Prior Restorative Procedures to Endodontic Treatment.

Tooth loss due to fracture and the failure of endodontic treatment (ET) are common situations in teeth with extensive tissue destruction. This is due to the fragility of the remaining dental structure and the difficulty in sealing cavities, which is sometimes associated with the violation of the supracrestal insertion tissue. The previous restoration of marginal ridges or cusps with composite resin (CR) restores their fracture resistance, due to the adhesive characteristics of the restorative material, while also protecting the quality of endodontic treatment through better sealing. However, the protocol adopted in teeth requiring endodontic treatment involves performing the restorative procedure only after the endodontic procedures. The objective of this study was to report a case in which restoration of marginal ridges and/or cusps was performed prior to endodontic treatment, focusing on maintaining the tooth in function without dental fracture. The restoration was performed with an inverted operative sequence before the endodontic treatment. There was a violation of the supracrestal insertion tissue, requiring crown lengthening surgery (CLS) prior to the restorative procedure. Clinical and radiographic evaluations were performed postoperatively at seven days, three, six, and nine months, and five years. Tooth function was maintained without dental fractures or restoration loss. Periradicular space healing occurred with the disappearance of the lesion. Performing the restorative procedure prior to endodontic treatment in teeth with extensive coronal destruction is an alternative technique that facilitates clinical procedures, reduces the likelihood of dental loss due to fracture, and promotes endodontic treatment success.

Anxiolytic effect of Anthemis nobilis L. (roman chamomile) and Citrus reticulata Blanco (tangerine) essential oils using the light-dark test in zebrafish (Danio rerio).

ETHNOPHARMACOLOGICAL RELEVANCE: The anxiety disorders are the most prevalent mental health condition, and anxiety is considered the sixth cause of disability surpassing diabetes mellitus, chronic obstructive pulmonary disease, and osteoarthritis. Besides, the COVID-19 pandemic provided an increase in the number of psychiatric diseases diagnosis in all social layers around the world. About 55%-94% of patients diagnosed with anxiety disorders are treated with benzodiazepines, meanwhile benzodiazepines can promote several adverse effects. In this way, alternative therapies, such as essential oils may offer significant benefits in the treatment of patients with anxiety disorders. However, the anxiolytic effect of these essential oils must be proper evaluated appropriate as well as the suitable dosage and side effect need further research. AIM OF THE STUDY: The aim was to evaluate the anxiolytic effect of Roman chamomile (Anthemis nobilis L.) and tangerine (Citrus reticulata Blanco) essential oils using the light-dark test in adult zebrafish (Danio rerio). MATERIAL AND METHODS: Both essential oils were analyzed by GC-MS and the major compounds were identified. The anxiolytic effect was evaluated by light-dark test in adult zebrafish. RESULTS: The results showed that roman chamomile essential oil has anxiolytic effect in adult zebrafish, whereas tangerine essential oil tends to reduce anxiety The major compounds of tangerine essential oil were limonene and γ-terpinene, and the major compounds of roman chamomile were pentadecyl-3-methyl-2-butenoate, hexadecyl-3-methyl-2-butenoate, 1-piperidinol and trans-1-ethyl-3-methyl-cyclopentane. CONCLUSIONS: The present study demonstrated that this anxiolytic effect may be attributed to the synergistic effect of the compounds present in roman chamomile essential oil, particularly the major compounds. The roman chamomile essential oil at the highest concentration showed anxiolytic effect. The tangerine essential oil showed a tendency to reduce anxiety, but it was not statistically significative. In addition, roman chamomile and tangerine essential oils did not cause cause alteration in locomotion activity and exploratory ability of the fish.

Donepezil Hydrochloride BCS Class Ambiguity: Relevant Aspects to be Considered in Drug Classification.

Donepezil hydrochloride (DH) is the most used anti-Alzheimer's disease drug, however, its classification according to the Biopharmaceutics Classification System (BCS) is not clear in the literature. BCS is one of the accepted criteria used to grant biowaiver (waiver of in vivo bioequivalence studies) of new drug products. So, the purpose of this work was to elucidate the BCS classification of DH and to raise the discussion about the possibility of biowaiver for new medicines containing it. The polymorphic form was previously identified as form III of DH. The drug showed high solubility in the entire pH range evaluated (1.2 to 6.8, at 37 °C) with a pH-dependent solubility profile. The effective permeability (Peff) values obtained with different DH concentrations, using in situ closed-loop perfusion model were statistically similar (p > 0.05), even when compared to high permeability control used (ketoprofen), demonstrating that DH has high permeability which, associated with its high solubility, allows to classify DH as BCS class 1. Relevant data to evaluate for granting a biowaiver for new medicines were also reviewed from the literature. Based on information reunited new immediate-release drug products containing DH should be eligible for BCS-based biowaiver.

