Cigarette smoke combined with staining beverages decreases luminosity and increases pigmentation in composite resin restorations.

This study evaluated the effect of cigarette smoke combined or not with colored beverages on the color change of a composite resin before and after repolishing procedures. Composite specimens were allocated into six groups (N = 10): 1) control (no colorant); 2) cigarette smoke; 3) coffee; 4) coffee and cigarette smoke; 5) red wine; and 6) red wine and cigarette smoke. During 21 days, groups 2, 4, and 6 were exposed daily to the smoke from 20 cigarettes, and groups 3, 4, 5, and 6 were immersed in coffee or red wine for 4 minutes each day. Color measurements were performed with a spectrophotometer at baseline, after 21 days, and after repolishing procedures. Statistical analysis indicated the exposure to cigarette smoke and staining beverages resulted in decreased luminosity (P = .0001) and increased red pigmentation in most experimental groups (P < .05). In groups 3, 4, and 6, an increased yellowish coloration (P = .001) was observed. Irrespective of the experimental group, total color changes were clinically significant (AE > 7.5). Repolishing resulted in greater luminosity, as well as decreased yellow pigmentation (P < .05). It could be concluded that combined staining agents such as cigarette smoke and red wine irreversibly change resin color regardless of the use of repolishing procedures.

Impact of periodontitis on the diabetes-related inflammatory status.

Wide-ranging activation of the innate immune system causing chronic low-grade inflammation is closely involved not only in the pathogenesis of type 2 diabetes mellitus and its complications, through an ongoing cytokine-induced acute-phase response, but also in the pathogenesis of periodontal diseases, whereby cytokines play a central role in the host's response to the periodontal biofilm. Although there is extensive knowledge about the pathways through which diabetes affects periodontal status, less is known about the impact of periodontal diseases on the diabetes-related inflammatory state. This review attempts to explain the immunobiological connection between periodontal diseases and type 2 diabetes mellitus, exploring the mechanisms through which periodontal infection can contribute to the low-grade general inflammation associated with diabetes (thus aggravating insulin resistance) and discussing the impact of periodontal treatment on glycemic control in people living with both diabetes and periodontal disease.

Reattachment of an autogenous tooth fragment in a fracture with biologic width violation: a case report.

An 11-year-old patient that fractured her maxillary left central incisor is presented. The fracture involved two thirds of the crown, compromising the pulp, and extended subgingivally on the palatal aspect, invading the biologic width. The procedure used to repair the fracture included flap surgery with a slight ostectomy and endodontic treatment. The reattachment of the tooth fragment and the restoration were performed with a bonding system and a resin composite. Examination 6 months after treatment revealed periodontal health, good esthetics, and normal function.

Importance of differential diagnosis in endodontic-periodontal lesions: case reports.

Two case reports are presented in which the radiographic characteristics induced initially incorrect diagnoses. Only after combined clinical and radiographic examinations were the appropriate diagnoses achieved. This article demonstrates the need for close cooperation between periodontists and endodontists to diagnose periradicular lesions accurately.

Effect of bismuth subgallate (local hemostatic agent) on wound healing in rats. Histological and histometric findings.

The aim of this research was to evaluate the effect of bismuth subgallate on wound healing. In 40 Wistar rats, two standard wounds (3.5 mm x 2 mm) were made using a biopsy punch on the back of each animal. Test wounds were filled with bismuth subgallate and control wounds with 0.9% saline. At 1, 4, 7, 11 and 18 days, the qualitative evolution of the granulation tissue morphology was observed and digitalized histologic images were evaluated. There were no significant histological differences between test and control. Histometrically, there were statistically significant differences between test and control (ANOVA--days 1 and 4; Student t test, p < 0.05--days 7, 11 and 18) in terms of the following parameters: area of ulceration--day 1; distance between epithelial edges--day 4; area of granulation tissue--days 7, 11 and 18. It was concluded that bismuth subgallate is biocompatible to the healing tissue, and did not interfere with the normal development of wound healing.

Immunosuppressant therapy and bone loss in ligature-induced periodontitis--a study in rats.

