Abstract The prevalence of periodontitis in Latin American and Caribbean countries (LACC) drew attention to a significant public health issue exacerbated by socio-economic disparities. This consensus report, based on the European Federation of Periodontology (EFP) S3 level clinical practice guidelines, proposed a multifaceted approach to periodontal health-care. The report highlighted the critical need for holistic, population-wide health policies and underscored the lack of documented community interventions in contemporary literature. The consensus advocated for a patient-centered approach to periodontal care, with non-surgical and surgical interventions, and a long-term commitment to supportive periodontal care (SPC). It emphasized the importance of patient engagement in biofilm control by means of home-care and professional interventions for long-term periodontal health. The report also stressed that subgingival instrumentation benefits even severely compromised teeth, by significantly reducing probing depths and gingival inflammation. Moreover, it emphasized the importance of personalized, long-term SPC for maintaining oral health post-treatment, and pointed out the need to identify factors influencing patient adherence. The aim of this report was to provide actionable guidance for clinicians and policymakers, focused on improving periodontal health outcomes and quality of life in LACC. LACC (LACC socioeconomic socio economic disparities EFP (EFP S guidelines healthcare. healthcare care. health-care holistic populationwide population wide literature patientcentered centered nonsurgical non longterm long term SPC. . (SPC) homecare home teeth inflammation Moreover personalized posttreatment, posttreatment post treatment, treatment post-treatment adherence policymakers (SPC

Resumo Os achados clinico-patológicos que caracterizam de forma precisa o líquen plano oral (LPO) e as lesões liquenoides orais (LLO) ainda representam um desafio. O objetivo do presente estudo foi analisar, pela perspectiva do patologista oral, os achados clínicos do LPO e das LLO. Espécimes preenchendo os critérios histológicos para o diagnóstico de LPO e LLO, e também aqueles compatíveis com LPO (LPO-C), foram selecionados e as informações clínicas foram obtidas a partir das requisições laboratoriais. A amostra final foi composta de 221 casos, incluindo 119 LPO (53.8%), 65 LPO-C (29.4%) e 37 LLO (16.7%). As mulheres foram mais acometidas nos três grupos, mas o número de homens acometidos foi maior nas LLO. A média de idade foi menor no LPO (52.3 anos) em comparação com as LLO (57.9 anos) (p=0.020). O envolvimento da mucosa jugal e da língua foi mais frequente no LPO; o envolvimento gingival foi incomum nas LLO. O padrão reticular foi mais frequentemente encontrado no LPO, enquanto a associação dos padrões reticular e atrófico/erosivo/ulcerado foi mais comum no LPO-C e nas LLO (p=0.025). Em conclusão, o gênero e a média de idade dos pacientes, assim como a localização anatômica e a manifestação clínica das LLO são diferentes do LPO, e podem ajudar a melhor caracterizar este grupo de condições. Espécimes diagnosticados como LPO-C mostraram parâmetros clínicos mais próximos ao LPO.

Abstract The clinicopathological features that precisely characterize oral lichen planus (OLP) and oral lichenoid lesions (OLL) still represent a challenge. The aim of the present study was to analyze, from an oral pathologist perspective, the clinical features from OLP and OLL. Specimens fullfilling the histological criteria for OLP and OLL, and also compatible with OLP (OLP-C), were selected and clinical information was retrieved from the laboratory forms. The final sample was composed by 221 cases, including 119 OLP (53.8%), 65 OLP-C (29.4%) and 37 OLL (16.7%). Females were more affected in the three groups, but the number of males was higher in OLL. Mean age was lower in OLP (52.3 years) in comparison with OLL (57.9 years) (p=0.020). Buccal mucosa and tongue involvement was more frequent in OLP; gingival involvement was uncommon in OLL. The reticular pattern was more frequently found in OLP, while the association of reticular and atrophic/erosive/ulcerated patterns was more common in OLP-C and OLL (p=0.025). In conclusion, gender and mean age of the patients, and anatomical location and clinical manifestation of OLL are different from OLP, and could help to better characterize this group of conditions. Specimens diagnosed as OLP-C showed clinical parameters close to OLP.

