Predictors of dental plaque and gingivitis in patients receiving integrated dental treatment-a longitudinal retrospective study.

OBJECTIVES: The identification of predictors of supragingival biofilm accumulation may improve the results of therapeutic strategies for dental caries and periodontal diseases in general clinical practice. This study aimed to determine predictors of changes in visible plaque (VP) and gingival bleeding (GB) during integrated dental care. MATERIALS AND METHODS: A retrospective longitudinal study was conducted by a census of patients receiving integrated dental care in a general clinical practice ambulatory at the Federal University of Rio Grande do Sul (Brazil). The sample comprised 91 charts of patients attended over a 6-months period. Gender, age, patient's main complaint, oral hygiene pattern, and clinical data were recorded from charts for the last two dental visits in the ambulatory. Changes in VP and GB were modeled by multiple linear regression and beta coefficients (b) were reported. RESULTS: The mean follow-up time was 13 months. Significant reductions in VP (32.8 ± 27.9 to 17.4 ± 19.4%; p < 0.001) and GB (27.1 ± 23.8 to 18.5 ± 17.3%; p < 0.001) were observed. Higher plaque reductions were predicted by higher baseline VP levels (p = 0.02), shorter time (< 12 months) elapsed between VP recordings (b = 14.1%, p = 0.02), interproximal cleansing (b = 11.9%, p = 0.03), lower number of sessions for oral hygiene instruction (b = 13.7%, p = 0.02), and presence of pockets ≥ 6 mm (b = - 12.4%, p = 0.02). GB was predicted by time of follow-up > 12 months and baseline VP. CONCLUSIONS: Plaque and gingivitis improved in patients under integrated dental care. Factors related to motivation, oral hygiene practices, and baseline periodontal status might be used as predictors of VP and GB changes. CLINICAL RELEVANCE: Visible plaque and gingivitis reduced in a sample of patients treated under integrated dental care. Some predictors may determine for which patients the treatment may be maximize and those who will need greater efforts to achieve the therapeutic goal for oral hygiene.

Fixed and on-demand regimens of acetaminophen in periodontal surgery: randomized clinical trial

Aim: to evaluate the clinical efficacy of an acetaminophen analgesic by comparing its prescription in fixed versus ondemand schedules after periodontal surgery. The hypothesis of the study was that the fixed regimen would be more effective than the on-demand regimen for postoperative analgesics following periodontal surgery. Methods: An open randomized clinical trial was conducted. The 68 patients who needed total flap surgery to restore supracrestal tissue attachment or surgical treatment of periodontitis were randomized". Visual Analogue Scale was used to assess pain. The fixed group (n = 34) received 500 mg of acetaminophen every 4 hours for 2 days. The on-demand group (n = 34) was instructed to use the acetaminophen "as needed," at intervals of no less than 4 hours between doses. Ibuprofen was the rescue medication for both groups. Pain scores and medication use were recorded 2, 6, 12, 24 and 48 hours after the surgical procedure. The study was registered at the Brazilian Registry of Clinical Trials under RBR-7wv259. Results: The two groups did not differ in relation to the frequency or the intensity of pain in a 48-hour period (n=20 in the fixed group, and n=22 in the on-demand group), or even in the intention-to-treat (n=34 in each group). Individuals who experienced moderate to severe pain used rescue medication more frequently in both groups. No adverse events were reported. Conclusion: Both regimens were effective in controlling postoperative pain after periodontal surgery

Chlorhexidine with or without alcohol against biofilm formation: efficacy, adverse events and taste preference.

In recent years, different chlorhexidine formulations have been tested, including an alcohol-free alternative, but the effect of this solution on early biofilm formation is not clear. A crossover, randomized, double-blind clinical trial was conducted to evaluate the effect of two chlorhexidine solutions against supra- and subgingival biofilm formation (NCT#02656251). Thirty-five participants were randomized and asked to rinse twice daily with 15 ml of an alcohol-containing 0.12% chlorhexidine solution, an alcohol-free 0.12% chlorhexidine solution, or placebo. The study was conducted in three experimental periods of 4 days each, with a 10-day washout between the periods. All the experimental periods followed the same protocol, except that the solutions were switched. Biofilm distribution was evaluated every 24 hours by the Plaque-Free Zone Index, during 96 hours. Adverse events were self-reported and sensory evaluation was performed using a hedonic scale. Compared to the placebo, the chlorhexidine solutions resulted in a significantly higher number of surfaces free of plaque over 96 hours (p < 0.01), and were able to prevent subgingival biofilm formation (p < 0.01). The alcohol-free chlorhexidine solution was associated with a lower incidence of adverse events, compared with alcohol-containing chlorhexidine (p < 0.05); it also received better sensory evaluation and acceptance by trial participants, compared with the alcohol-containing chlorhexidine (p = 0.007), and had a similar inhibitory effect on the formation of supra- and subgingival biofilms.