Immunosuppressive agents have been recognized as a factor affecting the soft tissues of the periodontium. However, little is known about their effect on periodontitis progression. The aim of the present study was to investigate the influence of cyclosporin A (CsA) administration, associated or not with nifedipine, on the bone loss resulting from a ligature-induced periodontitis in rats. Twenty-four adult male Wistar rats were used. After anesthesia, the mandibular first molar was randomly assigned to receive the cotton ligature in the sulcular area while the contralateral tooth was left unligated. The animals were randomly assigned to one of the following treatments: Group A--saline solution; Group B--CsA (10 mg/kg); Group C--nifedipine (50 mg/kg); Group D--CsA (10 mg/kg) plus nifedipine (50 mg/kg). Forty-five days later, the animals were sacrificed and the specimens routinely processed for serial decalcified sections. Intergroup analysis did not reveal significant differences regarding the bone loss volume in the ligated teeth between the experimental treatments (0.46 +/- 0.11, 0.63 +/- 0.32, 0.53 +/- 0.14, 0.50 +/- 0.18, for groups A, B, C and D, respectively--p > 0.05). However, intragroup analysis showed a greater bone loss volume in the ligated teeth than in the unligated ones (p < 0.05). Within the limits of the present study, the conclusion was that the administration of CsA, associated or not with nifedipine, may not influence bone loss in ligature-induced periodontitis in rats.

Relationship between glycemic subsets and generalized chronic periodontitis in type 2 diabetic Brazilian subjects.

OBJECTIVE: The aim of the present study was to evaluate the relationship between glycemic subsets and clinical periodontal conditions in type 2 diabetic Brazilians with generalized chronic periodontitis. DESIGN: Ninety-one Brazilians with type 2 DM and generalized chronic periodontitis were involved in this study. The clinical examination included full-mouth assessment of plaque index (PI), bleeding on probing (BoP), probing depth (PD), suppuration (SUP), clinical attachment level (CAL) and number of remaining teeth. Blood analyses were carried out for glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG). The relationship between the extent of periodontitis, defined as the percentage of sites with PD and CAL≥5 mm, and glycemic parameters were also analysed. In addition, clinical parameters were compared amongst four (HbA1c levels ≤7.5%, 7.6-9%, 9.1-11% and >11%) and two (<9% and ≥9%) glycemic subsets. RESULTS: The frequency of uncontrolled diabetic subjects (HbA1c>7.5%) was higher than well-controlled subjects (HbA1c≤7.5%). Amongst the clinical parameters evaluated, only PI was positively correlated with the levels of HbA1c and FPG (p<0.05). The number of remaining teeth was negatively associated with the levels of HbA1c (p<0.05). In addition, PI was significantly higher in subjects presenting HbA1c levels >11% and ≥9% than those with HbA1c levels ≤7.5% and <9%, respectively (p<0.05). CONCLUSION: Although an increased frequency of the subjects with generalized chronic periodontitis included presented type 2 uncontrolled DM, a dose-response relationship between the severity and extension of periodontitis and the glycemic control was not established in these subjects.

Influence of periodontal therapy on C-reactive protein level: a systematic review and meta-analysis.

UNLABELLED: The influence of oral infections, especially periodontal disease, on systemic diseases has been extensively discussed in the literature. Because periodontal disease is a persistent infection, it promotes an inflammatory response. C-reactive protein is a marker for inflammatory reactions that is frequently studied, since elevated levels of this protein are related to coronary events. OBJECTIVE: The aim of this study was to investigate the effect of periodontal therapy on reducing the serum levels of C-reactive protein, by means of a systematic review of the literature and meta-analysis. MATERIAL AND METHODS: A systematic review of the English-language literature was conducted in the PUBMED-MEDLINE database, using the key words "periodontal disease", "C-reactive protein", "periodontal therapy" and "periodontal treatment", in accordance with the terms for Medical Subject Headings (MeSH), to evaluate the effect of periodontal therapy on C-reactive protein levels. A qualitative analysis of studies of randomized clinical trial design was performed using CONSORT, with subsequent meta-analysis. RESULTS: The literature search initially retrieved 46 potentially relevant studies available in the databases. From these, in accordance with the inclusion criteria, only 11 were selected, of which only 4 fulfilled the criteria of randomized clinical trial design. According to CONSORT, the studies evaluated generally presented good quality with regard to the criteria analyzed. Through meta-analysis, the reduction in mean levels of C-reactive protein (-0.231; p=0.000) after introducing periodontal treatment was estimated. The result was statistically significant, without evidence of heterogeneity between the studies (p=0.311). CONCLUSIONS: The findings indicated that non-surgical periodontal treatment had a positive effect with regard to reduction of the serum levels of C-reactive protein.

