Condição bucal de comunidades em vulnerabilidade social: análise descritiva de um projeto voluntário paranaense / Oral health condition of communities in social vulnerability: descriptive analysis of a volunteer project in Paraná

O presente trabalho relata o impacto social e o papel do cirurgião--dentista nas ações do Projeto Pró-Riso por meio de análise descritiva das ações. O projeto Pró-Riso é uma iniciativa voluntária, sem fins políticos, religiosos ou lucrativos, que leva atendimento odontológico, assistência médica e educação em saúde a comunidades em vulnerabilidade social. Foi realizada a análise dos prontuários dos pacientes atendidos pelo projeto em 2019. As ações ocorreram nas comunidades do Pilarzinho e Caximba (Bairros do município de Curitiba) e Amparo (comunidade isolada em Área de Proteção Ambiental no município litorâneo de Paranaguá), locais de elevada prevalência de doenças bucais. Tal situação reflete uma importante questão de Saúde Pública para o país. Os resultados mostram que foram atendidos 260 pacientes, com diversas necessidades de tratamento bucal. Destes, 63% tiveram seus tratamentos concluídos nas ações. Ressalta-se, assim, a importância de trabalhos sociais que proporcionem melhor qualidade de vida e saúde a comunidades em vulnerabilidade social. (AU)

This paper reports the social impact and role of the dentist in the actions of the Pró-Riso Project through descriptive actions analysis. The Pró-Riso project is a voluntary, non-political, religious or for profit initiative that takes dental care, medical assistance and health education to communities in social vulnerability. An analysis of the medical patients records assisted by the project in 2019 was carried out. The actions took place in the communities of Pilarzinho and Caximba (Curitiba Municipality neighborhoods) and Amparo (isolated community in an Environmental Protection Area in the coastal municipality of Paranaguá), places of high prevalence of oral diseases. This situation reflects an important Public Health issue for the country. The results show that 260 patients were treated, with different needs for oral treatment. Of these, 63% had their treatments completed in the actions. Thus, the importance of social work that provides better health life quality to communities in social vulnerability is highlighted. (AU)

Use of Low-Dose Alendronate Improves Cranial Bone Repair and Is Associated With an Increase of Osteocalcin: An Experimental Study.

PURPOSE: The objective of the present study was to evaluate cranial bone repair and remodeling after systemic application of alendronate (ALN), using histologic analysis, histometric analysis, and immunohistochemistry (osteocalcin). MATERIALS AND METHODS: Female rabbits (n = 28) were randomly divided into 2 groups: control (C) and ALN treated (A). Group A received 3 systemic intraperitoneal injections of ALN weekly for 4 weeks, at a dose of 0.2 mg/kg. Group C received intraperitoneal injections of physiologic saline for the same period. After 4 weeks, all the rabbits underwent surgery to create 2 noncritical defects on the calvaria (5 mm in diameter). The groups were divided into 2 subgroups for sacrificing, at 15 and 60 postoperative days. After death, the analyses were performed. The data were also analyzed statistically. RESULTS: Histologic analysis of group C revealed healing in the dense connective tissue and trabecular bone, and the presence of compact bone with osteoblastic activity was noted in both 15- and 60-day subgroups. In group A, at 15 days, the presence of conjunctive tissue with osteoblastic activity and intense, compact, newly formed bone was observed. At 60 days, the created bone defect in group A showed a large amount of neoformed compact bone with a surface of dense modeled connective tissue and the presence of adipocytes and trabecular bone. The histometric analysis confirmed that a statistically significant difference was present between groups C and A when comparing the measured bone area and the area of connective tissue. Group A presented with a statistically significant larger amount of bone area in the 60-day subgroup than in the 15-day subgroup. The immunohistochemical analysis showed stronger immunostaining for osteocalcin in group A. CONCLUSIONS: Within the limits of the present study, our results have shown that the systemic application of ALN, at a dose of 0.2 mg/kg, increased the repair and remodeling of cranial bone.

Bond strength evaluation of cyanoacrylate-based adhesives and screws for bone fixation.

