Publications by authors named "Maísa Casarin"

17 Publications

  • Page 1 of 1

Prevalence of tooth loss and associated factors in institutionalized adolescents: a cross-sectional study.

Cien Saude Colet 2021 Jul 11;26(7):2635-2642. Epub 2021 Apr 11.

Departamento de Periodontologia, Faculdade de Odontologia, Universidade Federal Pelotas (UFPel). R. Gonçalves Chaves 457, Centro. 96015-560 Pelotas RS Brasil.

This study aimed to assess the prevalence of tooth loss and associated factors in institutionalized adolescents. This cross-sectional study included 68 male adolescents incarcerated from Socio-Educational Assistance Center (CASE) aged between 15 and 19 years. Questionnaires were applied individually to assess sociodemographical, economical, medical, behavioral and oral health self-perception variables. All present teeth were evaluated by Decay, Missing, Filling (DMF) Index. The prevalence of tooth loss was analyzed in individuals with ≥1 tooth loss. Associations between tooth loss and exposure variables studied were analyzed by Poisson Regression with robust variance estimation. The prevalence of tooth loss was 47.06%. First molars in the mandible and maxilla and central incisor in the maxilla were the most absent teeth. In the multivariate model, number of decayed teeth, and those that reported daily use of medication were associated with higher tooth loss. Besides, tooth loss was associated with decayed tooth and daily use of medication. Oral health promotion and treatment should be implemented in these institutions to reduce the prevalence of dental loss in these adolescents.
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http://dx.doi.org/10.1590/1413-81232021267.07162021DOI Listing
July 2021

Endodontic treatment during the COVID-19 pandemic - perception and behaviour of dental professionals.

Acta Odontol Latinoam 2021 Apr;34(1):63-70

Universidade Federal de Pelotas, Faculdade de Odontologia, Programa de Pós Graduação em Odontologia, Pelotas, Brasil.

This study evaluated the impact of COVID-19 on the endodontic treatment routine. It was a cross-sectional study using an online questionnaire applied to endodontists to collect information about practical modifications during endodontic treatment to protect professionals and patients against the COVID-19 outbreak. A total 1105 participants from Brazil participated in the survey. More than 90% of respondents identify the high risk of COVID-19 infection to dentists and the need to change some clinical practices. Most respondents (60.1%) are partially following social isolation. The need for a change in Personal Protective Equipment (PPE) during dental appointments was mentioned by 97.1% of respondents. The use of minimal adequate PPE during the pandemic period was associated with the area of residence and marital status of participants. Only 30% of respondents say they use the minimal adequate PPE. Most respondents will change cavity access preparation to reduce virus dissemination. Other changes in endodontic appointments were described in the survey: greater attention to biosafety measures, duration of dental appointments, and duration of intervals between appointments. Endodontists still need to identify the best arrangement for performing their procedures safely during the COVID-19 pandemic. Specific guidelines require detailed information for each specialty and its procedures.
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April 2021

Are periodontal diseases associated with sleep duration or sleep quality? A systematic review.

Arch Oral Biol 2021 Jun 6;129:105184. Epub 2021 Jun 6.

Department of Periodontology, School of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, Pelotas, RS, 96015-560, Brazil. Electronic address:

Objectives: This study aimed to systematically review the associations between periodontal diseases/tooth loss and sleep duration/quality.

Material And Methods: PubMed, Scopus, and Embase databases were searched (up to May 2021) to identify studies that assessed the association between periodontal diseases or number of teeth with sleep quality and sleep duration. Two researchers independently selected the studies and extracted the data. Considering the high heterogeneity among the included studies, meta-analysis was deemed unviable. Results are presented descriptively for sleep quality (studies that have used PSQI), self-reported sleep hours, and other tools that assessed sleep patterns.

