Improvement of periodontal parameters following intensive diabetes care and supragingival dental prophylaxis in patients with type 2 diabetes: A prospective cohort study.

AIM: This study aimed to investigate the effects of diabetes care on periodontal inflammation. MATERIALS AND METHODS: This prospective cohort study included 51 Japanese patients with type 2 diabetes who underwent intensive diabetes care including educational hospitalization and regular outpatient treatment for 6 months. Dental prophylaxis without subgingival scaling was provided three times during the observational period. Associations between changes in periodontal parameters and glycaemic control levels were evaluated using multiple regression analysis. RESULTS: Overall, 33 participants (mean age: 58.7 ± 12.9) were followed up for 6 months. At baseline examination, 82% were diagnosed with Stage III or IV periodontitis. Haemoglobin A1c (HbA1c) level changed from 9.6 ± 1.8% at baseline to 7.4 ± 1.3% at 6 months. The ratio of probing pocket depth (PPD) ≥4 mm, bleeding on probing (BOP), full-mouth plaque control record (PCR), periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) also significantly improved. The reduction in PPD and PESA was significantly associated with changes in both HbA1c and fasting plasma glucose (FPG) levels, and the reduction in PISA was significantly associated with an improvement in FPG after adjusting for smoking, change in body mass index and full-mouth PCR. CONCLUSIONS: This is the first study to report a significant improvement in PPD and BOP after intensive diabetes care and dental prophylaxis without subgingival scaling. CLINICAL TRIAL REGISTRATION NUMBER: UMIN000040218.

Influence of NaHCO3 powder on color and roughness of the composite submitted to bleaching and euterpe oleracea / Influencia del polvo de NaHCO 3 en el color y rugosidad del composite sometido a blanqueo y euterpe oleracea

Aim: This study aims to evaluate the surface roughness and susceptibility to staining of bleached composite resin with 22% carbamide peroxide, as well as the effect of subsequent prophylaxis with NaHCO3 powder. Material and Methods: Forty disk-shaped (2 × 6 mm) specimens of composite resin (Z250 XT) were prepared. Half of the specimens were subjected to bleaching with 22% carbamide peroxide, and the other half were stored in artificial saliva. In sequence, all specimens were immersed in acai juice (Euterpe oleracea) for 4 h for 14 days, and subdivided into two groups. Group 1 samples were subjected to prophylaxis treatment, while group 2 samples were subjected to treatment with artificial saliva. Surface roughness (Ra) and color (ΔE*) were measured after polishing (T0), bleaching (T1), immersion in acai juice (T2), and application of NaHCO3 powder (T3) using a profilometer and a spectrophotometer. Results: Statistical analyses (analysis of variance and Tukey's test, p≤0.05) revealed that regarding color there was statistically significance for the factors in isolation, except for the factor bleaching. For both color and surface roughness there was statistically significant difference for the interaction, except for the interaction between NaHCO3 power and bleaching. Conclusion: The NaHCO3 air-powder polishing decreases the staining of the composite resin; however, it increases the surface roughness. With respect to the color variable, the whitening factor had no significant effect on the tested material; however, it increases surface roughness.

Objetivo: Este estudio tiene como objetivo evaluar la rugosidad de la superficie y la susceptibilidad a la tinción de la resina compuesta blanqueada con peróxido de carbamida al 22%, así como el efecto de la profilaxis posterior con polvo de NaHCO3. Material y Métodos: Se prepararon cuarenta especímenes en forma de disco (2 × 6 mm) de resina compuesta (Z250 XT). La mitad de los especímenes se sometieron a blanqueo con peróxido de carbamida al 22% y la otra mitad se almacenó en saliva artificial. En secuencia, todos los especímenes se sumergieron en jugo de acai (Euterpe oleracea) durante 4h durante 14 días, y se subdividieron en dos grupos. Las muestras del grupo 1 se sometieron a tratamiento profiláctico, mientras que las muestras del grupo 2 se sometieron a tratamiento con saliva artificial. La rugosidad de la superficie (Ra) y el color (ΔE*) se midieron después del pulido (T0), el blanqueo (T1), la inmersión en jugo de acai (T2) y la aplicación de polvo de NaHCO3 (T3) utilizando un perfilómetro y un espectrofotómetro. Resultados: Los análisis estadísticos (análisis de varianza y prueba de Tukey, p≤0.05) revelaron que en relación al color hubo significancia estadística para los factores en forma aislada, excepto para el factor blanqueamiento. Tanto para el color como para la rugosidad de la superficie hubo una diferencia estadísticamente significativa para la interacción, excepto para la interacción entre el poder de NaHCO3 y el blanqueo. Conclusión: El pulido al aire con polvo de NaHCO3 disminuye el manchado de la resina compuesta; sin embargo, aumenta la rugosidad de la superficie. Con respecto a la variable color, el factor de blanqueamiento no tuvo efecto significativo sobre el material ensayado; sin embargo, aumenta la rugosidad de la superficie.

Immediate impact of dental prophylaxis and oral hygiene improvement on multifocal pyogenic granulomas: a case report.

