Treatment of lingual nerve paresthesia through photobiomodulation therapy: a case report employing an approach integrating extraoral and intraoral modalities

Aims: Oral nerve injuries are the primary cause of paresthesia in the head and neck regions. To report the managing of a combined protocol involving extraoral and intraoral photobiomodulation (PBM) therapy for lingual nerve paresthesia. Case report: A 38-year-old female patient underwent 25 PBM sessions using laser with dual wavelength infrared (810nm + 980 nm). The extraoral application included 6 seconds and 6J per point. per point, 1W, 4.91 cm², 1.2 J/cm. The intraoral protocol with 0.3W of power, a spot size of 0.38 cm², 15.78 J/cm² of energy density, 6J of energy per point, for 20 seconds. Results: Assessment of neurosensitivity on the dorsum of the tongue was a 75% improvement. On the lateral tongue improved to 50%. In the floor of the mouth, PBM demonstrated a 25% improvement. Conclusion: PBM is an important treatment option in the case of lingual nerve paresthesia. The use of PBM should be considered as a feasible, non-invasive treatment approach.

Screening of Hydroxyapatite Biomaterials for Alveolar Augmentation Using a Rat Calvaria Critical-Size Defect Model: Bone Formation/Maturation and Biomaterials Resolution.

BACKGROUND: Natural (bovine-/equine-/porcine-derived) or synthetic hydroxyapatite (HA) biomaterials appear to be the preferred technologies among clinicians for bone augmentation procedures in preparation for implant dentistry. The aim of this study was to screen candidate HA biomaterials intended for alveolar ridge augmentation relative to their potential to support local bone formation/maturation and to assess biomaterial resorption using a routine critical-size rat calvaria defect model. METHODS: Eighty adult male Sprague Dawley outbred rats obtained from a approved-breeder, randomized into groups of ten, were used. The calvaria defects (ø8 mm) either received sham surgery (empty control), Bio-Oss (bovine HA/reference control), or candidate biomaterials including bovine HA (Cerabone, DirectOss, 403Z013), and bovine (403Z014) or synthetic HA/ß-TCP (Reprobone, Ceraball) constructs. An 8 wk healing interval was used to capture the biomaterials' resolution. RESULTS: All biomaterials displayed biocompatibility. Strict HA biomaterials showed limited, if any, signs of biodegradation/resorption, with the biomaterial area fraction ranging from 22% to 42%. Synthetic HA/ß-TCP constructs showed limited evidence of biodegradation/erosion (biomaterial area fraction ≈30%). Mean linear defect closure in the sham-surgery control approximated 40%. Mean linear defect closure for the Bio-Oss reference control approximated 18% compared with 15-35% for the candidate biomaterials without significant differences between the controls and candidate biomaterials. CONCLUSIONS: None of the candidate HA biomaterials supported local bone formation/maturation beyond the native regenerative potential of this rodent model, pointing to their limitations for regenerative procedures. Biocompatibility and biomaterial dimensional stability could suggest their potential utility as long-term defect fillers.

Minimizing patient morbidity after free gingival graft harvesting:A triple-blind randomized-controlled clinical trial.

OBJECTIVES: This study aimed to evaluate the effect of photobiomodulation therapy (PBMT) on patient morbidity and donor site healing after free gingival graft (FGG) harvesting. METHODS: Forty-four patients requiring FGG were selected for this trial. Individuals were randomly assigned to test group (PBMT, n = 22) or control group (placebo, n = 22) applied immediately after surgery, 24 and 48 h after. Demographic, surgical-related and psychosocial variables possibly associated with treatment response were collected. The primary outcome was postoperative pain at the donor site evaluated using Visual Analog Scale (VAS) immediately after surgery and 6, 24, 48 and 72 h after. Secondary outcomes include medication consumption, patient-reported outcome measures (PROMs) and percentage of wound closure. RESULTS: Intragroup analysis showed no differences in VASLOG means for placebo group throughout the study (p > .05), whereas a significant difference in PBMT group at 6 h, 24 h, 48 h and 72 h (p < .05) were observed. Postoperative rescue analgesic requirement was significantly higher in the placebo group (p = .004). The number needed to treat(NNT) was 2.43. PBMT group reported significant better function related to sleeping, going to work/school and daily routine activities, less restriction to mouth opening, chewing and food consumption, less swelling and bleeding (p < .05), mainly in the first 48 h. PBMT group presented a significantly higher palatal wound closure at 7 days compared to placebo group (33.41 vs. 21.20 respectively, p = .024) after adjustment for confounding. No adverse effects were reported. CONCLUSIONS: Photobiomodulation therapy accelerated the pain resolution time and palatal closure, decreased rescue medication consumption and significantly improved patient satisfaction in the postoperative period.

