Root coverage of multiple gingival recessions treated with coronally advanced flap associated with xenogeneic acellular dermal matrix or connective tissue graft: a 6-month split-mouth controlled and randomized clinical trial.

OBJECTIVES: This study aimed to compare xenogeneic dermal matrix (XDM) to connective tissue graft (CTG) associated with coronally advanced flap (CAF) in treating Miller's class I and II (RT1) multiple gingival recession in a split-mouth randomized clinical trial. MATERIALS AND METHODS: Fifteen patients with bilateral Miller's class I and II multiple recessions were selected. The patient's side receiving each treatment was randomly allocated to receive XDM or CTG. The clinical parameters were measured at baseline and 6 months of follow-up. RESULTS: At 6 months, no significant difference in the root coverage (RC) (95.28 ± 6.89% for CTG and 92.68 ± 7.35% for XDM) and the keratinized tissue (KT) gain (0.91 ± 0.46 mm for CTG and 0.74 ± 0.39 mm for XDM) was observed between groups (p > 0.05). The CTG group presented higher complete root coverage (CRC) than XDM (60% and 33%, respectively) (p = 0.045). Multiple logistic regression indicated that the XDM (p = 0.01) and the XDM and KT interaction (p = 0.02) negatively interfered in the CRC. A 1-mm increase in the baseline KT when using XDM increases almost 6 times the chance of achieving CRC, and XDM reached a similar CRC probability to CTG when the receptor area presented at least 2 mm of KT. CONCLUSIONS: Both treatments were effective for treating multiple gingival recession; similar KT gain, GR reduction, and RC were obtained for CTG and XDM, while CTG promoted higher CRC than XDM. Moreover, the amount of KT at baseline was determinant for CRC when treating multiple gingival recession with XDM. CLINICAL RELEVANCE: XDM produces limited CRC in sites with a reduced amount of KT. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (REBEC) number RBR-56NZQ6.

Locally applied statins as adjuvants to non-surgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis.

OBJECTIVE: This review aimed at evaluating the effects of chronic periodontitis (CP) treatment with local statins as adjuncts to scaling and root planing (SRP), compared with SRP alone or with placebo. METHODS: Electronic and hand searches were conducted in three databases to select randomized controlled trials (RCTs) comparing SRP + statins versus SRP alone. Random effects models were conducted to determine the clinical attachment level (CAL) gain as the primary outcome variable, and probing pocket depth (PPD) reduction, modified sulcus bleeding index (mSBI), and intrabony defect depth (IBD) as the secondary outcomes. RESULTS: Of the 526 papers identified, 15 articles met the criteria for inclusion in this systematic review, and 13 in the meta-analysis. The meta-analysis showed a statistically significant CAL gain (mean differences [MD] = 1.84 mm, 95% confidence interval [CI] = 1.45 to 2.23; p = 0.000), PPD reduction (MD = 1.69 mm, 95% CI = 1.37 to 2.04; p = 0.000), mSBI change (MD = 0.70, 95% CI = 0.57 to 0.84; p = 0.000), and IBD (MD = 1.48, 95% CI = 1.30 to 1.67; p = 0.000) attributed to SRP + statin treatment (6 months). CONCLUSION: Within the limitations of this study, the collective evidence emerging from this systematic review and meta-analysis may support the use of locally applied statins as adjuncts to SRP in CP treatment, based on being an easy, low-cost alternative, with lesser adverse effects on bacterial resistance. These results should be interpreted with caution. CLINICAL RELEVANCE: Clinicians might consider the use of SRP + statins as an adjunct over other alternative approaches, based on the results of the present review. The informed decision should be taken, considering the patient's values and preferences, and the intervention to be implemented by the clinician.

Influence of Transmucosal Height on Loss of Prosthetic Abutment Torque After Mechanical Cycling.

