Association between sickle cell disease and periodontal disease: A systematic review.

Previous studies have evaluated the association between sickle cell disease (SCD) and periodontal disease; however, their effect on the periodontal parameters remains unclear. This systematic review aimed to investigate whether individuals with sickle cell disease (SCD) increase the risks of periodontal disease more than those without. For the selection of eligible studies, an electronic search was conducted in the MEDLINE/PubMed, Web of Science, Cochrane Library, and Scopus databases. The meta-analysis was based on the inversion of variance using the mean difference (MD) of the continuous outcomes. The quality assessment of included studies was performed using the JBI Critical Appraisal Tools. In total, 13 studies and 2381 participants were included in the qualitative analysis, while 9 studies were considered for the meta-analysis. The meta-analysis indicated that patients with SCD present similar Plaque Index, Clinical Attachment Level, Bleeding on Probing, and Probing Depth when compared to healthy patients (p > .05). However, the Gingival Index was higher for patients with SCD (p = .0002; MD: 0.20). Compared to healthy patients, patients with SCD did not have an increase in periodontal parameters, except for the gingival index. However, further well-designed studies are recommended to reassess the association between SCD and periodontal diseases.

Effect of systemic ozone therapy as a biomodulator of tissue regeneration and inflammatory response in rats / Efeito da terapia sistêmica de ozônio como um biomodulador da regeneração tecidual e da resposta inflamatória em ratos

Introduction Among the therapeutic effects of ozone therapy, improvement in cell metabolism and peripheral tissue oxygenation have been highlighted. Objective to evaluate the systemic effect of bio-oxidative therapy with ozone gas on wound healing. Material and method Tissue lesions with a circumference of 1.0 cm were induced in the skin on the back of 24 male Wistar rats. The animals were randomly divided into two groups: 1) Group C (control; n=12): with simulation of the application of ozone gas via the rectum and, 2) Group O3 (test; n=12): with application of ozone gas by means of rectal insufflation at a concentration of 50 µg/mL. The animals were euthanized at seven and 15 days, and samples were removed, fixed in formalin, and submitted to macroscopic, histological, and histometric analyses. Result The animals in the O3 group presented mixed inflammation at seven days, which translated into an absence of inflammation at 15 days. The C group exhibited acute inflammation on the 7th day, translating to chronic inflammation, which significantly increased from the 7th to the 15th day. The findings showed that the O3 group presented greater wound contraction (P<0.05) and a greater degree of neovascularization on the 7th day (P<0.05) when compared to group C. On the 15th day, both groups (O3 and C) showed complete re-epithelialization, however, the O3 group demonstrated complete muscle regeneration. Conclusion The systemic ozone therapy had a biomodulatory effect, reducing the characteristics of acute inflammation and increasing tissue repair and regeneration in rat skin.

Introdução Dentre os efeitos terapêuticos da ozonioterapia, destacam-se a melhora do metabolismo celular e da oxigenação dos tecidos periféricos. Objetivo avaliar o efeito sistêmico da terapia bio-oxidativa com gás ozônio na cicatrização de feridas. Material e método Lesões teciduais com circunferência de 1,0 cm foram induzidas na pele do dorso de 24 ratos Wistar machos. Os animais foram divididos aleatoriamente em dois grupos: 1) Grupo C (controle; n = 12): com simulação da aplicação de gás ozônio pelo reto e, 2) Grupo O3 (teste; n = 12): com aplicação de gás ozônio por meio de insuflação retal na concentração de 50 µg / mL. Os animais foram sacrificados com sete e 15 dias, e as amostras foram retiradas, fixadas em formalina e submetidas às análises macroscópica, histológica e histométrica. Resultado Os animais do grupo O3 apresentaram inflamação mista aos sete dias, que se traduziu em ausência de inflamação aos 15 dias. O grupo C apresentou inflamação aguda no 7º dia, traduzindo-se em inflamação crônica, que aumentou significativamente do 7º para o 15º dia. Os achados mostraram que o grupo O3 apresentou maior contração da ferida (P <0,05) e maior grau de neovascularização no 7º dia (P <0,05) quando comparado ao grupo C. No 15º dia, ambos os grupos (O3 e C) apresentaram completa reepitelização, entretanto, o grupo O3 demonstrou completa regeneração muscular. Conclusão A ozonioterapia sistêmica teve efeito biomodulador, reduzindo as características de inflamação aguda e aumentando a reparação e regeneração tecidual na pele de ratos.

