Photodynamic therapy decrease immune-inflammatory mediators levels during periodontal maintenance.

Antimicrobial photodynamic therapy (aPDT) was introduced as a promising adjuvant therapy on the periodontal treatment. The aim of this study was to evaluate the effect of aPDT on inflammatory mediator levels in residual periodontal pockets of patients with severe chronic periodontitis under periodontal maintenance, during 12 months follow-up. A randomized controlled trial study was conducted in 28 patients with severe chronic periodontitis. After non-surgical periodontal treatment, patients with at least four teeth with residual pocket probing depth (PPD) ≥4 mm were randomly assigned to either aPDT or control group. The aPDT (low power laser: 660 nm, 40 mW, 90 J/cm2, methylene blue 0.01 %) was performed at baseline and 3, 6, and 9 months. Clinical parameters were collected before and 3 and 12 months after the intervention, and gingival crevicular fluid was collected in the same times, including 1 week after the intervention. Immunological evaluation was carried out using the Luminex assay which quantified the expression of ten cytokines: interleukin (IL)-1α, IL-1ß, IL-8, IL-1ra, fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF), interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IL-4, and IL-10. All clinical variables showed significant improvement for both groups, but there was no statistical difference between groups with no clinical benefits. IL-1α, IL-1ß, IL-8, and VEGF showed significant differences (p < 0.05) between groups, whereas IL-1ra mediators, IFN-γ, and IL-10 demonstrated a statistical difference (p < 0.01) over time in the same group. At any time, FGF, IL-4, and TNF-α showed no statistical difference between groups (p > 0.05). aPDT therapy can improve the benefits on inflammation control during the periodontal maintenance.

Influência do tratamento periodontal na função endotelial da doença cardiovascular / The influence of periodontal treatment in the endothelial function of cardiovascular disease ­ a systematic review

Objetivo: diversos estudos epidemiológicos vêm estudando a associação entre doença periodontal e doença cardiovascular, defendendo a ideia de que a DP seria um fator de risco para a doença cardiovascular. A doença periodontal é uma inflamação crônica que está associada ao aumento de marcadores inflamatórios sistemicamente e interferência na função endotelial. Vale ressaltar que a inflamação e a função endotelial têm um importante papel na patogênese da aterosclerose. Material e métodos: pouca informação existe a respeito da influência do tratamento periodontal na doença cardiovascular, sendo assim, este trabalho consiste em uma revisão de literatura, através da busca no MedLine/Pubmed de ensaios clínicos randomizados que estudem a influência do tratamento periodontal nos marcadores da doença cardiovascular. Resultados: através deste trabalho, foi possível concluir que o tratamento periodontal parece exercer influência na melhora dos níveis séricos dos marcadores cardiovasculares. Conclusão: mais estudos são necessários para comprovar a real relação.

Objective: several epidemiological studies have investigated the association between periodontal disease and cardiovascular disease, defending the idea that the DP would be a risk factor for cardiovascular disease. Periodontal disease is a chronic inflammation which is associated with inflammatory markers increasing and systemically interference in endothelial function. It is noteworthy that inflammation and endothelial function play an important role in the pathogenesis of atherosclerosis. Material and methods: little information exists about the influence of periodontal treatment in cardiovascular disease; therefore this study consists of a randomized clinical trial literature review to study the influence of periodontal treatment on markers of cardiovascular disease, through search in MedLine/Pubmed. Results: through this work it was possible to conclude that the periodontal treatment looks to influence the improvement of the serious levels of the cardiovascular markets. Conclusion: more studies are necessary to verify the real relationship between them.

Antibioticoterapia como coadjuvante no tratamento periodontal não cirúrgico de pacientes diabéticos / Antibiotic therapy as an adjunct to non-surgical periodontal treatment in diabetic patients ­ a literature review

Objetivo: verificar se o uso de antibióticos sistêmicos, adjunto à terapia periodontal não cirúrgica, em pacientes diabéticos pode trazer benefícios adicionais no controle glicêmico e parâmetros clínicos periodontais. Material e métodos: após a busca nos bancos de dados PubMed e Lilacs, foram incluídos nove ensaios clínicos randomizados para essa revisão da literatura. Resultados: nos desfechos periodontais, seis dos nove ensaios clínicos encontraram algum benefício a favor da antibioticoterapia. Quanto ao controle glicêmico, a maioria dos estudos falhou ao tentar relacionar o uso de antibióticos a uma maior redução da hemoglobina glicada. Conclusão: com base nesta revisão, concluiu-se que o uso de antibióticos sistêmicos em conjunto com o tratamento periodontal não cirúrgico pode oferecer benefícios adicionais, quando comparado ao tratamento periodontal sozinho, no tratamento da periodontite em pacientes com diabetes. Não há evidências de que a antibioticoterapia possa contribuir no controle glicêmico desses pacientes, sendo necessários mais estudos clínicos.

