Made available in DSpace on 2017-07-24T19:22:19Z (GMT). No. of bitstreams: 1 FABIANE SCHREINER.pdf: 1371612 bytes, checksum: 4c92bfc09a7b2ad93f1107f9b7633f68 (MD5) Previous issue date: 2012-02-24 / Effects of alterations related to edentulism not necessarily represent changes in perception of oral health, being a matter point the exploration of the psychosocial and psychological changes for the better known of their long-term effects. Objective:The purpose of this exploratory study was to evaluate the impact of oral and prosthetic conditions on the quality of life of partially and fully edentulous patients from State University of Ponta Grossa. Method: A total of 90 individuals, 59 partially and 31 fully edentulous, were included in the study, and their socioeconomic, oral and prosthetic conditions were evaluated and compared to OHIP-14 questionnaire.The statistical data included the exploration of the psychometric properties of OHIP- 14, the bivariate analysis by Student's t test and Pearson correlation and the multivariate linear regression. Results: Sample was predominantly female and mean age presented was 52 years, ranging from 26 to 84 years. OHIP-14 mean for partially and fully edentulous was, respectively, 20.24 and 16.90; the difference was not significant (p=0.97). Items gender, education level, index of TMD and length of edentulism were associated with worse scores, whereas gender, educational level,mucosal injury and TMD index were associated with greater impact. Conclusion:After controlling the type of edentulism, both sociodemographic factors, and oral and prosthetic factors influenced the oral health related quality of life (OHRQoL). The questions with less interference in the scores were those that assessed the most severe impact, showing a high degree of adaptation to oral problems for thispopulation. / O efeito de alterações relacionadas ao edentulismo não se traduz, necessariamente, em mudanças na percepção de saúde bucal, sendo necessária a exploração das modificações psicossociais e psicológicas para que seus efeitos a longo prazo sejam melhor conhecidos. Objetivo: O propósito deste estudo exploratório foi avaliar o impacto das condições bucais e protéticas sobre a qualidade de vida de pacientes parcial e totalmente edêntulos da Universidade Estadual de Ponta Grossa. Método:Um total de 90 indivíduos, 59 parcial e 31 totalmente edêntulos foram incluídos no estudo, tendo as condições sociodemográficas, bucais e protéticas avaliadas e comparadas ao questionário Oral Health Impact Profile OHIP-14). A estatística dos dados compreendeu a exploração das propriedades psicométricas do OHIP-14, a análise bivariada por teste qui-quadrado e a análise multivariada por regressão de Poisson bruta e ajustada. Resultados: A amostra apresentou predominância do gênero feminino e idade média de 52 anos, variando de 26 a 84 anos. A média OHIP-14 para parcial e totalmente edêntulos foi 20,24 e 16,90, respectivamente, sendo a diferença não significante (p=0,97). Os itens gênero, escolaridade, índice de DTMs e tempo de edentulismo foram associados piores escores, enquanto gênero, escolaridade, lesões na mucosa e índice de DTMs foram associados a maiores impactos. Conclusão: Após controle do tipo de edentulismo, tanto fatores sociodemográficos, quanto fatores bucais e protéticos tiveram influência na qualidade de vida relacionada à saúde bucal (OHRQoL). As perguntas que menos interferiram nos escores foram as que avaliaram os impactos mais severos, demonstrando um alto grau de adaptação aos problemas bucais pela população avaliada.

