Deproteinized bovine bone derived with collagen improves soft and bone tissue outcomes in flapless immediate implant approach and immediate provisionalization: a randomized clinical trial.

OBJECTIVES: This study aimed at evaluating soft and hard tissue dimensions after immediate implant placement and immediate temporization with or without alveolar preservation at the maxillary anterior region. MATERIALS AND METHODS: Twenty-two patients needing maxillary incisor extraction and with the possibility of immediate implant placement were randomly assigned to the following groups: test (n = 11): immediate implant placement + deproteinized bovine bone derived with collagen inserted into the alveolus or control (n = 11): immediate implant placement without biomaterial. All soft tissue measurements were evaluated at baseline, 3 months, and 6 months after implant therapy. Cone beam tomography was performed at baseline and at 6 months after implant placement to evaluate hard tissue dimension. RESULTS: The test group presented higher height of soft tissue at mesiobuccal and distobuccal sites at 3 months and 6 months when compared to the control group (p < 0.05). Regarding the bone tissue, the test group showed higher buccolingual ridge dimension at 6 months when compared to the control group (p < 0.05). CONCLUSIONS: It can be concluded that the use of deproteinized bovine bone derived with collagen together with immediate dental implants results in better soft and bone tissue outcomes than immediate implants alone. CLINICAL RELEVANCE: The use of deproteinized bovine bone derived with collagen may enhance the results regarding soft and bone tissue in combination with immediate implant and temporization.

Defeito ósseo de Stafne û relato de dois casos / Stafne bone defect û report of two cases

A cavidade óssea de Stafne, também conhecida como pseudocisto de Stafne ou cavidade óssea idiopática, tem gerado muitos conflitos nos diagnósticos entre os profissionais de Odontologia. A lesão supracitada faz parte de um conjunto de lesões radiolúcidas e assintomáticas descritas por Edward Stanfe (1942) e está topograficamente localizada entre o ângulo mandibular e o primeiro molar inferior, abaixo do canal alveolar inferior, sendo denominada de depressão óssea mandibular lingual posterior. O tratamento consiste apenas em acompanhamento radiográfico e tomografia...

The bone cavity Stafne, also known as pseudocyst of Stafne or idiopathic bone cavity, has generated many conflicts regarding diagnosis among dental professionals. The aforementioned lesion is part of a set of radiolucent and asymptomatic lesions described by Edward Stanfe in 1942 and is topographically located between the mandibular angle and the lower first molar, under the inferior alveolar channel, and it is called posterior lingual mandibular bone depression. Treatment consists only of radiographic follow-up and cone-beam tomography...

Utilização de guias cirúrgicas para colocação de implantes dentários: revisão de literatura / The use of surgical guides for dental implant placement: literature review

Objetivo: esse trabalho pretendeu, por meio de uma revisão de literatura, evidenciar a literatura existente que abordou o tema de guias cirúrgicas utilizadas na implantodontia. Materiais e Métodos: pela revisão de literatura, foi possível abordar o tema com relatos de caso, outras revisões de literatura, estudos in vitro e estudos in vivo com pacientes. Sabemos também que diferentes tipos de guias cirúrgicas foram utilizadas, como as dento-suportadas, muco-suportadas e as apoiadas em osso. Os estudos avaliaram a precisão na colocação do implante utilizando a tomografia computadorizada para colocação virtual do implante, por meio de softwares, e comparando com a tomografia obtida após a colocação do implante. Dessa maneira, os estudos avaliaram a posição do implante no nível coronário e apical, bem como o desvio angular deste. Pelos resultados, pode-se perceber que a precisão e acurácia na colocação dos implantes é maior nos estudos in vitro em relação aos estudos in vivo clínicos. Conclusão: a utilização de guias cirúrgicas pode ser um grande avanço na tecnologia de colocação de implantes dentários, no entanto, mais estudos com maior critério de evidência científica devem ser conduzidos para que a utilização das guias seja melhor sustentada cientificamente.

