Concern about the risk of aerosol contamination from ultrasonic scaler: a systematic review and meta-analysis.

BACKGROUND: Many instruments used in dentistry are rotary, such as handpieces, water syringes, and ultrasonic scalers that produce aerosols. The spray created by these instruments can carry, in addition to water, droplets of saliva, blood, and microorganisms, which can pose a risk of infections for healthcare professionals and patients. Due to the COVID-19 pandemic, this gained attention. OBJECTIVE: The aim was to carry out a systematic review of the evidence of the scope of the aerosol produced by ultrasonic scaler in environmental contamination and the influence of the use of intraoral suction reduction devices. DESIGN: Scientific literature was searched until June 19, 2021 in 6 databases: Pubmed, EMBASE, Web of science, Scopus, Virtual Health Library and Cochrane Library, without restrictions on language or publication date. Studies that evaluated the range of the aerosol produced by ultrasonic scaler during scaling/prophylaxis and the control of environmental contamination generated by it with the use of low (LVE) and high (HVE) volume evacuation systems were included. RESULTS: Of the 1893 potentially relevant articles, 5 of which were randomized controlled trials (RCTs). The meta-analysis of 3 RCTs showed that, even at different distances from the patient's oral cavity, there was a significant increase in airborne bacteria in the dental environment with the use of ultrasonic scaler. In contrast, when meta-analysis compared the use of HVE with LVE, there was no significant difference (P = 0.40/CI -0.71[-2.37, 0.95]) for aerosol produced in the environment. CONCLUSIONS: There is an increase in the concentration of bioaerosol in the dental environment during the use of ultrasonic scaler in scaling/prophylaxis, reaching up to 2 m away from the patient's mouth and the use of LVE, HVE or a combination of different devices, can be effective in reducing air contamination in the dental environment, with no important difference between different types of suction devices.

Stress as worsening of the signs and symptoms of the geographic tongue during the COVID-19 pandemic: a pilot study.

BACKGROUND: Geographic Tongue (GT) is a benign inflammatory disorder of unknown etiology, which is characterized by the loss of epithelium due to the atrophy of filiform papillae. It usually occurs on the dorsum of the tongue and may extend to its lateral edges. It appears as an erythematous area surrounded by whitish and slightly elevated margins. In most cases, the condition is asymptomatic, although some individuals may report symptoms that include a burning sensation of the tongue. OBJECTIVE: Assess whether there was a change in the clinical aspect of Geographic Tongue (GT) during the COVID-19 pandemic. METHODS: Thirty-two participants were recruited from Dentistry School Universidade Federal Fluminense. Anamnesis and oral examination were performed to collect medical history. The participants were split into two groups: control group (no GT) n = 20 and test group (with GT) n = 12. In the second step, nine participants from a 12 (75%) of the test group were contacted by phone and answered a questionnaire about changes in the signs and symptoms of GT during the pandemic. The subjects were subdivided into two groups: GT with and without signs and symptoms exacerbation. RESULTS: In the first phase of the research, no statistical difference between control and test groups was observed regarding clinical criteria such as age (p + 0.72), gender (p = 0.24), and systemic diseases (p = 0.58). In the second phase, there was a statistical difference between GT groups with or without symptom exacerbation in terms of age and stress as a factor of the oral symptoms (p = 0.3 and 0.2), respectively. Younger patients showed a worsening of the oral lesions related to GT (p = 0.3) and reported stress during the pandemic (p = 0.02). CONCLUSION: Younger patients were more susceptible to stress and presented more exacerbation of the oral lesions related to GT.