Online search interest in the use of antibiotics for dental pain: an infodemiology study / Interesse em pesquisas online sobre o uso de antibióticos para dor dentária: um estudo infodemiológico

Objective: The objective of this study was to evaluate the online search interest pertaining to queries regarding antibiotics for dental pain. Material and Methods : Google Trends™ was used to identify the online search interest. Previously, a literature search was performed on the most frequently used antibiotics in dentistry in Brazil. Accordingly, the search terms used were Amoxicillin (AM), Clindamycin (CD), Azithromycin (AZ) and Metronidazole (MD), with the phrase "for toothache" in Portuguese and English. A time-series covered the last 240 weeks (from 2015 to 2020), and the results of each term were compared to their respective annual value. Geographic regions were also evaluated. To obtain a relative search volume (RSV), the resulting Google Trends™ numbers were then scaled to a range from 0 to 100 based on the ratio of searches on a topic to searches across all topics. Results : We observed an upward trend in all antibiotics search terms over the 5 years analyzed, with a peak of greater interest in 2019. The antibiotic of most interest related to toothache was 'AM', followed by 'AZ', 'MD', and 'CD'. The annual RSV of toothache searches rose steadily from 2015 to 2020. Variations were observed between Brazilian geographic regions, and the Northeast region presented with the greatest interest in the topic. Conclusion : Although there were variations in annual and regional trends, an expressive and persistent increase in collective interest regarding the use of antibiotics related to toothache, mainly amoxicillin, was observed. Our findings provide insights for public health promotion programs. (AU)

Objetivo: O objetivo deste estudo foi avaliar o interesse da pesquisa online em consultas sobre antibióticos para dor de dente. Material e métodos : o Google Trends™ foi usado para identificar o interesse de pesquisa online. Anteriormente, foi realizada uma pesquisa bibliográfica sobre os antibióticos mais utilizados em odontologia no Brasil. A partir daí, os termos de busca utilizados foram Amoxicilina (AM), Clindamicina (CD), Azitromicina (AZ) e Metronidazol (MD) com os termos "para dor de dente" em português e inglês. Uma série histórica abrangeu as últimas 240 semanas (abril de 2015 a abril de 2020), e os resultados de cada período foram comparados com seus respectivos valores anuais. Regiões geográficas também foram avaliadas. Os números resultantes do Google Trends ™ são dimensionados para um intervalo de 0 a 100 com base na proporção de um tópico para todas as pesquisas em todos os tópicos de busca. Isso é chamado de volume relativo de pesquisa (RSV). Resultados : Foi observada uma tendência crescente para todos os termos de antibióticos ao longo dos 5 anos analisados, com um pico de maior interesse em 2019. O antibiótico de maior interesse na dor de dente foi 'AM', seguido por 'AZ', 'MD' e 'CD'. O RSV anual das buscas de dor de dente cresceu continuamente de 2015 a 2020. Variações foram observadas entre as regiões geográficas brasileiras, sendo que a Região Nordeste apresentou o maior interesse pelo tema. Conclusão : Embora tenha havido variação nas tendências anuais e regionais, observou-se um aumento expressivo e persistente do interesse coletivo pelo uso de antibióticos relacionados à dor de dente, principalmente a amoxicilina. Nossas descobertas fornecem insights para programas de promoção pública.(AU)

Periodontal regeneration: is it still a goal in clinical periodontology?

