Angiotensin-converting enzyme inhibitors may increase the prevalence and extent of chronic periodontitis in Brazilian patients.

Osteopetrosis (OP) comprehends a rare group of conditions, presenting on radiographs increased bone density, deriving from irregularities in osteoclast differentiation or function. In the autosomal dominant osteopetrosis (ADO), some patients stay asymptomatic for some time, or only develop mild symptoms. The dental surgeon is often the first to presuppose the disease during routine imaging examinations, referring the patient to a specialized medical group. Furthermore, osteomyelitis is one of the major OP complications, and should be refrained through frequent dental monitoring. Signals of cortical interruption, sclerotic sequestra or periosteal new bone formation, should be looked for in these patients. Their dental management is complex and procedures encompassing bone tissue, such as implant procedures, tissue regenerations, tooth extractions, maxillofacial surgeries and orthodontic treatments, when elected, should be avoided. This case report describes a case of ADO with a diagnosis of moderate generalized chronic periodontitis, not statistically related to plaque index. This is the first case to describe such a condition, in which the systemic component and the altered bone metabolism seem to be related to the loss of periodontal apparatus, independent of the biofilm. Concerning prevention, we can reinforce the need for frequent dental monitoring to avoid further interventions in those cases.Learning points:This paper reports a case in which the systemic component and the altered bone metabolism seem to have been related to the loss of periodontal attachment apparatus, independent of the biofilm.The periodontal damage observed in the OP patient was not related to the dental plaque, which leads us to suggest that the cases of periodontitis in OP patients should be diagnosed as periodontitis as a manifestation of systemic diseases.The periodontitis prevention should be longed for in OP patients thus, we propose that doctors responsible for patients with OP refer them to a dental service as soon as possible and that dentists should be aware of the preventive dentistry value as well as the most appropriate dental management for those cases.

The inclusion criteria were epidemiological or clinical studies, experimental / animal model studies, inquiries or editorials on the theme periodontitis and infertility, published until May 2016. Letters to the editor, narrative reviews, and articles bringing out other endocrine or reproductive diseases that were not about infertility were not included. The first selection was conducted after the title and abstract reading, establishing which publications fit inclusion criteria, and could be chosen to take part in the review. References were selected for full-text reading when it was not possible to determine if the inclusion criteria were attended by their title and abstract. Additionally, the reference lists of the publications identified were searched for possible studies that did not come up in the initial search. After the selection, all papers were read in full and then grouped by study design. Main methods, results and conclusions were described for each article. Also, the strength of the evidence was analyzed, according to the Oxford Centre for Evidence-Based Medicine [12], key findings highlighted and limitations listed. Results The initial search retrieved 47 papers, from which 40 were excluded, and one was duplicated. Thus, six publications remained Methods This evidence-based review was conducted to gather results from the majority of the studies published evaluating the subject of periodontitis and infertility issue. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement [11], was consulted for reporting this review.

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