Periodontal Attachment Loss

Establishing an adequate bond and attachment between a mother and child is essential for preventing pathologies and developing this relationship in the future.

To identify the factors related to a disturbance of the mother-child bond or attachment.

A cross-sectional descriptive study was carried out with women with a biological child between 6 weeks and 18 months of age. The Mother-Child Bond-Attachment Questionnaire (VAMF, for its name in Spanish) was administered to measure the bond and postnatal attachment together with a questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn.

1114 women participated. The multivariate analysis showed that skin-to-skin contact (aOR = 0.58; 95% CI: 0.37, 0.90) and breastfeeding (aOR = 0.55; 95% IC: 0.35, 0.86) reduce the probability of presenting a bond disturbance. Anxiety during pregnancy, childbirth, and the puerperium (aOR = 3.95; 95% CI: 2.57, 6.05) and postpartum complications (aOR = 1.60; 95% CI: 1.03, 2.48) increase the chance of having a bond disturbance. Skin-to-skin contact (aOR = 0.61; 95% CI: 0.38, 1.00), breastfeeding (aOR = 0.47; 95% CI: 0.27, 0.80,) and an older age of the infant (months) (aOR = 0.77: 95% CI: 0.72, 0.82) reduces the probability of presenting an attachment disturbance.

Skin-to-skin contact and breastfeeding are associated with a lower probability of impaired bonding and attachment. Anxiety states during pregnancy, childbirth, and the puerperium, and complications after childbirth increase the probability of developing a bond disorder. The older the age of the infant, the lower the frequency of having an impaired attachment.

Identifying the factors associated with the establishment of the mother-child bond and attachment is essential for the development of prevention strategies and early identification of cases that may present alterations and avoid their consequences on the health of the mother and child.

Background Periodontitis, a chronic inflammatory disease, is triggered by the plaque biofilm culminating in periodontal attachment loss, bone loss, and tooth loss. Diabetes, a globally prevalent disease, causes an increased inflammatory response to the microflora associated with periodontitis. It has been observed that the link between these two diseases is bidirectional. Tissue repair is impaired in diabetic patients with periodontitis. Local drug delivery systems selectively target the inflamed sites contrary to systemic antibiotics which lead to resistance and many other adverse effects. Probiotics aid in the growth of beneficial microorganisms and have immunomodulatory effects on the host. Tetracyclines have anti-collagenase properties and reduce the bacterial load, curbing the progression of periodontitis. Interleukin (IL) 1β, a strong marker of periodontal tissue destruction, plays a pivotal role in inflammation, immune regulation, and bone resorption in periodontitis. This study evaluated and compared the benefits of probiotics and tetracycline fibers when used as adjunctive tools after scaling and root planing (SRP) on IL1β levels in type 2 diabetic patients with periodontitis. Methodology A total of 36 patients participated in this study. Group I included 12 patients with periodontitis and uncontrolled diabetes (HbA1c levels >7). After SRP, six patients received tetracycline fibers (IA), and six patients received probiotics (1B) as locally delivered agents. Group II included 12 patients with periodontitis and diabetes under control (HbA1c levels 6-7%). After SRP, six patients received tetracycline fibers (IIA), and six patients received probiotics (IIB) as locally delivered drugs (test groups). Group III, the control group, included 12 patients with periodontitis only, wherein a placebo was used as a local drug delivery (LDD) after SRP. The clinical parameters, such as plaque index, gingival index, and probing pocket depth, were recorded preoperatively and at eight and 12 weeks after non-surgical periodontal therapy. IL1β levels were assessed by enzyme-linked immunosorbent assay at baseline and six weeks after SRP. Results On intra and intergroup comparison, all groups showed improvement in both the clinical and biochemical parameters but significant results were seen in Group IIA (p < 0.01) when compared to the other groups. Conclusions Group II (well-controlled diabetics) performed significantly better than the other groups, which was followed by Group III. The use of LDDs as adjunctive tools after SRP was not beneficial in Group I (uncontrolled diabetics).

To explore the forewarning immunological indicators during periodontal attachment loss progression in American adults.

A total of 5744 participants with periodontal attachment loss were enrolled from the National Health and Nutrition Examination Surveys (NHANES) 2009-2014. In which, dependent variable was the counts of teeth with severe attachment loss (depth of periodontal probing was above 5 mm). Independent variables were circulatory immunological indexes, including counts of white blood cells (WBC), Lymphocytes, Monocytes, Neutrophils, Eosinophils, and Basophils. The association among variables was examined using multivariable linear regression models, fitting with smoothing curves, and generalizing additive models.

Based on the indicators of 5744 subjects, we found that severe attachment loss tended to occur in the elderly or males and was accompanied by higher WBC, Monocytes, and Neutrophils, as well as lower poverty-income ratio and educational qualification. WBC (above the inflection point: 6200 cells/µL) and Neutrophils (above the inflection point: 3300 cells/µL) counts were positively associated with attachment loss progression in each multivariable linear regression model. On subgroup analyses, stratified by sex and race, the positive correlation of WBC or Neutrophils with severe attachment loss was stable in both men and women, as well as in all races except blacks (WBC β = - 0.0576, 95% CI - 0.1945 to 0.0793, Neutrophils β = - 0.0527, 95% CI - 0.2285 to 0.1231).

Increasing WBC (above 6200 cells/µL) and Neutrophils (above 3300 cells/µL) counts were risk indicators of severe periodontal attachment loss among all races, except in blacks.