Analysis of GLT6D1 and CDKN2BAS gene polymorphisms in Brazilian patients with advanced periodontitis.

Gene polymorphisms can predispose to periodontal disease, as demonstrated by the well-documented association between aggressive periodontitis and single nucleotide polymorphisms (SNPs) such as rs153745 in the GLT6D1 gene and rs3217992 in the CDKN2BAS gene. The purpose of this study was to evaluate the presence of these SNPs in Brazilian patients with advanced periodontitis (stages III/IV, Grade B/C) vs. healthy controls. A total of 100 patients with periodontitis (Group BC) were enrolled. Of these, 51 patients were classified as stage III and 49 patients were classified as stage IV, and 52 were Grade B (Group B) and 48 were Grade C (Group C). The control Group consisted of 61 healthy subjects. DNA samples extracted from buccal epithelial cells were used to genotype the SNPs rs1537415 (GLT6D1) and rs3217992 (CDKN2BAS) by real-time quantitative PCR. No significant differences in polymorphism frequency were found between the control Group and each of the patient groups (BC, B, or C), and Group B did not differ from Group C. In conclusion, the evaluated SNPs had no significant influence on the prevalence of periodontal disease in the sampled Brazilian population.

Diagnostic accuracy of severe periodontitis case definitions: Comparison of the CDC/AAP, EFP/AAP, and CPI criteria.

BACKGROUND: This cross-sectional study aimed to evaluate the diagnostic accuracy of severe periodontitis by three different case definitions. METHODS: Patients aged >35 years (n = 243, mean age = 47.8 ± 9.3 years) were evaluated by periodontal examinations and classified in patients with severe periodontitis according to the case definition proposed by the Centers for Disease Control and Prevention (CDC) in collaboration with the American Academy of Periodontology (AAP)-CDC/AAP, the new periodontal disease classification proposed jointly by the AAP and the European Federation of Periodontology (EFP/AAP), and the Community Periodontal Index (CPI). The primary outcome was to compare the diagnostic accuracy of severe periodontitis between the three case definitions. Sensitivity (SS), specificity (SP), and area under the receiver operating characteristic (ROC) curve were used to analyze the accuracy. RESULTS: The proportion of subjects presenting the most severe definitions of each classification was: severe periodontitis (CDC/AAP) = 47.3%, type III and IV periodontitis (EFP/AAP) = 43.2% and CPI code 4 = 44.4%. When comparing the CDC/AAP case definitions with the EFP/AAP classification, SS, SP, and ROC of 81.7%, 91.4%, and 0.866 (CI, 95%: 0.816 to 0.916), respectively, were obtained. Similarly, when comparing CDC/AAP to CPI code 4, SS, SP, and ROC of 81.7%, 89.1%, and 0.854 (CI, 95%: 0.802 to 0.906), respectively, were obtained. When type III and IV periodontitis (EFP/AAP) was compared with CPI code 4, the values were 92.4%, 92%, and 0.922 (CI, 95%: 0.883 to 0.961), respectively. CONCLUSIONS: The EFP/AAP classification and the CPI demonstrated high diagnostic accuracy with the CDC/AAP case definition to diagnose severe periodontitis.

Analysis of GLT6D1 and CDKN2BAS gene polymorphisms in Brazilian patients with advanced periodontitis

Abstract Gene polymorphisms can predispose to periodontal disease, as demonstrated by the well-documented association between aggressive periodontitis and single nucleotide polymorphisms (SNPs) such as rs153745 in the GLT6D1 gene and rs3217992 in the CDKN2BAS gene. The purpose of this study was to evaluate the presence of these SNPs in Brazilian patients with advanced periodontitis (stages III/IV, Grade B/C) vs. healthy controls. A total of 100 patients with periodontitis (Group BC) were enrolled. Of these, 51 patients were classified as stage III and 49 patients were classified as stage IV, and 52 were Grade B (Group B) and 48 were Grade C (Group C). The control Group consisted of 61 healthy subjects. DNA samples extracted from buccal epithelial cells were used to genotype the SNPs rs1537415 (GLT6D1) and rs3217992 (CDKN2BAS) by real-time quantitative PCR. No significant differences in polymorphism frequency were found between the control Group and each of the patient groups (BC, B, or C), and Group B did not differ from Group C. In conclusion, the evaluated SNPs had no significant influence on the prevalence of periodontal disease in the sampled Brazilian population.

