RÉSUMÉ
O estágio de desenvolvimento humano é intimamente relacionado à sua maturidade óssea ou dentária, sendo essencial para a escolha do tratamento de alterações dentofaciais em crianças e adolescentes por ortodontistas e odontopediatras. Existem diversos indicadores biológicos para determinar a maturação do indivíduo, como a idade cronológica e as alterações hormonais, porém esses indicadores podem sofrer interferências. Visando uma determinação de desenvolvimento e dos picos de crescimento mais precisa, para um melhor diagnóstico e plano de tratamento, foram desenvolvidos diversos métodos para determinar a idade esquelética e a idade dentária, sendo estes a avaliação da maturação carpal, da morfologia das vértebras cervicais, da fusão óssea da sincondrose esfeno-occipital e da sutura palatina mediana, bem como dos estágios da calcificação dentária. A avaliação das radiografias de mão e punho é o padrão ouro da predição da idade esquelética, e sua correlação com outros métodos já é evidente. Sendo assim, é possível utilizar a avaliação das vértebras cervicais e das idades dentárias de Nolla e Demirjian.
The stage of human development is closely related to bone or dental maturity, being essential for the choice of treatment for dentofacial changes in children and adolescents by orthodontists and pediatric dentists. There are several biological indicators to determine an individual's maturation, such as chronological age and hormonal changes, but these indicators can suffer interference. Aiming at a more accurate determination of development and growth peaks, for a better diagnosis and treatment plan, several methods have been developed to determine skeletal age and dental age, these being the assessment of carpal maturation, the morphology of the cervical vertebrae, bone fusion of the spheno-occipital synchondrosis and the median palatal suture, as well as the stages of dental calcification. The evaluation of hand and wrist radiographs is the gold standard for predicting skeletal age, and its correlation with other methods is already evident. Therefore, it is possible to use the assessment of cervical vertebrae and dental ages by Nolla and Demirjian.
RÉSUMÉ
OBJECTIVES: To systematically review existing literature regarding clinical parameters comparing surgical laser and conventional surgery with scalpel for soft tissue adjunctive periodontal procedures in orthodontic patients. METHODS AND MATERIALS: MEDLINE, Scopus, Web of Science, The Cochrane Library, LILACS, Bibliografia Brasileira de Odontologia (Brazilian Dental Literature - BBO), Embase, Open Grey, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Coordination for the Improvement of Higher Education Personnel - CAPES), and Google Scholar were searched up to December 2020 without language restriction. Clinical trials comparing clinical parameters from surgical laser and conventional surgery with scalpel for soft tissue adjunctive periodontal procedures in orthodontic patients were selected. Risk of bias (RoB) assessments were performed using the Cochrane RoB2 tool. Narrative syntheses were performed, and the certainty of evidence was determined using the GRADE tool. RESULTS: Five randomized clinical trials were included. One study was rated as low RoB, whereas others presented some concerns or high RoB. The studies were highly heterogeneous in relation to the procedure performed, laser protocol, outcomes evaluated, and follow-up periods. In general, regardless of the procedure and laser protocol used, the studies did not show significant differences between laser and scalpel for the outcomes of probing pocket depth, clinical crown length, gingival index, and relapse rate. Pain and bleeding were significantly lower with the use of laser compared with the scalpel. The certainty of evidence ranged from moderate to very low. CONCLUSIONS: The existing literature on the subject is scarce and very heterogeneous and has methodological limitations. Based on the available evidence, it is not possible to draw definitive conclusions about the beneficial effect of laser use in orthodontic patients.
Sujet(s)
Soins dentaires , Brésil , Humains , Indice parodontalRÉSUMÉ
Cryptophytes are a small group of photosynthetic biflagellate organisms distributed worldwide in fresh, brackish and marine waters. Although members of this class are easily distinguished from other groups, species identification is difficult and studies concerning their diversity are scarce. Two strains of an undescribed Hemiselmis species were isolated from the marine waters off Brazil and Japan. Analyses of morphology, phycobiliprotein spectral characterization, molecular phylogeny and ITS2 secondary structure comparisons were performed to assist the identification. The morphological features of Hemiselmis aquamarina sp. nov. matches that of other species from the same genus, but it has a new type of phycocyanin. Molecular phylogeny and ITS2 secondary structure support H. aquamarina as a distinct species. Furthermore, phylogenetic inferences indicate H. aquamarina as closely related to H. tepida, H. andersenii and H. rufescens. Currently, all Hemiselmis species have been described from the Northern Hemisphere and most from the subtropical region. H. aquamarina is the first species of this genus described from the South Atlantic.
