Effects of furcation involvement on molar survival in periodontally treated patients / Efectos de la furcación sobre la supervivencia molar en pacientes sometidos a tratamiento periodontal

Objective: This study aims to analyze the survival time of molar tooth according to furcation involvement (FI) classification among periodontally treated patients under a supportive periodontal care program. Materials and Methods: A retrospective study was con-ducted among 77 periodontitis patients with 240 molars who had undergone periodontal therapy that were followed up with supportive periodontal therapy (SPT) for at least five years. Periodontitis patients' data were retrieved from the periodontic clinical record. The clinical parameters of all involved molars and treatment modality were recorded at baseline and SPT. Results: A total of 69 (28.8%) molars were extracted during active periodontal therapy, while 17 (7.1%) were lost during SPT. The 5-year survival rate of molars was 83.5% (95% confidence interval [CI], 76.9-88.4) for FI=0 (n=141), 81.0% (95% CI, 56.9-92.4) for FI=I (n=18), 50.0% (95% CI, 33.8-64.2) for FI=II (n=21), and 25.0% (95% CI, 6.9-48.8) for FI=III (n=4). Additionally, the 10-year survival rate for molars with FI = III was 12.5% (95% CI, 1.0-39.2), which was lower than that of molars with FI = 0 (77.1%; 95% CI, 69.7-83.0). Conclusions: The presence of a high degree of FI classifica-tion, especially Class III, is associated with a lower survival rate of molars among periodontally treated patients. Retention of molars is possible on a long-term basis through a maintenance program of periodontal therapy.

Objetivo: Este estudio tiene como objetivo analizar el tiempo de supervivencia de los molares según la clasificación de implicación de la furcación (IF) entre pacientes tratados periodontalmente bajo un programa de cuidado periodontal de apoyo. Materiales y Métodos: Se realizó un estudio retrospectivo entre 77 pacientes con periodontitis con 240 molares que habían sido sometidos a terapia periodontal y fueron seguidos con terapia periodontal de soporte (TPS) durante al menos cinco años. Los datos de los pacientes con periodontitis se recuperaron de la Historia Clínica de Periodoncia. Los parámetros clínicos de todos los molares involucrados y la modalidad de tratamiento se registraron al inicio y en el TPS. Resultado: Se extrajeron un total de 69 (28,8%) molares durante la terapia periodontal activa, mientras que 17 (7,1%) se perdieron durante la TPS. La tasa de supervivencia de los molares a 5 años fue del 83,5% (intervalo de confianza [IC] del 95%, 76,9-88,4) para FI=0 (n=141), del 81,0% (IC del 95%, 56,9-92,4) para FI=I ( n=18), 50,0% (IC 95%, 33,8-64,2) para FI=II (n=21) y 25,0% (IC 95%, 6,9-48,8) para FI=III (n=4). Además, la tasa de supervivencia a 10 años para los molares con FI = III fue del 12,5 % (IC del 95 %, 1,0-39,2), que fue inferior a la de los molares con FI = 0 (77,1 %; IC del 95 %, 69,7-83,0). Conclusión: La presencia de un alto grado de clasificación FI, especialmente Clase III, se asocia con una menor tasa de supervivencia de los molares entre los pacientes tratados periodontalmente. La retención de los molares es posible a largo plazo mediante un programa de mantenimiento de terapia periodontal.

Relação entre a doença periodontal e a doença de Alzheimer - Revisão da Literatura / Relationship between periodontal disease and Alzheimer disease ­ literature review

O objetivo do presente estudo foi revisar a literatura para buscar evidências na associação entre a doença de Alzheimer e a Periodontite. A metodologia usada resultou numa busca às bases de dados PubMed/MEDLINE, Cochrane Library e Web of Science, através dos artigos publicados entre o período de maio de 2000 a maio de 2022. A doença de Alzheimer (DA) é classificada como uma condição neurodegenerativa, um grupo heterogêneo de doenças caracterizadas pela perda lenta e progressiva de uma ou mais funções do sistema nervoso. A doença periodontal (DP) é uma doença infecciosa e inflamatória que causa principalmente destruição óssea alveolar e perda dentária e estima-se que entre 20 e 50% da população geral possa sofrer de DP, dos quais 15-20% apresentam formas graves. A inflamação desempenha um papel crítico no aparecimento e progressão de ambas as doenças. A conclusão desta revisão é que a literatura estudada mostra que os patógenos periodontais e as citocinas pró-inflamatórias contribuíram para a progressão do processo neurodegenerativo da doença de Alzheimer. Porém, são necessários mais estudos clínicos controlados randomizados para a confirmação da relação causal desta associação.

The aim of this study was to review the literature to look for evidence in the association between Alzheimer's disease and Periodontitis. The methodology used resulted in a search of the PubMed/MEDLINE, Cochrane Library and Web of Science databases, through the articles published between May 2000 and May 2022. Alzheimer's disease (AD) is classified as a neurodegenerative condition, a heterogeneous group of diseases characterized by the slow and progressive loss of one or more functions of the nervous system. Periodontal disease (PD) is an infectious and inflammatory disease that mainly causes alveolar bone destruction and tooth loss and it is estimated that between 20 and 50% of the general population may suffer from PD, of which 15-20% present severe forms. Inflammation plays a critical role in the onset and progression of both diseases. The conclusion of this review is that the literature studied shows that periodontal pathogens and pro-inflammatory cytokines contributed to the progression of the neurodegenerative process of Alzheimer's disease. However, more randomized controlled clinical trials are needed to confirm the causal relationship of this association.