O objetivo desta revisão sistemática foi avaliar a efetividade da terapia de alendronato (bifosfonatos) na prevenção da perda dentária em mulheres após a menopausa. A estratégia de pesquisa desenvolvida foi adaptada para nove bases de dados para ensaios clínicos controlados aleatorizados com pelo menos seis meses de duração. Foi associada a esta pesquisa uma busca em literatura cinzenta (gray literature). Além disso, entramos em contato com especialistas da área e companhias que fabricam alendronato, com a finalidade de obtermos outros estudos, materiais não publicados ou para esclarecer dados duvidosos. Os desfechos avaliados incluíram: perda dentária, mudanças no nível clínico de inserção, densidade mineral óssea dos maxilares, profundidade de sondagem e nível da crista óssea interproximal em radiografias periapicais. Foi realizada, em duplicata, a avaliação da qualidade metodológica e a extração de dados dos estudos selecionados. Não foi possível incluir ensaios clínicos nesta revisão. Entretanto, nós decidimos descrever resumidamente os dados de apenas um estudo relevante, mas com baixo poder de validade. Esta revisão, baseada em apenas um ensaio, com baixo poder de evidência, verificou que não houve diferença na perda dentária, em mulheres após a menopausa, que foram tratadas com alendronato. Além disso, não há evidências clínicas importantes para a utilização do alendronato como coadjuvante no tratamento periodontal. / The aim of the present systematic review was to evaluate the alendronate therapy (bisphosphonates) for the prevention of tooth loss in postmenopausal women. The research strategy included the nine major electronic databases for randomised controlled trials (RCTs) with at least six months follow-up. An electronic approach of the several grey literature was conducted, and several experts of groups/companies involved in bisphosphonates research were contacted to find trials of unpublished material or to clarify ambiguous or missing data. The following parameters were included: tooth loss, changes in clinical attachment levels, jaw bone mineral density, probing pocket depths, and marginal bone levels on intraoral radiographs. Duplicate screening assessment in eligible RCTs of methodological quality and data extraction were conducted. No trial could be included in this review. Therefore, it was decided to describe the data of the only relevant study, thorough wish low validity. This review, based on one trial with low powered support provided some data. These data analysis showed no differences in tooth loss for postmenopausal women treated with alendronate therapy. Furthermore, no important clinical evidence was found to support the use of alendronate as coadjuvant on treatment of periodontal diseases.

Introdução: Indivíduos diabéticos em situação de internamento apresentam pior controle glicêmico e maiores complicações do diabetes e consequentemente maiores chance de apresentar periodontite mais grave e extensa do que indivíduos diabéticos com bom controle glicêmico. Nesse contexto, torna-se importante avaliar a qualidade de vida relacionada à saúde bucal (QVRSB) entre pacientes com maior e menor experiência de periodontite. Esta dissertação é composta por uma apresentação, um manuscrito e considerações finais. Objetivo: avaliar o impacto das condições periodontais e bucais na qualidade de vida relacionada à saúde bucal de pacientes diabéticos e não diabéticos internados no Hospital de Clínicas de Porto Alegre (HCPA). Materiais e Métodos: Este foi um estudo observacional transversal realizado nas enfermarias clínicas do HCPA com 394 indivíduos diabéticos e não diabéticos. Os participantes responderam a um questionário estruturado, foram submetidos a um exame odontológico e periodontal detalhado e o OHIP-14 foi utilizado como instrumento para avaliar a qualidade de vida relacionada à saúde bucal. Resultados: Os indivíduos não diabéticos dentados apresentaram média de impactos negativos na QVRSB significativamente maior que os edêntulos do mesmo grupo (9,69 ± 9,62 versus 5,72 ± 7,38; p=0,01). Não houve diferença estatisticamente significativa na extensão, prevalência e severidade de impactos negativos para nenhum dos parâmetros bucais avaliados quando comparados pacientes diabéticos e não diabéticos. Ser idoso (RP=2,01; IC 95% 1,44-2,80; p=0,001) e possuir entre 6 e 19 dentes (RP=1,89; IC 95% 1,25-2,83; p=0,002) estiveram associados com alto impacto negativo na QVRSB. Conclusão: O presente estudo demonstrou que idade e perda dentária influenciam negativamente a QVRSB em pacientes internados, independentemente da presença do diabetes. / Background: Diabetic individuals admitted to a hospital have poor glycemic control and major complications of diabetes, and consequently greater chance of presenting more severe and extensive periodontitis than diabetic individuals with good glycemic control. In this context, it becomes important to assess the oral health related quality of life (OHRQOL) between patients with greater and lower periodontitis experience. This dissertation is composed of a presentation, a manuscript and conclusion. Aim: To evaluate the impact of periodontal and oral conditions on oral health related quality of life of diabetic and non-diabetic patients admitted to the Hospital de Clínicas de Porto Alegre (HCPA). Materials and Methods: This was an observational cross-sectional study realized in HCPA clinical wards with 394 diabetic and non-diabetic individuals. The participants answered a structured quiz, they were subjected to a detailed dental and periodontal examination and the OHIP-14 was used as a tool to evaluate the oral health related quality of life. Results: The dentate non-diabetic individuals presented mean of negative impacts on OHRQOL significantly greater than the edentulous by the same group (9.69 ± 9.62 versus 5.72 ± 7.38; p=0.01). There was no statistically significant differences on extent, prevalence and severity of negative impacts for all the evaluated oral parameters comparing diabetic and non-diabetic patients. To be elderly (PR=2.01; CI 95% 1.44-2.80; p=0.001) and have between 6 and 19 teeth (PR=1.89; CI 95% 1.25-2.83; p=0.002) were associated with high negative impact on the OHRQOL. Conclusion: This study demonstrated that age and tooth loss influence negatively the OHRQOL in admitted patients, independently of diabetes presence.

