Avaliação Clínica e Microbiológica da Saúde Periodontal de Crianças Portadoras de Fissura Completa de Lábio e Palato Unilateral Comparada a de Crianças sem Fissuras na Mesma Faixa Etária. / Clinical and microbiological evaluation of periodontal condition in 5 - 6 years old children with unilateral complete cleft lip and palate compared to normal controls.

Beatriz Costa

Children with cleft lip and palate have difficulty in achieving optimal tooth cleaning, mainly in maxillary anterior segment, because the anatomy of the cleft area and the residual scar tissue after surgical procedures. The purpose of this study was to compare the clinical and microbiological conditions of cleft and noncleft children through the evaluation of oral hygiene and gingival status, and the detection of P. gingivalis, P. nigrescens and T. denticola in subgingival dental plaque, using the Slot Immunoblot technique. A total of 57 children, with primary dentition and 5-6 years old was evaluated, including 30 with unilateral cleft lip and palate (experimental group) and 27 children without clefts (control group). To evaluate clinically the children, the Plaque Index (PI) and the Gingival Index (GI) described by Löe (1967) were utilized. The mean PI in the experimental group was higher (1.82±0.38) than that in control group (1.63±0.38), but there was no statistically significant difference. On the other hand, the mean GI in the experimental group (1.05±0.22) was found to be significantily higher than that of the control group (0.79±0.33) (p<.05). In the experimental group the cleft area (2 sites), with mean PI of 2.04±0.58 and mean GI of 1.11±0.26, when compared to the posterior area (4 sites), with mean PI of 1.74 ± 0.37 and mean GI of 1.04±0.26, showed statistically significant difference (p<.05) only as to the PI. In relation to the severity, most of the children in both experimental and control groups presented a moderate PI degree (73.33% and 81.48%, respectively), and a high prevalence of mild gingivitis (53.33% and 70.37%, respectively). When the groups were compared as to the PI and GI severity degrees, no difference were observed, the same ocurring with the comparison between areas in the experimental group. The analysis of the anaerobic Gram negative organisms showed that P. nigrescens was detected in 16.67% of the experimental group and 11.11% of the control group whereas P. gingivalis and T. denticola were not detected. Children with unilateral cleft lip and palate showed greater gingival inflammation than noncleft children, despite of the same plaque amount and the same percentage of the investigated microrganisms.

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