Obez hastalarda yapılan laparoskopik tüp mide ameliyatının periodontal duruma etkisi

Abstract

Amaç: Bu çalışmada, laparoskopik tüp mide ameliyatının operasyon sonrası 6. ayda klinik periodontal parametreler üzerindeki etkilerinin belirlenmesi amaçlandı. Gereç ve yöntem: Yaşları 18 ile 70 arasında değişen, periodontitisli 54 obez hasta, obezite ile ilişkili parametreler ve bariatrik cerrahi öncesi ve sonrasındaki periodontal durumları açısından değerlendirildi. Obezite cerrahisi sonrası 6. ayda periodontal parametrelerdeki değişiklikler ile toplam kilo kaybı ve vücut kitle indeksi (VKİ) kaybı arasındaki korelasyonlar Spearman korelasyon analizi ile belirlendi. P<0,05 istatistiksel anlamlılık değeri olarak kabul edildi. Bulgular: 6 aylık takipte VKİ değerlerinde ve C-reaktif protein, yüksek yoğunluklu lipoprotein, düşük yoğunluklu lipoprotein ve albümin seviyeleri gibi sistemik sağlıkla ilgili çeşitli serum biyobelirteçlerinde başlangıca kıyasla önemli iyileşmeler elde edildi. Plak indeksi (p=0,000), gingival indeks (p=0,004) ve sondlamada kanama (p=0,007) gibi periodontal paramatreler ameliyattan 6 ay sonra anlamlı derecede azaldı. Ancak sondlama derinliği ve klinik ataçman seviyesi değerlerinde anlamlı bir değişiklik gözlenmedi. Plak indeksi değerlerindeki değişiklikler toplam kilo kaybı yüzdesi ile pozitif korelasyon gösterdi (r=0,301, p=0,027). Ayrıca sondlamada kanama yüzdesindeki değişiklikler ile toplam kilo kaybı yüzdesi ve aşırı VKİ kaybı yüzdesi arasında pozitif anlamlı bir korelasyon tespit edildi (sırasıyla r=0,637, p=0,000 ve r=0,370, p=0,006). Sonuç: Laparoskopik tüp mide ameliyatı, 6 aylık takip döneminde VKİ seviyelerinde ve obezite ile ilişkili biyokimyasal belirteçlerde azalmaya paralel olarak periodontal inflamasyonda da azalma sağlamıştır.

Keywords

• Bariatrik cerrahi
• vücut kitle indeksi
• obezite
• periodontitis
• prospektif çalışmalar

Impact of laparoscopic sleeve gastrectomy on periodontal status in obese patients

Abstract

Purpose: This study aimed to determine the effects of laparoscopic sleeve gastrectomy surgery on clinical periodontal parameters at 6 months in the postoperative period. Materials and methods: Fifty-four obese patients with periodontitis between 18 and 70 years of age were evaluated for obesity-related parameters and periodontal status before and 6 months after bariatric surgery. Correlations of the changes in periodontal parameters and the total weight loss and body mass index (BMI) loss at 6 months after bariatric surgery were determined with Spearman correlation analysis. P<0.05 was considered as the statistical significance value. Results: Significant improvements were achieved at 6-month follow-up compared to baseline in BMI values and several systemic health-related serum biomarkers such as C-reactive protein, high-density lipoprotein, low-density lipoprotein, and albumin levels. Periodontal parameters; plaque index (p=0.000), gingival index (p=0.004), and bleeding on probing (p=0.007) were decreased significantly at 6 months after surgery. However, no significant changes in probing depth and clinical attachment level values were observed. The changes in plaque index values were positively correlated with the percent of total weight loss (r=0.301, p=0.027). Also, there was a positive significant correlation between the changes in the percent of bleeding on probing levels and the percent of total weight loss and the percent excess BMI loss (r=0.637, p=0.000 and r=0.370, p=0.006 respectively). Conclusion: Laparoscopic sleeve gastrectomy surgery resulted in a reduction in periodontal inflammation in parallel with the decrease in BMI levels and obesity-related biochemical markers during the 6-month follow-up period.

Keywords

• Bariatric surgery
• body mass index
• obesity
• periodontitis
• prospective studies

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