Flavoring agents present in a dentifrice can modify volatile sulphur compounds (VSCs) formation in morning bad breath.

This study aimed to evaluate the effects of a flavor-containing dentifrice on the formation of volatile sulphur compounds (VSCs) in morning bad breath. A two-step, blinded, crossover, randomized study was carried out in 50 dental students with a healthy periodontium divided into two experimental groups: flavor-containing dentifrice (test) and non-flavor-containing dentifrice (control). The volunteers received the designated dentifrice and a new toothbrush for a 3 X/day brushing regimen for 2 periods of 30 days. A seven-day washout interval was used between the periods. The assessed parameters were: plaque index (PI), gingival index (GI), organoleptic breath scores (ORG), VSC levels (as measured by a portable sulphide monitor) before (H1) and after (H2) cleaning of the tongue, tongue coating (TC) wet weight and BANA test from TC samples. The intra-group analysis showed a decrease in ORG, from 3 to 2, after 30 days for the test group (p < 0.05). The inter-group analysis showed lower values in ORG, H1 and H2 for the test group (p < 0.05). There was no difference between the amount of TC between groups and the presence of flavor also did not interfere in the BANA results between groups (p > 0.05). These findings suggest that a flavor-containing dentifrice seems to prevent VSCs formation in morning bad breath regardless of the amount of TC in periodontally healthy subjects.

Use of 0.1% chlorine dioxide to inhibit the formation of morning volatile sulphur compounds (VSC).

The aim of this study was to evaluate the VSC-inhibiting effect of a commercially available mouthrinse (0.1% chlorine dioxide) when compared to its placebo. A 2-step double blind, crossover, randomised study was conducted with 14 dental students with healthy periodontium, who refrained from any mechanical plaque and tongue coating control during two 4-day experimental periods. The subjects were instructed to rinse 3 times daily with the assigned product during each period. A 7-day washout interval was established. VSCs levels were measured by a sulphide monitor at the beginning (baseline) and at the end of each experimental period. Statistical analyses were performed using Wilcoxon's and Mann-Whitney's non-parametric tests. At baseline, intragroup analysis revealed that VSCs levels did not differ between groups (p > 0.05); at day 5, the use of the chlorine dioxide mouthrinse did not change the baseline VSCs scores in the control group (p > 0.05), while a 2-fold increase was observed with the use of the placebo mouthrinse (p < 0.05). Intergroup analysis showed a significant difference between the VSCs levels of the test and control groups (40.2 +/- 30.72 and 82.3 +/- 75.63 ppb, p < 0.001) at day 5. Within the limits of this study, the findings suggest that a mouthrinse containing chlorine dioxide can maintain VSCs at lower levels in the morning breath.

Influence of periodontal therapy on C-reactive protein level: a systematic review and meta-analysis