Periodontitis and identification of undiagnosed hyperglycemia / Periodontite e identificação da hiperglicemia não diagnosticada

Introduction Individuals with pre-diabetes have altered glycemic levels, are generally asymptomatic, and are at increased risk for developing type 2 diabetes mellitus. Objective Identify the prevalence of periodontal individuals with undiagnosed hyperglycemia and associated impact factors. Material and method Fifty-six patients with periodontitis and without diabetes self-report, users of dental clinic services at Federal University of Juiz de Fora were included in this research, during one year and a half of experimental evaluation. Socioeconomic and demographic data, anthropometric patterns, fasting capillary blood glucose, and complete periodontal examination (six sites per tooth) were evaluated. Result The sample consisted of 58.9% female, mean age 53 years old, 58.9% obese/overweight and 45.3% had a low level of education. A total of 28.6% (n=16) participants had undiagnosed hyperglycemia (between 100 to 160 mm / dL), of which 81.3% were obese/overweight, 25% were smokers, 56.3% reported having a history of diabetes in the family, 93.8% had a family income up to 2 brazilian´s minimum wages. BMI values ​​were higher in the group of patients with hyperglycemia (29.8 ± 5.7, p = 0.03) compared to the group without hyperglycemia (26.6 ± 5.6). Patients with hyperglycemia had a greater number of sites with clinical attachment loss (CAL) between 4 and 6 mm (p = 0.04) when compared with the normoglycemic group. Conclusion Undiagnosed CAL attachment loss between 4 and 6 mm due to periodontitis than normoglycemic individuals.

Introdução Indivíduos com pré-diabetes apresentam níveis glicêmicos alterados, geralmente são assintomáticos e apresentam risco aumentado para desenvolver diabetes mellitus tipo 2. Objetivo Identificar a prevalência de indivíduos periodontais com hiperglicemia não diagnosticada e os fatores de impacto associados. Material e método Cinquenta e seis pacientes com periodontite e sem autorrelato de diabetes, usuários de serviços de clínica odontológica da Universidade Federal de Juiz de Fora foram incluídos nesta pesquisa, durante um ano e meio de avaliação experimental. Foram avaliados dados socioeconômicos e demográficos, padrões antropométricos, glicemia capilar de jejum e exame periodontal completo (seis sítios por dente). Resultado A amostra foi composta por 58,9% do sexo feminino, média de idade de 53 anos, 58,9% obesidade / sobrepeso e 45,3% com baixa escolaridade. Um total de 28,6% (n=16) participantes tinham hiperglicemia não diagnosticada (entre 100 a 160 mm / dL), dos quais 81,3% eram obesos / com sobrepeso, 25% eram fumantes, 56,3% relataram ter histórico de diabetes na família, 93,8% tinham renda familiar de até 2 salários mínimos brasileiros. Os valores de IMC foram maiores no grupo de pacientes com hiperglicemia (29,8 ± 5,7, p = 0,03) em comparação ao grupo sem hiperglicemia (26,6 ± 5,6). Pacientes com hiperglicemia apresentaram maior número de sítios com perda clínica de inserção (CAL) entre 4 e 6 mm (p = 0,04) quando comparados ao grupo normoglicêmico. Conclusão A perda de inserção de CAL não diagnosticada entre 4 e 6 mm devido à periodontite do que indivíduos normoglicêmicos.

Effects of orthodontic tooth extrusion produced by different techniques, on the periodontal tissues: a histological study in dogs.

OBJECTIVE: The aim of this study was to compare the periodontal tissue changes resulting from different methods of orthodontic tooth extrusion in dogs. MATERIALS AND METHODS: Notches were surgically prepared in the root surface at the bone crest level of the first premolars of mongrel dogs. After 37 days, extrusion of the first lower and upper premolars was randomly performed by 3 different methods: conventional orthodontic extrusion (OE); open flap debridement performed immediately before orthodontic extrusion (OF); and orthodontic extrusion associated with weekly fiberotomy and scaling (FS). For all groups, extrusion was performed for 21 days followed by one-month retention and sacrifice. Periodontal parameters, descriptive histology, and histomorphometric analyses were performed at the end of the experimental period. RESULTS: The median extrusion was 2.25 in the fiberotomy group, 2.0 mm in the open flap group and 1.0 mm in the orthodontic extrusion group with no significant differences between groups. The highest distance between reference notch and bone crest was observed in the fiberotomy group (p < 0.05). Histologically, radicular resorption repaired with cellular cementum was detected in all groups. CONCLUSIONS: Tooth extrusion was successfully achieved with all of the different methods of orthodontic tooth extrusion with no statistical significance between techniques. The fiberotomy approach was effective in avoiding coronal displacement of periodontal tissues. Fiberotomy associated with scaling should be indicated if the objective of the treatment is extrusion without periodontal tissue displacement.