A 31-year-old man presented with gingival mass-like lesions. The patient reported occasional bleeding from lesions; otherwise, the lesions were asymptomatic. Intraoral examination revealed multiple interdental red/purple soft, sessile, nodular lesions involving both the maxillary and mandibular buccal and lingual gingivae, with poor oral hygiene. After performing incisional biopsy, the patient was diagnosed with pyogenic granuloma. Subsequently, the patient underwent cleaning of his teeth and within only 3 days of dental cleaning, the patient reported rapid regression of all his lesions.

The influence of prophylaxis with amino acid glycine powder and sodium bicarbonate jet on the bond strength of dental enamel / A influência da profilaxia com aminoácido glicina em pó e jato de bicarbonato de sódio na resistência de união do esmalte dentário

Aim: To compare the influence of prophylaxis with sodium bicarbonate and amino acid glycine powder on the bond strength of bovine teeth enamel and on the properties of two adhesive systems. Methods:Thirty-six extracted bovine incisors were randomly divided into six groups (n = 6) according to the prophylactic treatment received: no prophylactic treatment (NT), sodium bicarbonate powder (SB), and glycine powder (GL). Each group was subdivided into 2 groups based on what adhesive systems were used: conventional system (A) and universal system (B). Composite resin was applied on the buccal surface of the teeth in a block measurement 8x8x6 mm. The specimens were cut to obtain beams measuring 1.0 x 1.0 mm and were subjected to microtensile bond strength tests. Results were compared using two-way ANOVA (p ≤ 0.05). Results: The GLA group obtained the highest bond strength value for the conventional adhesive (18.97 MPa), but the GLB group obtained a lower strength value than the SBB group (GLB: 21.05 MPa and SBB: 22.29 MPa) (p < 0.05). Conclusions: Cleaning of the enamel surface increases the adhesive properties of restorative materials, and the bond strength was more effective in the group that received glycine prophylaxis and the conventional adhesive system.

Objetivo:Comparar a influência da profilaxia com bicarbonato de sódio e ClinproProphy ™ na resistência de união do esmalte de dentes bovinos e nas propriedades de dois sistemas adesivos.Métodos: Trinta e seis incisivos bovinos extraídos foram divididos aleatoriamente em 6 grupos (n = 6), cada um de acordo com o tratamento profilático recebido: nenhum tratamento profilático (NT), bicarbonato de sódio em pó (SB), glicina em pó (GL). Cada grupo foi subdividido em 2 grupos com base nos sistemas adesivos utilizados: sistema convencional (A) e sistema universal (B). A resina composta foi aplicada na superfície bucal dos dentes em um bloco de 8x8x6 mm. As amostras foram cortadas para obter blocos medindo 1,0 x 1,0 mm e submetidas a testes de resistência de união por microtração. Os resultados foram comparados usando o teste two-way ANOVA (p ≤ 0,05). Resultados: O grupo GLA obteve o maior valor de resistência de união para o adesivo convencional (18,97 MPa), mas o grupo GLB obteve um valor de resistência menor que o grupo SBB (GLB: 21,05 MPa e SBB: 22,29 MPa) (p < 0,05). Conclusão: A limpeza da superfície do esmalte aumenta as propriedades adesivas dos materiais restauradores, e a resistência adesiva foi mais eficaz no grupo que recebeu profilaxia com glicina e sistema adesivo convencional.

EVALUACIÓN DEL CONOCIMIENTO, LA ACTITUD Y LA PRÁCTICA SOBRE LAS AYUDAS PARA LA HIGIENE BUCAL ENTRE HIGIENISTAS DENTALES EN EL OESTE DE MAHARASHTRA, INDIA / EVALUATION OF KNOWLEDGE, ATTITUDE AND PRACTICE ABOUT ORAL HYGIENE AIDS AMONG DENTAL HYGIENISTS IN WESTERN MAHARASHTRA, INDIA

Introducción: El uso diario de ayudas para la higiene oral y la profilaxis oral anual o semestral por parte de los profesionales de la odontología (dentistas, higienistas dentales, asistentes dentales) son dos maneras efectivas de mantener una buena higiene oral. El presente estudio se llevó a cabo para evaluar el conocimiento, la actitud y la práctica sobre higiene bucal entre higienistas dentales que trabajan en el oeste de Maharashtra, India. Materiales y métodos: se realizó un estudio de cuestionario entre 52 higienistas dentales en activo de diferentes áreas del oeste de Maharashtra. Se diseñó un cuestionario estructurado, cerrado autoadministrado para recopilar los datos que constaba de dos partes y comprendía 31 preguntas. Se hizo un análisis estadístico utilizando estadísticas descriptivas. Resultados: En este estudio, más del 50% de los participantes conocían la importancia del mantenimiento de la higiene bucal y los diferentes tipos de ayudas para la higiene bucal y correctos métodos de uso de esas ayudas para la higiene oral. Alrededor del 96% de los participantes pensaba que la técnica de cepillado adecuada es necesaria para mantener una buena higiene bucal. Conclusión: El conocimiento general, la actitud y la práctica de los participantes del estudio con respecto a las ayudas para la higiene bucal se observaron en un nivel promedio.

