Does subgingival bacterial colonization differ between implants and teeth? A systematic review

Abstract The aim was of this study was to determine the current weight of evidence for the existence of specific differences between the microbiota of healthy teeth and healthy implants, or of teeth with periodontitis and implants with peri-implantitis. A systematic review was conducted according to the PRISMA statement. The MEDLINE, EMBASE and Cochrane databases were searched up to February 2018 for studies comparing microbiological data of biofilm samples collected from healthy teeth and implants or from teeth with periodontitis and implants with peri-implantitis. The weight of evidence was defined in three categories (strong, moderate and mild/some), according to the difference in number of studies showing statistically significantly higher counts and/or proportions and/or abundance and/or prevalence of microorganisms in health or in disease. Of the 132 articles identified, 8 were included. A wide range of microorganisms were present in different conditions but no microorganisms showed strong, moderate or mild/some evidence for a specific association with either teeth or implants. The results of this systematic review indicated that there is insufficient evidence in the literature to support specific differences between microorganisms colonizing teeth and implants, either in health or in disease.

Planejamento reverso na correção de sorriso gengival / Reverse planning on the correction of gummy smile

Este trabalho objetiva destacar a importância do planejamento reverso para correção de sorriso gengival. Levanta-se o tema a partir de um relato de caso, com o diagnóstico de erupção passiva alterada. O tratamento de escolha foi o aumento de coroa clínica no sextante superior anterior com planejamento reverso. O planejamento reverso consiste na confecção de um guia cirúrgico que possui diversas funções, tais como definir plano e arquitetura gengival para as incisões iniciais, estabelecer referência para osteoplastia e determinação da posição do zênite, e ainda simular o resultado esperado. Assim, é possível avaliar o impacto do tratamento proposto e, além disso, o paciente pode interagir e avaliar os resultados esperados. Para a confecção do guia cirúrgico executou-se moldagem com silicone de adição Adsil®, objetivando copiar fielmente os detalhes anatômicos dos dentes e gengivas. O modelo foi confeccionado em gesso especial e, aplicando os princípios estéticos de zênites sobre o modelo, foi realizado o enceramento das faces vestibulares até a área cervical a ser removida. A prensagem do guia foi feita com resina acrílica, não diferindo dos passos de prensagem de uma prótese total. Foi realizada a cirurgia e após 45 dias observou-se que o resultado almejado foi alcançado sem necessidade de cirurgias adicionais. Conclui-se que o planejamento reverso confere ao procedimento alto grau de precisão e previsibilidade

This paper aims to highlight the importance of reverse planning to the correction of gummy smile which is raised from a case report. With the diagnosis of altered passive eruption, the choosen treatment was the increase of the clinical crown in the upper anterior sextant with reverse planning. The reverse planning consists in preparing a surgical guide that has many functions, such as plan and gingival architecture for initial incisions, act as a reference to osteoplasty and to the position of the zenith and to simulate the expected results. Thus, it is possible to assess the impact of the proposed treatment and, moreover, the patient caninteract and evaluate the possible outcome. To prepare the surgical guide, it was used polysiloxane Adsil ®, to copyfaith fully the anatomic details of teeth and gums. The model was made of special plaster and applying the principles of esthetic zenith on the model, the waxing of the buccal faces was performed until the cervical area to be removed. The pressing of the guide was made with acrylic resin, not differing from the steps of pressing of a denture. Surgery was performed, and after 45 days it was observed that the desired results were achieved without the need for additional surgeries. It can be concluded that the reverse planning gives to the procedure a high degree of precision and predictability

Halitosis: a review of associated factors and therapeutic approach

Halitosis or bad breath is an oral health condition characterized by unpleasant odors emanating consistently from the oral cavity. The origin of halitosis may be related both to systemic and oral conditions, but a large percentage of cases, about 85 percent, are generally related to an oral cause. Causes include certain foods, poor oral health care, improper cleaning of dentures, dry mouth, tobacco products and medical conditions. Oral causes are related to deep carious lesions, periodontal disease, oral infections, peri-implant disease, pericoronitis, mucosal ulcerations, impacted food or debris and, mainly, tongue coating. Thus, the aim of the present review was to describe the etiological factors, prevalence data and the therapeutic mechanical and chemical approaches related to halitosis. In general, halitosis most often results from the microbial degradation of oral organic substrates including volatile sulfur compounds (VSC). So far, there are few studies evaluating the prevalence of oral malodor in the world population. These studies reported rates ranging from 22 percent to more than 50 percent. The mechanical and chemical treatment of halitosis has been addressed by several studies in the past four decades. Many authors agree that the solution of halitosis problems must include the reduction of the intraoral bacterial load and/or the conversion of VSC to nonvolatile substrates. This could be achieved by therapy procedures that reduce the amount of microorganisms and substrates, especially on the tongue.