DENTAL WEAR AND TOOTH LOSS IN MORBID OBESE PATIENTS AFTER BARIATRIC SURGERY

AZNAR, Fabiano Duarte; AZNAR, Fabio D.; LAURIS, José R.; CHAIM, Elinton Adami; CAZZO, Everton; SALES-PERES, Silvia Helena de Carvalho

doi:10.1590/0102-672020190001e1458

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ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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Sumário

Original Article • ABCD, arq. bras. cir. dig. 32 (03) • 2019 • https://doi.org/10.1590/0102-672020190001e1458 copy

DENTAL WEAR AND TOOTH LOSS IN MORBID OBESE PATIENTS AFTER BARIATRIC SURGERY

Authorship SCIMAGO INSTITUTIONS RANKINGS

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.

HEADINGS:
Obesity; Tooth loss; Bariatricsurgery; Tooth wear

Colégio Brasileiro de Cirurgia Digestiva Av. Brigadeiro Luiz Antonio, 278 - 6° - Salas 10 e 11, 01318-901 São Paulo/SP Brasil, Tel.: (11) 3288-8174/3289-0741 - São Paulo - SP - Brazil
E-mail: revistaabcd@gmail.com

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[1] Correspondence: Silvia Helena de Carvalho Sales-Peres E-mail: shcperes@usp.br

VARIABLE	CHARACTERISTICS	GO (n=60)	G24 (n=60)	G36 (n=60)	GC (n=60)	TOTAL (n=240)	p
Gender	Female	48 (80%)	48 (80%)	48 (80%)	48 (80%)	192 (80%)	0.682^¥
Gender	Male	12 (20%)	12 (20%)	12 (20%)	12 (20%)	48 (20%)
Race	Branca	33 (55%)	43 (71,7%)	42 (70%)	39 (65%)	157 (65,4%)	0.135^¥
	Negra	12 (20%)	9 (15%)	8 (13.3%)	4 (6.7%)	33 (13.8%)
	Parda	15 (25%)	8 (13.3%)	10 (16.7%)	17 (28.3%)	50 (20.8%)
Education	Elementary school incomplet	15 (25%)	9 (15%)	7 (11.7%)	8 (13.3%)	39 (16.3%)	0.108^£
	Elementary school complet	2 (3.3%)	5 (8.3%)	9 (15%)	7 (11.7%)	23 (9.6%)
	Hight school incomplet	7 (11.7%)	1 (1.7%)	4 (6.7%)	3 (5%)	15 (6.3%)
	Hight school complet	30 (50%)	32 (53.3%)	27 (45%)	24 (40%)	113 (47.1%)
	Higher education incomplet	2 (3.3%)	4 (6.7%)	4 (6.7%)	5 (21.7%)	15 (6.3%)
	Higher education complet	4 (6.7%)	9 (15%)	9 (15%)	13 (21.7%)	35 (14.6%)
Financial Class	Until 1 salary	15 (25%)	9 (15%)	11 (18.3%)	11 (18.3%)	46 (19.2%)	0.012^£
	From1 to 2 salaries	34 (56.7%)	23 (38.3%)	27 (45%)	22 (36.7%)	106 (44.2%)
	From 2 to 3 salaries	7 (11.7%)	14 (23.3%)	11 (18,3%)	11 (18.3%)	43 (17.9%)
	From 3 to 4 salaries	2 (3.3%)	8 (13.3%)	5 (21.7%)	9 (15%)	24 (10%)
	From 4 to 5 salaries	0 (0%)	2 (3.3%)	3 (5%)	3 (5%)	8 (3.3%)
	Above 5 salaries	2 (3.3%)	4 (6.7%)	3 (5%)	4 (6.7%)	13 (5.4%)
Hypertension	No	28 (46.7%)	51 (85%)	54 (90%)	55 (91.7%)	188 (78.3%)	<0.001^¥
Hypertension	With	32^a (53.3%)	9^b (15%)	6^b (10%)	5^b (8,3%)	52 (21.7%)
Diabetes	No	45 (75%)	57 (95%)	59 (98.3%)	60 (100%)	221 (92.1%)	<0.001^¥
Diabetes	With	15^a (25%)	3^b (5%)	1^b (1.7%)	0^b (0%)	19 (7.9%)
Triglycerides	No	55 (91.7%)	57 (95%)	59 (98.3%)	60 (100%)	231 (96.3%)	0.078^¥
Triglycerides	With	5 (8.3%)	3 (5%)	1 (1.7%)	0 (0%)	9 (3.8%)
Cholesterol	No	48 (80%)	55 (91.7%)	60 (100%)	56 (93.3%)	219 (91.3%)	0.001^¥
Cholesterol	With	12^a (20%)	5^a (8.3%)	0^b (0%)	4^ac (6.7%)	21 (8.8%)
Smoking	No	49 (81.7%)	54 (90%)	53 (88,3%)	52 (86.7%)	208 (86.7%)	0.568^¥
Smoking	With	11 (18.3%)	6 (10%)	7 (11.7%)	8 (13.3%)	32 (13.3%)
Alcoholism	No	52 (86.7%)	52 (86.7%)	48 (80%)	51 (85%)	203 (84.6%)	0.712^¥
Alcoholism	With	8 (13.3%)	8 (13.3%)	12 (20%)	9 (15%)	37 (15.4%)

