Prevalence, severity, and risk indicators of gingival inflammation in a multi-center study on South American adults: a cross sectional study

Carvajal, Paola; Gómez, Mariel; Gomes, Sabrina; Costa, Ricardo; Toledo, Andres; Solanes, Fernando; Romanelli, Hugo; Oppermann, Rui; Rösing, Cassiano; Gamonal, Jorge

doi:10.1590/1678-775720160178

Paola Carvajal

Universidade de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Laboratorio de Biología Periodontal, Santiago, Chile

Mariel Gómez

Universidad Maimónides, Facultad de Odontología, Buenos Aires, Argentina

Sabrina Gomes

Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil

Ricardo Costa

Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil

Andres Toledo

Universidad Maimónides, Facultad de Odontología, Buenos Aires, Argentina

Fernando Solanes

Universidade de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Laboratorio de Biología Periodontal, Santiago, Chile

Hugo Romanelli

Universidad Maimónides, Facultad de Odontología, Buenos Aires, Argentina

Rui Oppermann

Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil

Cassiano Rösing

Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil

Jorge Gamonal Corresponding address: Jorge Gamonal. Laboratorio de Biología Periodontal - Departamento de Odontología Conservadora - Facultad de Odontología - Universidad de Chile - Sergio Livingstone Pohlhammer 943 - 83800 - Independencia - Santiago - Chile - Phone: +56 229781833 - Fax: +56 229781815 - e-mail: jgamonal@odontologia.uchile.cl

Universidade de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Laboratorio de Biología Periodontal, Santiago, Chile

Corresponding address: Jorge Gamonal. Laboratorio de Biología Periodontal - Departamento de Odontología Conservadora - Facultad de Odontología - Universidad de Chile - Sergio Livingstone Pohlhammer 943 - 83800 - Independencia - Santiago - Chile - Phone: +56 229781833 - Fax: +56 229781815 - e-mail: jgamonal@odontologia.uchile.cl

Age (years)	PORTO ALEGRE^ p-value <0.05, Fisher's exact test to assess differences between prevalence of gingival inflammation and age		TUCUMÁN		SANTIAGO		TOTAL^ p-value <0.05, Fisher's exact test to assess differences between prevalence of gingival inflammation and age
	Gingival Inflammation		Gingival Inflammation		Gingival Inflammation		Gingival Inflammation		Total
	n	(%)	n	(%)	n	(%)	n	(%)	n	(%)
18–19	24	100	29	93.5	24	100	77	97.5	79	4.8
20–29	98	94.2	125	85.0	126	99.2	349	92.3	378	22.9
30–39	115	96.6	115	91.3	101	98.1	331	95.1	348	21.1
40–49	102	95.3	86	94.5	102	100	290	96.7	300	18.2
>50	196	100	142	91.6	192	99.0	530	97.3	545	33.0
Total	535	97.3^* * p-value <0.001, Fisher's exact test to assess differences between prevalence of gingival inflammation Tucumán versus P. Alegre and Santiago	497	90.4^* * p-value <0.001, Fisher's exact test to assess differences between prevalence of gingival inflammation Tucumán versus P. Alegre and Santiago	545	99.1^* * p-value <0.001, Fisher's exact test to assess differences between prevalence of gingival inflammation Tucumán versus P. Alegre and Santiago	1 577	95.6	1 650	100

Variables		PREVALENCE OF GINGIVAL INFLAMMATION BY CITY AND TOTAL
		n	(%)	PORTO ALEGRE		TUCUMÁN		SANTIAGO		TOTAL		p-value^ p-value, Fisher's exact test, to assess differences between prevalence of gingival inflammation in the total sample for each variable
				n	(%)	n	(%)	n	(%)	n	(%)
Gender	Female	867	52.6	275	98	274	92.6	286	98.3	835	96.3
	Male	783	47.5	260	96.3	223	87.8	259	100	742	94.8	0.127
Education (years)	≤12	1 099	66.6	424	97.9	352	94.9^* * p-value <0.05, Fisher's exact test, to assess differences between prevalence of gingival inflammation for each variable and city	293	99.3	1 069	97.3^* * p-value <0.05, Fisher's exact test, to assess differences between prevalence of gingival inflammation for each variable and city
	>12	551	33.4	111	94.9	145	81.0	252	98.8	508	92.2	0.000
Smoking	No	1 180	71.5	384	96.7	368	89.5	368	98.9	1 120	94.2
	Current (light)	171	10.4	17	100.0	57	96.6	94	98.9	168	98.3
	Current (moderate)	76	4.6	24	96.0	17	94.4	33	100.0	74	97.4
	Current (heavy)	223	13.5	110	99.1	55	88.7	50	100.0	215	96.4	0.194
Self-reported diabetes	No diabetes	1 528	92.6	489	97.0	493	90.3	473	99.0	1 455	95.2
	Yes	122	7.4	46	100	4	100	72	100	122	100^* * p-value <0.05, Fisher's exact test, to assess differences between prevalence of gingival inflammation for each variable and city	0.005
Self-reported hypertension	No hypertension	1 332	80.7	379	96.4	443	89.5	441	99.3	1 263	94.8
	Yes	318	19.3	156	99.4	54	98.2^* * p-value <0.05, Fisher's exact test, to assess differences between prevalence of gingival inflammation for each variable and city	104	98.1	314	98.7^* * p-value <0.05, Fisher's exact test, to assess differences between prevalence of gingival inflammation for each variable and city	0.001
Plaque Index	<30%	58	3.5	11	64.7	7	21.2	6	75.0	24	41.4
	≥30%	1 592	96.5	524	98.3^* * p-value <0.05, Fisher's exact test, to assess differences between prevalence of gingival inflammation for each variable and city	490	94.8^* * p-value <0.05, Fisher's exact test, to assess differences between prevalence of gingival inflammation for each variable and city	539	99.5^* * p-value <0.05, Fisher's exact test, to assess differences between prevalence of gingival inflammation for each variable and city	1 553	97.6^* * p-value <0.05, Fisher's exact test, to assess differences between prevalence of gingival inflammation for each variable and city	0.000

