Made available in DSpace on 2014-06-11T19:33:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-03-26Bitstream added on 2014-06-13T20:45:02Z : No. of bitstreams: 1 vergani_sa_dr_arafo.pdf: 639289 bytes, checksum: 6483b0519cf455414c9e0881668e277f (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O objetivo do presente estudo foi o de avaliar os efeitos do controle de placa supragengival, em pacientes com doença periodontal crônica generalizada, por meio dos parâmetros clínicos microbiológicos e imunológicos. Foram selecionados 30 pacientes, com idade entre 32 e 59 anos, apresentando 4 bolsas entre 3 e 5mm e 4 bolsas entre 6 e 10mm e sem envolvimento sistêmico. Após o exame inicial, os pacientes foram submetidos a raspagem supragengival e receberam instruções de higiene oral, sendo acompanhados semanalmente por um período de 30 dias. Os parâmetros clínicos avaliados foram profundidade de sondagem, recessão gengival, índice de placa, índice gengival e sangramento à sondagem. Amostras de fluido crevicular das bolsas foram coletadas para análise da concentração dos mediadores de inflamação interleucina-1b e prostaglandina E2 e identificação pela reação de polimerase em cadeia dos microrganismos Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Prevotella intermedia e Prevotella nigrescens. Os resultados demonstraram a ocorrência de melhoras evidenciadas pelos parâmetros clínicos avaliados. Observou-se ainda uma redução significante no número de Porphyromonas gingivalis, Bacteroides forsythus, Prevotella intermedia e Prevotella nigrescens. O microrganismo A. actinomycetemcomitans não apresentou diferença significante. Para o exame imunológico não foram encontradas diferenças nos níveis de interleucina-1b, sendo constatado ainda um aumento nas concentrações de prostaglandina E2 nas bolsas de 6 a 10mm que apresentavam sangramento no final do tratamento. Concluiu-se que decisão da necessidade de tratamento periodontal em sítios profundos, após a realização do controle de placa supragengival, baseada somente na ausência de sangramento à sondagem pode subestimar... . / The aim of the present study was to evaluate the effect of supragingival plaque control, in patients with generalized chronic periodontal disease using clinical, microbiological and immunological parameters. 30 patients were selected, aged 32 to 59 years, presenting 4 periodontal pockets between 3 and 5mm and 4 pockets between 6 and 10mm. After initial exam patients received supragingival scaling and oral hygiene instructions, which were reinforced once a week for 30 days. Clinical parameters were probing depth, gingival resection, plaque index, gingival index and bleeding upon probing. Samples of crevicular fluid were taken for analyses of interleukin-1b and prostaglandin E2 and for identification by polymerase chain reaction of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Prevotella intermedia and Prevotella nigrescens. The results demonstrated an improvement of the clinical parameters. The microbiological findings indicate reduction of Porphyromonas gingivalis, Bacteroides forsythus, Prevotella intermedia, and Prevotella nigrescens. A. actinomycetemcomitans did not show significant difference. In regard to the immunological exam, no differences were observed in interleukin-1b concentration. Prostaglandin E2 concentrations were elevated in pockets between 6 and 10mm with persistent bleeding upon probing after treatment. In conclusion the decision for treatment needs after supragingival plaque control only based on the absence of bleeding upon probing might underestimate the periodontal disease activity.

Magister Scientiae Dentium - MSc(Dent) / The epidemiology of periodontal disease in the Republic of South Africa has received only scant attention in the past and consequently the available information is limited. The present study was therefore planned with the primary goal being to establish base-line information regarding periodontal disease in a portion of the population. The adolescent age group was selected as the target for the survey in that destructive periodontal disease (periodontitis) probably commences in many instances during the teenage years and therefore the group would be the one most likely to derive maximum benefit from preventive care and simple treatment measures which could be realistically provided by existing community dental health services. To translate the result into practicality a simple method of treatment needs estimation was also incorporated. In view of the diverse nature of the inhabitants of the Republic of South Africa and in keep with previously conducted studies, the presedt survey was confined to a single ethnic group. The population comprised all 3 .684 white pupils in Standard VIII attending the 34 schools in the Cape Peninsula during 1977. A random sample of 500 was selected for investigation. The average age of the sample was 15 years 9 months and the two sexes were equally represented. Only 7,2% were classified in the lower grade socio-economic class and thus were considered not to have a significant effect on the results. METHOD A team of three, consisting of the author and two assistants, visited each school. Portable equipment included a reclining chair, lighting, compressed air, and hand instruments. The investigation began with a questionnaire to establish the attitude to and experience of symptoms, prevention, and treatment of periodontal disease within the sample. Each subject was then examined and at each of 12 sites, on the 8 incisors and 4 first molars, recordings were made of plaque, gingivitis, supragingival calculus, subgingival calculus, and loss of attachment (periodontitis) according to defined criteria. A standard statistical package was used to analyse the recordings. RESULTS The questionnaire: This showed that almost all the subjects (98%) were interested in the prevention and treatment of periodontal disease in order to achieve and maintain oral health. Not with standing this.The overall prevalence of plaque was 97% and the mean Plaque Index (Pl.I) was 0,94 with 75% of the subjects having a mean Pl.I=0,5. The site prevalence data revealed that out of 12 sites, on average, 4 had Pl.I~O, 4 had Pl.I~l, and 4 had Pl.I~2. In the maxilla the molar sites had the higher plaque levels, whilst in the mandible the incisor sites had higher plaque levels. The sex-specific data showed the males to have higher mean plaque levels than the females, but in 50% of sample with a mean PI.I 0,5 to 1,45 there was ) had had any appurtenant treatment. The overall prevalence of plaque was 97% and the mean Plaque Index (Pl.I) was 0,94 with 75% of the subjects having a mean Pl.I=0,5. The site prevalence data revealed that out of 12 sites, on average, 4 had Pl.I~O, 4 had Pl.I~l, nd 4 had Pl.I~2. In the maxilla the molar sites had the higher plaque levels, whilst in the mandible the incisor sites had higher plaque levels. The sex-specific data showed the males to have higher mean plaque levels than the females, but in 50% of sample with a mean PI.I 0,5 to 1,45 there was no difference.

