Systemic Antibiotics and Chlorhexidine Associated with Periodontal Therapy: Microbiological Effect on Intraoral Surfaces and Saliva.

The effect of systemic antibiotics on the microbial profile of extracrevicular sites after periodontal treatment is currently the subject of research. This study evaluated the microbiological effects on different oral cavity sites of scaling and root planing (SRP) combined with antimicrobial chemical control in the treatment of periodontitis. Sixty subjects were randomly assigned to receive SRP alone or combined with metronidazole (MTZ) + amoxicillin (AMX) for 14 days, with or without chlorhexidine mouth rinse (CHX) for 60 days. Microbiological samples were evaluated by checkerboard DNA-DNA hybridization until 180 days post therapy. The adjunctive use of antibiotics plus CHX significantly reduced the mean proportions of red complex species from subgingival biofilm and saliva (p < 0.05). Furthermore, the analysis of all intraoral niches showed a significantly lower mean proportion of the red complex species in the same group. In conclusion, the concomitant use of antimicrobial chemical control (systemic and local) demonstrated a beneficial effect on the composition of the oral microbiota.

Er,Cr:YSGG Laser Energy Delivery: Pulse and Power Effects on Enamel Surface and Erosive Resistance.

BACKGROUND: High power lasers have been suggested as a useful tool for dental caries and erosion prevention due to the increase of enamel acid resistance. OBJECTIVE: to evaluate the effect of Er,Cr:YSGG (erbium,chromium:yttrium, scandium, gallium, garnet) laser irradiation pulse frequency and power on enamel surface and acid erosion resistance. METHODS: By combining pulse frequency (5-75 Hz) and power settings (0.10-1.00 W), 20 irradiated groups and one nonirradiated control group were tested. A total of 63 bovine enamel blocks (n = 3/group) were prepared for surface hardness and roughness evaluation, performed in three phases: baseline, after irradiation, and after erosive challenge. Enamel blocks were irradiated with Er,Cr:YSGG laser with MZ8 tip (iPlus; Waterlase, Biolase, CA) for 30 sec according to experimental group and submitted. Erosive challenge consisted of four cycles alternating immersion in 0.01 M HCl (5 mL/mm2; 2 min; at 37°C) and immersion in artificial saliva for 3 h. Analysis of variance (three-way ANOVA), Tukey's test, and Pearson correlation were performed for the statistical analysis (p < 0.05). RESULTS: After irradiation, groups irradiated with pulse frequency of 10 and 15 Hz showed a decrease in surface hardness. After erosive challenge, 5 and 75 W groups showed increase in surface hardness; 0.25, 0.5, 0.75, and 1 W groups showed minor alterations in surface roughness. CONCLUSIONS: the irradiation of Er,Cr:YSGG laser with different parameters of power and pulse frequency settings may alter enamel surface and erosive resistance differently. Pulse frequency of 30 Hz and power of 0.50 W was considered the best parameter to prevent enamel acid erosion.

Cirurgia plástica periodontal para otimização de resultados estéticos na região anterior / Periodontal plastic surgery for optimal esthetic results in the anterior maxilla

O diagnóstico multidisciplinar envolvendo procedimentos restauradores, cirúrgicos e laboratoriais são essenciais para o sucesso de uma reabilitação estética. Este caso clínico descreve um protocolo multidisciplinar utilizado para a reabilitação de dentes anteriores superiores por meio de cirurgia plástica periodontal e restaurações cerâmicas adesivas. Após adequação inicial, foram realizados gengivoplastia para remoção de excesso e melhora do contorno gengival, e a confecção de preparos conservadores para laminados e coroas totais cerâmicas. Após a finaliza- ção deste caso, pôde-se concluir que um diagnóstico bem estabelecido associado a uma abordagem multidisciplinar são procedimentos fundamentais para obtenção de resultados estéticos previsíveis em áreas comprometidas esteticamente.

The multidisciplinary diagnosis considering clinical surgical and laboratorial procedures are essential for a successful aesthetic dental treatment. This clinical report describes a protocol to obtain optimal results in the anterior maxilla by conservative preparations on anterior teeth for adhesively retained porcelain restorations with periodontal plastic surgery. After the ini- tial preparation of patient and diagnostic additive wax-up confection, a periodontal aesthetic crown-Iengthening gengivoplasty followed by osteotomy to remove the excess of gingival was performed. Conservative preparations for ceramic laminate veneers and full-coverage crowns were used for the aesthetic rehabilitation of the patient. An accurate diagnostic and interdiscipli- nary approach is necessary for obtaining improved, conservative and predictable aesthetic results in esthetically compromised areas, such as the anterior maxillary dentition.