ABSTRACT
A busca por um sorriso considerado perfeito tem sido cada vez maior e isso tem se tornado um desafio para o Cirurgião-Dentista, visto que um sorriso harmônico não envolve somente dentes, mas também gengiva. A exposição excessiva da gengiva ao sorrir ou falar é considerada uma característica antiestética, pois gera uma desarmonia entre dentes, gengiva e lábios. Quando o paciente expõe 3 milímetros ou mais de gengiva ao sorrir, chamamos essa exposição de Sorriso Gengival. O presente trabalho tem como objetivo relatar o tratamento de um caso de sorriso gengival, onde foi realizada cirurgia periodontal ressectiva a fim de diminuir a exposição de tecido gengival ao sorrir. Descrição do caso: Paciente adulto 21 anos, sexo masculino, procurou atendimento no curso de graduação em Odontologia do Centro Universitário da Serra Gaúcha FSG, com queixa de insatisfação estética devido ao tamanho de seus dentes e mostrar muito tecido Gengival ao sorrir. Após anamnese, exame clínico e radiográfico, o paciente foi diagnosticado com Sorriso gengival. O plano de tratamento proposto foi de cirurgia periodontal ressectiva. Conclusão: A partir do exposto, podemos concluir que o tratamento do sorriso gengival depende de sua etiologia. Um correto diagnóstico é de extrema importância, pois dependendo do fator etiológico do sorriso gengival, o plano de tratamento pode ser elaborado de acordo com a necessidade do paciente. No caso apresentado, o procedimento escolhido, cirurgia periodontal ressectiva, se mostrou efetivo no tratamento do sorriso gengival, devolvendo estética e satisfação ao paciente(AU)
The search for a smile that is considered perfect has been increasing and this has become a challenge for the Dental Surgeon, since a harmonious smile does not only involve teeth, but also gums. Excessive exposure of the gums when smiling or talking is considered an unsightly feature, as it creates disharmony between teeth, gums and lips. When the patient exposes 3 millimeters or more of gum when smiling, we call this exposure Gummy Smile. The present work aims to report the treatment of a case of gummy smile, where resective periodontal surgery was performed in order to reduce the exposure of gingival tissue when smiling. Case description: A 21-year-old adult patient, male, sought care at the undergraduate course in dentistry at the Centro Universitário da Serra Gaúcha FSG, complaining of aesthetic dissatisfaction due to the size of his teeth and showing a lot of gingival tissue when smiling. After anamnesis, clinical and radiographic examination, the patient was diagnosed with gummy smile. The proposed treatment plan was resective periodontal surgery. Conclusion: From the above, we can conclude that the treatment of gummy smile depends on its etiology. A correct diagnosis is extremely important, because depending on the etiological factor of the gummy smile, the treatment plan can be elaborated according to the patient's needs. In the case presented, the chosen procedure, resective periodontal surgery, proved to be effective in the treatment of gummy smile, restoring aesthetics and patient satisfaction(AU)
Subject(s)
Humans , Male , Adult , Crown Lengthening , Gingivoplasty , Periodontium , Oral Surgical Procedures , Esthetics, DentalABSTRACT
Objective: To compare the effects of vaping and cigarette smoking and indicate their impact on periodontal health. Material and Methods: A total of 90 subjects divided into three groups. Group I: 30 Traditional cigarettes smoker who have smoked up to 10 cigarettes, Group II: 30 electronic cigarettes subjects who have been using vape at least one year and never smoke, and Group III: 30 subjects who have no smoking history. Using a mirror and a periodontal probe, periodontal parameters (plaque index, gingival index, probing depth and clinical attachment loss) were used to evaluate periodontal health. Results: The findings showed that the periodontal parameters had a highly significant differences at P ≤ 0.01 between traditional and electronic smoking groups. While clinical attachment loss demonstrated non-significant difference P ≥ 0.05 in comparison between electronic cigarettes and the group who never smoke. Conclusion: The results of this study suggested that traditional cigarettes and electronic cigarettes both had unfavorable impact on periodontal health status, never the less quit smoking showed positive impacts on periodontal parameters (AU)
Objetivo: O objetivo foi comparar os efeitos do uso do cigarro eletrônico e do cigarro convencional, indicando seus impactos na saúde bucal. Material e Método: 90 indivíduos foram divididos igualmente em três grupos: Grupo I, usuários de cigarro convencional que fumaram até 10 cigarros por dia; Grupo II: usuários de cigarro eletrônico que utilizam este por pelo menos há 1 ano e não fumavam antes disso; Grupo III: usuários sem qualquer história de hábitos tabagistas. Utilizando um espelho bucal e uma sonda periodontal, parâmetros periodontais (índice de placa, índice gengival, profundidade de sondagem e perda de inserção clínica) foram coletados para avaliar a saúde periodontal. Resultados: As evidências mostraram que os parâmetros periodontais apresentaram diferença significativa (P ≤ 0.01) entre os grupos I e II. Conclusão: Os resultados deste estudo sugerem que tanto o uso de cigarro convencional como o de cigarro eletrônico possuem impactos desfavoráveis na saúde periodontal, e que a cessação do uso destes mostraram impactos positivos nos parâmetros periodontais(AU)
Subject(s)
Humans , Periodontitis , Tobacco Use Disorder , Periodontium , Tobacco Products , VapingABSTRACT
Tendo em vista a importância da relação Dentística Restauradora e Periodontia na Odontologia atual, o presente estudo demonstrou o relato de um caso clínico realizado no Complexo Odontológico do Centro Universitário da Serra Gaúcha (FSG), retratando um procedimento de restauração transcirúrgica em um paciente cujo elemento 13 estava comprometido com uma cavidade subgengival disto-palatino, sendo a resina composta o material restaurador de escolha. Este estudo teve como objetivo apresentar um caso clínico demonstrando a técnica de restauração transcirúrgica e a integração do planejamento entre Periodontia e Dentística Restauradora realizado na Clínica de Odontologia do Centro Universitário da Serra Gaúcha -FSG. Este trabalho mostrou a importância da realização de uma técnica cirúrgica e restauradora correta por parte dos cirurgiões-dentistas, assim como na verificação de que os tecidos periodontais podem reagir de forma positiva à presença de materiais restauradores adesivos posicionados subgengivalmente(AU)
