Orthodontic treatment in patients with aggressive periodontitis.

INTRODUCTION: Aggressive periodontitis (AP) is a condition that promotes breakdown of the periodontal tissues in a short time. In severe cases, pathologic migration of teeth and tooth loss can occur, producing esthetic and functional problems for the patient. Orthodontic treatment may be recommended to restore esthetics and masticatory function. We assessed the effects of orthodontic movement in the periodontal tissues of treated patients with AP. METHODS: Ten subjects (ages 25.0 ± 5.22 years) with AP received periodontal treatment followed by orthodontic treatment. Maintenance sessions were performed monthly under a strict dental biofilm control. They were compared with 10 periodontally healthy subjects (ages 22.9 ± 5.23 years) who received orthodontic treatment. Probing pocket depth, clinical attachment level, bleeding on probing, and dental plaque index were measured at baseline, after orthodontic treatment, and after 4 months. RESULTS: Statistical analysis showed improvement in all clinical parameters between baseline and 4 months after orthodontic treatment: probing pocket depth (0.29 mm), clinical attachment level (0.38 mm), bleeding on probing (4.0%), and dental plaque index (11%). CONCLUSIONS: The periodontal parameters of the AP patients remained stable during orthodontic treatment under strict biofilm control.

Role of rhBMP-2 and rhBMP-7 in the metabolism and differentiation of osteoblast-like cells cultured on chemically modified titanium surfaces.

This study analyzed the role of recombinant human bone morphogenetic protein 2 (rhBMP-2) and recombinant human bone morphogenetic protein 7 (rhBMP-7) in the adhesion and differentiation of rat osteoblast-like (osteo-1) cells cultured on chemically modified titanium surfaces. Osteo-1 cells were cultured on chemically modified (modified sandblasted and acid-etched) titanium surfaces in 3 different types of medium: control, medium supplemented with 20 ng/mL rhBMP-2, and medium supplemented with 20 ng/mL rhBMP-7. The following parameters were evaluated: cell adhesion after 24 hours; total protein content; collagen content and alkaline phosphatase (AP) activity after 7, 14, and 21 days; and calcified nodule formation after 21 days. The addition of rhBMP-2 or rhBMP-7 did not influence cell adhesion (P = .1175). Cell differentiation was influenced by rhBMP-2, as demonstrated by a significant increase in collagen content after 7 days of culture (P < .0001) and a significant decrease in AP activity after 21 days (P < .0001). The addition of rhBMP-7 only influenced AP activity, and a significant increase was observed after 21 days (P < .0001). Within the limitations of the study, we conclude that the presence of rhBMP-2 or rhBMP-7 did not influence cell adhesion to chemically modified titanium surfaces but provided an additional stimulus during the differentiation of rat osteo-1 cells cultured on this type of surface.

Periodontal disease in adults with untreated congenital growth hormone deficiency: a case-control study.

AIM: The aim of this study was to investigate the possible associations between isolated growth hormone deficiency (IGHD) and periodontal attachment loss (PAL) in adults affected by congenital IGHD. MATERIALS AND METHODS: Forty-five previously identified IGHD subjects were eligible for this study. The final study sample comprised 32 cases (gender:20M/12F; age:44.8 ± 17.5) matched for age, gender, diabetes, smoking status and income to 32 controls (non-IGHD subjects). Participants were submitted to a full-mouth clinical examination of six sites per tooth and were interviewed using a structured, written questionnaire. Periodontitis was defined as proximal PAL≥5 mm affecting ≥30% of teeth. RESULTS: No significant differences were observed in the percentage of sites with visible plaque between IGHD and non-IGHD subjects (59.4% versus 46.9%, p=0.32). IGHD subjects had significant less supragingival calculus (31.3% versus 59.4%, p=0.02) and more bleeding on probing (71.9% versus 18.8%, p<0.01) than controls. PAL≥5 mm was significantly more prevalent (100% versus 71.9%, p<0.01) and affected more teeth (30.5% versus 6.7%, p<0.01) in cases than in controls. After adjusting for supragingival calculus, IGHD cases had a higher likelihood of having periodontitis than controls (OR=17.4-17.8, 95% CI=2.3-134.9, p=0.004-0.005). CONCLUSION: Congenital IGHD subjects have a greater chance of having PAL.