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Resumo: O objetivo do presente estudo foi o de avaliar os efeitos do controle de placa supragengival, em pacientes com doença periodontal crônica generalizada, por meio dos parâmetros clínicos microbiológicos e imunológicos. Foram selecionados 30 pacientes, com idade entre 32 e 59 anos, apresentando 4 bolsas entre 3 e 5mm e 4 bolsas entre 6 e 10mm e sem envolvimento sistêmico. Após o exame inicial, os pacientes foram submetidos a raspagem supragengival e receberam instruções de higiene oral, sendo acompanhados semanalmente por um período de 30 dias. Os parâmetros clínicos avaliados foram profundidade de sondagem, recessão gengival, índice de placa, índice gengival e sangramento à sondagem. Amostras de fluido crevicular das bolsas foram coletadas para análise da concentração dos mediadores de inflamação interleucina-1b e prostaglandina E2 e identificação pela reação de polimerase em cadeia dos microrganismos Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Prevotella intermedia e Prevotella nigrescens. Os resultados demonstraram a ocorrência de melhoras evidenciadas pelos parâmetros clínicos avaliados. Observou-se ainda uma redução significante no número de Porphyromonas gingivalis, Bacteroides forsythus, Prevotella intermedia e Prevotella nigrescens. O microrganismo A. actinomycetemcomitans não apresentou diferença significante. Para o exame imunológico não foram encontradas diferenças nos níveis de interleucina-1b, sendo constatado ainda um aumento nas concentrações de prostaglandina E2 nas bolsas de 6 a 10mm que apresentavam sangramento no final do tratamento. Concluiu-se que decisão da necessidade de tratamento periodontal em sítios profundos, após a realização do controle de placa supragengival, baseada somente na ausência de sangramento à sondagem pode subestimar... (Resumo completo, clicar acesso eletrônico abaixo). / Abstract: The aim of the present study was to evaluate the effect of supragingival plaque control, in patients with generalized chronic periodontal disease using clinical, microbiological and immunological parameters. 30 patients were selected, aged 32 to 59 years, presenting 4 periodontal pockets between 3 and 5mm and 4 pockets between 6 and 10mm. After initial exam patients received supragingival scaling and oral hygiene instructions, which were reinforced once a week for 30 days. Clinical parameters were probing depth, gingival resection, plaque index, gingival index and bleeding upon probing. Samples of crevicular fluid were taken for analyses of interleukin-1b and prostaglandin E2 and for identification by polymerase chain reaction of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Prevotella intermedia and Prevotella nigrescens. The results demonstrated an improvement of the clinical parameters. The microbiological findings indicate reduction of Porphyromonas gingivalis, Bacteroides forsythus, Prevotella intermedia, and Prevotella nigrescens. A. actinomycetemcomitans did not show significant difference. In regard to the immunological exam, no differences were observed in interleukin-1b concentration. Prostaglandin E2 concentrations were elevated in pockets between 6 and 10mm with persistent bleeding upon probing after treatment. In conclusion the decision for treatment needs after supragingival plaque control only based on the absence of bleeding upon probing might underestimate the periodontal disease activity. / Orientador: Rosemary Adriana Chiérici Marcantonio / Coorientador: Iracilda Zepponi Carlos / Banca: Carlos Rossa Júnior / Banca: Márcio Fernando de Moraes Grisi / Banca: Luciene Cristina de Figueiredo / Banca: Magda Feres / Doutor