In view of the importance of the restorative dentistry and periodontics relationship in current dentistry, the present study demonstrated the report of a clinical case carried out in the Dental Complex of the Centro Universitário da Serra Gaúcha - FSG, portraying a transsurgical restoration procedure in a patient whose element 13 was compromised with a subgingival cavity of this-palatine, the composite resin being the restorative material of choice. This study aimed to present a clinical case demonstrating the technique of transsurgical restoration and the integration of planning between Periodontics and Restorative Dentistry carried out at the Dentistry Clinic of the University Centro Universitário da Serra Gaúcha - FSG. This study showed the importance of performing a correct surgical and restorative technique by dentists, as well as in verifying that periodontal tissues can react positively to the presence of adhesive restorative materials positioned subgingival(AU)
Subject(s)
Humans , Male , Aged , Periodontium , Crown Lengthening , Composite Resins , Periodontics , Dentistry, OperativeABSTRACT
Introdução: A literatura tem apontado uma possível relação entre diversas condições sistêmicas e as doenças periodontais. Dentro das doenças sistêmicas que podem gerar o uso crônico de medicamentos, com potencial associação com as doenças periodontais, destacam-se a hipercolesterolemia e o uso de estatinas; e as doenças do metabolismo ósseo e o uso de bisfosfonatos. Objetivo: Dessa maneira, o presente estudo objetivou revisar a literatura sobre o efeito das estatinas e dos bisfosfonatos nos parâmetros clínicos e radiográficos periodontais de indivíduos adultos. Resultados: Apenas estudos observacionais em humanos foram incluídos. Um estudo mostrou que, em pacientes que apresentam doença periodontal e usam estatina, houve 37% menos bolsas periodontais (profundidade de sondagem ≥4mm) quando comparadas aos que não utilizam a medicação, além de apresentarem menor índice de carga inflamatória e menor perda de inserção clínica. Em relação aos bisfosfonatos em indivíduos com doenças que envolvem o metabolismo ósseo, sugere-se que a utilização do fármaco tem obtido resultados positivos nos parâmetros periodontais, como menores sinais clínicos de inflamação gengival, menor profundidade de sondagem, menor perda de inserção clínica e maior nível de osso alveolar, quando comparados aos que nunca realizam essa terapia. Conclusão: Dessa forma, as estatinas e os bisfosfonatos apresentam efeitos promissores, em pacientes sob tratamento para suas respectivas condições sistêmicas, na melhoria dos parâmetros periodontais, porém é importante salientar que são necessários mais estudos sobre o assunto para melhor entender os reais efeitos a longo prazo do uso desses fármacos.(AU)
Introduction: The literature showed a possible relationship between several systemic conditions and periodontal diseases. Within the systemic diseases that can generate the chronic use of these drugs, potentially related with periodontal diseases, it may be cited the hypercholesterolemia and the use of statins; and bone metabolism diseases and the use of bisphosphonates. Objective: In this sense, the present study aimed to review the literature about the effect of statins and bisphosphonates in the periodontal parameters of adults individuals. Results: Only observational studies in humans were included. A study showed that, in patients with periodontal disease and users of statins, there 37% fewer periodontal pockets (probing depth ≥4mm) when compared to those who do not use the medication, as well as having a lower rate of inflammatory burden and less loss of clinical insertion. Regarding the bisphosphonates in individuals diagnosed with diseases involving bone metabolism, it was suggested that the use of the drug has obtained positive results in periodontal parameters, such as a greater absence of plaque, less clinical signs of gingival inflammation, less probing depth, lower level of clinical insertion and higher level of alveolar bone when compared to those who never undergo this therapy. Conclusion: Thus, statins and bisphosphonates have promising effects in patients under treatment for their respective systemic condition in improving periodontal parameters, but it is important to emphasize that further studies on the subject are needed to better understand the long-term effects of the use of these drugs.(AU)
Subject(s)
Humans , Periodontal Diseases/chemically induced , Periodontium/drug effects , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Diphosphonates/adverse effects , Bone Diseases, Metabolic/complications , Bone Diseases, Metabolic/drug therapy , Risk Factors , Hypercholesterolemia/complications , Hypercholesterolemia/drug therapyABSTRACT
SUMMARY: The dentogingival junction (DGJ) is an adaptation of the oral mucosa composed of epithelial and connective tissues intimately related with the mineralised tissues of the tooth. The histological evidence available is mainly based on studies in animals, separate evaluations of hard and soft tissues, and studies using conventional histological techniques that eliminate the enamel from preparations. The aim of this study was to carry out a review of the existing evidence on histological techniques available for study of the tooth and periodontium in conjunction in humans. A scoping review was carried out of the available literature referring to study of the tooth and the periodontium in conjunction in humans, in the Web of Science (WoS), EMBASE, Scopus and SciELO databases, using the terms "Histological Techniques"[Mesh]) and "Epithelial Attachment"[Mesh]. One hundred and fifty-nine articles were found, of which 54 were selected for full- text reading. Ten were finally included in the qualitative synthesis, and we applied the Anatomical Quality Assurance (AQUA) checklist for analysis the methodological quality of the selected articles. The results showed that the only articles with a low risk of bias in all five domains according to the AQUA criteria corresponded to Silva et al. (2011) and Agustín-Panadero et al. (2020). Finally, we conclude that the quality of the histological sections to observe tissues that simultaneously contain the tooth and the periodontium, is conditioned by the selected technique and by the care required in certain specific tasks during the histological processing of the samples.
