Publications by authors named "Gláucia Santos Zimmermann"

10 Publications

  • Page 1 of 1

Biomarkers in biological fluids in adults with periodontitis and/or obesity: A meta-analysis.

J Indian Soc Periodontol 2020 May-Jun;24(3):191-215. Epub 2020 May 4.

Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina, Florianópolis, Brazil.

Obesity and periodontal diseases have been investigated to be interconnected, but the molecular mechanism underlying this association is still not clear. The aim of this systematic review is to assess the association of serum, salivary and gingival crevicular fluid (GCF) inflammatory markers (IMs), obesity, and periodontitis. Studies that evaluated IM of adults according to obesity status (O) and periodontitis status (P) (O+P+; O-P+; O+P-) were screened on several electronic databases and grey literature up until February 2019. Risk of bias assessment and level of evidence were evaluated through Fowkes and Fulton scale and Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analyses were grouped according to the biological matrix studied (serum/GCF) and groups (O+P+ vs. O-P+/O+P+ vs. O+P-). Out of the 832 studies screened, 21 were considered in qualitative synthesis and 15 in quantitative synthesis (meta-analysis). Although included studies showed mostly "no" or "minor" problems during the quality assessment, GRADE assessment indicated very low to moderate level of evidence based on the question answered. O+P+ adults exhibited significantly higher serum levels of C-reactive protein (CRP), interleukin 6 (IL-6), leptin, and tumor necrosis factor-α (TNF-alpha) and higher resistin GCF levels than O-P+. O+P+ adults showed significantly higher serum levels of IL-6 and leptin and lower adiponectin serum levels than O+P-. Only qualitative information could be obtained of the IM vaspin, omentin-1, chemerin, IL-10, progranulin, MCP-4, IL-1β, and interferon-γ (IFN-γ). Obesity and periodontitis, together or separately, are associated with altered serum and GCF levels of CRP, IL-6, leptin, TNF-alpha, adiponectin, and resistin. It was not possible to evaluate the association between obesity and periodontitis at salivary levels. The role of recently investigated biomarkers as vaspin, omentin-1, chemerin, IL-10, progranulin, MCP-4, IL-1β, and IFN-γ, which can be key points underlying the association between obesity and periodontitis, remains to be further investigated.
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http://dx.doi.org/10.4103/jisp.jisp_512_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307467PMC
May 2020

Precision of cone beam CT to assess periodontal bone defects: a systematic review and meta-analysis.

Dentomaxillofac Radiol 2018 Feb 27;47(2):20170084. Epub 2017 Oct 27.

2 Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil.

Objectives: Evaluate the diagnostic validity of CBCT in measuring periodontal bone defects when compared with the reference standard (in situ measurement).

Methods: Studies in which the main objective was to evaluate the diagnostic validity of CBCT in measuring periodontal bone defects when compared with the reference standard were selected. Four databases were searched. The studies were selected by two independent reviewers. The methodology of selected studies was assessed using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. The quality of evidence and strength of recommendation was assessed by The Grading of Recommendations Assessment Tool, Development and Evaluation.

Results: Using a selection process in two phases, 16 studies were identified and, in seven articles meta-analysis was performed. The results from these meta-analyses showed that no difference between the measurements of CBCT and in situ for alveolar bone loss, and demonstrated a concordance of 82.82% between CBCT and in situ for the classification of the degree of furcation involvement.

Conclusions: Based on a moderate level of evidence, CBCT could be useful for furcation involvement periodontal cases, but it should only be used in cases where clinical evaluation and conventional radiographic imaging do not provide the information necessary for an adequate diagnosis and proper periodontal treatment planning.
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http://dx.doi.org/10.1259/dmfr.20170084DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965906PMC
February 2018

Lipid parameters in obese and normal weight patients with or without chronic periodontitis.

Clin Oral Investig 2018 Jan 9;22(1):161-167. Epub 2017 Mar 9.

Department of Periodontology, Guarulhos University, São Paulo, Brazil.

Objective: The aim of this study was to evaluate the serum levels of lipids in patients with normal weight (NW) or obesity with or without chronic periodontitis (ChP).