Resumo A Organização Mundial da Saúde declarou a disseminação generalizada do SARS-CoV-2 e sua doença associada (COVID-19) uma emergência de saúde pública. O teste padrão ouro para detecção do vírus é o RT-PCR, realizado a partir de amostras de swab nasofaríngeo (NPS). No entanto, esse exame pode ser desconfortável para o paciente e requer treinamento específico e vestimenta do profissional de saúde responsável pela coleta da amostra. Portanto, a busca por formas alternativas de coleta de amostras que possam ser utilizadas no diagnóstico de COVID-19 é relevante. O objetivo deste estudo foi comparar os resultados obtidos em amostras de NPS e saliva. Amostras de NPS e saliva foram coletadas de 189 pacientes ambulatoriais sintomáticos com suspeita de COVID-19, que procuraram a Policlínica Piquet Carneiro. A extração de RNA foi realizada com o kit Bio-Gene DNA / RNA Viral Extraction (Bioclin®) e as reações em tempo real da reação em cadeia da polimerase-transcriptase reversa (RT-PCR) usaram o kit Molecular SARS-CoV-2 (E / RP) (Bio-Manguinhos). Os resultados indicaram que 142 apresentaram resultado não detectável (ND), enquanto 47 apresentaram resultado detectável (D). Entre os 142 "ND", 137 (94,4%) amostras de saliva obtiveram o mesmo resultado, enquanto 5 amostras (3,4%) foram "D". Dentre as 47 amostras de swab "D", 35 (74,4%) apresentaram o mesmo resultado nas amostras de saliva. A sensibilidade do teste de saliva foi de 0,74 e a especificidade foi de 0,97. O valor preditivo positivo foi de 0,88, enquanto o valor preditivo negativo foi de 0,92. Os resultados mostraram que a detecção de Sars-CoV-2 em amostras de saliva apresentou alta sensibilidade e especificidade quando comparada com swabs nasofaríngeos.

Abstract The World Health Organization has declared the widespread spread of SARS-CoV-2 and its associated disease (COVID-19) a public health emergency. The standard gold test for detecting the virus is the RT-PCR, performed from nasopharyngeal swab (NPS) samples. However, this test may be uncomfortable for the patient and requires specific training and attire from the health professional responsible for collecting the sample. Therefore, the search for alternative ways to collect samples that may be used in the diagnosis of COVID-19 is relevant. This study aimed to compare the results obtained from NPS and saliva samples. NPS and saliva samples were collected from 189 symptomatic outpatients suspected of COVID-19, who came to Piquet Carneiro Polyclinic. RNA extraction was performed using the Bio-Gene DNA/RNA Viral Extraction kit (Bioclin®). Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) reactions used the Molecular SARS-CoV-2 (E / RP) kit (Bio-Manguinhos). The results indicated that 142 showed a non-detectable result (ND), while 47 showed a detectable result (D). Among the 142 "ND", 137 (94.4%) saliva samples obtained the same result, while 5 samples (3.4%) were "D". Among the 47 "D" swab samples, 35 (74.4%) showed the same result in the saliva samples. The sensitivity of the saliva test was 0.74 and the specificity was 0.97. The positive predictive value was 0.88 while the negative predictive value was 0.92. The results showed that detection of Sars-CoV-2 using saliva samples showed high sensitivity and specificity compared to nasopharyngeal swabs.

Abstract In the last five decades, considerable progress has been made towards understanding the etiology and pathogenesis of periodontal diseases and their interactions with the host. The impact of an individual periodontal condition on systemic homeostasis became more evident because of this knowledge and prompted advances in studies that associate periodontitis with systemic diseases and conditions. The term Periodontal Medicine describes how periodontal infection/inflammation can affect extraoral health. This review presents the current scientific evidence on the most investigated associations between periodontitis and systemic diseases and conditions, such as cardiovascular diseases, diabetes, preterm birth and low birth weight, and pneumonia. Additionally, other associations between periodontitis and chronic inflammatory bowel disease, colorectal cancer, and Alzheimer’s disease that were recently published and are still poorly studied were described. Thus, the aim of this review was to answer the following question: What is the future of Periodontal Medicine? Epidemiological evidence and the evidence of biological plausibility between periodontitis and general health reinforce the rationale that the study of Periodontal Medicine should continue to advance, along with improvements in the epidemiological method, highlighting the statistical power of the studies, the method for data analysis, the case definition of periodontitis, and the type of periodontal therapy to be applied in intervention studies.

ABSTRACT: The novel Coronavirus (CoVid-19) outbreak is now consider a world pandemic, affecting more than 1,300,000 people worldwide. Cancer patients are in risk for severe disease, including a higher risk of intensive care unit (ICU) admission, need for invasive ventilation or death. Management of patients with lymphoid malignancies can be challenging during the outbreak, due to need of multiple hospital visits and admissions, immunosuppression and need for chemotherapy, radiotherapy and stem cell transplantation. In this article, we will focus on the practical management of patients with lymphoid malignancies during the COVID-19 pandemic, focusing on minimizing the risk for patients.

Abstract: Periodontal diseases are considered a worldwide public health problem, owing to their high prevalence in developed and developing countries. Periodontitis may lead to tooth loss, which can impact oral health-related quality of life. Gingivitis and periodontitis have been extensively studied regarding their etiopathogenesis, epidemiology, prevention and treatment outcomes. However, most of these aspects are studied and discussed globally, which may hamper a clear interpretation of the findings and the design of effective plans of action for specific regions or populations. For example, in Latin America, epidemiological data about the distribution of periodontal diseases is still scarce, mainly when it comes to nationwide representative samples. This Consensus aimed to address the following topics related to periodontal diseases in Latin America: a) The impact of the global burden of periodontal diseases on health: a global reality; b) Periodontal diseases in Latin America; c) Strategies for the prevention of periodontal diseases in Latin America; d) Problems associated with diagnosis of periodontal conditions and possible solutions for Latin America; e) Treatment of Periodontitis. This consensus will help to increase awareness about diagnosis, prevention and treatment of periodontal diseases, in the context of Latin American countries.

Abstract: Gingivitis and periodontitis are associated with a negative impact on Oral Health Related Quality of Life (OHRQoL), exerting a significant influence on aspects related to the patients' function and esthetics. Periodontitis has been associated with several systemic conditions, including adverse pregnancy outcomes, cardiovascular diseases, type 2 diabetes mellitus (DM), respiratory disorders, fatal pneumonia in hemodialysis patients, chronic renal disease and metabolic syndrome. The aim of this paper was to review the results of different periodontal treatments and their impacts on patients' OHRQoL and systemic health. Non-surgical and surgical periodontal treatments are predictable procedures in terms of controlling infection, reducing probing pocket depth and gaining clinical attachment. In addition, the treatment of periodontitis may significantly improve OHRQoL and promote a reduction in the levels of systemic markers of inflammation, including some cytokines associated with cardiovascular diseases. Studies have also suggested that periodontal treatment may improve glycemic control in patients with DM. Strategies and actions for preventing the onset and recurrence of periodontitis, and the challenges facing the field of periodontology in the XXI century are presented in this review.

Resumo Periodontite crônica (CP) e Diabetes mellitus tipo 2 (DMII) são doenças crônicas normalmente tratadas por práticas convencionais. Por outro lado, a homeopatia pode colaborar no tratamento de diferentes doenças. O objetivo do presente estudo foi avaliar os efeito da homeopatia como adjunto a terapia periodontal não cirúrgica (NSPT) em indivíduos com CP e DMII. Oitenta indivíduos com CP e DMII de ambos os sexos com idade entre 32 e 70 anos, participaram desse estudo clínico randomizado, placebo controlado, duplo cego. Os pacientes foram divididos em 2 grupos: grupo controle (CG) e grupo teste (TG), e ambos receberam NSPT. TG também recebeu terapia homeopática, incluindo Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, enquanto o CG recebeu placebo. Exames clínicos e laboratoriais foram avaliados no baseline e 1, 6 e 12 meses após o tratamento. Ambos grupos mostraram melhoras significantes através do estudo para a maioria dos parâmetros avaliados. TG apresentou um ganho significativo nos níveis clínicos de inserção aos 1 e 12 meses, quando comparado ao grupo controle. Valores médios de glicemia e hemoglobina glicada reduziram significativamente em ambos grupos aos 6 e 12 meses. Entretanto, houve uma redução adicional desses parâmetros no TG, quando comparado ao CG. Concluindo, homeopatia como suplemento a NSPT pode promover as condições de saúde, incluindo o controle glicêmico, em pacientes com DMII e CP.

