Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.09519
Revista de Odontologia da UNESP
Original Article

Perda de inserção periodontal e associações com indicadores de risco sociodemográficos e comportamentais

Periodontal attachment loss and associations with sociodemographic and behavioral risk indicators

Fernanda Cristina Figueira TEIXEIRA; Letícia MARÍN-LEÓN; Everton Padilha GOMES; Alice Moreira Neves PEDRÃO; Alexandre da Costa PEREIRA; Priscila Maria Bergamo Stolces FRANCISCO

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Resumo

Resumo: Introdução: A perda de inserção clínica periodontal (PIP) tem sido indicada como parâmetro determinante para o estudo de indicadores de risco de periodontite crônica.

Objetivo: Descrever a prevalência, severidade e extensão de PIP em um grupo populacional que se abstém de álcool e tabaco, além de avaliar associações com características sociodemográficas e comportamentais dos participantes.

Método: Uma amostra de 420 indivíduos adultos, participantes do Estudo Advento (São Paulo), foi submetida ao exame periodontal de seis sítios por dente e respondeu um questionário estruturado. As associações foram verificadas por meio de análise de regressão logística múltipla.

Resultado: A prevalência de periodontite foi de 20,7% e de gengivite, 38,8%; a PIP média foi de 1,38 mm (± 0,5) e a perda dental, 5,4 (± 9,0). A prevalência de PIP ≥ 3 mm, ≥ 4 mm e ≥ 6 mm foi de 69,7%, 31,7% e 9,6% dos indivíduos, e 11,4%, 4,4% e 1,2% dos dentes por indivíduo, respectivamente. Houve associação significativa de PIP ≥ 4 mm com sexo masculino, idade superior a 55 anos, baixa escolaridade, placa visível, autocuidado irregular, falta de orientação em higiene bucal e doença sistêmica referida. Para PIP ≥ 6 mm, foi observada maior razão de chances para as variáveis idade e doença sistêmica.

Conclusão: O grupo populacional estudado apresentou baixa extensão e severidade de PIP, possivelmente pelas características da amostra. As associações de risco encontradas confirmam a necessidade de atenção integral ao paciente, incluindo o incentivo à prevenção e ao controle de doenças crônicas, ao lado de orientações específicas para higiene bucal.

Palavras-chave

Periodontite, perda de inserção periodontal, epidemiologia, fatores de risco

Abstract

Abstract: Introduction: Clinical attachment loss (CAL) has been indicated as a determining parameter for the study of risk indicators of chronic periodontitis.

Objective: To describe the prevalence, severity and extent of CAL in a population group that abstains from alcohol and tobacco use and to evaluate associations with sociodemographic and behavioral characteristics of participants.

Method: A sample of 420 adult individuals, participants of the Advento Study (São Paulo) were submitted to a periodontal examination of six sites per tooth and answered a structured questionnaire. Associations were verified by multiple logistic regression analysis.

Result: Prevalence of periodontitis was 20.7% and gingivitis 38.8%; mean CAL was 1.38mm (±0.5) and dental loss 5.4 (±9.0). Prevalence of CAL ≥3 mm, ≥4 mm and ≥6 mm was 69.7%, 31.7% and 9.6% of the individuals, affecting 11.4%, 4.4% and 1.2% of the teeth per individual, respectively. After adjustments, there was a significant association of CAL ≥4 mm with males, over 55 years of age, low education, visible plaque, irregular self-care, lack of oral hygiene guidance and reported systemic disease. For CAL ≥6 mm, there was a higher odds ratio for the variables age group and systemic disease.

Conclusion: The population group studied presented low extension and severity of CAL, possibly due to the sample characteristics. The risk associations found confirm the need for comprehensive patient care, including encouraging prevention and control of chronic diseases, along with specific oral hygiene guidelines.
 

Keywords

Periodontitis, clinical attachment loss, epidemiology, risk factors

References

Steffens JP, Marcantonio RAC. Classificação das doenças e condições periodontais e peri-implantares 2018: guia prático e pontos-chave. Rev Odontol UNESP. 2018 Jul-Aug;47(4):189-97. http://dx.doi.org/10.1590/1807-2577.04704.

Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018;45(20 Suppl):S162-70. http://dx.doi.org/10.1111/jcpe.12946. PMid:29926490.

Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Clin Periodontol. 2018;45(20 Suppl):S149-61. http://dx.doi.org/10.1111/jcpe.12945. PMid:29926495.

Eke PI, Wei L, Thornton-Evans GO, Borrell LN, Borgnakke WS, Dye B, et al. Risk indicators for periodontitis in US adults: NHANES 2009 to 2012. J Periodontol. 2016 Oct;87(10):1174-85. http://dx.doi.org/10.1902/jop.2016.160013. PMid:27367420.

Albandar JM. Global risk factors and risk indicators for periodontal diseases. Periodontol 2000. 2002;29(1):177-206. http://dx.doi.org/10.1034/j.1600-0757.2002.290109.x. PMid:12102708.

Zeng J, Williams SM, Fletcher DJ, Cameron CM, Broadbent JM, Shearer DM, et al. Reexamining the association between smoking and periodontitis in the dunedin study with an enhanced analytical approach. J Periodontol. 2014 Oct;85(10):1390-7. http://dx.doi.org/10.1902/jop.2014.130577. PMid:24555730.

Wang J, Lv J, Wang W, Jiang X. Alcohol consumption and risk of periodontitis: a meta-analysis. J Clin Periodontol. 2016 Jul;43(7):572-83. http://dx.doi.org/10.1111/jcpe.12556. PMid:27029013.