Abstract In the last decades, Periodontal Regeneration has been one of the most discussed topics in Periodontics, attracting the attention of researchers and clinicians. This can be justified by the evident and continuous progress observed in the field, characterized by a better understanding of the biological mechanisms involved, significant improvement of operative and technical principles, and the emergence of a wide range of biomaterials available for this purpose. Together, these aspects put the theme much in evidence in the search for functional and esthetic therapeutic solutions for periodontal tissue destruction. Despite the evident evolution, periodontal regeneration may be challenging and require the clinician to carefully evaluate each case before making a therapeutic decision. With a critical reassessment of the clinical and preclinical literature, the present study aimed to discuss the topic to answer whether Periodontal Regeneration is still a goal in clinical periodontology. The main aspects involved in the probability of success or failure of regenerative approaches were considered. A greater focus was given to intrabony and furcation defects, clinical conditions with greater therapeutic predictability. Aspects such as more appropriate materials/approaches, long-term benefits and their justification for a higher initial cost were discussed for each condition. In general, deep intrabony defects associated with residual pockets and buccal/lingual class II furcation lesions have predictable and clinically relevant results. Careful selection of the case (based on patient and defect characteristics) and excellent maintenance are essential conditions to ensure initial and long-term success.

Association between severe periodontitis and chronic kidney disease severity in predialytic patients: A cross-sectional study.

OBJECTIVE: The aim of this cross-sectional study was to evaluate the association between periodontitis and different severities of chronic kidney disease (CKD) in predialytic patients. MATERIALS AND METHODS: Demographic, socioeconomic, and medical data of 139 patients from the nephrology service of one university hospital in Porto Alegre, Brazil, were obtained through interview and clinical records. Full-mouth six-sites per tooth periodontal examinations were performed. Associations between periodontitis, stages of CKD, and estimated glomerular filtration rate (eGFR) were estimated by multivariable models adjusted for sex, smoking, vitamin D supplementation, physical activity, and renal treatment duration. CKD was classified based on eGFR (<60 ml/min/1.73 m2 ) estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. RESULTS: Patients with severe periodontitis, compared to those without severe periodontitis, had 2.8 (95% CI: 1.25-6.62) and 3.4 (95% CI: 1.27-9.09) times higher risk of being in stages 4 and 5 of CKD, respectively. Having ≥ 2 teeth with clinical attachment loss (CAL) ≥6 mm increased 3.9 times the risk of being in stage 5 of CKD. Patients with severe periodontitis and ≥2 teeth with CAL ≥ 6 mm had 4.4 ml/min/1.732 and 5.2 ml/min/1.732 lower eGFR (p-values < .05), respectively. CONCLUSION: Severe periodontitis was associated with poor renal conditions in predialytic CKD patients, strengthening the importance of periodontal evaluation in such patient population.

The impact of maintenance on peri-implant health.

Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.

The impact of maintenance on peri-implant health

Abstract Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.

Screening of candidate biomaterials for alveolar augmentation using a critical-size rat calvaria defect model.

OBJECTIVE: To screen candidate biomaterials intended for alveolar augmentation relative to their potential to enhance local bone formation using a routine critical-size (ø8-mm) rat calvaria defect model. METHODS: One hundred and forty male Sprague Dawley outbred rats, age 11-12 weeks, weight 325-375 g, obtained from USDA approved breeder, randomised into 14 groups of 10 animals, each received one of the following treatments: sham-surgery (empty control), Bio-Oss (bovine HA/reference control), or candidate biomaterials including bovine HA, synthetic HA/ß-TCP and calcium phosphate constructs, mineralised/demineralised human bone preparations, a ß-TCP/calcium sulphate and an HA/calcium sulphate putty. A 4-week healing interval was chosen to discern local bone formation using incandescent and polarised light microscopy. Statistical analysis used one-way ANOVA followed by Bonferroni for pairwise comparisons. RESULTS: Candidate biomaterials all displayed biocompatibility. They exhibited limited, if any, appreciable bioerosion or biodegradation. No statistically significant differences in mean linear defect closure were observed among experimental groups, sham-surgery displaying the highest score (48.1 ± 24.3%). Sham-surgery also showed a significantly greater bone area fraction than all other groups (19.8 ± 13.9%, p < .001). The HA/calcium sulphate putty showed a significantly greater residual biomaterial area fraction than all other groups (61.1 ± 8.5%, p < .01). CONCLUSION: Within the limitations of this animal model, although biocompatible, none of the tested biomaterials enhanced local bone formation beyond the innate regenerative potential of this craniotomy defect.