Periodontal status in adult patients with leukemia: a literature review / Condição periodontal em pacientes adultos com leucemia: revisão de literatura

Periodontal disease is a highly prevalent chronic inflammatory disease that affects the tissues that support the teeth, while leukemia is a type of malignous cancer that affects the production of blood cells. Recent studies suggest that immune response and microbial disbiosis related to periodontal disease may be associated with an increased risk of developing leukemia and may affect its prognosis, as well as leukemia type and treatment may also have effects on the periodontium, demanding a interdiscipinary approach of these patients. The aim of this study was to conduct a literature review to assess the association between periodontal disease and leukemia in adult patients. An electronic database serch using the descriptors was performed. Clinical studies with periodontal examination in adult individuals with leukemia were selected. After literature search, 9 studies were reviewed. Gingival bleeding and periodontal pockets were frequent findings. Periodontitis prevalence varied among studies, ranging from 29% to 82,4% in patients diagnosed with leukemia. The relationship between periodontal disease and leukemia is complex and multifaceted and there are few studies available in adults, with heterogeneous exam protocols. Still, the high prevalence of gingivitis and periodontitis found in the studies suggest that periodontal diagnosis and treatment could be a helpful tool to prevent further complications in leukemia treatment.

A doença periodontal é uma doença inflamatória crônica altamente prevalente e que afeta os tecidos que sustentam os dentes, enquanto a leucemia é um tipo de câncer maligno que afeta a produção de células sanguíneas. Estudos recentes sugerem que a resposta imune e a disbiose microbiana relacionada a doença periodontal podem estar associadas a um risco aumentado de desenvolver leucemia e pode afetar o prognóstico da doença, assim como o tipo de leucemia e o tratamento também podem ter efeitos no periodonto, exigindo uma abordagem interdisciplinar desses pacientes. O objetivo deste estudo foi realizar uma revisão de literatura para avaliar a associação entre doença periodontal e leucemia em pacientes adultos. Foi realizada uma busca eletrônica em bancos de dados utilizando os descritores. Foram selecionados estudos clínicos com exame periodontal em indivíduos adultos com leucemia. Após busca na literatura, 9 estudos foram revisados. Sangramento gengival e bolsas periodontais foram achados frequentes. A prevalência da periodontite variou entre os estudos, sendo de 29% a 82,4% em pacientes diagnosticados com leucemia. A relação entre doença periodontal e leucemia é complexa e multifacetada e existem poucos estudos disponíveis em adultos, com protocolos de exames heterogêneos. Ainda assim, a alta prevalência de gengivite e periodontite encontrada nos estudos sugere que o diagnóstico e o tratamento periodontal podem ser uma ferramenta útil para prevenir maiores complicações no tratamento da leucemia.

Potencial das membranas de células-tronco mesenquimais na regeneração periodontal: uma revisão sistemática de estudos pré-clínicos em modelo animal / Potential of mesenchymal stem cell sheets on periodontal regeneration: a systematic review of pre-clinical animal studies

A periodontite é uma doença inflamatória crônica multifactorial caracterizada pela destruição progressiva do aparelho de suporte periodontal. Atualmente, as técnicas convencionais para regeneração desses tecidos periodontais perdidos tiveram sucesso limitado. A tecnologia de membranas de células usando células-tronco mesenquimais apareceu como uma estratégia promissora na medicina regenerativa periodontal. Embora estudos recentes tenham mostrado o papel das membranas de células-tronco mesenquimais (MSCSs) no aumento dos tecidos de suporte dentário e ósseo, não há uma revisão sistemática focada especificamente na avaliação da regeneração periodontal em modelos animais ortotópicos. Esta revisão tem como objetivo avaliar o potencial das MSCSs na regeneração periodontal em comparação ao controle, em modelos animais experimentais. Estudos pré-clínicos em defeitos periodontais de modelos animais foram considerados elegíveis. A busca eletrônica incluiu as bases de dados MEDLINE, Web of Science, EMBASE e LILACS. Além disso, uma busca manual avaliou as revistas científicas na área de periodontia/regeneração. A revisão sistemática foi conduzida de acordo com as diretrizes de Preferred Reporting Item for Systematic Reviews and Meta-Analyses statement guidelines. A ferramenta do Centro de Revisão Sistemática para Experimentação com Animais de Laboratório (SYRCLE) foi usada para avaliar o risco de viés. Dos 3989 estudos obtidos a partir da busca no banco de dados eletrônicos foram incluídos 17 artigos. Foram empregados MSCSs autólogos, alógenos e xenógenos para melhorar a regeneração periodontal. Estes incluíram MSCSs do folículo dentário (DF), MSCSs do ligamento periodontal (PDL), MSCSs da polpa dentária (DP), MSCSs da medula óssea (BM), MSCSs periosteais alveolares (AP) e MSCSs gengivais (G). Em relação ao protocolo de indução de células, a maioria dos estudos utilizou ácido ascórbico (52,94%), outros utilizaram placas de cultura com polímero termo responsivo (47,06%). Os efeitos adversos, em relação à utilização das MSCSs no sítio doador, não foram identificados na maioria dos estudos, mesmo com o uso adjunto de scaffolds, membranas ou ambos. Meta-análise não foi considerada devido a heterogeneidades metodológicas. PDL-MSCSs demonstrou ser superior para aumento da regeneração periodontal em comparação ao controle, mas em um microambiente inflamatório induzido, DF-MSCSs foram melhores. Os DF-MSCSs parecem estar relacionados à espessura do cemento e dimensão periodontal. Além disso, DP-MSCSs e BM-MSCSs mostraram resultados melhores em comparação com o controle. Em contraste, AP-MSCSs não foram associados a melhorias na regeneração periodontal. A avaliação do risco de viés com a ferramenta da SYRCLE revelou que 44,12% dos estudos apresentavam baixo risco de viés, 55,29% foram incertos e 0,59%, alto risco. A presente revisão sistemática mostrou que as MSCSs podem aumentar a regeneração periodontal em modelos animais de defeito periodontal, fornecendo uma estratégia promissora para aumentar a regeneração periodontal.