Insights for temporomandibular disorders management: From psychosocial factors to genetics-A case report.

AIMS: This case report aimed to discuss the multifactorial etiology and also the management of temporomandibular disorders (TMD) by addressing important associated psychosocial and biological factors, emphasizing the interaction between these factors and a probable genetic predisposition. METHODS AND RESULTS: A 21-year-old female patient was evaluated according to Research Diagnostic Criteria for TMD and diagnosed with arthralgia, myofascial pain, disc displacement without reduction, and temporomandibular joint (TMJ) degenerative disease. TMJ alterations were confirmed through magnetic resonance imaging and cone-beam computed tomography. Pressure pain threshold of masticatory structures was evaluated using a pressure algometer. Sleep bruxism, poor sleep quality, migraine with aura, mild anxiety, and history of facial trauma were also identified through anamnesis and clinical examination. Following this, genetic analysis was performed to evaluate the presence of single nucleotide polymorphisms (SNPs) already associated with TMD: SNP COMT Val158 Met (rs4680), MMP1-1607 (rs1799750), and tumor necrosis factor alpha-308 (rs1800629), which were all present. A personalized treatment for TMD management was performed, and it included self-management programs, occlusal appliance therapy, pharmacotherapy, anxiety management, and stress control. An 8-year follow-up demonstrated long-term stabilization of TMJ degenerative disease. CONCLUSION: Genetic evaluation, added to anamnesis and clinical examination, could be useful for TMD prognosis and management.

Analysis of Porphyromonas gingivalis fimA genotypes in severe periodontitis patients.

The aim of this study was to i) evaluate the prevalence of P. gingivalis and the genotypes fim A I, Ib, II, III, IV, and V in Brazilian patients with periodontitis stage III and IV, grades B and C, ii) compare periodontitis grades B and C with regard to the prevalence of P. gingivalis and fim A genotypes, and iii) correlate the presence of these pathogens with clinical periodontal variables. Two samples of subgingival biofilm were collected from the interproximal sites with the greatest clinical attachment loss (CAL) of each patient (grade B = 38; grade C = 54) and submitted to polymerase chain reaction (PCR) for the identification of P. gingivalis and fim A genotypes. The collected periodontal clinical parameters included gingival index, plaque index, probing depth (PD), bleeding on probing (BoP) and CAL. P. gingivalis was present in 61.96% of the samples, but more prevalent in patients with grade C periodontitis (p = 0.048) and higher CAL (p < 0.001), PD (p < 0.001), and BoP (p = 0.01) values, and at sites with high CAL values (p = 0.01). The fim A II genotype was more prevalent in patients with greater mean PD (p = 0.04) and a higher proportion of bleeding sites (p = 0.006). Thus, in this sample of Brazilian periodontitis patients, the presence of P. gingivalis was associated with grade C periodontitis and periodontal destruction, while the fim A II genotype was associated with increased PD and BoP, supporting the notion that P. gingivalis fim A II is an important virulence factor in periodontal tissues.

Analysis of porphyromonas gingivalis fimA genotypes in severe periodontitis patients

Abstract The aim of this study was to i) evaluate the prevalence of P. gingivalis and the genotypes fim A I, Ib, II, III, IV, and V in Brazilian patients with periodontitis stage III and IV, grades B and C, ii) compare periodontitis grades B and C with regard to the prevalence of P. gingivalis and fim A genotypes, and iii) correlate the presence of these pathogens with clinical periodontal variables. Two samples of subgingival biofilm were collected from the interproximal sites with the greatest clinical attachment loss (CAL) of each patient (grade B = 38; grade C = 54) and submitted to polymerase chain reaction (PCR) for the identification of P. gingivalis and fim A genotypes. The collected periodontal clinical parameters included gingival index, plaque index, probing depth (PD), bleeding on probing (BoP) and CAL. P. gingivalis was present in 61.96% of the samples, but more prevalent in patients with grade C periodontitis (p = 0.048) and higher CAL (p < 0.001), PD (p < 0.001), and BoP (p = 0.01) values, and at sites with high CAL values (p = 0.01). The fim A II genotype was more prevalent in patients with greater mean PD (p = 0.04) and a higher proportion of bleeding sites (p = 0.006). Thus, in this sample of Brazilian periodontitis patients, the presence of P. gingivalis was associated with grade C periodontitis and periodontal destruction, while the fim A II genotype was associated with increased PD and BoP, supporting the notion that P. gingivalis fim A II is an important virulence factor in periodontal tissues.

