Periodontal response to subgingival restorations in dogs with periodontitis

The aim of this study was to evaluate the periodontal response to subgingival restorations in dogs with naturally occurring periodontitis. At the baseline, the experimental teeth from three dogs (2nd and 3rd upper premolars and 2nd, 3rd and 4th lower premolars) were randomly assigned to Resin-modified Glass Ionomer Cement (RMGIC) and Amalgam (AM) restorations or controls (CT) at the buccal sites with (SUPRA+) or without mechanical supragingival plaque control (SUPRA-) and maintained for 90 days. Clinical [Periodontal Probing Depth (PPD), Clinical Attachment Loss (CAL), and Gingival Margin Recession (GMR)], histological (connective tissue inflammatory and epithelium condition) and histometric evaluation (distance between the apical border of the cavity and the bone level and between the apical extension of the epithelium and the bone level) were performed by a calibrated blinded examiner. Better clinical (especially regarding CAL) and histological results (unaltered epithelium and less severe inflammatory connective tissue) were observed associated with RMGIC sites. Histometric evaluation showed less bone loss associated to RMGIC. Overall, SUPRA+ sites presented less inflammatory response. It could be concluded that in dogs with periodontitis, subgingival RMGIC restorations, especially in the presence of supragingival plaque control, elicited better periodontal response than AM restorations.

O objetivo do presente estudo foi avaliar a resposta do periodonto a restaurações subgengivais em cães com diagnóstico de periodontite. No início do estudo, os dentes experimentais de três cães (2o e 3o molares superiores e 2o, 3o e 4o premolares inferiores) foram randomicamente designados para restauração com cimento de ionômero de vidro modificado por resina (CIVMR), amálgama (AM) ou Controle (CT) nos sítios vestibulares submetidos (SUPRA+) ou não (SUPRA-) a controle mecânico de placa supragengival e mantidos por 90 dias. Avaliações clínicas [Profundidade de Sondagem (PS), Nível de Inserção Clínica (NIC), Recessão Gengival (RG)], histológicas (condições inflamatórias do tecido epitelial e conjuntivo) e histométricas (distância entre a margem apical da cavidade e o nível ósseo e entre a extensão apical do epitélio e o nível ósseo) foram realizadas por examinador calibrado e cego. Melhores resultados clínicos (especialmente quanto à PI) e histológicos (epitélio sem alterações e tecido conjuntivo com menor severidade de infiltrado inflamatório) foram observados em associação a sítios restaurados com CIVMR. A avaliação histométrica mostrou menor perda óssea associada a restauração com CIVMR. Todos os sítios SUPRA+ exibiram menor resposta inflamatória. Pode ser concluído que, em cães com periodontite, restaurações subgengivais realizadas com CIVMR, especialmente na presença de controle mecânico de placa supragengival, apresentaram melhor resposta do periodonto quando comparadas com restaurações de amálgama.

Daily biofilm control and oral health: an epidemiological challenge consensus – brazilian advisory panel in oral health

Dental plaque is known as the primary etiological factor for the periodontal diseases. Knowledge about dental plaque has extensively evolved being recognized, not only as a simple bacterial conglomerate adhering to the tooth surface, but also defined as biofilm. Adequate oral hygiene is the most effective way to prevent periodontal disease and caries, which are caused by specific microorganisms found in the oral biofilm. Disorganization and constant removal of this biofilm represents the major strategy utilized in the prevention and treatment of such diseases. The inclusion of oral antiseptics, in daily home care, provides a more effective recommendation for prevention by dental professionals. It is possible to establish a hierarchical order of effectiveness. Chlorhexidine (CHX) promotes the highest anti-plaque effects followed by the essential oils (EOs), cetylpyridinium chloride (CPC) and finally triclosan. For anti-gingivitis action the EOs are equivalent to CHX being both superior agents when compared with CPC and triclosan. Based on the available scientific evidence this group of experts in oral care is favorable to recommending the daily use of an essential oil-containing mouthwash as the active principle, for the majority of the population, excluding children under 6 year of age, individuals with sensitivity to the formula components and those who present adequate oral hygiene using only mechanical methods (brushing and flossing) and dentifrice.