The aim of this study was to measure and record the universal transmucosal abutment height, and then evaluate whether it influenced loosening of the abutment screw by analyzing the torque and detorque values after mechanical cycling. Thirty-six implants, model CM Unitite, with internal conical connections (3.5 × 10 mm) and respective universal prosthetic abutments (n = 36, 3.25 × 6 mm), were divided into three groups (n = 12 each) with respective transmucosal heights of 0.8, 3.5, and 5.5 mm. Insertion torque of 20 Ncm was used in accordance with the manufacturer's specifications. Afterward, the samples were submitted to fatigue tests consisting of 500,000 cycles at a frequency of 2Hz, a dynamic compressive load of 120N, and an angle of 30°. The detorque values were measured with a digital torque meter and tabulated to perform statistical analyses; a level of significance of 5% was adopted. The mean detorque values (SD) obtained were 22.83 (6.30), 22.5 (5.45), and 19.41 (4.69) Ncm for transmucosal abutments with heights of 0.8, 3.5, and 5.5 mm, respectively, and showed no statistically significant difference ( P = .262). The authors of this study concluded that the transmucosal height of prosthetic abutments submitted to mechanical fatigue did not influence the detorque values.

Effect of a single-tufted toothbrush on the control of dental biofilm in orthodontic patients: A randomized clinical trial.

OBJECTIVE: To compare the effect of a single-tufted toothbrush combined or not with a conventional toothbrush to control dental biofilm in healthy orthodontic patients. MATERIALS AND METHODS: Twenty orthodontic patients were randomly assigned to receive three different treatments: Group 1-conventional toothbrush; Group 2-single-tufted toothbrush and Group 3-combination of single-tufted and conventional toothbrushes. Stained plaque index (SPI), visible plaque index (VPI) and gingival bleeding index (GBI) were recorded. The data were analysed by Kolmogorov-Smirnov test. Wilcoxon test was used for intragroup comparison and Friedman test for the intergroup comparison (α = 5%). RESULTS: Intragroup analysis showed that VPI and SPI significantly decreased (P < 0.05) after 72 hour in Group 3. Anterior and posterior teeth did not show any significant statistical differences after 72 hour (P > 0.05), but VPI values in the labial surfaces were different to Group 3 (P < 0.05) in comparison with the other groups after 72 hour. Group 3 showed a statistically significant reduction (P < 0.05) for SPI in the interproximal surfaces when compared with Group 1. CONCLUSION: The combination of single-tufted and conventional toothbrushes was effective for controlling dental biofilm formation in orthodontic patients.

Microwave radiation is effective at disinfecting dental stone surfaces without changing their physical properties.

The aims of this study were to evaluate the effectiveness of different microwave radiation regimens for disinfection of type IV dental stone surfaces and to assess the influence of these regimens on surface roughness and dimensional change following disinfection. Three hundred cylindrical (20 × 2-mm) test specimens were made in type IV stone and divided into subgroups of 20 according to the microorganisms tested (Staphylococcus aureus, Escherichia coli, or Candida albicans) and the 900-W microwave radiation protocol (cycles of 3, 5, or 7 minutes; a positive control; or a negative control). To test physical changes, 80 test specimens were made with the same dimensions except that they had 2 parallel and symmetrical indentations measuring 8 × 4 mm. These specimens were divided into 4 subgroups of 20 each (a subgroup for each radiation time and a negative control). The mean dimensional change and roughness data were analyzed by mixed models for repeated measures and Tukey-Kramer tests. Disinfection was analyzed with descriptive statistics. For E coli and C albicans, all radiation times proved effective at sterilizing the test specimens. For S aureus, sterilization was achieved with 5 and 7 minutes of exposure; however, colonies were observed in 10 Petri dishes (50%) exposed to 3 minutes of microwave radiation. No statistically significant difference in dimensional change or surface roughness was observed for any radiation regimen (P > 0.05).

Collagen Matrix for Increasing Peri-implant Mucosal Thickness in Smokers: A Prospective Case Series.

