Effects of subgingival irrigation on bacteremia following scaling and root planning

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Bacteremia following subgingival irrigation and scaling and root planing.

The purpose of this study was to determine the incidence of bacteremia after a single professional subgingival irrigation with a 0.12% chlorhexidine gluconate mouthrinse (CHX) as well as after a subsequent scaling and root planing (S/RP) during the same visit. Thirty subjects each with at least 1 site that probed 4 mm or more and bled on probing were randomly assigned to the following groups: 1) irrigation with 0.12% CHX; 2) irrigation with sterile water; and 3) non-irrigated controls. To begin the study blood was drawn just before and 2 minutes after irrigation. Thirty minutes later, blood was drawn again just before and 2 minutes after S/RP at the same site. Specimens were cultured for anaerobic and aerobic microorganisms using standard cultural techniques. Eighteen blood cultures from 15 subjects yielded positive cultures resulting in 23 isolates. Gram-positive rods comprised 34.8% of the total isolates; Gram-positive cocci 34.8%, Gram-negative rods 21.7%, and Gram-negative cocci 8.7%. In the CHX group, bacteremia was detected in 5 subjects after irrigation and in 2 other subjects after S/RP. In the water group, bacteremia was detected in one subject after irrigation and in 4 subjects after S/RP. The control group had 3 bacteremias after S/RP. There was no significant difference between the incidence of bacteremia associated with irrigation by CHX or sterile water (P = 0.141). There was also no significant difference in the incidence of bacteremia after S/RP between the CHX and sterile water irrigation groups and in patients who did not receive irrigation (control group) (P = 0.88).(ABSTRACT TRUNCATED AT 250 WORDS)link_to_subscribed_fulltex

Obesity and periodontal disease in diabetic pregnant women Obesidade e doença periodontal em gestantes diabéticas

This cross-sectional study investigated the impact of pregestational overweight and obesity on periodontal status of patients with gestational diabetes mellitus (GDM). Sixty pregnant women with gestational diabetes mellitus (GDM) were recruited for the study. According to the pregestational body mass index (BMI), patients were classified into 3 groups: normal, overweight or obese. The periodontal assessment parameters were the presence of gingival bleeding (GB) and bleeding on probing (BOP) per tooth. Clinical attachment loss (CAL) was assessed per tooth and classified according to following values: 1) absence of attachment loss; 2) between 1 and 2 mm, 3) between 3 and 5 mm; and 4) CAL > 6 mm. The means of individual percentage of teeth with GB and BOP and the means of the individual classified values of CAL were compared through ANOVA. Differences between the groups were established through post hoc Bonferroni test for multiple comparisons (p < 0.05). The analysis revealed significant differences between the normal group and the obese group considering GB (52.76% &plusmn; 27.99% and 78.85% &plusmn; 27.44%, respectively) and CAL (2.21 &plusmn; 0.41 and 2.61 &plusmn; 0.54, respectively). Although an increase was found in BOP as the BMI increased (ranging from 55.65% to 75.31%), no statistically significant differences were found among the groups. Patients with GDM and pregestational obesity had significantly more gingivitis and periodontal attachment loss that those with normal pregestational BMI. Periodontal treatment should be considered in the establishment of future recommendations for metabolic control for this special group of patients.<br>O objetivo do presente estudo foi examinar o efeito da massa corporal prévia à gestação (IMC - índice de massa corpórea) sobre o periodonto de pacientes com diabete mellitus gestacional (DMG). A amostra constituiu-se de 60 gestantes classificadas em 3 grupos segundo o IMC: normal, sobrepeso ou obeso. Os parâmetros de avaliação periodontal foram sangramento gengival (SG), sangramento à sondagem (SS) e perda de inserção clínica periodontal (PI) categorizada de acordo com os seguintes valores: 1) correspondente à ausência de perda de inserção; 2) PI entre 1 e 2 mm, 3) PI entre 3 e 5 mm; e 4) PI > 6 mm. Médias das porcentagens dos dentes com SG e SS e as médias dos valores categorizados, por dente, da perda de inserção foram comparadas por meio do teste ANOVA e as diferenças entre os grupos foram estabelecidas por meio do teste post hoc de Bonferroni para comparações múltiplas (p < 0,05). Diferenças estatisticamente significantes foram identificadas entre o grupo normal e obeso com relação às médias percentuais da presença de SG (52,76 &plusmn; 27,99% e 78,85 &plusmn; 27,44%, respectivamente) e às médias da categorização da PI (2,21 &plusmn; 0,41 mm e 2,61 &plusmn; 0,54 mm, respectivamente). Embora tenha se observado aumento no percentual médio de SS à medida do incremento do IMC, não foram observadas diferenças estatisticamente significantes entre os grupos, e a variação foi de 55,65% a 75,31%. Pacientes com DMG e obesidade pré-gestacional apresentaram significativamente mais gengivite e perda de inserção periodontal que aquelas com IMC pré-gestacional normal. O tratamento periodontal deve ser considerado na determinação de futuras recomendações de controle metabólico para esse grupo especial de pacientes