Abstract Chronic periodontitis (CP) and Diabetes mellitus type 2 (DMII) are chronic diseases usually treated by conventional practices. On the other hand, homeopathy can help to treat many different diseases. The aim of this study was to evaluate the effects of homeopathy (H) as an adjunct for non-surgical periodontal therapy (NSPT) in individuals with DMII and CP. Eighty individuals with CP and DM II, of both sexes and aged between 32 and 70 years, participated in this randomized, double-blind, placebo-controlled study. They were divided into two groups: control group (CG) and the test group (TG), and both groups received the NSPT. TG also received homeopathic therapy, including Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, while CG received placebo. Clinical and laboratorial examinations were evaluated at baseline and after 1, 6 and 12 months of treatment. Both groups showed significant improvement throughout the study, for most of the parameters studied, but TG presented significative gain of CAL at 1 and 12 months compared to CG. Mean glucose and glycated hemoglobin significantly decreased in both groups after 6 and 12 months. However, there was a significantly further reduction of these parameters in TG, as compared to CG. In conclusion, homeopathy as supplement of NSPT may further improve health condition, including glycemic control, in DMII patients with CP.

Resumo As micropartículas derivadas de células (MPs) têm sido descritas como contribuintes vitais para o processo inflamatório. No entanto, seu papel na patogênese da doença periodontal permanece obscuro. Por isso, nosso objetivo foi detectar a presença de micropartículas derivadas de neutrófilos (CD66b +) e plaquetas (CD41b +) no fluido gengival de indivíduos com periodontite e diabetes tipo 2. Doze pacientes (56,2 ± 7,2 anos) com periodontite crônica severa e diabetes tipo 2 foram incluídos no estudo. Foram coletados dados clínicos e metabólicos. O fluido gengival foi coletado usando tiras de filtro de papel em sítios rasos e profundos. As MPs foram detectadas por citometria de fluxo de acordo com o seu tamanho (<1 μm) e pela expressão de marcadores de superfície (CD66b para MPs derivadas de neutrófilos e CD41b para MPs derivadas de plaquetas). Todas as amostras foram positivas para os anticorpos. Os níveis médios de CD66b + MPs e CD41b + MPs foram, respectivamente, 3.677.0 (2,553.2 - 9,059.8) MP/μL e 520.7 (432.9 - 766.1) MP/μL nos sítios profundos. Nos sítios rasos, os valores correspondentes foram 2,644.9 (1,451.5 - 3,858.9) MP/μL e 371.2 (287.2 - 692.7) MP/μL. Não houve diferença significativa entre os sítios rasos e profundos (p>0.05). Concluindo, o presente estudo reportou a presença de micropartículas derivadas de neutrófilos e plaquetas no fluido gengival de pacientes com periodontite e com diabetes tipo 2 .

Abstract Cell-derived microparticles (MPs) have been described as vital contributors to the inflammatory process. However, its role in the periodontal disease pathogenesis remains unclear. Therefore, we aimed to detect the presence neutrophil (CD66b+) and platelet (CD41b+) derived microparticles in gingival crevicular fluid from individuals having periodontitis aggravated by type 2 diabetes. Twelve patients (56.2 ±7.2 yrs) with severe form of chronic periodontitis aggravated by type 2 diabetes were included. Clinical and metabolic data were gathered. Gingival crevicular fluid was collected using filter strips from deep and shallow sites. MPs were detected by flow cytometry according to their size (< 1 µm) and the expression of surface markers (CD66b for neutrophil-derived MPs and CD41b for platelet-derived MPs). All samples were positive for the antibodies. Median levels of CD66b+ MPs and CD41b+ MPs were, respectively, 3,677.0 (2,553.2 - 9,059.8) MP/µL and 520.7 (432.9 - 766.1) MP/µL in deep sites. In shallow sites, the corresponding values were 2,644.9 (1,451.5 - 3,858.9) MP/µL and 371.2 (287.2 - 692.7) MP/µL. There was no significant difference between deep and shallow sites (p>0.05). In conclusion, this study reported the presence of neutrophil and platelet derived microparticles in gingival crevicular fluid from individuals having severe periodontitis and type 2 diabetes.