Objective: to verify whether systemic antibiotic therapy along with non-surgical periodontal management in diabetic patients can bring additional benefi ts on the glycemic control and periodontal parameters. Material and methods: after an electronic search on Medline and Lilacs databases, 9 RCTs were included. Results: six articles found favorable outcomes for periodontal clinical parameters. Regarding the glycemic control, most studies failed to prove a relationship between antibiotic use and the reduction on glycated hemoglobin levels. Conclusion: within the limits of this review, it can be concluded that systemic antibioticotherapy added to non-surgical periodontal treatment can bring additional benefits when compared to non-surgical treatment alone for diabetes-affected periodontal patients. However, there is no evidence that antibiotics can contribute to the glycemic control and more studies are necessary on this subject.

O efeito da sinvastatina na osseointegração / The effect of simvastatin on osseointegration ­ a literature review

O crescente aumento de instalações de implantes dentais com carga imediata e de suas fixações em tecido ósseo de baixa densidade tem gerado a necessidade real de aceleração e aprimoramento do processo de osseointegração, e muitos métodos e técnicas têm sido propostos para solucionar este problema. Neste contexto, a presente revisão teve por objetivo discutir os principais aspectos do papel da sinvastatina como intervenção para a melhoria no processo de osseointegração. Os resultados indicaram que a sinvastatina apresentou efeitos positivos em estudos experimentais, sendo necessários ensaios clínicos randomizados.

With increasing applications of dental implants with immediate loading and their installation in low quality bone, there is a real need to speed up and improve the osseointegration process. This review aimed to discuss the use of simvastatin in improving the osseointegration. The results indicate that simvastatin showed positive results in experimental studies, although randomized clinical trials are necessary.

Antimicrobial photodynamic effect to treat residual pockets in periodontal patients: a randomized controlled clinical trial.

AIM: A randomized controlled clinical trial was designed to evaluate the efficacy of the photodynamic therapy (PDT) in the treatment of residual pockets of chronic periodontitis patients. MATERIAL AND METHODS: Thirty-four patients with at least four residual periodontal pockets undergoing maintenance care were included and randomly assigned to test group (PDT, n = 18) or control group (sham procedure, n = 16). The intervention was performed at baseline, 3, 6 and 12 months. Clinical parameters such as pocket probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP) and plaque index (PI) were measured before intervention and after 3, 6 and 12 months. Subgingival samples were obtained at baseline, and after 7 days, 3, 6 and 12 months to quantify Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia by real-time polimerase chain reaction (PCR). RESULTS: All clinical variables showed significant improvement during the study, but there was no significant difference between test and control groups. The microbiological analyses showed no differences between groups at any time during the study. CONCLUSION: Within the limits of this clinical trial and considering the laser and photosensitizer protocol used, PDT failed to demonstrate additional clinical and bacteriological benefits in residual pockets treatment.

Terapia fotodinâmica no tratamento periodontal: comparação microbiológica entre dois métodos / Photodynamic therapy adjunct in the treatment periodontal: microbiological comparison between two methods