Chlorhexidine with or without alcohol against biofilm formation: efficacy, adverse events and taste preference

Abstract In recent years, different chlorhexidine formulations have been tested, including an alcohol-free alternative, but the effect of this solution on early biofilm formation is not clear. A crossover, randomized, double-blind clinical trial was conducted to evaluate the effect of two chlorhexidine solutions against supra- and subgingival biofilm formation (NCT#02656251). Thirty-five participants were randomized and asked to rinse twice daily with 15 ml of an alcohol-containing 0.12% chlorhexidine solution, an alcohol-free 0.12% chlorhexidine solution, or placebo. The study was conducted in three experimental periods of 4 days each, with a 10-day washout between the periods. All the experimental periods followed the same protocol, except that the solutions were switched. Biofilm distribution was evaluated every 24 hours by the Plaque-Free Zone Index, during 96 hours. Adverse events were self-reported and sensory evaluation was performed using a hedonic scale. Compared to the placebo, the chlorhexidine solutions resulted in a significantly higher number of surfaces free of plaque over 96 hours (p < 0.01), and were able to prevent subgingival biofilm formation (p < 0.01). The alcohol-free chlorhexidine solution was associated with a lower incidence of adverse events, compared with alcohol-containing chlorhexidine (p < 0.05); it also received better sensory evaluation and acceptance by trial participants, compared with the alcohol-containing chlorhexidine (p = 0.007), and had a similar inhibitory effect on the formation of supra- and subgingival biofilms.

Effect of nifedipine on gingival enlargement and periodontal breakdown in ligature-induced periodontitis in rats.

OBJECTIVE: A recent consensus report could not find specific reports of the effect of nifedipine on the destruction of the periodontal tissues. The aim of the present study was to evaluate the effect of nifedipine on gingival enlargement and periodontal breakdown using a ligature-induced periodontitis in rats. MATERIALS AND METHODS: Fifty, male, 60 days old, Wistar rats, were divided into six groups. Cotton sutures were placed around the upper second molars. Two groups of 10 rats each did not receive ligatures and were treated daily with either saline solution or nifedipine 50mg/kg/day. Two groups of 10 rats received ligatures and were also treated daily with saline solution or nifedipine 50mg/kg/day. Two additional groups (nifedipine 10 and 100mg/kg/day) were included to explore a possible dose-response relationship. Animals were euthanatised at 30 days. Internal and oral epithelium, total and inflamed connective tissue, gingival thickness and height, and bone loss were assessed histologically. RESULTS: Nifedipine alone was not sufficient to promote gingival enlargement or periodontal destruction in the absence of the ligature. Compared to animals with ligatures only, the group that received ligatures and nifedipine 50mg/kg/day showed significant higher estimates for total and inflamed connective tissue, gingival thickness and height. No significant differences were observed for bone loss between these experimental groups. The other dosages of nifedipine did not provide additional information. CONCLUSION: Nifedipine itself did not lead to gingival enlargement in rats. In the presence of biofilm accumulation, nifedipine yielded greater gingival enlargement and periodontal inflammation, but it did not increase periodontal destruction.

Microscopic qualitative evaluation of fixation time and decalcification media in rat maxillary periodontium.