Objective: The objective of this study was, based on a literature review, evidenciate the literature that approached the subject surgical guides in dental implants. Materials and Methods: it was possible, through the literature review, introduce the subject with case reports, another literature reviews, in vitro studies and in vivo clinical studies. Different types of surgical guides were evaluated, as supported by teeth, muco-supported and bone fixed. The studys evaluated the precision at the dental virtual implant positioning, using the computed tomography, using softwares, and comparing with the computed tomography obtained after the implant placement – the factual implant, and using a software, compare the virtual implant with the factual implant. In this course, studys evaluated the position of the implant at coronal and apical level, and the angular deviation. Based on the studys results, the implant position is more accurate at in vitro studys, compared to the in vivo studys. Conclusion: The use of surgical guides can be a enourmous advance in technology at the dental implant instalation, although more studys with a major critery of scientific evidence must be conducted for the surgical guide more scientific sustentaion useness.

Assessment of the correlation between insertion torque and resonance frequency analysis of implants placed in bone tissue of different densities.

The primary stability of dental implants is fundamental for osseointegration. Therefore, this study aimed to assess the correlation between insertion torque (IT) and resonance frequency analysis (RFA) of implants placed in mandibles and maxillas of different bone densities. Eighty dental implants were placed in maxillas and mandibles, and IT and the implant stability quotient (ISQ) were measured at the time of implant insertion. Bone density was assessed subjectively by the Lekholm and Zarb index. The type I and II densities were grouped together (group A)as were the type III and IV densities (group B). The IT in group A was higher (Student t test, P = .0013) than in group B (46.27 ± 18.51 Ncm, 33.62 ± 14.74 Ncm, respectively). The implants placed in group A showed higher ISQ (Student t test, P = .0004) than those placed in group B (70.09 ± 7.50, 63.66 ± 8.00, respectively). A significant correlation between IT and the ISQ value was observed for group A (Pearson correlation test; r = 0.35; P = .0213) and for group B (r = 0.37; P = .0224). Within the limitations of this study, it was possible to conclude that there is a correlation between IT and RFA of implants placed in mandibles and maxillas of different bone densities.

Two-stage bone expansion technique using spear-shaped implants associated with overlapped flap: a case report.

The conventional method of ridge expansion uses a mucoperiosteal flap elevation to allow bone corticotomy, which is followed by bone expansion performed with chisels and bone expanders. To facilitate corticotomy and avoid flap elevation, bone expansion can be performed in 2 stages. This case report presents a modified 2-stage bone expansion technique to achieve better implant stabilization and wound closure. This modified approach may be an efficient procedure for minimizing complications.

Subgingival ultrasonic instrumentation of residual pockets irrigated with essential oils: a randomized controlled trial.

AIM: To evaluate the clinical efficacy of subgingival ultrasonic instrumentation irrigated with essential oils (EOs) of residual periodontal pockets. MATERIAL AND METHODS: Sixty-four individuals with chronic periodontitis were invited to participate in this randomized, double-blind, parallel, and placebo-controlled clinical trial. All subjects received non-surgical periodontal therapy. After re-evaluation (baseline), residual pockets (pocket depth ≥5 mm) received test (ultrasonic instrumentation irrigated with EOs) or control therapy (ultrasonic instrumentation irrigated with negative control). Probing pocket depth (PPD), gingival recession (R), clinical attachment level (CAL), bleeding on probing (BOP), and plaque were assessed at baseline and after 4, 12, and 24 weeks. Differences between groups and changes over the course of time were analysed according to a generalized linear model. RESULTS: There was a significant reduction in PPD and BOP, as well as a significant CAL gain in the two groups (p<0.001). Nevertheless, there were no differences between the groups at any time of the study. When only initially deep pockets (PPD ≥7 mm) were analysed, a significantly greater CAL gain (p=0.03) and PPD reduction (p=0.01) was observed in the test group. CONCLUSION: The adjunctive use of EOs may promote significant CAL gain and PPD reduction in deep residual pockets.

Clinical investigation of the efficacy of a commercial mouthrinse containing 0.05% cetylpyridinium chloride in preventing dental plaque.

