RESUMO
BACKGROUND: The aim of the present study was to assess the periodontal condition of individuals with Down syndrome and the association with sociodemographic and behavioural characteristics and family perception of oral health. METHODS: This cross-sectional observational study was performed at a referral centre for dental assistance to disabled persons in Araçatuba, Brazil. Parents of the individuals were interviewed, and the visible plaque index, bleeding on probing, probing pocket depth and clinical attachment level were recorded by one periodontist in six sites per tooth of all teeth. The individual was the unit of analysis. The significance level was set at 5%. RESULTS: Sixty-four subjects (23.8 ± 8.3 years old) were included. Eighteen (28.1%) were diagnosed with gingivitis and 46 (71.9%) with periodontitis. In the multiple logistic regression final model, age and self-reported oral hygiene practices were associated with the occurrence of periodontitis. The chance of having periodontitis was 4.7 times higher among individuals older than 20 years and approximately 4 times higher in patients whose oral hygiene was performed by themselves and their parents, compared with those who performed oral hygiene alone. Sex, follow-up time in the centre, education, degree of participants' dependence, flossing and family history of periodontal disease were not associated with the occurrence of periodontitis. Higher levels of plaque and bleeding were observed for participants with parents reporting bad gingival health (76.2% and 46.9%) and deficient oral hygiene (79.5% and 47.3%). The perception of parents regarding gingival bleeding was correlated with higher bleeding detected clinically (P = 0.01; 50.1%). CONCLUSIONS: The prevalence of periodontitis in individuals with Down syndrome is high and increases with age, even in the face of the parents' perception about their children's oral condition.
Assuntos
Síndrome de Down/epidemiologia , Doenças Periodontais/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Gengivite/epidemiologia , Humanos , Masculino , Periodontite/epidemiologia , Prevalência , Adulto JovemRESUMO
The aim of this randomised clinical trial was to evaluate the effect of Lactobacillus reuteri in chewable tablets as an adjunct to non-surgical periodontal treatment of chronic periodontitis in smoking patients. 34 patient smokers were selected and randomly divided into two groups. The SRP group (n=17) received scaling and root planing (SRP) in one session and a placebo; the PRO group (n=17) received SRP in one session and 2 probiotic tablets 2× per day, for 21 days. Bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), gingival recession (GR), and pockets with PD≥5 mm and bleeding were measured at baseline and 90 days. After 90 days of treatment, the PD and pockets with PD≥5 mm and bleeding were significantly lower in both groups compared to baseline (P<0.05). In the PRO group, the BOP had significantly reduced at 90 days when compared with the baseline (P<0.05). There was statistically significant reduction in PD between baseline and 90 days in the PRO group in deep pockets (P<0.05). There was no statistically significant difference between the groups in the reduction in PD (P=0.95) or gain in CAL (P=0.97) in moderate and deep pockets. The adjuvant use of L. reuteri in the treatment of chronic periodontitis was effective in controlling gingival inflammation because reduced bleeding on probing which means reduced gingival inflammation and was effective in reducing deep pocket in manner clinically relevant.