Otimização das etapas de confecção do protocolo Branemark com carga tardia utilizando o guia multifuncional / Optimization of the Branemark protocol late load preparation steps using the multifunctional guide

O "planejamento reverso" em implantodontia busca alcançar um melhor prognóstico para a reabilitação do paciente, permitindo uma maior previsibilidade para o tratamento a partir do momento em que se planeja a reabilitação oral protética antes mesmo de planejar os implantes osseointegráveis. O dispositivo de resina acrílica chamado guia multifuncional representa a disposição final dos dentes na reabilitação e auxilia demasiadamente na etapa protética em casos em que não é possível a carga imediata. Ainda, otimiza o número de consultas do tratamento pois orienta a relação maxilomandibular, dimensão vertical e correta posição dos dentes. O presente trabalho tem como objetivo apresentar um caso clínico da utilização do guia multifuncional para moldagem dos implantes em caso de protocolo Branemark com dois tempos cirúrgicos, mostrando sua utilidade para diminuição do número de consultas na etapa de confecção da prótese total inferior definitiva. Diante dos resultados obtidos na realização do caso, foi possível concluir que nos casos de protocolo Branemark quando não é possível realizar a carga imediata, o guia multifuncional pode ser aproveitado e utilizado com sucesso, para a moldagem e confecção da prótese definitiva, diminuindo o número de consultas e otimizando o tratamento.

Reverse planning in implantology aims to improve patient's rehabilitation prognosis allowing greater treatment predictability from the prosthetic planning and before the implants installation. The acrylic resin device called multifunctional guide represents the final teeth disposition and is very useful in the prosthetic step when immediate loading is not possible. And it optimizes appointments treatment number since it guides the maxillomandibular relation, vertical dimension and correct teeth position. The aim of this study was to present a clinical case using the multifunctional guide for implant molding a two steps Branemark protocol, showing its usefulness to reduce the appointments number during the inferior total denture preparation step. Based on these results, it was possible to conclude that in Branemark protocol, when it immediate loading is not possible, the multifunctional guide can be used successfully for molding and making the final prosthesis, reducing the number of visits and optimizing treatment.

Implante transitório de corpo único com ativação imediata para retenção de prótese total provisória - relato de caso / Single body transient implants immediate activated for provisional prosthesis retention ­ case report

A reabilitação protética ganhou um componente que veio solucionar problemas de pessoas edentadas que até então pareciam sem solução. Trata-se dos implantes osseointegráveis, introduzidos pelo professor Per Ingvar Branemark entre os anos 70 e 80, e que, nos dias de hoje, se tornou na maioria dos casos, a primeira opção para a reabilitação oral. No caso de edentados totais na mandíbula, a prótese total fixa sobre implantes instalados entre os forames mentuais é um tipo de tratamento reabilitador com elevado grau de sucesso. Nos casos onde não é possível a colocação da prótese fixa com carga imediata após a instalação dos implantes, o paciente pode usar uma prótese total provisória, diretamente sobre os implantes permanentes instalados ou retida por implantes transitórios de corpo único, com encaixe tipo bola/o'ring. O presente artigo relata um caso clinico com utilização de implantes transitórios de corpo único para reter prótese total provisória, durante o tempo da osseointegração dos implantes permanentes.

Prosthetic rehabilitation gained a component that solved problems of edentulous people. These are the Osseo integrative implants, introduced by Professor Per Ingvar Branemark between the 1970s and 1980s, and which has become in most cases the first option for oral rehabilitation. In the case of mandible total edentulous, the total fixed prosthesis on implants installed between the mental foramina is a type of rehabilitation treatment with a high degree of success. In cases where it is not possible to place the fixed prosthesis with immediate loading after implant installation, the patient may use a provisional total prosthesis, directly on the permanent implants installed or retained by transient implants of single body, ball-type fitting 'ring. The present article reports a clinical case with the use of single body transient implants to retain temporary total prosthesis during the time of osseointegration of permanent implants.

Peri-implant health after supportive mucositis therapy is associated with increased levels of FGF-2.

