4.4%) compared to negative control. EO provided a 26.9% decrease in plaque and a 20.5% decrease in gingivitis compared to CPC (P < 0.001). All rinses were well tolerated. The alcohol-free EO mouthrinse demonstrated superior efficacy in reducing plaque and gingivitis over 6 months compared to both negative control and alcohol-free CPC mouthrinse.
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Costa FO, Miranda Cota LO, Pereira Lages EJ, Soares Dutra Oliveira AM, Dutra Oliveira PA, Cyrino RM, Medeiros Lorentz TC, Cortelli SC, Cortelli JR. Progression of Periodontitis and Tooth Loss Associated with Glycemic Control in Individuals Undergoing Periodontal Maintenance Therapy: A 5-Year Follow-Up Study. J Periodontol 2013; 84:595-605. [DOI: 10.1902/jop.2012.120255] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Soares GMS, Figueiredo LC, Faveri M, Cortelli SC, Duarte PM, Feres M. Mechanisms of action of systemic antibiotics used in periodontal treatment and mechanisms of bacterial resistance to these drugs. J Appl Oral Sci 2013; 20:295-309. [PMID: 22858695 PMCID: PMC3881775 DOI: 10.1590/s1678-77572012000300002] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 09/20/2011] [Indexed: 11/22/2022] Open
Abstract
Antibiotics are important adjuncts in the treatment of infectious diseases, including periodontitis. The most severe criticisms to the indiscriminate use of these drugs are their side effects and, especially, the development of bacterial resistance. The knowledge of the biological mechanisms involved with the antibiotic usage would help the medical and dental communities to overcome these two problems. Therefore, the aim of this manuscript was to review the mechanisms of action of the antibiotics most commonly used in the periodontal treatment (i.e. penicillin, tetracycline, macrolide and metronidazole) and the main mechanisms of bacterial resistance to these drugs. Antimicrobial resistance can be classified into three groups: intrinsic, mutational and acquired. Penicillin, tetracycline and erythromycin are broad-spectrum drugs, effective against gram-positive and gram-negative microorganisms. Bacterial resistance to penicillin may occur due to diminished permeability of the bacterial cell to the antibiotic; alteration of the penicillin-binding proteins, or production of β-lactamases. However, a very small proportion of the subgingival microbiota is resistant to penicillins. Bacteria become resistant to tetracyclines or macrolides by limiting their access to the cell, by altering the ribosome in order to prevent effective binding of the drug, or by producing tetracycline/macrolide-inactivating enzymes. Periodontal pathogens may become resistant to these drugs. Finally, metronidazole can be considered a prodrug in the sense that it requires metabolic activation by strict anaerobe microorganisms. Acquired resistance to this drug has rarely been reported. Due to these low rates of resistance and to its high activity against the gram-negative anaerobic bacterial species, metronidazole is a promising drug for treating periodontal infections.
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Affiliation(s)
- Geisla Mary Silva Soares
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
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Cortelli SC, Cortelli JR, Romeiro RL, Costa FO, Aquino DR, Orzechowski PR, Araújo VC, Duarte PM. Frequency of periodontal pathogens in equivalent peri-implant and periodontal clinical statuses. Arch Oral Biol 2013; 58:67-74. [DOI: 10.1016/j.archoralbio.2012.09.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 07/20/2012] [Accepted: 09/22/2012] [Indexed: 12/22/2022]
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Feres M, Cortelli SC, Figueiredo LC, Haffajee AD, Socransky SS. Microbiological basis for periodontal therapy. J Appl Oral Sci 2012; 12:256-66. [PMID: 20976394 DOI: 10.1590/s1678-77572004000400002] [Citation(s) in RCA: 20] [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: 11/13/2003] [Accepted: 09/23/2004] [Indexed: 11/21/2022] Open
Abstract
The search for the etiologic agents of periodontal diseases started in the Golden Era of medical bacteriology, when the etiologic agents of many bacterial infections were isolated and characterized. After the initial enthusiasm in establishing the infectious nature and the true agents of periodontal diseases, this concept was virtually ignored for the next four decades. Until the early 1970s treatment regimens based on the non-specific plaque hypothesis were directed towards a non-specific reduction in plaque amount. Later, the specific plaque hypothesis established the role of some microorganisms such as A. actinomycetemcomitans, P. gingivalis, T. forsythensis, T. denticola, P. intermedia and F. nucleatum in different forms of periodontal diseases. It was recently suggested that these suspected periodontal pathogens seem to not act alone and interactions between species, especially the balance between pathogenic and beneficial species affect both progression of disease and response of tissues to periodontal therapy. Nowadays it is well established that one of the goals of therapy is to control such periodontal pathogens. Among the most commonly used therapies to treat periodontal infections are scaling and root planing (SRP), supragingival plaque control and periodontal surgeries. Many studies confirmed the reduction of "red complex" species by SRP, and apically repositioned flap can lead to an additional beneficial effect in the subgingival microbiota by decreasing levels of "red" and "orange complexes" species. Furthermore, the level of plaque control maintained by the patients has been considered a crucial step in preventing recurrence of destructive periodontitis.