OBJECTIVE: The objective of this independent, double-blind, seven-day clinical study was to assess the efficacy of a commercially available mouthrinse containing 0.05% cetylpyridinium chloride (CPC) in preventing dental plaque build-up relative to that of a control mouthrinse without 0.05% CPC. METHODS: Adult male and female subjects from the São Paulo, Brazil area reported to the clinical facility, having refrained from any oral hygiene procedures for 12 hours, and from eating, drinking, and smoking for four hours, for an assessment of the oral soft and hard tissues and a baseline dental plaque evaluation. Subjects qualifying for participation received a complete dental prophylaxis. Qualifying subjects were randomly assigned into one of the two treatment groups and were provided with their assigned mouthrinse, an adult soft-bristled toothbrush, and a commercially available fluoride toothpaste for home use. Over the seven-day period of home use, during which there were no restrictions regarding diet or smoking habits, subjects were instructed to brush their teeth for one minute twice daily (morning and evening) with the toothbrush and toothpaste supplied, to rinse their mouths with water after brushing, and then to rinse with 15 ml of their assigned mouthrinse for one minute before expectorating. The use of other oral hygiene products or procedures, such as floss or interdental stimulators, was not permitted during the study. After seven days of product use, subjects returned to the clinical facility having followed the same restrictions with respect to oral hygiene procedures, eating and drinking, as prior to the baseline examination, and the oral soft and hard tissue assessments and dental plaque evaluations were repeated. RESULTS: Forty-three subjects complied with the protocol and completed the study. Results demonstrated that after seven days of product use, mean plaque levels were statistically significantly lower (p < 0.05) than the pre-prophylaxis levels for both treatment groups. The mean plaque level for the CPC mouthrinse group was 46.1% of the pre-prophylaxis plaque level, whereas the mean plaque level for the control mouthrinse group was 75.5% of the pre-prophylaxis plaque level. The results demonstrate a statistically significant reduction in plaque build-up for the CPC mouthrinse group (29.3%) as compared to the control group. CONCLUSION: The overall results from this double-blind clinical study support the conclusion that, after seven days of product use, a mouthrinse containing 0.05% CPC provides significantly greater efficacy in preventing dental plaque build-up than a control mouthrinse without 0.05% CPC. As measurements were made 12 hours after final product use, the results also demonstrate that the CPC rinse provides 12-hour protection against dental plaque build-up.

Instrumentação ultra-sônica subgengival irrigada com óleos essenciais embolsas residuais-Ensaio clínico aleatório / Subgingival ultrasonic instrumentation irrigated with essential oils in residual pockets – randomized controlled trial

As diferenças entre os grupos e as alterações ao longo dotempo foram analisadas de acordo com um modelo linear generalizado (análise devariância de medidas repetidas). Houve redução significativa de PCS (1,59mm testee 1,16mm controle) e SS (44,4% teste e 52,62% controle) e ganho em NCI (1,15mmteste e 0,91mm controle) nos dois grupos (p<0,001). No entanto, não houvediferenças entre os grupos ao final do estudo. Quando foram analisadas apenas asbolsas com PCS inicial >7mm observou-se redução significativa na PCS no grupoteste (1,60mm, p = 0,004) e controle (1,10mm, p = 0,0008) e ganho de NCIsignificativo no grupo teste apenas (teste: 1,59mm, p<0,001; controle: 0,71mm,p=0,051), sendo que houve diferença significativa entre os grupos após 24 semanas(p=0,02). Concluiu-se que a instrumentação ultra-sônica subgengival em bolsasresiduais promoveu redução significativa em PCS, SS e ganho significativo de NCI.Além disso, o uso de óleos essenciais como agente irrigante promoveu benefíciosadicionais em ganho de NCI em bolsas > 7mm, quando comparado com o grupocontrole.

