Postgraduate Program in Dentistry of the Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, São Paulo, Brazil.
Department of Dentistry, Educational Foundation of Barretos, School of Dentistry, Barretos, São Paulo, Brazil.
J Periodontol. 2020 Sep;91(9):1123-1131. doi: 10.1002/JPER.19-0534. Epub 2020 Feb 26.
Obesity may represent a chronic low-grade inflammation, but there is a lack of long-term longitudinal studies. The aim of this longitudinal study was to evaluate the recurrence of periodontal disease in obese and normal weight patients submitted to scaling and root planing.
The study included 22 patients who had received periodontal treatment 2 years previously, 13 obese and nine non-obese. The patients were evaluated for anthropometric measurements of body mass index, waist circumference, waist-to-hip ratio, and fat percentage through bioimpedance. The following periodontal parameters were recorded: visible plaque index (VPI), gingival bleeding index (GBI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). The immunological evaluation analyzed the proinflammatory cytokines interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) in the gingival crevicular fluid (GCF).
Obese and normal weight patients did not differ in relation to the periodontal parameters of VPI, GBI, PD, CAL, or BOP 2 years after completion of the periodontal therapy. Sites with periodontitis in obese individuals showed higher levels of IL-6 and TNF-α in the gingival fluid (P <0.05).
Obese and normal weight individuals had similar periodontal behaviors, with low recurrence of the periodontal disease; however, obesity was related to increased inflammatory activity in gingival fluid, which may become a risk indicator for future greater recurrence of the disease in the presence of inadequate plaque control.
肥胖可能代表一种慢性低度炎症，但缺乏长期纵向研究。本纵向研究旨在评估接受牙周洁治和根面平整治疗的肥胖和正常体重患者牙周病的复发情况。
该研究纳入了 22 名患者，他们在 2 年前接受过牙周治疗，其中 13 名肥胖，9 名非肥胖。通过生物阻抗法评估患者的体重指数、腰围、腰臀比和体脂百分比等人体测量学指标。记录以下牙周参数：可见菌斑指数（VPI）、牙龈出血指数（GBI）、探诊深度（PD）、临床附着水平（CAL）和探诊出血（BOP）。免疫评估分析龈沟液（GCF）中的促炎细胞因子白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）。
肥胖和正常体重患者在牙周治疗完成 2 年后，VPI、GBI、PD、CAL 或 BOP 等牙周参数无差异。肥胖患者的牙周炎部位龈沟液中 IL-6 和 TNF-α水平更高（P<0.05）。
肥胖和正常体重患者的牙周行为相似，牙周病复发率较低；然而，肥胖与龈沟液中炎症活性增加有关，这可能成为在菌斑控制不足的情况下疾病复发风险增加的指标。