a terapia fotodinâmica (PDT) tem a finalidade de reduzir os periodontopatógenos no biofilme dental através da associação de um laser a um corante fotossensibilizador, que culmina na produção de oxigênio singleto, levando à morte celular. Este estudo-piloto compara dois diferentes métodos de irradiação do laser de baixa potência na PDT, através da análise dos patógenos periodontais Porphyromonas gingivalis (P.g.), Tannerella forsythia (T.f.), Treponema denticola (T.d.) e Aggregatibacter actinomycetencomitans (A.a.). Material e métodos: este estudo-piloto é parte de um estudo clínico longitudinal, prospectivo, randomizado e duplo-cego. Foram selecionados cinco pacientes portadores de periodontite crônica, com dois dentes unirradiculares contralaterais com profundidade de sondagem maior ou igual a 5 mm, sem comprometimento sistêmico. Os pacientes foram submetidos à raspagem e alisamento radicular, e subsequentemente à PDT nos dentes experimentais. Estes foram alocados em dois grupos, de acordo com a maneira de entrega do laser: grupo A (transgengival) e grupo B (intrasulcular). A quantificação dos periodontopatógenos foi avaliada pela PCR em tempo real, sete e 30 dias após a intervenção, sendo adotado o nível de significância p ≤ 0,05. Resultados: não houve diferença entre os grupos A (irradiação transgengival) e B (irradiação intrasulcular), em relação aos níveis de A.a., T.f. e T.d. em qualquer momento do estudo. Em relação aos níveis de Pg, houve diferença significativa entre os grupos após 30 dias (p=0,032). Conclusão: os dois métodos foram semelhantes na redução de A.a., T.d. e T.f.. O método B (intrasulcular) mostrou uma redução significativa do patógeno P.g. no sétimo e 30º dia de avaliação.

Introduction: photodynamic therapy (PDT) has the purpose of reducing the periodontal biofilm by combining a laser with a photosensitizing dye that culminates in the production of singlet oxygen, leading to cell death. This pilot study compares two different methods of irradiation of low power laser in PDT, by analyzing the periodontal pathogen Porphyromonas gingivalis (P.g.), Tannerella forsythia (T.f.), Treponema denticola (T.d.) and actinomycetencomitans Aggregatibacter (A.a.). Material and methods: this pilot is part of a longitudinal, prospective, randomized, double-blind study. Were selected five patients with chronic periodontitis with two contralateral single-rooted teeth with depth greater than or equal to 5 mm, without systemic involvement. Patients underwent scaling and root planing and subsequent to PDT in experimental teeth, which were divided into two groups according to the manner of delivery of the laser: group A (transgingival) and group B (intrasulcular). The reduction of periodontal pathogens was evaluated by PCR real-time, 7 and 30 days after the intervention, with significance level p ≤ 0.05. Results: there was no difference between groups A (transgingival irradiation) and B (intrasulcular irradiation) with respect to A.a., T.f. and T.d. at any time during the study. With respect to levels of P.g., a significant difference between groups at 30 days (p=0.032). Conclusions: the two methods were similar in reducing A.a., T.d., T.f.. The method B (intrasulcular) showed a significant reduction in pathogen P.g. 7 and 30 days of evaluation.

Detection and quantification of periodontal pathogens in smokers and never-smokers with chronic periodontitis by real-time polymerase chain reaction.

BACKGROUND: The purpose of the present investigation is to compare the presence and number of periodontal pathogens in the subgingival microbiota of smokers versus never-smokers with chronic periodontitis and matched probing depths (PDs) using real-time polymerase chain reaction (RT-PCR). METHODS: Forty current smokers and 40 never-smokers, matched for age, sex, and mean PD of sampling site, were included in this investigation. A full-mouth periodontal examination was performed, and a pooled subgingival plaque sample was collected from the deepest site in each quadrant of each participant. To confirm smoking status, expired carbon monoxide (CO) concentrations were measured with a CO monitor. The presence and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were determined using RT-PCR. RESULTS: Smokers had greater overall mean PD (P = 0.001) and attachment loss (P = 0.006) and fewer bleeding on probing sites (P = 0.001). An association was observed between smoking status and the presence of A. actinomycetemcomitans (P <0.001). The counts of A. actinomycetemcomitans (P <0.001), P. gingivalis (P = 0.042), and T. forsythia (P <0.001) were significantly higher in smokers. CONCLUSIONS: Smokers showed significantly greater amounts of P. gingivalis, A. actinomycetemcomitans, and T. forsythia than never-smokers. There was a significant association between smoking and the presence of A. actinomycetemcomitans.

Clinical and microbiological evaluation of high intensity diode laser adjutant to non-surgical periodontal treatment: a 6-month clinical trial.