Introduction: Everyday use of oral hygiene aids and annual or biannual oral prophylaxis by dental professionals (Dentists, Dental hygienists, Dental assistants) are two effective ways of maintaining good oral hygiene. The present study was conducted to assess the knowledge, attitude, and practice about oral hygiene among working dental hygienists in Western Maharashtra, India. Materials and methods: A questionnaire study was conducted among 52 working dental hygienists from different areas of Western Maharashtra. The structured, self-administered, close-ended questionnaire was designed to collect the data which consist of two parts and comprised 31 questions. Statistical analysis was done using descriptive statistics. Results: In this study, more than 50% of participants were known the importance of oral hygiene maintenance and different types of oral hygiene aids and correct methods of using those oral hygiene aids. About 96% participants thought that proper brushing technique is necessary to maintain good oral hygiene. Conclusion: The study participant's overall knowledge, attitude and practise regarding oral hygiene aids were seen at average level.

Enfermos com histórico de Febre Reumática e suas implicações em odontologia: uma revisão de literatura / Sick with history of rheumatic fever and its implications in dentistry: a literature review

Objetivo: analisar informações presentes na literatura sobre a citada patologia com enfoque odontológico, baseando-se em evidências atuais, a fim de estruturar uma conduta clínica, métodos preventivos e terapêuticos. Revisão de literatura: executou-se busca na literatura em dezembro de 2020, por meio dos descritores pré-estabelecidos, nos bancos de dados LILACS e PubMed/MEDLINE, além de complementações utilizando o Google Scholar. Foram encontrados 563 artigos, refinados em 10, juntamente ao uso de 3 livros. Considerações finais: a partir dos achados, constatou-se que a realização de uma anamnese criteriosa durante a primeira consulta faz-se imprescindível, por auxiliar na compreensão dos aspectos fisiopatológicos do paciente, os quais irão determinar o emprego ou não de fármacos, principalmente antes de procedimentos invasivos. Em contrapartida, verificou-se a negligência desse assunto no âmbito odontológico, pelo fato de existirem poucos estudos relacionados ao manejo clínico de pacientes com Febre Reumática (FR), sendo necessárias maiores pesquisas, com o fito de construir-se uma conduta clínica adequada, reduzindo-se os riscos e a incidência de tal enfermidade.(AU)

Objective: to analyze information in the literature about mentioned pathology with a dental focus, based on current evidence in order to structure a clinical conduct, preventive and therapeutic methods. Literature Review: literature searches were performed in December 2020, using pre-established descriptors, in the databases LILACS and PubMed/MEDLINE, in addition to complementations using Google Scholar. About 563 articles were found, refined in 10, along with the use of 3 books. Final Considerations: From the findings, it was found that the performance of a careful anamnesis during the first consultation is essential, as it helps to understand the patient's pathophysiological aspects, which will determine the use of drugs, mainly, before invasive procedures. On the other hand, this matter was neglected in the Dental field, due to the fact that there are few studies related to the clinical management of patients with Rheumatic Fever (RF), and further research is necessary, with the aim of building an adequate clinical conduct, reducing the risks and the incidence of such a disease.(AU)

The impact of timing and modalities of dental prophylaxis on the risk of 5-fluorouracil-related oral mucositis in patients with head and neck cancer: a nationwide population-based cohort study.

PURPOSE: This study investigated the impact of dental prophylaxis on 5-fluorouracil (5-FU)-related oral mucositis (OM) according to the head and neck cancer (HNC) locations and treatment times. METHODS: A total of 13,969 HNC participants, including 482 5-FU-related OM subjects and 13,487 comparisons were enrolled from the Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan between 2000 and 2008. All subjects were stratified into subgroups based on the times to perform chlorhexidine use, scaling, and fluoride application before 5-FU administration. The dental prophylaxis related to 5-FU-related OM was estimated by multiple logistic regression and represented with odds ratio (OR) and 95% confidence interval (CI). RESULTS: Fluoride gel application and scaling significantly impacted on OM development (p < 0.001), and the joint effect of fluoride gel and scaling induced 5-FU-related OM (OR = 3.46, 95% CI = 2.39-5.01). The risk of OM was raised 2.25-fold as scaling within 3 weeks before 5-FU-related chemotherapy (95% CI = 1.81-2.81), and a 3.22-fold increased risk of OM while fluoride gel was applied during 5-FU-related treatment (95% CI = 1.46-7.13). CONCLUSION: Dental prophylaxis significantly affected 5-FU-related OM in the HNC population. A short interval between dental scaling or fluoride application and 5-FU administration may be associated with higher prevalence of OM. Scaling simultaneously combined with chlorohexidine promoted 5-FU-related OM in specific HNC patients excluding the oral cancer and nasopharyngeal cancer population. Proper timing of the prophylactic dental treatments prior to 5-FU therapy could reduce the risk to develop 5-FU-related OM.