This study aimed to analyze Fibroblast Growth Factor-2 (FGF-2) levels in the peri-implant crevicular fluid throughout supportive mucositis therapy. Twenty-six participants with Branemark protocol prosthesis were divided into two groups: the control group, characterized by healthy peri-implants, and the mucositis group, presenting a diagnosis of peri-implant mucositis. All participants underwent clinical examination, radiographic analysis, prosthesis removal, and non-invasive peri-implant therapy (mechanical debridement associated with chlorhexidine 0.12%) during a period of 36 days divided into three intervals. Peri-implant crevicular fluid samples were collected at each interval in order to analyze FGF-2 levels by immuno-enzymatic assay. The control and mucositis groups showed difference in keratinized mucosa. The smaller the range of keratinized mucosa the higher susceptibility of peri-implant mucositis. Throughout the treatment intervals, participants were diagnosed in different groups indicating whether or not the non-invasive therapy was able to treat peri-implant mucositis. There was a significant difference of FGF-2 levels between groups, with the higher FGF-2 levels in the control group (p=0.01). After supportive therapy, the mucositis group showed significantly increased FGF-2 levels (p<0.01) compared to initial levels. After 36 days of supportive therapy, there was a reduction of peri-implant mucositis from 70% to 23%. Clinical and laboratory outcomes showed a clear correlation since FGF-2 levels increased after 36 days. It was concluded that the therapy protocol was effective and promoted a regenerative reaction and FGF-2 can be considered a future target for peri-implant mucositis understanding.

Epidermal Growth Factor Is Associated with Loss of Mucosae Sealing and Peri-Implant Mucositis: A Pilot Study.

This study aimed to evaluate the correlation between epidermal growth factor (EGF) and receptor (EGFR) levels in different clinical stages of dental implant rehabilitation and trace mucositis development's biological profile. Thirty-six participants from the Specialization in Implant Dentistry, Universidade Federal Fluminense, Brazil, were included in the study and underwent sample collection: inside the alveolar socket, immediately before implant placement (Group 1, n = 10); at the peri-implant crevicular fluid (PICF) during reopening (Group 2, n = 10); PICF from healthy peri-implant in function (Group 3, n = 8); and PICF from mucositis sites (Group 4, n = 18). Quantitative polymerase chain reaction (PCR) evaluated EGF/EGFR gene expression using the SYBR Green Master Mix detection system. The results showed that EGF expression in the peri-implant crevicular fluid was statistically different. There was a higher EGF expression for group C (peri-implant health) (p = 0.04) than for the other groups. Regarding EGFR, there was no statistical difference among the groups (p = 0.56). It was concluded that low levels of EGF gene expression in the peri-implant crevicular fluid are related to the development of peri-implant mucositis and the absence of mucosae sealing. There was no correlation between EGFR gene expression with health or mucositis.

Peri-implant health after supportive mucositis therapy is associated with increased levels of FGF-2

Abstract This study aimed to analyze Fibroblast Growth Factor-2 (FGF-2) levels in the peri-implant crevicular fluid throughout supportive mucositis therapy. Twenty-six participants with Branemark protocol prosthesis were divided into two groups: the control group, characterized by healthy peri-implants, and the mucositis group, presenting a diagnosis of peri-implant mucositis. All participants underwent clinical examination, radiographic analysis, prosthesis removal, and non-invasive peri-implant therapy (mechanical debridement associated with chlorhexidine 0.12%) during a period of 36 days divided into three intervals. Peri-implant crevicular fluid samples were collected at each interval in order to analyze FGF-2 levels by immuno-enzymatic assay. The control and mucositis groups showed difference in keratinized mucosa. The smaller the range of keratinized mucosa the higher susceptibility of peri-implant mucositis. Throughout the treatment intervals, participants were diagnosed in different groups indicating whether or not the non-invasive therapy was able to treat peri-implant mucositis. There was a significant difference of FGF-2 levels between groups, with the higher FGF-2 levels in the control group (p=0.01). After supportive therapy, the mucositis group showed significantly increased FGF-2 levels (p<0.01) compared to initial levels. After 36 days of supportive therapy, there was a reduction of peri-implant mucositis from 70% to 23%. Clinical and laboratory outcomes showed a clear correlation since FGF-2 levels increased after 36 days. It was concluded that the therapy protocol was effective and promoted a regenerative reaction and FGF-2 can be considered a future target for peri-implant mucositis understanding.