La unión dentogingival (DGJ) es una adaptación de la mucosa oral compuesta por tejidos epitelial y conectivo íntimamente relacionados con los tejidos mineralizados del diente. La evidencia histológica disponible se basa principalmente en estudios en animales, evaluaciones separadas de tejidos duros y blandos y estudios utilizando técnicas histológicas convencionales que eliminan el esmalte de las preparaciones. El objetivo de este estudio fue realizar una revisión de la evidencia existente sobre las técnicas histológicas disponibles para el estudio del diente y el periodonto en conjunto en humanos. Se realizó un scoping review de la literatura disponible referente al estudio del diente y el periodonto en conjunto en humanos, en las bases de datos Web of Science (WoS), EMBASE, Scopus y SciELO, utilizando los términos "Histological Techniques"[Mesh]) y "Epithelial Attachment"[Mesh]. Se encontraron 159 artículos, de los cuales 54 fueron seleccionados para lectura de texto completo. Diez fueron finalmente incluidos en la síntesis cualitativa, y se aplicó la lista de verificación Anatómica Quality Assurance (AQUA) para el análisis de la calidad metodológica de los artículos seleccionados. Los resultados mostraron que los únicos artículos con bajo riesgo de sesgo en los cinco dominios según los criterios AQUA correspondían a Silva et al. (2011) y Agustín-Panadero et al. (2020). Finalmente, concluimos que la calidad de los cortes histológicos para observar los tejidos que contienen simultáneamente el diente y el periodonto, está condicionada por la técnica seleccionada y por el cuidado requerido en ciertas tareas específicas durante el procesamiento histológico de las muestras.
Subject(s)
Humans , Tooth/anatomy & histology , Histological Techniques , Epithelial Attachment/anatomy & histology , Checklist , Gingiva/anatomy & histology , Periodontium/anatomy & histologyABSTRACT
Introdução: A procura pela estética do sorriso é crescente na Odontologia, pois, muitas vezes um sorriso alinhado e periodonto saudável não são o bastante. A cerâmica odontológica apresenta-se como uma ótima possibilidade restauradora, visto o avanço das técnicas de adesão entre o substrato dentário e as cerâmicas, torna-se mais previsível o resultado com este tipo de reabilitação. Objetivo: O presente artigo tem como objetivo descrever um caso clínico com envolvimento de diversos níveis de desgaste dentário para reabilitação estética com cerâmica de dissilicato de lítio. Relato de caso: Paciente 36 anos, gênero feminino, apresentava insatisfação com seu sorriso devido a forma e a alteração de cor dos seus dentes superiores anteriores e pré-molares. O plano de tratamento consistiu em realizar a troca da coroa metalocerâmica por coroa total cerâmica da unidade 14, coroa total cerâmica nas unidades 11, 21 e 22, facetas cerâmicas nas unidades 15, 13, 12, 23, 24 e 25, osteotomia e gengivoplastia das regiões de 2º prémolar superior esquerdo ao 2º pré-molar superior direito, clareamento dental caseiro da arcada inferior e placa oclusal superior de proteção. O material de escolha para a resolução do caso clínico foi a cerâmica vítrea reforçada à base de dissilicato de lítio, pois, possui um índice de refração de luz semelhante à estrutura dentária, sem interferência significativa da translucidez, além de ser passível de cimentação adesiva por se tratar de uma cerâmica ácido sensível e o tamanho do cristal e a sua disposição favorecem o aumento das propriedades mecânicas da restauração. Conclusão: O plano de tratamento realizado permitiu o restabelecimento da função e estética, com reprodução das características dos dentes naturais e promoção da jovialidade e da harmonia no sorriso(AU)
Introduction:The demand for smile aesthetics is growing in Dentistry, because, often a smile aligned and healthy periodontium are not enough. Dental ceramics, presented as an excellent restorative possibility, since the advancement of adhesion techniques between the dental substrate and the ceramics, becomes more predictable the result with this type of rehabilitation. Objective: This article aims to describe a clinical case involving several levels of dental wear for aesthetic rehabilitation with ceramics. Case Report: A 36-year-old female patient presented dissatisfaction with her smile due to the shape and color alteration of her anterior and premolar upper teeth. The treatment plan consisted of exchanging the metal-ceramic crown for the total ceramic crown of unit 14, total ceramic crown in units 11, 21 and 22, ceramic veneers in units 15, 13, 12, 23, 24 and 25, osteotomy and gingivoplasty of the regions from 2nd left upper premolar to 2nd right upper premolar, home tooth whitening of the lower arch and upper occlusal plate of protection. The material of choice for the resolution of the clinical case was the glass ceramic reinforced on the basis of lithium disilicate because it has a refractive index of light similar to the dental structure, without significant interference of translucency, besides being liable to adhesive cementation because it is a sensitive acid ceramic and the size of the crystal and its disposition favor the increase of the mechanical properties of the restoration. Conclusion: The treatment plan performed allowed the restoration of function and aesthetics, with reproduction of the characteristics of natural teeth and promotion of joviality and harmony in the smile(AU)