Repigmentação melânica gengival após cirurgia periodontal: relato de caso / Gingival melanin repigmentation after periodontal surgery: a case report

A pigmentação melânica fisiológica da gengiva é uma característica comum entre muitas raças. Muitas vezes, o paciente queixa-se da coloração gengival e mostra-se insatisfeito, uma vez que, segundo ele, compromete a estética. Os autores apresentam um caso clínico com a completa remoção da pigmentação melânica fisiológica gengival através do retalho de espessura parcial. Esta técnica pode ser utilizada com sucesso, pois permite um pós-operatório bem mais confortável que outras técnicas e com resultados satisfatórios dois anos depois.

Gingival melanin physiological pigmentation is a common characteristic among many races. Some times patients complain about gingival color and , insatisfied, show them unsatisfied because of the aesthetic factor. The authors show a case report with a complete removal of gingival melanin physiological pigmentation through partial thickness flap. This technique can be used with success since permits a more comfortable post-operative than another techniques and with satisfactory results in two years follow-up.

Compliance improvement in periodontal maintenance.

OBJECTIVES: The aim of this study was to assess the influence of efforts applied to modify the patients' behavior towards periodontal maintenance. MATERIAL AND METHODS: Patients were classified into three groups: Complete Compliance (participation in all visits), Irregular Compliance (irregular participation, one or more missing appointments), and Noncompliance (abandoned or never returned to the program). Complete compliers received usual procedures of the maintenance visit. The irregular compliers and non-compliers received usual procedures and strategies such as reminding next visit, informing patients on both periodontal disease and importance of maintenance, motivating the patient who showed an improvement in compliance. Thus, 137 patients were observed for 12 months. RESULTS: The degree of compliance has increased significantly during this period (p=0.001). No association was detected between age or gender and compliance degree. CONCLUSIONS: The results have shown that the intervention applied had a favorable influence on the patients' compliance.

Compliance improvement in periodontal maintenance

OBJECTIVES: The aim of this study was to assess the infuence of efforts applied to modify the patients' behavior towards periodontal maintenance. MATERIAL AND METHODS: Patients were classifed into three groups: Complete Compliance (participation in all visits), Irregular Compliance (irregular participation, one or more missing appointments), and Noncompliance (abandoned or never returned to the program). Complete compliers received usual procedures of the maintenance visit. The irregular compliers and non-compliers received usual procedures and strategies such as reminding next visit, informing patients on both periodontal disease and importance of maintenance, motivating the patient who showed an improvement in compliance. Thus, 137 patients were observed for 12 months. RESULTS: The degree of compliance has increased signifcantly during this period (p=0.001). No association was detected between age or gender and compliance degree. CONCLUSIONS: The results have shown that the intervention applied had a favorable infuence on the patients' compliance.

The subepithelial connective tissue pedicle graft combined with the coronally advanced flap for restoring missing papilla: a report of two cases.

This case report describes the clinical application of the coronally advanced flap procedure associated with the subepithelial connective tissue pedicle graft in the reconstruction of interdental papilla. This procedure was used in two distinct situations: to reconstruct missing papilla and cover two Miller Class IV gingival recessions between the maxillary right lateral incisor and canine (case 1) and to improve esthetics and restore missing papilla between the maxillary left central and lateral incisors (case 2). In case 1, there was a clinical attachment level gain, complete root coverage (canine), and an increase in papillary height. Case 2 showed similar improvements for the interdental papilla, ie, significant reduction of the black triangle. Subepithelial connective tissue pedicle graft associated with a coronally advanced flap yielded satisfactory esthetics and may be considered a viable approach for the treatment of missing papilla associated or not with recession-type defects. However, further investigation is required.

Abordagem cirúrgica para o restabelecimento estético/funcional dos pacientes com fibromatose gengival hereditária / Surgical approach for functional and aesthetic reestablishment of the patients with hereditary gingival fibromatosis

A fibromatose gengival hereditária (FGH) é uma condição bucal rara, caracterizada clinicamente pelo crescimento contínuo e progressivo do tecido gengival. O crescimento gengival severo causa comprometimento estético/funcional, tendo como sinais clínicos comuns diastemas, mau posicionamento dentário e proeminência labial. Este relato de caso descreve o tratamento cirúrgico em duas etapas de um paciente que se apresentou à Universidade de São Paulo (FOUSP) queixando-se do aspecto antiestético ao sorrir, devido ao aumento gengival. A primeira etapa consistiu em um retalho parcial com excisão de margem gengival (remoção de altura/espessura do tecido conjuntivo). Na segunda etapa, foi realizado um retalho total associado à excisão de margem, para obter acesso ao tecido ósseo e melhorar o contorno da margem gengival. O pós-operatório mostrou uma reparação satisfatória, com um padrão da margem gengival e da crista-óssea compatível com a saúde periodontal e de acordo com as expectativas estéticas do paciente. A avaliação histológica das biópsias gengivais confirmou o diagnóstico clínico de FGH. Considerando as limitações de um relato de caso, coloca-se uma alternativa viável para demonstrar que a associação dessas técnicas, desde que bem indicadas, é uma possível abordagem cirúrgica para o restabelecimento estético/funcional dos pacientes com FGH.

Hereditary gingival fibromatosis (HGF) is a rare buccal condition, characterized by a continuous and progressive enlargement of the maxilary and mandibular gingiva. The severe gingival overgrowth causes functional and aesthetic problems with common clinical aspects as diastemas, irregular dental positioning and labial prominence. This article describes the surgical treatment in 2 stages of a man who presented himself at the University of São Paulo (FOUSP) complaining of unfavorable smile sapect due to the gingival overgrowth. First stage consisted of a partial flap with internal bevel incision to remove height/thickness of the connective tissue. In the second stage mucoperiostal flaps with internal bevel incision were made to access the bone and to improve the contour of the gingival tissue. The postoperative course showed a satisfatory healing with a compatible relation between gingival tissue/bone crest, periodontal health and the aesthetic expectations of the patient. Histological examination of gingival specimens supported the clinical diagnosis of HGF. Considering the limitations of a case report, na alternative is presented to demonstrate the association of surgical techniques if well indicated and a possible surgical approach for functional and aesthetic reestablishment of the patients with HGF.

Risk indicators for aggressive periodontitis in an untreated isolated young population from Brazil.

This study aimed to assess the prevalence of aggressive periodontitis (AgP), and to investigate the association between demographic, socioeconomic and behavioral risk indicators with AgP in an untreated and isolated young population in Southeastern Brazil. For this cross-sectional survey, 134 subjects aged 12-29 years were selected by a census. Of those eligible, 101 subjects received a full-mouth clinical examination, and were interviewed using a structured written questionnaire. Cases were defined as individuals with 4 or more teeth with attachment loss > 4 mm or > 5 mm in the age groups 12-19 and 20-29, respectively. Overall, 9.9% of the subjects presented AgP (10.3% of the 12-19-year-olds and 9.7% of the 20-29-year-olds). The only risk indicator significantly associated with AgP in this isolated population was a high proportion of sites (> 30%) presenting supragingival calculus [OR = 23.2]. Having experienced an urgency dental treatment was a protective factor for AgP [OR = 0.1]. The authors concluded that this isolated and untreated population from Brazil presented a high prevalence of AgP. Local plaque-retaining factors played a major role in the prevalence of AgP in this isolated population, and should be included in further studies evaluating this destructive periodontal disease form.

Tooth loss prevalence and risk indicators in an isolated population of Brazil.

OBJECTIVE: The aim of this study was to assess the prevalence, extent, and risk indicators of tooth loss in an isolated population of Brazil. MATERIAL AND METHODS: Two-hundred-and-forty-two subjects, ranging in age from 14 to 82 years (mean 36.2 years), were identified by census in an isolated population of Brazil. All consenting subjects received a full-mouth clinical (DFT index and information about missing teeth) and periodontal examination of 6 sites per tooth. Furthermore, they were interviewed using a structured written questionnaire in order to gather information about demographic, environmental, and biological variables. RESULTS: Of the 200 subjects (80% response rate), 19 (9.5%) were edentulous, 90% had lost at least one tooth, and 39% had lost more than 8 teeth. The mean number of teeth lost was 9.5 (95% CI = 8.2-10.8). First mandibular molars were the most commonly missing teeth. In a multiple logistic regression analysis based on a theoretical hierarchical model of tooth loss, having more than 8 teeth lost was strongly associated with adult age (OR = 18.3-17.3, 95% CIs = 4.8-69.7 and 4.0-75.1) and female gender (OR = 5.9, 95% CI = 1.9-18.2) in the final model. CONCLUSIONS: Tooth loss was highly prevalent and extensive in this isolated population. Demographic and behavioral factors played an important role in tooth loss prevalence in this population.

Morphometric study of length and grooves of lower central incisors roots / Estudo morfométrico das concavidades proximais e do comprimento radicular dos incisivos centrais inferiores em humanos

Introduction: Root grooves are considered a risk factor for periodontal disease. The purpose of this study was to measure the length of the root of lower central incisors (LCI), as well as the width and depth of the concavities of their proximal surfaces. Material and methods: The width and depth of root concavities, as well as root length, were evaluated in 90 LCI. All teeth were measured using a digital contour measuring instrument (Contracer®) for the root grooves and a digital calliper for evaluating root length. Results: After statistical analysis (t-Student and Kruskal-Wallis Anova tests, p<0.05) it was possible to confirm: the mean root length on its distal surface (13.88 ±1.47 mm) and on its mesial surface (13.76±1.50 mm). Concavities were present in 100% of the samples; concavities were found 2 mm, coronally from the CEJ, at the CEJ, and at all root surface. The concavities were wider than deeper; on the mesial surface, the greatest width was 1.877 mm and the greatest depth was 0.135 mm; on the distal surface the greatest width was 1.717 mm and the greatest depth was 0.118 mm. Conclusion: The distal surface of the lower central incisor is the longest. The root concavities on the proximal surfaces are present in 100%; the greatest width and depth was at 6 mm apically from the CEJ at both sides, which corresponds to the root middle third. One must get acquainted to the morphological variations of roots to enhance diagnosis, prognosis and treatment.

Introdução e objetivo: Concavidades radiculares são tidas como fator de risco de doenças periodontais. Esta investigação foi realizada com o objetivo de estudar as concavidades radiculares proximais (largura e profundidade) e o comprimento radicular do incisivo central inferior (ICI). Material e métodos: A largura e a profundidade das concavidades radiculares, assim como o comprimento radicular, foram avaliadas em 90 ICI. Todos os dentes foram medidos por aparelho Contracer® computadorizado para as concavidades radiculares, enquanto os comprimentos radiculares foram medidos por meio de um paquímetro digital. Resultados: Após análise estatística (testes t de Student e Kruskal-Wallis Anova), foi possível confirmar a média dos comprimentos radiculares em sua superfície distal (13,88±1,47 mm) e mesial (13,76±1,50 mm). As concavidades estavam presentes em 100% da amostragem; foram encontradas concavidades 2 mm coronariamente à JEC, na JEC e também em toda a superfície radicular. As concavidades tinham maior largura do que profundidade; na superfície mesial, as maiores medidas de largura e profundidade foram 1,877 mm e 0,135 mm, enquanto na superfície distal foram 1,717 mm e 0,188 mm. Conclusão: A superfície distal do ICI é a mais longa. As concavidades estão presentes em todos os ICIs; a maior largura e profundidade foi de 6 mm apicalmente à JEC em ambos os lados, correspondendo ao médio da raiz. É preciso, portanto, conhecer as variações morfológicas de raízes para melhores diagnósticos, prognósticos e tratamentos.

Efeitos do plasma rico em plaquetas no processo de reparação de feridas dérmicas padronizadas em ratos / Effect of platelet-rich plasma on the standardizd dermal wound healing in rats

O uso do plasma rico em plaquetas (PRP) pode apresentar resultados favoráveis na reparação de feridas. Analisou- se os efeitos do plasma rico em plaquetas no processo de reparação tecidual em feridas dérmicas padronizadas, com a utilização de “punch”, para excisão do fragmento de pele, com 5mm de diâmetro e 2mm de profundidade, no dorso de 40 ratos. Destes, 40 foram utilizados para análise microscópica e 8 para macroscópica. Os animais foram divididos em dois grupos: grupo teste as feridas foram tratadas com plasma rico em plaquetas e grupo controle foi utilizado soro fisiológico. Além disso, foram utilizados 5 ratos para a determinação do número de plaquetas presentes no PRP. Os resultados morfométricos obtidos através do teste de Mann-Whitney mostraram que não existiram diferenças estatisticamente significantes com relação à área e perímetro, entre os grupos teste e controle. No entanto houve diferença estatisticamente significante, em ambos os grupos, entre os períodos de avaliação, sendo maior no período “baseline” seguido em ordem decrescente pelos períodos 24 horas 3, 7 e 14 dias. Através da análise histomorfológica, utilizando o teste de Mann-Whitney, não foram verificadas diferenças estatisticamente significantes entre os grupos teste e controle em relação às variáveis estudadas, edema, exsudato inflamatório, neovascularização, necrose, colagenização, presença de fibroblastos jovens, reepitelização, presença de crosta, nos quatro períodos de observação (24 horas, 3 dias, 7 dias e 14 dias). A análise histomorfométrica também realizada através do teste de Mann-Whitney não mostrou diferenças estatisticamente significantes entre os grupos teste e controle em relação à celularidade, espaço em branco e matriz extracelular (matriz colagênica) nos quatro períodos de observação mencionados acima.

The employment of platelet-rich plasma (PRP) can present favorable outcomes in tissue healing since it represents anatural source of growth factors. The purpose of this research was to analyze the effects of platelet-rich plasma on tissue healing. Standard dermical wounds were made with the useof a punch, to excise a skin fragment with 5 millimeters of diameter and 2 milliner’s in depth in the back of 48 rats.Forty rats were used for microscopical analysis and 8 for macroscopic analysis. The animals were divided into twogroups according to the treatment they were submitted: in one group called Test, the wounds were treated with plateletrich plasma and in another one called Control, saline was used. Also, 5 rats were used to determine the number of platelets present in the platelet-rich plasma. The specimens were processed for macroscopic and microscopic analysis...

Avaliação imunohistoquímica de proteínas da matriz extracelular na reparação de defeitos agudos de furca classe II em cães / Immunohistochemical evaluation of extracellular matrix proteins in the repair of acute class II furcation defects in dogs

O estudo da reparação periodontal deve se basear em modelos que forneçam os dados necessários para a análise deste fenômeno. O modelo proposto, de defeitos agudos de furca classe II, parece ser o mais indicado, pois possui um grau previsível de regeneração espontânea, fornecendo um ambiente em que é possível o estudo dos fatores que favorecem a regeneração dos tecidos periodontais. O objetivo deste trabalho foi avaliar a qualidade da reparação de defeitos agudos de furca classe II por meio da imunoexpressão de proteínas da matriz extracelular (MEC). Após a elevação de retalhos de espessura total, em quatro cães, foram criados defeitos agudos de furca classe II nos segundos, terceiros e quartos pré-molares de um dos lados da mandíbula. Os retalhos foram posicionados coronariamente e suturados. Após 45 dias, os espécimes foram coletados, descalcificados e analisados, em um plano vestíbulo- lingual, por meio de técnica imunohistoquímica para osteopontina (OPN), sialoproteína óssea (BSP) e osteonectina (BON). Nos tecidos periodontais originais, a marcação para os anticorpos testados foi fracamente positiva na MEC, caracterizando a presença de tecidos maduros. Já no interior dos defeitos, houve diferença na marcação, com marcação mais pronunciada para BSP, OPN e BON. Conclui-se que os resultados evidenciam maior atividade metabólica nos tecidos reparativos.

The study of periodontal repair should be based on models that provide the data required for analysis of thisphenomenon. The proposed model of acute class II furcation defects seems to be the most appropriate, as it provides apredictable degree of spontaneous regeneration, creating an environment where the factors that promote the regeneration of periodontal tissues can be studied. The objective of this study was to evaluate the quality of repair ofacute class II furcation defects, by means of immunoexpression of extracellular matrix (ECM) proteins.After lifting full thickness flaps in 4 dogs, acute class II furcation defects were created in the second, third and fourth premolar in one side of the mandible. The flaps were coronallypositioned and sutured. After 45 days, the specimens were collected, decalcified and analyzed in a buccal-lingual plane, by immunohistochemistry technique for osteopontin (OPN), bone sialoprotein (BSP) and osteonectin (BON). In original periodontal tissues, the marking for the tested antibodieswas weakly positive in the ECM, characterizing the presence of mature tissues. Inside the defects, there was a difference in the marking, with markings more pronounced for BSP, OPN and BON. It was concluded that the results showed greater metabolic activity in the reparative tissues.

Risk indicators for aggressive periodontitis in an untreated isolated young population from Brazil

This study aimed to assess the prevalence of aggressive periodontitis (AgP), and to investigate the association between demographic, socioeconomic and behavioral risk indicators with AgP in an untreated and isolated young population in Southeastern Brazil. For this cross-sectional survey, 134 subjects aged 12-29 years were selected by a census. Of those eligible, 101 subjects received a full-mouth clinical examination, and were interviewed using a structured written questionnaire. Cases were defined as individuals with 4 or more teeth with attachment loss > 4 mm or > 5 mm in the age groups 12-19 and 20-29, respectively. Overall, 9.9 percent of the subjects presented AgP (10.3 percent of the 12-19-year-olds and 9.7 percent of the 20-29-year-olds). The only risk indicator significantly associated with AgP in this isolated population was a high proportion of sites (> 30 percent) presenting supragingival calculus [OR = 23.2]. Having experienced an urgency dental treatment was a protective factor for AgP [OR = 0.1]. The authors concluded that this isolated and untreated population from Brazil presented a high prevalence of AgP. Local plaque-retaining factors played a major role in the prevalence of AgP in this isolated population, and should be included in further studies evaluating this destructive periodontal disease form.

O uso de enxaguatórios bucais no controle da halitose / Use of the mouthrinses on halitosis control

A halitose é causada principalmente pela presença dos compostos sulfurados voláteis produzidos por bactérias proteolíticas na cavidade bucal por meio da degradação dos substratos orgânicos presentes na saliva, no fluido do sulco gengival, nos tecidos moles e duros da boca. Diferentes produtos, como os enxaguatórios bucais, vêm sendo utilizados em ampla escala pela população para o controle da halitose, como um suplemento à limpeza mecânica dos dentes e do dorso da língua. O objetivo da presente revisão de literatura é avaliar a eficácia de alguns enxaguatórios bucais disponíveis no mercado nacional na redução dos compostos sulfurados voláteis e, consequentemente, da halitose.

Oral malodor is mainly caused by the presence of volatile sulfur-compounds produced by proteolitic bacteria in the oral cavity by means of degradation of organic substrates presents in saliva, crevicular fluid, oral soft and hard tissues. Various products, as mouthrinses, have been used in large scale by the population to control halitosis as a supplement to mechanical cleaning of teeth and tongue dorsum. The aim of this review is to evaluate the efficacy of some mouthrinses available in the national market in the reduction the volatile sulfur compounds and, consequently, the halitosis.

Detection of MMP-2 and MMP-9 salivary levels in patients with chronic periodontitis before and after periodontal treatment / Detecção de MMP-2 e MMP-9 antes e após o tratamento periodontal de pacientes com periodontite crônica

Purpose: Patients suffering from periodontal disease have high salivary levels of gelatinases, especially metalloproteinases (MMPs). The aim of this study was to evaluate MMP-2 and MMP-9 levels in whole saliva of patients with chronic periodontitis before and after non-surgical treatment, using a zimographic assay. Methods: The test group comprised 8 patients with chronic periodontitis before (G1) and after (G2) periodontal treatment. The control group (GC) consisted of 8 subjects with no evidence of periodontal disease. The whole stimulated saliva was collected and analyzed by zymography. Gels were assessed with the AphaDigiDoc RT® software program. Data were analyzed by paired t test, ANOVA, and t-Student tests.Results: The MMP-9 mean values (±SD) in arbitrary units (AU) for G1 were 74.17 (±16.28) AU, for G2 65.58 (±20.18) AU, and for GC 74.75 (±23.16) AU. MMP-2 mean values were 100.33 (±25.24) AU for G1, 93.62 (±30.93) AU for G2, and 97.50 (±24.82) AU for GC. No statistically significant differences were found between groups for MMP-2 and MMP-9 activity (P>0.05).Conclusion: The results suggest that the analysis of gelatinases in saliva using zymography may not be a precise indicator of periodontal disease activity.

Objetivo: Pacientes com doença periodontal possuem altos níveis de gelatinases, especialmente metaloproteinases (MMPs) na saliva. O objetivo deste estudo foi avaliar os níveis de gelatinases (MMP-2 e MMP-9) na saliva total de pacientes portadores de periodontite crônica antes e após tratamento periodontal, utilizando a zimografia. Metodologia: O grupo teste foi constituído por 8 portadores de periodontite crônica generalizada antes (G1) e (G2) depois do tratamento periodontal. O grupo controle (GC) constituído por 8 indivíduos sem sinais de doença periodontal. A saliva total estimulada foi coletada e analizada por zimografia. Os géis foram avaliados pelo programa AlphaDigiDoc® RT 2. Os dados foram analisados por teste-t pareado, ANOVA e teste-t de Student. Resultados: Para MMP-9 os valores médios (±DP) em unidades arbitrárias (UA) foram 74,17 (±16,28) UA para G1, 65,58 (±20,18) UA para G2, e 74,75 (±23,16) UA para GC. Para MMP-2, os valores foram 100,33 (±25,24) UA para G1, 93,62 (±30,93) UA para G2 e 97,50 (±24,82) UA para GC. Não houve diferença estatisticamente significante entre os grupos para os níveis de MMP-2 e MMP-9 (P>0,05). Conclusão: Os resultados sugerem que a análise da gelatinase na saliva utilizando a zimografia não é um indicador preciso da atividade da doença periodontal.

Risk indicators for increased probing depth in an isolated population in Brazil.

BACKGROUND: The aim of this study was to assess the prevalence, extent, and severity of probing depth (PD) and to investigate the associations between demographic, socioeconomic, and behavioral risk indicators and PD in a periodontally untreated and isolated population in Brazil. METHODS: The target population consisted of all individuals aged > or =12 years as identified by a census. Consenting participants were submitted to a full-mouth clinical examination of six sites per tooth and were interviewed using a structured written questionnaire. RESULTS: Among the 214 subjects who were interviewed and clinically examined, PD > or =4 mm was observed in 54% to 83% of the subjects, depending on age, whereas the age-dependent prevalence of PD > or =6 mm ranged from 5% among 12- to 19-year-olds to 50% among 40- to 49-year-olds, decreasing to 40% among subjects > or =50 years of age. Multivariate analyses identified supragingival calculus (odds ratio [OR] = 5.4 to 10.3; 95% confidence intervals [CIs]: 2.5 to 11.6 and 4.0 to 26.2 for 20% to 50% and >50% of the sites, respectively) as a risk indicator for PD > or =4 mm, whereas age > or =40 years (OR = 9.0; 95% CI: 1.7 to 48.5), being a moderate/heavy smoker (OR = 3.7; 95% CI: 1.4 to 10.1), and having supragingival calculus in 20% to 50% of sites (OR = 6.8; 95% CI: 1.4 to 32.4) or in >50% of sites (OR = 15.3; 95% CI: 3.2 to 73.6) were risk indicators for PD > or =6 mm. Having undergone urgency dental treatment was a protective factor for PD > or =4 and > or =6 mm (OR = 0.4; 95% CI: 0.2 to 0.8). CONCLUSIONS: Increased PD is highly prevalent in this isolated population. Behavioral factors played a significant role as risk indicators for increased PD in this isolated population.

Prática laboratorial de cirurgiaperiodontal: otimizando oensino-aprendizagem / Laboratorial practice of periodontal surgery: improvement of the teaching and learning process

O objetivo deste trabalho foi apresentar uma atividadede laboratório com mandíbula de porco utilizadana Disciplina de Periodontia da Faculdade de Odontologiada Universidade de São Paulo (FOUSP) queotimiza o ensino-aprendizado das técnicas cirúrgicasperiodontais. A mandíbula de porco tem característicasanatômicas semelhantes às das estruturas gengivaise periodontais humanas. É importante ressaltar queessa prática pré-clínica parece ter resultado num aprimoramentodo aprendizado por parte dos alunos.

Periodontal attachment loss in an untreated isolated population of Brazil.

BACKGROUND: The aim of this study was to assess the prevalence, extent, and severity of clinical attachment loss (CAL) and to investigate the association of demographic, socioeconomic, and behavioral risk indicators with CAL in an untreated isolated population in Brazil. METHODS: All subjects aged > or =12 years were identified by a census. Participants were submitted to a full-mouth clinical examination of six sites per tooth and were interviewed using a structured, written questionnaire. RESULTS: Among the 214 subjects who were interviewed and examined clinically, CAL > or =5 mm in at least one site was observed in 8% of the 12- to 19-year-olds and in all dentate subjects > or =50 years of age; the age-dependent prevalence of CAL > or =7 mm in at least one site ranged from 5% among 12- to 19-year-olds to 83% among subjects > or =50 years old. Multivariate analysis identified plaque (odds ratio [OR] = 2.8), supragingival calculus (OR = 2.9 to 10.6), age > or =30 years (OR = 11.4), and smoking (OR = 2.4) as risk indicators for CAL > or =5 mm and smoking (OR = 8.2) as a risk indicator for CAL > or =7 mm. CONCLUSIONS: CAL is highly prevalent in this isolated population. The high occurrence of CAL in young age groups and the confirmation of traditional risk indicators for CAL in this study suggest that other factors, such as host susceptibility, may be needed to explain the high levels of CAL found. Age and behavioral factors were risk indicators associated significantly with the CAL found in this population and may be useful indicators of high-risk subjects for periodontal diseases.

Radiographic alveolar bone loss in patients undergoing periodontal maintenance.

The aim of the present cross-sectional investigation was to evaluate percentage of bone loss in patients who had been one year under periodontal maintenance at the Department of Periodontology, Faculty of Dentistry, University of São Paulo by radiographic analysis. Complete sets of periapical radiographs provided data regarding percentage of alveolar bone loss, which was correlated with arches, tooth group and proximal sites. The sample consisted of 27 men and 53 women ranging in age from 16 to 85 years (mean: 48.3 years). A total of 1,120 periapical radiographs (1,970 teeth) were digitized and analyzed with the Image Tool software (University of Texas Health Science Center). Bone loss was defined as when the distance between the cemento-enamel junction and the alveolar bone crest was greater than 2 mm. Two examiners (p<0.0001) performed radiographic measurements of bone loss. The Greenhouse-Geisser normality test and a univariate analysis of variance were used for statistical analysis. Mean bone loss was 20.60% (+/-12.12). The highest level of bone loss was observed on the distal surface and in the upper arch, as well as in the upper incisors and molars.