Results: Twenty studies (16 cross-sectional, two case-control, and two cohort) were included. Eight studies used the Pittsburgh Sleep Quality Index (PSQI) to assess quality of sleep. Six of these studies demonstrated that individuals with worse periodontal conditions demonstrated poorer sleep quality. However, most of the included studies that performed adjusted analysis showed no statistically significant association between self-reported hours of sleep and periodontitis. The mean number of present teeth was assessed in four studies; three of them demonstrated lower numbers of present teeth in individuals with inadequate sleep.

Conclusion: The literature shows conflicting results for the association between sleep hours and periodontitis. However, inadequate sleep may be associated with lower number of present teeth and periodontal diseases. Further studies are necessary in order to confirm these results.
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http://dx.doi.org/10.1016/j.archoralbio.2021.105184DOI Listing
June 2021

Alcohol use disorders are associated with higher prevalence of periodontitis in a rural area of Brazil.

J Periodontal Res 2021 May 31. Epub 2021 May 31.

Department of Stomatology, Postgraduate Program in Dentistry, Universidade Federal de Santa Maria (UFSM, Santa Maria, Rio Grande do Sul, Brazil.

Objective: The aim of the present cross-sectional study was to determine whether alcohol use disorders (AUD) are independently associated with severe and extent cases of periodontitis in individuals living in a rural area of Brazil.

Methods: A representative probability sample (N = 585) was evaluated using six-site full-mouth periodontal examination. AUD was assessed using the alcohol use disorders identification test (AUDIT) and considered in its unidimensional and bidimensional factor structures. The first address hazardous alcohol consumption [HAC (overall scores ≥8)], and the second deals with two distinct constructs, harmful use [HU (items 1-3 scores ≥4 for men or ≥3 for women)], and alcohol-related consequences [ARC (items 4-10 scores ≥1)]. Periodontal outcomes were defined based on the criteria proposed by the CDC-AAP (2012) and an adaptation of the EFP-AAP (2018) definition of generalized stages III or IV periodontitis (GP). Adjusted multilevel multinomial and binary logistic regression analysis were used with a conceptual hierarchical approach to calculate the odds ratios (OR) of periodontal outcomes.

Results: In the adjusted model, HU (OR = 2.69; 95% CI: 1.29-5.58) and ARC (OR = 3.79; 95% CI: 1.51-9.51) were significantly associated with higher prevalence of severe periodontitis (SP). Higher occurrence of GP was detected in individuals presenting HAC (OR = 1.88; 95% CI: 1.05-3.37) and ARC (OR = 2.90; 95% CI: 1.61-5.24).

Conclusion: AUD was independently associated with higher prevalence of SP and GP in individuals living in a rural area.
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http://dx.doi.org/10.1111/jre.12890DOI Listing
May 2021

Association between clinical measures of gingival inflammation and obesity in adults: systematic review and meta-analyses.

Clin Oral Investig 2021 Jul 27;25(7):4281-4298. Epub 2021 Apr 27.

Department of Periodontology, Faculty of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, Pelotas, RS, 96015-560, Brazil.

Objective: This study aimed to systematically review the literature about the association between clinical measures of gingival inflammation and obesity in adults.

Material And Methods: Searches for studies were performed in five databases (Medline-PubMed, Scopus, Web of Science, Cochrane Library, and Embase) to compile studies of any design that evaluated the association between clinical measures of gingival inflammation and obesity in adults. Selection of studies, data extraction and risk of bias analysis were performed independently by two reviewers, and a third researcher was involved to resolve disagreements. Meta-analyses were performed for measures of gingival inflammation as compared to body mass index (BMI). Independent analyses were performed for studies involving periodontitis, gingivitis, and population-based/studies that did not provide a periodontal diagnosis. Standard mean deviation (SMD) and its 95% confidence interval (95%CI) were estimated.

Results: Ninety studies were included (cross-sectional/clinical trials [n=82], case-control [n=3], cohorts [n=5]). Most of the studies demonstrated no significant difference in the measures of gingival inflammation regardless of the comparison performed. However, meta-analysis showed that among individuals with periodontitis, significantly higher levels of gingival inflammation are observed in those with obesity (n of individuals=240) when compared to those who were not obese (n of individuals=574) (SMD:0.26; 95%CI:0.07-0.44). When considering population-based/those studies that did not provide periodontal diagnosis, significantly higher measures of gingival inflammation were observed in the groups with higher BMI.