INTRODUCTION: Bone graft is a very common procedure that is performed when bone volume needs to be increased before a dental implant. Screws and miniplates are the clinical standards for osteosynthesis. However, some disadvantages for this method have been reported, including artifacts on radiological images, infection, screw loosening, and the need to remove screws that interfere with the dental implants. Bone adhesives are a promising alternative for bone graft surgery. PURPOSE: The aim of this study was to compare the shear bond strength of two cyanoacrylate-based adhesives and titanium screws for bone graft fixation. METHODS: Pig jaw samples were cut into rectangular bars (2 × 6 × 20 mm) and bonded with a 5-mm overlap of N-butyl cyanoacrylate and ethyl cyanoacrylate, and 1.5-mm titanium screws were inserted into the center of the contact area. The blocks were fixed on a shear bond strength device that was coupled to a universal testing machine. The maximum force (N) was recorded on a computer and divided by the bonded area (in mm(2)) in order to calculate the bond strength (MPa). The data were statistically analyzed with ANOVA and Tukey's test (α = 0.05). RESULTS: The shear bond strengths of the screws were significantly higher than both cyanoacrylate adhesives, which presented statistically similar bond strength means, and have the biomechanical potential to be used for bone fixation. CONCLUSIONS: Ethyl cyanoacrylate is an inexpensive adhesive that has multiple purposes and can be considered as an alternative for bone fixation.

Leukocyte-platelet-rich plasma (L-PRP) induces an abnormal histophenotype in craniofacial bone repair associated with changes in the immunopositivity of the hematopoietic clusters of differentiation, osteoproteins, and TGF-ß1.

BACKGROUND: Leukocyte-platelet-rich plasma (L-PRP) is considered an important source of growth factors, especially Transforming growth factor ß 1 (TGF-ß1), which modulates the proliferation and regulation of mesenchymal cells, and also exerts an influence on the hematopoiesis, osteogenesis, and adipogenesis in bone microenvironment. Thus, the aim of this study was to evaluate the effect of L-PRP on the calvarial bone repair and compare its results on the presence of TGF-ß1, CD34, CD45, bone morphogenetic protein 2 (BMP2), BMPR1B, and Runx2 proteins detected by immunohistochemistry. MATERIAL AND METHODS: Four bone defects were created on the calvaria of 23 rabbits. The defects were treated with autograft, L-PRP alone, and L-PRP mixed with autograft. The animals were euthanized at 2, 4, and 6 weeks post-surgery. RESULTS: Unlike autograft and sham groups, the defects treated with L-PRP demonstrated significant positivity to TGF-ß1, while the BMP2 was scarce. These results coincided with the lower bone matrix deposited and larger medullary area, which were composed of fibrosis, when treated with only L-PRP, or intense adiposity on defects filled with L-PRP mixed with autograft. The fibrosis that occurred was associated with a minor percentage of osteoproteins, intense presence of CD34(+) CD45(-) cells, and significant expression of TGF-ß1 in all time periods analyzed. The adiposity occurred from the major presence of osteoprogenitor BMPR1B (+) Runx2(+) cells simultaneously to BMP2(-) TGF-ß1(+) and CD34(+) CD45(+/-) expressions predominantly on the earlier period. CONCLUSION: From this study, it can be concluded that the L-PRP used alone or mixed to autograft hindered the osteoneogenesis due to suppression of immunoexpression of BMP2, while the immunopositivity of TGF-ß1 was intense. When used alone, the L-PRP induced a fibrotic condition associated with TGF-ß1 presence and lack of osteoproteins, but when L-PRP was mixed to autograft, it induced the presence of the osteolineage cells (BMPR1B (+) Runx2(+) ), but also inhibited the terminal osteoblastic maturation associated with the lack of BMP2 and the presence of TGF-ß1(+) , a fact that contributed to cellular transdifferentiation into fat cells.

Cirurgia plástica periodontal para correção de sorriso gengivoso / Periodontal plastic surgery for treatment of gummy smile. Reports of clinical

A necessidade de um sorriso perfeito e de tratamentos estéticos tem aumentado nos últimos anos. O sorriso é determinado por posição, forma, tamanho do dente, textura, cor e linha da gengiva e dos lábios e a forma da maxila. O objetivo do presente trabalho foi relatar dois casos clínicos de sorriso gengivoso e descrever os diferentes fatores etiológicos e as formas de tratamento.