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Sinada N, Wang CI. Fixed prosthodontic rehabilitation of a patient after bariatric surgery using a facially driven fully digital workflow: A clinical report with a 3-year follow-up. J Prosthet Dent 2024:S0022-3913(24)00139-2. [PMID: 38556404 DOI: 10.1016/j.prosdent.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 04/02/2024]
Abstract
Patients who have received bariatric surgery have specific and complex dental needs. After surgery, nutrient deficiencies, osteoporosis, gastroesophageal reflux, and changes to the oral cavity may be seen, and erosion, caries, wear, xerostomia, hypersensitivity, and changes to the salivary buffering capacity may occur. In addition, patients are advised to ingest smaller, more frequent, meals throughout the day, and the oral condition may decline rapidly after surgery. Without oversight, this accelerated decline may even necessitate complete mouth rehabilitation postoperatively. Dental providers should be an integral part of the multidisciplinary management team of these patients. This clinical report describes a patient with a terminal dentition following bariatric surgery who underwent prosthodontic rehabilitation with a facially driven fully digital workflow.
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Marquezin MCS, Chaves-Júnior SDC, Rasera I, Pacheco ERP, Gavião MBD, Lamy E, Castelo PM. Oral Health and Nutritional Characteristics of Adults With Morbid Obesity: A Multivariate Analysis. Front Nutr 2020; 7:589510. [PMID: 33330590 PMCID: PMC7714904 DOI: 10.3389/fnut.2020.589510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/09/2020] [Indexed: 12/25/2022] Open
Abstract
The relationship between oral health and nutritional aspects are complex, especially in individuals with chronic diseases and comorbidities, such as morbid obesity. Thus, the aim of the present study was to identify oral health and nutritional-related patterns in 113 individuals, aged 19–68 years (92 females), seeking treatment for morbid obesity. Sociodemographic variables and medical records were examined, in addition to the consumption of fruit, vegetables, candies, and processed foods. Measures of body mass index, neck, waist and hip, caries experience (DMFT index), Community Periodontal Index (CPI index), and salivary physicochemical aspects were gathered. Aspects of oral health-related quality of life and symptoms of dry mouth were evaluated by means of Oral Health Impact Profile (OHIP-14) and Xerostomia Inventory-XI questionnaires. K-means cluster analysis and, subsequently, comparisons between clusters (one-way ANOVA) were performed (α = 5%). Three clusters were generated: Cluster 1 (labeled “Young”; n = 77) was characterized by younger participants with higher BMI, who reported the use of distractors while eating, the smallest number of meals/day, and who consumed sweetened drinks and processed food the day before. Cluster 2 (labeled “Diabetic individuals”; n = 12) was characterized by older participants with the highest proportion of diabetic participants (100% were diabetic; 73% insulin users), lower BMI, higher DMFT index and OHIP-14 and xerostomia scores, and who reported having consumed fruit and vegetables the day before. Finally, Cluster 3 (labeled “Poor periodontal health”; n = 24) was characterized by participants with the worse periodontal condition (higher CPI), and lower salivary flow, pH, and buffer capacity. Cluster 1 and 2 were the groups that showed higher demand for nutritional and dietetic counseling, because of the poor eating behavior and higher serum glucose levels, respectively. On the other hand, Cluster 2 and 3 showed the higher demand for oral rehabilitation and dental treatment because of the loss of teeth and worse periodontal condition, respectively, besides the need for dietetic counseling. This sample of individuals with morbid obesity showed very unique oral-health and nutritional characteristics and special needs patterns that should be identified to adjust or change unhealthy habits, thus improving the assistance of this condition.