Subject(s)
Humans , Female , Adult , Ceramics , Crowns , Dental Veneers , Esthetics, Dental , Lithium , Osteotomy , Tooth Bleaching , Periodontium , Occlusal Splints , Tooth Wear , GingivoplastyABSTRACT
Introdução: A periodontite é uma doença infecto-inflamatória, resultante da disbiose microbiana e da resposta do hospedeiro, que leva à destruição dos tecidos de suporte dentário, inclusive das fibras colágenas periodontais, podendo culminar na perda do elemento dental. Objetivo: Avaliar o comportamento das fibras colágenas periodontais durante a progressão da periodontite experimental induzida em ratos. Material e método: Doze ratos Wistar foram distribuídos nos grupos: Controle (C), Periodontite Experimental 14-dias (PE-14d), Periodontite Experimental 21-dias (PE-21d) e Periodontite Experimental 42-dias (PE-42d). No dia 0, os animais do grupo C foram eutanasiados. Neste mesmo dia, os animais remanescentes foram submetidos à instalação de uma ligadura de algodão ao redor do primeiro molar inferior esquerdo para indução da periodontite experimental. Tais animais foram eutanasiados aos 14 (PE-14d), 21 (PE-21d) e 42 (PE-42d) dias após a instalação da ligadura. Executou-se o processamento histológico das hemimandíbulas e as secções foram submetidas à reação histoquímica pelo vermelho picro-sirius. A análise qualitativa descritiva foi realizada sob microscopia de luz polarizada, na região de furca dental, evidenciando as fibras do ligamento periodontal. Resultado: O grupo C exibiu feixes espessos e orientados de fibras colágenas maduras, condizentes com aspecto de normalidade. Os grupos com periodontite experimental exibiram desestruturação tecidual severa, com fibras colágenas imaturas e de menor espessura, sendo tais condições mais exacerbadas nos grupos PE-14d e PE-21d. Conclusão: As fases iniciais da periodontite apresentam caráter agudo e, portanto, resultam na rápida destruição dos tecidos periodontais de suporte, prejudicando potencialmente a fibrilogênese e a reestruturação do colágeno no ligamento periodontal.
Introduction: Periodontitis is an infectious-inflammatory disease resulting from microbial dysbiosis and host response that leads to the destruction of tooth support tissues, including periodontal collagen fibers, which may culminate in tooth loss. Objective: To evaluate the behavior of periodontal collagen fibers during the progression of induced experimental periodontitis in rats. Material and method: Twelve Wistar rats were distributed into groups: Control (C), 14-days Experimental Periodontitis (PE-14d), 21-days Experimental Periodontitis (PE-21d) and 42-days Experimental Periodontitis (PE-42d). At day 0, the animals of group C were euthanized. At the same day, the remaining animals were submitted to the installation of a cotton ligature around the lower left first molar for the induction of experimental periodontitis. The animals were euthanized at 14 (PE-14d), 21 (PE-21d) and 42 (PE-42d) days after the installation of ligature. Histological processing of the hemi-mandibles was performed and the sections underwent histochemical reaction using picro-sirius red. The descriptive qualitative analysis was performed under polarized light microscopy, in the dental furcation region, evidencing the fibers of the periodontal ligament. Result: Group C exhibited thick and oriented bundles of mature collagen fibers, consistent with a normal appearance. The groups with experimental periodontitis exhibited severe tissue disruption, with immature and thinner collagen fibers, with such conditions being more exacerbated in the PE-14d and PE-21d groups. Conclusion: The early stages of periodontitis present acute response, and therefore result in rapid destruction of periodontal support tissues and potentially impair fibrillogenesis and collagen restructuring in the periodontal ligament.
Subject(s)
Animals , Rats , Periodontitis , Periodontium , Photomicrography , Collagen , Microscopy, Polarization , MolarABSTRACT
Periodontal diseases are inflammatory diseases caused by oral pathogens around the periodontal supporting tissues, leading to systemic and chronic inflammatory conditions. The continuous chronic systemic inflammation may be a trigger of neuroinflammation, which is the prominent feature of a variety of neurological disorders. It implies that there may be a causal link between periodontal diseases and neurological disorders. This article presents epidemiological and biological evidences that periodontal diseases can induce or exacerbate neurological disorders, including Alzheimer's disease, Parkinson's disease, multiple sclerosis and major depressive disorder, and analyzes the possible mechanisms. The importance of maintaining oral health as well as preventing and treating periodontal diseases are emphasized. At the same time, this may provide novel approaches to study the relationship between periodontal diseases and neurological disorders in the prevention and treatment strategies of neurological disorders.