Magister Scientiae Dentium - MSc(Dent) (Restorative Dentistry) / Loss of teeth has a negative impact on appearance, nutrition, function and diet. Rehabilitation of tooth loss is an important function of oral health care. Rehabilitation with removable prosthesis of mandibular terminal edentulous areas has been associated with more negative outcomes than of tooth-bounded regions.

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No. of bitstreams: 1 Dissertação - José felipe de Freitas Gomes.pdf: 1288785 bytes, checksum: e279518c5c0d5e8a10ec57f74309e2c5 (MD5) Previous issue date: 2014-08-28 / FAPEAM - Fundação de Amparo à Pesquisa do Estado do Amazonas / Despite the reduction in tooth loss worldwide, edentulism is still considered important problem among the elderly. Added to this, the contextual social determinants associated with tooth loss are poorly understood. The aim of this study was to estimate the prevalence and geographical distribution of edentulism in the elderly population residing in state capitals and the Federal District, as well as to test the association of contextual and individual socioeconomic inequalities with edentulism. We used data of the elderly 65 to 74 years who participated in the National Oral Health Survey (SB Brazil 2010) and had completely filled for the investigated variables (n = 5435). Contextual social indicators included Municipal Human Development Index (HDI-M) and the Gini Index. Other contextual variables were assessed as coverage of oral health care by the Family Health Strategy (ESB / ESF) and the water fluoridation. The individual variables included gender, ethnicity, family income, years of education, number of residents per room and number of household assets. Multilevel logistic regression models were used to estimate odds ratios (OR) and 95% intervals of confidence (95% CI) between contextual and individual variables and edentulism. The prevalence of edentulism in the Brazilian elderly was 68.6% (95% CI 64.9, 72.2), with considerable variation between state capitals and the Federal District. The interaction variable (HDI-M and family income) was, in all its categories, independently associated with edentulism. Among the individual variables, it was found that males (OR 0.60, 95% CI 0.52 to 0.66) and with black skin color (OR 0.78, 95% CI 0.63 to 0.96 ) had lower chances for edentulism, while individuals with lower education (OR 4.46, 95% CI 3.61 to 5.52) and fewer household assets (OR 1.30, 95% CI 1.10 to 1 , 54) showed greater risk for tooth loss. The results suggest that the level of contextual economic development as well as individual characteristics of social position are associated with the prevalence of edentulism. / Apesar da redução da perda dentária em todo o mundo, o edentulismo ainda é considerado importante problema entre os idosos. Somado a isso, os determinantes sociais contextuais associados ao edentulismo são pouco conhecidos. Este estudo teve por objetivo estimar a prevalência e a distribuição geográfica do edentulismo na população idosa domiciliada nas capitais brasileiras e Distrito Federal, assim como testar a associação das desigualdades socioeconômicas contextuais e individuais com o edentulismo. Para isso, foram utilizados dados dos idosos de 65 a 74 anos que participaram da Pesquisa Nacional de Saúde Bucal – SB Brasil 2010 e que possuíam os dados completamente preenchidos para as variáveis investigadas (n=5435). Os indicadores sociais contextuais incluíram o Índice de Desenvolvimento Humano Municial (IDH-M) e o Índice de Gini. Outras variáveis contextuais avaliadas foram à cobertura de equipes de saúde bucal da Estratégia Saúde da Família (ESB/ESF) e a fluoretação da água de abastecimento. As variáveis individuais incluíram sexo, cor da pele, renda familiar, anos de estudos, número de moradores por cômodo e número de bens no domicílio. Modelos de regressão logística multinível foram usados para estimar odds ratios (OR) e intervalos de 95% de confiança (IC 95%) entre as variáveis contextuais e individuais e o edentulismo. A prevalência de edentulismo em idosos brasileiros foi de 68,6% (IC95% 64,9-72,2), com variações consideráveis entre as capitais brasileiras e o Distrito Federal. A variável de interação (IDH-M e renda familiar) foi, em todas as suas categorias, independentemente associada ao edentulismo. Dentre as variáveis individuais, verificou-se que indivíduos do sexo masculino (OR 0,60; IC95% 0,52-0,66) e com cor de pele preta ( OR 0,78; IC95% 0,63-0,96) apresentaram menores chances para o edentulismo, enquanto indivíduos com menor escolaridade (OR 4,46; IC95% 3,61-5,52) e com menor número de bens no domicílio (OR 1,30; IC95% 1,10-1,54) apresentaram maiores chances para perda dentária. Os resultados obtidos sugerem que o nível de desenvolvimento econômico contextual, bem como características individuais de posição social estão associados à prevalência de edentulismo.