The rat model is widely used in periodontal research and the quality of histological sections is essential. The purpose of this study was to evaluate the histological characteristics of periodontal tissues in Wistar rat maxillae, with different times of fixation and decalcified by nitric acid or formic acid (Anna Morse Solution). Fifteen rats were used. Fixation was performed for 24, 48 and 72 hours. The maxillae were hemi-sectioned and each part was decalcified either in nitric acid for 7 days or in Anna Morse solution for 35 days. Two trained and blinded examiners performed the evaluation. Fourty eight hours of fixation and decalcification with Anna Morse solution showed more clear characteristics of the epithelium-connective tissue interface and of the periodontal structures. Mean measurements between the cementum-enamel junction and the bone crest varied in the different experimental times from 176.5 (+/- 60.45) to 210.94 (+/- 39.33) pixels on the buccal aspect, and from 199.69 (+/- 38.33) to 298.55 (+/-70.81) pixels on the palatal aspect, with no statistically significant differences (ANOVA, p > 0.05). In the same fixation period, decalcification with nitric acid or Anna Morse solution did not display any statistically significant differences. It may be concluded that for a qualitative histological analysis, fixation should preferably be for 48 hours and the demineralization should be made by Anna Morse solution. For a histomorphometric analysis, the decalcification solution does not interfere in the results.

Comparison of histometric and morphometric analyses of bone height in ligature-induced periodontitis in rats.

The purpose of this study was to compare histologic and morphometric procedures of bone height measurement. Microscopic measurements are the most frequent methods in periodontal studies with animals, but have limited capacity to identify bone levels associated with both healthy tissues and periodontal disease. Ligatures were placed in the maxillary left second molars of 10 male 60-day-old Wistar rats for 30 days. Left and right maxillary sides of 5 rats were processed for histologic analysis (H), sectioned buccolingually, and stained with HE. The maxillae of the other 5 rats were defleshed and used for morphometric analysis (M). Histometric measurements from the cementoenamel junction to the bone crest were performed. Standardized photographs were used for morphometric analysis. The t test was used for dependent or independent samples (alpha = 0.05%). Distances from cementoenamel junction to bone crest were 0.95 +/- 0.25 and 1.07 +/- 0.30 mm for H and M, respectively. Buccal measurements were 0.92 +/- 0.16 and 1.08 +/- 0.35 mm for H and M. The values obtained using H and M for areas without ligatures were 0.44 +/- 0.15 and 0.47 +/- 0.11 mm for lingual measurements and 0.23 +/- 0.08 and 0.41 +/- 0.10 mm for buccal measurements. No significant differences were found between the two methods in the detection of bone height associated with the placement of ligatures in rats.

Escovas elétricas: efetividade clínica no controle do biofilme supragengival / Powered toothbrushes: a clinically effective approach for controlling the supragingival biofilm

O controle do biofilme supragengival pelo paciente é uma das medidas mais importantes para a obtenção e manutenção da saúde bucal. Parece ser tarefa fácil, entretanto demanda o reconhecimento de que a higiene bucal faz parte da higiene corporal, assim como demanda o conhecimento anatômico da boca e de suas peculiaridades, o que é facilitado quando realizado por indivíduos com boa coordenação motora. As escovas de dente elétricas foram criadas para indivíduos com dificuldades de realização do controle mecânico de placa com escovas convencionais, principalmente por falta de motricidade. Em seu processo de evolução, entretanto, posicionou-se como um recurso para controle mecânico do biofilme supragengival utilizado por indivíduos sem essa dificuldade. A utilização tem base tanto em estudos de eficácia e efetividade como de segurança e de preferência dos pacientes. Esta coluna tem por objetivo apresentar aspectos que suportam o uso de escovas elétricas como uma alternativa preventiva e terapêutica em odontologia contemporânea...

Controlling supragingival plaque by the patient is one of the most important measures for achieving and maintaining the oral health. It seems an easy task, however it demands the recognition that oral hygiene is part of body hygiene, as well as anatomic knowledge and its peculiarities. This is ultimately facilitated when performed by individuals with good motor skills. Powered toothbrushes were designed for individuals with difficulties in performing mechanical plaque control with conventional toothbrushes, mainly due to lack of fine motricity. In its evolutionary process, however, it has been used as a tool for individuals without these impairments. Its use is based in studies of efficacy and effectiveness, as well as safety and patient’s preference studies. The aim of this report is to present aspects that support the use of powered toothbrushes as a preventive and therapeutic alternative in contemporary dentistry...