Conclusions: Within the limitations of the present study, it was concluded that higher measures of gingival inflammation may be expected for those with higher BMI.

Clinical Relevance: Clinicians must be aware that higher measures of gingival inflammation may be expected for individuals with higher BMI. However, there is a necessity for further longitudinal studies regarding the association between obesity and gingival inflammation.
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http://dx.doi.org/10.1007/s00784-021-03961-1DOI Listing
July 2021

Local delivery therapies as adjuvants to non-surgical periodontal treatment of periodontitis grade C: a systematic review.

Clin Oral Investig 2020 Dec 17;24(12):4213-4224. Epub 2020 Oct 17.

Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.

Objectives: The aim of this article was to perform a systematic review on the effectiveness of local adjuvant therapies in the treatment of aggressive periodontitis (AgP), now reported as periodontitis grade C.

Materials And Methods: The authors selected randomized clinical trials of AgP patients who received local therapy as adjuvants to non-surgical periodontal with a duration of at least 90 days. Seven databases were searched up to January 2020. The gain in clinical attachment level (CAL) and reduction of probing depth (PD) were the outcomes of interest.

Results: Of the 3583 studies found, only five articles were included in the qualitative analysis. Among the substances analyzed, only 1.2 mg of simvastatin gel (SMV) (1.2 mg/0.1 ml), 1% of alendronate gel (ALN) (10 mg/ml), and 25% metronidazole gel (MTZ) (Elyzol) showed a significant decrease in the probing depth when compared with their respective control groups. The gain CAL was shown using 1.2 mg SMV gel (1.2 mg/0.1 ml) and 1% ALN gel (10 mg/ml).

Conclusion: Although 1.2 mg SMV gel (1.2 mg/0.1 ml), 1% ALN gel (10 mg/ml), and 25% MTZ gel (Elyzol) have shown better results, local therapies adjuvant to SRP the data found were limited. Future clinical studies with appreciable methodological quality should be conducted.

Clinical Relevance: Despite some benefits of local delivery therapy, up to now, it has not been possible to prove the efficacy of local therapy as an adjunct to standard treatment of AgP (periodontitis grade C).
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http://dx.doi.org/10.1007/s00784-020-03631-8DOI Listing
December 2020

Self-reported depressive symptoms in dental students: Systematic review with meta-analysis.

J Dent Educ 2021 Feb 15;85(2):135-147. Epub 2020 Sep 15.

Department of Periodontology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.

Objective: This study aimed to systematically review the literature about the prevalence of self-reported depressive symptoms in dental students.

Methods: PUBMED, SCOPUS, and EMBASE databases were search up to January 2020 with the following focused questions: "What is the prevalence of self-reported depression symptom in dental students?" and "Are sex and years of educational training associated with self-reported depressive symptom in dental students?". Observational studies that applied a questionnaire assessing depression were eligible. Standard mean differences (SMD) and pooled odds ratios (OR) were calculated for the questionnaires' scores and self-reported depressive symptom, respectively.

Results: Fifty-eight studies were included, and 15 different questionnaires were used. The prevalence of self-reported depressive symptoms/at least mild depression ranged from 2.75% to 89.84%, and the pooled overall prevalence was 29% (95% confidence interval [CI]: 26-34). Meta-analysis showed significantly lower scores in the questionnaires for self-reported depressive symptoms of male students (SMD: -0.22; 95% CI: -0.42 - -0.03). Conversely, no significant difference was detected for the OR of self-reported depressive symptom in the comparison between sex (OR: 1.11 - 95% CI: 0.77-1.62). Similarly, no significant difference was observed for the different school years regardless of the analytical strategy used.