OBJECTIVES: This randomized split-mouth clinical trial was designed to evaluate the efficacy of scaling and root planing associated to the high-intensity diode laser on periodontal therapy by means of clinical parameters and microbial reduction. MATERIALS AND METHODS: A total of 36 chronic periodontitis subjects, of both genders, were selected. One pair of contralateral single-rooted teeth with pocket depth >5 mm was chosen from each subject. All patients received non-surgical periodontal treatment, after which the experimental teeth were designated to either test or control groups. Both teeth received scaling, root planing and coronal polishing (SRP) and teeth assigned to the test group (SRP + DL) were irradiated with the 808 ± 5 nm diode laser, for 20 s, in two isolated appointments, 1 week apart. The laser was used in the continuous mode, with 1.5 W and power density of 1,193.7 W/cm(2). Clinical and microbiological data were collected at baseline, 6 weeks and 6 months after therapy. RESULTS: There was a significant improvement of all the clinical parameters-clinical attachment level (CAL), probing depth (PD), plaque index (PI) and Bleeding on Probing (BOP)-for both groups (P < 0.001), with no statistical difference between them at the 6 weeks and the 6 months examinations. As for microbiological analysis, a significant reduction after 6 weeks (P > 0.05) was observed as far as colony forming units (CFU) is concerned, for both groups. As for black-pigmented bacteria, a significant reduction was observed in both groups after 6 months. However, the difference between test and control groups was not significant. There was no association between group and presence of Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans at any time of the study. CONCLUSIONS: After 6 months of evaluation, the high-intensity diode laser has not shown any additional benefits to the conventional periodontal treatment. CLINICAL RELEVANCE: The high intensity diode laser did not provide additional benefits to non-surgical periodontal treatment. More studies are necessary to prove the actual need of this type of laser in the periodontal clinical practice.

Clinical and microbiologic evaluation, by real-time polymerase chain reaction, of non-surgical treatment of aggressive periodontitis associated with amoxicillin and metronidazole.

BACKGROUND: The aim of the present study is to evaluate the clinical and microbiologic changes resulting from non-surgical periodontal treatment associated with amoxicillin and metronidazole in individuals with aggressive periodontitis. METHODS: Fifteen individuals with aggressive periodontitis received non-surgical periodontal treatment and 45 days after completion of treatment were treated with antibiotics. Clinical data and samples of subgingival plaque were collected at baseline, 45 days after the non-surgical periodontal treatment, and 1 month after the use of antimicrobial agents. After 3 and 6 months, only clinical data were collected. The presence and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), and Dialister pneumosintes were determined by real-time polymerase chain reaction. RESULTS: All clinical parameters, with the exception of clinical attachment level (CAL), had significantly (P <0.05) improved at the end of the third month after non-surgical therapy associated with antibiotics. There was significant (P <0.05) reduction in the quantities of Td and Tf. After 1 month, there were significant (P <0.05) reductions in the frequencies of Pg and Tf. CONCLUSION: Non-surgical mechanical treatment associated with the use of amoxicillin and metronidazole led to an improvement in all clinical parameters studied, except for CAL, and significantly reduced the amount of subgingival Tf and Td.

A prospective 12-month study of the effect of smoking cessation on periodontal clinical parameters.

AIM: The aim of this 12-month prospective study was to assess the adjunctive effect of smoking cessation in non-surgical periodontal therapy of subjects with severe chronic periodontitis. MATERIALS AND METHODS: Of the 201 subjects enrolled from a smoking cessation clinic, 93 were eligible and received non-surgical periodontal treatment and concurrent smoking cessation treatment. Periodontal maintenance was performed every 3 months. Full-mouth periodontal examination in six sites per tooth was performed by a calibrated examiner, blinded to smoking status, at baseline, 3, 6 and 12 months after non-surgical periodontal treatment. Furthermore, expired air carbon monoxide concentration measurements and interviews based on a structured questionnaire were performed in order to collect demographic and smoking data. RESULTS: Of the 93 eligible subjects, 52 remained in the study after 1 year. Of these, 17 quit smoking and 35 continued smoking or oscillated. After 1 year, only quitters presented significant clinical attachment gain (p=0.04). However, there were no differences between the groups regarding clinical attachment level, probing depth, bleeding on probing and plaque index after 1 year (p>0.05). CONCLUSION: Smoking cessation promoted clinical attachment gain in chronic periodontitis subjects from a smoking cessation clinic after 1 year of follow-up.