Resumo Este estudo teve como objetivo analisar os níveis de FGF-2 no fluido crevicular peri-implantar durante a terapia de suporte da mucosite. Vinte e seis participantes com prótese protocolo Branemark foram divididos em dois grupos: o grupo controle, caracterizado por saúde peri-implanter, e o grupo mucosite, apresentando diagnóstico de mucosite peri-implantar. Todos os participantes foram submetidos a exame clínico, análise radiográfica, retirada da prótese e terapia não invasiva peri-implantar (debridamento mecânico associado à clorexidina 0,12%) durante um período de 36 dias, dividido em três intervalos. Amostras de fluido crevicular peri-implantar foram coletadas em cada intervalo para análise dos níveis de FGF-2, por ensaio imunoenzimático. Os grupos controle e mucosite não apresentaram diferença nos parâmetros clínicos, exceto para mucosa queratinizada. Ao longo dos intervalos de tratamento, os participantes foram diagnosticados em diferentes grupos, indicando se a terapia não invasiva era ou não capaz de tratar a mucosite peri-implantar. Houve diferença significativa dos níveis de FGF-2 entre os grupos, sendo os níveis de FGF-2 maiores no grupo controle (p = 0.01). Após a terapia de suporte, o grupo com mucosite apresentou níveis de FGF-2 significativamente aumentados (p <0.01) em comparação aos níveis iniciais. Após 36 dias de terapia de suporte, houve redução da mucosite peri-implantar de 70% para 23%. Os resultados clínicos e laboratoriais mostraram uma correlação clara, uma vez que os níveis de FGF-2 aumentaram após 36 dias. O protocolo de terapia foi eficaz e promoveu uma reação regenerativa. O FGF-2 pode ser considerado um alvo futuro para o tratamento da mucosite peri-implantar.

Analysis of Active Oral Tactile Sensitivity in Individuals with Complete Natural Dentition.

AIM: To evaluate the active tactile sensitivity in individuals with complete natural dentition, determining the smallest thickness detected by the participants, and clarifying if there is a difference between the thicknesses analyzed. MATERIALS AND METHODS: Active tactile sensitivity was evaluated in 40 research participants. Inclusion criteria included participants with complete natural dentition, without active or history of periodontal disease, absence of temporomandibular disorders, bruxism, and restorations in the evaluated area. Exclusion criteria included age below 18 years. The active tactile perception threshold was evaluated by using carbon sheets of different thicknesses (0, 12, 24, 40, 80, 100, and 200 µm), which were inserted in the participants' premolars, bilaterally. The carbon sheet was inserted so as not to come into contact with the oral soft tissues. Subsequently, the participant occluded and was asked about the perception of the intraocclusal object 20 times in each occlusal contact. The collected data were tabulated considering the amount of positive and negative responses for each carbon thickness. Values of p < 0.05 were considered significant. RESULTS: The results showed that there was linearity in perception, on both sides, besides, the natural dentition was able to perceive difference in thickness from 12 µm. CONCLUSION: We conclude that the 12 µm thickness is noticeable in occlusion and can be differentiated from other thicknesses in natural dentition and that there is no difference between the tactile sensitivity of the right and left sides. CLINICAL SIGNIFICANCE: A better understanding of active oral tactile sensitivity will contribute to numerous clinical applications in dentistry, including occlusal adjustment in dental rehabilitation, dental implants prosthesis design, and survival of prosthetic rehabilitation.

A Etiologia da Lesão Cervical não Cariosa: Um Novo Desafio para o Cirurgião-Dentista do Século XXI / The Etiology of Noncarius Cervical Lesions: a New Challenge for the 21ST Century Dentist