Nitrate reduction capacity of the oral microbiota is impaired in periodontitis: potential implications for systemic nitric oxide availability / 国际口腔科学杂志·英文版

The reduction of nitrate to nitrite by the oral microbiota has been proposed to be important for oral health and results in nitric oxide formation that can improve cardiometabolic conditions. Studies of bacterial composition in subgingival plaque suggest that nitrate-reducing bacteria are associated with periodontal health, but the impact of periodontitis on nitrate-reducing capacity (NRC) and, therefore, nitric oxide availability has not been evaluated. The current study aimed to evaluate how periodontitis affects the NRC of the oral microbiota. First, 16S rRNA sequencing data from five different countries were analyzed, revealing that nitrate-reducing bacteria were significantly lower in subgingival plaque of periodontitis patients compared with healthy individuals (P < 0.05 in all five datasets with n = 20-82 samples per dataset). Secondly, subgingival plaque, saliva, and plasma samples were obtained from 42 periodontitis patients before and after periodontal treatment. The oral NRC was determined in vitro by incubating saliva with 8 mmol/L nitrate (a concentration found in saliva after nitrate-rich vegetable intake) and compared with the NRC of 15 healthy individuals. Salivary NRC was found to be diminished in periodontal patients before treatment (P < 0.05) but recovered to healthy levels 90 days post-treatment. Additionally, the subgingival levels of nitrate-reducing bacteria increased after treatment and correlated negatively with periodontitis-associated bacteria (P < 0.01). No significant effect of periodontal treatment on the baseline saliva and plasma nitrate and nitrite levels was found, indicating that differences in the NRC may only be revealed after nitrate intake. Our results suggest that an impaired NRC in periodontitis could limit dietary nitrate-derived nitric oxide levels, and the effect on systemic health should be explored in future studies.

The importance of cyclooxigenase in dentistry: a narrative review

Aim: Cyclooxygenase enzymes (COX) catalyze the conversion of arachidonic acid to prostaglandins and thromboxanes during pain and inflammation conditions. These enzymes have also been linked to several other conditions and diseases, and hence, in dentistry, it is crucial to identify the processes that increase the levels of these mediators. This paper aims to describe the significance of COX in dental practice through a narrative review. Methods: Articles relating to COX upregulation published in English and Spanish over the last 51 years in databases such as EBSCO, Google Scholar, Science Direct, PubMed, and Web of Science; were analyzed. Results: A total of 115 articles demonstrating the relationship between COX upregulation and multiple conditions and diseases of importance in prosthodontics, periodontics, oral pathology, orthodontics, and endodontics were included. Conclusions: COX upregulation is related to inflammatory and malignant diseases in oral tissues, such as periodontitis, pulpitis, and oral cancer, nevertheless, its expression is advantageous in other fields of study such as orthodontics. Additionally, is well documented that dental materials provoke an undesired increase in COX expression, which could be a significant factor that directly affects pulpal health

Efectos de inducción recíproca entre periodontitis e hiposalivación: revisión de la literatura / Reciprocal induction effects between periodontitis and hyposalivation: a review of the literature

Muchas investigaciones se han ocupado de evaluar la vinculación entre las afecciones bucales y otras funciones o afecciones del organismo. Algunos de esos estudios han sentado precedentes acerca de la influencia mutua que puede existir entre la fun-cionalidad de las glándulas salivales y la enfermedad periodontal, y cómo la presencia de una condición puede modificar la evolución o inducir la aparición de la otra. El objetivo del presente trabajo es hacer una revisión bibliográfica de las publicaciones cientí-ficas que evalúan los efectos de inducción recíproca que existe entre la enfermedad periodontal y la hi-posalivación. Trabajos de nuestro grupo y de otros autores demuestran que la hiposalivación reduce la capacidad del organismo para defenderse contra las bacterias patógenas, mantener un ambiente sa-ludable y facilitar la cicatrización en la cavidad bu-cal, promoviendo los procesos de inflamación y daño tisular gingivoperiodontal. A su vez, varios estudios reportan que la enfermedad periodontal induce cam-bios en las glándulas salivales y altera el volumen de secreción salival. Por su parte, el sistema endo-cannabinoide (SEC) muestra estar involucrado tanto en el proceso de secreción salival como en la infla-mación y la reabsorción ósea presentes en la enfer-medad periodontal, en tanto que la activación de los mecanismos del SEC emerge como una de las vías a través de las cuales se desarrollaría el fenómeno de inducción recíproca (AU)

Many investigations have focused on evaluating the link between oral conditions and other functions or conditions of the body. Some of these studies have set precedents about the mutual influence that may exist between the functionality of the salivary glands and periodontal disease, and how the presence of one condition can modify the evolution or induce the appearance of the other. The objective of this work is to carry out a bibliographic review of scientific publications that evaluate the reciprocal induction effects that exist between periodontal disease and hyposalivation. Studies by our group and other authors show that hyposalivation reduces the capacity of the organism to defend itself against pathogenic bacteria, maintain a healthy environment and facilitate healing in the oral cavity, promoting inflammation and gingivoperiodontal tissue damage. In turn, several studies report that periodontal disease induces changes in the salivary glands and alters the volume of salivary secretion. In turn, the endocannabinoid system (ECS) is shown to be involved in the salivary secretion process as well as in the inflammation and bone resorption present in periodontal disease, while the activation of ECS mechanisms emerges as one of the pathways through which the reciprocal induction phenomenon would develop (AU)

The impact of traditional smokers versus electronic cigarette smokers on periodontal parameters in iraqi males / O impacto do uso de cigarros tradicionais versus uso de cigarros eletrônicos nos parâmetros periodontais em homens iraquianos

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)

Molecular detection of IL-10 level to determine severity of periodontitis in type 2 Diabetes Mellitus patients / Detecção molecular do nível de IL-10 para determinar a gravidade da periodontite em pacientes com Diabetes Mellitus tipo 2