Tratamiento profiláctico en extracciones dentarias con la terapia floral de bach (crab apple) / Prophylactic treatment in tooth extractions with bach flower therapy (crab apple)

Introducción: La terapia floral de Bach es una terapia medicamentosa no farmacológica que brinda un conjunto de remedios vibracionales; es un remedio de limpieza por excelencia, se le considera el antibiótico de elección del citado sistema floral. Objetivo: caracterizar a los pacientes atendidos en el Servicio de Estomatología de la Facultad de Ciencias Médicas de Morón tarados con Terapia Floral de Bach (Crab Apple), como profilaxis en extracciones dentarias. Método: se realizó un estudio experimental (cuasi experimento), para el mismo se crearon dos grupos uno experimental y otro control en el período comprendido de Junio 2019 a Enero de 2020. La población la constituyó 370 pacientes que acudieron al Servicio de Estomatología de la Facultad de Ciencias Médicas "Arley Hernández Moreira" para realizarse extracciones dentarias; la muestra se seleccionó utilizando el método probabilístico aleatorio simple la cual quedó conformada por 260 pacientes. Resultados: la respuesta preoperatoria del 100 % de los pacientes del grupo experimental fue satisfactoria, el 9,5 % perteneciente al grupo control fue no satisfactoria. El 100 % de los pacientes del grupo experimental y el 89,1 % del grupo control durante el transoperatorio presentaron respuesta satisfactoria. Durante el posoperatorio solo el 2,5% del grupo experimental alcanzó resultados no satisfactorios y en el grupo control el 9,4 %. Conclusiones: El estudio mostro la efectividad de la terapia floral de Bach como profilaxis ante la extracción dentaria presentando un menor número de complicaciones y respondiendo con mayor efectividad su uso durante el posoperatorio el transoperatorio y el posoperatorio.

Avaliação do comportamento odontológico infantil durante procedimentos de profilaxia e exodontia / Evaluation of children's dental behavior during prophylaxis and extraction procedures

Objetivo: Avaliar o comportamento infantil durante os tratamentos odontológicos de profilaxia e de exodontia. Métodos: Este estudo transversal contou com 58 crianças, entre 6 e 9 anos de idade. Dentre essas, 29 crianças foram submetidas ao procedimento de exodontia e 29 ao procedimento de profilaxia. O comportamento infantil frente ao tratamento odontológico proposto foi avaliado por um cirurgião-dentista treinado através da versão brasileira e validada da Escala Comportamental de Venham (Venham's Behavior Rating Scale (BvVBRS). Avaliou-se também a ansiedade infantil prévia ao tratamento odontológico através da Venham Picture Test modificada (VPTm). A condição bucal foi avaliada pelo índice CPO-D e ceo-d, por pesquisador previamente calibrado (Kappa > 0,7). Os pais/responsáveis responderam a um questionário socioeconômico e questões relacionadas a experiência odontológica prévia das crianças. Realizou-se análise descritiva e teste Qui-quadrado com nível de significância de 5%. Resultados: Em relação ao comportamento o grupo submetido à profilaxia apresentou 100% das crianças com um comportamento positivo, enquanto no grupo submetido à exodontia houve 75,9% das crianças com comportamento positivo (p = 0,010). Idade, gênero e presença de ansiedade prévia aos procedimentos não tiveram relação estatisticamente significante com o comportamento infantil. A presença de cárie na dentição decídua esteve associada ao comportamento negativo durante os procedimentos odontológicos (p = 0,013). Conclusão: Foi observado que durante o procedimento de profilaxia os pacientes demonstraram um comportamento mais colaborador quando comparado ao procedimento de exodontia.

Aim:To investigate the behavior of children during dental treatments of prophylaxis and dental extraction. Methods: Fifty-eight children, 6 to 9 years of age, and their caregivers participated of this cross-sectional study. Of these, 29 children underwent prophylaxis and 29 dental extraction. Child behavior was assessed through the Brazilian version of the Venham's Behavior Rating Scale (BvVBRS), and dental anxiety was measured by the Venham Picture Test modified (VPTm). Clinical examination was performed by a calibrated examiner (Kappa > 0.7), using the decay, missing, filled index for primary and permanent dentition dmft/DMFT index. The caregivers answered a socioeconomic questionnaire and questions related to the previous dental experience of the children. Descriptive data analysis and Chi-square test were performed, with a significance level of 5%. Results:Regarding behavior, the prophylaxis group presented 100% of children with a positive behavior, while the extraction group contained 75.9% of children with positive behavior, and this difference was statistically significant (p = 0.010). Age, gender, and presence of anxiety prior to the procedures had no statistically significant relationship to the presented child behavior. The presence of caries in the deciduous dentition was associated with child behavior during dental procedures (p = 0.013). Conclusion: It was observed that the type of procedure interfered directly in the negative behavior of the children, with a difference in cooperation with invasive (dental extraction) and non-invasive (prophylaxis) procedures.

Comparison of Total Anaerobic Microbiota in Periodontitis Before and After the Subgingival Irrigation with Chlorhexidine at 0. 12 % / Comparación de la Microbiota Anaerobia Total en Periodontitis antes y Después de la Irrigación Subgingival con Clorhexidina al 0, 12 %

ABSTRACT: The objective of this study was to determine the effect of the subgingival irrigation of chlorhexidine 0.12 % of the total anaerobic microbiota. Microbial sampling to 30 subjects with periodontitis stage II Grade B, in pockets with a periodontal probing depth > 4 mm. The subgingival irrigation was made with 5 mL of chlorhexidine in the test group and with 5 mL of distilled water in the control group. 24 hours after the procedure was obtained a second sample to compare. It was found that the subgingival irrigation with chlorhexidine at 0.12 % achieved a statistically significant decrease in anaerobic microbiota (p< 0.05).