This prospective case series aimed to evaluate the feasibility of using a volume collagen matrix for soft tissue augmentation to increase mucosal thickness in single implants in smokers who consume more than 10 cigarettes per day. Participants had single submerged implants necessitating soft tissue thickening. Soft tissue augmentation was done using a collagen matrix in the second-stage surgery. The primary outcome was soft tissue thickness at 90 days post-surgery. Secondary outcomes included median thickness at 30 and 60 days, changes in buccal soft tissue profile (digital measurements) at 30, 60, and 90 days, and oral health-related quality of life using OHIP-14 up to 90 days post-surgery. Pain levels via VAS scale and adverse effects were also assessed. Ten participants (4 men, 6 women) aged 45.2 ± 13.18 years initially smoked 10-20 cigarettes daily (average: 14.70 ± 3.47 cigarettes/day). After 90 days, median soft tissue thickness increased to 3.00 (2.00;3.00) mm. Buccal soft tissue profile (median change in ROI) increased by 0.40 (0.25;0.62) mm at 90 days. Pain levels decreased, and oral health-related quality of life improved significantly. No complications were reported. The collagen matrix significantly augmented buccal soft tissue thickness at implant sites in smokers (>10 cigarettes/day), with favorable outcomes and no complications.

Finishing and polishing systems influence the roughness and color stability of acrylic and bis-acryl composite resins.

Background: To evaluate the effect of different finishing and polishing systems on the surface roughness and color changes of bis-acryl (Protemp 4 - 3M ESPE- St. Paul, USA; Structur 3 - Voco, Cuxhaven, Germany) and chemically activated acrylic materials (Duralay - Reliance, SP, Brazil). Material and Methods: Specimens (10 x 2 mm) thick were prepared for each material. The specimens were subjected to polishing and finishing procedures with aluminum oxide discs (Diamond Master - FGM, Joinville, Santa Catarina, Brazil) and spiral rubber disks (Sof-Lex - 3M ESPE, Germany). The control did not receive any polishing and finishing procedures. Surface roughness and color measurement values were obtained after the finishing and polishing procedures and immediately after 30 days of storage in water, coffee, and red wine. Data for each material were analyzed by One-Way ANOVA (p<0.05). Results: The polishing with aluminum oxide discs was able to affect the initial surface roughness values of chemically activated acrylic material (p<0.05). After immersion in staining solutions, lower ∆E values were only observed for the bis-acryl composite resins compared to the control group (p<0.05). Conclusions: The finishing and polishing systems influenced the surface roughness and color stability of the materials tested. The chemically activated acrylic resin showed lower surface roughness and higher color stability than the bis-acryl materials. Key words:Acrylic resin, bis-acryl resin, provisional restoration.

Use of Local Melatonin with Xenogeneic Bone Graft to Treat Critical-Size Bone Defects in Rats with Osteoporosis: A Randomized Study.

The aim of this study was to evaluate the effect of local administration of melatonin (MLT) on molecular biomarkers and calvaria bone critical defects in female rats with or without osteoporosis, associated or not with a xenogeneic biomaterial. Forty-eight female rats were randomly divided into two groups: (O) ovariectomized and (S) placebo groups. After 45 days of osteoporosis induction, two critical-size defects (5 mm diameter) were created on the calvaria. The groups were subdivided according to the following treatment: (C) Clot, MLT, MLT associated with Bio-Oss® (MLTBO), and Bio-Oss® (BO). After 45 days, the defect samples were collected and processed for microtomography, histomorphometry, and biomolecular analysis (Col-I, BMP-2, and OPN). All animals had one femur harvested to confirm the osteoporosis. Microtomography analysis demonstrated a bone mineral density reduction in the O group. Regarding bone healing, the S group presented greater filling of the defects than the O group; however, in the O group, the defects treated with MLT showed higher mineral filling than the other treatments. There was no difference between the treatments performed in the S group (p = 0.05). Otherwise, O-MLT had neoformed bone higher than in the other groups (p = 0.05). The groups that did not receive biomaterial demonstrated lower levels of Col-I secretion; S-MLT and S-MLTBO presented higher levels of OPN, while O-C presented statistically lower results (p < 0.05); O-BO showed greater BMP-2 secretion (p < 0.05). In the presence of ovariectomy-induced osteoporosis, MLT treatment increased the newly formed bone area, regulated the inflammatory response, and increased OPN expression.