Sujet(s)
Cryptophyta , Phycobiliprotéines , Cryptophyta/génétique , Japon , Photosynthèse , PhylogenèseRÉSUMÉ
O objetivo do estudo foi analisar os efeitos da técnica de preenchimento com ácido hialurônico em gel em pacientes com triângulos negros, quanto ao preenchimento da papila interdental, durabilidade e recidiva dos efeitos do preenchimento; e à percepção do paciente quanto ao triângulo negro e à aplicação do ácido hialurônico. A amostra consistiu em 51 sítios de aplicação de 15 pacientes com triângulos negros na região anterior superior ou inferior. Foi realizado tratamento periodontal não cirúrgico, instruções de higiene bucal personalizadas, exame clínico e exame periodontal. Foram realizadas radiografias periapicais digitais dos dentes adjacentes ao defeito gengival, como medida controle; e aquisição de imagens fotográficas, realizadas perpendicularmente aos dentes de interesse, com auxílio de um posicionador personalizado para cada paciente, padronizando a distância da tomada fotográfica. As imagens fotográficas foram inseridas no programa ImageJ para avaliação da área do espaço negro. Aplicaram-se, para cada paciente, questionários, sobre a percepção do triângulo negro e sua vontade de corrigi-lo, e sobre a percepção do procedimento. Foram injetados até 0,1 ml de ácido hialurônico de cross-linking elevado 2-3 mm apical à extremidade mais oclusal da papila interdental em três tempos, com três semanas de intervalo entre eles. As respostas locais foram bastante variáveis entre indivíduos, locais de aplicação, e tamanho dos triângulos negros, havendo desde nenhuma modificação até a eliminação total do espaço. Todas as variáveis das profundidades de sondagem tiveram valores significativos na comparação de T0 a T4. A distância entre o ponto de contato e a crista óssea não mudou ao longo do tempo. A taxa de preenchimento da papila interdentária foi bastante variável, variando de nenhum preenchimento ao preenchimento completo da papila. Durante o período observado, os resultados obtidos foram mantidos. Os pacientes se declararam bastante incomodados com a presença do triângulo negro, e apesar da sensação dolorosa durante a aplicação se mostraram satisfeitos com o resultado e informaram que se submeteriam novamente ao procedimento. O AH injetável pode ser um tratamento promissor para melhorar a estética papilar. (AU)
The objective of this study was to analyze the effects of the hyaluronic acid gel filling technique in patients with black triangles regarding interdental papilla filling, durability and recurrence of filling effects; and the patient's perception about the black triangle and application of hyaluronic acid. The sample consisted of 51 sites of application from 15 patients with black triangles located in the upper or lower teeth in anterior region. Non-surgical periodontal treatment, personalized oral hygiene instructions, clinical examination and periodontal examination were performed. Digital periapical radiographs of the teeth adjacent to the gingival defect were performed as a control measure; and acquisition of photographic images, performed perpendicular to the teeth of interest, with the aid of a customized positioner for each patient, standardizing the distance of the photographic socket. The photographic images were inserted in the ImageJ program to evaluate the black space area. For each patient, questionnaires were applied on the perception of the black triangle and its willingness to correct it, and on the perception of the procedure. Up to 0.1 ml of cross-linking hyaluronic acid raised 2-3 mm apical to the most occlusal end of the interdental papilla in three times, with a three-week interval between them, were injected. All variables of probing depths had significant values in the comparison of T0 to T4. Distance between the point of contact and the bone crest did not change over time. The filling rate of the interdental papilla was quite variable, ranging from no filling to full filling of the papilla. During the observed period the obtained results were maintained. Patients were very uncomfortable with the presence of the black triangle, and despite the painful sensation during the application, they were satisfied with the results and would undergo the procedure again. Injectable hyaluronic acid gel may be a promising treatment for enhancing papillary esthetics. (AU)