Resumo Esse estudo objetivou avaliar a possível associação entre periodontite e complicações sistêmicas em uma população brasileira com diabetes tipo 1. Foi realizado um estudo transversal, multicêntrico em 28 clínicas públicas em 20 cidades brasileiras. Dados de 3.591 pacientes foram obtidos (56% mulheres, 57,2% caucasianos), com idade média de 21,2±11,7 anos, em que a duração média da diabetes tipo 1 foi 9,6±8,1 anos. Periodontite foi avaliada através de auto-relato. Odds ratio (OR) e intervalos de confiança 95% foram calculados para avaliar a associação entre periodontite e complicações sistêmicas da diabetes (complicações crônicas micro e macrovasculares e hospitalizações por hiperglicemia e cetoacidose diabética). A prevalência de periodontite foi 4,7% (n=170). Pacientes com periodontite apresentaram idade média de 27,4±12,9 anos. Esse grupo foi mais velho (p<0,001), exibiu duração mais longa de diabetes e tinha colesterol total (p<0,05) e triglicerídeos (p<0,001) elevados e menor HDL (p<0,05) que pacientes sem periodontite. Pressões sanguíneas sistólica e diastólica foram significativamente aumentadas em pacientes com periodontite (p<0,01). Pacientes com periodontite apresentaram OR aumentada para complicações microvasculares (2,43 [1,74-3,40]) e para hospitalizações relacionadas à hiperglicemia (2,76 [1,72-4,42]) e cetoacidose (2,72 [1,53-4,80]). Concluindo, periodontite foi associada a complicações sistêmicas em pacientes brasileiros com diabetes tipo 1.

Abstract This study aimed to evaluate the possible association between periodontitis and systemic complications in a Brazilian type 1 diabetes population. A multicentre, sectional study was carried out in 28 public clinics located in 20 Brazilian cities. Data from 3,591 patients were obtained (56.0% females, 57.2% Caucasians), with an average age of 21.2 ± 11.7 years and whose mean duration of type 1 diabetes was 9.6 ± 8.1 years. Periodontitis was evaluated through self-report. Odds ratios (OR) and 95% confidence intervals were calculated to evaluate the association between periodontitis and systemic diabetes complications (chronic micro and macrovascular complications and hospitalizations by hyperglycemia and diabetic ketoacidosis). The prevalence of periodontitis was 4.7% (n=170). Periodontitis patients had mean age of 27.4 ± 12.9. This group was older (p<0.001), exhibited longer diabetes duration (p<0.0001) and had elevated total cholesterol (p<0.05), triglycerides (p<0.001) and lower HDL (p<0.05) values than patients without periodontitis. Systolic and diastolic blood pressures were significantly increased in periodontitis patients (p<0.01). Periodontitis patients had increased odds of microvascular complications (2.43 [1.74-3.40]) and of hospitalizations related to hyperglycemia (2.76 [1.72-4.42]) and ketoacidosis (2.72 [1.53-4.80]). In conclusion, periodontitis was associated to systemic complications in Brazilian type 1 diabetes patients.

Resumo O objetivo deste estudo caso controle foi determinar a associação entre extensão e severidade da periodontite crônica e câncer da cavidade oral e/ou orofaringe. O grupo caso consistiu de 35 pacientes (idade média 56,1±8,4), diagnosticados para câncer oral e/ou de orofaringe. O grupo controle foi composto por 40 pacientes (idade média 55,4±9,4) sem diagnóstico de câncer. Todos os pacientes foram submetidos a exame periodontal, incluindo sangramento à sondagem, índice de placa, índice gengival, profundidade de sondagem e nível de inserção clínica, além do índice de dentes cariados, perdidos e obturados (CPOD). O grupo caso tinha significativamente mais sítios com placa. Índice gengival e sangramento à sondagem mostraram valores similares em ambos os grupos. A mediana dos valores de profundidade de bolsa à sondagem e nível de inserção clínica foram significativamente maiores para o grupo caso. A prevalência de periodontite crônica generalizada foi de 80% em pacientes com câncer oral e/ou de orofaringe. Oitenta e nove por cento dos pacientes no grupo de caso apresentaram periodontite crônica severa. Não houve diferença significante entre os grupos para os valores medianos de CPOD. A extensão e severidade da periodontite crônica permaneceram como indicadores de risco para câncer oral e/ou de orofaringe mesmo após o ajuste para fatores de confundimento tradicional, isto é, fumo e consumo de álcool.