Objective: The prevalence of periodontal disease is increasing in most countries including developing and developed countries. It affects 20-50-% of the global population. Patients with type 2 Diabetes Mellitus (DM) with severe periodontal disease had a 3.2 times higher risk of death than individuals without periodontitis. Periodontitis contributes to small-scale systemic inflammation. The objective of this study was to determine the severity of periodontitis using IL-10 (Interleukin-10) level in type 2 diabetes mellitus. Materials and Methods: This study was cross-sectional. All methods were performed following the guidelines and regulations of the Ethics Committee, Faculty of Dental Medicine, Universitas Airlangga. The samples were 90 subjects. The instruments used were questionnaires, periodontal status measurements based on Community Periodontal Index (CPI), and random blood glucose measurements. Data on the IL-10 level was obtained using Gingival Crevicular Fluid (GCF). Results: There was a significant difference in lifestyle in each group. The highest IL-10 level was found in the periodontitis group, followed by the periodontitis with the type 2 DM group. Conclusion: The level of IL-10 can be used to determine periodontitis severity in type 2 DM. Most respondents with the highest level of IL-10 were found in periodontitis followed by periodontitis with type 2 DM group. High levels of IL-10 will decrease the synthesis of Tumor Necrosis Factor Alpha (TNF-α), Interleukin-1 (IL-1), Interleukin-6 (IL-6), activation of macrophages, and Polymorphonuclear neutrophil (PMN) (AU)

Objetivo: A prevalência da doença periodontal tem aumentado na maioria dos países, incluindo países em desenvolvimento e desenvolvidos, Afetando 20-50% da população global. Pacientes com Diabetes Mellitus tipo 2 (DM) com doença periodontal grave apresentaram risco 3,2 vezes maior de morte do que indivíduos sem periodontite. O objetivo deste estudo foi determinar a gravidade da periodontite utilizando o nível de IL-10 (Interleucina-10) no diabetes mellitus tipo 2. Materiais e Métodos: Este estudo transversalfoi realizadoseguindo as orientações e regulamentos do Comitê de Ética da Faculdade de Medicina Dentária da Universitas Airlangga. Noventa participantes,responderam um questionário e foram examinados , para o estado periodontal, baseadas no Índice Periodontal Comunitário (IPC) e medidas aleatórias de glicemia. Os dados do nível de IL-10 foram obtidos utilizando Fluido Crevicular Gengival (GCF). Resultados: Houve uma diferença significativa no estilo de vida em cada grupo. O nível mais alto de IL-10 foi encontrado no grupo com periodontite, seguido pela periodontite com o grupo DM tipo 2. Conclusão: O nível de IL-10 pode ser utilizado para determinar a gravidade da periodontite no DM tipo 2. A maioria dos participantes com maior nível de IL-10 estava no grupo periodontite seguida de periodontite com DM tipo 2. Altos níveis de IL-10 diminuiem a síntese do Fator de Necrose Tumoral Alfa (TNF-α), Interleucina-1 (IL-1), Interleucina-6 (IL-6), ativação de macrófagos e neutrófilos polimorfonucleares (PMN) (AU)

Assessing the Attitude and Practices of Dental Surgeons Towards Periodontal Health After the COVID-19 Outbreak

ABSTRACT Objective: To assess the orientation of dental practitioners in understanding the probable relationship between COVID-19 and periodontal infection and the measures they took toward periodontal health during the pandemic. Material and Methods: A cross-sectional questionnaire-based survey was conducted, including registered dentists in Moradabad. The questionnaire provided was a self-administered, closed-ended questionnaire with 26 questions, shared via an online survey link utilizing Google Forms. The data collected was tabulated and statistically evaluated. Results: The participants implemented many preventive measures in their daily lives against COVID-19, such as hand washing, frequent hand sanitization, face shields, mouth masks, social distancing not, being in overcrowded places, using HEPA filters and different combinations of protective measures against COVID-19. 82.23% of participants learned from the official websites of organizations like the Ministries of Health, WHO, and professional organizations about COVID-19. Conclusion: Most participants endorsed oral hygiene measures and the use of mouthwashes by their patients, yet a significant number of dental surgeons needed to be made aware of a probable correlation between COVID-19 infection and chronic periodontitis.

O uso de probióticos como adjunto no tratamento da periodontite: revisão literatura / The use of probiotics as adjunct in the treatment of periodontitis: revisão literatura

A periodontite é definida como uma doença inflamatória crônica de natureza multifatorial associada com biofilme disbiótico. O tratamento padrão para periodontite é a Raspagem e Alisamento Radicular (RAR), no entanto quando há a presença de bolsas profundas, áreas com dificuldades de inacessibilidade como lesão de furca ou perfil microbiológico especifico, pode ser necessário a prescrição de métodos auxiliares como a antibioticoterapia. No entanto o uso de antibióticos pode causar efeitos indesejáveis. Diante disso, ao longo dos últimos anos vem crescendo o interesse de estudos sobre o uso de probióticos no tratamento da periodontite, uma vez que estes são microrganismos vivos, ou seja, que quando ingeridas corretamente são benéficas à saúde. Diante disso o presente trabalho teve como objetivo realizar uma revisão de literatura quanto ao uso de probióticos como adjuvante no tratamento da periodontite, onde foram avaliados diversos artigos científicos. Foi observado que o uso de probióticos como adjuvantes no tratamento periodontal é benéfico, no entanto, há a necessidade de realização de mais estudos para averiguação da eficiência do mesmo, assim como a necessidade deste uso ser mais conhecido pelos Cirurgiões dentistas(AU)

Periodontitis can be defined as a chronic inflammatory disease of a multifactorial nature associated with a dysbiotic biofilm. The standard treatment for periodontitis is Scaling and Root Planing (RAR, in Portuguese), however when there is the presence of deep pockets, areas with inaccessibility difficulties such as furcation lesion or specific microbiological profile, it can be necessary to prescribe auxiliary methods such as antibiotic therapy. However, the use of antibiotics can cause undesirable effects. In view of this, over the last few years, interest in studies on the use of probiotics in the treatment of periodontitis has been growing, since these are live microorganisms, that is, when ingested correctly they are beneficial to health. Therefore, the present article aimed to carry out a literature review regarding the use of probiotics as an adjuvant in the treatment of periodontitis, where several scientific articles were analyzed. It was observed that the use of probiotics as adjuvants in periodontal treatment is beneficial, however, there is a need to carry out more studies to investigate if it's really efficient, as well the dentists needs to be known about the right use(AU)