VARIABLE	GO (n=60) $\bar{x} \bar{x}$ dp	G24 (n=60) $\bar{x} \bar{x}$ dp	G36 (n=60) $\bar{x} \bar{x}$ dp	GC (n=60) $\bar{x} \bar{x}$ dp	p
Age	38.083^a ± 8.158	37.900^a ± 7.852	38.583^a ± 7.308	36.700^a ± 8.110	0.604^§
BMI	49.604^a ± 7.774	30.021^b ± 5.116	29.034^b ± 6.743	22.214^c ± 1.951	<0.001^§
% Lossweight		40,552^a ± 10.703	33.162^b ± 12.000		<0.001^§*
WHR	0.910^a ± .095	0,881^b ± 0.110	0.844^b ± 0.094	0.817^b ± 0.083	<0.001^§

PLACE	GO n $\bar{x} \bar{x}$ dp	G24 n $\bar{x} \bar{x}$ dp	G36 n $\bar{x} \bar{x}$ dp	GC n $\bar{x} \bar{x}$ dp	Total n $\bar{x} \bar{x}$ dp	p entre grupos
Sextant I	59 0.411^a ± 0.125	59 0.412^ab ± 0.121	56 0.425^a ± 0.119	58 0.378^a ± 0.077	232 0.406^a ± 0.113	0.145^§
Sextant II	59 0.599^b± 0.125	59 0.564^c ± 0.200	56 0.641^b ± 0.178	57 0.609^c ± 0.143	231 0.603^c ± 0.177	0.133^§
Sextant III	59 0.415^a ± 0.125	59 0.385^b± 0.095	52 0.411^a± 0.127	580.381^a± 0.083	228 0.398^a ± 0.122	0.316^§
Sextant IV	59 0.444^a± 0.125	57 0.460^a± 0.150	55 0.449^a ± 0.129	59 0.448^b ± 0.160	230 0.450^b ± 0.161	0.958^§
Sextant V	59 0.615^b± 0.125	59 0.596^c± 0.160	58 0.602^b ± 0.104	59 0.626^c± 0.079	235 0.609^c± 0.118	0.508^§
Sextant VI	59 0.433^a ± 0.125	59 0.455^a± 0.149	57 0.457^a± 0.154	58 0.420^ab± 0.132	233 0.441^b ± 0.146	0.455^§
Total	59 0.510 ± 0.105	59 0.498 ± 0.107	58 0.526 ± 0.099	59 0.505 ± 0.072	235 0.510 ± 0.097	0.448^§

SEXTANTS	I	II	III	IV	V	VI
I	x	< 0.001	0.995	< 0.001	< 0.001	0.007
II	< 0.001	x	< 0.001	< 0.001	0.953	< 0.001
III	0.995	< 0.001	x	< 0.001	< 0.001	< 0.001
IV	< 0.001	< 0.001	< 0.001	x	< 0.001	0.979
V	< 0.001	0.953	< 0.001	< 0.001	x	< 0.001
VI	0.007	< 0.001	< 0.001	0.979	< 0.001	x

Model	Coeficients not adjusted		Adjusted coeficients	t	p	Confidence intervalof B (95%)
Model	B	Error	Beta			Minimum	Maximum
(Constant)	0.282	0.062		4.519	0.000	0.159	0.404
GO	-0.010	0.032	-0.046	-0.318	0.751	-0.073	0.053
G24	-0.009	0.017	-0.043	-0.548	0.585	-0.043	0.025
G36	0.013	0.017	0.059	0.781	0.435	-0.020	0.047
Age	0.005	0.001	0.427	6.566	0.000	0.004	0.007
Sex	0.024	0.017	0.094	1.450	0.149	-0.009	0.057
Black	-0.020	0.016	-0.073	-1.234	0.218	-0.053	0.012
Brown	0.003	0.014	0.011	0.189	0.850	-0.026	0.031
Education	0.001	0.004	0.011	0.170	0.865	-0.007	0.009
Financial Class	0.005	0.005	0.072	1.127	0.261	-0.004	0.015
Hypertension	0.002	0.016	0.009	0.123	0.902	-0.030	0.034
Diabetes	0.019	0.025	0.052	0.774	0.440	-0.030	0.069
Triglycerides	-0.041	0.034	-0.081	-1.202	0.231	-0.108	0.026
Cholesterol	-0.006	0.023	-0.019	-0.272	0.786	-0.052	0.039
Smoking	0.004	0.017	0.016	0.268	0.789	-0.028	0.037
Alcoholism	-0.003	0.016	-0.013	-0.217	0.828	-0.034	0.028
BMI	0.000	0.001	0.047	0.375	0.708	-0.002	0.002
WHR	-0.019	0.069	-0.020	-0.280	0.780	-0.155	0.116
Loss teeth	0.006	0.002	0.220	3.327	0.001	0.002	0.009