Um modelo de análise sócio-econômica: construção e resultados obtidos

A model of socio-economic analysis is here presented with the purpose of constructing a possible scale of society's structure and determinating the position of a certain population in it. The model was constructed from a group of indicators, previously selected as being the most significative for further evaluation of the socio-economic level of the sample. The objective of the construction of this particular model is to demonstrate the interference of socio-economic variables in the occurrence of certain oral problems. The investigation showed the following composition for the studied population: inferior low, 21.8%; superior low, 39.9%; inferior middle, 26.6%; superior middle, 9.1%; inferior high, 1.7%; superior high, 0.5%.Apresenta-se um modelo de análise sócio-econômica, construído com o objetivo de chegar a um escalonamento possível da posição de uma determinada população na estrutura da sociedade. Tal modelo foi construído a partir de um conjunto de indicadores previamente selecionados como os mais significativos para a avaliação do nível sócio-econômico da população amostrada. Pretendeu-se, com a construção desse modelo, mostrar a interferência de fenômenos de natureza sócio-econômica na ocorrência de determinados problemas bucais. A investigação mostrou a seguinte composição da população estudada: baixa inferior, 21,8%; baixa superior, 39,9%; média inferior, 26,6%; média superior, 9,1%; alta inferior, 1,7% e alta superior, 0,5%

Irrigación subgingival com clorhexidina en terapia periodontal no quirúrgica

El objetivo del siguiente estudio es evaluar los efectos clínicos de la irrigación profesional subgingival con Clorhexidina como terapia adjunta a los procedimientos de raspado y alisado radicular. Este estudio fue desarrollado en 17 pacientes con cuatro bolsas periodontales de 6 mm o más de profundidad, los pacientes fueron divididos en cuatro grupos: solo raspado y alisado radicular; raspaje y alisado radicular más irrigación con solución salina; raspado y alisado radicular más irrigación con 0.12% e irrigación previa con 0.12% seguida de raspado y alisado radicular. Los parámetros clínicos evaluados fueron Índice de Placa, Índice Gingival, Profundidad Clínica al Sondaje, Nivel de Inserción, Sangramiento y Supuración después del sondaje del fondo de la bolsa. El análisis fue realizado al inicio del estudio y 60 días después de los procedimientos clínicos. Los resultados muestran mejora en todos los parámetros de todos los grupos experimentales, estadísticamente fueron similares, con excepción del Sangramiento al Sondaje del fondo de la bolsa que mostró mejores resultados en los grupos irrigados en relación al grupo que fue solo instrumentado mecánicamente. Por tanto, se puede concluir que la irrigación como un adjunto, ya sea con Clorhexidina o solución salina, brinda mejor reparo en los procedimientos de la terapia periodontal no quirúrgica.The present study had as objective to evaluate the clinical effect of professional subgingival irrigation with chlorhexidine as adjunct to scaling and root planning procedures. The study was developed in 17 patients with 5 periodontal pockets 6 or more millimeters depth and similar, which were divided in 4 groups: only subgingival scaling and root planning, scaling and root planning plus subsequent irrigation with saline, scaling and root planning and subsequent irrigation with chlorhexidine 0.12% and irrigation with chlorhexidine 0.12% previous to scaling and root planning. The clinical parameters evaluated were Plaque Index, Gingival Index, Probing Depth, Level of Attachment, Bleeding and Suppuration upon probing of the bottom of the pocket. The analysis was done at the beginning of the study and 60 days after the clinical procedures. The results demonstrate improvement in all parameters of all experimental groups, statistically similar, with exception of Bleeding on Probing of the bottom of the pocket that showed better results to the irrigated groups in relation to the group that was only mechanically instrumented. Thus, it was concluded that irrigation as an adjunct, either with chlorhexidine or with saline solution, provides better repair of non-surgical periodontal therapy procedures

El papel del óxido nítrico en la modulación del proceso inflamatorio de la enfermedad periodontal

Nitric oxide (NO) is a free radical with participation in almost all physiologic host processes; however, in high concentrations it may damage the tissues. Its immunoregulatory action is present in the inflammation and in auto-immune mechanisms, being intensively studied in the medical area. Recently, some studies have also reported that NO could play a role as etiopathogenic factor of the periodontal disease, which shows inflammatory and multifactorial course. Due to beneficial or damage effects of NO, according to its concentrations, some studies have been focused in the evaluation of inhibitor of NO-Synthase (NOS) as therapeutic agents in inflammatory processes. In this context, the aim of this study was to report the role of NO and NOS inhibition in the periodontal disease modulation process. In conclusion, it could be suggested that NO seems to play an essential role in evolution of inflammatory periodontal disease, and that the NOS inhibition may be considered as a promising therapeutic in modulation of inflammatory process.El óxido nítrico (NO) es un radical libre que participa de prácticamente todos los procesos fisiológicos del organismo; sin embargo, en grandes concentraciones puede actuar de forma perjudicial en los tejidos. Su acción inmuno-regulatoria está presente en la inflamación y en los mecanismos de auto inmunidad, siendo intensamente estudiada en el área médica. Recientemente, algunos estudios también han citado al NO como factor etiopatogénico de la enfermedad periodontal, el cual posee naturaleza inflamatoria y multifactorial. La acción del NO depende de su concentración en el organismo, pudiendo ser benéfica o perjudicial y, basada en eso, investigaciones han enfocado el efecto de algunos inhibidores de NO como supuestos agentes terapéuticos en los procesos inflamatorios. A partir de ese contexto, este trabajo tuvo como objetivo relatar el papel del NO y de la inhibición de la óxido nítrico sintasa (NOS) en el proceso de la modulación de la enfermedad periodontal. En conclusión, se puede sugerir que el NO parece ejercer un papel fundamental en la evolución de la enfermedad periodontal inflamatoria y, que la inhibición de la NOS puede ser considerada una terapéutica promisora en la modulación del proceso inflamatorio

Clinical and microbiological effects of photodynamic therapy associated with nonsurgical periodontal treatment. A 6-month follow-up

Experimental studies in animals and in vitro have shown the usefulness of photodynamic therapy (PDT) as an adjunct to periodontal treatment. The aim of this study was to evaluate the long-term clinical and microbiological effects of PDT associated with nonsurgical periodontal treatment. Three sites in each of 33 patients with chronic periodontitis were randomly allocated in a split-mouth design to a treatment group: (1) scaling and root planing (SRP group); (2) SRP and irrigation with toluidine blue O (TBO group); and (3) SRP, irrigation with TBO and low-level laser irradiation (PDT group). Clinical parameters including visible plaque index, bleeding gingival index, bleeding on probing, probing depth, gingival recession and clinical attachment level were measured at baseline, and after 60, 90 and 180 days. Additionally, subgingival plaque samples were collected for microbiological analysis by PCR. Intergroup and intragroup statistical analyses were performed. All treatment groups showed an improvement in all clinical parameters, and a significant reduction in the proportion of sites positive for periodontopathogens at 60, 90 and 180 days compared to baseline (p 0.05). At 180 days, PDT treatment led to a significant reduction in the percentage of sites positive for all bacteria compared to SRP alone (p < 0.05). Within the limits of this study it may be concluded that PDT as an adjunct to periodontal treatment produced statistically significant reductions in some of the key periodontal pathogens but produced no statistically significant benefit in terms of clinical outcome.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP