Efficacy of acellular xenogeneic dermal matrix graft in the treatment of multiple gingival recessions: systematic review and meta-analysis.

OBJECTIVE: This study aimed to compare the efficacy of acellular xenogeneic dermal matrix graft (AXDM) compared to connective tissue graft (CTG) in treating multiple gingival recessions. MATERIALS AND METHODS: A systematic search of electronic databases was conducted to identify randomized clinical trials (RCTs) that compared AXDM and CTG. The selected studies were subjected to bias risk assessment, data extraction, and meta-analyses. Parameters such as gingival recession height, width, mean percentage of root coverage, and complete root coverage were analyzed. RESULTS: Seven RCTs involving 146 patients were included. The meta-analyses indicated that CTG was statistically superior to AXDM in reducing gingival recession height at the final follow-up (mean difference: -0.104 mm, 95% confidence interval [CI]: -0.180-0.028, p = 0.008) and width at the final follow-up (mean difference: -0.285 mm, 95% CI: -0.541-0.030, p = 0.029). CTG also demonstrated a significantly higher mean percentage of root coverage at the 6-month follow-up (difference in means: -2.761 mm, 95% CI: -4.932-0.590, p = 0.013) and a higher percentage of complete root coverage at the 6-month follow-up (odds Ratio [OR]: 0.598, 95% CI: 0.4-0.892, p = 0.012) compared to AXDM. However, there was no significant difference in the number of teeth with complete root coverage between CTG and AXDM (OR: 1.610, 95% CI: 0.983-2.636, p = 0.058) and aesthetic outcomes (mean difference: 0.148, 95% CI: -0.277-0.573, p = 0.494). CONCLUSIONS: CTG is more effective than AXDM in treating multiple gingival recessions. This is evidenced by significant reductions in gingival recession height and width, a higher mean percentage of root coverage, and a greater percentage of complete root coverage at the 6-month follow-up. CLINICAL RELEVANCE: In some clinical situations an alternative to CTG is required for the treatment of multiple gingival recessions. AXDM, despite presenting clinical outcomes that are not as satisfactory as CTG, can be used for this purpose.

Effect of different combinations of papain-based gels on dissolving pulp tissue / Efeito de diferentes combinações de géis à base de papaína na dissolução do tecido pulpar

The focus of this study was to evaluate the capacity to dissolve pulp tissue of various combinations of papain-based gels and other antimicrobial agents. 105 bovine pulps were used, of standardized sizes, fragmented into 15mm-sized portions and weighed on an analytical balance, divided into 7 groups (n=15): 1 - 0.9% Saline Solution (negative control); 2- 8% Papain gel; 3- 8% Papain gel + 0.5% Chloramine; 4- 0.5% Chloramine gel; 5- 8% Papain gel + 2% Chlorhexidine; 6- 2% Chlorhexidine gel; and 7- 5.25% Sodium Hypochlorite solution (positive control). After initial weighing, the pulp fragments were inserted in test tubes for dissolution for time intervals of 30, 60, 90 and 120 minutes, and then weighed again. The data were analyzed using the Kruskal­Wallis and Mann­Whitney tests (p<0.05). In the time interval of 120 minutes the 0.5% chloramine gel demonstrated 64.9% ability to pulp dissolve, followed by 8% papain gel with 61.3%; papain associated with 0.5% chloramine, 58%; and papain associated with 2% chlorhexidine, 55.4%; which showed statistically significant difference with 5.25% Sodium Hypochlorite (p<0.05). All the gels that contained papain and the 0.5% chloramine gel promoted pulp tissue dissolution, however on a significantly lower scale than 5.25% sodium hypochlorite. The 2% chlorhexidine demonstrated no capacity to dissolve pulp, as did the control.

O foco deste estudo foi avaliar a capacidade de dissolução do tecido pulpar de várias combinações de géis à base de papaína e outros agentes antimicrobianos. Foram utilizadas 105 polpas bovinas, de tamanhos padronizados, fragmentadas em porções de 15mm e pesadas em balança analítica, divididas em 7 grupos (n = 15): 1 - 0,9% de Solução Salina (controle negativo); 2- 8% de gel de papaína; 3- 8% de gel de papaína + 0,5% de cloramina; 4- 0,5% de gel de cloramina; 5- 8% de gel de papaína + 2% de clorhexidina; 6- 2% de gel de clorexidina e 7- 5,25% de solução de hipoclorito de sódio (controlo positivo). Após pesagem inicial, os fragmentos de polpa foram inseridos em tubos de ensaio para dissolução durante intervalos de tempo de 30, 60, 90 e 120 minutos e depois pesados novamente. Os dados foram analisados pelos testes de Kruskal-Wallis e Mann-Whitney (p <0,05). No intervalo de tempo de 120 minutos o gel de cloramina a 0,5% demonstrou 64,9% de capacidade de dissolver polpa, seguido pelo gel de papaína a 8% com 61,3%; papaína associada a 0,5% de cloramina, 58%; e papaína associada a clorexidina a 2%, 55,4%; que apresentaram diferença estatisticamente significativa com hipoclorito de sódio a 5,25% (p <0,05). Todos os géis que continham papaína e o gel de cloramina a 0,5% promoveram a dissolução do tecido de polpa, contudo em uma escala significativamente inferior a 5,25% de hipoclorito de sódio. A clorexidina a 2% não demonstrou capacidade para dissolver a polpa, assim como o controle.

Perception of Esthetic Impact of Smile Line in Complete Denture Wearers by Different Age Groups.

PURPOSE: To evaluate esthetic perceptions based on tooth exposure when smiling of patients wearing complete dentures by evaluators in different age groups. MATERIALS AND METHODS: Alterations were made to a front view photograph of a smiling patient wearing complete maxillary and mandibular dentures. Alterations in the smile line were simulated to increase or decrease tooth exposure (increments of 0.5 mm). For this purpose, image manipulation software was used. After manipulation, images were printed on photo paper, attached to a questionnaire, and distributed to individuals in three age groups (n = 150). To evaluate the esthetic perception for each image, a visual analog scale was used, with 0 representing least attractive, 5 representing attractive, and 10 representing very attractive. Differences between examiners were analyzed using the Mann-Whitney test. All statistical analyses were performed with a degree of confidence of 95%. RESULTS: Two evaluators did not observe any differences between images. The images given the best and worst scores were E and O (alterations of 2 and 7 mm), respectively, in the 15- to 19-year-old group, B and O (alterations of 0.5 and 7 mm), respectively, in the 35- to 44-year-old group, and A and M (no alteration and 6 mm alteration), respectively, in the 65- to 74-year-old group. When the images were presented together (images 1 and 2), the unaltered image was selected by individuals of different age groups as the best, and the image with a change of 7 mm was selected as the worst. CONCLUSION: In this study, complete dental prostheses with smile lines that coincided with the cervical margins of the anterior teeth were the most acceptable. Less exposure of the maxillary teeth when smiling corresponded with decreased attractiveness.

Avaliação da rugosidade superficial de cimentos ionoméricos modificados por resina / Evaluation of roughness surface of resin-modified glass ionomer cements

Objetivo: Analisar a rugosidade superficial dos cimentos ionoméricos resinosos Vitro Fil LC e Vitremer através de testes in vitro. Materiais e Métodos: Vinte corpos de prova foram utilizados e divididos em dois grupos: 1) Vitro Fil LC; 2) Vitremer. Após 24 horas, uma das faces de cada corpo de prova sofreu polimento mecânico e a outra serviu de controle positivo. Os materiais usados para a realização do polimento foram pontas siliconizadas para polimento Composite Fine, o material foi utilizado de acordo com as recomendações do fabricante. Terminado o polimento, os corpos de prova foram submetidos à análise de rugosidade superficial média (Ra), através da utilização de um Rugosímetro, expressa em micrômetros. Os resultados obtidos foram comparados pelo teste U de Mann-Whitney, após verificação da normalidade dos dados por meio da análise da simetria da curva de Gauss. O nível de significância adotado foi de 5% (α = 0,05). Os dados foram tabulados e analisados no programa estatístico BioEstat (versão 5.0, Belém-PA, Brasil). Resultados: Houve diferença significativa na Ra superficial entre a face polida e não polida, para os dois tipos de cimentos. Enquanto para o Vitro Fill LC foi verificada maior Ra superficial na face polida (p = 0,041), para o Vitremer foi observada na face não polida (p = 0,002). Para as faces polidas, o Vitremer apresentou Ra superficial significativamente menor (p = 0,001) do que o Vitro Fill LC. Conclusão: O cimento ionomérico resinoso Vitremer, quando polido, apresentou menor rugosidade superficial

Objective: To analyze the surface roughness of Resin-Modified Glass Ionomer Cements Vitro Fil LC and Vitremer through in vitro tests. Materials and Methods: Twenty specimens were used and divided into two groups: 1) Vitro Fil LC; 2) Vitremer. After 24 hours, one face of each specimen suffered mechanical polishing and the other served as a positive control. The materials used to perform the polishing were siliconized tips for polishing Composite Fine, the material was used according to the manufacturer's recommendations. After the polishing, the specimens were subjected to analysis of average surface roughness (Ra), by using a Surface Roughness Tester, expressed in micrometers. The results were compared by Mann-Whitney test, after verification of normality of the data by analyzing the symmetry of the bell curve. The level of significance was set at 5% (α = 0.05). The data were analyzed with statistical software BioEstat (version 5.0, Belém-PA, Brazil). Results: There was significant difference in surface roughness between the polished and unpolished compared to the two types of cements. As for the LC Vitro Fill greater surface was observed on the polished face Ra (p = 0.041), for Vitremer was not observed in the polished face (p = 0.002). For the polished faces, Vitremer showed superficial Ra significantly lower (p = 0.001) than the LC Fill Vitro. Conclusion: The ionomer resin cement Vitremer, when polished, showed lower surface roughness

Influência da cor da máscara facial de Delaire na atratividade estética / The influence of Delaire´s facial mask color on esthetical attractiveness

Objetivo: avaliar a atratividade estética de máscaras faciais do tipo Delaire de diferentes cores. Métodos: oito cores de máscaras faciais ortopédicas do tipo Delaire foram avaliadas. As imagens foram obtidas de um mesmo paciente e padronizadas por meio do editor de imagens Adobe Photoshop CS. As cores avaliadas foram: branca, cinza, verde, amarela, azul, rosa, marrom e preta. Após a aquisição das imagens, essas foram impressas em papel fotográfico e incorporadas a um questionário específico e personalizado. O questionário foi distribuído para crianças de ambos os sexos, nas faixas etárias de 7 a 8 e de 9 a 10 anos, em escolas públicas e privadas (n = 200). O teste de Mann-Whitney foi usado para análise das notas atribuídas a cada imagem, e, para a análise entre os grupos, usou-se a correlação de Spearman. O nível de significância adotado foi de 5%. Resultados: apenas as notas dadas à cor azul apresentaram diferenças estatisticamente significativas entre os estudantes de escolas públicas e privadas. Na comparação entre sexos, os meninos pontuaram melhor as cores cinza e preta, enquanto as meninas pontuaram melhor a cor rosa. Comparando as faixas etárias examinadas, não houve diferença estatística. Conclusão: a cor da máscara facial do tipo Delaire influencia na atratividade estética para crianças de 7 a 10 anos, e a preferência por determinadas cores sofre influencia também do sexo e do tipo de escola (pública ou privada).