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Affiliation(s)
- Magda Feres
- Dental Research Division, Department of Periodontology, Guarulhos University, SP, Brasil
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Cortelli JR, Cogo K, Aquino DR, Cortelli SC, Ricci-Nittel D, Zhang P, Araujo MWBD. Validation of the anti-bacteremic efficacy of an essential oil rinse in a Brazilian population: a cross-over study. Braz Oral Res 2012; 26:478-84. [DOI: 10.1590/s1806-83242012005000021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 06/12/2012] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | | | | | - Paul Zhang
- Johnson & Johnson Consumer & Personal Products Worldwide, USA
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Fernandes CB, Aquino DR, Franco GCN, Cortelli SC, Costa FO, Cortelli JR. Do elderly edentulous patients with a history of periodontitis harbor periodontal pathogens? Tex Dent J 2012; 129:751-761. [PMID: 22988660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES The presence of periodontal pathogens in the oral cavity may impact implant survival. Therefore, this study aimed to determine the prevalence of Campylobacter rectus, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Tannerella forsythia, Treponema denticola, Eikenella corrodens, and Parvimonas micra in a specific elderly population with a history of periodontitis who have never worn dentures. MATERIAL AND METHODS Thirty dentate subjects (mean age 61.7 +/- 7.05 years) and 30 edentulous subjects (mean age 65.8 +/- 8.05 years) were included in this cross-sectional study. Microbiological samples of cheek mucosa and the dorsum of the tongue were taken from all subjects. In addition, sulcus samples were taken from the dentate group. All samples were analysed using a bacterial DNA-specific polymerase chain reaction. RESULTS All the pathogens studied were detected in dentate and edentulous subjects. When cheek and tongue samples were combined, C. rectus, A. actinomycetemcomitans and E. corrodens presented with a similar prevalence in both groups, whereas the other species were more prevalent specifically in the dentate group (P<0.05). In dentate subjects, P. intermedia and T. denticola were present in higher frequencies in the cheek mucosa (26.67% and 66.67%, respectively), whereas P. gingivalis and T. forsythia were more prevalent in the tongue samples (26.67% and 56.67%, respectively). CONCLUSIONS Periodontal pathogens may persist in the oral cavity of edentulous subjects who have had periodontal disease, even 1 year after the extraction of all teeth and in the absence of other hard surfaces in the mouth.
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Cortelli SC, Cortelli JR, Wu MM, Simmons K, Charles CA. Comparative antiplaque and antigingivitis efficacy of a multipurpose essential oil-containing mouthrinse and a cetylpyridinium chloride-containing mouthrinse: A 6-month randomized clinical trial. Quintessence Int 2012; 43:e82-e94. [PMID: 22670258] [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
OBJECTIVE This 6-month, examiner-blind, single-center, randomized, parallel group clinical trial compared the antiplaque and antigingivitis effects of an essential oil-containing mouthrinse with zinc chloride and sodium fluoride (EO) to a 0.05% cetylpyridinium chloride-containing mouthrinse (CPC) also with fluoride. METHOD AND MATERIALS Four hundred and eight gingivitis subjects were monitored for the primary outcomes of modified Gingival Index (MGI) and Plaque Index (PI) at baseline and 3 and 6 months. Subjects were randomly assigned to 6-month twice a day unsupervised use of EO, CPC, or negative control rinse in conjunction with normal brushing and flossing. RESULTS EO was always better than CPC at 3 and 6 months considering all parameters. All benefits allowed by EO increased from 3 to 6 months. CPC was better than the negative control at 3 and 6 months with respect to whole mouth plaque, and the proportion of more severe sites (baseline scores ≥ 3) in PI and MGI. At 6 months, CPC did not differ from negative control in relation to whole mouth MGI reduction, proximal MGI reduction, and percentages of sites improved over baseline in PI and MGI. CONCLUSION This new EO mouthrinse provided superior clinical benefits to CPC and demonstrated increasing plaque and gingivitis reductions over 6 months. Our findings support the regular long-term use of the EO mouthrinse and selection over a 0.05% CPC rinse for better efficacy.
