Clinical, radiographic, and patient-centered outcomes after use of enamel matrix proteins for the treatment of intrabony defects in patients with aggressive periodontitis: A 12-month multicenter clinical trial.

BACKGROUND: The aim of this study was to evaluate the clinical, radiographic and patient-centered results of enamel matrix derivative (EMD) therapy in intrabony defects in aggressive periodontitis (AgP) patients and compare them with those in chronic periodontitis (CP) patients. METHODS: Sixty intrabony defects in AgP and CP patients associated with ≥ 6 mm residual probing pocket depth (PPD) were included and randomly assigned to one of three groups: AgP+CS (conservative surgery) (n = 20); AgP+CS/EMD (n = 20); CP+CS/EMD (n  =  20). Clinical parameters were measured at baseline and after 6 and 12 months. Defect resolution (DR) and bone filling (BF) were used for radiographic analysis. The quality of life was recorded at baseline and 6 months using OHIP-14 and VAS scale in the early post-therapy period. RESULTS: PPD and relative clinical attachment level (rCAL) improved for all groups during follow-up (P ≤ 0.05), and AgP+CS/EMD presented a higher rCAL gain (2.4 ± 1.0 mm) when compared to AgP control patients (1.6 ± 1.6 mm, P ≤ 0.05) after 12 months. No difference was observed between AgP+CS/EMD and CP+CS/EMD groups (P > 0.05). No radiographic differences were observed among groups at any time point (P > 0.05). All the groups reported a positive impact on OHIP-14 total score, without differences among them. CONCLUSIONS: EMD therapy of intrabony defects promotes additional benefits in AgP patients, presenting a similar regeneration rate compared to CP patients, and has proven to be a viable therapy for the treatment of individuals with AgP.

Omega-3 Fatty Acids and Low-Dose Aspirin in the Treatment of Periodontitis and Metabolic Syndrome: Case Report.

AIMS: To investigate the use of ω-3 fatty acids and low-dose aspirin as adjuncts to periodontal debridement in a patient with periodontitis and metabolic syndrome. METHODS: Periodontal and systemic parameters were assessed at baseline and 6 months. Gingival crevicular fluid was analyzed for interleukin (IL)-1ß, IL-6 and interferon (IFN)-γ levels by multiplex ELISA at baseline, 3 and 6 months. RESULTS: The treatment was effective in reducing probing depth, clinical attachment level, bleeding on probing and plaque index, and glycated hemoglobin, triglycerides IL-1ß, IL-6 and IFN-γ levels over time. CONCLUSIONS: The adjunctive use of ω-3 and low-dose aspirin to periodontal debridement might have potential benefits in the treatment of periodontitis in a patient with metabolic syndrome.

Avaliação da suplementação diária de ácidos graxos poli-insaturados de ômega-3 e aspirina em baixa dosagem no tratamento de periodontite agressiva generalizada: estudos clínicos controlados randomizados / Evaluation of omega-3 polyunsaturated fatty acids daily supplementation plus low-dose aspirin to treat generalized aggressive periodontitis: randomized controlled clinical trials