A relevância da odontologia na Síndrome Treacher Collins: relato de caso / The relevance of dentistry in Treacher Collins Syndrome: case report

Treacher Collins também chamada de disostose mandibulofacial, é uma alteração genética dominante rara caracterizada pela má-formação dos ossos e tecidos da face. É uma síndrome crânio-facial que apresenta alterações bilaterais e simétricas de estruturas originadas do primeiro e segundo arcos branquiais. A maioria dos casos possui transmissão autossômica dominante e expressividade variável. O objetivo do presente estudo é realizar um relato de caso sobre o impacto do tratamento odontológico na qualidade de vida do paciente portador de Treacher Collins. Paciente, 39 anos, sexo feminino compareceu a uma clínica odontológica em Belo Horizonte, com a queixa principal de falhas dentárias e sensibilidade. Durante a anamnese a paciente relatou ter a STC, durante o exame clínico extraoral verificou a presença de hipoplasia malar e mandibular, malformação dos pavilhões auriculares com perda auditiva, obliquidade e coloboma palpebral inferior. Ao exame intraoral observou ser classe II de Angle, ausência dos dentes 11, 12, 13, 21 e 22 e extrusão do dente 41 e recessão gengival e periodontite estágio I grau A. Após exames de periodontograma e complementares foi realizado uma raspagem nas áreas com profundidade de sondagem maior que 3mm, frenectomia labial inferior, aplicação de laser para sensibilidade, enxerto gengival e colocação de prótese parcial removível. A paciente ao final do tratamento relatou ter se sentido realizada e contente com a sua conclusão, ela foi encaminhada ao Sistema único de Saúde para realizar as cirurgias para corrigir as alterações crânio-faciais. O tratamento odontológico deve ser adaptado a cada indivíduo de acordo com sua necessidade, tendo uma abordagem multidisciplinar, possibilitando uma melhora na qualidade de vida e estética do paciente(AU)

Treacher Collins syndrome is a rare dominant genetic disorder characterized by malformation of the bones and tissues of the face. It is a craniofacial syndrome that presents bilateral and symmetrical alterations of structures originating from the first and second branchial arches. The aim of the present study is to perform a case report on the impact of dental treatment on the quality of life of a patient with CTS. Patient, 39 years old, female, attended a dental clinic in Belo Horizonte, with the main complaint of dental flaws and sensitivity. During the anamnesis the patient reported having CTS, during the extraoral clinical examination she verified the presence of malar and mandibular hypoplasia, malformation of the pinnae with hearing loss, obliquity and lower eyelid coloboma. Intraoral examination revealed Angle class II, missing teeth 11, 12, 13, 21 and 22, extrusion of tooth 41, gingival recession and stage I periodontitis grade A. After periodontogram and complementary exams it was performed a scaling in areas with a probing depth greater than 3mm, lower lip frenectomy, laser application for sensitivity, gingival graft and placement of partial removable prosthesis. The patient at the end of treatment reported feeling fulfilled and happy with its completion, she was referred to the Unique Health System to undergo surgery to correct the craniofacial changes. The current treatment aims at functional and aesthetic correction and the need for psychosocial support, having the joint participation of a multidisciplinary team to achieve this goal(AU)

The association Between Sleep Quality, Fatigue and Periodontal Status: a pilot study / La asociación entre la calidad del sueño, la fatiga y el estado periodontal: un estudio piloto

Abstract Reduced sleep duration, poor sleep quality and fatigue are related to reduced immunity and increased inflammatory markers. Due to its potential to influence inflammation, poor sleep quality and fatigue could be factors for periodontitis and quality of life. Ninety-three individuals with untreated periodontitis and thirty-one individuals with healthy gingiva were included in the study. The research involved a clinical examination and a questionnaire. Demographic information, information on oral health, oral hygiene habits, the Pittsburgh Sleep Quality Index, Jenkins Sleep Scale, Multidimensional Assessment of Fatigue Scale, and Oral Health Impact Profile-14 were included in the questionnaire. Patients were diagnosed based on the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. No statistically significant difference was revealed between sleep quality, fatigue, oral health related quality of life, and stage-grade of periodontitis (p<0.05). However, periodontitis group had higher Oral Health Impact Profile-14 scores (p<0.05). A statistically significantly lower sleep duration was observed in stage IV periodontitis group than the other groups (p<0.05). A statistically significant positive correlation was observed between the Pittsburgh Sleep Quality Index and the scores of the other questionnaires (p<0.05). The stage of periodontitis may impact sleep duration.

Resumen La reducción de la duración del sueño, la mala calidad del sueño y la fatiga están relacionados con una inmunidad reducida y un aumento de los marcadores inflamatorios. Debido a su potencial para influir en la inflamación, la mala calidad del sueño y la fatiga podrían ser factores determinantes en el desarrollo de la periodontitis e incidir en la calidad de vida. Noventa y tres personas con periodontitis no tratada, además de treinta y una personas con encía sana se incluyeron en el estudio. La investigación involucró un examen clínico y un cuestionario. En el cuestionario se incluyeron información demográfica, información sobre salud bucal, hábitos de higiene bucal, el índice de calidad del sueño de Pittsburgh, la escala de sueño de Jenkins, la escala de evaluación multidimensional de la fatiga y el perfil de impacto en la salud bucal-14. Los pacientes fueron diagnosticados en base al Taller Mundial 2017 sobre la Clasificación de Enfermedades y Condiciones Periodontales y Periimplantarias. No se revelaron diferencias estadísticamente significativas entre la calidad del sueño, la fatiga, la calidad de vida relacionada con la salud bucal y el grado de etapa de la periodontitis (p<0,05). Sin embargo, el grupo de periodontitis tuvo puntajes más altos en el Perfil de Impacto en la Salud Oral-14 (p<0.05). Se observó una duración del sueño significativamente menor desde el punto de vista estadístico en el grupo de periodontitis en estadio IV que en los otros grupos (p<0,05). Se observó una correlación positiva estadísticamente significativa entre el Índice de Calidad del Sueño de Pittsburgh y las puntuaciones de los otros cuestionarios (p<0,05). La etapa de la periodontitis puede afectar la duración del sueño.