Subject(s)
Humans , Alzheimer Disease , Depressive Disorder, Major/complications , Inflammation/complications , Periodontal Diseases/complications , PeriodontiumABSTRACT
La exposición a hipoxia es considerada un estímulo estresante, por lo que el organismo desarrolla meca-nismos de aclimatación para asegurar la homeosta-sis. Si bien el efecto de la hipoxia sobre los distintos sistemas de tejidos y órganos ha sido bien documen-tado, el rol de los bajos niveles de O2 en la cavidad oral no ha recibido el mismo análisis. En este trabajo se revisaron los datos bibliográficos disponibles sobre el efecto de la hipoxia sobre el tejido periodontal, las glándulas salivales, la pulpa dental y el hueso mandi-bular y alveolar. De lo analizado en la bibliografía, re-sulta evidente que los bajos niveles de O2 aumentan el número de mediadores inflamatorios que inducen la progresión de la enfermedad periodontal y, a su vez, la inflamación establecida durante dicha enfermedad agrava aún más las condiciones de hipoxia tisular. Las glándulas salivales también se encuentran afectadas durante la exposición a hipoxia, disminuyendo la can-tidad de saliva secretada, observándose alteraciones ultraestructurales en el parénquima glandular. Por otra parte, se ha establecido que la hipoxia puede te-ner efectos deseados para el cultivo de células madre de la pulpa dental, lo cual resulta útil en el campo de la odontología reparativa y también para el movimien-to dental durante los tratamientos ortodónticos. En conclusión, para determinar los efectos de la hipoxia en la cavidad oral se debe analizar no sólo el tipo de tejido involucrado sino también las condiciones de hi-poxia a las cuales éste es sometido, así también como la duración de la exposición y la modalidad de hipoxia (AU)
Exposure to hypoxia is considered a stressful stimulus, therefore the organism develops acclimation mechanisms to try to ensure homeostasis. Although the effect of hypoxia on different tissues and organs has been very well documented, the role of low levels of O2 in the oral cavity has not received the same analysis. In this review, we analyzed the available bibliographic data concerning the effects of hypoxia on periodontal tissue, salivary glands, and dental pulp. The published evidence demonstrates that low O2 levels increase the number of inflammatory mediators that induce the progression of periodontal disease, and, in turn, the inflammation established during the progression of periodontitis aggravates tissue hypoxia conditions. Salivary glands are also affected during hypoxic exposure, decreasing salivary secretion, and leading to ultrastructural alterations in the glandular parenchyma. On the other hand, hypoxia could also be beneficial in some scenarios. It has been established that dental pulp cells grow better in culture under hypoxic conditions than they do in normoxia. Furthermore, mild hypoxia seems to stimulate periodontal ligament cells proliferation and matrix degradation, key events during for orthodontic treatments. In conclusion, to determine the effects of hypoxia in the oral cavity, it is necessary to analyze not only the type of tissue involved but also the hypoxic conditions to which it is subjected, as well as its duration and modality (AU)
Subject(s)
Humans , Hypoxia/complications , Mouth Diseases/etiology , Salivary Glands/pathology , Periodontium/pathology , Dental Pulp/pathology , Homeostasis , Mandible/pathologyABSTRACT
SUMMARY: The aim of the article was to study changes in periodontal tissues in rats with spontaneous periodontitis (SP) and to evaluate the effect of hyaluronic acid (HA) on the state of the periodontium. Wistar rats with signs of SP were divided into 6 groups: 1) intact group; 2) intact animals with HA "HD-1,0 MDa"; 3) SP group; 4) SP with HA "S-2,4 MDa"; 5) SP with HA "ST-2,4 MDa"; 6) SP with HA "HD-1,0 MDa". The study of the periodontium rats with SP noted the main structural changes (collagen reduction, resorption of alveolar bone, dilatation and stasis of the vessels of the periodontium, gingival papilla and tooth pulp), which were assessed as moderate. Morphological evidence of inflammation was infiltration of neutrophils into the connective tissue of the gums, without the formation of abscesses. Local administration of HA did not cause additional structural damage in periodontal tissues of rats with SP, but also did not affect changes in the microvascular system of periodontium and tooth pulp, periodontal ligaments, only a tendency to inhibit alveolar bone resorption in rats was noted. One can consider the tendency to improve the condition of periodontal tissues in the group of rats injected with high molecular HA and HA with mannitol (2.4 MDa).
