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Brazilian Oral Research, Volume: 21, Issue: spe, Published: 2007
  • The contribution of special issues and the New BOR Management

    Rode, Sigmar de Mello
  • Proceedings of the First South American Oral Health Panel

    Pannuti, Cláudio Mendes
  • An overview of the epidemiology of periodontal diseases in Latin America Original Articles

    Oppermann, Rui Vicente

    Abstract in Portuguese:

    O objetivo do presente estudo foi identificar a presença das doenças periodontais e a importância relativa de reconhecidos fatores de risco nos países da América Latina. Foram encontradas informações esparsas, sendo que os dados se mostraram inconsistentes. Para a maioria dos países não existem informações. Gengivite é um achado universal na região, afetando todas as idades, independentemente do nível socioeconômico. A extensão da presença de sangramento pode variar entre 40% e 70% dos sítios. A prevalência de periodontite agressiva é maior na América Latina do que nos países industrializados. A prevalência varia de 0,3% a 4,5%, sendo que a forma localizada é a menos prevalente. A prevalência de periodontite crônica é alta e pode variar muito (40% a 80%) provavelmente em decorrência de diferenças na metodologia e nos critérios diagnósticos. Diferenças regionais podem ser relevantes. Os fatores de risco reconhecidos estão presentes nas populações estudadas. Fatores próprios como idade, gênero e genética foram relacionados em estudos brasileiros e chilenos. Tabagismo e diabetes demonstraram-se importantes fatores de risco. A importância do nível socioeconômico, ainda que presente como um fator de risco, é muito pouco relevada. Higiene oral é extremamente deficiente na região, embora seja um hábito cultural presente na maioria das populações. Pode-se concluir que as doenças periodontais apresentam alta prevalência nas populações da América Latina. Sua presença e extensão estão associadas a reconhecidos fatores de risco. Hábitos de higiene oral são deficientes. Estudos epidemiológicos com metodologia adequada e validade externa são necessários.

    Abstract in English:

    The aim of the present review was to identify the presence of periodontal diseases and the relative importance of known risk factors in Latin American countries. The retrieved data are sparse and inconsistent, lacking information for the majority of the countries. Gingivitis is ubiquitous in the region, affecting all ages independently of the socioeconomic background. The extension of bleeding may vary greatly, ranging from 40% to 70% of sites. The prevalence of aggressive periodontitis is higher in Latin America than in industrialized countries. Prevalence ranges from 0.3% to 4.5%, and the localized form is the less prevalent. The prevalence of chronic periodontitis is high, with a large variation (40-80%) probably due to differences in methodology and diagnostic criteria. Regional differences may be relevant. Known risk factors are present in the populations studied. Non-modifiable factors such as age, gender and genetics have been associated in Brazilian and Chilean populations. Tobacco smoking and diabetes are relevant risk factors. The importance of socioeconomic status, although present as a risk factor, has been largely underestimated. Oral hygiene is extremely deficient in the area although it is a cultural habit in most populations. It can be concluded that periodontal diseases are highly prevalent in Latin American populations. Its prevalence and extent are associated with known risk factors. Oral hygiene habits are deficient. Well designed epidemiological studies with external validity are needed.
  • Mouthrinses containing alcohol and oral cancer: revision of epidemiological studies Original Articles

    Blanc, Silvia Adriana López de; Baruzzi, Ana María

    Abstract in Spanish:

    Existen numerosas publicaciones que informan una fuerte asociación entre el consumo de alcohol y el desarrollo del cáncer oral (CO). Debido a que algunos colutorios contienen cantidades significativas de etanol se ha considerado una posible relación entre su uso y esta patología. El propósito del presente trabajo es analizar algunos estudios epidemiológicos en los cuales se evaluó la posibilidad de que los colutorios comerciales puedan estar involucrados en la etiología del CO. Aunque algunos autores informan asociación, la mayoría de los estudios son poco claros y algunas veces contradictorios. Los aspectos controversiales respecto al papel del alcohol en el CO, dificultan el hallazgo de una relación directa entre el uso de los colutorios que contienen alcohol y el CO.

