title: Weight loss after bariatric surgery and periodontal changes: a 12-month prospective study.
abstract: BACKGROUND
  Several longitudinal studies have explored the association of obesity and weight gain with periodontal disease. However, the effect of weight loss on periodontal tissues remains unclear.
  
  
  OBJECTIVE
  To explore whether weight loss after bariatric surgery was associated with changes in periodontal measures over 12 months.
  
  
  METHODS
  Two public hospitals in São Paulo, Brazil.
  
  
  METHODS
  We used data from 110 morbidly obese patients (body mass index [BMI]>40 kg/m2or≥35 kg/m2with co-morbid conditions) who underwent bariatric surgery between April 2011 and March 2013. Data on demographic factors, BMI, smoking habits, and glucose levels were extracted from medical records preoperatively and after 6 and 12 months postsurgery. A full-mouth periodontal examination was conducted by trained examiners to assess probing pocket depth, clinical attachment loss, and bleeding on probing (BOP) at baseline and 6 and 12 months after surgery. Data were analyzed using linear mixed-effects models.
  
  
  RESULTS
  BMI was not significantly related to the proportion of sites with BOP at baseline, but it was negatively associated with the rate of change in the proportion of sites with BOP. The greater the BMI loss, the higher the proportion of sites with BOP, particularly 6 months after surgery. However, BMI was not associated with baseline probing pocket depth and clinical attachment loss or rates of changes in these periodontal outcomes.
  
  
  CONCLUSIONS
  The findings suggest that weight loss was associated with increased gingival bleeding, showing a peak at 6 months after bariatric surgery. Periodontal pocketing and attachment loss remained unchanged during the study period.
authors.affiliation: Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. Electronic address: shcperes@usp.br.
authors.forename: Silvia Helena de Carvalho
authors.initials: SHC
authors.lastname: Sales-Peres
authors.affiliation: Department of Surgery, Clinical Hospital of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Matheus de Carvalho
authors.initials: MC
authors.lastname: Sales-Peres
authors.affiliation: Department of Surgery, Clinical Hospital of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Reginaldo
authors.initials: R
authors.lastname: Ceneviva
authors.affiliation: Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College, and St. Thomas' Hospitals, London, United Kingdom.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bernabé
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects*; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D010510:Periodontal Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D013997:Time Factors; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult
keywords: Adults; Bariatric surgery; Cohort studies; Periodontal diseases; Weight