O termo Lesões Cervicais Não Cariosas (LCNCs) refere-se à perda de tecido dentário duro na Junção Cemento-Esmalte (JCE), cuja etiologia não está relacionada com o envolvimento bacteriano. A origem e a progressão desses defeitos cervicais são consideradas multifatoriais, sendo atribuídas a três fatores principais, sendo eles: abfração, biocorrosão e abrasão. Tais fatores podem estar combinados e associados a eventos de força excessiva aplicada durante a escovação, juntamente com a abrasividade de dentifrícios, hábitos alimentares e/ou parafuncionais. Essas lesões podem ter morfologias diferentes de acordo com seu fator etiológico principal, podendo se apresentar em forma de cunha, oval ou arredondada. O objetivo deste trabalho foi realizar uma revisão de literatura a fim de apresentar os desafios do Cirurgião-Dentista na descoberta dos diferentes fatores etiológicos das LCNCs. O desafio em questão se dá pelo estudo da combinação desses diversos fatores, bem como a realização de um diagnóstico preciso, fazendo-se necessário o conhecimento adequado da etiologia a fim de prevenir futuras novas lesões, estagnar as existentes e assim, capacitar o Cirurgião-Dentista a realizar um tratamento eficaz e longínquo das LCNCs. No entanto, ainda existem muitas controvérsias na literatura, tornando necessária a elaboração de mais estudos para elucidar a etiologia das LCNCs

The term noncarious cervical lesions (NCCL) refers to the loss of hard tooth tissue at the Cemento-Enamel Junction (CEJ), whose etiology is not related to bacterial involvement. The origin and progression of these cervical defects are considered multifactorial, being attributed to three main factors: abfraction, biocorrosion and abrasion. Such factors may be combined and associated with excessive force events applied during brushing, along with the abrasiveness of dentifrices, eating and/or parafunctional habits. These lesions may have different morphologies according to their main etiological factor, and may be wedge-shaped, oval or rounded. Our aim in this paper was to perform a literature review in order to present the challenges of the dental surgeon in identifying the different etiological factors of NCCL. Such challenge regards the study of the combination of these factors, as well as the achievement of an accurate diagnosis, requiring adequate knowledge of the etiology in order to prevent future lesions, stagnate existing ones, thus enabling the Dental Surgeon to treat NCCL effectively in the long term. However, there are still many controversies in the literature, making it necessary to develop more studies to elucidate the etiology of NCCL

Smoking as a Risk Factor for the Development of Periimplant Diseases.

BACKGROUND: Risk factors associated with periimplant disease have been exhaustively explored in many studies. However, despite the high incidence of smokers in the general population, it is still unclear whether smoking is a risk factor for the development of periimplant diseases. PURPOSE: The aim of this review was to analyze all pertinent literature, including systematic reviews, clinical trials, and long-term follow-up, to evaluate smoking as a real risk factor for periimplant diseases. MATERIAL AND METHODS: A comprehensive search was conducted on MEDLINE through PubMed database of the US National Library of Medicine, for articles published until March 2018. All searches were performed using medical subject headings or free-text words. After screening, data extraction, and duplicate removal from 972 found articles, 19 were included in this review. RESULTS: The influence of smoking on the healing process around implants has been explored for potential disruption of the healing process and periimplant disease development. Despite the discussed results in many studies, most of the analyzed literature shows a scientific basis to determine smoking as a risk factor for periimplant disease development, considering that smoking increases the susceptibility to periimplant disease. However, future studies excluding confounding factors need to be performed. CONCLUSION: This review showed that smoking is a real risk factor that increases the likelihood of development of periimplant disease.

Implantes imediatos em alvéolos infectados ­ relato de caso / Immediate implants in infected socket ­ case report

Para ser a primeira opção em um plano de tratamento, a terapia com implantes deve atender requisitos funcionais e estéticos. A técnica de instalação de implantes imediatos tem sido indicada devido à diminuição do tempo de tratamento, o que traz benefícios para o paciente. Antes de avaliar a viabilidade do implante, é essencial o conhecimento da indicação para uma adequada instalação em área infectada. Áreas de infecção periodontal subaguda, infecção perio-endo, infecção periodontal crônica, lesão periapical crônica e cisto periodontal só devem receber implantes imediatos desde que medidas pré, pós e durante o procedimento cirúrgico sejam tomadas. O presente artigo relata um caso de instalação de implante imediato em alvéolo infectado com a utilização de enxerto autólogo com 18 meses de acompanhamento (AU).