RESUMEN: El objetivo del artículo fue estudiar los cambios en los tejidos periodontales en ratas con periodontitis espontánea (PE) y evaluar el efecto del ácido hialurónico (HA) sobre el estado del periodonto. Las ratas Wistar con signos de PE se dividieron en 6 grupos: 1) grupo intacto; 2) animales intactos con HA "HD-1,0 MDa"; 3) grupo PE; 4) PE con HA "S-2,4 MDa"; 5) PE con HA "ST-2,4 MDa"; 6) PE con HA "HD-1,0 MDa". En las ratas con PS se observaron los principales cambios estructurales (reducción de colágeno, reabsorción del hueso alveolar, dilatación y estasis de los vasos del periodonto, papila gingival y pulpa dentaria), que fueron evaluados como moderados. La evidencia morfológica de inflamación fue la infiltración de neutrófilos en el tejido conectivo de las encías, sin la formación de abscesos. La administración local de HA no causó daño estructural adicional en los tejidos periodontales de las ratas con PE, pero tampoco se produjo cambios en el sistema microvascular del periodonto y en la pulpa dental y ligamentos periodontales.Se observó una tendencia a inhibir la resorción del hueso alveolar. Se puede considerar la tendencia a mejorar el estado de los tejidos periodontales en el grupo de ratas inyectadas con HA de alto peso molecular y HA con manitol (2,4 MDa).
Subject(s)
Animals , Rats , Periodontitis , Periodontium/drug effects , Hyaluronic Acid/pharmacology , Rats, Wistar , InflammationABSTRACT
Introdução: Devido à crescente demanda estética, a odontologia restauradora se renova na intenção de alcançar melhores resultados na harmonia do sorriso. Entretanto, a atenção deve voltar-se também aos tecidos periodontais, visto que há uma integração entre material restaurador e os tecidos. Objetivo:Descrever e discutir as etapas clínicas para a confecção de laminados cerâmicos, atentando-se a preparos minimamente invasivos, contorno cervical e fatores que podem intervir na longevidade do procedimento.Relato de caso:Paciente do sexo masculino, 28 anos de idade, compareceu a Associação Brasileira de Odontologia, seção de Alagoas, relatando insatisfação em relação ao tamanho dos seus dentes. Os arcos superior e inferior foram moldados para a obtenção dos modelos de estudo e enceramento diagnóstico. Ao início do tratamento foi orientado ao paciente clareamento dental pela técnica combinada. O preparo dos dentes foi guiado por uma matriz de silicone, sendo estes uniformes e conservadores, seguido de moldagem, fase laboratorial e cimentação final. Finalizado o caso foi realizado o ajuste oclusal solicitando ao paciente que realizasse movimentos de lateralidade e protrusão. Conclusões:A técnica do preparo influência na longevidade dos laminados cerâmicos, por relacioanar-se à adesão e a saúde periodontal. O preparo deve ser mínino e limitado ao esmalte dental sempre que possível, determinando assim um maior e melhor prognóstico (AU).
Introduction:Due to the growing aesthetic demand, restorative dentistry is renewed to achieve better results in smile harmony. However, attention should also be turned to periodontal tissues since there is an integration between restorative material and tissues. Objective:To describe and discuss the clinical steps for the manufacture of laminate veneers, paying attention to minimally invasive preparations, cervical contour, and factors that can intervene in the procedure's longevity. Case report:A 28-year-old male patient attended the Brazilian Dental Association, the Alagoas section, reporting dissatisfaction with his teeth' size. The upper and lower arches were molded to obtain the study and diagnostic waxing models. At the beginning of treatment, the patient was instructed by the combined technique. After the case, the occlusal adjustment was performed, asking the patient to perform laterality and protrusion movements. Conclusions:The preparation technique influences the longevity of laminate veneers due to adherence and periodontal health. The preparation should be minimal and limited to dental enamel whenever possible, thus determining a higher and better prognosis (AU).
Introducción: Debido a la creciente demanda estética, la odontología restauradora se renueva para lograr mejores resultados en la armonía de la sonrisa. Sin embargo, también se debe prestar atención a los tejidos periodontales ya que existe una integraciónentre el material restaurador y los tejidos.Objetivo: Describir y discutir los pasos clínicos para la confección de carillas laminares, prestando atención a las preparaciones mínimamente invasivas, al contorno cervical y a los factores que pueden intervenir en la longevidad del procedimiento.Reporte del caso: Un paciente masculino de 28 años asistió a la Asociación Dental Brasileña, sección de Alagoas, reportando insatisfacción con el tamaño de sus dientes. Los arcos superior e inferior fueron moldeados para obtener los modelos de depilación de estudio y diagnóstico. Al comienzo del tratamiento, el paciente fue instruido por la técnica combinada. La preparación de los dientes fue guiada por una matriz de silicona, siendo estas uniformes y conservadoras, seguidas de moldeo, fase de laboratorio y cementación final. Después del caso, se realizó el ajuste oclusal, pidiendo al paciente que realizara movimientos de lateralidad y protuberancia. Conclusiones: La técnica de preparación influye en la longevidad de los laminados cerámicos, debido a la adherencia y la salud periodontal. La preparación debe ser mínima y limitada al esmalte dental siempre que sea posible, determinando así un pronóstico más alto y mejor (AU).