Abstract The aim of this case control study was to assess the association between the extent and severity of chronic periodontitis and oral cavity and/or oropharyngeal cancer. The case group comprised 35 patients (mean age 56.1±8.4), diagnosed for oral and/or oropharyngeal cancer. The control group comprised 40 individuals (mean age 55.4±9.4) without diagnostic of cancer. All individuals were subjected to a periodontal examination, including bleeding on probing, plaque index, gingival index, probing pocket depth (PPD), clinical attachment loss (CAL), and decayed, extracted and filled teeth index (DMFT). The case group had significantly more sites with plaque. GI and BOP had similar values in both groups. The median PPD and CAL values were significantly higher for the case group. Chronic generalized periodontitis was predominant in 80% of patients with oral and/or oropharyngeal cancer. Eighty nine percent of the patients in the case group presented severe chronic periodontitis. There was no significant difference between groups for median values of DMFT. The extent and severity of chronic periodontitis remained as risk indicators for oral cavity and/or oropharyngeal cancer even after the adjustments for traditional confound factors, i.e. smoking and alcohol consumption.

As adipocinas estão presentes em processos inflamatórios e podem estar diretamente relacionadas à doença periodontal. Além disso, suas atividades podem ser reguladas pelos ácidos graxos. Este estudo teve como objetivo quantificar as concentrações das principais adipocinas, leptina, adiponectina e resistina, e dos ácidos graxos: ácido docosahexaenóico (DHA), ácido docosapentaenóico (DPA), ácido eicosapentaenóico (EPA) e ácido araquidônico (AA), em pacientes com periodontite crônica generalizada. Como objetivo secundário, avaliar as proporções destas substâncias no sangue desses pacientes. O estudo incluiu 15 pacientes sistemicamente saudáveis com periodontite crônica generalizada (grupo teste) e 15 com gengivite (grupo controle). Foram coletados parâmetros médicos e periodontais e amostras de sangue. As concentrações séricas dos ácidos graxos foram analisadas por cromatografia gasosa e as das adipocinas foram analisadas pelo método multiensaio multiplex. Não houve diferença significativa entre os níveis de adipocinas entre os grupos. No entanto, houve uma tendência para menores valores nos níveis da adiponectina nos pacientes com periodontite. Com relação aos ácidos graxos, os valores foram significativamente maiores no grupo teste em comparação com os controles. As razões entre res/DHA, res/AA, adipon/DHA, adipon/AA e adipon/DPA foram significativamente menores no grupo teste. Não houve correlação significativa entre as adipocinas e os parâmetros clínicos e entre os níveis de adipocinas e ácidos graxos. Conclui-se que pacientes com periodontite crônica generalizada apresentaram níveis significativamente maiores de ácidos graxos em relação à gengivite, adiponectina apresentou uma tendência a valores menores no grupo periodontite, mesmo após a correção de Ancova. Os resultados das razões sugerem uma menor proporção de adiponectina e resistina em relação aos ácidos graxos em pacientes com periodontite crônica generalizada.

Adipokines are present in inflammatory processes and may be directly related to periodontal disease. Moreover, their activities may be regulated by fatty acids. The goal of this study was to quantify the concentrations of the main adipokines, leptin, adiponectin and resistin, and the docosahexaenoic (DHA), docosapentaenoic (DPA), eicosapentaenoic (EPA) and arachidonic (AA) fatty acids, in patients with generalized chronic periodontitis. As a secondary objective, the ratios of these substances in the blood of these patients were evaluated. The study included 15 systemically healthy patients with generalized chronic periodontitis (test group) and 15 patients with gingivitis (control group). Medical and periodontal parameters and blood samples were collected. Serum concentrations of fatty acids were analyzed by gas chromatography and adipokines by multiplex bead immunoassay. There was no significant difference in adipokines between groups. However, there was a tendency for lower values of adiponectin in periodontitis patients. Regarding the fatty acids, they were significantly higher in the test group compared with controls. The res/DHA, res/AA, adipon/DHA, adipon/AA and adipon/DPA ratios were significantly lower in the test group. There was no significant correlation between adipokines and clinical parameters and between adipokines and fatty acids levels. It was concluded that generalized chronic periodontitis patients showed significantly higher levels of fatty acids in comparison to gingivitis; adiponectin revealed a trend to lower values in the periodontitis group, even after Ancova correction. The ratios suggest a minor proportion of adiponectin and resistin in relation to the fatty acids in patients with generalized chronic periodontitis.