To be the first choice in a treatment planning, implant therapy must join both functional and aesthetic requirements. Implant installation technique has been indicated due to the reduction of time treatment, which brings benefits to the patient. Before evaluating the viability of the implant, it is essential to know the proper indication of the immediate implant installation in an infected area. Areas of subacute periodontal infection, endo-perio lesion, chronic periodontal infection, chronic periapical lesion, and periodontal cyst should only receive immediate implants provided that measures are taken pre, post, and during surgical procedures. The present article reports 18 months follow up after the installation of an immediate implant in infected socket associated to autologous graft (AU).

Dental genetics in Brazil: Where we are.

Dentistry constitutes the basic nucleus of professionals of higher level of health in Brazil with one of the largest concentrations of dentists per capita in the world. However, the genetic in dentistry in Brazil is explored, basically, in research field. Future actions need to be performed in order to deep the whole knowledge about diagnosis and treatment of diseases with genetic basis in dentistry, in Brazil.

Chronic Periodontitis and RANKL/OPG Ratio in Peri-Implant Mucosae Inflammation

Abstract tHistory of chronic periodontitis (CP) is a risk factor for oseointegration failure. The osteoclastogenesis system (RANK, RANKL and OPG) is critical for bone homeostatic control. We investigated the levels of OPG and RANKL in peri-implant tissues from volunteers with and without a history of CP and their association with mucosae inflammation. This is a single-blind case-contro study. Diagnosis of a history of CP and peri-implant examination was performed on 46 volunteers, divided into control (without history of CP, n=26) and CP group (with history of CP, n=20). Gingival biopsies were harvested during implant exposure. Quantitative PCR evaluated OPG/RANKL mRNA expressions. OPG and RANKL proteins were analyzed by western blot and immunohistochemistry assay. The chi-square test analyzed the significance of nominal variables between groups while continuous variables were analyzed by T-test or Mann-Whitney test, after Shapiro-Wilk test evaluation. The 2-ΔΔCT Livak method calculation evaluated the gene expression. Values of p<0.05 were considered statistically significant. Volunteers with CP history had 23 times higher chance of developing mucosae inflammation. High mucosae levels of RANKL (p=0.04) and RANKL/OPG (p=0.001) mRNA expressions were observed in CP group. CP volunteers showed increased RANKL protein levels in opposition to decreased OPG expression. Even without active periodontitis, volunteers with a history of CP had elevated gingival levels of RANKL/OPG and higher correlation with peri-implant mucosae inflammation and implant loss.

Resumo A história de periodontite crônica (CP) é um fator de risco para falhas na osseointegração. O sistema de osteoclastogênese (RANK, RANKL e OPG) é crucial para o controle da homeostase óssea. O objetivo deste estudo foi investigar os níveis de OPG e RANKL no tecido peri-implantar de voluntários com e sem histórico de CP e sua associação com inflamação da mucosa. Este é um estudo tipo caso-controle. O exame para diagnóstico de CP e na região peri-implantar foi realizado em 46 voluntários, divididos em controle (sem história CP, n=26) e grupo CP (com histórico de CP, n=20). Descartes gengivais foram obtidos durante a exposição do implante. PCR quantitativo avaliou a expressão do RNAm de OPG/RANKL. As proteínas OPG e RANKL foram analisadas por western blot e imunohistoquímica. O teste do qui-quadrado analisou a significância entre as variáveis nominais enquanto as variáveis contínuas foram analisadas pelo teste-t e Mann-Whitney, após o teste de Shapiro-wilk. O método do Livak 2--ΔΔCT avaliou a expressão gênica. Os voluntários com CP apresentaram 23 vezes mais chances de desenvolver inflamação da mucosa. Expressão elevada no RNAm de RANKL (p=0.04) e RANKL/OPG (p=0.001) foram observadas no grupo CP. Voluntários com CP mostraram aumento dos níveis da proteína RANKL em contraste com diminuída expressão de OPG. Mesmo sem periodontite ativa, voluntários com histórico de CP apresentaram elevado nível gengival de RANKL/OPG e alta correlação com inflamação peri-implantar e perda do implante.