    Abstract in English:

    The strong association between alcohol usage and the development of oral cancer (OC) has been reported in numerous papers. As some mouthrinses contain significant amounts of ethanol, a possible relationship to this pathology has been considered. The purpose of the present paper is to analyze several epidemiological studies which evaluated the association between commercial mouthrinses and the etiology of OC. Although some authors report an association, most of the studies are unclear and sometimes contradictory. The controversial aspects regarding the role of alcohol in OC may also make difficult to find a clear relationship between the use of mouthrinses containing alcohol and OC.
  • The effect of mouthrinses against oral microorganisms Original Articles

    Cortelli, José Roberto; Thénoux, Raul Emilio de La Sotta

    Abstract in Portuguese:

    O propósito desta revisão foi mostrar os benefícios decorrentes do uso de enxaguatórios bucais no controle do biofilme dental. Atualmente sabe-se que a cavidade bucal dos humanos é habitada por aproximadamente de 600 a 700 espécies microbianas incluindo bactérias, fungos e vírus. Este aglomerado microbiano, atualmente definido como biofilme dental, é o principal agente etiológico das patologias bucais, incluindo cárie e doença periodontal. Logo, cuidados em relação ao controle destas doenças passam necessariamente pela eliminação ou redução do biofilme dental, incluindo métodos mecânicos adequados de higiene bucal e motivação do paciente. Todavia, a escovação dental e o uso de fio dental podem ser uma tarefa tediosa e consumir tempo exagerado para a rotina de muitos pacientes. Além disso, o controle mecânico do biofilme dental pode ser dificultado por fatores locais como uso de próteses e aparelhos ortodônticos, mau posicionamento dental, entre outros. Assim, o uso de enxaguatórios bucais, associado ao controle mecânico, pode ser incorporado rotineiramente aos cuidados de higiene bucal controlando terapêutica e preventivamente o biofilme supragengival, a gengivite e a halitose. De acordo com a ADA, agentes ativos vinculados aos enxaguatórios bucais devem demonstrar efeitos terapêuticos in vivo e in vitro para que estes sejam classificados como droga. Diferentes estudos incluídos nesta revisão demonstraram que a clorexidina e os óleos essenciais podem, em associação ao hábito regular de escovar os dentes e usar corretamente o fio dental, prevenir e controlar tanto o biofilme supragengival quanto as gengivites.

    Abstract in English:

    This paper reviews the benefits of the use of antimicrobial mouthrinses for controlling dental biofilm. It is currently known that the human oral cavity is inhabited by approximately 600 to 700 different species of microorganisms, including bacteria, fungi and viruses, organized in biofilms. Biofilm accumulation represents the principal etiologic agent of oral diseases including caries and periodontal diseases. For that reason, prevention of biofilm accumulation has been shown to be associated with the control of diseases. Patient motivation and oral hygiene instruction are claimed to be a major factor influencing the degree of biofilm control. Therefore, mechanical home-care methods, including toothbrushing and flossing, represent the best way for patients to remove biofilm. For many patients, however, the elimination of all biofilm present in the oral cavity through home-care methods could be tedious and time-consuming. Additionally, some local conditions, including malpositioned teeth, presence of bridge-work or orthodontic appliances, among others, may render the mechanical control of biofilm especially difficult. Chemotherapeutic agents, including mouthrinses, could have a key role as adjuncts to daily home care, preventing and controlling supragingival plaque, gingivitis and oral malodor. Indeed, according to the ADA, the active ingredients of mouthwashes must demonstrate a therapeutic effect in vivo and in vitro to be classified as drugs. Several studies included in the present review have demonstrated the effectiveness of mouthrinses containing active ingredients such as chlorhexidine and essential oils in preventing and controlling both supragingival plaque and gingivitis, especially when used adjunctively to regular toothbrushing and flossing procedures.
  • Age and oral health: current considerations Original Articles