Materials And Methods: One hundred and sixty non-smoking patients without history of diabetes and/or cardiovascular events were allocated into one of the following groups: NW patients with periodontal health (NWH; n = 40), NW patients with ChP (NWChP; n = 40), obese patients with periodontal health (ObH; n = 40), and obese patients with ChP (ObChP; n = 40). Serum levels of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TRG) were estimated.

Results: After adjustments for gender and age, both NW groups presented lower levels of TRG than both obese groups (p < 0.05). The NWH group presented lower levels of LDL than both periodontitis groups (p < 0.05) and the lowest TC/HDL ratio when compared to the other groups (p < 0.05). Females from the NWH group exhibited higher levels of HDL and lower LDL/HDL ratio than females from the ObChP group (p < 0.05). Furthermore, individuals from the ObChP group were more likely to have levels of LDL ≥130 mg/dl and HDL ≤40 mg/dl, compared to those from the NWH group (p < 0.05).

Conclusions: ChP and obesity, jointly or individually, are associated with undesirable pro-atherogenic lipid profiles.

Clinical Relevance: There is interest in identifying clinical conditions associated with dyslipidemia to improve preventive and treatment strategies. This study demonstrated that ChP, obesity, and the association of both conditions might be related to pro-atherogenic lipid profiles.
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http://dx.doi.org/10.1007/s00784-017-2095-1DOI Listing
January 2018

Does obesity influence the subgingival microbiota composition in periodontal health and disease?

J Clin Periodontol 2016 12 26;43(12):1003-1012. Epub 2016 Oct 26.

Department of Periodontology, Guarulhos University, São Paulo, Brazil.

Aim: To evaluate whether obesity affects the subgingival microbial composition of patients with periodontal health or chronic periodontitis (CP).

Materials And Methods: Based on periodontal parameters, body mass index and waist-hip ratio, 166 patients were allocated into one of the following groups: Normal weight (NW) patients with periodontal health (n = 44), NW patients with CP (n = 40), obese patients with periodontal health (n = 40) and obese patients with CP (n = 42). Six subgingival biofilm samples per patient were analysed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization.

Results: Obese patients with CP harboured higher levels and/or higher proportions of several periodontal pathogens than those with NW and CP, including Aggregatibacter actinomycetemcomitans, Eubacterium nodatum, Fusobacterium nucleatum ss vincentii, Parvimonas micra, Prevotella intermedia, Tannerella forsythia, Prevotella melaninogenica and Treponema socranskii. The proportions of most of these pathogens, as well Campylobacter rectus and Eikenella corrodens, were more increased in the diseased sites of the obese patients than in those with NW. Furthermore, the healthy sites of the obese patients, presenting or not CP, also exhibited higher proportions of some of the pathogens than patients with NW.

Conclusions: Obesity is associated with increased levels and proportions of periodontal pathogens, especially in patients with CP.
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http://dx.doi.org/10.1111/jcpe.12634DOI Listing
December 2016

Local and serum levels of adipokines in patients with obesity after periodontal therapy: one-year follow-up.

J Clin Periodontol 2015 May 30;42(5):431-9. Epub 2015 Apr 30.

Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.

Aim: This study evaluated the effects of scaling and root planing (SRP) on gingival crevicular fluid (GCF) and serum levels of adipokines in patients with chronic periodontitis (CP) with or without obesity.

Methods: Twenty patients with obesity and 20 patients without obesity, all with CP, received SRP. Serum and GCF levels of resistin, adiponectin, leptin, tumour necrosis factor [TNF]-α and interleukin [IL]-6 were evaluated by enzyme-linked immunosorbent assay at baseline, 3, 6 and 12 months post-therapy.

Results: SRP reduced the amounts of TNF-α in deep sites and increased the concentration of adiponectin in shallow sites of non-obese patients (p < 0.05). SRP increased the concentrations of TNF-α and leptin in patients with obesity (p < 0.05). GCF levels of TNF-α were higher in patients with obesity than in patients without obesity at all time-points (p < 0.05). There were no changes in serum levels of any adipokines for any group after therapy (p > 0.05). Patients with obesity exhibited higher serum levels of leptin at all time-points and IL-6 at 3 months post-therapy (p < 0.05).