Efficacy of high intensity diode laser as an adjunct to non-surgical periodontal treatment: a randomized controlled trial.

The high intensity diode laser has been studied in periodontics for the reduction of subgingival bacteria in non-surgical treatment. Our study evaluated the bacterial effect as well as changes in periodontal clinical parameters promoted by root scaling and planing associated with this wavelength. Twenty-seven patients randomly assigned in two groups underwent root scaling and planing on the tested sites, and only the experimental group received the diode laser irradiation. Among the clinical parameters studied, the clinical probing depth (CPD) and the clinical attachment level (CAL) resulted in significant enhancement in the control group when compared with the experimental group (P = 0.014 and P = 0.039, respectively). The results were similar for both groups regarding the plaque index (PI) and bleeding on probing (BP). No significant difference in the microbiological parameters was observed between the control and experimental groups. It was possible to conclude that the high power diode laser adjunct to the non-surgical periodontal treatment did not promote additional effects to the conventional periodontal treatment.

Compliance improvement in periodontal maintenance.

OBJECTIVES: The aim of this study was to assess the influence of efforts applied to modify the patients' behavior towards periodontal maintenance. MATERIAL AND METHODS: Patients were classified into three groups: Complete Compliance (participation in all visits), Irregular Compliance (irregular participation, one or more missing appointments), and Noncompliance (abandoned or never returned to the program). Complete compliers received usual procedures of the maintenance visit. The irregular compliers and non-compliers received usual procedures and strategies such as reminding next visit, informing patients on both periodontal disease and importance of maintenance, motivating the patient who showed an improvement in compliance. Thus, 137 patients were observed for 12 months. RESULTS: The degree of compliance has increased significantly during this period (p=0.001). No association was detected between age or gender and compliance degree. CONCLUSIONS: The results have shown that the intervention applied had a favorable influence on the patients' compliance.

Terapia fotodinâmica em periodontia clínica / Photodynamic therapy in periodontics

O objetivo do tratamento periodontal é restabelecer a saúde dos tecidos periodontais, através da eliminação e controle dos fatores etiológicos, reduzindo a agressão microbiana. Alguns microrganismos persistem na superfície radicular mesmo após a raspagem. Dessa maneira, o tratamento mecânico convencional pode falhar em reduzir o número dos periodontopatógenos a níveis compatíveis com saúde. O objetivo deste estudo é analisar estudos clínicos que empregaram a Terapia Fotodinâmica (PDT) no tratamento não-cirúrgico da periodontite. A literatura atual mostrou seis ensaios clínicos que empregaram a PDT como coadjuvante ao tratamento não-cirúrgico de periodontite crônica, que apresentaram resultados controversos em relação ao benefício adicional da PDT no tratamento periodontal. Mais estudos são necessários para que se estabeleça um consenso a respeito do uso da PDT na prática clínica.

The goal of periodontal treatment is to restore tissue health through the elimination and control of etiologic factors, reducing the microbial aggression. Some microorganisms persist in the root surface even after scaling. Thus, the conventional mechanical treatment may fail to reduce the number of periodontal pathogens to levels compatible with health. The objective of this study is to analyze clinical studies that used Photodynamic Therapy (PDT) in non-surgical treatment of periodontitis. The current literature showed six clinical trials that used PDT as an adjuvant to non-surgical treatment of chronic periodontitis, which showed controversial results regarding the added benefit of PDT in treating periodontal disease. More studies are needed to establish a consensus regarding the use of PDT in clinical practice.

Effect of laser phototherapy on the release of fibroblast growth factors by human gingival fibroblasts.

The effects of laser phototherapy on the release of growth factors by human gingival fibroblasts were studied in vitro. Cells from a primary culture were irradiated twice (6 h interval), with continuous diode laser [gallium-aluminum-arsenium (GaAlAs), 780 nm, or indium-gallium-aluminum-phosphide (InGaAlP),_660 nm] in punctual and contact mode, 40 mW, spot size 0.042 cm(2), 3 J/cm(2) and 5 J/cm(2) (3 s and 5 s, respectively). Positive [10% fetal bovine serum (FBS)] and negative (1%FBS) controls were not irradiated. Production of keratinocyte growth factor (KGF) and basic fibroblast growth factor (bFGF) was quantified by enzyme-linked immunosorbent assay (ELISA). The data were statistically compared by analysis of variance (ANOVA) followed by Tukey's test (P

Nd:YAG laser clinical assisted in class II furcation treatment.