Subject(s)
Humans , Male , Adult , Tooth Bleaching , Periodontium , Tooth Preparation, Prosthodontic/instrumentation , Dental Veneers , Brazil/epidemiology , Radiography, Dental/instrumentation , Ceramics , Occlusal Adjustment , Dental Enamel , Research Report , Longevity , Models, AnatomicABSTRACT
OBJECTIVES@#The safety of root canal filling with 200 °C hot gutta-percha was investigated to study the effect of continuous wave technique combined with high-temperature injectable gutta-percha condensation technique on the surface temperature of periodontal tissue.@*METHODS@#CT technique and Mimics, Geomagic, and Solidworks software were utilized to build the entity models of alveolar bone, dentin and root canal, periodontal ligament, and blood flow, respectively, which were then assembled in Solidworks into a finite element model of tooth with blood flow. By utilizing ABAQUS collaborative simulation platform, fluid-structure coupling was analyzed on the whole process of root canal filling. Consequently, the surface temperature of the periodontal tissue was obtained.@*RESULTS@#In the absence of blood flow, the temperature of the periodontal ligament surface reached 50.048 ℃ during root canal filling with 200 ℃ gutta-percha. Considering blood flow, the temperature of periodontal ligament surface was 39.570 ℃.@*CONCLUSIONS@#The temperature of the periodontal ligament surface increased when the continuous wave root canal was filled with 200 ℃ gutta-percha, and the periodontal tissue was not damaged.
Subject(s)
Humans , Dental Pulp Cavity , Finite Element Analysis , Gutta-Percha , Hot Temperature , Periodontium , Root Canal Filling Materials , Root Canal Obturation , TemperatureABSTRACT
Nowadays, orthodontic treatment has become increasingly popular. However, the biological mechanisms of orthodontic tooth movement (OTM) have not been fully elucidated. We were aiming to summarize the evidences regarding the mechanisms of OTM. Firstly, we introduced the research models as a basis for further discussion of mechanisms. Secondly, we proposed a new hypothesis regarding the primary roles of periodontal ligament cells (PDLCs) and osteocytes involved in OTM mechanisms and summarized the biomechanical and biological responses of the periodontium in OTM through four steps, basically in OTM temporal sequences, as follows: (1) Extracellular mechanobiology of periodontium: biological, mechanical, and material changes of acellular components in periodontium under orthodontic forces were introduced. (2) Cell strain: the sensing, transduction, and regulation of mechanical stimuli in PDLCs and osteocytes. (3) Cell activation and differentiation: the activation and differentiation mechanisms of osteoblast and osteoclast, the force-induced sterile inflammation, and the communication networks consisting of sensors and effectors. (4) Tissue remodeling: the remodeling of bone and periodontal ligament (PDL) in the compression side and tension side responding to mechanical stimuli and root resorption. Lastly, we talked about the clinical implications of the updated OTM mechanisms, regarding optimal orthodontic force (OOF), acceleration of OTM, and prevention of root resorption.
Subject(s)
Humans , Osteoblasts , Osteoclasts , Periodontal Ligament , Periodontium , Root Resorption , Tooth Movement TechniquesABSTRACT
Although mesenchymal stem cell-derived exosomes (MSC-exos) have been shown to have therapeutic effects in experimental periodontitis, their drawbacks, such as low yield and limited efficacy, have hampered their clinical application. These drawbacks can be largely reduced by replacing the traditional 2D culture system with a 3D system. However, the potential function of MSC-exos produced by 3D culture (3D-exos) in periodontitis remains elusive. This study showed that compared with MSC-exos generated via 2D culture (2D-exos), 3D-exos showed enhanced anti-inflammatory effects in a ligature-induced model of periodontitis by restoring the reactive T helper 17 (Th17) cell/Treg balance in inflamed periodontal tissues. Mechanistically, 3D-exos exhibited greater enrichment of miR-1246, which can suppress the expression of Nfat5, a key factor that mediates Th17 cell polarization in a sequence-dependent manner. Furthermore, we found that recovery of the Th17 cell/Treg balance in the inflamed periodontium by the local injection of 3D-exos attenuated experimental colitis. Our study not only showed that by restoring the Th17 cell/Treg balance through the miR-1246/Nfat5 axis, the 3D culture system improved the function of MSC-exos in the treatment of periodontitis, but also it provided a basis for treating inflammatory bowel disease (IBD) by restoring immune responses in the inflamed periodontium.
Subject(s)
Humans , Colitis , Exosomes , Periodontitis/therapy , Periodontium , T-Lymphocytes, Regulatory , Th17 CellsABSTRACT
Eosinophilic granuloma, a rare disease, has various clinical manifestations and no specific X-rays features and is thus easily misdiagnosed. This paper reports a case of multifocal eosinophilic granuloma of jaw with long-term follow-up. The patient initially presented with periodontal tissue destruction.The diagnosis, treatment and prognosis of multifocal eosinophilic granuloma of jaw were discussed in combination with the literature to alert this disease in clinical practice.