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Costa FO, Miranda Cota LO, Pereira Lages EJ, Lima Oliveira AP, Cortelli SC, Cortelli JR, Medeiros Lorentz TC, Costa JE. Periodontal Risk Assessment Model in a Sample of Regular and Irregular Compliers Under Maintenance Therapy: A 3-Year Prospective Study. J Periodontol 2012; 83:292-300. [DOI: 10.1902/jop.2011.110187] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pataro AL, Costa FO, Cortelli SC, Cortelli JR, Dupim Souza AC, Nogueira Guimarães Abreu MH, Girundi MG, Costa JE. Influence of Obesity and Bariatric Surgery on the Periodontal Condition. J Periodontol 2012; 83:257-66. [DOI: 10.1902/jop.2011.100782] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Costa FO, Santuchi CC, Pereira Lages EJ, Miranda Cota LO, Cortelli SC, Cortelli JR, Medeiros Lorentz TC, Costa JE. Prospective Study in Periodontal Maintenance Therapy: Comparative Analysis Between Academic and Private Practices. J Periodontol 2012; 83:301-11. [DOI: 10.1902/jop.2011.110101] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bonifácio JD, Aquino DR, Franco GCN, Cortelli SC, Cogo K, Guimarães dos Santos J, Costa FO, Cortelli JR. Prevalence of periodontopathogens in a black Brazilian secluded community matched with a black urban population. Community Dent Health 2011; 28:301-304. [PMID: 22320070] [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: 05/31/2023]
Abstract
OBJECTIVE To evaluate the prevalence of periodontopathogens according to periodontal profile in a black Brazilian secluded community matched with an urban black population. PARTICIPANTS A total of 84 subjects were selected, 42 (mean age 25.7 sd 18.0 years) from a secluded community called Santo Antonio do Guapore (SAG) and 42 (mean age 25.4 sd 18.1 years) from an urban area of Sao Paulo State (SPT). METHODS Participants received clinical examinations as follows: periodontal pocket depth; clinical attachment loss; plaque and gingival indexes. After examination, the secluded population was classified as periodontal health (13), gingivitis (15) or periodontitis (14). Then, 182 urban volunteers were screened and 42 subjects were selected matched for the variables: periodontal diagnosis, age (+/- 2 years) and gender. Samples were taken for microbial analysis. Genomic DNA for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus, Tannerella forsythia and Prevotella intermedia was provided by polymerase chain reaction. RESULTS Except for C. rectus, all pathogens were present in both groups with no statistically significant difference. In particular, C. rectus was more prevalent only in gingivitis subjects from the SPT group (p<0.05). A high frequency of periodontopathogens was related to the severity of periodontal disease. CONCLUSION In general, the prevalence of the examined periodontopathogens in this study did not differ between a secluded black Brazilian population and an urban black population.
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Affiliation(s)
- J D Bonifácio
- Department of Periodontology, Dentistry School, University of Taubaté, Brazil
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Fagundes JAG, Monoo LD, Euzébio Alves VT, Pannuti CM, Cortelli SC, Cortelli JR, Holzhausen M. Porphyromonas Gingivalisis Associated With Protease-Activated Receptor-2 Upregulation in Chronic Periodontitis. J Periodontol 2011; 82:1596-601. [DOI: 10.1902/jop.2011.110073] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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