The Nd:YAG laser efficacy associated with conventional treatment for bacterial reduction has been investigated throughout literature. The purpose of this study was to evaluate the bacterial reduction after Nd:YAG laser irradiation associated with scaling and root planning in class II furcation defects in patients with chronic periodontitis. Thirty-four furcation lesions were selected from 17 subjects. The control group received conventional treatment, and the experimental group received the same treatment followed by Nd:YAG laser irradiation (100 mJ/pulse; 15 Hz; 1.5 W, 60 s, 141.5 J/cm(2)). Both treatments resulted in improvements of most clinical parameters. A significant reduction of colony forming unit (CFU) of total bacteria number was observed in both groups. The highest reduction was noted in the experimental group immediately after the treatment. The number of dark pigmented bacteria and the percentage of patients with Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans reduced immediately after the treatment and returned to values close to the initial ones 6 weeks after the baseline for both groups. The Nd:YAG laser associated with conventional treatment promoted significant bacterial reduction in class II furcation immediately after irradiation, although this reduction was not observed 6 weeks after the baseline.

Radiographic alveolar bone loss in patients undergoing periodontal maintenance.

The aim of the present cross-sectional investigation was to evaluate percentage of bone loss in patients who had been one year under periodontal maintenance at the Department of Periodontology, Faculty of Dentistry, University of São Paulo by radiographic analysis. Complete sets of periapical radiographs provided data regarding percentage of alveolar bone loss, which was correlated with arches, tooth group and proximal sites. The sample consisted of 27 men and 53 women ranging in age from 16 to 85 years (mean: 48.3 years). A total of 1,120 periapical radiographs (1,970 teeth) were digitized and analyzed with the Image Tool software (University of Texas Health Science Center). Bone loss was defined as when the distance between the cemento-enamel junction and the alveolar bone crest was greater than 2 mm. Two examiners (p<0.0001) performed radiographic measurements of bone loss. The Greenhouse-Geisser normality test and a univariate analysis of variance were used for statistical analysis. Mean bone loss was 20.60% (+/-12.12). The highest level of bone loss was observed on the distal surface and in the upper arch, as well as in the upper incisors and molars.

Laser de Diodo em periodontia estudo "in vivo" da redução bacteriana em bolsas periodontais, como coadjuvante ao tratamento radicular convencional / Diode Ia ser in periodontics: an in vivo study of bacterial reduction in periodontal pockets, as an adjuvant of conventional treatment

O laser de Diodo de alta intensidade tem sido estudado em periodontia para redução da microbiota subgengival no tratamento não cirúrgico, como coadjuvante aos procedimentos de raspagem. O objetivo deste estudo foi avaliar a redução bacteriana e mudanças nos parâmetros clínicos promovida pela raspagem associada ou não ao laser de Diodo de alta (808:t5nm) intensidade, em 27 pacientes, de ambos os sexos, portadores de periodontite crônica, em dentes unirradiculares com profundidade clínica de sondagem maior ou igual a 5mm. O estudo foi cego, comparativo randomizado, onde todos os pacientes receberam, primeiramente, preparo de boca e em seguida foram subdivididos em dois grupos: teste e controle. Ambos os grupos receberam raspagem dos sítios experimentais, sendo que apenas o grupo teste recebeu aplicação do laser de Diodo (1,5W, contínuo, 20s) 1 mm aquém da profundidade clínica de sondagem (PGS), em duas sessões, com intervalo semanal. Os parâmetros clínicos e microbiológicos avaliados, foram coletados no início e 6 semanas após o tratamento. De acordo com a metodologia desenvolvida, pudemos concluir que: o laser de Diodo de alta intensidade associado à raspagem, assim como a raspagem isolada, demonstraram melhoras estatisticamente significantes em relação à média do número de ufcs de bactérias totais, à média do número de ufcs de bactérias pigmentadas de preto e à média do número total de ufcs de Actinobacillus actinomycetemcomitans, porém sem diferença estatística entre os grupos. Quanto aos parâmetros clínicos índice de Placa, sangramento à sondagem, distância Margem Gengival - Junção Esmalte Gemento (IP, IG, distância MG-JEG) os resultados foram semelhantes para ambos os grupos.