Conclusion: It was concluded that female dental students presented more self-reported depressive symptoms, but no difference is demonstrated during the years of dental education.
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http://dx.doi.org/10.1002/jdd.12408DOI Listing
February 2021

Anti-biofilm and anti-inflammatory effect of a herbal nanoparticle mouthwash: a randomized crossover trial.

Braz Oral Res 2019 20;33:e062. Epub 2019 Dec 20.

Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil.

Laboratory evidence has demonstrated the antimicrobial effect of Melaleuca alternifolia (MEL) against oral microorganisms. This randomized, double-blind, crossover clinical trial, compared the anti-biofilm and anti-inflammatory effects of MEL nanoparticles with 0.12% chlorhexidine gluconate (CHX) on biofilm-free (BF) and biofilm-covered (BC) surfaces. Before each experimental period, the participants refrained from all oral hygiene practices for 72 hours. The 60 participants were randomly assigned to professional prophylaxis in two quadrants (Q1-Q3 or Q2-Q4), and rinsed with MEL or CHX for four days. The Quigley & Hein plaque index (QHPI), gingival crevicular fluid (GCF) volume, and participants' perceptions were assessed. CHX showed significantly lower mean QHPI on BF (2.65 ± 0.34 vs. 3.34 ± 0.33, p < 0.05) and BC surfaces (2.84 ± 0.37 vs. 3.37 ± 0.33, p < 0.05). Intragroup comparisons indicated reductions in GCF in all the groups, with significant differences only for CHX on BF surfaces (p < 0.05). Intergroup comparisons revealed no significant differences (p > 0.05). Based on individual perceptions, CHX had better taste and biofilm control, but resulted in a greater change in taste. Nevertheless, MEL demonstrated anti-inflammatory effects similar to those of CHX. Further clinical trials testing different protocols, concentrations and follow-up periods are required to establish its clinical application.
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http://dx.doi.org/10.1590/1807-3107bor-2019.vol33.0062DOI Listing
January 2020

Effect of herbal mouthrinses on dental plaque formation and gingival inflammation: A systematic review.

Oral Dis 2021 Mar 26;27(2):127-141. Epub 2019 Dec 26.

Department of Stomatology, Periodontics, School of Dentistry, Universidade Federal de Santa Maria - UFSM, Santa Maria, Brazil.

To evaluate the effect of herbal mouthrinses as an adjuvant to oral hygiene on dental plaque and gingival inflammation in subjects with gingivitis. Searches were conducted in the PubMed/MEDLINE, Cochrane-CENTRAL, EMBASE, Web of Science, LILACS/BIREME, Clinical Trials Registry and grey literature for Randomised Clinical Trials (RCTs) published up to April 2018 without language restrictions. From 4,013 paper found, 20 studies met the eligibility criteria and were included. The herbal mouthrinses achieved significant reductions in dental plaque and gingival inflammation compared to placebo rinses. Five herbal products (Camelia sinensis, Azadirachta indica, Anacardium occidentale Linn, Schinus terebinthifolius and Curcuma longa) showed better results than chlorhexidine in dental plaque and gingival inflammation reductions. However, the unclear risk of bias of most included RCTs precludes definitive conclusions. Therefore, it is necessary to improve the design of future RCT in other reduced potential bias that may affect the degree of precision of treatment outcomes in order to evaluate the effect size and clinical relevance of herbal mouthrinses.
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http://dx.doi.org/10.1111/odi.13254DOI Listing
March 2021

Rieger Syndrome: Rehabilitation With Dental Implants.

Clin Adv Periodontics 2019 12 8;9(4):172-176. Epub 2019 Aug 8.

UCLA School of Dentistry, Los Angeles, CA, USA.

Introduction: Axenfeld-Rieger syndrome (ARS), also known as Rieger syndrome, is a rare autosomal dominant condition defined by craniofacial, ocular, dental, periumbilical, and systemic anomalies.