The influence of oral infections, especially periodontal disease, on systemic diseases has been extensively discussed in the literature. Because periodontal disease is a persistent infection, it promotes an inflammatory response. C-reactive protein is a marker for inflammatory reactions that is frequently studied, since elevated levels of this protein are related to coronary events. OBJECTIVE: The aim of this study was to investigate the effect of periodontal therapy on reducing the serum levels of C-reactive protein, by means of a systematic review of the literature and meta-analysis. MATERIAL AND METHODS: A systematic review of the English-language literature was conducted in the PUBMED-MEDLINE database, using the key words "periodontal disease", "C-reactive protein", "periodontal therapy" and "periodontal treatment", in accordance with the terms for Medical Subject Headings (MeSH), to evaluate the effect of periodontal therapy on C-reactive protein levels. A qualitative analysis of studies of randomized clinical trial design was performed using CONSORT, with subsequent meta-analysis. RESULTS: The literature search initially retrieved 46 potentially relevant studies available in the databases. From these, in accordance with the inclusion criteria, only 11 were selected, of which only 4 fulfilled the criteria of randomized clinical trial design. According to CONSORT, the studies evaluated generally presented good quality with regard to the criteria analyzed. Through meta-analysis, the reduction in mean levels of C-reactive protein (-0.231; p=0.000) after introducing periodontal treatment was estimated. The result was statistically significant, without evidence of heterogeneity between the studies (p=0.311). CONCLUSIONS: The findings indicated that non-surgical periodontal treatment had a positive effect with regard to reduction of the serum levels of C-reactive protein.

Flavoring agents present in a dentifrice can modify volatile sulphur compounds (VSCs) formation in morning bad breath

This study aimed to evaluate the effects of a flavor-containing dentifrice on the formation of volatile sulphur compounds (VSCs) in morning bad breath. A two-step, blinded, crossover, randomized study was carried out in 50 dental students with a healthy periodontium divided into two experimental groups: flavor-containing dentifrice (test) and non-flavor-containing dentifrice (control). The volunteers received the designated dentifrice and a new toothbrush for a 3 X/day brushing regimen for 2 periods of 30 days. A seven-day washout interval was used between the periods. The assessed parameters were: plaque index (PI), gingival index (GI), organoleptic breath scores (ORG), VSC levels (as measured by a portable sulphide monitor) before (H1) and after (H2) cleaning of the tongue, tongue coating (TC) wet weight and BANA test from TC samples. The intra-group analysis showed a decrease in ORG, from 3 to 2, after 30 days for the test group (p < 0.05). The inter-group analysis showed lower values in ORG, H1 and H2 for the test group (p < 0.05). There was no difference between the amount of TC between groups and the presence of flavor also did not interfere in the BANA results between groups (p > 0.05). These findings suggest that a flavor-containing dentifrice seems to prevent VSCs formation in morning bad breath regardless of the amount of TC in periodontally healthy subjects.

Use of 0.1 percent chlorine dioxide to inhibit the formation of morning volatile sulphur compounds (VSC)

The aim of this study was to evaluate the VSC-inhibiting effect of a commercially available mouthrinse (0.1 percent chlorine dioxide) when compared to its placebo. A 2-step double blind, crossover, randomised study was conducted with 14 dental students with healthy periodontium, who refrained from any mechanical plaque and tongue coating control during two 4-day experimental periods. The subjects were instructed to rinse 3 times daily with the assigned product during each period. A 7-day washout interval was established. VSCs levels were measured by a sulphide monitor at the beginning (baseline) and at the end of each experimental period. Statistical analyses were performed using Wilcoxon's and Mann-Whitney's non-parametric tests. At baseline, intragroup analysis revealed that VSCs levels did not differ between groups (p > 0.05); at day 5, the use of the chlorine dioxide mouthrinse did not change the baseline VSCs scores in the control group (p > 0.05), while a 2-fold increase was observed with the use of the placebo mouthrinse (p < 0.05). Intergroup analysis showed a significant difference between the VSCs levels of the test and control groups (40.2 ± 30.72 and 82.3 ± 75.63 ppb, p < 0.001) at day 5. Within the limits of this study, the findings suggest that a mouthrinse containing chlorine dioxide can maintain VSCs at lower levels in the morning breath.