Correlation between gingival thickness and gingival recession in humans / Correlação entre espessura do tecido gengival e recessão gengival

Gingival recession is characterized by the apical migration of the gingival margin, exposing the root surface. Studies have demonstrated several etiological factors for gingival recession such as periodontitis, traumatic toothbrushing, use of oral piercing, and past orthodontic therapy, among others. It might not be possible to identify and quantify the influence of each factor, and gingival recession at some sites may be the result of the combination of these factors. Gingival recession affects individuals at all ages, with prevalence increasing as time passes. The aim of this study was to observe whether there is correlation between gingival thickness and gingival recession. Fifty-five subjects of both genders aged 18-35 years participated in the study. The volunteers were under treatment at the School of Dentistry of the Federal University of Rio Grande do Sul. Buccal gingival thickness was measured on incisors, canines and bicuspids, under anesthesia, following inclusion and exclusion criteria. Statistical analysis was performed with STATA version 10.1. The results had a Pearson Correlation Coefficient of -0.216. Linear regression had a statistically significant p-value of 0.025. It may be concluded that there is weak negative correlation between gingival thickness and gingival recession.

A recessão gengival é caracterizada pelo deslocamento apical da margem gengival, expondo a superfície radicular. Pesquisas têm apresentado vários fatores relacionados à etiologia da recessão gengival como: periodontite, escovação traumática, uso de piercing oral, tratamento ortodôntico passado, entre outros. Pode não ser possível identificar e quantificar a influência de cada fator,e a recessão gengival, em determinados sítios, pode ser o resultado da confluência de várias causas. A prevalência da recessão gengival atinge indivíduos de todas as idades, aumentando significativamente com o passar dos anos. O objetivo do presente estudo foi observar se existe correlação entre a espessura do tecido gengival e a recessão gengival. Participaram da pesquisa pacientes de ambos os gêneros, com idade entre 18 e 35 anos, que estavam em tratamento nas clínicas odontológicas da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul.Foram medidas a espessura e recessão gengival das faces vestibulares dos dentes incisivos, caninos e pré-molares, previamente anestesiados, seguindo os critérios estabelecidos para inclusão e exclusão no estudo. Para avaliação e comparação dos resultados foi utilizado o programa estatístico STATA versão 10.1. Os resultados mostraram que a correlação de Pearson entre a espessura gengival e a recessão foi de -0.216. A regressão linear apresentou um p= 0.025, estatisticamente significativo. Pode-se concluir que existe uma correlação fraca e inversa entre espessura gengival e recessão gengival.

O emprego da engenharia tecidual na odontologia / The use of tissue engineering in dentistry

Avanços na biologia molecular e celular vêm contribuindo para o desenvolvimento de técnicas na área de reparo e regeneração de órgãos e tecidos lesados por doenças, traumas e deformidades congênitas. A engenharia tecidual é um campo multidisciplinar que se vale de princípios da engenharia, biologia e ciências clínicas para o desenvolvimento de substitutos biológicos capazes de manter, restaurar ou aprimorar a função de órgãos e tecidos. Esta nova ciência baseia-se em três componentes: células, matrizes biocompátiveis e moléculas bioativas, que são responsáveis pela sinalização morfogenética. As células freqüentemente utilizadas são as células-tronco. O objetivo deste artigo é atualizar os cirurgiões dentistas nos conceitos de engenharia tecidual e no contexto em que esta ciência vem sendo estudada na Odontologia, especialmente nas áreas relacionadas ao periodonto e tecido pulpar.

Advances in molecular and cellular biology have contributed to the development of techniques to repair, or even regenerate, organs and tissues that have been injured by diseases, traumas and congenital deformities. Tissue engineering is an interdisciplinary field that applies the principles of engineering, biology and the clinical sciences to the development of biological substitutes that are able to maintain, restore or improve the function of organs and tissues. This new science is based on three components: cells, biocompatible matrices and bioactive molecules which are responsible for morphogenic signals. The cells most often used are stem cells. This article is aimed to bring dental surgeons up to date on tissue engineering concepts and the context in which tissue engineering is being studied within Dentistry; specifically, areas related to periodontium and pulp.