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Affiliation(s)
- Maria Carolina Salomé Marquezin
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Irineu Rasera
- Piracicaba Medical School, Anhembi Morumbi University, São Paulo, Brazil
| | | | - Maria Beatriz Duarte Gavião
- Department of Pediatric Dentistry, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Elsa Lamy
- MED Mediterranean Institute for Agriculture, Environment and Development, University of Évora, Évora, Portugal
| | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Foratori‐Junior GA, Máscoli LS, Jesuino BG, Missio ALT, Sales‐Peres SHDC. Evaluation of systemic conditions, tooth loss, body image, and quality of life of women with obesity and women who underwent gastric bypass surgery. Spec Care Dentist 2020; 40:151-159. [DOI: 10.1111/scd.12453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Gerson Aparecido Foratori‐Junior
- Department of Pediatric DentistryOrthodontics and Public HealthBauru School of DentistryUniversity of São Paulo Bauru São Paulo Brazil
- University of Integrated Faculties of Ourinhos Ourinhos São Paulo Brazil
| | - Leonardo Silva Máscoli
- Department of Pediatric DentistryOrthodontics and Public HealthBauru School of DentistryUniversity of São Paulo Bauru São Paulo Brazil
| | - Bruno Gualtieri Jesuino
- Department of Pediatric DentistryOrthodontics and Public HealthBauru School of DentistryUniversity of São Paulo Bauru São Paulo Brazil
| | - Alana Luiza Trenhago Missio
- Department of Pediatric DentistryOrthodontics and Public HealthBauru School of DentistryUniversity of São Paulo Bauru São Paulo Brazil
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Castilho AVSS, Foratori-Junior GA, Sales-Peres SHDC. BARIATRIC SURGERY IMPACT ON GASTROESOPHAGEAL REFLUX AND DENTAL WEAR: A SYSTEMATIC REVIEW. ACTA ACUST UNITED AC 2019; 32:e1466. [PMID: 31859919 PMCID: PMC6918764 DOI: 10.1590/0102-672020190001e1466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/09/2019] [Indexed: 12/18/2022]
Abstract
Introduction: Several oral problems may be perceived in individuals who were submitted to bariatric surgery, due to metabolic and behavioral changes relative to diet and oral hygiene. Tooth wear appears to suffer impact after bariatric surgery, because there may be an increase in gastroesophageal reflux. Objective: To systematically review the literature regarding the impact of bariatric surgery on gastroesophageal reflux and tooth wear. Method: The following databases were accessed by two independent, calibrated examiners: PubMed, Medline, Lilacs, Scielo and Cochrane using the following descriptors: “bariatric surgery” AND “dental erosion” OR “bariatric surgery” AND “dental erosion” AND “gastroesophageal reflux disease”. After excluding duplicate studies, 12 studies were initially evaluated by the title and abstract. The excluded studies were those without relevance to the present research, literature review studies and case reports. Thus, four articles were included in this study. All the articles evaluated indicated high association between gastroesophageal reflux and tooth wear in patients submitted to bariatric surgery. Association of these outcomes was more evident six months after the surgical procedure. Conclusion: Patients submitted to bariatric surgery showed higher prevalence of gastroesophageal reflux and tooth wear.
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Affiliation(s)
| | - Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Aznar FD, Aznar FD, Lauris JR, Chaim EA, Cazzo E, Sales-Peres SHDC. DENTAL WEAR AND TOOTH LOSS IN MORBID OBESE PATIENTS AFTER BARIATRIC SURGERY. ACTA ACUST UNITED AC 2019; 32:e1458. [PMID: 31826085 PMCID: PMC6902887 DOI: 10.1590/0102-672020190001e1458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/16/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Obesity and its surgical treatment have been related with oral diseases. Aim: To evaluate and compare dental wear and dental loss in eutrophic and morbidly obese patients submitted to Roux-en-Y gastric bypass. METHOD Observational and analytical study with gender and age matching. The sample consisted of 240 patients, divided into four groups: eutrophic (GC=60), morbidly obese (GO=60), operated with up to 24 months (G24=60) and operated on for more than 36 months (G36=60). The following variables were analyzed: race, schooling, economic class, hypertension, diabetes, triglycerides, cholesterol, BMI, weight loss, waist-hip ratio, smoking, alcoholism, tooth loss and tooth wear. RESULTS GO presented lower economic class (p=0.012), hypertension (p<0.001), diabetes (p<0.001), cholesterol (p=0.001), BMI (p<0.001), waist-hip ratio (p<0.001) and percentage of weight loss percent (p<0.001) than groups G24 and G36. Dental wear was higher among the II and V sextants. CONCLUSION Individuals submitted to Roux-en-Y gastric bypass, regardless of the surgery period, presented more dental wear on the incisal/occlusal surfaces, and the anterior teeth were the most affected. Dental wear was associated with age and number of missing teeth.