RESUMEN: El objetivo del presente estudio fue determinar el efecto de la irrigación subgingival de la clorhexidina 0,12 % sobre la microbiota anaeróbica total. Se tomaron muestras microbiológicas a 30 sujetos con periodontitis estadio II grado B, en sacos periodontales con una profundidad de sondaje > 4 mm. Se realizó la irrigación subgingival con 5 mL. de clorhexidina en el grupo test y con 5 mL. de agua destilada en el grupo control. 24 horas después del procedimiento se obtuvo una segunda muestra a comparar. Se detectó que la irrigación subgingival con clorhexidina al 0,12 % logra disminuir en forma estadísticamente significativa la microbiota anaeróbica total (p< 0,05).

Inflammatory markers in the saliva of cerebral palsy individuals with gingivitis after periodontal treatment.

The aim of this study was to evaluate the effect of periodontal treatment on the salivary cytokine levels and clinical parameters of individuals with cerebral palsy (CP) with gingivitis. A non-randomized, clinical trial was conducted in individuals diagnosed with spastic CP. Thirty-eight individuals were enrolled in the study and were categorized according to gingival index scores between 0-1 or 2-3, assigned to groups G2 or G1, respectively. Periodontal treatment comprised oral hygiene instructions, conventional mechanical treatment and 0.12% chlorhexidine applied as an adjunct. Clinical parameters and saliva samples were collected at baseline and at the 15-day follow-up visit. Bleeding on probing and periodontal screening and recording were determined. Non-stimulated saliva samples were obtained, and the salivary flow rate, the osmolality and the levels of cytokines IL-1ß, IL-6, IL-8, IL-10, TNF-α and IL-12p70 were evaluated by a cytometric bead array. The Wilcoxon test, the Mann-Whitney test, Spearman correlation analysis, Poisson regression analysis and an adjusted analysis were performed (α = 0.05). The groups differed significantly in periodontal clinical parameters at baseline and at follow-up. Salivary flow rate and osmolality were similar in both groups at both timepoints. However, TNF-α and IL-1ß levels were higher in G1 than in G2 at baseline. Mechanical treatment resulted in improved clinical parameters for both groups. Furthermore, mechanical treatment resulted in a significant reduction in salivary IL-1ß and IL-8 levels for both groups after treatment. Periodontal treatment performed in individuals with CP and gingivitis reduces the levels of TNF-α, IL-1ß, IL-6 and IL-8.

Photobiomodulation as an Inflammatory Therapeutic Following Dental Prophylaxis in Canines.

Objective: The aim of this study was to determine if a single photobiomodulation treatment can reduce oral erythema and edema following routine dental prophylaxis in canines. Background: Photobiomodulation therapy has been documented to accelerate healing time through mitigation of erythema and edema in human and veterinary patients. Methods: Canine patients were randomly assigned into three groups: CG (Control, n = 9, mock gingiva treatment without irradiation), LTG (left side treated, n = 8, irradiation of left upper and lower dental arcade), and RTG (right side treated, n = 7, irradiation of right upper and lower dental arcade). Immediately following anesthetized dental prophylaxis, the canines in the RTG and LTG received four points of irradiation (GaAlInP-650 nm, continuous wave, 0.1 W, 0.2 W/cm2, 100 sec, 10 J, 20 J/cm2). Erythema and edema along the gingival surface of each dental arcade were scored 24 h after treatment by a blinded veterinary evaluator. Analysis of variance and Bonferroni correction were used for data analysis. Results: Using a composite evaluation, there was significantly lower inflammation scores for the RTG (p = 0.017) and LTG (p = 0.025) relative to the CG at the location of the lower right dental arcade. Evaluating erythema individually, a significant reduction was found in the LTG (p = 0.049) when compared with the CG for the lower left dental arcade. Conclusions: Despite the limitations in this study, the canines who received a single photobiomodulation treatment demonstrated some degree of reduction in oral inflammation and erythema following dental prophylaxis.

Cleaning effectiveness of a nickel-titanium ultrasonic tip in ultrasonically activated irrigation: a SEM study.

In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer's protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey's tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.

Oral hygiene instructions and professional control as part of the treatment of desquamative gingivitis. Systematic review.

BACKGROUND: The aim of this present article was to evaluate the scientific evidence on the efficacy of daily hygiene and professional prophylaxis for treatment of desquamative gingivitis. MATERIAL AND METHODS: The present systematic review was conducted following the PRISMA protocol. Searches were carried out in Pubmed, Embase, Web of Science and Cochrane Library up to July 2018, randomized clinical trials and cohort studies on desquamative gingivitis (DG), and oral diseases joined to DG. RESULTS: After screening, we found that nine publications met the eligibility criteria eight cohort studies and one randomized control trial. The diagnosis of the diseases corresponded to oral lichen planus (n=185), mucous membrane pemphigoid (n=13); plasma cell gingivitits (n=15) and pemphigus vulgar (n=11). The follow-up was between a week and a year after instructing patients. Dental daily hygiene and professional prophylaxis, at least with supragingival scaling and polishing have significantly improved the extension of the lesion and reduced the activity of DG, and gingival bleeding in all patients. Furthermore, these techniques have also reduced pain and gingival plaque. CONCLUSIONS: In conclusion the studies presented support the efficacy of maintaining personal and professional oral hygiene in patients with GD, reducing the clinical signs of the disease, regardless of its pathogenesis.