Oral health related quality of life among pregnant women: a randomized controlled trial

Abstract: The aim of the present study was to compare negative impacts of oral conditions in Oral Heath Related Quality of Life (OHRQoL) assessed by the Oral Health Impact Profile-14 (OHIP-14) scores in pregnant women receiving or not comprehensive periodontal treatment. This randomized controlled clinical trial included pregnant women aged between 18 and 35 years old. Participants were randomized in a test group with 96 and a control group with 114 women. Patients in the test group received comprehensive periodontal treatment, supra and subgingival scaling and root-planning and periodontal maintenance appointments. The OHIP-14 was applied before and after treatment. The primary outcome was changes in OHIP-14 scores after follow-up period. The impact of having received or not comprehensive periodontal treatment on the change of the OHIP-14 scores was also investigated. Both groups showed significant reduction in OHIP-14 scores and effect size for the test group was 0.60 and 0.36 for the control group. Multinomial logistic regression analysis showed that participants of the control group had 5.9-fold odds (CI 95% 1.88-18.52) of worsening in OHIP-14 scores and their perception of oral conditions in relation to test group. Comprehensive periodontal treatment during pregnancy can reduce the negative impacts in OHRQoL.

Sinus augmentation using a mini-pig model: Effect of ceramic and allogeneic bone biomaterials.

BACKGROUND: Present clinical practice broadly relies on off-the-shelf allogeneic, xenogeneic or synthetic bone biomaterials in support of sinus augmentation. Also, recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support clinically relevant bone formation when used to augment the maxillary sinus. OBJECTIVES: To evaluate local bone formation/dental implant osseointegration following implantation of two particulate bone biomaterials using the mini-pig sinus augmentation model. METHODS: Nine adult Göttingen mini-pigs were used for evaluation of a biphasic ceramic (15%/85% HA/ß-TCP) and an allogeneic mineralized bone biomaterial. Treatments randomized to contralateral sinus sites included sham-surgery (control) and biomaterials. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each sinus site. The animals were euthanized at 8 weeks for histologic analysis. RESULTS: Execution of the surgical protocol and healing was unremarkable. Limited infraorbital swelling was observed until suture removal. The biphasic ceramic and allogeneic bone biomaterials produced significantly increased bone formation (5.2 ± 1.9 mm and 4.9 ± 1.6 mm vs. 2.6 ± 0.5 mm, p < 0.05) and osseointegration (18.0 ± 6.0% and 25.1 ± 18.2% vs. 10.1 ± 8.0%, p < 0.05) over the sham-surgery control. No significant differences were observed between biomaterials. CONCLUSIONS: Implantation of biphasic ceramic or allogeneic bone biomaterials enhances bone formation in the mini-pig maxillary sinus, however, dental implant bone support is incomplete resulting in overall limited osseointegration.

Effect of Platform Shift on Crestal Bone Levels and Mucosal Profile Following Flap Surgery and Subcrestal Implant Placement in Presence/Absence of Gap Defects.