O objetivo do presente estudo foi avaliar o efeito inibitório do enxaguatório de dióxido de cloro a 0,1 por cento sobre a formação dos CSVs, quando comparados a um placebo. Um estudo randomizado, cruzado, duplo cego foi conduzido com 14 estudantes de odontologia apresentando saúde periodontal, os quais se abstiveram dos hábitos de escovação dentária e limpeza da língua durante dois períodos experimentais de 4 dias. Os voluntários foram orientados a utilizar o enxaguatório designado 3 vezes ao dia conforme indicado no rótulo. Um intervalo de 7 dias foi estabelecido entre os períodos experimentais. No início ("baseline") e no final de cada período experimental, os níveis de CSVs foram medidos com o uso do monitor de sulfetos. Análise estatística foi realizada utilizando-se os testes não-paramétricos de Wilcoxon e Mann-Whitney. No "baseline", uma análise intragrupo revelou que os níveis de CSVs não diferiram entre os grupos (p > 0.05); no dia 5, o uso do dióxido de cloro não promoveu mudanças significativas nos níveis de CSVs em relação ao "baseline" no grupo controle (p > 0,05), entretanto os níveis de CSVs duplicaram com a utilização enxaguatório placebo (p < 0,05). Uma análise entre os grupos teste e controle revelou diferença significante para os níveis de CSVs (40,2 ± 30,72 e 82,3 ± 75,63 ppb, p < 0,001) no dia 5. Dentro dos limites deste estudo, os achados sugerem que o uso de enxaguatórios contendo dióxido de cloro pode promover a manutenção de baixos níveis de CSVs no hálito matinal.

Avaliação histométrica em ratos do efeito da fumaça da cannabis sativa (maconha) no reparo ósseo ao redor de implantes de titânio / A histometric study in rats about the effects of Cannabis sativa (marijuana) in bone filling around titanium implants

[Objetivos] Este estudo visa fazer uma revisão de literatura sobre os principais aspectos relacionados à ação da fumaça da Cannabis sativa (maconha) no reparo ósseo. [Material e métodos] Após anestesia geral, um implante de titânio com superfície usinada (2,2mm x 4,0mm) foi posicionado em uma das tíbias de 30 ratos machos e adultos da raça Wistar. Os animais foram aleatoriamente e igualmente divididos em 2 grupos experimentais. O Grupo A foi utilizado como controle e os ratos receberam apenas a colocação dos implantes. O Grupo B foi submetido ao mesmo procedimento, contudo sofreu também exposição à fumaça da Cannabis sativa durante três períodos diários de 8 minutos durante 60 dias. Os animais foram mortos 60 dias após a colocação dos implantes. As secções não descalcificadas da tíbia foram dissecadas e avaliadas histometricamente quanto ao preenchimento ósseo nos limites das roscas de cada implante; à extensão de contato direto osso-implante e em relação à densidade óssea a 500μm do implante. Médias representativas de cada grupo foram obtidas e comparadas estatisticamente pelo teste T Student (α=0,05). [Resultados] Os achados demonstraram um efeito deletério significante da fumaça da maconhano reparo ósseo ao redor de implantes, levando a uma diminuição na quantidade de tecido ósseo em contato direto com o implante, assim como na área óssea dentro dos limites das roscas dos implantes e na área de tecido ósseo a 500μm do implante. [Conclusões] Considerando as limitações do presente estudo, a inalação da fumaça de Cannabis sativa tem uma repercussão deletéria no reparo ósseo ao redor de implantes de titânio colocados em tíbias de ratos. Esses efeitos podem ser considerados durante a avaliação dos resultados sucesso/fracasso dos implantes.

[Purpose] This study aims to make a review of literature on the majors aspects related to the action of the smoke of Cannabis sativa (marijuana) in bone repair. [Materials and Methods] After general anesthesia, one screw-shaped pure titanium implant (2,2mm x 4,0mm), was placed in one tibia of 30 male Wistar rats. The animals were randomly and equally divided in two experimental groups. Group A was used as control and the rats received only the placing of implants. Group B was submitted to the same procedure and also was exposed to Cannabis sativa’s smoke inhalation for 8 minutes, three times a day during 60 days. The animals were sacrificed 60 days after implant placement. Undecalcified tibia’s sections were dissected and appraised histometrically considering bone filling around each spiral’s limit of every implant, extension of direct contact between bone and implant and bone density in a 500μm wide-zone lateral to the implant. [Results] Representative means of each group were obtained and compared statistically using Student-t test (α=0,05). [Results] The findings showed a significant negative impact of marijuana smoke inhalation on bone filling around titanium implants leading to a decrease in bone density, as well as in the extension of bone to implant contact and on bone area whitin the limits of threads. [Conclusions] Considering the limitations of the present study, the Cannabis sativa smoke inhalation may represent a deleterious impact on bone healing around titanium implants in rats tibiaes.These effects should be a new concern for implant success/failure.