O objetivo desse estudo foi avaliar os efeitos do tratamento periodontal não cirúrgico na densidade do osso alveolar e na altura óssea alveolar usando radiografias digitais diretas. Dezenove pacientes (média de idade 36±7,3 anos) com pacientes com periodontite crônica generalizada foram examinados no tempo 0 e aos 90 (90AT) e 180 (180AT) dias após o tratamento periodontal não cirúrgico. Dois grupos de sítios foram radiografados, 39 com profundidade de bolsa a sondagem (PBS)≤3 mm e nível de inserção clínica (NIC)≤1 mm (sítios rasos) e 62 com PBS≥5 mm and NIC≥3 mm (sítios profundos). A densidade foi avaliada considerando as regiões ósseas de interesse na crista óssea alveolar (ROI I) e no osso medular (ROI II). A altura óssea compreendia a distância entre a crista óssea alveolar e a junção cemento-esmalte. Os sítios profundos mostraram um significante aumento na densidade óssea na ROI I tendo p<0,007 em 90AT e p<0,005 em 180AT. Uma redução na densidade óssea foi vista na ROI II 180AT (p<0,04) enquanto a altura óssea reduziu somente nos sítios rasos 90 AT. Como conclusão, um aumento na densidade foi observado na crista óssea alveolar de sítios profundos em pacientes com periodontite. No entanto, nenhuma alteração significante na altura óssea alveolar foi observada nesses sítios.

The aim of this study was to evaluate the effects of nonsurgical periodontal treatment on alveolar bone density (ABD) and bone height (BH) using direct digital radiography. Nineteen patients (mean age: 36±7.3 years) with generalized chronic periodontitis were examined at baseline, 90 (90AT) and 180 (180AT) days after nonsurgical periodontal therapy. Radiographs were taken from two sites with specific characteristics: 39 sites with probing pocket depth (PPD)≤3 mm and clinical attachment level (CAL)≤1 mm (shallow sites); and 62 sites with PPD≥5 mm and CAL≥3 mm (deep sites). The ABD was assessed considering the bone regions of interest at the alveolar bone crest (ROI I) and at the medullar bone (ROI II). The BH was assessed considering the distance from the alveolar bone crest to the cementoenamel junction. Mann-Whitney test was used for the overall demographic data, Wilcoxon test was used to compare the baseline, 90AT and 180AT data as well as to compare the groups and subgroups within the same evaluation period. The significance level was set at 5%. The deep sites showed a significant increase of ABD in ROI I at 90AT (p<0.007) and at 180AT (p<0.005). ABD decrease was seen in ROI II at 180AT (p<0.04) while BH reduced only in shallow sites at 90AT. In conclusion, an increase in ABD was observed in deep sites of patients with generalized chronic periodontitis. However, no significant change in alveolar BH was observed in these sites.

OBJETIVOS: Avaliar a densidade óssea alveolar (DOA) na região dos primeiros molares superiores em pacientes com artrite idiopática juvenil (AIJ) e compará-la à de controles sistemicamente saudáveis. Como objetivos secundários, a influência da medicação e a atividade de doença reumática na DOA foram avaliadas, além da correlação entre a DOA e os parâmetros clínicos periodontais e reumatológicos. PACIENTES E MÉTODOS: Foram incluídos neste estudo 16 pacientes com AIJ (seis meninos e 10 meninas com idade média de 16,2 ± 2 anos) e 11 controles (seis meninos e cinco meninas com idade média de 16,4 ± 2,1 anos). A profundidade de sondagem (PS), o índice de placa visível (IPV), o índice de sangramento gengival (ISG) e o nível de inserção clínica (NIC) foram registrados. Radiografias bite-wings foram tiradas, e a DOA foi mensurada pelo sistema de radiografia digital RVG KODAK 6100, na região dos molares superiores. RESULTADOS: DOA, percentual de sítios com PS > 4 mm e ISG foram significativamente menores nos pacientes com AIJ, comparado aos controles (P = 0,001; P = 0,019; P = 0,011, respectivamente). A DOA não foi influenciada pela medicação nem pela atividade da AIJ, e não apresentou correlação com os parâmetros clínicos periodontais e reumatológicos. CONCLUSÃO: A DOA foi menor nos pacientes com AIJ, e parece não ser influenciada por medicação ou por atividade de doença reumática. Além disso, não foram observadas correlações entre a DOA e os indicadores clínicos periodontais e reumatológicos