BACKGROUND: Physiologic remodeling resulting in crestal bone loss appears a common corollary to dental implant surgery. Several hypotheses and clinical strategies have been advanced to explain and avert crestal remodeling; however, causative mechanisms remain unclear and the efficacy of clinical protocols uncertain. PURPOSE: The objective of the present study was to provide a histologic account of crestal bone levels and mucosal profile at implant sites receiving platform shift/switch and standard abutments following conventional flap surgery and subcrestal implant placement in presence or absence of crestal gap defects using a dog model. MATERIALS AND METHODS: Four dental implants were placed into the left/right edentulated posterior mandible in five adult male Hound Labrador mongrel dogs using flap surgery including subcrestal placement with/without a 1 × 5 mm (width × depth) gap defect, and using platform shift/switch and standard abutments. Block biopsies were collected for histological/histometric analysis following an 8-week healing interval. RESULTS: No significant differences in crestal resorption were observed among experimental groups; crestal resorption being significantly more advanced at buccal than at lingual sites (p < .001). Similarly, crestal bone-implant contact was not significantly different among groups; crestal bone-implant contact being consistently below the implant platform at buccal sites (p < .01). Moreover, the peri-implant mucosal profile was not statistically different among groups, the mucosal height being significantly greater at buccal than at lingual sites (p < .001). Also, no significant differences among groups were observed for the apical extension of the epithelial attachment, the epithelial attachment being arrested more than 2 mm above the implant platform at both platform shift/switch and standard abutments. CONCLUSIONS: Using a clinical strategy including flap surgery and subcrestal implant placement, implant technology comparing platform shift/switch with standard abutments, surgical approach, and abutment selection seems to have a limited impact on crestal remodeling, associated bone loss, and mucosal profile.

Effect of Platform Shift/Switch on Crestal Bone Levels and Mucosal Profile Following Flapless Surgery and Crestal/Subcrestal Implant Placement.

BACKGROUND: Crestal remodeling/bone loss appears a common sequel to dental implant placement. Several hypotheses and clinical strategies have been advanced to explain and avert crestal remodeling; however, causative mechanisms remain unclear and the efficacy of clinical protocol uncertain. OBJECTIVE: The objective of the present study was to provide a histologic record of crestal versus subcrestal implant placement on crestal remodeling and mucosal profile comparing platform shift/switch and standard abutments following flapless implant surgery using a dog model. METHODS: Four dental implants each were placed into the left and right edentulated posterior mandibles in five adult male hound-Labrador mongrel dogs using a flapless approach including crestal versus subcrestal placement and using platform shift versus standard abutments. Block biopsies were collected for histological/histometric analysis following an 8-week healing interval. RESULTS: Both crestal and subcrestal implant installation resulted in significant crestal remodeling and bone loss, in particular at buccal sites, without significant differences between platform shift/switch and standard abutments. Implants installed subcrestally exhibited a significantly taller mucosal profile over crestal-level implants without significant differences between platform shift/switch and standard abutments; the epithelial attachment at all times arrested on the abutment surface. CONCLUSIONS: Comparing platform shift/switch versus standard abutments using a minimally invasive flapless approach including crestal or subcrestal implant placement, the platform shift/switch abutments offer no selective advantage over standard abutments.

Effect of Platform Shift/Switch and Concave Abutments on Crestal Bone Levels and Mucosal Profile following Flap and Flapless Implant Surgery.

BACKGROUND: Crestal remodeling/bone loss appears to be a common sequel to dental implant placement. Several hypotheses/clinical strategies have been proposed to explain/avert crestal remodeling; however, causative mechanisms remain unclear and the efficacy of these clinical approaches uncertain. OBJECTIVE: The objective of the present study was to provide a histological account of crestal bone levels and mucosal profile at platform shift/switch and concave abutments following flapless and conventional flap surgery and subcrestal implant placement using a dog model. METHODS: Four dental implants each were placed in the left/right mandibular posterior jaw quadrants in five adult male Hound/Labrador mongrel dogs using flap surgery with a 1 × 5 mm gap defect or using a flapless approach, both involving placement 2 mm subcrestally and platform shift/switch versus concave abutments. Block biopsies for histological/histometric analysis were collected at 8 weeks. RESULTS: No significant differences were observed regarding crestal bone levels, with all groups showing mean bone levels above the implant platform. Similarly, crestal bone-implant contact was not significantly different among groups. Moreover, peri-implant mucosal profiles were not statistically different among groups for buccal sites; average mucosal height reached 4.1 to 4.9 mm above the implant platform. Comparison between buccal and lingual sites showed a nonsignificant tendency toward greater crestal resorption at buccal sites, adjusting for other factors. Mean crestal bone-implant contact level approximated the implant platform for lingual sites while consistently remaining below the platform at the buccal sites. Peri-implant mucosal height was significantly higher at buccal than at lingual sites, with the epithelial attachment located a significant distance away from the implant platform at buccal sites. CONCLUSIONS: The surgical approaches (subcrestal implant placement by flap surgery or a flapless approach) and abutment designs (platform shift/switch or concave) used in this study seem to have a limited impact on crestal remodeling, associated bone loss, and mucosal profile. Bioclinical strategies should be developed to circumvent the limitations of current clinical protocol.

