-
[show abstract]
[hide abstract]
ABSTRACT: Background: Prospective studies that investigated the influence of glycemic control in the progression of periodontitis and tooth loss (TL) during periodontal maintenance therapy (PMT) programs have not been previously reported. The aim of the present study was to evaluate associations between glycemic control status and the progression of periodontitis and tooth loss among cohort PMT individuals. Methods: A total of 92 individuals, all recruited from a prospective cohort with 238 participants under PMT, participated in this study. Diabetes control was assessed by percentage of glycated hemoglobin (HbA1c). Individuals were matched for gender and smoking and were divided into three groups: 23 diabetic individuals with poor glycemic control (PMC), 23 diabetic individuals with good glycemic control (GMC), and 46 non-diabetic controls (NDC). Full-mouth periodontal examination including bleeding on probing (BOP), probing depth (PD), and clinical attachment level were determined at all PMT visits during a 5-year interval. Results: Progression of periodontitis and TL were significantly higher among PMC when compared to GMC and NDC. The final logistic model in final examination included: (1) for the progression of periodontitis - HbA1c ≥6.5% (Odds ratio [OR]=2.9), smoking (OR=3.7), and BOP in more than 30% of the sites (OR=4.1); (2) for tooth loss - HbA1c ≥6.5% (OR=3.1), smoking (OR=4.1), and PD 4-6mm up to 10% of the sites (OR=3.3). Conclusion: PMC individuals presented higher progression of periodontitis and tooth loss when compared to NDC and GMC individuals, especially among smokers. This result highlights the influence of the glycemic control in maintaining a good periodontal status.
Journal of Periodontology 07/2012; · 2.60 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This prospective study aims to evaluate and compare the periodontal status, periodontitis progression, tooth loss, and influence of predictable risk variables of two periodontal maintenance therapy programs over a 12-month period.
A total of 288 individuals diagnosed with chronic moderate-to-advanced periodontitis, who had finished active periodontal treatment, were evaluated in a public academic environment (AG) (n = 138), as well as in a private clinic (PG) (n = 150). A full-mouth periodontal examination was performed at baseline and at quadrimestral recalls, evaluating plaque index, probing depth, clinical attachment level, furcation involvement, bleeding on probing (BOP), and suppuration. Individuals' social, demographic, and biologic data, as well as compliance with recalls, were recorded. The effect of variables of interest and confounders were tested by univariate and multivariate analysis.
The PG demonstrated lower rates of periodontitis progression and tooth loss than did the AG. After adjusting for confounders, the risk variables of BOP (P = 0.047), smoking (P = 0.003), and diabetes (P = 0.028) for the PG and smoking (P = 0.047) for the AG showed a negative influence on periodontal status.
In both groups, the periodontal maintenance therapy minimized the negative effect of the risk variables. However, PG showed significantly less progression of periodontitis and tooth loss compared to AG.
Journal of Periodontology 07/2011; 83(3):301-11. · 2.60 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study is to investigate the association of the periodontal risk assessment (PRA) model with the recurrence of periodontitis and tooth loss during periodontal maintenance therapy (PMT).
In a prospective PMT program, 75 regular complier (RC) and 89 erratic complier (EC) patients were selected. A periodontal examination and PRA were performed after active periodontal therapy and after 3 years of PMT. Risk profiles (low, moderate, or high) of participants were evaluated, and the recurrence of periodontitis and tooth loss were analyzed using univariate and multivariate analyses.
RCs showed less recurrence of periodontitis and tooth loss than ECs (P <0.05). Rates of periodontitis recurrence in RCs and ECs were 2.7% and 3.4%, respectively, for the moderate-risk profile and 6.7% and 11.2%, respectively, for the high-risk profile. During PMT, 49 teeth (0.65 ± 1.4 teeth per participant) were lost in the RC group, and 70 teeth (0.78 ± 2.1 teeth per participant) were lost in the EC group. High-risk profile participants showed more recurrence of periodontitis and lost significantly more teeth than did participants with moderate- or low-risk profiles in RC and EC groups (P <0.05).
