Treatment of peri-implantitis using nonsurgical debridement combined with bioresorbable doxycycline nanospheres: a case report with 3-year follow-up.

Treatment of peri-implant diseases focuses on reducing the bacterial load and consequent infection control. The use of local antimicrobials as an adjunct to mechanical therapy may result in a better outcome. Among antimicrobials, doxycycline stands out because of its local modulation of cytokines, microbial reduction, and clinical parameters in the treatment of periodontal diseases. The objective of this case report was to describe the combined application of mechanical debridement and bioresorbable doxycycline-loaded nanospheres for the treatment of peri-implantitis in a 71-year-old man. At the 3-year evaluation, the peri-implant tissues had improved, showing decreased probing depths, an absence of bleeding on probing, and no suppuration. This case report highlights the importance of supportive therapy, which is essential for the long-term success of peri-implantitis treatment.

Smoking negatively impacts the clinical, microbiological, and immunological treatment response of young adults with Grade C periodontitis.

OBJECTIVE: This study aimed to investigate the influence of smoking on clinical, microbiological and immunological parameters in young adult with stage III-IV Grade C periodontitis after full-mouth ultrasonic debridement (FMUD) associated with Amoxicillin and Metronidazole (AMX + MTZ), comparing smokers (PerioC-Y-Smk) with non-smokers (PerioC-Y-NSmk). MATERIALS AND METHODS: Fifteen PerioC-Y-NSmk and 14 PerioC-Y-Smk patients underwent FMUD associated with AMX + MTZ for 10 days. All parameters were collected at baseline and 3 and 6 months after treatment. Plaque index (PI), bleeding on probing (BoP), probing depth (PD), clinical attachment level (CAL)- the primary variable-, and gingival recession (GR) were clinically assessed. The impact of PI on CAL change at 6-month was verified by a regression analysis. Samples of the subgingival biofilm was collected for detection of levels of Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P.gingivalis), Tannerella forsythia (T. forsythia), and Fusobacterium nucleatum ssp (F. nucleatum), and were analyzed by real-time qPCR; gingival crevicular fluid was collected for detection of levels of interleukin (IL)-1ß, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ, which were analyzed using an enzyme immunoassay. RESULTS: PerioC-Y-Smk had significantly higher PI, BOP, and GR at baseline compared to non-smokers (p < .05). PerioC-Y-Smk presented higher PD, CAL, and GR at 3 and 6 months (p < .05) compared with PerioC-Y-NSmk in the same periods; PI negatively affected CAL gain in PerioC-Y-NSmk at 6-month follow-up (p = .052) and did not impact on clinical response in PerioC-Y-Smk (p = .882). Lower levels of IFN-γ, IL1-ß, and IL-4 were observed at 3 months in the PerioC-Y-NSmk (p < .05) compared with PerioC-Y-Smk. Lower proportions of P. gingivalis were observed in PerioC-Y-NSmk at baseline and at 3 months (p < .05) and lower proportions of F. nucleatum were observed at 6 months, in the PerioC-Y-NSmk (p < .05). CONCLUSIONS: PerioC-Y-Smk presents an unfavorable clinical, microbiological, and immunological response after 3 and 6 months after FMUD associated with AMX + MTZ. CLINICAL RELEVANCE: Smoking worsens periodontal condition of young treated adults presenting stage III/IV Grade C periodontitis.

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.

Clinical and Microbiological Evaluation of Surgical and Nonsurgical Treatment of Aggressive Periodontitis.