Perda dentária e doença periodontal associada ou não a condições sistêmicas ­ revisão de literatura / Tooth loss and periodontal disease associated or not with systemic conditions - literature review

Associações significativas entre doença periodontal, cárie e perda dentária têm sido relatadas. Este trabalho teve por objetivo analisar a relação entre doença periodontal e perda dentária, associada ou não a alterações sistêmicas através de uma revisão sistematizada da literatura. Para a seleção dos artigos utilizados nesta revisão, foi feita uma busca na base bibliográfica PubMed (www.ncbi.nlm.nih.gov/pubmed), utilizando as palavras-chave: "periodontal disease" ou "periodontitis" em combinação com "tooth loss". Realizou-se um refinamento na pesquisa bibliográfica utilizando como critérios de inclusão: publicações na língua inglesa, estudos clínicos em humanos, longitudinais ou transversais, publicados nos últimos 35 anos. Foram encontrados 1072 resumos. Após a leitura de títulos e resumos,18 artigos que avaliaram a relação da perda dentária com a doença periodontal, associada ou não a condições sistêmicas, foram considerados válidos para a realização desta revisão. Sete estudos abordaram a associação da condição periodontal com a perda dentária em pacientes normossistêmicos e 11 apresentaram relações da perda dentária com a periodontite associada a alterações sistêmicas. A periodontite foi encontrada e classificada como a primeira ou segunda maior causa de perda dentária pelos estudos levantados nesta revisão, tendo ainda sido relatada uma correlação positiva significativa entre perda dentária e níveis de inserção clínica. A diabetes foi associada diretamente a maiores danos nas condições periodontais e, consequentemente, perda dentária. Porém, pacientes diabéticos insulino-controlados apresentaram resultados semelhantes a indivíduos não diabéticos.(AU)

Significant associations between periodontal disease, caries and tooth loss have been reported. The aim of this study was to analyze the relationship between periodontal disease and tooth loss, associated or not to systemic alterations through a systematic review of the literature. We searched the PubMed databases (www.ncbi.nlm.nih.gov/pubmed) for the selection of the articles used in this review, using the keywords "periodontal disease" or "periodontitis" in combination with "tooth loss". A refinement in the bibliographic research was made using as inclusion criteria: publications in the English language, clinical studies in humans, longitudinal or transverse, published in the last 35 years. 1072 abstracts were found. After reading titles and abstracts, 18 articles that assessed the relationship between tooth loss and periodontal disease, associated or not with systemic conditions, were considered valid for this review. Seven studies addressed the association of periodontal condition with tooth loss in normosystemic patients and 11 presented relationships of tooth loss with periodontitis associated with systemic alterations. Periodontitis was found to be the first or second largest cause of tooth loss in studies reviewed in this review, and a significant positive correlation between tooth loss and clinical attachment loss has been reported. Diabetes was directly associated with greater damage in periodontal conditions and, consequently, tooth loss. However, insulin-controlled diabetic patients presented similar results to non-diabetic individuals (AU).

Periodontitis, edentulism and glycemic control in patients with type 2 diabetes: a cross-sectional study.

OBJECTIVES: To compare the glycemic control in non-smoking patients with type 2 diabetes according to their periodontal and dental status. RESEARCH DESIGN AND METHODS: This cross-sectional study investigated patients previously diagnosed with type 2 diabetes and under antidiabetic medication. Clinical data and fasting blood glucose (FBG) levels were collected from medical and dental records. Patients were divided into three groups according to dental and periodontal diagnosis: no or mild periodontitis (NO/MILD, n=96), moderate or severe periodontitis (MOD/SEV, n=74) and edentulous (n=141). FBG levels were compared between groups. Logistic regression was also applied to estimate the OR of presenting hyperglycemia. RESULTS: Edentulous patients had significantly higher FBG levels of 155.7±70.9 (mean±SD mg/dL) than those in the MOD/SEV (136.6±33.8) and the NO/MILD (123.1±36.7) groups. Differences between the latter two groups were also significant. Edentulous patients had adjusted ORs of 4.53, 4.27 and 3.95 of having FBG≥126, ≥150 and ≥180 mg/dL, respectively, in comparison with NO/MILD group. The MOD/SEV group also presented significant odds of having FBG≥126 mg/dL (OR=2.66) and ≥150 mg/dL (OR=2.45) than the NO/MILD group. CONCLUSIONS: Patients in the MOD/SEV group had worse glycemic control than the ones in the NO/MILD group. However, edentulous patients presented higher glycemic levels than both dentate groups, and also presented with higher odds of having hyperglycemia.