The risk profile influenced the recurrence of periodontitis and tooth loss. RCs had less recurrence of periodontitis and less tooth loss. The PRA model can be useful in particularizing the risk of patients and adjusting recall intervals.
Journal of Periodontology 06/2011; 83(3):292-300. · 2.60 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To our knowledge, prospective studies (matched for sex, smoking, and diabetes) that investigated the influence of compliance in the progression of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs were not previously reported.
A total of 58 regular complier (RC) and 58 erratic complier (EC) individuals were recruited from a prospective cohort with 238 patients under PMT and matched by sex, diabetes, and smoking habits. A full-mouth periodontal examination that included bleeding on probing (BOP), probing depths (PDs), clinical attachment levels, and number of teeth were determined at all PMT visits during a 3-year interval. The influence of variables of interest was tested through multivariate logistic regression.
The progression of periodontitis and tooth loss was significantly lower among RC compared to EC patients. A higher progression of periodontitis was observed among EC patients who smoked. The final logistic model for the progression of periodontitis in the RC group included smoking (odds ratio [OR]: 4.2) and >30% of sites with BOP (OR: 2.8), and the final logistic model for the progression of periodontitis in the EC group included smoking (OR: 7.3), >30% of sites with BOP (OR: 3.2), PDs of 4 to 6 mm in 10% of sites (OR: 3.5), diabetes (OR: 1.9), and number of lost teeth (OR: 3.1).
RC patients presented a lower progression of periodontitis and tooth loss compared to EC patients. This result highlighted the influence of the pattern of compliance in maintaining a good periodontal status. Moreover, important risk variables such as smoking and diabetes influenced the periodontal status and should be considered when determining the risk profile and interval time for PMT visits.
Journal of Periodontology 02/2011; 82(9):1279-87. · 2.60 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To our knowledge, the association between personality traits and oral health impacts on daily activities among patients under periodontal maintenance was not previously evaluated. The present study aims to determine the oral health impacts among regular- and erratic-complier patients and their correlations with personality traits by means of the oral impacts on daily performance (OIDP) and the neuroticism extraversion openness five-factor inventory (NEO FFI-R) instruments.
A total of 58 regular and 58 erratic compliers matched by sex, diabetes, and smoking were recruited from a cohort of 238 participants under periodontal maintenance. Periodontal examinations and questionnaire applications were performed in recalls during a 3-year interval. The influence of variables of interest on the OIDP was evaluated through univariate and multivariate linear regression analyses.
The periodontal status of regular compliers was significantly better than that of erratic compliers. Erratic compliers presented higher OIDP scores (36.34 ± 6.64) compared to regular compliers (30.45 ± 7.72). Higher scores of neuroticism and conscientiousness (R(2) = 68%; P <0.001) were associated with higher OIDP scores among regular compliers, whereas among erratic compliers, lower scores of neuroticism, higher openness, and extraversion (R(2) = 77%; P = 0.001) were associated with higher OIDP scores.
Personality traits, mainly neuroticism, showed significant influences on OIDP among patients under periodontal maintenance.
Journal of Periodontology 02/2011; 82(8):1146-54. · 2.60 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to evidence the clinical efficacy of an alcohol-free mouthwash containing 5.0% (W/V) Brazilian green propolis (MGP 5%) for the control of plaque and gingivitis. Twenty five subjects, men and women aging between 18 and 60 years old (35 ± 9), were included in a clinical trials phase II study who had a minimum of 20 sound natural teeth, a mean plaque index of at least 1.5 (PI), and a mean gingival index of at least 1.0 (GI). They were instructed to rinse with 10 mL of mouthwash test for 1 minute, immediately after brushing in the morning and at night. After 45 and 90 days using mouthwash, the results showed a significant reduction in plaque and in gingival index when compared to samples obtained in baseline. These reductions were at 24% and 40%, respectively (P < .5). There were no important side effects in soft and hard tissues of the mouth. In this study, the MGP 5% showed evidence of its efficacy in reducing PI and GI. However, it is necessary to perform a clinical trial, double-blind, randomized to validate such effectiveness.
Evidence-based Complementary and Alternative Medicine 01/2011; 2011:750249. · 4.77 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This prospective study aimed to evaluate the progression of periodontitis and the influence of risk variables among individuals attending a programme of periodontal maintenance treatment in an academic environment.
