Soft Tissues Changes After Immediate and Delayed Single Implant Placement in Esthetic Area: A Systematic Review.

The aim of the present study was to conduct a systematic review of the literature to compare soft tissue aspects of immediate and delayed implant placement in esthetic areas. This review of literature was conducted in the following databases: MEDLINE (PubMed), Lilacs, Scielo, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). For those studies that met the inclusion/exclusion criteria, the results were analyzed and summarized according to the treatment protocol used for implant placement. The primary parameters taken into consideration were papilla level (PL) and marginal mucosa level (MML) around implants. Four randomized controlled trials (RCT) were selected for analysis, but all were deemed as being of poor quality according to quality assessment. No studies reported any statistically significant differences concerning the soft tissue esthetic parameters analyzed around immediate or delayed implants at any follow-up periods reported. However, PL results seemed to be more reliable than were MML results, due to the PL standardization of the method of analysis, which showed a tendency for poorer results around immediately placed implants. In conclusion, although the results are based on only a few poor quality RCTs, both treatment options for implant placement demonstrated similar outcomes in the esthetic area, especially when PL was considered.

Efeitos nos níveis clínicos e de s. mutans de um protocolo de controle de biofilme dental em adolescentes portadores de aparelho ortodôntico fixo / Effect on the clinical levels of s. mutans of a dental biofilm control protocol in adolescents with fixed orthodontic appliances

A utilização de acessórios durante o tratamento ortodôntico fixo aumenta o risco à ocorrência de manchas brancas, cárie e gengivite devido aos sítios retentores de biofilme dental. O objetivo deste estudo foi observar o efeito de um protocolo de controle de biofilme dental nos níveis de gengivite e risco à cárie em adolescentes portadores de aparelho ortodôntico fixo. Foram selecionados 21 pacientes de ambos os gêneros, entre 12 e 18 anos, que usavam aparelho fixo. Os critérios de exclusão foram: doenças sistêmicas, uso de antibiótico, gravidez e fumo. Os pacientes receberam instrução de higiene oral individualmente, reforçada mensalmente, e tiveram a saliva coletada no início e no final do estudo para avaliar o número de streptococcus mutans (SM) em unidades formadoras de colônias (UFC) e o risco à cárie. Nos tempos 1, 30, 60 e 90 dias, foram analisados os níveis clínicos de placa bacteriana corada (IPC) e gengivite (IG). Os pacientes receberam profilaxia com jato de bicarbonato de sódio a cada exame. Para comparação da contagem de SM nos dois tempos analisados, foi utilizado o teste t de Student; para os tempos do IPC e IG, utilizou-se a análise de variância (Anova), com post-hoc Tukey, ambos com significância de 5%. Ocorreu redução entre as avaliações iniciais e finais do IPC (72,72% ± 11,93% para 54,18% ± 16,87%), do IG (1,10 ± 0,47 para 0,44 ± 0,27) e da contagem de SM (1,16 ± 1,345 UFC para 0,536 ± 0,56 UFC), todos com p < 0,05. A implementação do protocolo melhorou as condições de gengivite e risco à cárie na população durante o período de estudo.

The use of appliances during fixed orthodontic treatment increases the risk of occurrence of white spot, caries and gingivitis due to presence of dental biofilm at the retentive sites. The objective of this study was to observe the effect of a dental biofilm control protocol on the levels of gingivitis and caries risk in adolescents with fixed orthodontic appliances. Twenty-one patients of both genders, between 12 and 18 years, participated in the study. The exclusion criteria were: systemic diseases, use of antibiotics, pregnancy and smokers. Patients received individual monthly oral hygiene instructions, and had their saliva collected at the beginning and the end of the study to assess the number of streptococcus mutans (SM) in colony forming units (CFU) and caries risk. At 1, 30, 60 and 90 days, clinical levels of bacterial plaque (CPI) and gingivitis (GI) were analyzed. Patients received prophylaxis with sodium bicarbonate jets at each exam. Student t test was used to compare SM counts at the two analyzed moments, while analysis of variance (Anova) was used for CPI and GI times, followed by Tukeyposthoc test, at a significance of 5%. Reductions in CPI levels (72.72% ± 11.93% to 54.18% ± 16.87%), GI levels (1.10 ± 0.47 to 0.44 ± 0.27) and SM counts (1.16 ± 1.345 UFC para 0.536 ± 0.56 UFC) were observed between the initial and the final assessments, all with p < 0.05. The implementation of the biofilm control protocol improved gingivitis conditions and caries risk in the population studied during the experimental period.