	PORTO ALEGRE				TUCUMÁN SANTIAGO								TOTAL				p-value*	p-value**	p-value***	p-value****
	(n = 550)				(n = 550)				(n = 550)				(n = 1650)
Variable	Healthy		GI		Healthy		GI		Healthy		GI		Healthy		GI
	n=15		n=535		n=53		n=497		n=5		n=545		n=73		n=1577
	mean	SD	mean	SD	mean	SD	mean	SD	mean	SD	mean	SD	mean	SD	mean	SD
G-Index	0.44	0.05	1.12	0.34	0.36	0.11	1.11	0.35	0.24	23.4	1.73	0.28	0.37	0.12	1.33	0.44	0.000	0.424	0.000	0.000
Inter G-Index	0.49	0.08	1.17	0.32	0.36	0.11	1.09	0.35	0.30	0.28	1.76	0.28	0.38	0.13	1.35	0.43	0.000	0.002	0.000	0.000
GBI	3.1	3.0	22.9	18.4	0.02	2.3	23.0	19.7	2.2	2.2	74.1	23.4	2.3	2.5	40.6	31.9	0.000	0.408	0.000	0.000
VPI	35.8	18.8	70.5	18.1	29.4	12.1	73.5	20.0	44.2	21.9	81.6	18.1	31.7	14.8	75.2	19.4	0.001	0.001	0.000	0.000
Inter VPI	45.1	22.5	79.0	17.1	30.0	12.5	74.0	20.3	52.4	27.1	88.9	16.0	34.6	17.7	81.2	18.8	0.004	0.002	0.000	0.000
CI	52.0	34.9	88.5	21.1	25.9	26.9	73.8	32.0	41.2	28.5	81.1	27.2	32.0	30.2	81.3	27.7	0.003	0.000	0.000	0.003

		Gingival Index					Interproximal Gingival Index					Gingival Bleeding Index
	Age (years)	Mean	IC 95%	p-value *	p-value **	p-value ***	mean	IC 95%	p-value *	p-value **	p-value ***	mean	IC 95%	p-value *	p-value **	p-value ***
PORTO ALEGRE	18–19	1.00	0.89,1.11	0.005			1.06	0.95,1.16	0.010			18.5	1.0,56.0	0.344
	20–29	1.07	1.01,1.13				1.12	1.07,1.18				21.1	0.0,72.0
	30–39	1.07	1.02,1.13				1.13	1.07,1.18				20.6	1.0,78.0
	40–49	1.11	1.05,1.18				1.16	1.10,1.22				22.3	1.0,94.0
	≥50	1.19	1.14,1.25				1.23	1.18,1.28				25.9	0.0,100
TUCUMÁN	18–19	1.15	1.00,1.29	0.188	0.683		1.12	0.97,1.27	0.229	2.263		23.6	15.9,31.3	0.285	1.358
	20–29	1.07	1.01,1.13		2.535		1.05	1.00,1.11		0.078		21.0	18.0,24.1		2.333
	30–39	1.10	1.04,1.16		1.175		1.07	1.01,1.13		0.556		21.9	18.8,25.0		1.415
	40–49	1.08	1.01,1.16		1.043		1.06	0.99,1.14		0.042		21.6	17.0,26.2		0.422
	≥50	1.17	1.11,1.23		2.167		1.15	1.08,1.21		0.093		26.4	22.7,30.1		2.969
SANTIAGO	18–19	1.51	1.34,1.67	0.000	0.000	0.005	1.55	1.39,1.70	0.000	0.000	0.000	57.1	44.8,69.4	0.000	0.000	0.000
	20–29	1.66	1.61,1.70		0.000	0.000	1.68	1.64,1.73		0.000	0.000	67.1	63.0,71.2		0.000	0.000
	30–39	1.72	1.66,1.79		0.000	0.000	1.76	1.70,1.82		0.000	0.000	74.2	69.3,79.1		0.000	0.000
	40–49	1.77	1.71,1.82		0.000	0.000	1.8	1.75,1.86		0.000	0.000	77.7	73.3,82.2		0.000	0.000
	≥50	1.78	1.74,1.81		0.000	0.000	1.8	1.77,1.84		0.000	0.000	78.8	75.8,81.7		0.000	0.000
TOTAL	18–19	1.21	1.12,1.31	0.000			1.23	1.14,1.32	0.000			32.5	26.2,38.7	0.002
	20–29	1.28	1.24,1.33				1.3	1.26,1.34				37.7	34.6,40.8
	30–39	1.28	1.23,1.33				1.3	1.25,1.35				37.4	34.0,40.8
	40–49	1.33	1.28,1.39				1.36	1.30,1.41				41.6	37.7,45.5
	>50	1.40	1.36,1.44				1.42	1.38,1.45				45.2	42.4,48.0