Case Presentation: This case report describes in detail a multidisciplinary approach to successfully restore the oral function and esthetics of a 22-year-old patient diagnosed with ARS. The patient's clinical evaluation revealed that the area corresponding with teeth #13, #12, #11, #21, #22, and #23 was occupied by four malformed and/or deciduous teeth. The four anterior teeth were extracted, and socket preservation was performed using bovine-derived porous bone mineral. Six months after extractions, two implants were placed in the location of the lateral incisors and additional bone graft was performed. Two months after the initial healing, a temporary fixed partial was delivered and 9 months after implant placement the implants were restored with a porcelain-fused-to-metal fixed partial denture.

Conclusions: The use of implant-supported fixed partial dentures to restore missing teeth in patients with ARS provides biological and mechanical advantages over conventional, fixed, or removable prosthodontics. Further evaluation is needed to determine the longevity and long-term prognosis of dental implants in patients with ARS.
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http://dx.doi.org/10.1002/cap.10065DOI Listing
December 2019

Sampling strategy of an epidemiological survey using a satellite image program.

Rev Saude Publica 2019 May;53:47

Universidade Federal de Santa Maria . Curso de Odontologia. Departamento de Estomatologia . Santa Maria , RS , Brasil.

Objective: To describe the sampling strategy of an epidemiological survey with the aid of satellite images, including details of the multistage probability sampling process.

Methods: A probability sample of individuals living in the rural area of Rosário do Sul, state of Rio Grande do Sul, Brazil, aged 15 years old or more, was evaluated. Participants answered questionnaires (medical history, sociodemographic characteristics, habits, alcohol use, quality of life, stress, rumination, and self-perceived periodontal diseases), and were subjected to clinical oral examinations as well as anthropometric measurements (blood pressure, height, weight, abdominal and waist circumferences). Oral evaluation comprehended a complete periodontal exam at six sites per tooth, including the following assessments: furcation involvement; dental abrasion; tooth decay, including the indexing of missing and filled surfaces; O'Brien index; gingival abrasion; oral cavity and lip lesions; complete periapical radiographic exam, and use of prostheses. Besides this oral clinical approach, subgingival plaque, crevicular gingival fluid, saliva, and blood samples were collected. Examiners were trained and calibrated during previous evaluations. A pilot study allowed the logistic of the performed exams to be adjusted as needed.

Results: Among 1,087 eligible individuals, 688 were examined (63.3%). Age, sex, and skin color data were compared to data from the last demographic census (2010) of the Brazilian Institute of Geography and Statistics, which served to validate the sampling strategy.

Conclusions: The careful methods used in this study, in which satellite images were used in the delimitation of epidemiological areas, ensure the quality of the estimates obtained and allow for these estimates to be used in oral health surveillance and health policies improvements.
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http://dx.doi.org/10.11606/S1518-8787.2019053000834DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6536105PMC
May 2019

Female undergraduate dental students may present higher depressive symptoms: A systematic review.

Oral Dis 2019 04 27;25(3):726-729. Epub 2019 Jan 27.

Department of Periodontology, Federal University of Pelotas, Pelotas, Brazil.

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http://dx.doi.org/10.1111/odi.13029DOI Listing
April 2019

Histological and inflammatory analysis to diagnostic method of proximal gingivitis by flossing.

Clin Oral Investig 2019 Aug 6;23(8):3193-3202. Epub 2018 Nov 6.

Department of Pathology, Oral Pathology, School of Dentistry, Federal University of Santa Maria - UFSM, Santa Maria, Rio Grande do Sul, Brazil.

Objectives: The aim of this study was to assess with histological and inflammatory analysis the use of flossing as a diagnostic method for detecting proximal gingivitis.

Material And Methods: This is a diagnostic accuracy paper composed of two different studies. In the first study, three groups were identified based on papilla status: bleeding (+) with both methods (N = 26); bleeding (+) with dental floss, but no bleeding (-) with probing (N = 26); and no bleeding (-) with either method (N = 26). One papilla from all 78 participants was biopsied and analyzed for the determination of inflammatory infiltrate and percentage of collagen fibers. Sensibility, specificity, positive and negative predictive, and accuracy values were analyzed. In the second study, the volume of gingival crevicular fluid (GCF) was analyzed in 49 participants with flossing+/probing- and flossing-/probing- at contralateral proximal sites. The GCF volume was compared between these sites (n = 172).

Results: Significantly greater frequencies of moderate/intense inflammation were found in the flossing+/probing+ (100%) and flossing+/probing- (92.3%) groups compared to those in the flossing-/probing- (0%) group. Significantly different percentages of collagen fibers were found among the three groups (flossing+/probing+ (40.90 ± 3.68); flossing+/probing- (45.78 ± 4.55); flossing-/probing- (60.01 ± 36.66)) (P < 0.001). Dental floss increased the balance between sensitivity and specificity values and showed highest positive predictive (100%) and accuracy (97%) values. Among the 172 sites evaluated, positive bleeding sites had a significantly greater volume of GCF (38 (27-68)) than negative sites (25 (16-51)) (P < 0.001).

Conclusions: The findings suggest that flossing can be used as a diagnostic method for proximal gingivitis in subjects with no history of periodontitis.

Clinical Relevance: Dental floss can be used as a complementary diagnostic method for proximal gingivitis in adults without clinical attachment loss in clinical practice as well as epidemiology studies.
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http://dx.doi.org/10.1007/s00784-018-2742-1DOI Listing
August 2019

Early intervention of peri-implantitis and periodontitis using a mouse model.

J Periodontol 2018 06;89(6):669-679

University of California, Los Angeles, Section of Periodontics, Los Angeles, California.

Background: Peri-implantitis is an inflammatory response to bacterial biofilm resulting in bone loss and can ultimately lead to implant failure. Because of the lack of predictable treatments available, a thorough understanding of peri-implantitis's pathogenesis is essential. The objective of this study is to evaluate and compare the response of acute induced peri-implantitis and periodontitis lesions after insult removal.

Methods: Implants were placed in one-month-old C57BL/6J male mice eight weeks post extraction of their left maxillary molars. Once osseointegrated, ligatures were placed around the implants and contralateral second molars of the experimental groups. Controls did not receive ligatures. After one week, half of the ligatures were removed, creating the ligature-retained and ligature-removed groups. Mice were sacrificed at two time points, 5 and 14 days, from ligature removal. The specimens were analyzed via micro-computed tomography and histology.

Results: By 5 and 14 days after ligature removal, the periodontitis group experienced significant bone gain, whereas the peri-implantitis group did not. Histologically, all implant groups exhibited higher levels of cellular infiltrate than any of the tooth groups. Osteoclast numbers increased in peri-implantitis and periodontitis ligature-retained groups and decreased following insult removal. Collagen was overall more disorganized in peri-implantitis than periodontitis for all groups. Peri-implantitis experimental groups revealed greater matrix metalloproteinase-8 and NF-kB levels than periodontitis.

Conclusions: Implants respond slower and less favorably to insult removal than teeth. Future research is needed to characterize detailed peri-implantitis disease pathophysiology.
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http://dx.doi.org/10.1002/JPER.17-0541DOI Listing
June 2018

Melaleuca alternifolia and its application against dental plaque and periodontal diseases: A systematic review.

Phytother Res 2018 Feb 12;32(2):230-242. Epub 2017 Dec 12.

Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil.

This is a systematic review of clinical and laboratory studies evaluating the effect of Melaleuca alternifolia on periodontopathogens, dental plaque, gingivitis, periodontitis, and inflammatory responses. The PubMed, Cochrane, Web of science, Bireme, Lilacs, Prospero, Open Grey, and Clinical Trials databases were searched to identify potentially eligible studies through October 2016. Of 1,654 potentially eligible studies, 25 were included in the systematic review. Their methodology was evaluated through the Cochrane Handbook for clinical studies and the GRADE system for in vivo/in vitro studies. Although clinical studies must be interpreted with caution due to methodological limitations, laboratory studies have found promising results. In vitro evidences showed that M. alternifolia has bactericidal and bacteriostatic effects against the most prevalent periodontopathogens. Clinical studies found comparable effects to chlorhexidine 0.12% in reducing gingival inflammation, although the antiplaque effect was lower. M. alternifolia also showed antioxidant properties, which are beneficial to the host, allied to the reduction on immune-inflammatory responses to pathogens. This systematic review suggests that the M. alternifolia has potential anti-inflammatory and antimicrobial properties, which can be easily applied to the periodontal tissues. However, further clinical trials are needed to elucidate the clinical relevance of its application.
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http://dx.doi.org/10.1002/ptr.5974DOI Listing
February 2018