A destruição periodontal resulta principalmente da resposta inflamatória exacerbada do hospedeiro frente ao desafio bacteriano. Por isso, pesquisas envolvendo a modulação da resposta do hospedeiro têm sido desenvolvidas com o objetivo de facilitar a resolução da inflamação, bem como promover reparação tecidual e estabilidade periodontal. Recentemente, o uso de ácidos graxos poli-insaturados de ômega-3 (AGP Ω-3) e ácido acetilsalicílico (AAS) foi relacionado à produção de mediadores lipídicos mais bioativos e à melhores resultados clínicos no tratamento de periodontite crônica. Desse modo, pesquisas envolvendo modulação das respostas inflamatórias de portadores de periodontite agressiva (PAg) podem ser de grande valia. Assim, o objetivo dos presentes estudos clínicos controlados randomizados foi avaliar a utilização da suplementação de 900 mg AGP Ω-3 e 100 mg de AAS por 180 dias como adjuvantes ao tratamento de PAg generalizada (PAgG). (1) Selecionou-se 38 pacientes com PAgG os quais receberam debridamento subgengival associado a AGP Ω-3 e AAS (n=19) ou placebo (n=19). Ambos os grupos apresentaram diminuição (p<0,05) em todos os parâmetros clínicos avaliados, bem como em IL-1ß, sem diferença entre os tratamentos (p>0,05). O nível de TIMP-2 diminuiu significantemente no grupo controle, porém se manteve estável no grupo teste. Concluiu-se que a nova terapia proposta não trouxe benefícios clínicos no tratamento não-cirúrgico de PAgG. (2) Selecionou-se 34 pacientes com PAgG previamente submetidos à terapia básica que apresentavam bolsas residuais e foram submetidos à cirurgia de acesso para raspagem e alisamento radicular associado a AGP Ω-3 e AAS (n=17) ou placebo (n=17). Após 6 meses, ambos os grupos obtiveram diminuição na PS (p<0,05), porém somente o grupo teste obteve ganho no NIC na comparação intergrupo (p=0,02), assim como apresentou menor recessão gengival (p=0,03), diminuição da hipersensibilidade dentinária (p=0,01), menor consumo de analgésicos (p=0,02) e diminuição intragrupo de IL-10 (p<0,05). Concluiu-se que a nova terapia proposta trouxe benefícios clínicos no tratamento de bolsas residuais de pacientes com PAgG(AU)

Periodontal destruction results mainly from the exacerbated host inflammatory response to the bacterial challenge. For this reason, research involving the modulation of host response has been developed aiming to facilitate the resolution of inflammation, as well as to promote tissue repair and periodontal stability. Recently, the use of omega-3 polyunsaturated fatty acids (Ω-3 PUFA) and low-dose acetylsalicylic acid (ASA) was related to the production of enhanced lipidic mediators and to better clinical outcomes in the treatment of chronic periodontitis. Thus, the aim of the present randomized controlled clinical trials was to evaluate the use of 900 mg Ω-3PUFA and 100 mg ASA for 180 days as adjuvants to the treatment of generalized aggressive periodontitis (GAgP). (1) Thirty-eight GAgP patients were submitted to subgingival debridement associated with Ω-3 PUFA and ASA (n=19) or placebo (n=19). Both groups showed a statistically significant decrease (p<0.05) in all clinical parameters, as well as a decrease in IL-1ß, with no difference between treatments (p>0.05). The TIMP-2 level significantly decreased in the control group and remained stable in the test group. It was concluded that the proposed new therapy did not bring clinical benefits in the non-surgical treatment (NST) of GAgP. (2) Thirty-four GAgP patients previously submitted to NST with residual pockets were selected and underwent open flap debridement associated with Ω-3 PUFA 3 and ASA (n=17) or placebo (n=17). After 6 months, both therapies led to decreased PD (p>0.05), but only the test group had CAL gain in the intergroup comparison (p=0,02), as well as presented less gingival recession (p=0,03), decreased dentin hypersensitivity (p=0,01), lower consumption of analgesics (p=0,02) and significant intragroup reduction of IL-10 (p<0.05). It was concluded that the proposed new therapy brought clinical benefits in the surgical treatment of GAgP patient(AU)

Evaluation of the local effect of nonsurgical periodontal treatment with and without systemic antibiotic and photodynamic therapy in generalized aggressive periodontitis. A randomized clinical trial.

BACKGROUND: This study's aim was to evaluate the local effect of clarithromycin associated with antimicrobial photodynamic therapy (aPDT) in the treatment of generalized aggressive periodontitis. MATERIALS AND METHODS: The study sample comprised 72 periodontal pockets on single-rooted teeth in multiple quadrants, with both probing depth and clinical attachment level ≥5 mm, and with bleeding on probing. The pockets were randomly distributed into four groups (n = 18 each) that received ultrasonic periodontal debridement in addition to placebo (the UPD group), systemic clarithromycin (the UPD + CLM group), aPDT (the UPD + aPDT group), or both systemic clarithromycin and aPDT (the UPD + CLM + aPDT group). The measurements were performed prior to treatment (baseline) and at 3 and 6 months postoperatively. The following parameters were evaluated: plaque index, bleeding on probing, probing depth, gingival recession, and clinical attachment level. A 5% significance level was used in the statistical analysis. RESULTS: At 3 months, UPD + aPDT, UPD + CLM, and UPD + CLM + aPDT groups all exhibited reduced probing depths relative to the UPD group (p < 0.05). However, at 6 months, the reduction in mean probing depth was greater in the antibiotic groups (UPD+CLM and UPD+CLM+aPDT) than in the UPD and UPD+aPDT groups (p < 0.05). Regarding clinical attachment level, only the UPD+CLM+aPDT group presented a significant gain relative to the UPD and UPD + PDT groups (p < 0.05). CONCLUSIONS: Ultrasonic periodontal debridement has greater clinical advantages when associated with clarithromycin than with associated with aPDT. However, the joint application of aPDT and clarithromycin did not present additional benefits.