The aim of this study was to evaluate the clinical effect of ultrasonic instrumentationirrigated with essential oils in the reduction of sites with a probing depth of 5 mm ormore. For this purpose, a randomized, double-blind, parallel-arm and placebocontrolledclinical trial was conducted. Sixty-four individuals with chronic periodontitiswere invited to participate in this study. The patients were randomly allocated to thetest group (irrigation with essential oils containing 0.064% Thymol, 0.092%Eucalyptol, 0.06% Methyl Salicylate, 0.042% Menthol and 21.6% Alcohol) or control(irrigation with placebo, 21% alcoholic solution). Probing pocket depth (PD), clinicalattachment level (CAL), gingival recession (R), bleeding on probing (BOP) andplaque index (PI) were assessed. The individual was considered the statistical unit.The differences between the groups and the alterations over the course of time wereanalyzed according to a generalized linear model (repeated measures analysis ofvariance). There was a significant reduction in PD (1.59mm test and 1.16mm control)and BOP (44.4% test and 52.62% control) and CAL gain (1.15mm test and 0.91mmcontrol) in both groups (p<0.001). However, there was no difference between groupsat the end of the trial. When sites with PD >7mm at baseline were analyzed, asignificant reduction in PD was observed in test (1.60mm, p = 0.004) and controlgroups (1.10mm, p = 0.0008), as well as a significant gain in CAL in test group only(test: 1.59mm, p<0.001; control: 0.71mm, p=0.051).

Controle químico do biofilme dentário supragengival: revisão de literatura / Chemical control of supragingival dental biofilm

A remoção mecânica da placa bacteriana é a forma mais utilizada de higiene bucal. Entretanto, muitos indivíduos não apresentam destreza e motivação suficientes para realizar uma correta higienização. Assim, o uso complementar de agentes químicos tem sido estudado como um modo de superar as deficiências na higiene bucal. O objetivo deste trabalho foi apresentar uma revisão sobre o uso de produtos para higiene bucal contendo agentes químicos destinados ao controle da placa bacteriana supragengival. Foram revisados estudos in vitro e ensaios clínicos dos seguintes agentes químicos: clorexidina, óleos essenciais, triclosan, cloreto de cetilpiridínio e novos produtos como delmopinol e dióxido de cloro. Os autores concluem que diversos estudos demonstram a eficácia de enxaguatórios contendo clorexidina e óleos essenciais, assim como dentifrícios contendo triclosan. No entanto, mais estudos são necessários para comprovar a eficácia dos demais agentes químicos.

Effectiveness of a triclosan/copolymer dentifrice on dental plaque and gingivitis in Brazilian individuals with cerebral palsy.

This randomized clinical trial investigated the effect of a dentifrice containing triclosan on the reduction of dental plaque and gingivitis in institutionalized individuals with cerebral palsy. Fifty-seven residents were randomly allocated to a test group (n=28, dentifrice with triclosan) and a control group (n=29, conventional dentifrice). A single calibrated investigator performed examinations at baseline and after three months. The amount of dental plaque was assessed, and gingivitis was measured. The caretakers performed brushing with dentifrice. After three months, there was a significant reduction in the plaque index in both groups, but there was no difference between the two groups. There was a significant reduction in gingivitis only in the test group, and the difference between groups was significant after three months. The authors concluded that the dentifrice with triclosan reduced interdental bleeding in the studied population.

Triclosan - agente quimioterápico utilizado como coadjuvante no controle de placa bacteriana e gengivite / Triclosan - chemotherapeutic agents for bacterial dental plaque control and gingivitis

O Triclosan é um quimioterápico que apresenta propriedades antimicrobianas, antiinflamatórias e analgésicas e, atualmente, vem sendo incorporado em enxaguatórios bucais e dentifrícios. O objetivo deste trabalho é informar o clínico quanto ao uso, vantagens e desvantagens desse quimioterápico.

Triclosan is an antimicrohial, anti-inflammatory and analgesic chemotherapeutic agent that has been added to dentifrices and oral rinses. The aim of this paper is inform the clinician about the properties, advantages and disadvantages of this product.

A clorexidina como coadjuvante no controle do biofilme dental durante o tratamento ortodôntico / The use of chlorhexidine in the biofilm control during the orthodontic treatment

O uso da clorexidina como adjunto a remoção mecânica do biofilme dental deve ser levado em consideração para os indivíduos que apresentam dificuldades de higienização bucal. Seu uso, porém deve ser bem-indicado e prescrito da maneira correta para evitar o aparecimento dos efeitos colaterais.

The use of chlorhexidine associated to the mechanic removal of the dental biofilm must be taken in consideration for the individuals that present difficulties of oral hygiene. Its use, however must well be indicated and be prescribed in the correct way to prevent the appearance of the collateral effect.