The Role of Dental Providers in Preventing HPV-Related Diseases: A Systems Perspective.

Successfully educating dental providers and patients about the link between human papillomavirus (HPV) and oropharyngeal cancer requires coordinated efforts to increase HPV-related prevention practices. The aim of this study was to identify, using a systems perspective, the multi-level determinants related to how dental providers can promote HPV prevention in dental practices. Data for this qualitative study were collected in 2015-16 from focus groups with dentists (four focus groups, n=33), focus groups with dental hygienists (four focus groups, n=48), and in-depth interviews with dental opinion leaders (n=13). Results were triangulated and mapped along micro, meso, and macro system levels. At the micro level, participants identified patient characteristics and low self-efficacy as influential determinants when discussing HPV prevention. At the meso level, relationships among dentists, dental hygienists, and the physical practice environment were factors affecting dental providers' HPV prevention efforts. At the macro level, professional organizations impacted how dental providers interacted with their patients on this topic. These results suggest that improving HPV prevention among dental providers requires a multi-level approach that considers the distinctive context of dental settings, dental training, and perceptions of professional roles. The findings suggested that the macro- and meso-level determinants may be challenging to modify due to the distinctive culture and practice models of dentistry. Nevertheless, the association between HPV and oral cancer requires an expansion of prevention strategies used in dental practices. Improving dental providers' self-efficacy to communicate HPV prevention through continuing education and integration of skill-guided training in dental and dental hygiene curricula could facilitate this process.

Clinical evaluation of non-surgical cleaning modalities on titanium dental implants during maintenance care: a 1-year follow-up on prosthodontic superstructures.

OBJECTIVES: To investigate tissue health around implants with newly attached superstructures over 12 months of preventive maintenance appointments and instrumentation when necessary. MATERIAL AND METHODS: In a randomized, split-mouth study 32 implants (8 participants with 4 implants each) received followed-up care every 3 months after superstructure attachment. Implants and superstructures were randomly assigned to four treatment groups and treated if necessary: (1) titanium curettes (TC), (2) stainless steel ultrasonic tip (PS), (3) erythritol air-polishing powder (EP), or (4) rubber cup polishing (CON). Probing depths (PDs), bleeding on probing (BOP), modified gingival (mucosal) bleeding index (GBI) around implants, and full-mouth Plaque Control Record (PCR) were measured every 3 months. Clinical attachment levels (CALs) and height of keratinized mucosa (KM)/gingival margins (GMs) for implants/teeth and PD, BOP, and GBI for teeth were documented at baseline, 6 months, and 12 months. Matrix metalloproteinase 8 (MMP-8) and periopathogens were measured at baseline and 12 months. RESULTS: Participants exhibited minimal signs of periodontal inflammation with statistically significant PD improvement (3.0 ± 0.2 to 2.8 ± 0.3 mm; p = 0.022) and overall CAL (4.3 ± 0.8 to 4.0 ± 0.7 mm; p = 0.048) after 1 year. Implants showed no statistically significant differences (p > 0.05) between or within groups at baseline or 12 months for any parameter, except MMP-8 decreased significantly for PS (14.50 ± 17.58 to 4.63 ± 7.56 ng; p = 0.044), and after 12 months, PCR showed a significant difference between TC and PS (p = 0.018). CONCLUSIONS: Treatment was necessary as inflammation was observed around newly placed superstructures within the first year of maintenance care. All tested treatment modalities yielded comparable clinical improvements. CLINICAL RELEVANCE: Early assessment and diagnosis of mucositis and regular maintenance can promote long-lasting implant health.

Perioperative intervention by oral medicine team in cardiovascular surgery patients.

In brief, perioperative oral intervention consists of elimination of odontogenic foci and maintenance of oral hygiene in patients undergoing surgery. The importance of oral intervention before, during, and after medical treatments is well-known, especially in cancer patients, because odontogenic foci such as untreated deep dental caries or periodontitis can cause systemic infection in patients with myelosuppression resulting from chemotherapy. Although perioperative oral intervention is currently recommended for patients with cardiovascular disease, its efficacy in this population has not been established. This article consists of three sections: first, we review the current knowledge about the association between dental disease and cardiovascular disease to show the importance of oral hygiene maintenance and the risks of invasive dental procedures in patients with cardiovascular disease; second, we introduce pertinent, but limited evidence concerning the effect of oral care in preventing postoperative pneumonia; and finally, we present the optimal strategy for perioperative oral intervention in cardiovascular surgery patients.

Cleaning effectiveness of a nickel-titanium ultrasonic tip in ultrasonically activated irrigation: a SEM study

Abstract In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer's protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey's tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.