Titanium dioxide nanotubes applied to conventional glass ionomer cement influence the expression of immunoinflammatory markers: An in vitro study.

Objectives: To assess the impact of different concentrations TiO2-nt incorporated into a glass ionomer cement on the proliferation, mitochondrial metabolism, morphology, and pro- and anti-inflammatory cytokine production of cultured fibroblasts (NIH/3T3), whether or not stimulated by lipopolysaccharides (LPS-2 µg/mL, 24 h). Methods: TiO2-nt was added to KM (Ketac Molar EasyMix™, 3 %, 5 %, 7 % in weight); unblended KM was used as the control. The analyses included: Cell proliferation assay (n = 6; 24/48/72h); Mitochondrial metabolism assay (n = 6; 24/48/72h); Confocal laser microscopy (n = 3; 24/48/72h); Determination of biomarkers (IL-1ß/IL-6/IL-10/VEGF/TNF) by using both multiplex technology (n = 6; 12/18 h) and the quantitative real-time PCR assay (q-PCR) (n = 3, 24/72/120 h). The data underwent analysis using both the Shapiro-Wilk and Levene tests, and by generalized linear models (α = 0.05). Results: It demonstrated that cell proliferation increased over time, regardless of the presence of TiO2-nt or LPS, and displayed a significant increase at 72 h; mitochondrial metabolism increased (p < 0.05), irrespective of exposure to LPS (p = 0.937); no cell morphology changes were observed; TiO2-nt reverted the impact of KM on the secreted levels of the evaluated proteins and the gene expressions in the presence of LPS (p < 0.0001). Conclusions: TiO2-nt did not adversely affect the biological behavior of fibroblastic cells cultured on GIC discs.

One stage, full-mouth, ultrasonic debridement in the treatment of severe chronic periodontitis in smokers: a preliminary, blind and randomized clinical trial.

OBJECTIVE: The aim of this clinical trial was to assess the performance of a full-mouth ultrasonic debridement protocol in the treatment of severe chronic periodontitis in comparison with scaling and root planing in a quadrant-wise procedure in smokers. MATERIALS AND METHODS: The trial consisted of 30 participants presenting with periodontitis divided into 3 groups: Group FMUD - full-mouth ultrasonic debridement, i.e., one session of 45 minutes of ultrasonic instrumentation for smokers (n = 10), Group SRP- scaling and root planing performed in a quadrant-wise manner for smokers (n = 10), and Group Control - SRP for nonsmokers (n = 10), treated following the same protocol as the SRP group. The parameters evaluated were: plaque/bleeding on probing indices, probing pocket depth, relative recession, and relative probing attachment level at baseline, 45, 90 and 180 days after therapy. RESULTS: Full-mouth ultrasonic debridement and scaling and root planing resulted in comparable gain of attachment 6 months after therapy. Both groups exhibited probing pocket depth reduction at all experimental periods as compared to baseline. Smokers, however, had less probing pocket depth reduction and relative probing attachment level gain compared to non-smokers, despite the mechanical protocol used (p < 0.05). Moreover, at 180 days, nonsmokers presented with fewer sites requiring re-treatment (probing pocket depth > 5 mm and bleeding on probing) than smokers (p < 0.05). CONCLUSIONS: Full-mouth ultrasonic debridement and scaling and root planing result in comparable clinical outcomes for the treatment of smokers with severe chronic periodontitis. Despite the non-surgical technique used, smokers had a less favorable clinical response than non-smokers.

