Araújo Milena Moreira, Albuquerque Bárbara Nascimento, Cota Luís Otávio Miranda, Cortelli Sheila Cavalca, Cortelli José Roberto, Costa Fernando Oliveira
Department of Periodontology, UFMG Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Braz Dent J. 2019 Jul 22;30(4):342-349. doi: 10.1590/0103-6440201902480.
The aim of the present study was to compare periodontal conditions between intensive care unit (ICU) in-patients and non-ICU patients through clinical and microbiological periodontal parameters. This case-control study included 88 individuals hospitalized in ICU and 176 non-hospitalized controls. All individuals underwent a complete periodontal examination and microbiological sampling. The total bacterial load and counts of Porphyromonas gingivalis, Treponema denticola and Aggregatibacter actinomycetemcomitans were evaluated using qPCR. Data were analyzed through the Chi-square, Fisher exact, and t-Student tests, and the Spearman correlation, as appropriate. The prevalence of periodontitis was 39.7% among controls and 59.0% among ICU in-patients (OR=2.18; p=0.002). ICU in-patients had a significantly higher occurrence of cardiovascular disease (p=0.002; OR=2.20) and history of periodontal disease (p=0.031; OR=1.92) than controls. Bacterial counts of A. actinomycetemcomitans, T. denticola and P. gingivalis were significantly higher in ICU in-patients with periodontitis than in controls. The correlation between periodontal parameters and microbiological findings among cases and controls showed a significant and positive correlation between: total bacteria load and % of sites with probing depth (PD) ≥ 4 mm (cases: r=0.22 and controls: r=0.13) and P. gingivalis and % sites with bleeding on probing (BOP) (cases: r=0.22 and controls: r=0.23). Thus, ICU in-patients presented a higher prevalence of periodontitis and worse periodontal condition (higher mean plaque index, BOP, clinical attachment level ≥3 mm, and sites with PD 4 to 6 mm).
本研究的目的是通过临床和微生物学牙周参数，比较重症监护病房（ICU）住院患者和非ICU患者的牙周状况。这项病例对照研究纳入了88名在ICU住院的个体和176名非住院对照。所有个体均接受了全面的牙周检查和微生物采样。使用qPCR评估牙龈卟啉单胞菌、具核梭杆菌和伴放线聚集杆菌的总细菌载量和计数。根据情况，通过卡方检验、Fisher精确检验和t检验以及Spearman相关性分析数据。对照组中牙周炎的患病率为39.7%，ICU住院患者中为59.0%（比值比=2.18；p=0.002）。与对照组相比，ICU住院患者心血管疾病的发生率（p=0.002；比值比=2.20）和牙周疾病史（p=0.031；比值比=1.92）显著更高。患牙周炎的ICU住院患者中，伴放线聚集杆菌、具核梭杆菌和牙龈卟啉单胞菌的细菌计数显著高于对照组。病例组和对照组中牙周参数与微生物学结果之间的相关性显示，总细菌载量与探诊深度（PD）≥4mm的部位百分比之间存在显著正相关（病例组：r=0.22，对照组：r=0.13），牙龈卟啉单胞菌与探诊出血（BOP）部位百分比之间存在显著正相关（病例组：r=0.22，对照组：r=0.23）。因此，ICU住院患者牙周炎患病率更高，牙周状况更差（平均菌斑指数、BOP、临床附着水平≥3mm以及PD为4至6mm的部位更高）。