Desgaste del esmalte por diferentes tratamientos químicos y mecánicos / Wear of the enamel by different chemical and mechanical treatments / Desgaste do esmalte por diferentes tratamentos químicos e mecânicos

Introducción: La microabrasión se describe como un procedimiento realizado sobre el esmalte dental en el cual mediante la utilización de un agente ácido y un agente abrasivo se logra corregir alteraciones cromáticas superficiales. Algunos estudios demuestran como los parámetros de tiempo, número de aplicaciones y la presión ejercida, influyen en la can-tidad de esmalte eliminado. Objetivo: Establecer el espesor de esmalte dental eliminado según la capacidad abrasiva de 9 tratamientos químico mecánicos, mediante estereomicroscopia. Materiales y métodos: Con el aval del comité de ética de la Facultad de Odontología de la Universidad Nacional de Colombia, se recolectaron 90 terceros molares bajo consentimiento informado y se mantuvieron almacenados bajo los parámetros de la norma ISO 11405. Sobre bloques de acrílico se fijaron las mitades linguales de las coronas dentales, creando sobre ellas superficies planas mediante serie de lijas con irrigación y tomando impresiones con silicona de adición. Se distribuyeron de forma aleatoria en 9 grupos (n 10). Cada grupo recibió un tratamiento por un periodo de 30 segundos: G1: Opalustre® (Ultradent), G2: Piedra pómez y ácido fosfórico al 37% (Ultra-Etch®, Ultradent), G3: Piedra pómez, glicerina y ácido fosfórico al 37% (Ultra-Etch®, Ultradent), G4: Fresas de halo amarillo (Komet), G5: Fresas de halo blanco (Komet), G6: Discos Sof-Lex® (3M), color amarillo, G7: Discos Sof-Lex® (3M), color amarillo y amarillo claro, G8: Arenado, y G9: Puntas ultrasónicas Perfect Margin (Acteon). El espesor de desgaste creado fue medido utilizando un estéreo microscopio con un aumento de 10X. Los datos reco-lectados se analizaron a través de las pruebas de Kruskal-Wallis (p≤0.05) para comparar todos los grupos y la prueba U de Mann-Whitney (p≤0.05) para comparaciones individuales. Resultados: Independientemente del tratamiento realizado todos los grupos presentaron un desgaste del esmalte. El mayor desgaste se registró para el grupo tratado con fresa de halo amarillo (122,66 ± 22,64µm) y el menor desgaste para el grupo de arenado (11,5 ± 2,36µm). Se presentó diferencia estadísticamente significativa entre todos los grupos. Conclusiones: Bajo las limitaciones del presente estudio se puede concluir: La mayor microabrasión en esmalte se produjo con fresas de grano extrafino (halo amarillo) y el menor desgaste se produjo con arenado.

Introduction: Microabrasion is described as a procedure performed on tooth enamel in which the use of an acidic agent and an abrasive agent can correct surface chromatic alterations. Some studies show how the parameters of time, number of applications and the pressure exerted influence the amount of enamel removed.Objective: To establish the thickness of tooth enamel removed according to the abrasive capacity of 9 mechanical chemical treatments, using stereomicroscopy. Materials and methods: With the endorsement of the ethics committee of the School of Dentistry of the National University of Colombia, 90 third molars were collected under informed consent and kept stored under the parameters of ISO 11405. Acrylic blocks were fixed the lingual halves of the dental crowns, creating on them flat surfaces by means of series of sandpaper with irrigation and taking impressions with silicone of addition.They were distributed randomly in 9 groups (n 10). Each group was treated for a period of 30 seconds: G1: Opalustre® (Ultradent), G2: Pumice and 37% phosphoric acid (Ultra-Etch®, Ultradent), G3: Pumice, glycerin and phosphoric acid 37 % (Ultra-Etch®, Ultradent), G4: Yellow halo straw-berries (Komet), G5: White halo strawberries (Komet), G6: Sof-Lex® discs (3M), yellow color, G7: Sof-Lex discs ® (3M), yellow and light yellow, G8: Sandblasted, and G9: Perfect Margin ultrasonic tips (Acteon). The wear thickness created was measured using a stereo microscope with an increase of 10X. The collected data were analyzed through the Kruskal-Wallis tests (p≤0.05) to compare all groups and the Mann-Whitney U test (p≤0.05) for individual comparisons. Results: Regard-less of the treatment performed, all groups presented enamel wear. The highest wear was recorded for the group treated with yellow halo strawberry (122.66 ± 22.64µm) and the lowest wear for the sandblasting group (11.5 ± 2.36µm). There was a statistically significant difference between all groups. Conclusions: Under the limitations of the present study, it can be concluded: The greatest microabrasion in enamel was produced with strawberries of extra-fine grain (yellow halo) and the least wear occurred with sandblasting.