Evaluation of soft tissues around single tooth implants in the anterior maxilla restored with cemented and screw-retained crowns.

Implant-supported restorations can be attached as screw-retained or cemented prostheses. In both situations, the characteristics of the soft tissues around the implants are crucial for oral rehabilitation and patient satisfaction. Therefore, this study uses the Pink Esthetic Score (PES), which allows evaluation of gingival esthetics around implants, to evaluate the soft tissues around implants in the anterior maxilla rehabilitated with cemented prostheses (CP) and screw-retained prostheses (SP). Forty implants placed in the anterior maxilla were evaluated, and these had been rehabilitated with prosthetic crowns for a minimum of 1 year. Periodontal examination was performed to evaluate probing depth (PD) and bleeding on probing (BOP) of the implant and the corresponding natural tooth. The total mean (±SD) PES for SP was 10.73 (±1.98) and 10.41 (±2.67) for CP, which was not statistically significant (P ≥ .05). Periodontal examination revealed that CP and SP showed no difference for BOP (P ≥ .05). Differences were only detected in PD when comparing the reference teeth of both groups to CP and SP (P ≤ .05). The present study demonstrates that the PES proved to be an efficient index to assess peri-implant tissues, and that the type of crown retention does not influence the health and quality of the soft tissues around implants.

Histologic and histomorphometric analysis of two biomaterials of xenogenous origin for maxillary sinus elevation: a clinical study.

Objective: This study analyzed two xenogenous biomaterials based on deproteinized bovine bone mineral applied for maxillary sinus elevation. Method and materials: Fourteen patients were submitted to maxillary sinus augmentation with one of the following biomaterials: Criteria Lumina Bone Porous (test group) or Geistlich Bio-Oss (control group), both of large granules (1 to 2 mm). After 6 months, trephine biopsies were collected at the time of implant placement: 27 samples (11 patients) in the test group; 7 samples (3 patients) in the control group. Biopsies were analyzed by descriptive histology and histomorphometry, in which the percentages of newly formed bone, residual biomaterial particles, and connective tissue were evaluated. Results: Histomorphometry showed means for test and control groups, respectively, of 32.41% ± 9.42% and 26.59% ± 4.88% for newly formed bone, 22.89% ± 4.58% and 25.00% ± 4.81% for residual biomaterial, and 44.70% ± 9.54% and 48.41% ± 3.36% for connective tissue. There were no differences between groups (P > .05). Conclusion: This study concluded that Criteria Lumina Bone Porous presented similar histologic and histomorphometric characteristics to Geistlich Bio-Oss 6 months after sinus elevation surgery, identifying the tested biomaterial as an interesting alternative for bone augmentation in the maxillary sinus.

Inflammatory cell profile using different autologous fibrin protocols.

Autologous fibrin has been widely used in surgical procedures for both soft and hard tissue repair. There are different protocols and devices to obtain this matrix, with varying centrifugal time, gravity force, speed, angle of the sample tube and spinning radius. The aim of this study was to compare three methods of obtaining autologous fibrin: L-PRF using the Intra-Spin L-PRF centrifuge (Dohan protocol), the advanced PRF (A-PRF) using the Intra-Spin L-PRF centrifuge and autologous leukocyte fibrin (ALF), using the Kasvi centrifuge. Venous blood was collected from 7 healthy volunteers, which were submitted to the 3 different methods of centrifugation. The membranes were tissue-processed and evaluated by immunohistochemistry for CD3, CD20, CD68 and CD138. For CD68+, a lower number of cells was immunolabelled in the L-PRF group when compared to the other groups (A-PRF and ALF). For CD3+, a lower number of immunolabellated cells was observed in the ALF group when compared to the remaining groups (p < 0.05). In the A-PRF group, the CD20+ cell count was lower than in the remaining groups. No difference was observed in CD138+ cell counts between the groups. The 3 protocols tested are suitable for obtaining autologous fibrin membranes.