OBJECTIVES: To evaluate the alveolar bone density (ABD) in the upper first molars of patients with juvenile idiopathic arthritis (JIA) and to compare their ABD with that of healthy controls. Secondary objectives included the evaluation of the influence of medication and rheumatic disease activity on ABD, in addition to the correlation between ABD and periodontal and rheumatologic clinical parameters. PATIENTS AND METHODS: This study assessed 16 patients with JIA (six boys and 10 girls; mean age, 16.2 ± 2 years) and 11 controls (six boys and five girls; mean age, 16.4 ± 2.1 years). Probing depth (PD), visible plaque index, gingival bleeding on probing (GBP), and the clinical insertion level (CIL) were recorded. Bite-wing radiographs were obtained and ABD was measured in the upper molars by use of the Kodak RVG 6100 Digital Radiography System. RESULTS: ABD, the percentage of sites with PD > 4 mm, and GBP were significantly lower in patients with JIA than in controls (P = 0.001; P = 0.019; P = 0.011, respectively). ABD was influenced by neither medication nor JIA activity, and showed no correlation with periodontal and rheumatologic clinical parameters. CONCLUSION: ABD was lower in patients with JIA and seemed to be influenced by neither medication nor rheumatic disease activity. In addition, no correlation was observed between ABD and periodontal and rheumatologic clinical parameters

O objetivo desse estudo foi avaliar o efeito do tratamento periodontal não-cirúrgico sobre os níveis da IL-18 em sítios inflamados de pacientes com doença periodontal. Foram avaliados 14 pacientes com doença periodontal, sendo 9 pacientes com periodontite crônica generalizada (idade média: 48,8 DP ± 7,4 anos) e 5 pacientes com gengivite (idade média: 43,6 DP ± 11,8 anos). Os pacientes foram divididos nos seguintes grupos: sítios sem perda de inserção nos pacientes com periodontite (GP), sítios com perda de inserção nos pacientes com periodontite (PP) e sítios sem perda de inserção nos pacientes com gengivite (GG). Profundidade de bolsa (PB), nível de inserção (NI), índice de placa (IP) e índice gengival (IG) foram avaliados e amostras do fluido gengival foram coletadas. Os pacientes receberam terapia não-cirúrgica e foram reavaliados 30 dias após tratamento (AT). Houve uma redução significante no IP dos GG (1,0 ± 0,4 para 0,5 ± 0,2), GP (1,2 ± 0,3 para 0,5 ± 0,3) e PP (1,3 ± 0,4 para 0,7 ± 0,3) 30 AT. Também houve uma redução significante no IG do GG (1,3 ± 0,3 para 0,7 ± 0,4). A profundidade de bolsa reduziu no GG (2,4 ± 0,6 para 1,9 ± 0,1) e no PP (6,7 ± 1,1 para 5,2 ± 0,9) 30 AT. Quando todas as amostras foram analisadas juntas, houve uma redução significante do IL-18 (12,9 ± 7,2 para 10,0 ± 3,1). Esse estudo mostrou que a terapia periodontal não-cirúrgica é eficaz em reduzir os níveis de IL-18 no fluido gengival de sítios inflamados

The aim of this study was to evaluate the effectiveness of the non-surgical periodontal treatment in reducing the gingival crevicular fluid (GCF) levels of IL-18 from inflamed periodontal sites. Fourteen patients with periodontal disease were included, being 9 patients with chronic periodontitis (mean age: 48.8 SD ± 7.4 years) and 5 patients with gingivitis (mean age: 43.6 SD ± 11.8). The patients were divided in the following groups: gingivitis sites from periodontitis patients (sites GP), periodontitis sites from periodontitis patients (sites PP), and gingivitis sites from gingivitis patients (sites GG). Probing pocket depth (PPD), probing attachment level (AL), plaque index (PI) and gingival index (GI) were recorded, and gingival fluid samples were collected. The subjects received non-surgical treatment and were re-evaluated 30 days after treatment (day 30 AT). There was a significant reduction in PI in GG (1.0 ± 0.4 to 0.5 ± 0.2), GP (1.2 ± 0.3 to 0.5 ± 0.3), and in PP (1.3 ± 0.4 to 0.7 ± 0.3) 30 AT. There was also a significant reduction in the GI in GG (1.3 ± 0.3 to 0.7 ± 0.4). PPD reduced significantly in GG (2.4 ± 0.6 to 1.9 ± 0.1), and PP (6.7 ± 1.1 to 5.2 ± 0.9) 30 AT. When all the samples were analyzed together, there was a significant reduction in IL-18 (12.9 ± 7.2 to 10.0 ± 3.1). This study showed that non-surgical treatment was effective in reducing GCF levels of IL-18 from inflamed periodontal sites.