Immunosuppressant therapy and bone loss in ligature-induced periodontitis: a study in rats

O uso de agentes imunossupressores tem sido reconhecido como um fator que afeta os tecidos moles do periodonto. Entretanto, pouco se sabe sobre o seu efeito na progressäo da periodontite. O objetivo do presente estudo foi investigar a influência da CsA, associada ou näo à nifedipina, na perda óssea resultante da periodontite induzida por ligaduras em ratos. Vinte e quatro ratos Wistar machos, adultos, foram incluídos no estudo. Após anestesia, foram colocadas ligaduras de fio de algodäo ao redor do primeiro molar inferior direito ou esquerdo, aleatoriamente escolhido. O dente contralateral foi deixado sem ligadura. Os animais foram aleatoriamente escolhidos para receber um dos seguintes tratamentos: Grupo A - soluçäo salina, Grupo B - CsA (10mgkg), Grupo C - nifedipina (50mgkg), Grupo D - CsA (10mgkg) e nifedipina (50mgkg). Após 45 dias, os animais foram sacrificados para a análise histométrica. A análise intergrupos näo revelou diferenças significantes quanto ao volume da perda óssea entre os diferentes tratamentos (0.46 + 0.11, 0.63 + 0.32, 0.53 + 0.14, 0.50 + 0.18, para os grupos A, B, C e D respectivamente - P>0.05). Entretanto, a análise intragrupo mostrou um maior volume de perda óssea nos dentes com ligadura, comparados aos dentes sem ligadura (P<0,05). Dentro dos limites deste estudo, conclui-se que a administraçäo de CsA, associada ou näo à nifedipina, näo influenciou a perda óssea alveolar na periodontite induzida por ligaduras em ratos

Effect of bismuth subgallate (local hemostatic agent) on wound in rats: histological and histometric findings

O objetivo do presente trabalho foi avaliar o efeito do subgalato de bismuto (SGB) no processo de reparação de feridas. Em 40 ratos Wistar, duas feridas padronizadas foram feitas no dorso dos animais utilizando-se um bisturi circular para biópsia (punch) de 3,5 mm X 2,0 mm. As feridas teste foram preenchidas com SGB e as controle, com salina 0,9 por cento e avaliadas com 1, 4, 7, 11 e 18 dias. A evolução qualitativa do tecido de granulação foi avaliada histologicamente e imagens digitalizadas foram medidas histometricamente. A avaliação histológica não demonstrou diferenças significativas entre teste e controle e histometricamente, houve diferenças significativas (ANOVA- dias 1 e 4; teste student, p<0,05 - dias 7, 11 e 18) em relação aos parâmetros analisados, ou seja, no dia 1: área de ulceração; dia 2: distância entre bordas epiteliais; dia 7, 11 e 18: área de tecido de granulação. Pode-se concluir que o SGB apresenta-se biocompatível aos tecidos em reparação e não interferiu significativamente com o desenvolvimento do processo de reparação.

Necessidade de tratamento periodontal avaliada pelo CPITN e sua relaçäo com a qualidade de acabamento cervical das restauraçöes / Need for periodontal treatment evaluated through CPITN and its relation to the quality of the cervical margin of restorations