Oral conditions and body weight in children from a public school in Manaus, AM, Brazil / Condições orais e peso corporal em crianças de uma escola pública de Manaus, AM, Brasil

Introduction: Some studies have pointed to links between the prevalence of caries and periodontal disease, and the occurrence of overweight or obesity; but, few studies have been conducted in children. Objective: To assess the relationship between periodontal disease, tooth decay and body weight in children from a public school in Manaus, AM, Brazil. Material and method: The study included one hundred and sixty-nine children. Records were obtained of decayed, missing and filled (DMFT) permanent teeth, and of decayed, extracted, or filled (DEF) deciduous teeth, as well as the record of the community periodontal index (CPI). The classification of body weight category was obtained in percentile using the z-Score table. Result: Higher averages of weight and body mass index (BMI) were seen in the overweight and obesity groups (p<0.05). All groups were similar regarding the DMFT /DEF and CPI codes from 0 to 4 (p>0.05). All groups showed higher averages of CPI 0 in comparison with other CPI codes from 1 to 4 (p<0.05), and most of the children showed sites with probing depth <3.5 mm and without bleeding on probing. Conclusion: There was no relationship between body weight and the occurrence of dental caries and periodontal disease in the studied population. Obesity and overweight showed no negative influence on the increase in the prevalence of these diseases.

Introdução: Estudos têm apontado para relações existentes entre prevalência de cárie e doença periodontal e ocorrência de sobrepeso ou obesidade, porém poucos estudos foram conduzidos em crianças. Objetivo: Avaliar a relação entre doença periodontal, cárie e peso corporal em crianças de uma escola pública de Manaus – AM, Brasil. Material e método: Cento e sessenta e nove crianças foram incluídas no estudo. Registros foram obtidos, tais como, dentes cariados, perdidos e obturados na dentição permanente (CPO-D) e cariados, com extração indicada e obturados em decíduos (ceo), além do registro do índice periodontal comunitário (CPI). A classificação da categoria de peso corporal foi obtida em percentil pela tabela Escore-z. Resultado: Maiores médias de peso e índice de massa corporal (IMC) foram verificados nos grupos com sobrepeso e obesidade (p<0,05). Todos os grupos foram semelhantes com relação aos códigos do CPO-D/ceo e CPI de 0 a 4 (p>0,05). Todos os grupos apresentaram maiores médias de CPI 0 em comparação aos demais códigos CPI de 1 a 4 (p<0,05), ou seja, a maioria das crianças apresentou sítios com profundidade de sondagem <3,5 mm e sem sangramento à sondagem. Conclusão: Não houve relação entre o peso corporal com a ocorrência de cárie dental e doença periodontal nessa população estudada. A obesidade e o sobrepeso não mostraram influência negativa para o aumento da prevalência dessas doenças.

Tratamento periodontal em adolescente e avaliação do grau de severidade inflamatória gengival / Periodontal treatment and the severity of inflammatory disease in the adolescent ­ a case report

O objetivo deste estudo foi apresentar um caso avaliando os aspectos inflamatórios gengivais antes e após o tratamento periodontal não cirúrgico em uma paciente adolescente. Uma menina de 14 anos de idade apresentou-se com queixa principal de ausência das restaurações protéticas nos dentes 36 e 46. O índice de placa inicial era de 96%, e o exame radiográfico detectou perda óssea alveolar incipiente nos dentes 16 e 26 (coroas de aço inoxidável) com média de perda óssea próxima aos 3 mm. Após 60 dias de tratamento, o índice gengival (IG) final foi reduzido em 50% (de 1,6 para 0,5, teste de Qui-quadrado, p < 0,0001) com melhora signifi cativa nos graus 0 e 2. Ainda, os valores de profundidade de sondagem (2 mm para 1,7 mm) e sangramento (SS) ­ 90% contra 30% do sítios ­ também mostraram melhora signifi cativa (testes de Wilcoxon e McNemar, p < 0,001). Pode-se concluir que, apesar de haver influência dos hormônios sobre os tecidos periodontais durante a puberdade, com o aumento da condição inflamatória, o controle da placa bacteriana mostrou-se mais importante para a determinação da presença de saúde ou doença periodontal. A motivação e o acompanhamento constante desses pacientes em fase puberal são importantes para o controle de placa.

The aim of this study was to present a case assessing the inflammatory gingival aspects before and after non-surgical periodontal treatment in the adolescent patient. A 14-years-old girl presented with a chief complaint of absence of prosthetic restorations on teeth36 and 46. The initial plaque index was 96%, and the radiographic examination detected incipient alveolar bone loss for teeth 16 and 26 (stainless steel crowns) with a mean bone loss up to 3 mm. After 60 days of therapy, the gingival index (GI) was reduced by 50% (from 1.6 to 0.5, Chi-square test, p < 0.0001) with significant improvement in 0 and 2 scores. Also, probing depth (2 mm to 1.7 mm) and bleeding on probing (SS) ­ 90% versus 30% of the sites ­ values also showed signifi cant improvements (Wilcoxon and McNemar's tests, p < 0.001). It can be concluded that, although the hormonal imbalance can affect the periodontal tissues during puberty increasing the inflammatory condition, plaque control was more important to determine the presence of health or periodontal disease. Motivation and constant monitoring of these patients at the pubertal stage are fundamental.

Avaliação de doença periodontal e cárie em escolares adolescentes de Barretos, interior de São Paulo / Evaluation of periodontal disease and caries in school teens from Barretos, São Paulo

Objetivo: avaliar as necessidades de tratamento odontológico de adolescentes de uma escola privada da cidade de Barretos/SP. Material e métodos: adolescentes avaliados entre 12 e 18 anos de idade, incluídos no estudo após o consentimento de seus pais/ responsáveis, que assinaram o termo de consentimento livre e esclarecido. A condição bucal desses pacientes foi avaliada por meio da aplicação do índice periodontal comunitário (CPI), índice de placa visível (IPV) e índice de dentes permanentes cariados, perdidos e obturados (CPO-D). Resultados: foram incluídos no estudo 109 adolescentes, sendo 58 homens e 51 mulheres, com média de idade de 14,1 ± 1,67 anos e porcentagem média de IPV de 60,15 ± 38,7. O código 0 do CPI apresentou maior frequência média (3,3 ± 2,1), seguido pelo código 1 (2,4 ± 1,8), sem diferenças estatísticas. Com relação ao CPO-D, verificou-se que a média de dentes hígidos foi a maior de todas (23,15 ± 6,6). Conclusão: pôde-se concluir que a população estudada apresentou baixo índice de cárie, porém, grande proporção de inflamação gengival e acúmulo de biofilme dental, sendo necessária ênfase especializada para um adequado controle de placa, especialmente nos sulcos gengivais.

Objectives: to evaluate the needs of dental treatment of teenagers from a private school in the city of Barretos/SP. Material and methods: adolescents between 12 and 18 years of age were assessed after the consent of their parents/guardians by signing the consent form and informed (IC). The oral health status of these patients was evaluated by applying the community periodontal index (CPI), visible plaque index (IPV) and the decayed, missing and filled permanent teeth index (DMF-T). Results: this study included 109 teenagers, 58 men and 51 women, with mean age 14.1 ± 1.67 years and VPI mean of 60.15 ± 38.7. The CPI code zero showed the highest frequency of average (3.3 ± 2.1), followed by the code 1 (2.4 ± 1.8), without statistical differences among them. Considering the DMF-T, the highest average was found for the healthy teeth (23.15 ± 6.6). Conclusion: it can be concluded that the population studied showed a low rate of tooth decay, but showed a high proportion of gingival inflammation and dental biofilm accumulation, requiring specialized emphasis to adequate plaque control, especially in the gingival crevice.

Periodontal treatment in a patient with generalized idiopathic dystonia.

Dystonia is a neurological disorder that can cause constant muscle contractions and motor limitations. This work reports a clinical case of periodontal treatment in a patient with generalized idiopathic dystonia. The intraoral clinical examination was focused on the presence of caries and periodontal diseases. The plaque index (PI), probing depth (PD), and bleeding on probing (BOP) were measured. Initially, oral hygiene instruction was provided using a soft conventional toothbrush and dental floss, but the clinical results achieved using these methods were inadequate. Alternative methods of plaque removal were offered, such as the use of a power toothbrush and a dental floss fork, which resulted in improvement in the PI, PD, and BOP and allowed the patient to undergo periodontal surgery for the restoration of subgingival caries. Our results suggested that generalized idiopathic dystonia leads to motor limitations that may cause difficulty with regard to plaque control, but adaptations of the methods used for oral hygiene may improve the oral health conditions in these patients.

Torque Analysis of a Triple Acid-Etched Titanium Implant Surface.

The present study aimed to evaluate the removal torque of titanium implants treated with triple acid etching. Twenty-one rats were used in this study. For all animals, the tibia was prepared with a 2 mm drill, and a titanium implant (2 × 4 mm) was inserted after treatment using the subtraction method of triple acid etching. The flaps were sutured. Seven animals were killed 14, 28, and 63 days after implant installation, and the load necessary for removing the implant from the bone was evaluated by using a torque meter. The torque values were as follows: 3.3 ± 1.7 Ncm (14 days), 2.2 ± 1.3 Ncm (28 days), and 6.7 ± 1.4 Ncm (63 days). The torque value at the final healing period (63 days) was statistically significantly different from that at other time points tested (ANOVA, p = 0.0002). This preliminary study revealed that treatment with triple acid etching can create a promising and efficient surface for the process of osseointegration.

Oral Myiasis Caused by Cochliomyia hominivorax in a Disabled Person.

Myiasis is a parasitic disease caused by developing maggots of fly species, which can infect humans. Patients with special needs, especially those with severe neuropsychomotor limitations, may have oral manifestations of this disease. Here, we present a clinical case in which a disabled person was affected by oral myiasis caused by Cochliomyia hominivorax. Maggots were found in two ulcerated lesions, a 2 cm diameter lesion in the maxilla and a 6 cm diameter lesion in the mandible. Forty-five maggots were removed during inspection, whereas 75 maggots were surgically removed under general anesthesia with nasotracheal intubation. Dipyrone, ivermectin, and clindamycin were prescribed, and the patient remained hospitalized for 3 days. Seven days after surgical intervention, no maggots were observed. Our study emphasizes that dentists must recognize the symptoms and behaviors of parasitic diseases that affect the oral cavity.

Treatment of Oroantral Communication Using the Lateral Palatal Sliding Flap Technique.

Herein, we present a case of oroantral communication that was to be treated with clinical examination, tomography, and prototyping. A patient presented with oroantral communication with purulent exudation for 4 months, since the displacement of the dental implant and O-ring component to the maxillary sinus. Tomographic examination and prototyping revealed a 5 mm bone gap. The patient underwent local washes and antibiotic therapy. After local palpation, a bone defect detected by prototyping was suspected to be greater than that observed. For the surgery, a communication tunnel was made, and the bone defect was found to be 12 mm in diameter. A pedicle flap was raised on the palate, followed by sliding and suturing. No complications were observed during the postoperative period, and the suture was removed after a week. Four months later, communication did not resume, and the patient did not complain of pain, foul smelling, or purulent discharge and was satisfied with the outcome. The findings of this case suggest that the lateral sliding flap can be used as an efficient technique for closing oroantral communications. An accurate clinical examination is a critical tool that can be used instead of tomography and prototyping, which can be misleading.

Connective tissue graft as a biological barrier for guided tissue regeneration in intrabony defects: a histological study in dogs.

BACKGROUND: The use of the autogenous periosteal graft as biological barrier has been proposed for periodontal regeneration. The aim of this study was to evaluate the histometric findings of the subepithelial connective tissue graft as barrier in intrabony defects compared to a bioabsorbable membrane. METHODS: Three-walled intrabony defects were created surgically in the mesial aspect of the right and left maxillary canines in five healthy mongrel dogs. The defects were chronified, and two types of barriers were randomly carried out for guided tissue regeneration in a split-mouth design: the test group with a subepithelial connective tissue graft and the control group with a bioabsorbable membrane. The specimens were processed for histometric analyses of the epithelium (E), connective tissue (CT), newly formed cementum (NC), new bone (NB), and total newly formed tissues (NFT). RESULTS: The test side showed smaller mean of NC (3.6 ± 1.2), NB (2.1 ± 0.7), and NFT (7.7 ± 0.8) than the control group (NC 7.3 ± 0.5; NB 5.3 ± 1.3; NFT 10.1 ± 2.2; P < 0.05). No statistically significant differences were verified for E (test 3.1 ± 2.0; control 2.8 ± 2.1; P > 0.05) and CT (test 2.5 ± 1.1; control 2.0 ± 0.5; P > 0.05) between groups. CONCLUSION: The bioabsorbable membrane was more effective in maintaining the space for periodontal regeneration than periosteal connective graft when used as barrier. CLINICAL RELEVANCE: The bioabsorbable membrane showed more favorable regenerative results in intrabony defects in dogs than the subepithelial connective tissue graft as biological barrier.

Satisfação e qualidade de vida de paciente com prótese unitária implantossuportada: caso clínico / Satisfaction and quality of life in a patient with implant-supported single-tooth crown: a case report

Questionários que quantificam dados subjetivos podem ser úteis para registrar a opinião dos pacientes. O objetivo deste estudo foi relatar a aplicação dos questionários de satisfação e de qualidade de vida em uma paciente tratada por meio de prótese unitária implantossuportada. Para isto, foi incluída uma paciente que teve implante dentário osseointegrável instalado em área estética. A satisfação estética e funcional focando a mastigação, fonação e autoestima foi avaliada por meio de uma Escala Visual Analógica (escala de zero a dez) e a Qualidade de Vida o foi por meio do questionário OHIP-14. O valor de satisfação estética obtido foi de 9,7, enquanto no quesito fonação, o valor encontrado foi de 9,9 resultando em média de 9,8, mostrando efetividade do tratamento e uma alta satisfação da paciente. O valor total obtido pela avaliação do OHIP-14 foi de 0,45, o que sugere boa qualidade de vida. Dentro dos limites do presente caso clínico, sugere-se que os questionários empregados sejam de fácil preenchimento, eficientes em quantificar as sensações da paciente e que a reabilitação implantossuportada levou à melhora na satisfação e qualidade de vida...

Questionnaires that quantify subjective data may be useful to register the opinion of the patients. The objective of this study was to test the use of questionnaires concerning the satisfaction and quality of live in a patient treated by means of a single-tooth implantsupported crown. Thus, a patient was included that had an osseointegrated implant installed in esthetic area. The satisfaction concerning esthetics and function focusing on mastication, speech and self-esteem was evaluated using a visual analog scale (ranging from zero to ten), and Quality of Live by means of the OHIP-14 questionnaire. The esthetic satisfaction value obtained was 9.7, while in the item speech, the value was 9.9 (range from 0 to 10), resulting in an average of 9.8, showing effectiveness in the treatment and high patient satisfaction. The total value obtained with OHIP-14 was 0.45, suggesting good quality of live. Within the limits of this case report, it may be suggested that the questionnaires are easy to fill, efficient to quantify the feelings of the patient, and that the implant-supported rehabilitation led to improved satisfaction and quality of life...

Multiple marginal tissue recession treated with a simplified lateral sliding flap technique.

Marginal tissue recession is a common esthetic problem that is usually accompanied by dentin sensitivity, and patients frequently report a fear of dental loss. Lateral sliding flaps have been used for localized recession, but they are rarely used for multiple recessions. The aim of this paper was to report a case of coverage of multiple marginal tissue recessions by means of a lateral sliding flap associated with a connective tissue graft. This was a modification of Nelson's technique, which was originally described as the combination of the double papilla technique, lateral sliding flap, and connective tissue graft. In the present case, double papilla was not performed, rendering the maneuver less complicated. After surgery on teeth #23 to #25, total root coverage, decreased dentin sensitivity, and increased keratinized tissue band and gingival thickness were achieved. In the present case, modified Nelson technique proved to be a more simple procedure for the treatment of multiple recessions in one session, resulting in adequate healing, predictable root coverage, and, more importantly, esthetic and functional success.

Bone-implant contact around crestal and subcrestal dental implants submitted to immediate and conventional loading.

The present study aims to evaluate the influence of apicocoronal position and immediate and conventional loading in the percentage of bone-implant contact (BIC). Thus, 36 implants were inserted in the edentulous mandible from six dogs. Three implants were installed in each hemimandible, in different positions in relation to the ridge: Bone Level (at crestal bone level), Minus 1 (one millimeter apical to crestal bone), and Minus 2 (two millimeters apical to crestal bone). In addition, each hemimandible was submitted to a loading protocol: immediate (prosthesis installed 24 hours after implantation) or conventional (prosthesis installed 120 days after implantation). Ninety days after, animals were killed, and implant and adjacent tissues were prepared for histometric analysis. BIC values from immediate loaded implants were 58.7%, 57.7%, and 51.1%, respectively, while conventional loaded implants were 61.8%, 53.8%, and 68.4%. Differences statistically significant were not observed among groups (P = 0.10, ANOVA test). These findings suggest that different apicocoronal positioning and loading protocols evaluated did not interfere in the percentage of bone-implant contact, suggesting that these procedures did not jeopardize osseointegration.

Raspagem radicular cirúrgica associada a enxerto conjuntivo para prevenção de recessão pós-operatória / Surgical root scaling associated with connective graft to prevent postoperative recession

O tratamento cirúrgico da doença periodontal pode ocasionar recessão gengival, causando alterações estéticas e sensibilidade cervical. Assim, este artigo teve como objetivo apresentar um caso clínico onde foi realizada a associação das técnicas de raspagem em campo aberto e enxerto conjuntivo com retalho posicionado coronalmente, a fim de prevenir a recessão pós-operatória. Após o tratamento periodontal básico, optou-se por realizar o tratamento periodontal cirúrgico, por meio de retalho total para visualização e raspagem da região. Após raspagem radicular e remoção do tecido de granulação, removeu-se o enxerto de tecido conjuntivo do palato, que foi suturado ao retalho. Este foi então posicionado coronalmente e suturado. Após três meses, o nível gengival estava estável e não foram detectados sinais de atividade da doença periodontal. Assim, pôde-se concluir que a técnica utilizada mostrou-se efetiva para o tratamento da doença periodontal, tendo sido capaz de prevenir a recessão pós-operatória.

Patient discomfort following single-tooth implant placement: a randomized controlled trial of immediate vs. conventional tooth restoration.

AIMS: Evaluate postoperative discomfort (pain, bleeding and swelling) in single-tooth implant patients submitted to immediate or conventional tooth restoration together with assessment of treatment time. METHODS: Twenty-four patients who received single-tooth maxillary dental implants were randomly assigned to an IR (Immediate Restoration) or CR (Conventional Restoration) group. In IR, an implant was inserted and a provisional tooth crown was delivered within the same session, while in CR it was delivered three months after implantation. Pain (first three days), bleeding (first day) and swelling (first seven days) were assessed using a questionnaire with Visual Analogue Scales (VAS). RESULTS: Treatment time was longer for IR than for CR (57±14 and 33±8 min, respectively; p<0.0001). Mean VAS scores for pain, bleeding, and swelling were low for both groups at the first postoperative day. VAS scores for pain and swelling decreased continuously over the time period in both groups. CONCLUSIONS: The longer treatment time in IR didn't increase patients' perception of pain, bleeding and swelling, compared to CR. The impact of immediate tooth restoration on patients' esthetic outcome should be further considered.

Biomechanical effect of one session of low-level laser on the bone-titanium implant interface.

Low-level laser (LLL) has been used on peri-implant tissues for accelerating bone formation. However, the effect of one session of LLL in the strength of bone-implant interface during early healing process remains unclear. The present study aims to evaluate the removal torque of titanium implants irradiated with LLL during surgical preparation of implant bed, in comparison to non-irradiation. Sixty-four Wistar rats were used. Half of the animals were included in LLL group, while the other half remained as control. All animals had the tibia prepared with a 2 mm drill, and a titanium implant (2.2 × 4 mm) was inserted. Animals from LLL group were irradiated with laser (gallium aluminum arsenide), with a wavelength of 808 nm, a measured power output of 50 mW, to emit radiation in collimated beams (0.4 cm(2)), for 1 min and 23 s, and an energy density of 11 J/cm(2). Two applications (22 J/cm(2)) were performed immediately after bed preparation for implant installation. Flaps were sutured, and animals from both groups were sacrificed 7, 15, 30, and 45 days after implant installation, when load necessary for removing implant from bone was evaluated by using a torquimeter. In both groups, torque values tended to increase overtime; and at 30 and 45 days periods, values were statistically higher for LLL group in comparison to control (ANOVA test, p < 0.0001). Thus, it could be suggested that a single session of irradiation with LLL was beneficial to improve bone-implant interface strength, contributing to the osseointegration process.

Lesão endoperio: apicectomia com abordagem palatina. Relato de caso clínico com 30 meses de acompanhamento

A fitoterapia é uma prática usada desde a antiguidade e, no âmbito odontológico, observa-se grande número de dentifrícios com extratos de plantas e produtos naturais incorporados em suas formulações, como Aloe vera e própolis, devido as suas propriedades anti-inflamatórias e antimicrobianas. Proposição: comparar a eficácia de um dentifrício com Aloe vera e própolis em sua formulação no controle da placa dental supragengival em relação a outro de uso difundido e sem esses componentes. Material a Métodos: foram analisados os índices de placa (IHOS – índice de higiene oral simplificado) em 30 pacientes divididos em três grupos, sendo o grupo I (apenas água e escova dental para higienização bucal), o grupo II (Colgate Ação Total) e o grupo III (Forever Bright Tooth Gel) nos dias zero e após 15 dias, tendo-se submetidos os dados a análise estatística comparativa, Teste de Fiedman (p < 0,0001) e Teste de Comparação Múltipla de Dunn’s (p < 0,05). Resultados: encontrou-se significância quando comparados os grupos I e II (p < 0,05) e os grupos I e III (p < 0,01), sendo que não houve diferença estatisticamente significante quando comparados os grupos II e III (p > 0,05). Conclusão: não houve desvantagem do dentifrício com Aloe vera e própolis em sua formulação em relação a outro dentifrício de uso difundido no controle de placa dental supragengival e o uso de dentifrícios pela população em geral é importante para suprir deficiências nas técnicas de higiene bucal através da ação de substâncias com ação efetiva no controle da placa dental e no intuito de evitar a desmotivação dos pacientes.

Avaliação clínica em curto prazo do sistema de Cone Morse e plataforma reduzida em prótese sobre implantes do tipo protocolo: estudo piloto randomizado controlado / Short-term clinical evaluation of morse taper and platform switching in implant-supported protocol-type prosthesis: pilot randomized controlled study

Introdução: Implantes dentários com conexões do tipo Cone Morse combinados a plataforma reduzida podem minimizar a reabsorção da crista óssea perimplantar. Entretanto, ainda não está claro se seu uso resultaria também em uma melhor manutenção da altura dos tecidos moles, o que poderia interferir no resultado estético final. Objetivo: Este estudo teve o objetivo de avaliar os tecidos moles ao redor de implantes dentários com Cone Morse, comparativamente àqueles com hexágono interno, em pacientes com edentulismo total, submetidos a carregamento imediato com prótese total fixa inferior. Material e método: Dez pacientes tiveram quatro implantes instalados na mandíbula, dois com Cone Morse e dois com hexágono interno, sendo a prótese instalada 72 horas após esse procedimento. Três meses depois, o índice de placa, o índice de sangramento à sondagem, a profundidade de sondagem, a posição do tecido marginal e o nível de inserção relativo foram avaliados pelos testes t e Wilcoxon (α = 5%). Resultado: Nos implantes com Cone Morse, a profundidade de sondagem foi significantemente menor do que naqueles com hexágono interno (p = 0,02). Nos implantes com Cone Morse, o tecido marginal estava em média 0,6 mm coronal à junção prótese-conector protético, enquanto que, nos implantes com hexágono interno, o tecido marginal esteve em média 0,4 mm apical à junção prótese-componente protético (p = 0,001). Adicionalmente, a inserção clínica nos implantes com Cone Morse estava em um nível mais coronal do que naqueles com hexágono interno (p = 0,02). Conclusão: Nas condições estudadas, os implantes do sistema Cone Morse se mostraram mais eficientes em manter a altura dos tecidos moles perimplantares do que os implantes do sistema hexágono interno.

Introduction: Dental implants with Morse taper connection combined with platform switching may minimize peri-implant crestal bone resorption. However, it remains unclear whether its use would better maintain soft tissue height, which could interfere with the esthetic outcome. Objective: The aim of this study was to evaluate the soft tissue around dental implants with Morse taper, compared to implants with internal hexagon connection, in patients with total edentulism who were submitted to immediate loading with lower fixed complete dentures. Material and method: Ten patients had four implants installed in the mandible, two with Morse taper and two with internal hexagon; and a provisional prosthesis was installed 72 hours afterward. Three months later, plaque index, bleeding on probing index, probing depth, position of soft tissue margin, and relative attachment level. Result: In implants with Morse taper, probing depth was significantly lower than in those with internal hexagon (p = 0.02). In Morse taper implants, the soft tissue margin was positioned 0.6 mm coronal to the prosthesis-abutment junction; in internal hexagon implants, marginal tissue was 0.4 mm apical to the prosthesis-abutment junction (p = 0.001). Additionally, in the Morse taper implants, the attachment level was at a more coronal level than in the internal hexagon implants (p = 0.02). Conclusion: Under the conditions studied, implants with the Morse taper connection were more effective in maintaining the height of peri-implant soft tissue than implants with internal hexagon.