Aggressive periodontitis presents a higher degree of bilateral symmetry in comparison with chronic periodontitis.

The purpose of this cross-sectional study was to evaluate the occurrence of bilateral symmetry in the distribution of clinical parameters in subjects with generalized aggressive periodontitis (GAP) and severe chronic periodontitis (SCP). The sample comprised 53 subjects with GAP and 33 with SCP. Probing depth (PD) and clinical attachment loss (CAL) were recorded from both buccal and lingual interproximal sites of incisors and molars. The symmetry of periodontal destruction was analyzed in terms of intraclass coefficient correlations (ICC) for pairs of contralateral sites at which PD and/or CAL was ≥5 mm at one of the sites of the subjects in each group. GAP patients had a higher proportion of both PD and CAL ≥ 5 mm and also a higher mean proportion of subjects having PD and/or CAL ≥ 5 mm at one or both sites. The GAP group had 20 pairs of contralateral sites with PD (ICC = 0.22-0.63) and 26 pairs with CAL (ICC = 0.20-0.63), the correlation being statistically significant, while the SCP group had only 2 pairs (ICC = 0.36-0.48) with PD and 5 pairs with CAL (ICC = 0.33-0.58) showing a significant correlation. It can be concluded that GAP shows more symmetric periodontal destruction than SCP.

Influence of Periodontal Disease on Changes of Glycated Hemoglobin Levels in Patients With Type 2 Diabetes Mellitus: A Retrospective Cohort Study.

BACKGROUND: Little evidence is available regarding the effects of long-term periodontal infection on diabetes mellitus (DM) control. The aim of this retrospective cohort study is to evaluate influence of periodontal status on changes of glycated hemoglobin (HbA1c) levels of patients with type 2 DM (DMt2). METHODS: Eighty patients (mean age: 56.0 ± 8.9 years) with DMt2 were included. Patients were non-smokers, aged ≥40 years, and using antidiabetic drugs. Demographics, health history, and HbA1c levels were retrieved from medical charts. Probing depth and clinical attachment loss (AL) were recorded. RESULTS: Patients were examined at two time points within a mean interval of 38.6 ± 6.6 months. Increase in HbA1c over time was statistically significant when severe periodontitis was diagnosed at baseline (2.32%, 95% confidence interval [CI]: 1.50% to 3.15%), in patients showing at least one tooth with ≥2 mm of AL progression (2.24%, 95% CI: 1.56% to 2.91%), in males (2.75%, 95% CI: 1.72% to 3.78%), and in those with HbA1c <6.5% at baseline (3.08%, 95% CI: 2.47% to 3.69%). After adjusting for baseline HbA1c, significant changes were still observed for severe periodontitis and progression of AL with increases of 0.85% and 0.9%, respectively. After adjusting for sex and HbA1c, AL progression was also statistically significant, with increases of 0.84%. CONCLUSIONS: Periodontitis progression was associated with increase in HbA1c in patients with DMt2. Identification of these risk factors suggests that periodontal treatment may improve glycemic control of patients with DMt2 by eliminating periodontal infection.