Chronic Periodontitis and RANKL/OPG Ratio in Peri-Implant Mucosae Inflammation.

tHistory of chronic periodontitis (CP) is a risk factor for oseointegration failure. The osteoclastogenesis system (RANK, RANKL and OPG) is critical for bone homeostatic control. We investigated the levels of OPG and RANKL in peri-implant tissues from volunteers with and without a history of CP and their association with mucosae inflammation. This is a single-blind case-contro study. Diagnosis of a history of CP and peri-implant examination was performed on 46 volunteers, divided into control (without history of CP, n=26) and CP group (with history of CP, n=20). Gingival biopsies were harvested during implant exposure. Quantitative PCR evaluated OPG/RANKL mRNA expressions. OPG and RANKL proteins were analyzed by western blot and immunohistochemistry assay. The chi-square test analyzed the significance of nominal variables between groups while continuous variables were analyzed by T-test or Mann-Whitney test, after Shapiro-Wilk test evaluation. The 2-ΔΔCT Livak method calculation evaluated the gene expression. Values of p<0.05 were considered statistically significant. Volunteers with CP history had 23 times higher chance of developing mucosae inflammation. High mucosae levels of RANKL (p=0.04) and RANKL/OPG (p=0.001) mRNA expressions were observed in CP group. CP volunteers showed increased RANKL protein levels in opposition to decreased OPG expression. Even without active periodontitis, volunteers with a history of CP had elevated gingival levels of RANKL/OPG and higher correlation with peri-implant mucosae inflammation and implant loss.

Uma discussão sobre o efeito da rhBMP-2 no aumento ósseo alveolar / A discussion on the effect of rhBMP-2 in the alveolar bone augmentation

O objetivo deste trabalho foi apresentar uma revisão da literatura sobre a proteína óssea morfogenética tipo 2 (BMP-2) e seu efeito no aumento ósseo alveolar. A proteína óssea morfogenética (BMP) foi identificada, em 1965, por um norte-americano chamado Marshal Urist, que mostrou que essa proteína, extraída da cortical óssea bovina, poderia induzir a formação de novo osso quando implantada em locais não ósseos. Atualmente, muitos trabalhos têm estudado a regeneração óssea através do uso de BMPs em substituição aos enxertos ósseos. O presente estudo conclui que a proteína óssea morfogenética é capaz de induzir neoformação óssea de maneira eficaz, tornando-se uma alternativa na substituição dos enxertos ósseos e a necessidade da descoberta de novos carreadores facilitando a estabilidade mecânica da BMP-2 no leito receptor.

The aim of this paper is to review the literature about bone morphogenetic protein type 2 (BMP-2) and on the effect in the alveolar bone augmentation. In 1965, the BMP was isolated by Marshal Urist, who showed that this protein extracted from bone narrow could induce bone neoformation when implanted in sites without bone cells. Recently, a lot of studies have been looking for bone regeneration using BMPs without bone grafts. The present study it was concluded that the bone morphogenetic protein induces bone neoformation, being an alternative as a substitute to bone grafts and that new carrier discovery is necessary to smooth stability of this carriers in receptor site.

Histopathologic changes in dental pulp of teeth with chronic periodontitis.

OBJECTIVE: The aim of this study was to evaluate the histopathologic changes in dental pulp of teeth with chronic advanced periodontitis. METHODS: In 22 patients, 30 teeth were selected for inclusion. Patients had received no periodontal treatment. No teeth had caries, abrasion, attrition, erosion, trauma, or restoration. Radiographically, all teeth showed bone-support destruction to the apex. Thermal and cavity tests were used to evaluate pulp vitality. After tooth extractions, crowns were separated from roots at the cementoenamel junction. Both the crowns and the roots were prepared for histopathologic analyses. Radicular pulp was analyzed considering both coronal and apical halves. RESULTS: In 100 percent of the cases, coronal pulp exhibited soft connective tissue. In the coronal half of radicular pulp, soft connective tissue was present in 60 percent of the cases, fibrosis in 30 percent, and fibrosis associated with dystrophic calcification in 10 percent. In the apical half of radicular pulp, 6.6 percent of the cases demonstrated fibrosis; 23 percent exhibited fibrosis associated with pulp atrophy and secondary dentin; and 63.3 percent showed fibrosis, pulp atrophy, secondary dentin, and diffuse calcification. CONCLUSION: Radicular pulp of teeth with chronic periodontitis presents characteristics compatible with pulp changes resulting from pulp aging. In such cases, endodontic treatment is not indicated to enhance periodontal treatment results.