Tobacco use and smoking cessation among third-year dental students in southern Brazil.

The aim of the present cross-sectional study was to assess tobacco use and smoking cessation among third-year dental students in southern Brazil. The Global Health Professions Student Survey questionnaire was used in eight dental schools in Rio Grande do Sul state, Brazil. Of the 663 eligible students, 576 (87%) participated. The prevalence of current smoking was 19.1% [95% confidence interval (CI): 12.9-25.3%], and 61.6% (95% CI: 54.9-68.3%) of students reported having smoked at least once in their lifetime. The prevalence of dental students who had smoked ≥ 100 cigarettes in their lifetime was 17.1% (95% CI: 12.5-21.7%). Being frequently exposed to other smokers at home or in other places (second-hand smoke) increased the likelihood of current smoking by two- to threefold. Approximately 6.1% (95% CI: 3.5-8.7%) of the students reported that they currently wanted to stop smoking and 7.5% (95% CI: 5.3-9.6%) had tried to stop smoking in the last year. Friends and family were the most frequent sources of help or counselling, and only a limited proportion of students received help from health professionals. Tobacco use and exposure to second-hand smoking is widespread among dental students in southern Brazil. Smoking-cessation initiatives targeting health care students are urgently needed.

Effect of rhBMP-2 dose on bone formation/maturation in a rat critical-size calvarial defect model.

BACKGROUND: Application of recombinant human bone morphogenetic protein-2 (rhBMP-2) has been associated with significant adverse events in craniofacial settings, including swelling and seroma formation. Recent work has demonstrated an inverse relationship between bone formation/maturation and rhBMP-2 dose, frequency/severity of adverse events increasing with rising dose. OBJECTIVE: The objective of this study was to determine the most effective dose for rhBMP-2 soak-loaded onto an absorbable collagen sponge (ACS) carrier for bone formation/maturation using an established defect model. METHODS: One hundred sixty-eight outbred male Sprague-Dawley rats, age 11-13 weeks, weight 325-375 g randomized into seven groups of 24 subdivided into groups of eight, were used to provide radiographic and light microscopy observations of bone formation/maturation and aberrant healing events at 2, 4 and 8 weeks following application of rhBMP-2/ACS into critical-size, ø8-mm, through-through, calvarial osteotomy defects for a dose of 1.25, 2.5, 5.0, 10.0 and 20.0 µg rhBMP-2/defect, or serve as ACS or sham-surgery controls. RESULTS: rhBMP-2 dosages ≥ 2.5 µg/defect showed histological defect closure >90% within 2 weeks, and complete resolution within 4 weeks. Adverse healing events including swelling, excessive bone formation or seroma formation could not be determined with certainty in this defect model. Notably ACS control sites showed complete defect closure at the 8-week healing interval. CONCLUSIONS: rhBMP-2/ACS accelerates local bone formation in the rat critical-size through-through calvarial defect model once reaching an osteoinductive dose threshold. This threshold may already be reached at a 1.25-/2.5-µg dose in this model. No further enhancement to bone formation/maturation may be observed adding rhBMP-2 above the 2.5-µg dose. The 1.25-20.0 µg dose range did not invoke appreciable aberrant healing events.

Is there a positive effect of smoking cessation on periodontal health? A systematic review.