Manutenção preventiva periódica: uma responsabilidade da profissão / Periodical preventive maintenance: a responsibility of the profession

A manutenção preventiva periódica é uma das atividades mais importantes da profissão odontológica, porque de nada adianta realizar tratamentos extensos, curando os indivíduos, sem dar a oportunidade de manutenção dos resultados. Entretanto, eventualmente, profissionais e pacientes acabam por dar importância menor à manutenção, subestimando sua necessidade e sua capacidade resolutiva. É imperioso também lembrar que a atuação de um profissional da saúde deve se pautar na responsabilidade de acompanhamento longitudinal daqueles que a ele confiaram sua saúde. Também é fundamental se ter claro que uma clínica odontológica tem nos pacientes de manutenção grande percentual de sua atividade. Não se constrói uma vida clínica somente com pacientes novos em tratamento, é primordial manter os resultados obtidos. Nesse sentido, manter a saúde dos pacientes e responsabilidade da profissão, com estratégias e terapêuticas que envolvam todos os aspectos relacionados com a saúde do paciente, tanto intrabucais quanto relativos à obtenção e manutenção de um estilo de vida saudável.

Periodical preventive maintenance is one of the most important activities of the dental profession. This relates to the fact that is useless to perform extensive treatments, healing individuals, without giving opportunity to maintaining the results. However, eventually, professionals and patients tend to give less importance to maintenance, underestimating its necessity and its resolution potential. It is also important to remember that a health professional needs to act based on the responsibility of long-term follow-up of those that sook treatment. It is also fundamental to know clearly that a dental clinic has a great percent of its activity with maintenance patients. That is, the daily practice is note only based in new patients being treated – to maintain the results is fundamental. In this sense, health maintenance of the patients is a responsibility for the profession, with procedures that include all aspects of patients' health, including intra-oral as well as those related to obtaining and maintaining a healthy lifestyle.

Lesão de células gigantes periférica em paciente periodontal: relato de caso / Peripheral giant cells lesion in a periodontal patient: a case report

A lesão de células gigantes periférica é uma enfermidade que envolve os tecidos moles da gengiva ou do rebordo alveolar. Tem etiologia desconhecida, embora seja considerada uma lesão reacional que ocorre em resposta à irritação local crônica, como cálculo subgengival e restaurações mal-adaptadas. Clinicamente, a LCGP apresenta-se como elevação nodular, pediculada ou séssil, de coloração avermelhada a roxa e superfície lisa ou lobulada; pode ou não estar ulcerada e possui evolução lenta e crescimento limitado. O tratamento envolve a remoção cirúrgica da lesão, que pode recidivar em torno de 10 por cento dos casos. Este trabalho tem por objetivo relatar um caso de recidiva de LCGP associada a periodontite

Comparison of histometric and morphometric analyses of bone height in ligature-induced periodontitis in rats

The purpose of this study was to compare histologic and morphometric procedures of bone height measurement. Microscopic measurements are the most frequent methods in periodontal studies with animals, but have limited capacity to identify bone levels associated with both healthy tissues and periodontal disease. Ligatures were placed in the maxillary left second molars of 10 male 60-day-old Wistar rats for 30 days. Left and right maxillary sides of 5 rats were processed for histologic analysis (H), sectioned buccolingually, and stained with HE. The maxillae of the other 5 rats were defleshed and used for morphometric analysis (M). Histometric measurements from the cementoenamel junction to the bone crest were performed. Standardized photographs were used for morphometric analysis. The t test was used for dependent or independent samples (alpha = 0.05 percent). Distances from cementoenamel junction to bone crest were 0.95 ± 0.25 and 1.07 ± 0.30 mm for H and M, respectively. Buccal measurements were 0.92 ± 0.16 and 1.08 ± 0.35 mm for H and M. The values obtained using H and M for areas without ligatures were 0.44 ± 0.15 and 0.47 ± 0.11 mm for lingual measurements and 0.23 ± 0.08 and 0.41 ± 0.10 mm for buccal measurements. No significant differences were found between the two methods in the detection of bone height associated with the placement of ligatures in rats.