Petersen PE, Ogawa H. The global burden of periodontal disese: towards integration with chronic disease prevention and control. Periodontol 2000. 2012 Oct;60(1):15-39. http://dx.doi.org/10.1111/j.1600-0757.2011.00425.x. PMid:22909104.

Oppermann RV, Haas AN, Rösing CK, Susin C. Epidemiology of periodontal diseases in adults from Latin America. Periodontol 2000. 2015 Feb;67(1):13-33. http://dx.doi.org/10.1111/prd.12061. PMid:25494596.

Eke PI, Dye BA, Wei L, Slade GD, Thornton-Evans GO, Borgnakke WS, et al. Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J Periodontol. 2015 May;86(5):611-22. http://dx.doi.org/10.1902/jop.2015.140520. PMid:25688694.

Leroy R, Eaton KA, Savage A. Methodological issues in epidemiological studies of periodontitis – how can it be improved? BMC Oral Health. 2010 Apr;10(1):8. http://dx.doi.org/10.1186/1472-6831-10-8. PMid:20409298.

Natto ZS, Abu Ahmad RHA, Alsharif LT, Alrowithi HF, Alsini DA, Salih HA, et al. Chronic periodontitis case definitions and confounders in periodontal research: a systematic assessment. Biomed Res Int. Nov; 2018:4578782. http://dx.doi.org/10.1155/2018/4578782. PMid: 30622957.

Holtfreter B, Albandar JM, Dietrich T, Dye BA, Eaton KA, Eke PI, et al. Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies. Proposed standards from the joint EU/USA Periodontal Epidemiology Working Group. J Clin Periodontol. 2015 May;42(5):407-12. http://dx.doi.org/10.1111/jcpe.12392. PMid:25808877.

Eke PI, Page RC, Wei L, Thorton-Evans GO, Genco RJ. Update of case definitions for population-based surveillance of periodontitis. J Periodontol. 2012 Dec;83(12):1449-54. http://dx.doi.org/10.1902/jop.2012.110664. PMid:22420873.

Brasil. Ministério da Saúde. Divisão Nacional de Saúde Bucal. Projeto SBBrasil 2010: Pesquisa Nacional de Saúde Bucal – Resultados principais. Brasília 2011. 92 p.[citado 2017 Out 27]. Disponível em: dab.saude.gov.br/cnsb/sbbrasil/arquivos/projeto_sb 2010.‬‬‬‬‬‬‬‬‬‬‬‬

Susin C, Vecchia CFD, Oppermann RV, Haugejorden O, Albandar JM. Periodontal attachment loss in a urban population of Brazilian adults: effect of demographic, behavioral and environment risk indicators. J Periodontol. 2004 Jul;75(7):1033-41. http://dx.doi.org/10.1902/jop.2004.75.7.1033. PMid:15341364.

Ragghianti MS, Greghi SLA, Lauris JRP, Sant’Ana ACP, Passanezi E. Influence of age,sex, plaque and smoking on periodontal conditions in a population from Bauru, Brazil. J Appl Oral Sci. 2004 Dec;12(4):273-9. http://dx.doi.org/10.1590/S1678-77572004000400004. PMid:20976396.

Lorenzo SM, Alvarez R, Andrade E, Piccardo V, Francia A, Massa F, et al. Periodontal conditions and associated factors among adults and the elderly: findings from the first National Oral Health Survey in Uruguay. Cad Saude Publica. 2015 Nov;31(11):2425-36. http://dx.doi.org/10.1590/0102-311X00012115. PMid:26840821.

Frias AC, Pereira AC, Vieira V. Pesquisa estadual de saúde bucal (SB São Paulo): relatório final. Águas de São Pedro: Livro novo, 2016. 97p. [citado 2017 Set]. Disponível em: http://www.saude.sp.gov.br/ses/perfil/profissional-da-saude/areas-tecnicas-da-sessp/saude-bucal/sb-sao-paulo-2015-pesquisa-estadual-de-saude-bucal-relatorio-final.

Oliveira ERA, Cade NV, Velten APC, Silva GA, Faerstein E. Estudo comparativo da mortalidade cardiovascular e por neoplasia de Adventistas e Não Adventistas do Estado do Espírito Santo, no período de 2003 a 2009. Rev Bras Epidemiol. 2016 Mar;19(1):112-21. http://dx.doi.org/10.1590/1980-5497201600010010. PMid:27167653.

Orlich MJ, Singh PN, Sabaté J, Jaceldo-Siegl K, Fan J, Knutsen S, et al. Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Intern Med. 2013 Jul;173(13):1230-8. http://dx.doi.org/10.1001/jamainternmed.2013.6473. PMid:23836264.

Shiau HJ, Reynolds MA. Sex differences in destructive periodontal disease: a systematic review. J Periodontol. 2010 Oct;81(10):1379-89. http://dx.doi.org/10.1902/jop.2010.100044. PMid:20450376.

Peres MA, Antunes JL, Boing AF, Peres KG, Bastos JL. Skin colour is associated with periodontal disease in Brazilian adults: a population-based oral health survey. J Clin Periodontol. 2007 Mar;34(3):196-201. http://dx.doi.org/10.1111/j.1600-051X.2006.01043.x. PMid:17257159.

Vettore MV, Marques RA, Peres MA. Social inequalities and periodontal disease: multilevel approach in SBBrasil 2010 survey. Rev Saúde Pública. 2013 Dec;47(Suppl 3):29-39. http://dx.doi.org/10.1590/S0034-8910.2013047004422. PMidD: 24626579.

Garcia A, Clavijo EMA, Flório FM, Okajima LS, Fonseca-Silva AS. Perception assessment of periodontal patients regarding their self-care. RGO Rev Gaúch Odontol. 2014 Jun;62(2):153-8. http://dx.doi.org/10.1590/1981-8637201400020000081192.
 

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