The purpose of this thesis was to assess the prevalence and management of established cardiovascular (CV) risk factors and the prevalence and influence of self-reported markers (number of teeth and frequency of gum bleeding) of periodontal disease (PD), a less explored CV risk factor, in patients with stable chronic coronary heart disease (CHD). We studied patients from the global STabilization of Atherosclerotic plaque By Initiation of darapLadIb TherapY (STABILITY) trial (n=15,828), in which patients with stable chronic CHD were randomized to either darapladib or placebo. Our studies were performed using descriptive statistics and multivariable linear, logistic and Cox regression models. The use of secondary preventive medications was generally high across the whole study population. Despite this, CV risk factors were highly prevalent, including obesity, hypertension and hypercholesterolemia. Achievement of guideline-recommended treatment targets was lacking and little improvement was seen throughout the study duration. Approximately 40% of patients reported having <15 remaining teeth and 25% reported gum bleeding. More tooth loss was associated with a greater CV risk factor burden after adjustment, while the associations for gum bleeding were less evident. After multivariable adjustment for CV risk factors and socioeconomic status, more tooth loss was associated with an increased risk of major adverse CV events (a composite of CV death, myocardial infarction and stroke), CV mortality, all-cause mortality and fatal or non-fatal stroke. We found associations between a higher degree of tooth loss and elevated levels of several prognostic biomarkers known to reflect various pathophysiological mechanisms involved in CV morbidity and mortality. Most biomarkers had little attenuating effect on the relationship between tooth loss and outcomes in a multivariable model. In conclusion, we found an inadequate CV risk factor control despite a high use of evidence-based pharmacological therapies, likely to explain some of the excess risk in CHD patients. Further, we demonstrated a high prevalence of PD markers, tooth loss in particular, that were associated with a wide range of established CV risk factors, prognostic biomarkers and outcomes. Collectively, these findings indicate that tooth loss may be a significant risk factor among patients with stable chronic CHD.

No description available.

