Roberta Tunes | Escola Bahiana de Medicina e Saúde Pública (original) (raw)
Papers by Roberta Tunes
Journal of Periodontology, 2007
Background: The subepithelial connective tissue graft (SCTG) is one of the most used and predicta... more Background: The subepithelial connective tissue graft (SCTG) is one of the most used and predictable periodontal plastic surgery procedures; reports of late complications are very rare. This article presents an SCTG case with a previously unreported late complication of epithelial origin, and we suggest a potential link between the patient's dermatologic condition and this complication. Late SCTG complications also are reviewed.Methods: A 19‐year‐old female presented with a 3‐mm deep Miller Class I recession defect on the mandibular right central incisor. An SCTG procedure was performed for root coverage, with uneventful initial postoperative healing that resulted in complete root coverage. At 4 months, an asymptomatic solid white discharge was observed at sites along the original graft margin without evidence of inflammation. A month later, the somewhat reduced but still evident discharge was collected and submitted for microscopic examination.Results: Cytologic examination rev...
OBJECTIVE: Th is study evaluated the presence of halitosis and alterations in salivary parameters... more OBJECTIVE: Th is study evaluated the presence of halitosis and alterations in salivary parameters in individuals with type 2 diabetes mellitus (DM) and periodontitis (P). MATERIAL AND METHODS: Patients with the following characteristics of both sexes were screened: Group (G)1: 16 patients with DM and with P; G2: 11 patients with DM and without periodontitis; G3: 14 non-diabetic patients with P and G4:15 non-diabetic patients without periodontitis. Physical and laboratory tests were performed, as well as analysis of tongue coating, halitometry and salivary parameters. RESULTS: Th is study showed positive and signifi cant correlations between periodontal parameters and tongue coating with volatile sulfur compounds (VSC) concentrations. Diabetic individuals showed higher levels of salivary urea (p = 0.018) and total protein (p = 0.001), as well as lower calcium levels (p = 0.0001). Groups G1, G2 e G3 showed higher values of salivary phosphate (p = 0.0001). However, there were no signifi cant diff erences between the groups regarding halitosis, salivary fl ow and buff er capacity (p = 0.95, p = 0.06, p = 0.318, respectively). CONCLUSIONS: DM and/or periodontitis infl uenced the presence of tongue coating, which was correlated with VSC parameters. However, DM and periodontitis did not directly infl uence halitosis as well as salivary parameters.
OBJECTIVE: The clinical management of the interrelationship between diabetes and periodontitis is... more OBJECTIVE: The clinical management of the interrelationship between diabetes and periodontitis is a challenge for all parties involved in health care. For this reason, this project aims to provide subsidies for the implementation of routines that increase the partnership between endocrinologists, periodontists, and other health professionals in the patient care team. MATERIAL AND METHODS: The Brazilian Society of Periodontology – SOBRAPE and the Brazilian Society of Endocrinology and Metabolism – SBEM appointed specific committees to develop joint guidelines addressing the interrelationship between diabetes and periodontitis. Results: Guidelines were developed for patients, physicians, dentists, and teams working in the Unified Health System. CONCLUSION: The application of the guidelines can provide a complete approach to patients with diabetes and periodontitis, with a consequent improvement in quality of life, and an improvement in medical parameters, with possible cost reduction for all medical and dental activities.
Brazilian Oral Research, 2007
Revista da Faculdade de Odontologia da Universidade Federal da Bahia, Jun 3, 2020
Anais da Faculdade de Odontologia de Ribeirão Preto da Universidade de São Paulo, 2002
PubMed, 2010
Wide-ranging activation of the innate immune system causing chronic low-grade inflammation is clo... more Wide-ranging activation of the innate immune system causing chronic low-grade inflammation is closely involved not only in the pathogenesis of type 2 diabetes mellitus and its complications, through an ongoing cytokine-induced acute-phase response, but also in the pathogenesis of periodontal diseases, whereby cytokines play a central role in the host's response to the periodontal biofilm. Although there is extensive knowledge about the pathways through which diabetes affects periodontal status, less is known about the impact of periodontal diseases on the diabetes-related inflammatory state. This review attempts to explain the immunobiological connection between periodontal diseases and type 2 diabetes mellitus, exploring the mechanisms through which periodontal infection can contribute to the low-grade general inflammation associated with diabetes (thus aggravating insulin resistance) and discussing the impact of periodontal treatment on glycemic control in people living with both diabetes and periodontal disease.
Anais da Faculdade de Odontologia de Ribeirão Preto da Universidade de São Paulo, 2002
Journal of Dentistry & Public Health, Jun 25, 2018
Revista Odontológica do Brasil Central, Aug 25, 2017
Dedico este trabalho, À Deus, Que me deu o maior dos presentes, o dom da vida, e cuja fé me dá fo... more Dedico este trabalho, À Deus, Que me deu o maior dos presentes, o dom da vida, e cuja fé me dá força e coragem para vivê-la como se os milagres não existissem, mas também esperança, alegria e sabedoria para vivê-la como se tudo fosse um milagre.
Diabetes mellitus (DM) and periodontal disease (PD) are chronic disorders that are interrelated. ... more Diabetes mellitus (DM) and periodontal disease (PD) are chronic disorders that are interrelated. There is an bidirectional relation between both the diseases, in which the DM is a risk factor that favors the progression of PD, while the PD can worse the glycemic control in diabetics. Despite of the association between DM and PD, it seems relevant the relationship between gestatational diabetes mellitus (GDM) and PD, since it was observed that pregnants with GDM presents higher prevalence of PD than those whithout the disease. Therefore, the aim of this paper is to review the literature about of the relationship between chronic PD and GDM. The DM induces changes in the periodontum, interfering in the function of neutrophils and macrophages. In the same way, PD can contribute the dissemination by bloodstream, of inflammatory mediators that can induce a systemic inflammatory state, increasing insulin resistence and worsening the glycemic control in diabetics. During pregnancy, there may be na intense inflammation in the periodontal tissue, due to higher levels of estrogen and progesterone. Besides the hormonal changes, there is a higher maternal insulin resistence, that act like na physiological mechanism to assure adequate supply of carbohydrates to the fetus, and can contribute to a sensitivity reduction of insulin action. It is suggested that PD can intensify the low insulin sensitivity resulted from the pregnancy, contributing to the glucose intolerance and GDM. Therefore, existing a biological plausibility to the relationship between PD and GDM, it is possible to exist an association between both diseases.
Brazilian Journal of Periodontology
OBJECTIVE: The clinical management of the interrelationship between diabetes and periodontitis is... more OBJECTIVE: The clinical management of the interrelationship between diabetes and periodontitis is a challenge for all parties involved in health care. For this reason, this project aims to provide subsidies for the implementation of routines that increase the partnership between endocrinologists, periodontists, and other health professionals in the patient care team. MATERIAL AND METHODS: The Brazilian Society of Periodontology – SOBRAPE and the Brazilian Society of Endocrinology and Metabolism – SBEM appointed specific committees to develop joint guidelines addressing the interrelationship between diabetes and periodontitis. Results: Guidelines were developed for patients, physicians, dentists, and teams working in the Unified Health System. CONCLUSION: The application of the guidelines can provide a complete approach to patients with diabetes and periodontitis, with a consequent improvement in quality of life, and an improvement in medical parameters, with possible cost reduction ...
Orientadores: Getulio da Rocha Nogueira Filho, Maria Cristina Foss de FreitasTese (doutorado) - U... more Orientadores: Getulio da Rocha Nogueira Filho, Maria Cristina Foss de FreitasTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Este estudo objetiva verificar a influência sistêmica da periodontite crônica severa frente ao controle metabólico bem como do tratamento periodontal na resposta imunológica de indivíduos diabéticos tipo 2 através da análise da expressão gênica e protéica de citocinas por células mononucleares aderentes de sangue periférico. Foram selecionados 20 pacientes divididos em: grupo teste - 10 diabéticos tipo 2 com periodontite crônica severa e controle metabólico inadequado; grupo controle - 10 diabéticos tipo 2 sem periodontite e controle metabólico inadequado. Primeiramente, os pacientes foram hospitalizados por 8 dias para a obtenção de um controle metabólico adequado, permanecendo inalterada a condição periodontal nesta fase. Posteriormente, o grupo teste foi submetido à terapia mecânica em estágio único associ...