Conclusions: Obesity may modulate systemic and periodontal levels of adipokines in favour of pro-inflammation, independently of periodontal therapy. SRP did not affect the circulating levels of adipokines in patients with or without obesity.
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http://dx.doi.org/10.1111/jcpe.12396DOI Listing
May 2015

Microbial reduction by two chemical-mechanical protocols in primary teeth with pulp necrosis and periradicular lesion - an in vivo study.

Braz Dent J 2014 ;25(4):307-13

Department of Morphological Sciences, UFSC - Federal University of Santa Catarina, Florianópolis, SC, Brazil.

The objective of this study was to determine the efficacy of chemical-mechanical procedures of two endodontic protocols for septic content reduction of root canals from primary teeth with pulp necrosis and periradicular lesion. Twenty-four primary root canals with pulp necrosis and periradicular lesion were divided into two treatment groups (n=12): multiple-visit and single-visit protocols. Samples were collected using sterile paper points before and after endodontic cleaning followed by microbiological identification through checkerboard DNA-DNA hybridization. Statistical analysis was performed using Proportion Test for score=0 comparing the findings before and after treatment for each group (Wilcoxon's test) as well as the differences in scores between protocols (Mann-Whitney's test) (p<0.05). Data were expressed as prevalence (presence or absence) and estimate of the average count (x10(5) cells) of each species. Differences in proportions of score=0 prior to treatment were non-significant (p=0.415), demonstrating equivalence between groups. A significant increase in score=0 was detected after treatment for both groups (p<0.0001). Single-visit protocol achieved a significantly greater reduction in mean scoring following endodontic treatment (p=0.024). Both protocols were capable of significantly reducing septic content in root canals of primary teeth with periradicular lesion. Moreover, single-visit protocol showed greater efficacy in reducing endodontic infection.
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http://dx.doi.org/10.1590/0103-6440201302416DOI Listing
August 2016

Effects of scaling and root planing on clinical response and serum levels of adipocytokines in patients with obesity and chronic periodontitis.

J Periodontol 2015 Jan;86(1):53-61

Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, São Paulo, Brazil.

Background: Despite several investigations suggesting that obesity is a risk indicator for periodontitis, little is known about the effect of obesity on periodontal treatment response. The aim of this study is to evaluate the effects of scaling and root planing (SRP) on clinical parameters and circulating levels of leptin and adiponectin in patients with obesity with chronic periodontitis (CP).

Methods: Twenty-four patients with obesity and CP and 24 patients without obesity with CP were submitted to SRP. Clinical parameters were assessed at baseline and 3 and 6 months after therapy. Serum levels of leptin and adiponectin were evaluated at all time points, using enzyme-linked immunosorbent assay.

Results: SRP improved the clinical parameters of both groups at 3 and 6 months (P < 0.05). Nonetheless, the patients without obesity presented a lower mean probing depth (PD) at 6 months after therapy and a greater reduction in PD from baseline to 6 months in the full-mouth analysis (primary outcome variable) and in initially deep sites (P < 0.05). Leptin serum levels were higher in patients with obesity than in patients without obesity at all time points (P < 0.05). No changes in the serum levels of leptin and adiponectin were observed in groups with and without obesity after therapy (P > 0.05).

Conclusions: Patients with obesity and CP presented lower reductions in PD than patients without obesity with CP at 6 months after SRP. Furthermore, the treatment did not affect the circulating levels of leptin and adiponectin in any group.
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http://dx.doi.org/10.1902/jop.2014.140266DOI Listing
January 2015

Microbial profile of root canals of primary teeth with pulp necrosis and periradicular lesion.

J Dent Child (Chic) 2014 Jan-Apr;81(1):14-9

Department of Morphological Sciences, at the School of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.

Purpose: The purpose of this study was to assess the microbial content of root canals of human primary teeth with pulp necrosis and periradicular lesion.

Methods: Microbial samples were collected from 24 canals of children treated at a pediatric dentistry clinic. Microbiological identification was performed using checker-board DNA-DNA hybridization for 40 different bacteria. Data were analyzed per canal based on the mean count and frequency of each bacterial species.

