Condição periodontal de indivíduos internados em Unidades de Terapia Intensiva: aspectos clínicos, epidemiológicos e microbiológicos

Abstract

Periodontitis is an inflammatory chronic disease of periodontal tissues, with progressive loss of periodontal attachment resulting from infection and interaction of specific bacterial species with the components of the host response in susceptible individuals. In addition, periodontal infections can be a potential risk factor for several chronic systemic diseases. This cross-sectional observational study evaluated the periodontal condition of individuals hospitalized in the Intensive Care Unit (ICU) of the Hospital São Francisco de Assis in Belo Horizonte, Minas Gerais, Brazil, under a clinical, epidemiological, and microbiological perspective. The study aimed to: (1) determine the periodontal condition [through clinical periodontal parameters of bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and plaque index] and prevalence of periodontitis of ICU hospitalized individuals; (2) identify the risk variables associated with the presence of periodontitis; (3) quantify, by means qPCR, the periodontopathogens Porphyromonas gingivalis (P. gingivalis), Treponema denticola (T. denticola), Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Actinomyces naeslundii (A. naeslundii), Streptococcus oralis (S. oralis). From an initial population of 284 individuals hospitalized in the ICU, a final sample of 94 individuals of both genders, aged 30-81 years, mean number of tooth 15.2 (± 6.9) underwent a complete periodontal and microbiological examination. A prevalence rate of periodontitis of 71.3%, mostly in the moderate chronic and localized form, was observed. Individuals hospitalized in ICU showed high plaque index (score 2 and 3 respectively in 46.8% and 39.4% of the sample). Bacterial count of T. denticola alone and associated with P. gingivalis was significantly higher in the group with periodontitis. The percentage of sites with BOP showed a significant positive correlation with the separate count of P. gingivalis, T. denticola and A. actinomycetemcomitans. The percentage of sites with PD 4mm showed significant positive correlation with total bacterial count and P. gingivalis and T. denticola counts, where a worsening of periodontal parameters was accompanied by an increase of the count of these bacteria. The most frequent chronic systemic diseases were cardiovascular diseases (66%), diabetes mellitus (33.3%), and respiratory diseases (14.9%). No association was found between the occurrence, the severity, and the extent of periodontitis and cardiovascular chronic systemic diseases, diabetes mellitus and respiratory diseases. This study found a high prevalence of periodontitis among ICU hospitalized individuals, with high plaque index; the periodontal pathogens P. gingivalis and T. denticola significantly increased in sites with greater probing depth and bleeding on probing.