Assuntos
Periodontite Crônica/terapia , Limosilactobacillus reuteri/fisiologia , Probióticos/uso terapêutico , Fumantes , Adulto , Periodontite Crônica/patologia , Terapia Combinada , Raspagem Dentária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Aplainamento Radicular , Resultado do TratamentoRESUMO
BACKGROUND AND OBJECTIVE: This study aimed to assess the effect of multiple sessions of a low-level laser therapy (LLLT) adjuvant to scaling and root planing (SRP) on the treatment of experimental periodontitis (EP) in rats treated with 5-fluorouracil (5-FU). MATERIAL AND METHODS: A total of 120 rats were divided into five groups: no treatment (NT); treatment with 5-FU (60 and 40 mg/kg) and no local periodontal treatment (5FU); treatment with 5-FU and SRP (5FU-SRP); treatment with 5-FU, SRP and one LLLT session (660 nm; 0.035 W; 4.2 J; 120 s) (5FU-SRP-1LLLT); and treatment with 5-FU, SRP and four LLLT sessions (0, 24, 48 and 72 h) (5FU-SRP-4LLLT). EP was induced in the mandibular molars through ligature placement. The alveolar bone loss (ABL) area in the furcation region was analysed histometrically. TRAP, proliferating cell nuclear antigen, RANKL, osteoprotegerin and activated caspase-3 patterns were analysed by immunolabeling. Prostaglandin E2 was quantified using an ELISA, and tumour necrosis factor α and interleukin-6 were assessed using the multiplex method. The prevalence rates of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella nigrescens, Prevotella intermedia and Fusobacterium nucleatum were assessed using the PCR method. The data were subjected to statistical analysis (α = 5%). RESULTS: 5FU, 5FU-SRP and 5FU-SRP-1LLLT treatment groups showed higher ABL compared with the NT group (p < 0.05), whereas the 5FU-SRP-4LLLT group showed lower ABL compared with the 5FU group on day 7 and decreased RANKL immunolabeling (p < 0.05). CONCLUSION: Treatment with 5-FU worsened EP, and multiple LLLT sessions adjuvant to SRP seemed to improve periodontitis in rats subjected to 5-FU chemotherapy.
Assuntos
Tratamento Farmacológico/métodos , Fluoruracila/farmacologia , Fluoruracila/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Periodontite/terapia , Perda do Osso Alveolar/patologia , Perda do Osso Alveolar/terapia , Animais , Bactérias/isolamento & purificação , Caspase 3/análise , Terapia Combinada , Raspagem Dentária/métodos , Dinoprostona/análise , Inflamação/patologia , Interleucina-6/análise , Masculino , Mandíbula , Dente Molar , Osteoprotegerina/análise , Periodontite/microbiologia , Periodontite/patologia , Ligante RANK/análise , Ratos , Ratos Wistar , Aplainamento Radicular/métodos , Fator de Necrose Tumoral alfa/análiseRESUMO
BACKGROUND AND OBJECTIVE: This study assessed the effects of the local use of Saccharomyces cerevisiae as monotherapy and as an adjuvant to the mechanical treatment of ligature-induced periodontitis in rats. MATERIAL AND METHODS: Periodontitis was induced in 72 rats via the installation of a ligature around the mandibular first molar. After 7 d, the ligature was removed and the rats were placed in one of the following groups: no treatment (C; n = 18); scaling and root planing (SRP; n = 18); local irrigation with probiotics (PRO; n = 18); and SRP followed by local irrigation with probiotics (SRP/PRO; n = 18). Six rats from each group were killed at 7, 15 and 30 d. The histological characteristics, alveolar bone loss (ABL) and immunolabeling of tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1ß), interleukin-10 (IL-10) and TRAP on the furcation area of the first molar were assessed. RESULTS: The PRO group showed features of acceleration of the tissue-repair process during the entire experiment. On day 15, there was less ABL in the SRP/PRO group compared with the C group. There were fewer TRAP-positive cells in the SRP and SRP/PRO groups at 30 d. There was less immunostaining for TNF-α in the PRO and SRP/PRO groups and less immunostaining for IL-1ß in the PRO group. However, there was more immunostaining for IL-10 in the PRO group on day 15. CONCLUSION: Local use of the probiotic did not result in any adverse effects on periodontal tissues. When used as monotherapy or as an adjuvant, the probiotic was effective at controlling periodontitis in rats.