DC-STAMP and TACE Levels are Higher in Patients with Periodontitis.

Although periodontitis is one of the commonest infectious inflammatory diseases in humans, the mechanisms involved with its immunopathology remain ill understood. Numerous molecules may induce inflammation and lead to bone resorption, secondary to activation of monocytes into osteoclasts. TACE (TNF-α converting enzyme) and DC-STAMP (dendritic cell-specific transmembrane protein) appear to play a role on bone resorption since TACE induces the release of sRANKL (soluble receptor activator of nuclear factor kappa-ß ligand) whereas DC-STAMP is a key factor in osteoclast induction. The present study evaluated the levels of TACE and DC-STAMP in patients with and without periodontitis. Twenty individuals were selected: 10 periodontally healthy participants undergoing gingivectomy for esthetic reasons and 10 diagnosed with periodontitis. Protein levels of such molecules in gingival tissue were established using Western blotting. Protein levels of both TACE and DC-STAMP were higher in the periodontitis group than in the control group (p<0.05; Student t-test). In conclusion, TACE and DC-STAMP protein levels are elevated in patients with periodontitis, favoring progression of bone resorption.

Preliminary findings on the possible role of B-lymphocyte stimulator (BLyS) on diabetes-related periodontitis.

The possible role of B-cell growth and differentiation-related cytokines on the pathogenesis of diabetes-related periodontitis has not been addressed so far. The aim of this study was to evaluate the effects of diabetes mellitus (DM) on the gene expression of proliferation-inducing ligand (APRIL) and B-lymphocyte stimulator (BLyS), two major cytokines associated to survival, differentiation and maturation of B cells in biopsies from gingival tissue with periodontitis. Gingival biopsies were obtained from subjects with periodontitis (n = 17), with periodontitis and DM (n = 19) as well as from periodontally and systemically healthy controls (n = 10). Gene expressions for APRIL, BLyS, RANKL, OPG, TRAP and DC-STAMP were evaluated using qPCR. The expressions APRIL, BLyS, RANKL, OPG, TRAP and DC-STAMP were all higher in both periodontitis groups when compared to the control group (p < 0.05). Furthermore, the expressions of BLyS, TRAP and RANKL were significantly higher in the subjects with periodontitis and DM when compared to those with periodontitis alone (p < 0.05). The mRNA levels of BLyS correlated positively with RANKL in the subjects with periodontitis and DM (p < 0.05). BLyS is overexpressed in periodontitis tissues of subjects with type 2 DM, suggesting a possible role of this cytokine on the pathogenesis DM-related periodontitis.

Lithium chloride improves bone filling around implants placed in estrogen-deficient rats.

OBJECTIVE: This study evaluated the ability of lithium chloride (LiCl) to increase bone filling (BF) around threaded titanium implants inserted in estrogen-deficient rats and, thein-vitro effects of this drug on osteoblast-like cell viability, proliferation, mineralization and expression of bone-related markers. DESIGN: In vivo: Rats received sham surgery plus water (Estrogen-sufficient group), ovariectomy plus water (Estrogen-deficient group) or ovariectomy plus LiCl (150 mg/kg/every other day) (LiCl/estrogen-deficient group). On the 21st day after ovariectomy/sham surgeries, a threaded titanium implant was inserted in the rat tibia. BF and the number of TRAP + cells were assessed at 10, 20 and 30 days after implant placement. In vitro: Osteosarcoma SAOS-2 cells were exposed to 0, 0.01, 0.05, and 0.1 mM of LiCl; cell proliferation, viability, mineralization (alizarin red staining) and gene expressions of RUNX-2, OCN, OPN, BSP and ALP (Real Time PCR) were estimated in the cultures. RESULTS: In vivo: The estrogen-sufficient and LiCl/estrogen-deficient groups demonstrated higher percentages of BF, within the limits of implant threads, than the estrogen-deficient group at 20 and 30 days (p < 0.05). The number of TRAP + cells was lower in LiCl/estrogen-deficient than in the estrogen-deficient group at all experimental times (p < 0.05). In vitro: Cell cultures exposed to LiCl (0.01 or 0.05 mM) exhibited larger areas of mineralized matrix than the non-exposed cultures (p < 0.05) and demonstrated the highest expressions of the genes investigated. CONCLUSION: LiCl treatment improved BF around threaded titanium implants inserted in estrogen-deficient rats and stimulated matrix mineralization and overexpression of bone-formation markers in osteoblastic cells in culture.