A total of 150 individuals diagnosed with chronic moderate-advanced periodontitis, and who had finished active periodontal treatment, were incorporated into the periodontal maintenance therapy. Social, demographic and biological variables of interest from subjects were collected at quarterly recalls, over a 12-month period. The effect of variables of interest and confounding on the periodontal status and progression of periodontitis was tested by univariate and multivariate logistic analysis.
A total of 130 subjects (86.7%) showed stable periodontal status, whereas 20 subjects (13.3%) presented periodontitis progression. Twenty-eight subjects (18.66%) presented tooth loss that resulted in a total of 47 lost teeth (1.38%). Diabetes was not found to be associated with periodontitis progression (p=0.67). Smoking was significantly associated with a greater progression of periodontitis (OR=2.7, 95% CI 1.01-7.22).
Periodontal maintenance programmes in academic environment can stabilize the periodontal condition obtained after active periodontal therapy as well as control the action of risk variables for the progression of periodontitis.
Journal Of Clinical Periodontology 11/2008; 36(1):58-67. · 3.00 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Periodontal disease has been considered a systemic exposure implicated in a higher risk of adverse pregnancy outcomes. The aim of the present study was to determine whether maternal periodontitis is associated with an increased risk of preeclampsia.
A case-control study was conducted in a public hospital in Belo Horizonte, Brazil. During the study period, 588 women, aged 14 to 46 years, were deemed eligible and had data available for analysis. Maternal demographic and medical data were collected from medical records. Preeclampsia was defined as blood pressure >140/90 mm Hg and > or =1+ proteinuria after 20 weeks of gestation. A periodontal examination was performed postpartum. Maternal periodontitis was defined as the presence of four or more teeth with one or more sites with a probing depth > or =4 mm and clinical attachment loss > or =3 mm at the same site. The effects of maternal age, chronic hypertension, primiparity, smoking, alcohol use, and number of prenatal visits were analyzed. Adjusted odds ratios (ORs) for preeclampsia were calculated using multivariate logistic regression.
The prevalence of periodontitis was 63.9% and preeclampsia was 18.5%. Variables associated with preeclampsia were chronic hypertension (OR = 4.10; 95% confidence interval [CI] = 2.0 to 8.4; P = 0.001), primiparity (OR = 2.40; 95% CI = 1.5 to 3.9; P = 0.004), maternal age (OR = 1.07; 95% CI = 1.0 to 1.1; P = 0.001), and maternal periodontitis (OR = 1.88; 95% CI = 1.1 to 3.0; P = 0.001).
Maternal periodontitis was determined to be associated with an increased risk of preeclampsia.
Journal of Periodontology 01/2007; 77(12):2063-9. · 2.60 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This prospective study aimed to evaluate the incidence, the underlying reasons, and the influence of predictors of risk for the occurrence of tooth loss (TL) in a program of Periodontal Maintenance Therapy (PMT). The sample was composed of 150 complier individuals diagnosed with chronic moderate-severe periodontitis who had finished active periodontal treatment and were incorporated in a program of PMT. Social, demographic, behavioral and biological variables were collected at quarterly recalls, over a 12-month period. The effect of predictors of risk of and confounding for the dependent variable TL was tested by univariate and multivariate analysis, as well as the underlying reasons and the types of teeth lost. During the monitoring period, there was a considerable improvement in periodontal clinical parameters, with a stability of periodontal status in the majority of individuals. Twenty-eight subjects (18.66%) had TL, totaling 47 lost teeth (1.4%). The underlying reasons for TL were: periodontal disease (n = 34, 72.3%), caries (n = 3, 6.4%), prosthetic reasons (n = 9, 19.2%), and endodontic reasons (n = 1, 2.1%). Additionally, subjects with 10% of sites with probing depth between 4 and 6 mm were 5 times more likely to present TL (OR = 5.13, 95% CI 2.04-12.09). In this study, the incidence of TL was small and limited to few individuals. Additionally, gender and severity of periodontitis were significantly associated with TL during the monitoring period.
Brazilian oral research 24(2):231-7.