Results: Detectable levels of bacterial species were observed for 35 probes (88%). The most frequent bacteria were Fusobacterium nucleatum sp. nucleatum, Fusobacterium periodonticum, Prevotella melaninogenica, Prevotella nigrescens, and Prevotella intermedia. Facultative species were identified in 20 root canals (83%), anaerobic species were identified in 24 root canals (100%), and aerobic species in 18 root canals (75%). Black-pigmented bacilli were found in 23 samples (96%). The number of different bacterial species detected per canal ranged from five to 33.

Conclusion: Endodontic infection in primary teeth with pulp necrosis and periradicular lesion is multimicrobial, including aerobic, facultative, and anaerobic micro-organisms.
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December 2014

Local and circulating levels of adipocytokines in obese and normal weight individuals with chronic periodontitis.

J Periodontol 2013 May 27;84(5):624-33. Epub 2012 Jul 27.

Department of Periodontology, Guarulhos University, São Paulo, Brazil.

Background: The aim of this study is to evaluate the local and circulating levels of adipocytokines (resistin, adiponectin, leptin, tumor necrosis factor [TNF]-α, and interleukin [IL]-6) in individuals who are obese and individuals who are normal weight (NW) with chronic periodontitis (CP).

Methods: Periodontal and anthropometric examinations were performed. Based on these measurements, the individuals were divided into one of the following groups: NW non-periodontitis (NP) (NWNP; n = 20); NWCP (n = 20); obese NP (ONP; n = 18); and obese CP (OCP; n = 20). The levels of adipocytokines were evaluated in the serum and gingival crevicular fluid of shallow and deep sites by enzyme-linked immunosorbent assay.

Results: In serum, resistin levels were higher whereas adiponectin levels were lower in periodontitis than in NP groups (P <0.05). The NWNP group presented the lowest serum leptin levels (P <0.05). The ONP and OCP groups demonstrated higher TNF-α levels in periodontal sites than the NWNP and NWCP groups (P <0.05). Serum levels of IL-6 (P = 0.04) and leptin (P = 0.01) were correlated with the OCP group, with odds ratios of 0.99 (95% confidence interval [CI]: -0.01 to -0.00) and 0.99 (95% CI: -0.00 to -0.00), respectively.

Conclusions: Periodontitis mainly influenced the circulating levels of resistin and adiponectin, whereas both obesity and periodontitis affected the circulating levels of leptin in favor of proinflammation. In addition, obesity upregulated the local levels of TNF-α.
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http://dx.doi.org/10.1902/jop.2012.120254DOI Listing
May 2013

Relationship between glycemic subsets and generalized chronic periodontitis in type 2 diabetic Brazilian subjects.

Arch Oral Biol 2012 Mar 3;57(3):293-9. Epub 2011 Sep 3.

Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil.

Objective: The aim of the present study was to evaluate the relationship between glycemic subsets and clinical periodontal conditions in type 2 diabetic Brazilians with generalized chronic periodontitis.

Design: Ninety-one Brazilians with type 2 DM and generalized chronic periodontitis were involved in this study. The clinical examination included full-mouth assessment of plaque index (PI), bleeding on probing (BoP), probing depth (PD), suppuration (SUP), clinical attachment level (CAL) and number of remaining teeth. Blood analyses were carried out for glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG). The relationship between the extent of periodontitis, defined as the percentage of sites with PD and CAL≥5 mm, and glycemic parameters were also analysed. In addition, clinical parameters were compared amongst four (HbA1c levels ≤7.5%, 7.6-9%, 9.1-11% and >11%) and two (<9% and ≥9%) glycemic subsets.

Results: The frequency of uncontrolled diabetic subjects (HbA1c>7.5%) was higher than well-controlled subjects (HbA1c≤7.5%). Amongst the clinical parameters evaluated, only PI was positively correlated with the levels of HbA1c and FPG (p<0.05). The number of remaining teeth was negatively associated with the levels of HbA1c (p<0.05). In addition, PI was significantly higher in subjects presenting HbA1c levels >11% and ≥9% than those with HbA1c levels ≤7.5% and <9%, respectively (p<0.05).

Conclusion: Although an increased frequency of the subjects with generalized chronic periodontitis included presented type 2 uncontrolled DM, a dose-response relationship between the severity and extension of periodontitis and the glycemic control was not established in these subjects.
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http://dx.doi.org/10.1016/j.archoralbio.2011.08.003DOI Listing
March 2012
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