Viability and collagen secretion by fibroblasts on titanium surfaces with different acid-etching protocols.

BACKGROUND: From the consolidation of surface treatments of dental implants and knowledge on the cellular mechanisms of osseointegration, studies have highlighted the importance of a connective tissue seal against the implant to prevent contamination from the oral environment and consequent biofilm formation. OBJECTIVE: This in vitro study aimed to evaluate whether different titanium surface treatments using acid solutions promoted an increase in collagen secretion, proliferation, and viability of fibroblasts. MATERIAL AND METHODS: Commercially pure grade-4 titanium disks (6 × 2 mm) were treated with different acid solutions (hydrochloric, nitric, and sulfuric) for 20 and 60 min, respectively, obtaining mean surface roughness of 0.1 to 0.15 µm and 0.5 to 0.7 µm. Human fibroblasts were seeded onto different surfaces and assessed after 24 h, 48 h, and 72 h for cell proliferation and viability using Trypan blue staining and MTT, respectively, as well as the secretion of type I collagen on to such surfaces using ELISA. Machined titanium surfaces were used as controls. Data were statistically analyzed using one-way ANOVA and Fisher's LSD test for multiple comparisons, adopting a significance level of 5%. RESULTS: No significant difference was observed in cell proliferation for the different surfaces analyzed. Cell viability was significantly lower on the machined surface, after 48 h, when compared to the groups treated with acid for 20 or 60 min, which did not differ from each other. The expression of type I collagen was lowest on the acid-treated surfaces. CONCLUSION: The results showed that the acid treatment proposed did not promote fibroblast proliferation and viability nor favor type I collagen synthesis.

Effects of sodium lauryl sulphate (SLS), present in dentifrice, on volatile sulphur compound (VSC) formation in morning bad breath.

The purpose of the present investigation was to evaluate the effects of sodium lauryl sulphate (SLS), present in a commercial dentifrice, on the formation of volatile sulphur compounds (VSC) and tongue coating in a panel of periodontally healthy subjects. A two-step blinded, crossover, randomized study was carried out in 25 dental students with healthy periodontium; these were divided into two experimental groups: SLS (dentifrice with SLS) and WSLS (dentifrice without SLS). The volunteers received the designated dentifrice and a new toothbrush for a 3x/day brushing regimen for 2 periods of 30 days. A seven-day washout interval was used between the periods. The assessed parameters were: plaque index (PI), gingival index (GI), organoleptic breath (ORG), VSC levels by portable sulphide monitor before (H1) and after (H2) cleaning of the tongue, tongue coating wet weight (TC) and benzoyl-DL-arginine-naphthylamide (BANA) test from tongue coating samples. The intra-group analysis showed a decrease in the median of organoleptic scores from 3 to 2 after 30 days for the SLS group (p < 0.05). The inter-group analysis showed lower values in ORG and H1 for the SLS group (p < 0.05). There was no difference between the amount of TC in SLS and WSLS groups. In the BANA test, the presence of SLS did not affect the BANA number of +/- results (p > 0.05). These findings suggest that sodium lauryl sulphate (SLS), present in dentifrice, appears to prevent VSC formation in morning bad breath regardless of the amount of tongue coating in periodontally healthy subjects.

Peri-implant diseases may be associated with increased time loading and generalized periodontal bone loss: preliminary results.