Association between crack cocaine use and reduced salivary flow.

Braz Oral Res 2017 Jun 5;31:e42. Epub 2017 Jun 5.

Universidade Luterana do Brasil, Postgraduate program in Dentistry, Canoas, RS, Brazil.

Crack cocaine use appears to have an impact on oral conditions. However, changes in the salivary flow among crack users have not been fully clarified. The aim of this study was to compare stimulated salivary flow and the occurrence of hyposalivation between crack users and non-users. A cross-sectional study was conducted involving 40 crack users and 40 controls matched for sex, age, and smoking habits. Interviews were conducted to acquire data on the perception of dry mouth (xerostomia) and drug use. Stimulated salivary flow was determined using the spitting method. A significant reduction in stimulated salivary flow was found among crack users in comparison to non-users (1.02 vs. 1.59 ml/min). A total of 42.5% and 15% of crack users had very low and low stimulated salivary flow, respectively. Moreover, 65% of users reported xerostomia in comparison to 37.5% non-users (p < 0.012). No significant association was found between xerostomia and hyposalivation (p = 0.384). A multivariate analysis revealed that individuals older than 26 years of age, those with a low household income, and crack users (prevalence ratio: 2.59) had a significant association with the occurrence of hyposalivation. A significant association was found between the use of crack and reduced salivary flow. The use of crack was associated with the occurrence of hyposalivation in the multivariate analysis.
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http://dx.doi.org/10.1590/1807-3107BOR-2017.vol31.0042DOI Listing
June 2017

Partial-mouth periodontal examination protocols for the determination of the prevalence and extent of gingival bleeding in adolescents.

Community Dent Oral Epidemiol 2017 10 6;45(5):427-433. Epub 2017 Jun 6.

Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.

Objective: To compare the performance of partial-mouth periodontal examination (PMPE) protocols with different cut-off points to the full-mouth examination (FME) in the assessment of the prevalence and extent of gingival bleeding in adolescents.

Methods: A cross-sectional study was conducted involving 12-year-old adolescents. Following a systematic two-stage cluster sampling process, 1134 individuals were evaluated. Different PMPE protocols were compared to the FME with six sites per tooth. Sensitivity, specificity, area under the ROC curve (AUC), intraclass correlation coefficient (ICC), relative and absolute biases and the inflation factor were assessed for each PMPE protocol with different cut-off points for the severity of gingival bleeding.

Results: The highest AUC values were found for the six-site two-diagonal quadrant (2-4) (0.97), six-site random half-mouth (0.95) and Community Periodontal Index (0.95) protocols. The assessment of three sites [mesiobuccal (MB), buccal (B) and distolingual (DL)] in two diagonal quadrants and the random half-mouth protocol had higher sensitivity and lower specificity than the same protocols with distobuccal (DB) sites. However, the use of DB sites led to better specificity and improved the balance between sensitivity and specificity, except for the two-diagonal quadrant (1-3) protocol. The ≥1 cut-off point led to the most discrepant results from the FME.

Conclusion: Six-site two-diagonal quadrant (2-4) and random half-mouth assessments perform better in the evaluation of gingival bleeding in adolescents. However, when a faster protocol is needed, a two-diagonal quadrant assessment using only MB, B and DL sites can be used with no important loss of information.
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http://dx.doi.org/10.1111/cdoe.12306DOI Listing
October 2017