Tratamento da pigmentação melânica gengival ­ revisão sistemática da literatura / Treatment of gingival melanin pigmentation - systematic literature review

A pigmentação oral é uma descoloração que atinge principalmente a gengiva e a mucosa oral, associada a fatores etiológicos endógenos e exógenos. A melanina é um dos pigmentos responsáveis por essa coloração sendo produzida pelos melanossomos presentes nos melanócitos, que estão localizados ao nível da camada basal e suprabasal do epitélio. A pigmentação melânica gengival configura-se como um problema estético. Este trabalho teve por objetivo fazer uma revisão sistematizada da literatura abordando ensaios clínicos que apresentassem técnicas de remoção da pigmentação melânica gengival. Para a seleção dos artigos utilizados foi realizada uma busca online nas bases bibliográficas PubMed (www.ncbi.nlm.nih.gov/pubmed) e Scopus (https://www.scopus.com) compreendendo o período de janeiro de 2006 a abril de 2016, utilizando os descritores: "gingival", "melanin", "pigmentation", "hyperpigmentation" e "depigmentation", em combinação. Realizou-se um refinamento na pesquisa bibliográfica utilizando como critérios de inclusão: publicações na língua inglesa de estudos clínicos de intervenção em humanos. Foram selecionados inicialmente 188 artigos e após a leitura dos títulos e resumos 15 estudos foram considerados válidos para essa revisão. A técnica da desepitelização para remoção da pigmentação melânica gengival com o uso de broca e lâmina de bisturi é considerada padrão ouro, sendo uma alternativa economicamente viável e de fácil execução. Porém, o uso do laser vem sendo indicado como opção ao tratamento. Foram encontrados relatos de recidivas das pigmentações em todas as técnicas apresentadas, com maiores relatos de repigmentações nas técnicas que promovem a remoção do epitélio (AU)

The oral pigmentation is a discoloration that primarily affects the gums and oral mucosa is associated with endogenous and exogenous etiological factors. Melanin is a pigment responsible for this coloring being produced by the present melanosomes in melanocytes, which are located at the level of the basal and suprabasal layer of the epithelium. The gingival melanin pigmentation appears as an aesthetic problem. This study aimed to make a systematic review of the literature regarding clinical trials to submit removal techniques of gingival melanin pigmentation. For the selection of articles used a search online bibliographic databases was conducted in PubMed (www.ncbi.nlm.nih.gov/pubmed) and Scopus (https://www.scopus.com) covering the period from January 2006 to April 2016, using the key words: "gingival" "melanin", "pigmentation", "hyperpigmentation" and "depigmentation" in combination. This was a refinement in the literature search using the following inclusion criteria: clinical intervention studies in humans published in English. They were initially selected 188 articles and after reading the titles and abstracts 15 studies were considered valid for this review. The scalpel technique for removal gingival melanin pigmentation using drill and scalpel blade is considered the gold standard, with an economically viable and easy to perform. However, the use of laser has been recommended as an option for treatment. The recurrence of pigmentations was observed on all the techniques presented with greater repigmentações reports on techniques that promote surgical stripping (AU)

Analysis of polymorphisms in Interleukin 10, NOS2A, and ESR2 genes in chronic and aggressive periodontitis.

The objective of this study was to investigate the association between single nucleotide polymorphisms (SNPs) in the IL10, NOS2A, and ESR2 genes and chronic periodontitis (CP) and aggressive periodontitis (AgP). Three groups of patients underwent periodontal and radiographic evaluations: CP (n = 61), AgP (n = 50), and periodontally healthy (control group=61). Genomic DNA was extracted from oral epithelial cells and used for genotyping by real-time polymerase chain reaction using TaqMan® probes. The investigated SNPs were: -1087G > A, -819C > T and -592C > A in the IL10; +2087G > A in the NOS2A, and +1730G > A in the ESR2 gene. Differences in genotype and allele frequencies of each polymorphism and some individual characteristics were analyzed using the chi-square test and multivariate logistic regression analysis. Analysis of SNPs and haplotypes in the IL10 and SNP in the ESR2 gene did not present any significant association with AgP or CP. The +2087G allele of the NOS2A gene tended to be significantly associated with periodontal disease. Patients carrying the genotype +2087GG in the NOS2A gene were genetically protected against the development of CP (p = 0.05; OR = 0.44; 95%CI = 0.20-0.95). This result showed greater significance when patients with AgP and CP were combined (total PD) (p = 0.03; OR = 0.46; 95%CI = 0.23-0.92). In conclusion, the studied Brazilian population had a significantly higher frequency of the GG genotype for the +2087 SNP in the NOS2A gene in individuals without periodontitis, although statistical significance was not maintained after multiple logistic regression.