O objetivo deste estudo foi comparar procedimentos de medida da altura óssea histológica e morfométrica. O método mais freqüente de mensuração da altura óssea em estudos em animais são as medidas microscópicas. No entanto, tem limitada capacidade de identificar os níveis ósseos associados com os tecidos saudáveis e doença periodontal. Foram colocadas ligaduras no segundo molar superior esquerdo de 10 ratos machos Wistar com 60 dias de vida durante um período de 30 dias. Hemimaxilas direitas e esquerdas de 5 ratos foram processadas para a análise histológica (H), cortadas no sentido vestíbulo-lingual e coradas com HE. Hemimaxilas dos outros 5 ratos tiveram toda a matéria orgânica removida para análise morfométrica (M). Medidas histométricas da junção cemento-esmalte (JCE) à crista óssea alveolar foram realizadas. Fotografias padronizadas foram utilizadas na análise morfométrica. O teste t foi utilizado para amostras dependentes e independentes (alfa = 0,05 por cento). As distâncias entre a JCE e a crista óssea na face palatina foram de 0,95 ± 0,25 e 1,07 ± 0,30 mm para H e M, respectivamente. As medidas vestibulares foram 0,92 ± 0,16 e 1,08 ± 0,35 mm para H e M. Os valores obtidos usando H e M para áreas sem ligadura foram 0,44 ± 0,15 e 0,47 ± 0,11 mm por lingual e 0,23 ± 0,08 e 0,41 ± 0,10 mm por vestibular, respectivamente. Não houve diferenças estatisticamente significativas entre os dois métodos na detecção da altura óssea associada à colocação de ligaduras em ratos.

Microscopic qualitative evaluation of fixation time and decalcification media in rat maxillary periodontium

The rat model is widely used in periodontal research and the quality of histological sections is essential. The purpose of this study was to evaluate the histological characteristics of periodontal tissues in Wistar rat maxillae, with different times of fixation and decalcified by nitric acid or formic acid (Anna Morse Solution). Fifteen rats were used. Fixation was performed for 24, 48 and 72 hours. The maxillae were hemi-sectioned and each part was decalcified either in nitric acid for 7 days or in Anna Morse solution for 35 days. Two trained and blinded examiners performed the evaluation. Fourty eight hours of fixation and decalcification with Anna Morse solution showed more clear characteristics of the epithelium-connective tissue interface and of the periodontal structures. Mean measurements between the cementum-enamel junction and the bone crest varied in the different experimental times from 176.5 (± 60.45) to 210.94 (± 39.33) pixels on the buccal aspect, and from 199.69 (± 38.33) to 298.55 (± 70.81) pixels on the palatal aspect, with no statistically significant differences (ANOVA, p > 0.05). In the same fixation period, decalcification with nitric acid or Anna Morse solution did not display any statistically significant differences. It may be concluded that for a qualitative histological analysis, fixation should preferably be for 48 hours and the demineralization should be made by Anna Morse solution. For a histomorphometric analysis, the decalcification solution does not interfere in the results.

O modelo rato é extensamente usado na pesquisa periodontal, e a qualidade dos cortes histológicos é essencial. A proposta deste estudo foi avaliar as características histológicas dos tecidos periodontais nas maxilas de ratos Wistar, após diferentes períodos de fixação e descalcificação pelo ácido nítrico ou pelo ácido fórmico (Solução de Anna Morse). Quinze ratos foram usados. A fixação foi realizada nos períodos de 24, 48 e 72 horas. As maxilas foram divididas e parte foi descalcificada em ácido nítrico durante 7 dias e parte com solução de Anna Morse por 35 dias. Dois examinadores treinados e cegos executaram a avaliação. Quarenta e oito horas de fixação e descalcificação com solução de Anna Morse mostraram características mais evidentes da interface epitélio-conjuntivo, assim como das estruturas periodontais. As médias, por vestibular, entre a junção cemento-esmalte e a crista óssea nos diferentes tempos experimentais variaram entre 176,5 (± 60,45) e 210,94 (± 39,33) "pixels", e, na face palatina, entre 199,69 (± 38,33) e 298,55 (± 70,81) "pixels", sem nenhuma diferença estatisticamente significativa (ANOVA, p > 0,05). No mesmo período de fixação, a descalcificação com ácido nítrico ou solução de Anna Morse não mostrou diferenças estatisticamente significantes. Pode-se concluir que, para a análise histológica qualitativa, a fixação deve ser preferivelmente em 48 horas e a desmineralização por solução de Anna Morse. Para a análise histo-morfométrica, a solução descalcificadora não interferiu nos resultados.