The use of high intensity Diode laser for bacterial reduction in subgingival microbiota as an adjuvant to no surgical periodontal treatment has been approached in several studies. The purpose of this study was to evaluate the bacterial reductíon and clínical changes after root scaling associated or not to Diode laser irradiation. This clinical trial was a blinded, randomized and consisted of 27 patients of both sex, mean age 48.5 years old, with chronic periodontites and pocket depth 2: 5mm. They received previous periodontal treatment, except for the experimental sites. The control group underwent manual scaling and the test group received the same treatment followed by the Diode laser irradiation (1.5W; Continuous Wave; 20sec), 1 mm less than the pocket depth in two weekly appointments one day after the scaling to avoid laser thermal damage. The clinical (Plaque Index, bleeding on probing, Pocket Depth, Clinical Attachment, Enamel-cement junction gingival marge Distance) and microbiologic (Total bacteria CFlJ, Black pigmented CFU, Actinobacillus actinomycetemcomitans) parameters were evaluated before and six weeks after the treatment. As a conclusion after the end of study, both groups demonstrated microbiological improvements six weeks after treatment without statistical differences between than. The clinical parameters, Plaque Index (PI) bleeding on probing (BP) showed clinical improvements for both group without difference between than.

Atuação dos lasers terapêuticos em periodontia: revisão de literatura / The use of therapeutic lasers in periodontics: literature review

Essa revisão da literatura teve por finalidade avaliar os principais trabalhos sobre a atuação dos lasers terapêuticos tanto na reparação tecidual como na redução bacteriana em Periodontia. Apesar de ainda não existirem parâmetros totalmente definidos para a utilização desses lasers, os estudos sugerem que os mesmos parecem atuar como facilitadores da reparação tecidual e como coadjuvantes no processo de redução bacteriana quando associados a corantes fotossensíveis.

This literature review had the purpose of report the activity of therapeutic lasers on gingival tissue restitution and on the bacterial reduces in Periodontics. Despite of doesn't exist yet parameters totally defined to use this, the studies suggest that the therapeutic lasers seem to improve tissue restitution and facilitate the bacterial reduces when associated to photosensitizer.

Orthodontic extrusion with or without circumferential supracrestal fiberotomy and root planing.

The aim of this randomized clinical trial was to carry out a biometric comparison between the orthodontic extrusion (OE, group B) technique and OE combined with fiberotomy and root planing (OEFRP, group A). Twenty single-root teeth were extruded and assigned to two different groups. In both groups, fixed orthodontic appliances were activated weekly during the course of 3 weeks. After activation, the extruded teeth were maintained in retention for a period of 8 weeks. In group A, along with weekly activation, fiberotomy and root planing were carried out on the top of the alveolar bone crest. Statistical analysis revealed that the amount of dental structure exposed was greater in group A, where the gingival margin and bone tissue remained stable (P < .05). Group B presented coronal migration of the gingival tissue and bone tissue of 2 mm and 1.5 mm, respectively.

Mensuração da perda óssea alveolar em radiografias: quais são os recursos disponíveis na prática clínica? / Measurement of alveolar bone loss and methods available in pratical clinic

É indiscutível a importância do exame radiográfico conjugado ao exame clínico na avaliação e no tratamento das doenças periodontais. As radiografias intra-bucais são rotineiramente utilizadas na clínica para dar suporte ao diagnóstico, ao plano de tratamento, ao prognóstico e, finalmente, à análise, a longo prazo, do resultado do tratamento instituído (ARMITAGE, 1996). Esta revisão revelou que, na prática clínica, as radiografias periapicais e interproximais são as mais utilizadas quando o objetivo é mensurar a perda óssea alveolar. Essas imagens aparecem sempre associadas a sondas periodontais milimetradas (convencionais ou eletrônicas), lupas, réguas, compassos de ponta seca, telas milimetradas e programas de computador. Adicionalmente, observou-se que a ausência de integridade do tecido ósseo foi descrita sempre que a distância entre a junção esmalte cemento (JCE) e a crista óssea alveolar (COA) se apresentava > 2 mm.