Comparación potencial de las actividades antiinflamatorias de las formulaciones de enjuague bucal de quercetina y diclofenaco / Potential Comparison of Anti-inflammatory Activities of Quercetin and Diclofenac Mouthwash Formulations

Introduction: Periodontitis is a pandemic, with about 14 percent of people worldwide already suffering from severe periodontitis. Early intervention in the disease could probably reduce its progression and eliminate the need for the extraction of affected teeth. Quercetin is a probable candidate as it has exemplary anti-inflammatory properties. The presence of phenolic hydroxyl groups in them greatly contributes to their antioxidant and anti-inflammatory activities. Objectives: The study introduces the formulation of Quercetin mouthwash and assesses its anti-inflammatory properties in comparison to Diclofenac sodium. Methods: Quercetin mouthwash was prepared using a commercially procured bioactive agent. One standard nonsteroidal anti-inflammatory drug, Diclofenac was used as a reference drug. The percentage inhibition of protein denaturation was calculated and its anti-inflammatory properties were evaluated through Bovine Serum Albumin Assay and Egg Albumin Assay. Results: Quercetin mouthwash showed parallel anti-inflammatory properties and showed a proportionate increase in anti-inflammatory properties with the increase in the concentration of the mouthwash. Comparable inhibition of protein denaturation at 10µl and 50µl concentrations with a proportionate variation of 1 percent (p>0.05) to the control in Egg Albumin Assay and 47 percent and 83 percent denaturation at 10µl and 50µl of Bovine Serum Albumin Assay were observed. Conclusion: Quercetin mouthwash has shown significant anti-inflammatory activity and hence is considered a potent anti-inflammatory agent comparable to Diclofenac sodium. It is found to be a suitable agent as an oral formulation for reducing the progression of inflammatory conditions(AU)

Introducción: La periodontitis es una pandemia, ya que alrededor del 14 por ciento de las personas en todo el mundo padecen periodontitis grave. Una intervención precoz en la enfermedad podría, probablemente, reducir su progresión y eliminar la necesidad de extraer los dientes afectados. La quercetina es un candidato probable, ya que tiene propiedades antiinflamatorias ejemplares. Su presencia de grupos hidroxilos fenólicos contribuye en gran medida a sus actividades antioxidantes y antiinflamatorias. Objetivos: El estudio presenta la formulación del colutorio de quercetina y evalúa sus propiedades antiinflamatorias en comparación con el diclofenaco sódico. Métodos: Se preparó un colutorio de quercetina, utilizando un agente bioactivo obtenido comercialmente. Se utilizó como fármaco de referencia un antiinflamatorio no esteroideo estándar, el diclofenaco. Se calculó el porcentaje de inhibición de la desnaturalización de proteínas y se evaluaron sus propiedades antiinflamatorias mediante ensayo con albúmina de suero bovino y con albúmina de huevo. Resultados: El colutorio de quercetina mostró propiedades antiinflamatorias paralelas y mostró un aumento proporcional de las propiedades antiinflamatorias con el aumento de la concentración del colutorio. Se observó una inhibición comparable de la desnaturalización de proteínas a concentraciones de 10µl y 50µl con una variación proporcional del 1 por ciento (p > 0,05), respecto al control en el ensayo de albúmina de huevo y una desnaturalización del 47 por ciento y 83 por ciento a 10µl y 50µl del ensayo de albúmina de suero bovino. Conclusiones: El enjuague bucal de quercetina ha mostrado una actividad antiinflamatoria significativa, por lo que se considera un potente agente antiinflamatorio comparable al diclofenaco sódico. Se considera un agente adecuado como formulación oral para reducir la progresión de las afecciones inflamatorias(AU)

Revisão crítica da nova classificação das periodontites / Critical review of periodontitis classification

Para o correto diagnóstico e tratamento da doença periodontal precisamos usar as classificações da doença periodontal. A mais recente foi proposta pela Academia Americana de Periodontia em conjunto com a Federação Europeia de Periodontia. Para a assimilação dos conceitos estabelecidos precisamos avaliar criticamente as informações que foram trazidas pelo consenso realizado há quase 6 anos. O objetivo do presente estudo é revisar o tópico periodontite da classificação, de forma a colaborar para o entendimento dessa doença pelos estudantes de graduação.

The periodontal diseases classifications are important for the correct diagnosis and treatment of periodontal diseases. The most recent classification was proposed by the American Academy of Periodontology in a consensus with the European Federation of Periodontology. For the assimilation of the established concepts, a critical evaluation of the information that was brought by the consensus almost 6 years ago, must be performed. The objective of the present study is to review the periodontitis topic of the new classification, in order to contribute to the understanding of this disease by undergraduate students.

Periodontitis en niños sanos de 3 años: dos casos con seguimiento a 5 años / Periodontitis in healthy 3-year-old children: two cases with 5-year follow-up

Objetivo: La periodontitis en dentición primaria es ex- cepcional en niños sin enfermedades sistémicas. El objetivo de este informe es describir las características clínicas y ra- diográficas de dos casos de niños de 3 años sistémicamente sanos con periodontitis, y su tratamiento con seguimiento a 5 años. Casos clínicos: En ambos casos, a los 3 años de edad los niños fueron derivados al especialista en periodoncia por su odontopediatra debido a la pérdida muy temprana de inci- sivos inferiores. El examen clínico y radiográfico mostró pér- dida de inserción clínica, pérdida ósea y movilidad dental en otros incisivos superiores e inferiores. Se realizó la intercon- sulta médica y se descartó que los niños padecieran enferme- dades relacionadas con el diagnóstico de periodontitis como manifestación de una enfermedad sistémica. El tratamiento consistió en la instrucción de medidas de higiene bucal que debían ser ejecutadas por los padres, ins- trumentación subgingival, antisépticos locales, medicación antibiótica sistémica y mantenimiento periodontal. No se rea- lizaron extracciones como parte del tratamiento. En ambos casos uno de los incisivos presentes al momento de la con- sulta se perdió prematuramente, antes de los 4 años. El resto de los incisivos primarios cumplieron su ciclo normal. Luego de 5 años de seguimiento, a la edad de 8 años, ambos niños presentaban los incisivos y los primeros molares permanentes periodontalmente sanos y el resto de los dientes primarios sin signos de periodontitis (AU)