Avaliaçäo das condiçöes de higiene oral e gengival nas diferentes fases do tratamento periodontal / Evaluation of the oral and gingival hygiene in different phases of periodontal treatment

O presente estudo tem por objetivo avaliar as condiçöes periodontais de pacientes tratados no Curso de Especializaçäo em Periodontia. Participaram dezoito pacientes com doença periodontal em diferentes graus de evoluçäo e que estavam em manutençäo por um período mínimo de 12 meses. Para avaliar o estado gengival dos pacientes foram utilizados os índices de Placa (Silness & Löe) e Gengival (Löe & Silness). O desenvolvimento do tratamento seguiu a seguinte ordem: exame inicial, controle de placa supragengival, controle de placa subgengival, exame pós-raspagem subgengival, nova raspagem subgengival, se necessário (com ou sem acesso cirúrgico), exame controle e exame manutençäo. O tempo médio de tratamento e manutençäo foi de 28 meses. Foram tratados 415 dentes, sendo que 381 dentes sem acesso cirúrgico à placa subgengival (92 por cento ) e 34 dentes com acesso cirúrgico (8 por cento ). De acordo com os resultados dos índices de placa e gengival, pôde-se observar que as áreas onde foi realizado acesso cirúrgico no início do tratamento apresentavam mais altos índices que as áreas onde näo foi realizado acesso cirúrgico, e que após a fase ativa do tratamento, esses índices se igualaram e mantiveram-se durante o período de manutençäo. Ao longo do tratamento e durante o período de manutençäo houve uma reduçäo dos índices em relaçäo às condiçöes iniciais e isto pode estar relacionado com a forma como se desenvolveu o tratamento periodontal

Avaliação clínica da deplacagem com pasta profilática e cloroxidina 1 por cento / Clinical evaluation of professional plaque control with prophylactic paste and 1 por cento chlorhexidine

O objetivo desse estudo foi comparar a nova formação de placa dental e a quantidade de fluido gengival secretado após a remoção profissional de placa dental supragengival-deplacagem-utilizando pasta profilática e clorexidina gel 1 por cento. Teve como caracteristica ser um estudo cruzado e com examinador cego para o tipo tratamento utilizado. A formação de placa dental foi avaliada pelo índice de placa de QUIGLY e HEIN, modificado por TURESKY(1970), a cada 24 horas por um período de 96 horas na ausência de higiene bucal. O fluido gengival secretado foi coletado inicialmente e após quatro dias de acúmulo de placa dental. Os resultados foram avaliados por medianas, para o índice de placa, e médias para o fluido gengival secretado, sendo os resultados comparados pelo teste T de student e ANOVA (p>0,05) respectivamente. Através da análise dos resultados pode-se observar que houve um aumento gradual na formação de placa dental nos dois grupos. A utilização de clorexidina gel 1 por cento mostrou diferença estatística com maior número de superfícies livres de placa 48 horas e com menor formação de placa dental em 72 horas quando comparada com a pasta profilática em situação semelhantes. A quantidade de fluido gengival secretado não mostrou ser diferente após 96 horas de acúmulo de placa dental, no início e final do estudo, com ambos os tratamentos. Conclui-se que houve uma menor formação de placa após o controle profissional supragengival associado com uma única aplicação de clorexidina gel 1 por cento para um período de 72 horas

Fibroma ossificante: relato de um caso / Ossifying fibroma: report of a case

Os autores apresentam um caso clínico de fibroma ossificante em paciente de 46 anos de idade. Säo discutidos a etiopatogenia, aspectos clínicos, radiográficos e microscópicos e diagnóstico diferencial

Aspectos importantes da inter-relação entre endodontia e periodontia: uma revisão da literatura / The endodontics-periodontics inter-relatioshinp: a review of the literature

A inter-relação entre a Endodontia e Periodontia tem sido objetivo de estudo ao longo dos anos. Relações de natureza embriológica, morfológica são descritas na literatura. Modernamente, inclusive a possibilidade de que lesões endodônticas sejam fatores de risco à progressão da doença periodontal tem sido levantada. A presente revisão de literatura aborda os aspectos relevantes da relação Endodontia-Periodontia, com vistas a uma odontologia integral