The present study aimed to evaluate clinical and microbiological effects of surgical and nonsurgical periodontal therapy in generalized aggressive periodontitis (GAgP) treatment. Sixteen GAgP patients were included in this randomized split-mouth design clinical trial. Maxillary quadrants were allocated into two groups: Nonsurgical Therapy (NST) and Surgical Therapy (ST). The following clinical parameters were assessed: plaque index (PI), bleeding on probing index (BoP), probing depth (PD), clinical attachment level (CAL) and gingival margin position (GMP). Concentrations of Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) in the subgingival biofilm were also determined. Clinical and microbiological parameters were assessed at baseline (n=16), 3 (n=15), 6 (n=15) and 12 months (n=8) after treatment. ST was able to promote higher PD reduction compared to NST in deep pockets at 12 months (p<0.05) and in posterior teeth at 6 months (p<0.05). In addition, higher gingival recession was observed in posterior teeth of the ST group at the 6th month (p<0.05). However, ST failed to promoted additional CAL gain in any timepoint (p>0.05). Moreover, microbiological evaluation showed no statistical difference in levels of Aa and Pg for both groups at all follow-up periods. Surgical therapy promoted similar clinical benefits to GAgP therapy. Moreover, both therapies failed to reduce Aa and Pg levels at different follow-up times.

O uso da matriz colágena porcina na reconstrução tecidual em Periodontia / The use of the porcin collagen matrix in the periodontal tissue reconstruction

A doença periodontal causa uma perda na estrutura de suporte dos elementos dentários. Como consequência, ocorre o aparecimento de sequelas provenientes dessa doença. Por conta disso foram desenvolvidos materiais com a fi nalidade de regeneração tecidual na estrutura de suporte, para que houvesse maior sobrevida desses elementos, aumento na quantidade de gengiva inserida e melhor otimização estética para os pacientes. Dentre os inúmeros materiais, temos a Matriz Colágena Porcina, que simplesmente é uma membrana obtida a partir de suínos, sendo que esta passa por uma cadeia de procedimentos, com a fi nalidade de minimizar e/ou eliminar qualquer tipo de interação alergênica no ser humano. A sua utilização é dada principalmente no aumento de tecidos moles ao redor de dentes afetados com a doença periodontal e em implantes osseointegrados, trazendo como principal vantagem a redução de morbidade do paciente, evitando, assim, a necessidade de um segundo sítio cirúrgico.

Periodontal disease results in the loss of structural support on dental elements. As such, sequels can be seen in the mouth. For this, materials were develop for tissue regeneration in order to increase the amount of attached gingiva and to optimize patient esthetics. The porcine collagen matrix is a product were the collagen undergoes a series of several treatments to minimize any type of allergic reaction to the human body. For example, it can be used for soft tissue augmentation around affected teeth and dental implants. Also, the porcine collagen matrix can reduce patient morbidity because it avoids autologous soft tissue harvesting.

Condição periodontal em puérperas atendidas em Hospital Universitário da FMJ, Brasil / Periodontal condition of postpartum women at the University Hospital of Faculty of Medicine of Jundiaí, Brazil

Objetivo: avaliar a prevalência das doenças periodontais em uma amostra de puérperas atendidas no Hospital Universitário da Faculdade de Medicina de Jundiaí. Material e métodos: a amostra foi composta por 400 gestantes que realizaram o parto no hospital acima referido. Os dados coletados até 48 horas pós-parto foram: anamnese, índice de placa (IP), índice de sangramento a sondagem (IS), profundidade de sondagem e nível de inserção clínica. Após a coleta, a amostra foi dividida em dois grupos: sem doenças periodontais (saudável, com gengivite ou com periodontite leve ­ P1); ou com doenças periodontais (periodontite moderada ­ P2 ou periodontite severa ­ P3). Resultados: a prevalência das doenças periodontais de moderada a severa (P2-P3) na população estudada foi de 38,7%. A prevalência das doenças periodontais com alguma perda de inserção, ou seja, de leve a severa (P1-P3) foi de 77,7%, sendo 39% com periodontite leve (P1) e apenas 6,2% com periodontite severa (P3). Os valores médios de IP e IS foram signifi cantemente menores (p < 0,0001) no grupo sem doenças periodontais (57,9% e 57,6%, respectivamente), quando comparado ao grupo com doenças periodontais (80,1% e 78,7%, respectivamente). Conclusão: as doenças periodontais foram bastante expressivas na população examinada.