Journal of Periodontology, 2007
Background: The subepithelial connective tissue graft (SCTG) is one of the most used and predicta... more Background: The subepithelial connective tissue graft (SCTG) is one of the most used and predictable periodontal plastic surgery procedures; reports of late complications are very rare. This article presents an SCTG case with a previously unreported late complication of epithelial origin, and we suggest a potential link between the patient's dermatologic condition and this complication. Late SCTG complications also are reviewed.Methods: A 19‐year‐old female presented with a 3‐mm deep Miller Class I recession defect on the mandibular right central incisor. An SCTG procedure was performed for root coverage, with uneventful initial postoperative healing that resulted in complete root coverage. At 4 months, an asymptomatic solid white discharge was observed at sites along the original graft margin without evidence of inflammation. A month later, the somewhat reduced but still evident discharge was collected and submitted for microscopic examination.Results: Cytologic examination rev...
OBJECTIVE: Th is study evaluated the presence of halitosis and alterations in salivary parameters... more OBJECTIVE: Th is study evaluated the presence of halitosis and alterations in salivary parameters in individuals with type 2 diabetes mellitus (DM) and periodontitis (P). MATERIAL AND METHODS: Patients with the following characteristics of both sexes were screened: Group (G)1: 16 patients with DM and with P; G2: 11 patients with DM and without periodontitis; G3: 14 non-diabetic patients with P and G4:15 non-diabetic patients without periodontitis. Physical and laboratory tests were performed, as well as analysis of tongue coating, halitometry and salivary parameters. RESULTS: Th is study showed positive and signifi cant correlations between periodontal parameters and tongue coating with volatile sulfur compounds (VSC) concentrations. Diabetic individuals showed higher levels of salivary urea (p = 0.018) and total protein (p = 0.001), as well as lower calcium levels (p = 0.0001). Groups G1, G2 e G3 showed higher values of salivary phosphate (p = 0.0001). However, there were no signifi cant diff erences between the groups regarding halitosis, salivary fl ow and buff er capacity (p = 0.95, p = 0.06, p = 0.318, respectively). CONCLUSIONS: DM and/or periodontitis infl uenced the presence of tongue coating, which was correlated with VSC parameters. However, DM and periodontitis did not directly infl uence halitosis as well as salivary parameters.
OBJECTIVE: The clinical management of the interrelationship between diabetes and periodontitis is... more OBJECTIVE: The clinical management of the interrelationship between diabetes and periodontitis is a challenge for all parties involved in health care. For this reason, this project aims to provide subsidies for the implementation of routines that increase the partnership between endocrinologists, periodontists, and other health professionals in the patient care team. MATERIAL AND METHODS: The Brazilian Society of Periodontology – SOBRAPE and the Brazilian Society of Endocrinology and Metabolism – SBEM appointed specific committees to develop joint guidelines addressing the interrelationship between diabetes and periodontitis. Results: Guidelines were developed for patients, physicians, dentists, and teams working in the Unified Health System. CONCLUSION: The application of the guidelines can provide a complete approach to patients with diabetes and periodontitis, with a consequent improvement in quality of life, and an improvement in medical parameters, with possible cost reduction for all medical and dental activities.
Brazilian Oral Research, 2007
Revista da Faculdade de Odontologia da Universidade Federal da Bahia, Jun 3, 2020
Anais da Faculdade de Odontologia de Ribeirão Preto da Universidade de São Paulo, 2002
PubMed, 2010
Wide-ranging activation of the innate immune system causing chronic low-grade inflammation is clo... more Wide-ranging activation of the innate immune system causing chronic low-grade inflammation is closely involved not only in the pathogenesis of type 2 diabetes mellitus and its complications, through an ongoing cytokine-induced acute-phase response, but also in the pathogenesis of periodontal diseases, whereby cytokines play a central role in the host's response to the periodontal biofilm. Although there is extensive knowledge about the pathways through which diabetes affects periodontal status, less is known about the impact of periodontal diseases on the diabetes-related inflammatory state. This review attempts to explain the immunobiological connection between periodontal diseases and type 2 diabetes mellitus, exploring the mechanisms through which periodontal infection can contribute to the low-grade general inflammation associated with diabetes (thus aggravating insulin resistance) and discussing the impact of periodontal treatment on glycemic control in people living with both diabetes and periodontal disease.