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Affiliation(s)
- Fabiano Duarte Aznar
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Faculty of Dentistry of Bauru, University of São Paulo, Bauru, SP; Brazil
| | - Fabio D Aznar
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Faculty of Dentistry of Bauru, University of São Paulo, Bauru, SP; Brazil
| | - José R Lauris
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Faculty of Dentistry of Bauru, University of São Paulo, Bauru, SP; Brazil
| | - Elinton Adami Chaim
- Department of Surgery, Faculty of Medicine, University of Campinas, Campinas, SP, Brazil
| | - Everton Cazzo
- Department of Surgery, Faculty of Medicine, University of Campinas, Campinas, SP, Brazil
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Denucci GC, Mantilla TF, Amaral F, Basting RT, França F, Turssi CP. Saliva with reduced calcium and phosphorous concentrations: Effect on erosion dental lesions. Oral Dis 2018; 24:957-963. [PMID: 29423930 DOI: 10.1111/odi.12843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 12/27/2017] [Accepted: 01/31/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate whether saliva formulations with reduced calcium (Ca) and inorganic phosphorous (Pi) concentration would affect dental erosion caused by hydrochloric acid (HCl). METHODS Enamel and root dentine bovine slabs were embedded, polished, and measured for surface Knoop microhardness (SMH). After reference areas were created, specimens were exposed to HCl solution (0.01 M; pH 2; 120 s) and immersed in artificial salivas (6 hr) containing three different Ca/Pi concentrations (n = 15), which simulate serum conditions of normo-, mild, or severe hypocalcemia. The control group was immersed in Ca/Pi-free saliva. The study protocol was carried out 2×/day for 5 days. Surface loss of enamel and root dentine was assessed using an optical profilometer, and SMH was remeasured for enamel. RESULTS One-way analysis of variance (p < .001) and Tukey's test showed that enamel loss in groups subjected to artificial salivas that simulated mild or severe hypocalcemia did not differ from that resembling normocalcemia. %SMH was lower when saliva was mildly and normally concentrated in Ca/Pi (p < .001). Root dentine loss was higher in saliva simulating severe hypocalcemia than in those referring to mild, hypo-, and normocalcemia. CONCLUSIONS Depending on the dental substrate, salivary formulations resembling serum hypocalcemia affected surface loss due to erosion and rehardening thereof.