Prevalence of Porphyromonas gingivalis fimA II genotype in generalized aggressive periodontitis patients

Purpose: The objective of this study was to evaluate the prevalence of Porphyromonas gingivalis (Pg) and its filmA II genotype in a sample of Brazilian patients with generalized aggressive periodontitis (GAgP) and to correlate the presence of each pathogen/genotype eith clinical parameters. Methods: We used polymerase chain reaction (PCR) to evaluate the presence of Pg and filmA II genotype in subgingival plaque samples collected from the deepest site of 45 Brazilian patients aged 15-40 years with GAgP and correlated findings with age and clinical parameters (plaque index, gingival bleeding index, probing depth and clinical attachment loss). Results: Pg was identified in 64.4% patients. FilmA II genotype was present in 82.6% of Pg-positive patients. The presence of Pg and filmA II genotype was significantly associated with greater clinical attachment loss at the sampled periodontal site. Pg-positive patients were slightly older than Pg-negative patients. Conclusions: Pg and filmA II genotype were highly prevalente in Brazilian patients with GAgP. Pg was more commonly observed in slightly older individuals and in sites with more clinical attachment loss. (AU)

Analysis of polymorphisms in Interleukin 10, NOS2A, and ESR2 genes in chronic and aggressive periodontitis

Abstract The objective of this study was to investigate the association between single nucleotide polymorphisms (SNPs) in the IL10, NOS2A, and ESR2 genes and chronic periodontitis (CP) and aggressive periodontitis (AgP). Three groups of patients underwent periodontal and radiographic evaluations: CP (n = 61), AgP (n = 50), and periodontally healthy (control group=61). Genomic DNA was extracted from oral epithelial cells and used for genotyping by real-time polymerase chain reaction using TaqMan® probes. The investigated SNPs were: -1087G > A, -819C > T and -592C > A in the IL10; +2087G > A in the NOS2A, and +1730G > A in the ESR2 gene. Differences in genotype and allele frequencies of each polymorphism and some individual characteristics were analyzed using the chi-square test and multivariate logistic regression analysis. Analysis of SNPs and haplotypes in the IL10 and SNP in the ESR2 gene did not present any significant association with AgP or CP. The +2087G allele of the NOS2A gene tended to be significantly associated with periodontal disease. Patients carrying the genotype +2087GG in the NOS2A gene were genetically protected against the development of CP (p = 0.05; OR = 0.44; 95%CI = 0.20-0.95). This result showed greater significance when patients with AgP and CP were combined (total PD) (p = 0.03; OR = 0.46; 95%CI = 0.23-0.92). In conclusion, the studied Brazilian population had a significantly higher frequency of the GG genotype for the +2087 SNP in the NOS2A gene in individuals without periodontitis, although statistical significance was not maintained after multiple logistic regression.

Leukotoxicity of Aggregatibacter actinomycetemcomitans in generalized aggressive periodontitis in Brazilians and their family members.

OBJECTIVE: The purpose of this study was to examine the leukotoxin promoter types of Aggregatibacter actinomycetemcomitans clones in subjects with generalized aggressive periodontitis (GAgP) and in their family members (FM). MATERIAL AND METHODS: Thirty-five patients with GAgP (33.9±7.1 years), 33 of their FM (22.8±11.4 years), and 41 patients with chronic periodontitis (CP) (44.1±9.4 years) were clinically analyzed using the plaque index, gingival index, probing depth (PD), and clinical attachment level (CAL). Subgingival biofilm samples were collected from four interproximal periodontal sites (>PD and >CAL) of each patient. The presence of A. actinomycetemcomitans and its leukotoxic clone was confirmed by polymerase chain reaction (PCR). RESULTS: A. actinomycetemcomitans was observed in 23 (51.1%) GAgP patients and 16 (30.1%) CP patients. Thirty-seven (94.8%) patients showed minimally leukotoxic strains and 2 (5.1%) showed highly leukotoxic strains. In the FM group, 10 (30.3%) had aggressive periodontitis (AgP), 12 (36.3%) had CP, 11 (33.3%) were periodontally healthy or had gingivitis, and 12.2% were A. actinomycetemcomitans positive. Greater full mouth PD and CAL were observed in GAgP patients positive for the bacteria than those negative for it (p<;0.05), and the presence of A. actinomycetemcomitans positively correlated with GAgP (Odds ratio, 3.1; confidence interval, 1.4-7.0; p=0.009). CONCLUSIONS: The presence of A. actinomycetemcomitans was associated with the clinical condition of GAgP, with most patients exhibiting a generalized form of the disease and minimally leukotoxic clones. Most of the relatives of GAgP patients presented either CP or AgP.