Aim: Periodontitis in primary dentition is exceptional in children without systemic diseases. The objective of this article is to describe the clinical and radiographic charac- teristics of two cases of systemically healthy 3-year-old chil- dren with periodontitis, and their treatment, with a 5-year follow-up. Clinical cases: In both cases, at 3 years of age, the chil- dren were referred to a periodontic specialist by their pediat- ric dentist, due to the very early loss of lower incisors. Clin- ical and radiographic examination showed loss of clinical attachment, bone loss and dental mobility in other upper and lower incisors. A medical consultation was carried out and diseases related to the diagnosis of periodontitis as a mani- festation of a systemic disease were ruled out. The treatment consisted of instruction on oral hygiene measures that had to be carried out by the parents, subgingival instrumentation, local antiseptics, systemic antibiotic medication, and perio- dontal maintenance. No extractions were performed as part of the treatment. In both cases, one of the incisors present at the time of consultation was lost prematurely, before the age of 4 years. The rest of the primary incisors completed their normal cycle. After 5 years of follow-up, at the age of 8 years, both children showed periodontally healthy incisors and first permanent molars, and the rest of the primary teeth without signs of periodontitis (AU)

Adopción/Adaptación mediante Comentario para Argentina por intermedio de la Federación Iberopanamericana de Periodoncia (FIPP) de la Guía de Práctica Clínica (GPC) de nivel S3: Tratamiento de la periodontitis en los estadios I ­ III, de la Federación Europea de Periodoncia (EFP), traducida por la Sociedad Española de Periodoncia (SEPA) / Adoption/Adaptation by Comment, for Argentina through the Iberopanamerican Federation of Periodontology (FIPP) of the S3 Level Clinical Practice Guideline (CPG): Treatment of periodontitis in stages I ­ III, of the European Federation of Periodontology (EFP), translated by the Spanish Society of Periodontics (SEPA)

La Sociedad Argentina de Periodoncia ha formulado un Comentario, analizando los condicionantes del contexto na- cional, para determinar si las recomendaciones generadas en la Guía de Práctica Clínica de nivel S3 de la Federación Eu- ropea de Periodoncia para el tratamiento de la periodontitis en estadios I-III, podrían ser aplicadas para dar respuesta a la demanda de la población, en lo referido a la salud periodontal (AU)

The Argentine Society of Periodontics has formulated a Commentary, analyzing the determining factors of the nation- al context, to determine if the recommendations generated in the Level S3 Clinical Practice Guideline of the European Fed- eration of Periodontics for the treatment of periodontitis in stages I-III could be applied to respond to the demand of the population, regarding periodontal health (AU)

Tratamento de periodontite estágio III localizado grau C em um indivíduo fumante: um relato de caso / Treatment of periodontitis stage III localized grade C in smoker individual: a case report

Objetivo: A periodontite é uma doença infecto-inflamatória que acomete os tecidos de inserção periodontal, e ser fumante representa um risco modificável significativo para todos os graus da doença. Ainda, indivíduos fumantes apresentam uma resposta inflamatória alterada quando comparados a não fumantes. Nesse contexto, o objetivo deste estudo foi reportar um relato de caso de tratamento periodontal de paciente fumante pesado. Relato de caso: O paciente DRS, sexo masculino, 22 anos, foi encaminhado à Faculdade de Odontologia da Universidade Federal de Pelotas (UFPel) com a queixa principal de necessidade de "realização de uma limpeza dentária". Na anamnese, relatou fumar 20 cigarros ao dia, há 7 anos (7 maços-ano). Na consulta inicial, foi encontrado índice de placa visível (IPV) de 100% e índice de sangramento gengival (ISG) de 66,67%. Foi encontrado cálculo supragengival como fator retentivo de placa (FRP) em 46,30% dos sítios. Estabeleceu-se o diagnóstico de periodontite estágio III localizado grau C. Os exames periodontais foram realizados por um único pesquisador calibrado e optou-se pelo tratamento periodontal não cirúrgico. Ao exame de 12 meses, o paciente apresentou IPV de 23,45% e ISG de 22,83%. Houve ausência de FRP. De uma forma geral, foi possível constatar a diminuição significativa das bolsas periodontais, bem como o ganho significativo de inserção clínica periodontal. Considerações finais: Dessa forma, é possível concluir a efetividade da terapia periodontal não cirúrgica, aliada à manutenção periodontal e instruções de higiene para o tratamento de periodontite estágio III, grau C, em paciente fumante.(AU)

Objective: Periodontitis is an infect-inflammatory diseases that affects the periodontal attachment tissues, and being smoker represents a significant modifiable risk for all degrees of the disease. Moreover, smokers have an altered inflammatory response when compared to non-smokers. Therefore, the aim of this study was to report a case report of periodontal treatment of a heavy smoker. Case report: A patient DRS, male, 22 years old, was referred to the School of Dentistry of the Federal University of Pelotas (UFPel) with the main complaint of the need to "perform a dental cleaning". During the anamnesis, he reported smoking 20 cigarettes a day for 7 years (7 pack-years). In the initial appointment, a visible plaque index (VPI) of 100% and a gingival bleeding index (GBI) of 66.67% were found. Supragingival calculus was found as a plaque retentive factor (PRF) in 46.30% of the sites. The diagnosis of periodontitis stage III localized grade C was established. Periodontal examinations were performed by a single calibrated researcher and non-surgical periodontal treatment was chosen. At the 12-month appointment, the patient had an VPI of 23.45% and an GBI of 22.83%. There was absence of PRF. In general, it was possible to observe a significant decrease in periodontal pockets, as well as a significant gain in periodontal clinical attachment. Final considerations: Thus, it is possible to conclude the effectiveness of non-surgical periodontal therapy, combined with periodontal maintenance and hygiene instructions for the treatment of periodontitis stage III localized grade C in a smoker.(AU)

