The incidence of internal hernias in laparoscopic Roux-en-Y gastric bypass is 0.5-9.7%2,7. The diagnosis of intestinal obstruction should always be suspected in the presence of abdominal pain in patients previously submitted to it laparoscopically. Internal hernias are the main causes of intestinal obstruction after this surgical procedure14, and may occur through the mesenteric breach at the level of the enteroenteral anastomosis or the Petersen space, located between the transverse mesocolon and the mesentery of the alimentary loop elevated to the gastric pouch via antecolic and antegastric route. The most frequent intestinal obstruction, and also more severe, is that resulting from a Petersen hernia involving the biliopancreatic loop, because it has a closed loop.
Systemic bone loss may lead to more severe periodontal destruction, decreasing local bone mineral density.
A cross-sectional designed was performed to study associations among alveolar bone pattern, salivary leptin concentrations, and clinical periodontal status in premenopausal obese and eutrophic women.
Thirty morbid obese (G1) and 30 normal-weight (G2) women were included. Anthropometric and periodontal measurements (probing depth - PD, clinical attachment levels - CAL, presence of calculus, bleeding on probing -BOP, and plaque accumulation) were assessed. OHIP-14 was used for assessment of oral health impact on quality of life. Panoramic radiography was used to obtain the panoramic mandibular index (PMI), mandibular cortical index (MCI), and mental index (MI). Intraoral periapical (PA) radiography was taken to measure the total trabecular bone volume. Leptin was measured in saliva of fasted overnight women.
Groups 1 and 2 differed in all anthropometric aspects, but height. Pocket depth, calculus, BOP, and plaque index were worse in G1. No differences between groups were found considering OHIP. Normal-weight subjects showed higher proportion of dense bone trabeculae than obese subjects for pre-molars, but not for molars. Mental and panoramic mandibular indexes did not differ and were in normal level. Leptin concentration was dependent only on BMI.
Obesity affected the periodontal conditions, the alveolar bone pattern, and the salivary leptin concentration.
HEADINGS:
Obesit, Quality of lif; Lepti, Periodontal disease, Alveolar bone loss,
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