Abstract
ABSTRACT Background: Bariatric surgery may have a negative impact on oral bone structure. Aim:To verify the alveolar bone pattern through radiomorphometric indices of panoramic radiography and linear measurements performed in periapical radiographs in eutrophic and morbidly obese patients before and after bariatric surgery. Methods:The sample consisted of 31 women aged 20-35 years old, divided into two groups: obese group (GO-obese grade III) and control group (GC-eutrophic). Twenty eutrophic and 11 obese morbidities were evaluated in the pre and postoperative bariatric surgery (six months). Radiomorphometric and plaque indices were evaluated at T0 (baseline) and T1 (six months) times, in both groups. In the radiographic analysis the trabecular pattern through the Lindh visual ladder and the bone loss were evaluated by calculating the distance from the cement-enamel junction to the bone crest in periapical radiographs. Panoramic radiographs were used to measure the mandibular cortical index (ICM), mentonian index (IM) and panoramic mandibular index (MPI), in addition to the Turesky plate index. Results:There was a significant loss of bone in T1 in patients submitted to bariatric surgery, when compared to eutrophic patients (p<0.05). The trabecular pattern became sparser after surgery with a visual difference. The plate index showed a slight improvement after surgery and the eutrophic maintained similar values over time. Conclusion:The standard alveolar bone presents greater bone loss in obese patients and worsens this standard after bariatric surgery when compared to eutrophic patients. The same happens with the trabecular pattern that becomes sparser after bariatric surgery.
Highlights
Obesity and overweight are defined as the accumulation of abnormal or excessive fat that can be detrimental to health
The results showed that obese patients present bone loss, at the oral level, which worsens after treatment with bariatric surgery
Vitamin D absorption that occurs in the jejunum and ileum is affected by mixing ingested nutrients, which is retarded with bile acids and pancreatic enzymes
Summary
Obesity and overweight are defined as the accumulation of abnormal or excessive fat that can be detrimental to health. Once considered problems in high-income countries, obesity and overweight are increasing in low- and middle-income countries, especially in urban areas[27]. There are several oral health studies involving obesity[1,8,16,28,29] and bariatric surgery[17,18]. Secondary hyperparathyroidism and bone loss may develop as a consequence[10] Another challenge is microbial, since the increased prevalence of periodontal disease in obese adults may be associated with the high frequency of food consumption and, the increased accumulation of plaque, which may be aggravated due to poor oral hygiene[28]. This study aims to elucidate the scientific knowledge about bone pattern and alveolar bone resorption in morbidly obese patients before and after bariatric surgery and to relate them to people with normal weight
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