Tratamento da estrongiloidíase humana e outras parasitoses intestinais com dose única de ivermectina / Treatment of human strongyloidiasis and other intestinal parasitosis with a single dose of ivermectin

Os autores trataram 70 pacientes portadores de estrongiloidíase, ascaríase, tricuríase e ancilostomíase com dose única de ivermectina (200 ug/kg). A cura parasitológica obtida foi de 95 porcento para estrongiloidíase, de 100 poecento para ascaríase e tricuríase e de 60 porcento para ancilostomíase. As reaçöes adversas foram observadas em 3 porcento dos pacientes - cefaléia, náuseas e vômitos.(au)

Parasitoses intestinais no período infantil / Intestinal parasitoses in childhood

Os autores atualizam os aspectos mais importantes das parasitoses intestinais que ocorrem na infância, subdividindo-as em dois grandes grupos: helmintíases e protozooses. Em cada caso discorre sobre o agente etiológico, quadro clínico e diagnóstico, detendo-se particularmente no estudo da terapêutica, em que säo relacionados os medicamentos utilizados em cada uma das parasitoses, pela denominaçäo genérica do sal e as denominaçöes comerciais dos produtos correspondentes disponíveis no mercado farmacêutico.

Estudo histopatológico da polpa de dentes humanos portadores de doença periodontal envolvendo o ápice radicular / Histopathological study of human dental pulp in teeth with periodontal disease involving the radicular apex

O objetivo deste trabalho foi analisar as possíveis alteraçöes pulpares em dentes humanos portadores de doença periodontal envolvendo o ápice radicular. Foram selecionados 52 pacientes, e obtidos 60 dentes unirradiculares, 30 portadores de Periodontite do adulto e 30 portadores de Periodontite de início precoce. Todos os dentes eram isentos de cárie, abrasäo, atriçäo, erosäo, restauraçöes e/ou tratamento periodontal prévio, apresentando, no exame radiográfico, destruiçäo de todo o osso de suporte até o ápice radicular. Pela avaliaçäo periodontal observou-se que a destruiçäo dos tecidos de suporte ultrapassava o ápice radicular. Adicionalmente a avaliaçäo endodôntica mostrou que todos os dentes estavam vitais. Após a exodontia e procedimentos para microscopia de luz as lâminas obtidas foram analisadas em fotomicroscópio. O estudo demonstrou que dentes vitais, isentos de cárie, abrasäo atriçäo, erosäo, e/ou restauraçöes, quando da presença de PA e PIP, apresentam diversas patologias pulpares. Na avaliaçäo histológica as alteraçöes observadas foram: atrofia pulpar, dentina reparadora, fibrose, calcificaçäo distrófica e infiltrado inflamatório crônico. Dentro dos limites deste trabalho foi possível concluir que, em dentes de pacientes portadores de PIP a patologia de maior freqüencia foi a fibrose seguida de calcificaçäo distrófica. E nos dentes de pacientes portadores de PA a patologia mais freqüente também foi a fibrose, seguida de dentina reparadora com conseqüente atrofia pulpar, e de calcificaçäo distrófica

Avaliaçäo clínica e histopatológica da polpa dental de humanos jovens 60 dias após seu condicionamento com ácido fosfórico a 37 por cento e colocaçäo de um sistema adesivo de quarta geraçäo sobre a área da exposiçäo / The clinical and histopathologic evaluation of the young human dental pulp 60 days after 37 per cent phosphoric acid action's and phacement of on adhesive system of the fourth generation in an exposition area

Neste trabalho, os autores observaram a açäo do ácido fosfórico a 37 por cento de um sistema adesivo em contato íntimo com a polpa de humanos jovens. Análise clínica e histopatológica, 60 dias após, constatou-se ausência de infiltraçäo com discreta fibrose na área de exposiçäo