Anais da Faculdade de Odontologia de Ribeirão Preto da Universidade de São Paulo, 2002
Journal of Dentistry & Public Health, Jun 25, 2018
Revista Odontológica do Brasil Central, Aug 25, 2017
Dedico este trabalho, À Deus, Que me deu o maior dos presentes, o dom da vida, e cuja fé me dá fo... more Dedico este trabalho, À Deus, Que me deu o maior dos presentes, o dom da vida, e cuja fé me dá força e coragem para vivê-la como se os milagres não existissem, mas também esperança, alegria e sabedoria para vivê-la como se tudo fosse um milagre.
Diabetes mellitus (DM) and periodontal disease (PD) are chronic disorders that are interrelated. ... more Diabetes mellitus (DM) and periodontal disease (PD) are chronic disorders that are interrelated. There is an bidirectional relation between both the diseases, in which the DM is a risk factor that favors the progression of PD, while the PD can worse the glycemic control in diabetics. Despite of the association between DM and PD, it seems relevant the relationship between gestatational diabetes mellitus (GDM) and PD, since it was observed that pregnants with GDM presents higher prevalence of PD than those whithout the disease. Therefore, the aim of this paper is to review the literature about of the relationship between chronic PD and GDM. The DM induces changes in the periodontum, interfering in the function of neutrophils and macrophages. In the same way, PD can contribute the dissemination by bloodstream, of inflammatory mediators that can induce a systemic inflammatory state, increasing insulin resistence and worsening the glycemic control in diabetics. During pregnancy, there may be na intense inflammation in the periodontal tissue, due to higher levels of estrogen and progesterone. Besides the hormonal changes, there is a higher maternal insulin resistence, that act like na physiological mechanism to assure adequate supply of carbohydrates to the fetus, and can contribute to a sensitivity reduction of insulin action. It is suggested that PD can intensify the low insulin sensitivity resulted from the pregnancy, contributing to the glucose intolerance and GDM. Therefore, existing a biological plausibility to the relationship between PD and GDM, it is possible to exist an association between both diseases.
Brazilian Journal of Periodontology
OBJECTIVE: The clinical management of the interrelationship between diabetes and periodontitis is... more OBJECTIVE: The clinical management of the interrelationship between diabetes and periodontitis is a challenge for all parties involved in health care. For this reason, this project aims to provide subsidies for the implementation of routines that increase the partnership between endocrinologists, periodontists, and other health professionals in the patient care team. MATERIAL AND METHODS: The Brazilian Society of Periodontology – SOBRAPE and the Brazilian Society of Endocrinology and Metabolism – SBEM appointed specific committees to develop joint guidelines addressing the interrelationship between diabetes and periodontitis. Results: Guidelines were developed for patients, physicians, dentists, and teams working in the Unified Health System. CONCLUSION: The application of the guidelines can provide a complete approach to patients with diabetes and periodontitis, with a consequent improvement in quality of life, and an improvement in medical parameters, with possible cost reduction ...
Orientadores: Getulio da Rocha Nogueira Filho, Maria Cristina Foss de FreitasTese (doutorado) - U... more Orientadores: Getulio da Rocha Nogueira Filho, Maria Cristina Foss de FreitasTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Este estudo objetiva verificar a influência sistêmica da periodontite crônica severa frente ao controle metabólico bem como do tratamento periodontal na resposta imunológica de indivíduos diabéticos tipo 2 através da análise da expressão gênica e protéica de citocinas por células mononucleares aderentes de sangue periférico. Foram selecionados 20 pacientes divididos em: grupo teste - 10 diabéticos tipo 2 com periodontite crônica severa e controle metabólico inadequado; grupo controle - 10 diabéticos tipo 2 sem periodontite e controle metabólico inadequado. Primeiramente, os pacientes foram hospitalizados por 8 dias para a obtenção de um controle metabólico adequado, permanecendo inalterada a condição periodontal nesta fase. Posteriormente, o grupo teste foi submetido à terapia mecânica em estágio único associ...