The effect of smoking on gingival crevicular fluid volume during the treatment of gingivitis / Efeito do tabagismo sobre o volume de fluido crevicular gingival durante o tratamento da gengivite

Smoking is detrimental to periodontal tissues, and periodontal destruction is greater among smokers. Paradoxically, smokers seem to have less gingival bleeding than never-smokers with comparable supragingival plaque. There is scarce information about the impactof smoking on gingival crevicular fluid (GCF) volume. This singlearm study clinical trial assessed the effect of smoking on GCF volume during the treatment of gingivitis. The sample included 24 never-smokers (47.3 ± 6.7 years old, 41.7% males) and 21 smokers (45.8 ± 5.1 years old; 55% males; 19.6 ± 11.8 cigarettes/day; 24.1 ± 8.7 years of smoking) with gingivitis and chronic periodontitis. After baselinesupragingival scaling, patients received oral hygiene instructions weekly for 180 days. Participants were examined at baseline, 30, 90 and 180 days, and gingival bleeding index (GBI), bleeding on probing (BOP), periodontal probing depth (PPD) and GCF volume wererecorded. Statistical analysis was performed using linear models (Wald test, p<0.05%). Smokers had significantly smaller GCF volumes than never-smokers. This finding was not attributed to GBI, BOP or PPD. Higher volumes of GCF were significantly associated with deeper pockets. GCF was significantly reduced throughout thestudy for both smokers and never-smokers, and the largest reductionswere seen at 30 days. Smoking affected the GCF crevicular fluid volumeindependently of the presence of gingival bleeding, BOP and PPD. Smoking status and PPD should be taken into account when GCG volume and components are under investigation.

O tabagismo é capaz de alterar a resposta periodontal determinando maior expressão de destruição periodontal em pacientes fumantes. Paradoxalmente, estes pacientes apresentam menos sangramento gengival frente a uma quantidade semelhante de biofilme dental, quando comparados a pacientes que nuncafumaram. Por outro lado, existe pouca informação sobre o impacto do tabagismo sobre o volume de fluido crevicular gengival (FCG). O presente ensaio clínico de braço único teve comoobjetivo avaliar o efeito do tabagismo sobre o volume de FCG durante o tratamento da gengivite. A amostra foi composta por 24 pacientes que nunca fumaram (47.3 ± 6.7 anos, 41.7% homens) e 21 fumantes (45.8 ± 5.1 anos; 55% homens; 19.6 ± 11.8cigarros por dia; 24.1 ± 8.7 anos de exposição ao tabaco), com diagnóstico de gengivite e periodontite crônica. Os exames periodontais: Índice de Placa Visível (IPV), Índice de SangramentoGengival (ISG), Sangramento à Sondagem (SS) e Profundidade de Sondagem (PS) e a coleta de FCG foram realizados nos dias 0, 30, 90 e 180. Após a raspagem supragengival realizada no dia zero (dia 0), os pacientes receberam instrução de higienebucal semanalmente, até o dia 180. A análise estatística utilizou modelos lineares (Teste de Wald, p<0.05%). Os fumantes apresentaram um volume significativamente menor de FCG. Esteresultado não esteve associado ao ISG, SS ou PS. Sítios com maiores valores de PS apresentaram maior volume de FCG.Durante o tratamento, uma redução significante do volume de FCG foi observada em fumantes e pacientes que nunca fumaram. Conclui-se que o tabagismo influenciou o volume de FCG independente da presença de sinais inflamatórios clínicos e que o hábito de tabagismo e a PS devem ser observados quando o volume de FCG e seus componentes estiverem sob investigação.