Background and hypothesis. Edentulous patients may be at risk for malnutrition and cardiovascular disease even with well made dentures. Improvements in methods used to assess nutritional status suggest that functional biomarkers such as plasma homocysteine (tHcy), in addition to traditional methods, will provide a better quality assessment. The hypothesis is that there is an association between functional biomarkers of nutritional status and traditional cardiovascular disease risk factors in a community dwelling edentulous elderly population. / Methods. This was a cross-sectional study of the baseline characteristics of a convenient sample of 254 edentulous community dwelling elderly over 65 years. Measurements included anthropometric, body composition, homocysteine, vitamins and relevant blood components. Correlations, multiple regression models and Adjusted Odds Ratios (AOR) for tertiles were used to assess the relationship between vitamins and other parameters with hyperhomocystenemia, defined as THcy value of ≥ 14mmol/L. The independent effect of edentulism on hyperhomocysteinemia was sought using the NHANES III data. / Results. The prevalence of hyperhomocysteinemia was 49.2%. Effect of folate on hyperhomocysteinemia was significant (p = 0.037). Low folate tertile group had a 2.45 times higher odds (CI: 1.23, 4.87) of hyperhomocysteinemia than patients in the higher tertile (p = 0.019). Groups with normal folate did not have higher odds of hyperhomocysteinemia regardless of levels of vitamin B6 or B12. AOR for vitamin B12 tertiles in relation to hyperhomocysteinemia were 2.36 (CI: 1.18, 4.75) and 2.12 (1.07, 4.22) for lower vs. high. A weak inverse relationship existed between tHcy and vitamin C (r= -0.11, p= 0.045). A borderline negative correlation existed between HDL and THcy adjusted for age (r = - 0.12; P = 0.05). Significant correlation existed between THcy and BMI (r = 0.15, P = 0.02), small waist circumference (r = 0.22; p = 0.0004) and waist/hip ratio (r = 0.23, p = 0.0003). In a multivariate analyses, edentulism was associated with hyperhomocysteinemia (p = 0.012). / Conclusions. In this sample, homocysteine levels appeared much higher than one would expect with folate fortification, and were related to several cardiovascular risk factors. Using data from NHANES III, edentulism was found to independently predict hyperhomocysteinemia. The inverse relationship between homocysteine and vitamin C and the effect of folate on hyperhomocysteinemia suggests that increasing dietary intake of fruit and vegetables in edentulous individuals might be beneficial. Furthermore, the latter are at risk of developing hyperhomocysteinemia, a condition associated with cognitive impairment, dementia and coronary artery disease risk.

Thesis (M.Sc. (Maxillofacial Prosthetics))--Mahidol University, 2008.

Reduction of oral health disparities is a worldwide goal because oral health has been shown to mimic individual and community health overall. At the end of the twentieth century, oral health made remarkable achievements; however, problems still remain in many communities around the world, especially within third world countries, such as those in South Asia. Member countries of the South-East Asia region of the World Health Organization (WHO) have stated that dental caries, tooth loss, periodontal disease, and oral cancer are some of the contending public health issues in their countries and action must be taken to reduce their numbers (WHO, 2008). The goals of this study are to determine what cultural aspects of the South Asian population aid in the increase of poor dental care in these communities. Our overall goal is to provide recommendations for a new oral health promotion program in South Asia that has been determined by understanding what cultural aspects are important in creating a successful dental care community program. As seen by the various studies, smokeless tobacco is a cultural norm in South Asia and is affecting the quality of life for many of the people there. Tobacco use is common but smokeless tobacco is becoming more prevalent in these countries. It is clear that with such statistics there is a need for governmental public programs to educate the population on the importance of proper oral care. This study analyzed the current literature to determine (i) what were the cultural aspects of South Asia that are detrimental to oral health, (ii) what is the oral health status of the individual countries found in South Asia, and lastly (iii) what aspects are necessary in creating an effective oral health program. The goal of this study is to determine what cultural aspects of the South Asian population contribute to poor dental care in these communities and to provide recommendations for a new oral health promotion program in South Asia that is strengthened by understanding what cultural aspects are important in creating a successful dental care community program. The conclusions presented here suggest an oral policy framework for the initiation of discussions aimed at designing and implementing an oral health program in their South-Asian country. Additionally, we suggest future directions once the guidelines are met. Overall, proper oral health should be enjoyed by all and this study aims to the aid the South Asian region’s governments towards moving forward in meeting those goals.