Periodontopathogenic bacteria DNA and periodontal condition in bariatric patients

Objectives: To evaluate periodontal conditions and the presence of a periodontopathogenic bacterium,  Porphyromonas gingivalis, associating with morbid obesity and bariatric surgery.Methods: This is a longitudinal study, composed by patients before and six months after bariatric surgery, using Fobi-Capella technical, held in three hospitals in the State of São Paulo - Brazil. The sample size was 55 patients, 9 males and 46 females. North Caroline periodontal probe was used for the clinical exam, which measured probing pocket depth and clinical attachment levels. The presence and amount of Porphyromonas gingivalis DNA from gingival crevicular fluid was analyzed by reactions of Real-time PCR. Body mass index (BMI) was measured by weight and height. Other health information, such as c-reactive protein (CRP) and glucose, were obtained by the patient's medical files. The dependent “t” test was applied to evaluate the statistic difference between both groups (before and after bariatric surgery) and Spearman correlation to verify the relationship between bacterium presence and other quantitative variables. Results: The mean age was 39 years. Before surgery 63% of patients had high levels of CRP (>1.0mg/dL) and 39% high levels of glucose (>99mg/dL). Data showed that, after surgery, there was a significant reduction in CRP and glucose levels (p<0.000), and only 4 patients presented high levels for both exams. The average BMI decreased from obesity type III to type II in 6 months after surgery (48.95±8.54kg/m2 to 35.14±7.80kg/m2) (p<0.000). In the same period the prevalence of periodontal pocket greater than 4 mm increased (p=0.033) and the average of probing pocket depth and clinical attachment levels significantly increased (p<0.000) about 0.3mm. The amount of P.gingivalis also increased six months after bariatric surgery (p=0,032). Conclusions:  The morbid obesity patients who have periodontal disease should be undergone submitted dental care before undergoing bariatric surgery to reduce the side-effects in postoperatively.