The aim of this study was to evaluate the prevalence of peri-implant diseases around Branemark system implants in Brazilians and the possible relationship with periodontal bone loss, systemic condition, and demographic profile. A total of 113 individuals were enrolled in this study, and they received 347 implants. The implants were clinically and radiographically examined and diagnosed as healthy implants, mucositis, or peri-implantitis. The demographic and systemic profiles of the individuals were assessed via questionnaires, and the time of loading was obtained from files. The presence of periodontal bone loss in partially edentulous patients was determined by standardized radiographic evaluation. With regard to implants, the prevalence was 60.5% (n = 210), 32% (n = 111), and 7.5% (n = 26) for healthy tissues, mucositis, and peri-implantitis, respectively. No correlation was found between peri-implant tissue conditions and socioeconomic status, body mass index, smoking status, gender, age, diabetes mellitus, osteopenia, and osteoporosis. Statistically significant positive correlations were found in implants with mucositis and peri-implantitis in relation to time of loading and with peri-implantitis in relation to periodontal bone loss in the 4 quadrants (P < .05). Presence of peri-implant diseases may be associated with the increasing time of loading and generalized periodontal bone loss.

Microbiological analysis of tongue dorsum coating in patients hospitalized in ICU / Análise microbiológica da saburra em dorso lingual de pacientes internados em UTI

ABSTRACT Objective: ssess quantitatively and qualitatively tongue coating microbiota in ICU patients. Methods: Analytical observational study, convenience sample comprising 65 patients was included for medical report analysis and collection of general data, tongue coating assessment through visual inspection and microbiological sample collection for further laboratory analysis. The collection was performed by a single examiner using a sterile swab introduced and rubbing the posterior portion of the tongue close to the oropharynx. Results: Most patients (60%) belonged to the female sex, at mean age of 74.2 years. The main reasons for hospitalization were lung issues (26.2%) - prevailing associated comorbidities were diabetes (43.1%) and high blood pressure (66.2%). The mean length of stay in the ICU was one day. All patients presented tongue dorsum coating. There were Candida albicans (37%), Streptococcus parasanguinis (26.1%) and Streptococcus mitis (32.6%) in 1/3 of lingual extension. Streptococcus mitis (p=0,0265) was the most prevalent species. Conclusion: There was no significance between the amount of coating and number of observed species, although all assessed patients had presented coating. The most prevalent microorganisms were Candida albicans, Streptococcus parasanguinis and Streptococcus mitis.

RESUMO Objetivo: Avaliar quantitativa e qualitativamente a microbiota da saburra lingual em pacientes internados em UTI. Métodos: Estudo observacional analítico, amostra de conveniência composta por 65 pacientes para análise de laudo médico e coleta de dados gerais, avaliação da saburra lingual por inspeção visual e coleta de amostra microbiológica para posterior análise laboratorial. A coleta foi realizada por um único examinador por meio de swab estéril introduzida e fricção na porção posterior de língua próxima à orofaringe. Resultados: A maioria dos pacientes (60%) pertencia ao sexo feminino, com média de idade de 74,2 anos. Os principais motivos de internação foram problemas pulmonares (26,2%) - as comorbidades associadas predominantes foram diabetes (43,1%) e hipertensão arterial (66,2%). O tempo de internação médio na UTI foi de um dia. Todos os pacientes apresentavam saburra do dorso da língua. Havia Candida albicans (37%), Streptococcus parasanguinis (26,1%) e Streptococcus mitis (32,6%) em 1/3 da extensão lingual. Streptococcus mitis (p=0,0265) foi a espécie mais prevalente. Conclusões: Não houve significância entre a quantidade de recobrimento e o número de espécies observadas, embora todos os pacientes avaliados tenham apresentado recobrimento. Os microrganismos mais prevalentes foram Candida albicans, Streptococcus parasanguinis e Streptococcus mitis.