Efficacy of treatment of class II furcation lesions using membrane associated with bone grafting in mandibular molars compared to membrane only: a systematic review and meta-analysis / Eficacia del tratamiento de lesiones de furca grado II utilizando membrana asociada con injerto óseo en molares mandibulares en comparación con solamente membrana: revisión sistemática y metanálisis

Objective: The objective of the present systematic review and meta-analysis was to compare treatment with membrane associated with bone grafting and treatment exclusively with membrane in the approach of Class II furcation defects in mandibular molars. Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. Searches were conducted in five databases (PubMed, Web of Science, Scopus, Ovid, and Lilacs), in Septem-ber 2021, without restriction regarding publication year or language. Studies comparing membranes associated with bone grafting and membranes exclusively in the treatment of Class II furcation lesions were included. Cross-sectional, case-control studies, and reviews were excluded. Study selection, data extraction, and risk of bias assessment (MINORS) were performed by two review authors. The certainty of the evidence (GRADE) was evaluated and meta-analysis was performed. Mean difference (MD) and 95% confidence interval (CI) were provided. Results: Four hundred eighty-six references were iden-tified and four studies were included. Greater reduction in probing depth [MD = 0.32 (CI = 0.09, 0.56)] and greater clinical attachment level gain [MD = 0.41 (CI = 0.24, 0.57)] were observed when membrane and bone grafting were used. The risk of bias of included studies was low. Conclusions: This present systematic review and meta-analysis demonstrated that treatment of Class II furcation defects in mandibular molars using membrane and bone grafing is significantly more efficacious than treatment with the exclusive use of membrane.

Objetivo: El objetivo de la presente revisión sistemática y metanálisis fue comparar el tratamiento con membrana asociado a injerto óseo y el tratamiento exclusivamente con membrana en el abordaje de lesiones de furca grado II en molares mandibulares. Materiales y Métodos: Se siguió la declaración de elementos de informe preferidos para revisiones sistemáticas y metanálisis (PRISMA). Las búsquedas se realizaron en cinco bases de datos (PubMed, Web of Science, Scopus, Ovid y Lilacs), en septiembre de 2021, sin restricción de año de publicación o idioma. Se incluyeron estudios que compararon membranas asociadas con injertos óseos y membranas exclusivamente en el tratamiento de lesiones de furca de grado II. Se excluyeron los estudios transversales, de casos y controles y las revisiones. Dos revisores realizaron la selección de estudios, la extracción de datos y la evaluación del riesgo de sesgo (MINORS). Se evaluó la certeza de la evidencia (GRADE) y se realizó un metanálisis. Se proporcionaron la diferencia de medias (DM) y el intervalo de confianza (IC) del 95%. Resultados: Se identificaron 486 referencias y se incluyeron cuatro estudios. Se observó una mayor reducción en la profundidad de sondaje [DM = 0,32 (IC = 0,09, 0,56)] y una mayor ganancia en el nivel de inserción clínica [DM = 0,41 (IC= 0,24, 0,57)] cuando se utilizaron injertos de membrana y hueso. El riesgo de sesgo de los estudios incluidos fue bajo. Conclusión: La presente revisión sistemática y metanálisis demostró que el tratamiento de los defectos de furca de grado II en molares mandibulares utilizando membrana e injertos de hueso es significativamente más eficaz que el tratamiento con el uso exclusivo de membrana.

Auto-reporte de Periodontitis en diabéticos. Estudio transversal en Montevideo, Uruguay / Self-report of Periodontitis in Diabetes. A cross-sectional study

Objetivo: Conocer la ocurrencia de periodontitis a partir de un cuestionario de auto-reporte en una población de diabéticos en Montevideo, Uruguay. Materiales y métodos: Fueron invitados los participantes del 1er Encuentro de Diabetes en Uruguay, con diagnóstico de diabetes según auto-reporte, con al menos 18 años de edad y que firmaron el consentimiento informado. En todos los casos, fue aplicado un cuestionario con ocho preguntas previamente validadas al español de forma de estimar la ocurrencia de la Periodontits además de identificar indicadores asociados. Resultados: Un total de 37 personas respondieron el cuestionario suministrado, en su mayoría correspondientes al sexo femenino y de 45 años de edad promedio. La ocurrencia de periodontits fue del 68% de los encuestados, no existiendo diferencias significativas para el tipo de diabetes y las franjas etarias consideradas. Sin embargo las personas que presentaban periodontits tuvieron menos dientes naturales (según auto-reporte) al ser comparados con quienes no tenían periodontitis (27.5 vs. 20.4, p=0.01). Conclusiones: Los resultados del estudio permiten apreciar una condición oral deficitaria en aquellos diabéticos con periodontitis auto-reportada debido a la ocurrencia elevada de la misma así como la menor cantidad de dientes naturales.

Objective: To determine the occurrence of periodontitis from a self-report questionnaire in a population of diabetics in Montevideo, Uruguay. Materials and methods: Participants of the 1st Diabetes Meeting in Uruguay, with a diagnosis of diabetes according to self-report, with at least 18 years of age and signed the informed consent, were invited. In all cases, a questionnaire with eight questions previously validated in Spanish was applied in order to estimate the occurrence of Periodontits in addition to identifying associated indicators. Results: A total of 37 people answered the supplied questionnaire, mostly corresponding to the female sex and an average age of 45 years. The occurrence of periodontitis was 68%, with no significant differences for the type of diabetes and the age groups considered. However, people with periodontitis had fewer natural teeth (according to self-report) when compared to those who did not have periodontitis (27.5 vs. 20.4, p = 0.01). Conclusions: The results of the study allow us to appreciate a poor oral condition in those diabetics with self-reported periodontitis due to its high occurrence as well as the lower number of natural teeth.