BACKGROUND: Although the detrimental effects of tobacco on the periodontal tissues have been reported extensively, little is known about the potential beneficial effect of smoking cessation on periodontal health. The aim of this systematic review is to evaluate the effect of smoking cessation on periodontitis progression and response to periodontal therapy. METHODS: Two independent reviewers completed the review process through title (n = 118), abstract (n = 24), and whole-paper selection (n = 5). Sources include Medline and EMBASE databases (up to December 2012) and a reference list of selected studies. Prospective studies comparing progression rates of periodontitis between smokers and quitters and clinical trials evaluating the effect of smoking-cessation programs, alone or in combination with periodontal treatment, were included. At least 1 year of follow-up was required for inclusion. RESULTS: Of 331 potentially relevant publications, five studies fulfilled the inclusion criteria. Because of heterogeneity of the studies, a meta-analysis could not be performed. One study reported that the progression of clinical attachment loss (AL) ≥3 mm during a 6-year period was approximately three times higher among smokers than quitters (P <0.001). Two studies (10 and 20 years of follow-up) observed a decrease in radiographic bone loss of ≈30% among quitters when compared with smokers. Among individuals receiving non-surgical periodontal treatment, quitters were more likely to have periodontal probing depth reductions (P <0.05) than non-quitters/oscillators. No differences in AL were observed. CONCLUSION: Based on the limited available evidence, smoking cessation seems to have a positive influence on periodontitis occurrence and periodontal healing.

Dentine hypersensitivity: analysis of self-care products

Dentine hypersensitivity is a condition that is often present in individuals, leading them to seek dental treatment. It has been described as an acute, provoked pain that is not attributable to other dental problems. Its actual prevalence is unknown, but it is interpreted as very unpleasant by individuals. Several therapeutic alternatives are available to manage dentine hypersensitivity, involving both in-office treatment and home-use products. The aim of this literature review was to evaluate self-care products for managing dentine hypersensitivity. Among the products available, dentifrices and fluorides are the most studied self-care products, with positive effects. However, a high percentage of individuals is affected by the placebo effect. Among dentifrices, those containing potassium salts seem to be the most promising. Dental professionals need to understand the advantages and limitations of these therapies and use this knowledge in a positive approach that might help in decreasing dentine hypersensitivity among patients.

Epidemiologia e fatores de risco para as doenças periimplantares / Epidemiology and risk factors for peri-implant diseases

Implantes tornaram-se uma alternativa viável para substituir dentes ausentes. Não há dúvidas sobre seu alto nível de sobrevivência ao longo dos anos, ainda que as taxas de sucesso sejam menores. Considera-se sucesso, entre outros, a ausência completa de sinais inflamatórios aos redor dos implantes. Portanto, a taxa de sucesso relatada é sempre menor que a taxa de sobrevivência. Existem poucos estudos acerca da prevalência e incidência de mucosite e periimplantite. Geralmente, os estudos reportam a perda de implantes, subestimando, portanto, a condição dos implantes remanescentes na boca. Além disso, poucos relatos consideram o individuo como unidade de análise, o que determina uma subestimação da prevalência/incidência destas doenças. Os resultados mostram um aumento na prevalência e incidência destas doenças ao longo dos anos. Mais que 76% dos indivíduos e 48% dos implantes apresentam mucosite. Indivíduos com histórico prévio de periodontite apresentam maior prevalência de periimplantite (38%) do que indivíduos sem histórico desta doença (5,8%). Dentre os supostos fatores de risco às doenças periimplantares, o histórico prévio de doença periodontal e a exposição ao fumo são, em maior número e com maior nível de evidência, relatados. Outros supostos fatores, tais como diabetes e sistema de implantes, precisam de comprovação. Sendo assim, conclui-se que os estudos precisam estimar de forma adequada a prevalência/incidência de problemas a fim de que os fatores de risco possam ser elucidados e, conseqüentemente, possa existir maior evidência para a decisão pela colocação de implantes e recursos para a sua manutenção em condições de saúde.