Leukotoxicity of Aggregatibacter actinomycetemcomitans in generalized aggressive periodontitis in Brazilians and their family members

OBJECTIVE: The purpose of this study was to examine the leukotoxin promoter types of Aggregatibacter actinomycetemcomitans clones in subjects with generalized aggressive periodontitis (GAgP) and in their family members (FM). MATERIAL AND METHODS: Thirty-five patients with GAgP (33.9±7.1 years), 33 of their FM (22.8±11.4 years), and 41 patients with chronic periodontitis (CP) (44.1±9.4 years) were clinically analyzed using the plaque index, gingival index, probing depth (PD), and clinical attachment level (CAL). Subgingival biofilm samples were collected from four interproximal periodontal sites (>PD and >CAL) of each patient. The presence of A. actinomycetemcomitans and its leukotoxic clone was confirmed by polymerase chain reaction (PCR). RESULTS: A. actinomycetemcomitans was observed in 23 (51.1%) GAgP patients and 16 (30.1%) CP patients. Thirty-seven (94.8%) patients showed minimally leukotoxic strains and 2 (5.1%) showed highly leukotoxic strains. In the FM group, 10 (30.3%) had aggressive periodontitis (AgP), 12 (36.3%) had CP, 11 (33.3%) were periodontally healthy or had gingivitis, and 12.2% were A. actinomycetemcomitans positive. Greater full mouth PD and CAL were observed in GAgP patients positive for the bacteria than those negative for it (p<;0.05), and the presence of A. actinomycetemcomitans positively correlated with GAgP (Odds ratio, 3.1; confidence interval, 1.4-7.0; p=0.009). CONCLUSIONS: The presence of A. actinomycetemcomitans was associated with the clinical condition of GAgP, with most patients exhibiting a generalized form of the disease and minimally leukotoxic clones. Most of the relatives of GAgP patients presented either CP or AgP. .

Debridamento ultrassônico de boca toda no tratamento da periodontite crônica: uma revisão sistematizada / Full mouth ultrasonic debridement in the treatment of chronic periodontitis: a systematic review

Introdução: O debridamento ultrassônico de boca toda visa a uma instrumentação mais leve e conservadora da superfície radicular, evitando a recolonização da bolsa periodontal. Objetivo: Este trabalho verificou os efeitos do debridamento subgengival com o uso de ultrassom sobre os parâmetros clínicos periodontais no tratamento da periodontite crônica por meio de uma revisão na literatura. Material e Método: A revisão foi realizada nas bases de busca bibliográfica PubMed, Lilacs, Scielo, Medline e Centro de Registro de Ensaios Clínicos Controlados (Biblioteca Cochrane). Foram incluídas publicações na língua inglesa que abordaram estudos clínicos de intervenção em humanos, randomizados e controlados, e que utilizaram o debridamento ultrassônico para o tratamento não cirúrgico da periodontite crônica. Resultado: Inicialmente, foram encontradas 167 referências e, a partir da análise dos títulos e resumos, dez estudos perfizeram as características exigidas e foram considerados válidos para a realização desta revisão. Os estudos mostraram que a abordagem pelo debridamento ultrassônico pode ser terapia favorável ao tratamento da periodontite crônica. Conclusão: O tratamento da periodontite crônica por meio do debridamento ultrassônico periodontal de boca toda produz resultados clínicos semelhantes aos conseguidos na raspagem e no alisamento radicular convencionais.

Introduction: The full-mouth ultrasonic debridement seeks a more conservative instrumentation with light pressure of the root surface, preventing recolonization of periodontal pockets. Objective: This study examined the effects of subgingival debridement through the use of ultrasonic devices on clinical periodontal parameters in the treatment of chronic periodontitis by a review of the literature. Material and Method: Studies were selected on the bibliographic databases PubMed, Lilacs, Scielo, Medline and the Central Registry of Controlled Trials (The Cochrane Library). It was included English language publications with clinical studies of human intervention, randomized controlled trials that used ultrasonic debridement for the nonsurgical treatment of chronic periodontitis. Result: Initially, we found 167 references and analyzing the titles and abstracts totaled ten studies the characteristics required and were considered valid for the completion of this review. Studies have shown that the approach by ultrasonic debridement therapy may be favorable to the treatment of chronic periodontal disease. Conclusion: It can be concluded that the treatment of chronic periodontitis by full mouth periodontal ultrasonic debridement produces similar outcomes to those achieved in conventional scaling and root planing.