Clarithromycin as an Adjunct to One-Stage Full-Mouth Ultrasonic Periodontal Debridement in Generalized Aggressive Periodontitis: A Randomized Controlled Clinical Trial.

BACKGROUND: The aim of the present study is to evaluate the periodontal clinical and microbiologic responses and possible adverse effects of clarithromycin (CLM) combined with periodontal mechanical therapy in the treatment of patients with generalized aggressive periodontitis. METHODS: Forty patients were selected and randomly assigned into one of two groups: 1) CLM (n = 20): one-stage full-mouth ultrasonic debridement (FMUD) associated with CLM (500 mg, every 12 hours for 3 days); and 2) placebo (n = 20): FMUD associated with placebo pills. Clinical and microbiologic parameters were evaluated at baseline and 3 and 6 months postoperatively. RESULTS: Both treatments presented statistically significant clinical and microbiologic improvements. However, the CLM group presented lower means of probing depth for pockets ≥7 mm at 6 months (4.0 ± 1.7 mm) compared with the placebo group (4.7 ± 1.3 mm) (P = 0.04). In addition, the CLM group also presented greater reduction of Porphyromonas gingivalis (Pg) DNA counts at 6 months (P = 0.0001). CONCLUSION: Results from this study suggest both treatments are effective; however, adjunct use of CLM to FMUD leads to better reduction of deep pockets and Pg at 6 months compared with FMUD alone.

Connective Tissue Graft and Crown-Resin Composite Restoration for the Treatment of Gingival Recession Associated with Noncarious Cervical Lesions: Case Series.

The purpose of this case series is to describe a restorative and surgical approach to treat the combined defect (CD)-gingival recession associated with noncarious cervical lesions (NCCL)-through connective tissue graft in combination with partial resin composite filling, restoring the crown zone plus 1 mm of the NCCL. A total of 10 patients were included. Bleeding on probing, probing depth, relative gingival recession, clinical attachment level, CD height, and dentin hypersensitivity were measured. The treatment provided statistically significant gain in clinical attachment level and shallow probing depths. The percentage of the combined defect coverage was 70% ± 20.2%. It can be concluded that this treatment protocol, in the presence of a partial resin composite restoration, can be used successfully to treat CD.

2-Year Assessment of Tissue Biostimulation With Low-Level Laser on the Outcomes of Connective Tissue Graft in the Treatment of Single Gingival Recession: A Randomized Clinical Trial.

BACKGROUND: Periodontal wound healing has been accelerated by different low-level laser therapy (LLLT) protocols. However, just a few studies have evaluated use of this therapy adjunctive to periodontal plastic surgery procedures. The present study shows 2-year results of a connective tissue graft (CTG) associated with LLLT in the treatment of gingival recession (GR) defects. METHODS: Forty patients presenting Miller Class I and II GRs were previously treated by CTG (control group; n = 20) or CTG + LLLT (test group; n = 20). A diode laser (aluminum-gallium-arsenide, 660 nm) was applied to test sites immediately after surgery and every other day for 14 days (total of eight applications). After a follow-up of 2 years, clinical and esthetic evaluations were performed in 36 patients. RESULTS: Mean percentage of root coverage was 93.43% for the test group and 92.32% for the control group (P = 0.55). Complete root coverage was 79% (n = 15) for the test group and 76% (n = 13) for the control group (n = 13) (P = 0.80). Both groups showed esthetics maintenance after 2 years. CONCLUSION: Within the limitations of this study, results indicate that LLLT showed no additional benefit in the long term when associated with a CTG in the treatment of Miller Class I and II GRs.