Irregularidades do acabamento cervical de restauraçöes constituem fatores de retençäo de placa bacteriana, dificultando o controle de placa pelos procedimentos habituais de higiene bucal, favorecendo o desenvolvimento da doença periodontal. O objetivo deste estudo foi avaliar as condiçöes periodontais e a necessidade de tratamento em funçäo do acabamento cervical de restauraçöes dentais. Foram examinados 367 dentes restaurados com classe II e V de amálgama, classe III em resina, restauraçäo metálica fundida e prótese unitárias. Utilizando-se sonda periodontal (OMS), verificou-se a posiçäo do término da restauraçäo (supragengival, subgengival ou ao nível da margem gengival); a qualidade das restauraçöes (falta ou excesso de material restaurador) e a presença de grau 2 do CPITN. Após a análise dos dados, foi possível concluir que: 1) o término supragengival ofereceu a melhor adaptaçäo marginal e a menor freqüência de grau 2 do CPITN; 2) a falta ou excesso de material restaurador favorecem o desenvolvimento de grau 2, independentemente do material utilizado e 3) nos términos subgengivais, foi maior a freqüência de adaptaçäo marginal incorreta, principalmente casos de excesso de material restaurador, sendo estes casos de maior ocorrência de grau 2 do CPITN

Técnica de frenectomia associada a enxerto de mucosa mastigatória: relato de caso clínico / Frenectomy tecnique associated with mastigatory mucosa graft: clinical case report

Freios labiais possuem a função de limitar os movimentos dos lábios, promovendo a estabilização da linha média e impedindo a excessiva exposição da gengiva. A colocação de enxerto da mucosa mastigatória após frenectomia parece evitar a recidiva, aumentar a faixa de gengiva queratinizada e melhorar a estética do paciente. Portanto, o objetivo do presente trabalho é apresentar um caso clínico de frenectomia associada a enxerto de mucosa mastigatória.

Labial frenum have the function to limit the lips moviments, promoting the stability of the medium line and limiting gingival excessive exposition. The mastigatory mucosa graft installation after frenectomy seems to avoid relapse, increase keratinized gingival and improve aesthetics. Then, the objective of this study is to present a case report of the frenectomy combined with a mastigatory mucosa graft.

Tratamento periodontal de pacientes imunossuprimidos / Periodontal treatment of immunosuppressed patient

O número de pacientes periodontais com deficiências do sistema imune tem aumentado. A imunodeficiência pode afetar não apenas a integridade do periodonto, mas também ter profundos efeitos no hospedeiro. Conseqüentemente, o tratamento periodontal de imunodeficientes requer o entendimento do status médico do paciente e o conhecimento de possíveis complicações bucais e sistêmicas. Cuidados com a saúde bucal desempenham um importante papel, contribuindo para diminuir a morbidade e promover uma qualidade de vida para pacientes imunocomprometidos. Este trabalho tem como objetivo descrever sobre o tratamento periodontal de pacientes transplantados, com leucemia e portadores de HIV, reconhecendo as modificações dos tecidos periodontais causados pela imunossupressão.

The number of periodontal patients with deficiencies of the immune system is growing. Immunodeficiency may not only affect the integrity of the periodontum but has a profound effect on the host. Consequently, the periodontal treatment of the immunodeficient patient relies on an understanding of the patient's medical status and knowledge of possible oral and systemic complications. Oral health care play an important role in contributing to decreased morbidity and in improving the quality of life of immunodeficient patient. The aim of this study is to describe about the periodontal treatment of the transplantation patients, with leukemia and HIV-infected individuals, identifying the modifications of the periodontal tissues caused by immunosuppression.

Revisão sistemática: um guia da melhor evidência para a prática clínica / Systematic review: a guide to the best evidence for clinicai practice

Experiência clínica, habilidade técnica e senso crítico são indispensáveis, mas não suficientes para promover os melhores resultados para o tratamento do paciente. Dentro deste contexto, as revisões sistemáticas estão sendo amplamente utilizadas para a avaliação da corrente evidência em todos os campos da biomedicina, inclusive na odontologia. O objetivo de uma revisão sistemática é fornecer uma avaliação compreensiva e atual da pesquisa, utilizando métodos transparentes, minimizando a presença de vieses. Em suma, uma metodologia de pesquisa pré-estabelecida é empregada para conduzir a revisão. Este artigo tem como objetivo apresentar noções do que é uma revisão sistemática, enfatizando a diferença existente entre esta e uma revisão narrativa, bem como demonstrara importância do uso desse tipo de evidência, para tomar decisões clínicas.