Introdução: A microabrasão do esmalte dental é descrita como um procedimento realizado no esmalte dentário, no qual o uso de um agente ácido e um abrasivo pode corrigir alterações cromáticas na superfície. Alguns estudos mos-tram como os parâmetros de tempo, número de aplicações e pressão exercida influenciam na quantidade do esmalte removido. Objetivo: Estabelecer a espessura do esmalte dentário removido de acordo com a capacidade abrasiva de 9 tratamentos químicos ou mecânicos, utilizando estereomicroscopia. Materiais e métodos: Com o aval do comitê de ética da Faculdade de Odontologia da Universidade Nacional da Colômbia, 90 terceiros molares hígidos foram coletados sob consentimento informado e mantidos armazenados sob os parâmetros da norma ISO 11405. Em blocos de acrílico foram fixadas as metades linguais das coroas dentárias, criando sobre elas superfícies planas por meio de séries de lixa mais irrigação e toma de impressões com silicone de adição. Eles foram distribuídos aleatoriamente em 9 grupos (n= 10). Cada grupo foi tratado por um período de 30 segundos: G1: Opalustre® (Ultradent), G2: Pedra-pomes e ácido fosfórico a 37% (Ultra-Etch®, Ultradent), G3: Pedra-pomes, glicerina e ácido fosfórico 37 % (Ultra-Etch®, Ultradent), G4: brocas diaman-tadas halo amarelo (Komet), G5: brocas diamantadas halo branco (Komet), G6: discos Sof-Lex® (3M), cor amarelo, G7: discos Sof-Lex ® (3M), amarelo e amarelo claro, G8: jateamento e G9: pontas ultra-sônicas Perfect Margin® (Acteon). A espessura de desgaste criada foi medida usando um microscópio estéreo com um aumento de 10X. Os dados coletados foram analisados pelos testes de Kruskal-Wallis (p≤0,05) para comparar todos os grupos e pelo teste U de Mann-Whit-ney (p≤0,05) para comparações individuais. Resultados: Independentemente do tratamento realizado, todos os grupos apresentaram desgaste do esmalte. O maior desgaste foi registrado para o grupo tratado com broca diamantada com halo amarelo (122,66 ± 22,64 µm) e o menor desgaste para o grupo de jateamento (11,5 ± 2,36 µm). Houve diferença estatisticamente significante entre todos os grupos. Conclusões: Sob as limitações do presente estudo, pode-se concluir que a maior microabrasão no esmalte foi produzida com brocas de grão extra-fino (halo amarelo) e o menor desgaste ocorreu com o jateamento.

The effect of a 3% hydroxyapatite paste prophylaxis after different root-scaling procedures in periodontics / Efeito da profilaxia com pasta de hidroxiapatita 3% após diferentes procedimentos de raspagem radicular na periodontia

Abstract Introduction Root-scaling procedures on the root surface show to increase root surface roughness during instrumentation. The use of a prophylactic paste reduces the roughness. Objetive This study evaluated the influence of prophylaxis paste on the surface roughness of root dentin after hand instruments (HI), ultrasonic scalers (US) and rotational instruments (RI) were applied to root surfaces. Material and method Fifty bovine roots were prepared and randomly divided into 10 groups (n=5) in which instrumentation with HI, US, or RI was carried out with or without prophylaxis using either conventional or 3% hydroxyapatite paste; additionally, a control group without treatment was included. The Ra and Rz roughness values were measured using a perfilometer. The morphological aspects of the root surfaces were analysed qualitatively by scanning electron microscopy (SEM). Data were analysed using two-way ANOVA followed by Tukey's test (α = 0.05). Result The scaling method and the prophylaxis procedure significantly influenced (p < 0.05) root surface roughness. Treatment with US and prophylaxis with 3% hydroxyapatite paste resulted in lower values ​​of Ra (0.14 µm ± 0.02 µm) and Rz (0.89 µm ± 0.18 µm) compared to the other groups. SEM analysis showed smoother and more homogeneous surfaces in the groups with prophylaxis compared to the groups without prophylaxis. There were no substantial differences between the results of applying different pastes. Conclusion The prophylaxis procedure performed with the experimental paste containing 3% hydroxyapatite reduced the roughness of root surfaces treated with HI, US and RI at the same level as the conventional prophylactic paste.

Resumo Introdução Procedimentos de raspagem na superfície radicular aumentam a rugosidade superficial durante a instrumentação. O uso de pasta profilática pode reduzir a rugosidade. Objetivo Este estudo avaliou a influência da profilaxia com pasta na rugosidade superficial da dentina radicular após instrumentação manual (IH), ultrassom (US) e instrumentos rotatórios (IR) aplicados em superfícies radiculares. Material e método Cinquenta raízes bovinas foram preparadas e divididas aleatoriamente em 10 grupos (n = 5) nos quais a instrumentação com HI, US ou RI foi realizada com ou sem profilaxia usando pasta convencional ou hidroxiapatita a 3%; adicionalmente, um grupo controle sem tratamento foi incluído. As rugosidades de Ra e Rz foram medidas por um perfilômetro. Os aspectos morfológicos das superfícies radiculares foram analisados ​​qualitativamente por microscopia eletrônica de varredura (MEV). Os dados foram analisados ​​por meio de ANOVA de dois fatores, seguido pelo teste de Tukey (α = 0,05). Resultado O método de raspagem e o procedimento de profilaxia influenciaram significativamente (p <0,05) a rugosidade da superfície radicular. O tratamento com US e a profilaxia com pasta de hidroxiapatita ao 3% resultaram em menores valores de Ra (0,14 µm ± 0,02 µm) e Rz (0,89 µm ± 0,18 µm) em relação aos demais grupos. A análise por MEV mostrou superfícies mais lisas e mais homogêneas nos grupos com profilaxia em comparação aos grupos sem profilaxia. Não houve diferenças substanciais entre os resultados da aplicação das diferentes pastas. Conclusão O procedimento de profilaxia realizado com a pasta experimental contendo 3% de hidroxiapatita reduziu a rugosidade das superfícies radiculares tratadas com HI, US e RI no mesmo nível da pasta profilática convencional.