    Tawse-Smith, Andrew

    Abstract in Spanish:

    La placa dental es aún considerada el factor etiológico primario de la enfermedad periodontal. La etiopatogenia de esta enfermedad ha avanzado del concepto anterior donde una gingivitis progresaba lentamente a una periodontitis, a un escenario más complejo donde varios factores de riesgo se correlacionan. Dentro estos factores, el envejecimiento ha sido asociado con mayores porcentajes de enfermedad periodontal a medida que la población envejece. Aunque la pérdida ósea y de inserción es común en el adulto mayor y los cambios del periodonto son evidentes con la edad, la enfermedad periodontal severa no es una consecuencia natural del envejecimiento. La importancia de identificar en una etapa temprana del individuo y de la enfermedad los factores de riesgo que participan en la patogenesis de la enfermedad periodontal, así como la evaluación de la capacidad del individuo para controlar la placa dental, permitirán la implementación de programas preventivos adecuados, donde las necesidades y limitaciones del individuo son consideradas para el establecimiento de procedimientos personalizados de higiene oral y el enjuague oral a utilizar.

    Abstract in English:

    Dental plaque is still considered the main etiological factor for periodontal diseases. Our understanding of periodontal disease has advanced from the previous concepts where gingivitis slowly progressed to periodontitis to a more complex scenario that correlates several risk factors in the pathogenesis of periodontal disease. Among these factors, age has been associated with increased rates of periodontal disease as the population gets older. Although the loss of alveolar bone and periodontal attachment is common in the elderly population, and there is evident age-related changes in the periodontium, severe periodontitis is not a natural consequence of ageing. The importance of identifying the risk factors that participate in the pathogenesis of periodontal disease at an early phase, both of the individual and the disease, as well as evaluating the capacity of the individual to control dental plaque will enable the implementation of an adequate preventive program, where the needs and limitations of the individual are considered to specifically tailor the oral hygiene procedures and the mouthwashes to be used.
  • Compliance & dexterity, factors to consider in home care and maintenance procedures Original Articles

    Criado, Victoria; Tawse-Smith, Andrew

    Abstract in Spanish:

    El control de la placa dental parece ser el mecanismo primario para controlar el crecimiento de la placa dental supragingival. Aunque la práctica diaria de la higiene bucal y el cuidado profesional periódico, son considerados la base para cualquier programa dirigido a la prevención y tratamiento de las enfermedades de la cavidad bucal, estos procedimientos son técnicamente exigentes, consumen tiempo y pueden ser afectados por la aceptación y la destreza manual del paciente. Las destrezas individuales y los patrones de comportamiento adquiridos, determinan la efectividad de un programa preventivo y la práctica de la higiene bucal. El éxito de los programas preventivos y los procedimientos del cuidado bucal en el hogar dependen claramente de la interacción y compromiso entre el odontólogo y el paciente. La importancia de identificar la capacidad del individuo para cumplir con las recomendaciones y la evaluación de la destreza del paciente para remover la placa dental supragingival, permitirán la implementación de un adecuado programa de prevención que podría ayudar a la selección de un agente antibacteriano coadyuvante y los dispositivos necesarios para alcanzar una rutina de cuidado bucal efectivo.

    Abstract in English:

    Mechanical plaque control appears to be the primary means of controlling supragingival dental plaque build-up. Although daily oral hygiene practices and periodic professional care are considered the basis for any program aimed at the prevention and treatment of oral diseases, these procedures are technically demanding, time consuming and can be affected by the compliance and manual dexterity of the patient. Individual skills and acquired behavior patterns determine effectiveness of a preventive program and oral hygiene practice. Successful preventive programs and home care procedures clearly depend on the interaction and commitment between the dental professional and the patient. Identifying the capacity of the individual to comply with the professional recommendations and evaluating the dexterity of the patient to remove supragingival dental plaque will permit the implementation of an adequate preventive program and can help on the selection of adjunctive antimicrobial agents and devices needed to reach an effective oral care routine.
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