Tratamento cirúrgico para recobrimento radicular em molar superior / Surgical treatment for root coverage in the upper molar tooth ­ a case report

A recessão gengival é uma condição muito comum atualmente, definida como o deslocamento da margem gengival apicalmente à junção cemento/esmalte, com consequente exposição da superfície radicular ao ambiente bucal. Apesar das recessões gengivais afetarem diversos grupos de dentes, poucos trabalhos tentam elucidar qual é o melhor protocolo de tratamento para as recessões gengivais presentes em molares. Visando um protocolo cirúrgico que proporcione uma satisfatória taxa de recobrimento radicular e um melhor resultado estético, o presente relato de caso teve como objetivo apresentar uma técnica cirúrgica alternativa para o tratamento de recessões gengivais em molares superiores. Para tal, um retalho dividido foi confeccionado por meio de incisões relaxantes e deslocado lateralmente, a partir da área doadora, para o elemento dental com a recessão. Após o deslocamento do retalho, o mesmo foi suturado em posição. Seis meses após o procedimento, o paciente estava satisfeito com o resultado final alcançado, demonstrando que esse protocolo pode ser uma alternativa de tratamento aos protocolos existentes para o tratamento de recessões gengivais.

Gingival recession is a condition defined as the apical positioning of the gingival margin in relation to the cemento-enamel junction, resulting in root exposure in the oral environment. Although gingival recession may affect many groups of teeth, there are few studies that attempt to clarify which is the best treatment protocol for gingival recessions localized in molars. In order to evaluate a surgical approach that lead to a satisfactory root coverage rate and a good esthetic outcome, the aim of this case report is to present an alternative surgical technique for the treatment of gingival recession in upper molar teeth. For this, a split-flap was made through vertical incisions and laterally positioned from the donor area to the affected tooth and sutured in position. Six months after the procedure, the patient was satisfied with the final result achieved, showing that this protocol may be an alternative to the existing treatments for the gingival recession.

Local adjunct effect of antimicrobial photodynamic therapy for the treatment of chronic periodontitis in type 2 diabetics: split-mouth double-blind randomized controlled clinical trial.

Diabetes has become a global epidemic. Its complications can have a significant impact on quality of life, longevity, and public health costs. The presence of diabetes might impair the prognosis of periodontal treatments due to its negative influence on wound healing. Antimicrobial photodynamic therapy (aPDT) is a local approach that can promote bacterial decontamination in periodontal pockets. The aim of this study was to investigate the local effect of adjunct aPDT to ultrasonic periodontal debridement (UPD) and compare it to UD only for the treatment of chronic periodontitis in type 2 diabetic patients. Twenty type 2 diabetic patients with moderate to severe generalized chronic periodontitis were selected. Two periodontal pockets with probing depth (PD) and clinical attachment level (CAL) ≥5 mm received UPD only (UPD group) or UPD plus adjunct aPDT (UPD + aPDT group). Periodontal clinical measures were collected and compared at baseline and 30, 90, and 180 days. After 180 days of follow-up, there were statistically significant reductions in PD from 5.75 ± 0.91 to 3.47 ± 0.97 mm in the UPD group and from 6.15 ± 1.27 to 3.71 ± 1.63 mm in the UPD + aPDT group. However, intergroup analysis did not reveal statistically significant differences in any of the evaluated clinical parameters (p > 0.05). The adjunct application of aPDT to UPD did not present additional benefits for the treatment of chronic periodontitis in type 2 diabetic patients. The ClinicalTrials.gov identifier of the present study is NCT02627534.

Aspects affecting the choice for scientific journal publishing / Aspectos que influenciam na escolha do periódico para publicação científica

This study aimed to evaluate the social and academic aspects and factors related to scientific journal that influence and motivate the authors to choose the journal to publish their academic work. Material and Methods: The study was conducted with professors and graduate students of the Institute of Science and Technology of Sao Jose dos Campos, UNESP. Participants responded to an online questionnaire, sentvia email, and the data were tabulated and analyzed. Result: The Thomson Reuters impact factor, followed by Qualis CAPES Index were considered of greater importance at the moment of choosing the journal for 56% of respondents. All respondents considered peer review relevant and 89% pointed out double-blind review as the most important aspect. Indexing and the journal’s quality were considered the most significant factors by most respondents. 98% of respondents have knowledge on both open access journals and Digital Object Identifier (DOI). Conclusion: The assessed academic community demonstrated good knowledgeon the factors inherent to the publication of scientific papers. Impact factor, indexing, and journal’s quality influenced on scientific journal publishing...

O objetivo deste trabalho foi avaliar aspectos sociais e acadêmicos e fatores relacionados a revista cientifica que influenciam e motivam os autores na escolha do periódico para publicação de seus trabalhos acadêmicos. Material e Métodos: O estudo foi realizado com docentes e pós-graduandos do Instituto de Ciência e Tecnologia de São José dos Campos, UNESP. Os participantes responderam a um questionário online, enviado via e-mail, e os dados coletados foram tabulados e analisados. Resultados: O fator de impacto Thomson Reuters, seguido pelo Índice Qualis CAPES foram considerados os de maior importância no momento da escolha da revista para 56% dos entrevistados.Todos consideram relevante a revisão por pares e 89% assinalaram a revisão duplo-cego como a mais importante. A indexação e o conceito da revista foram considerados os fatores mais significativos pela maioria dos respondentes. 98% dos participantes responderam ter conhecimento sobre as revistas de acesso aberto e sobre o DOI (Digital Object Identifier). Conclusão: A comunidade acadêmica avaliada demonstrou ter bons conhecimentos sobre os fatores inerentes a publicação de trabalhos científicos. Fator de impacto, indexação e conceito da revista influenciam os autores no momento de escolher o periódico para publicação de artigos...

Essential oil of Melaleuca alternifolia for the treatment of oral candidiasis induced in an immunosuppressed mouse model.

BACKGROUND: The search for alternative therapies for oral candidiasis is a necessity and the use of medicinal plants seems to be one of the promising solutions. The objective of this study was to evaluate the in vitro and in vivo effects of the essential oil of Melaleuca alternifolia on Candida albicans. METHODS: The minimum inhibitory concentration (MIC) and minimum biofilm eradication concentration (MBEC) of M. alternifolia were determined by the broth microdilution assay. For the in vivo study, twelve immunosuppressed mice with buccal candidiasis received topical applications of M. alternifolia with MBEC. After treatment, yeasts were recovered from the mice and quantified (CFU/mL). Mice were killed for morphologic analysis of the tongue dorsum by optical and scanning electron microscopy. Data were analyzed using Student's t test or Mann-Whitney test. RESULTS: The MIC of M. alternifolia was 0.195% and the MBEC was 12.5%. Treatment with M. alternifolia achieved a 5.33 log reduction in C. albicans and reduced the microscopic lesions of candidiasis. CONCLUSIONS: M. alternifolia oil at a 12.5% was effective to eradicate a C. albicans biofilm formed in vitro and to reduce yeasts of C. albicans in an immunosuppressed mouse model.

Effect of erythrosine- and LED-mediated photodynamic therapy on buccal candidiasis infection of immunosuppressed mice and Candida albicans adherence to buccal epithelial cells.

OBJECTIVE: This study evaluated the effects of photodynamic therapy (PDT) on buccal candidiasis in mice and on the adherence of yeast to buccal epithelial cells (BECs) in vitro. STUDY DESIGN: A total of 56 immunosuppressed mice with buccal candidiasis were subjected to PDT, consisting of treatment with erythrosine (400 µmol/L) followed by exposure to a green LED (14.34 J cm(-2)). After treatment, the yeasts recovered from the mice were quantified (CFU/mL) and analyzed for the effects of PDT on their adherence to BECs. The data were analyzed using ANOVA, the Tukey test, Kruskal-Wallis test and Student t test. RESULTS: PDT significantly reduced the amount of yeast present in the lesions by 0.73 log(10) (P = .018) and reduced C. albicans adherence to BECs by 35% without damaging adjacent tissues (P = .045). CONCLUSIONS: Photodynamic therapy exhibited antifungal effects against C. albicans biofilms formed in vivo and reduced the capacity of C. albicans to adhere to BECs in vitro.