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Affiliation(s)
- G C Denucci
- São Leopoldo Mandic School of Dentistry, Campinas, Brazil
| | - T F Mantilla
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Flb Amaral
- Division of Cariology and Restorative Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Campinas, Brazil
| | - R T Basting
- Division of Cariology and Restorative Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Campinas, Brazil
| | - Fmg França
- Division of Cariology and Restorative Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Campinas, Brazil
| | - C P Turssi
- Division of Cariology and Restorative Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Campinas, Brazil
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Foratori GA, de Andrade FJP, Mosquim V, Sales Peres MDC, Ceneviva R, Chaim EA, Sales Peres SHDC. Presence of Serum Ferritin before and after Bariatric Surgery: Analysis in Dentate and Edentulous Patients. PLoS One 2016; 11:e0164084. [PMID: 27695053 PMCID: PMC5047524 DOI: 10.1371/journal.pone.0164084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/19/2016] [Indexed: 12/12/2022] Open
Abstract
Society has changed its own lifestyle, specially its eating habits and physical activities, leading to excessive weight and a sedentary behavior, which has contributed to obesity increase. Bariatric surgery is the most effective treatment to obesity, allowing weight loss and its maintenance. However, it has been related high levels of iron deficiency after surgery. A person's nutritional status might be affected by total or partial tooth loss. The aim of this longitudinal prospective cohort study was to evaluate the levels of serum ferritin before and after bariatric surgery and to identify if there is a relation with tooth loss. The sample was composed of 50 patients selected and assisted at Amaral Carvalho Hospital, located in Jaú city, Brazil. The use and necessity of prosthesis, dental absence or presence, and serum ferritin dosage were evaluated. Student's t test, Univariate analysis, Chi-square and Odds Ratio were adopted (p<0.05). There was no significant difference regarding the serum ferritin levels between dentate and edentulous patients prior to surgery (p = 0.436). After surgery, the serum ferritin levels were higher in edentulous patients (prosthesis users) when compared to the pre-surgical levels, and the post-surgical levels presented significant difference regarding the dentate patients (p = 0.024). It can be concluded that rehabilitated patients in postoperative period showed better levels of serum ferritin after surgical intervention.
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Affiliation(s)
- Gerson Aparecido Foratori
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Victor Mosquim
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Reginaldo Ceneviva
- Department of Surgery and Anatomy, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Elinton Adami Chaim
- Department of Surgery, Faculty of Medical Science of Campinas, State University of Campinas, Campinas, São Paulo, Brazil
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Yamashita JM, de Moura-Grec PG, de Freitas AR, Sales-Peres A, Groppo FC, Ceneviva R, Sales-Peres SHDC. Assessment of Oral Conditions and Quality of Life in Morbid Obese and Normal Weight Individuals: A Cross-Sectional Study. PLoS One 2015; 10:e0129687. [PMID: 26177268 PMCID: PMC4503766 DOI: 10.1371/journal.pone.0129687] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 05/12/2015] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to identify the impact of oral disease on the quality of life of morbid obese and normal weight individuals. Cohort was composed of 100 morbid-obese and 50 normal-weight subjects. Dental caries, community periodontal index, gingival bleeding on probing (BOP), calculus, probing pocket depth, clinical attachment level, dental wear, stimulated salivary flow, and salivary pH were used to evaluate oral diseases. Socioeconomic and the oral impacts on daily performances (OIDP) questionnaires showed the quality of life in both groups. Unpaired Student, Fisher’s Exact, Chi-Square, Mann-Whitney, and Multiple Regression tests were used (p<0.05). Obese showed lower socio-economic level than control group, but no differences were found considering OIDP. No significant differences were observed between groups considering the number of absent teeth, bruxism, difficult mastication, calculus, initial caries lesion, and caries. However, saliva flow was low, and the salivary pH was changed in the obese group. Enamel wear was lower and dentine wear was higher in obese. More BOP, insertion loss, and periodontal pocket, especially the deeper ones, were found in obese subjects. The regression model showed gender, smoking, salivary pH, socio-economic level, periodontal pocket, and periodontal insertion loss significantly associated to obesity. However, both OIDP and BOP did not show significant contribution to the model. The quality of life of morbid obese was more negatively influenced by oral disease and socio-economic factors than in normal weight subjects.
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Affiliation(s)
- Joselene Martinelli Yamashita
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Patrícia Garcia de Moura-Grec
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Adriana Rodrigues de Freitas
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Arsênio Sales-Peres
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Francisco Carlos Groppo
- Department of Surgery and Anatomy, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Reginaldo Ceneviva
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Cardozo DD, Hilgert JB, Hashizume LN, Stein AT, Souto KEP, Meinhardt NG, Hugo FN. Impact of Bariatric Surgery on the Oral Health of Patients with Morbid Obesity. Obes Surg 2014; 24:1812-6. [DOI: 10.1007/s11695-014-1364-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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