Tratamento da periodontite agressiva e alterações nos compostos sulfurados voláteis
Abstract
O objetivo deste estudo foi avaliar o efeito do tratamento periodontal na produção de compostos sulfurados voláteis (CSV) em pacientes com periodontite agressiva. Foram incluídos 17 indivíduos (13-26 anos) com pelo menos um molar/incisivo com profundidade de sondagem (PS) e perda de inserção (PI) = 4 mm. O tratamento foi realizado em duas fases: tratamento da gengivite (controle de placa supragengival por 14 dias), e da periodontite (raspagem e alisamento radicular subgengival). Placa visível, sangramento gengival, PS e PI foram avaliados no início, após tratamento da gengivite, 3 e 6 meses após tratamento da periodontite. CSV foram medidos nos mesmos momentos com um monitor portátil de CSV (Halimeter). Alterações foram comparadas ao longo do estudo através do teste de Friedman. Associações entre variáveis clínicas e alterações nos CSV foram avaliadas com correlação de Pearson (r). Níveis de placa e gengivite reduziram significativamente ao longo dos 6 meses. Houve reduções significativas do início para o final do estudo em PS (3,2 ± 0,8 mm para 2,3 ± 0,3 mm; p < 0,001) e PI (1,6 ± 1,0 mm para 1,3 ± 0,9 mm; p < 0,001). Os níveis de CSV se mostraram reduzidos ao longo do estudo e não se alteraram significativamente (medianas: 34 ppb inicial, 36 ppb após controle de placa, 57 ppb 3 meses, 18 ppb 6 meses; p = 0,197). Indivíduos com maiores percentuais de placa antes do tratamento da periodontite demonstraram maiores reduções de CSV após o mesmo (r = 0,54; p = 0,024). Conclui-se que o tratamento periodontal não levou a alterações nos níveis de CSV em pacientes com periodontite agressiva.
UNITERMOS: halitose; periodontite agressiva; compostos sulfurados voláteis.
SUMMARY
Objectives: The aim of this study was to evaluate the effect of periodontal treatment on the production of volatile sulfur compounds (VSC) in young individuals with periodontitis. Methods: 12 individuals (13-26 years old) with at least one permanent first molar and/or incisor with probing depth (PD) ≥4 mm and clinical attachment loss (CAL) ≥4 mm were included in the study. All subjects had a 14-days initial program of supragingival scaling and plaque control. Subgingival scaling and root planing was performed in a subsequent period of 14 days. Presence of visible plaque (VP), gingival bleeding (GB), PD, CAL and bleeding on probing (BOP) were assessed at baseline, 14 days after supragingival plaque control and three months after subgingival therapy by one calibrated examiner. At the same intervals, levels of VSC were measured with a VSC portable monitor (Halimeter, Interscan TM). Clinical variables were compared using paired t test and VSC levels with Friedman’s test. Associations between VSC alterations and initial VP, GB, BOP, mean PD and percent of sites with PD ≥4 mm were assessed with Pearson’s correlation coefficient (r). Results: Periodontal treatment resulted in significant reductions in PD (6.55 ± 1.23 mm to 3.91 ± 0.75 mm) and CAL (5.19 ± 1.47 mm to 3.26 ± 1.61 mm). Initial low levels of VSC were observed in the sample (median 29.50, maximum and minimum 214-7). There were no significant differences between VSC levels at baseline, after supragingival plaque control and after three months (median, maximum and minimum: 29.50, 214, 7; 20.00, 156, 8; 35.00, 140, 11; respectively). It was observed a significant correlation between initial percent of sites with gingival bleeding and VSC reduction after treatment (r = 0.69, p = 0.01). Conclusions: Periodontal treatment did not promote alterations in VSC production in young individuals with periodontitis.
UNITERMS: halitosis, aggressive periodontitis, volatile sulfur compounds.
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