Subject(s)
Humans , Diagnosis, Differential , Eosinophilic Granuloma/diagnostic imaging , Jaw , Periodontium , RadiographyABSTRACT
OBJECTIVE@#Calprotectin, the heterdimer of S100A8 and S100A9, is the major cytoplasmic protein of neutrophils, which is also expressed or induced in gingival epithelial cells, activated mononuclear macrophages and vascular endothelial cells. Calprotectin is intimately associated with the initiation and progression of periodontitis, but the in vivo expression patterns of calprotectin in healthy and inflamed periodontal tissue are not fully understood. To observe the expression, distribution and cellular localization of calprotectin in the samples of healthy periodontal tissues and experimental periodontitis tissues of Beagles and to explore their relationship with periodontal inflammation and possible effect.@*METHODS@#Experimental periodontitis model was established by ligation around the mandibular second molar of the Beagle dogs, while the contralateral teeth were healthy controls. Induction duration was 12 weeks, before the dogs were executed. Tissue specimens were demineralized and serial sections were made conventionally. The in vivo expression of calprotectin in the healthy and inflamed periodontal tissues were examined by immunohistochemistry. The in vitro expression of calprotectin in human primary gingival fibroblasts (GFs) and periodontal ligament (PDL) cells were detected by immunocytochemistry.@*RESULTS@#Immunohistochemistry analysis indicated that calprotectin was expressed in gingival epithelial cells and infiltrated neutrophils in the healthy periodontium within the gingival epithelium, S100A8/A9 was most strongly expressed in the junctional epithelium, followed by surface epithelium, and least expressed in the sulcular epithelium. The S100A8/A9 expression levels were sharply defined at the junction between the junctional epithelium and the sulcular epithelium. In periodontal inflammatory lesions, the expression level of calprotectin in sulcular epithelium and junctional epithelium was up-regulated than that in the healthy gingival epithelium. Calprotectin was inducibly expressed in fibroblast-like cells in gingival connective tissue and periodontal ligament tissue, microvascular endothelial cells (ECs) and bone marrow fibroblasts under inflammatory conditions. Additionally, the expression of calprotectin in primary human GFs and PDL cells was confirmed by immunnocytochemistry staining.@*CONCLUSION@#Constitutively expressed in neutrophils and gingival epithelial cells, and calprotectin might maintain the homeostasis and integrity of periodontium. Inflammation-induced expression of calprotectin in GFs, PDL cells, microvascular ECs and bone marrow fibroblasts might process anti-microbial function and promote leukocytes transmigration to defend the host against the microorganisms.
Subject(s)
Animals , Dogs , Humans , Endothelial Cells , Epithelial Attachment , Gingiva , Leukocyte L1 Antigen Complex , PeriodontiumABSTRACT
Abstract Objective: To measure the level of immunoglobulin G (IgG) in the gingival crevicular fluid (GCF). Material and Methods: A total of 158 patients aged >45 years were examined for periodontitis and interviewed regarding their menopausal status. The non-menopause group entailed female patients with periodontitis without menopause (n=23). The menopause group included females who stopped menstruating since >1 year, had a pocket depth of 4-5 mm, and did not have other systemic conditions (n=40). Samples were selected based on periodontal and menopausal status. In total, 63 samples of GCF were collected from the participants and tested using an enzyme-linked immunosorbent assay kit for IgG. Results: The median level of IgG in the menopause group was 39.50 (g/mL, whereas that of the non-menopause group was 41.08 (g/mL. There was a positive correlation between the plaque index and IgG level in both groups. In contrast, there was a negative correlation between age and IgG level. However, there was no correlation between plaque index and age regarding the IgG level in both groups (p>0.05). Conclusion: The IgG levels in the menopause group were lower than those in the non-menopause group. As such, menopausal females should take great care of their overall health, including the periodontium.
Subject(s)
Humans , Female , Adult , Middle Aged , Periodontal Diseases/pathology , Periodontitis/pathology , Periodontium , Immunoglobulin G , Menopause , Cross-Sectional Studies/methods , Gingival Crevicular Fluid , Statistics, Nonparametric , Indonesia/epidemiologyABSTRACT
La enfermedad periodontal (EP) es una patología que afecta principalmente los tejidos que rodean a la pieza dentaria (PD) y se caracteriza, en la mayoría de los casos, por una exposición bacteriana que favorece una respuesta destructiva e inflamatoria del huésped, que conduce a la pérdida de inserción periodontal de la PD, provocando una marcada reabsorción ósea y la posible pérdida de las PD. El diagnóstico de EP implica evaluaciones clínicas y radiográficas, en la actualidad se están realizando diversas investigaciones para evaluar posibles compuestos en los fluidos orales a través de lo cual puede ser posible evaluar la presencia y gravedad de estas enfermedades, como así también el riesgo en los pacientes. Hay evidencias de la interacción de macromoléculas salivales, como las mucinas, con microorganismos específicos. De esta manera las mucinas, junto con otros productos de la saliva, ayudan a modular tanto el número como el tipo de proliferación de ciertos organismos y provocar la disminución de otros. La revisión de la literatura actual concluye que las mucinas salivales pueden servir como un parámetro bioquímico de la inflamación del periodonto (AU)
Periodontal disease (PD) is a pathology that mainly affects the tissues surrounding the tooth (PD) and is characterized, in most cases, by a bacterial exposure that favors a destructive and inflammatory response of the host, which leads to the loss of periodontal insertion of the PD, causing a marked bone resorption and the possible loss of the PD. The diagnosis of PD involves clinical and radiographic evaluations, at present several investigations are being carried out to evaluate possible compounds in oral fluids through which it may be possible to evaluate the presence and severity of these diseases, as well as the risk in patients. There is evidence of the interaction of salivary macromolecules, such as mucins, with specific microorganisms. In this way, mucins, together with other saliva products, help modulate both the number and type of proliferation of certain organisms and cause the decrease of others. The review of the current literature concludes that salivary mucins can serve as a biochemical parameter of inflammation of the periodontium (AU)