Assuntos
Periodontite , Perda do Osso Alveolar , Animais , Raspagem Dentária , Ligadura , Probióticos , Ratos , Ratos Wistar , Saccharomyces cerevisiaeRESUMO
BACKGROUND AND OBJECTIVE: Antimicrobial therapy can suppress periodontal pathogens and increase the effectiveness of conventional mechanical treatment. The aim of this study was to assess bone loss and the immune inflammatory response of rats under the influence of two photosensitizing agents (MB and TBO) at two different concentrations in antimicrobial photodynamic therapy (aPDT), used as an adjuvant therapy in the treatment of periodontitis. MATERIAL AND METHODS: Periodontitis was induced in the mandibular first molars of 162 rats. The animals were divided into nine groups: G1 - scaling and root planing (SRP); G2 - SRP plus 100 µg/mL of methylene blue (MB); G3 - SRP plus 10 mg/mL of MB; G4 - SRP plus 100 µg/mL of toluidine blue (TBO); G5 - SRP plus 10 mg/mL of TBO; G6 - SRP plus 100 µg/mL of MB and laser; G7 - SRP plus 10 mg/mL of MB and laser; G8 - SRP plus 100 µg/mL of TBO and laser; and G9 - SRP plus 10 mg/mL of TBO and laser. Six animals from each group were euthanized 7, 15, or 30 d after treatment. Bone loss (BL) in the furcation region was evaluated using histomorphometric and immunohistochemical analyses to detect the receptor activator of nuclear factor-Κappa B ligand (RANKL), osteoprotegerin (OPG) and tartrate-resistant acid phosphatase (TRAP). RESULTS: There was significantly less BL in animals treated with aPDT using low concentrations of MB and TBO at 7, 15 and 30 d. Immunohistochemical analysis revealed decreased RANKL and increased OPG in the aPDT groups and decreased TRAP-positive cells in G6 and G8. CONCLUSIONS: aPDT, using low concentrations of MB and TBO, was the most effective adjuvant therapy to SRP, acting indirectly as a downregulator of the molecular mechanisms that control bone resorption in periodontitis.
Assuntos
Perda do Osso Alveolar/tratamento farmacológico , Periodontite/tratamento farmacológico , Fenotiazinas/administração & dosagem , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/administração & dosagem , Fosfatase Ácida/análise , Perda do Osso Alveolar/imunologia , Animais , Terapia Combinada , Tecido Conjuntivo/patologia , Raspagem Dentária/métodos , Isoenzimas/análise , Terapia com Luz de Baixa Intensidade/instrumentação , Linfócitos/patologia , Masculino , Azul de Metileno/administração & dosagem , Neutrófilos/patologia , Osteoclastos/patologia , Osteoprotegerina/análise , Periodontite/imunologia , Ligante RANK/análise , Ratos , Ratos Wistar , Aplainamento Radicular/métodos , Fosfatase Ácida Resistente a Tartarato , Fatores de Tempo , Cloreto de Tolônio/administração & dosagemRESUMO
OBJECTIVE: The objective of this study was to evaluate the effect of Er:YAG laser on the formation of CaF(2), after the application of acidulated phosphate fluoride (APF), and its influence on the anti-cariogenic action in human dental enamel. BACKGROUND DATA: Er:YAG laser was designed to promote ablation of the enamel. However, the possibility of using this energy to increase the enamel's resistance to caries has hardly been explored, and neither has its interaction with the use of fluorides. MATERIALS AND METHODS: One hundred and twenty blocks of enamel were allocated to four groups of 30 blocks each: (1) C, control group; (2) Er:YAG, laser; (3) APF; and (4) Er:YAG+APF. Of these, 80 blocks were submitted to pH cycling for 14 days. In the other 40 blocks, fluoride (CaF(2)) was measured before cycling. After pH cycling, surface microhardness (SMH), microhardness in cross-section (converted to mineral contents % vol. min.), and fluoride after cycling (40 blocks) were also determined. RESULTS: SMH decreased in all groups. The control group showed the highest decrease, and Er:YAG+APF showed the lowest decrease (p < 0.05). Groups APF and Er:YAG showed the same results (p > 0.05). Mineral content at depths 10, 20, and 40 microm was lower in the control and Er:YAG groups, and higher in groups APF and Er:YAG+APF. CaF(2) (microgF/cm(2)) deposited before pH cycling was higher in the APF group when compared to the Er:YAG+APF group. Control and Er:YAG groups showed the lowest values (p > 0.05). CONCLUSION: It was concluded that Er:YAG laser influenced the deposition of CaF(2) on the enamel and showed a superficial anti-cariogenic action, but not in depth.