			MILD GI			MODERATE GI			SEVERE GI
	Age (years)	n	%	IC 95%	n	%	IC 95%	n	%	IC 95%	p-value*	p-value**
PORTO ALEGRE	18–19	13	54.2	34.2,72.9	11	45.8	27.1,65.8	0	0.0
	20–29	37	37.8	28.7,47.8	61	62.2	52.2,71.3	0	0.0
	30–39	54	47.0	38.0,56.1	57	49.6	40.5,58.7	4	3.5	1.3,9.0	0.090
	40–49	41	40.2	31.1,50.0	58	56.9	47.0,66.2	3	2.9	0.9,8.8
	≥50	64	32.7	26.4,39.6	126	64.3	57.3,70.7	6	3.1	1.4,6.7
TUCUMÁN	18–19	12	41.4	24.9,60.0	16	55.2	36.8,72.2	1	3.5	0.4,21.5
	20–29	55	44.0	35.5,52.9	69	55.2	46.4,63.7	1	0.8	0.1,5.5
	30–39	48	41.7	33.0,51.0	65	56.5	47.3,65.3	2	1.7	0.4,6.7	0.300
	40–49	42	48.8	38.4,59.4	41	47.8	37.3,58.3	3	3.5	1.1,10.4
	≥50	51	35.9	28.4,44.2	90	63.4	55.1,70.9	1	0.7	0.1,4.9
SANTIAGO	18–19	3	12.5	4.0,33.0	21	87.5	67.0,96.0	0	0.0			0.007
	20–29	2	1.6	0.4,6.2	118	93.7	87.8,96.8	6	4.8	2.1,10.2		0.000
	30–39	6	6.0	2.7,12.7	90	89.1	81.3,93.9	5	5.0	2.1,11.4	0.230	0.000
	40–49	3	2.9	0.9,8.8	93	91.2	83.8,95.4	6	5.9	2.7,12.5		0.000
	≥50	4	2.1	0.8,5.4	176	91.7	86.8,94.8	12	6.3	3.6,10.7		0.000
TOTAL	18–19	28	36.4	26.4,47.7	48	62.3	51.0,72,5	1	1.3	0.2,8.7
	20–29	94	26.9	22.5,31.8	248	71.1	66.1,75.6	7	2.0	1.0,4.2
	30–39	108	32.6	27.8,37.9	212	64.1	58.7,69.1	11	3.3	1.9,5.9	0.019
	40–49	86	29.7	24.7,35.2	192	66.2	60.6,71.4	12	4.1	2.4,7.2
	≥50	119	22.5	19.1,26.2	392	74	70.0,77.5	19	3.6	2.3,5.6

		TOTAL (n=1650)			PORTO ALEGRE (n=550)			TUCUMÁN (n=550)			SANTIAGO (n=550)
Variables		OR	CI 95%	p-value	OR	CI 95%	p-value	OR	CI 95%	p-value	OR	CI 95%	p-value
Gender	Male
	Female	1.93	1.03,3.59	0.039	6.48	1.32,31.86	0.021	1.59	0.72,3.53	0.254	0.00	0.00	0.997
Education	>12
(years)	≤12	2.18	1.19,4.02	0.012	1.29	0.33,5.06	0.713	3.21	1.46,7.08	0.004	1.88	0.24,15.06	0.550
CI (mean)		18.59	7.13,48.50	0.000	25.66	3.89,169.10	0.001	18.24	5.44,61.19	0.000	36.61		0.099
												0.51,2634.86
VPI	<30%
	≥30%	14.56	6.75,31.40	0.000	10.78	2.06,56.49	0.005	21.10	7.33,60.71	0.000	18.70	1.30,269.52	0.031
City	Tucumán
	Porto Alegre	1.75	0.81,3.79	0.153
	Santiago	7.17	2.58,19.93	0.000

[1] Corresponding address: Jorge Gamonal. Laboratorio de Biología Periodontal - Departamento de Odontología Conservadora - Facultad de Odontología - Universidad de Chile - Sergio Livingstone Pohlhammer 943 - 83800 - Independencia - Santiago - Chile - Phone: +56 229781833 - Fax: +56 229781815 - e-mail: jgamonal@odontologia.uchile.cl

Brasil

Brasil

Prevalence, severity, and risk indicators of gingival inflammation in a multi-center study on South American adults: a cross sectional study

ABSTRACT

Objectives:

Material and Methods:

Results:

Conclusions: