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Eficácia do tratamento periodontal não cirúrgico na clínica de Pós-graduação de periodontologia da FMDUL
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Introdução: A terapia periodontal não cirúrgica compreende o controlo de placa supragengival pelo paciente, e a destartarização e alisamento radicular pelo clínico, com o objetivo de criar uma superfície que favoreça a inserção de fibras do ligamento periodontal, contribuindo na redução da profundidade de sondagem (PS). A resposta ao tratamento poderá ser inferior em determinados pacientes, nomeadamente fumadores e diabéticos, e em localizações de difícil acesso como molares e bolsas profundas.
Objetivo: Avaliar a eficácia do tratamento periodontal não cirúrgico e a existência de fatores que condicionam o seu sucesso como o tabagismo e o tipo de dente.
Materiais e Métodos: recolha de dados de processos clínicos de pacientes submetidos a terapia periodontal não cirúrgica como proporção das PS, PS média e índices de avaliação periodontal, nos momentos inicial e de reavaliação. Foram incluídos 1622 dentes naturais de 112 pacientes. As variáveis foram analisadas em função do tipo de dente e hábitos tabágicos.
Resultados: Houve maior redução na percentagem de bolsas ≥ 5mm em fumadores leves (-13,1±19,2 mm) que pesados (-6,2±8,5 mm), apesar de não ser estatisticamente significativa. Quanto ao tipo de dente, houve uma maior redução na percentagem de bolsas ≥ 5mm nos molares (-11,1±17,1 %), em relação aos pré-molares (-7,0±12,0 %) e anteriores (-8,3±12,8 %). Nos molares e pré-molares, as percentagens de bolsas residuais foram significativamente maiores para fumadores ≥10cig/dia (19,9 ±22,1 % e 36,0%±23,0 %, respetivamente), comparativamente com não fumadores (9,0±14,4 % e 22,6±19,1 %, respetivamente) e fumadores <10 cig/dia (9,9±12,8 % e 25,5±21,7 % respetivamente). Os pré-molares e anteriores obtiveram resposta semelhante, independentemente dos hábitos tabágicos.
Conclusão: A motivação do paciente para a descontinuação ou redução do consumo de tabaco para menos de 10 cigarros por dia é crucial para uma maior eficácia da terapia não cirúrgica.
Introduction: Non-surgical periodontal therapy comprises supragingival plaque control by the patient, and scaling and root planning by the clinician, with the aim of creating a surface that favours the insertion of periodontal ligament fibers, contributing to the reduction of probing depth (PD). The response to treatment may be lower in certain patients, namely smokers and diabetics, and in harder-to-reach locations such as molars and deep pockets. Aim: to evaluate the efficacy of non-surgical periodontal therapy and the existing factors that affect its success, such as smoking and the type of tooth. Materials and Methods: data was collected from clinical records of patients undergoing non- surgical periodontal therapy, like the proportion of PD, average PD and periodontal assessment indices, at baseline and revaluation. 1622 natural teeth (15732 sites) from 112 patients were included. The variables were analyzed depending on type of tooth and smoking habits. Results: There was a greater reduction in the percentage of pockets ≥ 5mm in light smokers (-13.1±19.2 mm) than heavy smokers (-6.2±8.5 mm), despite not being statistically significant. Regarding the type of teeth, there was a greater reduction in the percentage of pockets ≥ 5mm in molars (-11.1±17.1 %), comparing to premolars (-7.0 ± 12.0 %) and anterior teeth (-8.3±12.8%). In molars and premolars, the percentages of residual pockets were significantly higher for smokers ≥10cig/day (19.9 ±22.1% and 36.0%±23.0%, respectively), compared to non-smokers (9.0±14.4% and 22.6±19.1%, respectively) and smokers <10 cig/day (9.9±12.8% and 25.5±21.7%, respectively). Premolars and anterior teeth obtained a similar response, regardless of smoking habits. Conclusion: It is crucial to motivate patient motivation to discontinue or reduce tobacco consumption to less than 10 cigarettes per day for greater effectiveness of nonsurgical therapy.
Introduction: Non-surgical periodontal therapy comprises supragingival plaque control by the patient, and scaling and root planning by the clinician, with the aim of creating a surface that favours the insertion of periodontal ligament fibers, contributing to the reduction of probing depth (PD). The response to treatment may be lower in certain patients, namely smokers and diabetics, and in harder-to-reach locations such as molars and deep pockets. Aim: to evaluate the efficacy of non-surgical periodontal therapy and the existing factors that affect its success, such as smoking and the type of tooth. Materials and Methods: data was collected from clinical records of patients undergoing non- surgical periodontal therapy, like the proportion of PD, average PD and periodontal assessment indices, at baseline and revaluation. 1622 natural teeth (15732 sites) from 112 patients were included. The variables were analyzed depending on type of tooth and smoking habits. Results: There was a greater reduction in the percentage of pockets ≥ 5mm in light smokers (-13.1±19.2 mm) than heavy smokers (-6.2±8.5 mm), despite not being statistically significant. Regarding the type of teeth, there was a greater reduction in the percentage of pockets ≥ 5mm in molars (-11.1±17.1 %), comparing to premolars (-7.0 ± 12.0 %) and anterior teeth (-8.3±12.8%). In molars and premolars, the percentages of residual pockets were significantly higher for smokers ≥10cig/day (19.9 ±22.1% and 36.0%±23.0%, respectively), compared to non-smokers (9.0±14.4% and 22.6±19.1%, respectively) and smokers <10 cig/day (9.9±12.8% and 25.5±21.7%, respectively). Premolars and anterior teeth obtained a similar response, regardless of smoking habits. Conclusion: It is crucial to motivate patient motivation to discontinue or reduce tobacco consumption to less than 10 cigarettes per day for greater effectiveness of nonsurgical therapy.
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Teses de mestrado - 2022 Saúde Oral