Objective: to evaluate the prevalence of periodontal disease in a sample of postpartum women at the University Hospital of the Faculty of Medicine of Jundiai. Material and methods: it consisted of 400 women who delivered at the hospital above. The data collected up to 48 hours postpartum were: history, plaque index, bleeding on probing index probing depth and clinical attachment level. After data collection, the sample was divided into two groups: no periodontal disease (healthy or with gingivitis or mild periodontitis ­ P1) or periodontal disease (moderate periodontitis ­ P2; or severe periodontitis ­ P3). The data showed that the prevalence of moderate to severe periodontal diseases (P2-P3) in the study population was 38.7%. Results: of periodontal diseases with some loss of insertion, i.e., from mild to severe (P1-P3) was 77.7%, 39% with mild periodontitis (P1) and only 6.2% with severe periodontitis (P3). The average value of PI and SI were significantly lower (p < 0.0001) in the group without periodontal diseases (57.9% and 57.6% respectively) than in the group with periodontal diseases (80.1% and 78.7% respectively). Conclusion: periodontal diseases were quite expressive in the population examined.

Periodontia e Ortodontia: o paciente ortodôntico e o controle do biofilme / Periodontics and Orthodontics: the orthodontic patient and biofilm control

Está bem estabelecido que a presença de uma microflora patogênica no biofilme é o fator etiológico primário no desenvolvimento das doenças periodontais. Assim, o principal objetivo durante a terapia periodontal é o rompimento e remoção do biofilme, juntamente com a restauração do relacionamento homeostase entre a resposta imune do hospedeiro e a comunidade polimicrobiana do biofilme. Fatores como as características de uma superfície podem influenciar a quantidade e a qualidade do biofilme a ser removido da superfície dental, como é possível observar em pacientes ortodônticos. O tratamento ortodôntico com componentes fixos é utilizado amplamente na resolução de diversas más-oclusões. Durante a terapia ortodôntica, os ortodontistas são frequentemente confrontados com gengivite generalizada em seus pacientes, entre outras alterações periodontais. Não há um consenso na literatura sobre a transitoriedade dessas reações no periodonto. Assim, o objetivo desta revisão da literatura foi discutir diferentes perspectivas relacionadas às áreas de Periodontia e Ortodontia no controle do biofilme em pacientes ortodônticos.

It is well established that the presence of a pathogenic microflora in biofilm is the primary etiological factor in the development of periodontal diseases. Thus, the main objective in periodontal therapy is the disruption and removal of biofilm along with the restoration of homeostasis relationship between the host immune response and polymicrobial biofilm community. Factors such as the characteristics of a surface can influence the quantity and quality of the biofilm to be removed from the tooth surface, as can be seen in orthodontic patients. Orthodontic treatment with fixed components is widely used in solving various malocclusions. During orthodontic treatment, orthodontists are often faced with generalized gingivitis in their patients, among other periodontal changes. There is no consensus in the literature about the transience of these reactions in periodontal tissues. The objective of this literature review was to discuss differents perspectives related areas of Periodontics and Orthodontics about the biofilm control in orthodontics patients.

Diagnóstico, etiologia e tratamento das doenças peri-implantares / Diagnosis, etiology, and treatment of peri-implant diseases

Sendo a mucosite e a peri-implantite as lesões mais recorrentes ao redor de implantes, e cada vez mais frequentes no consultório odontológico, faz-se necessária uma compreensão abrangente sobre seus principais fatores etiológicos, métodos de prevenção e modalidades de tratamento para uma correta conduta clínica. A presente revisão da literatura visa, de forma clara e sintetizada, identificar e ressaltar as principais causas de mucosite e peri-implantite descritas na literatura, orientar o cirurgião-dentista na obtenção do diagnóstico, informar o leitor sobre as principais modalidades de tratamento e destacar a importância da terapia de suporte para a manutenção da saúde peri-implantar. A busca eletrônica nas bases de dados Scopus, PubMed e Web of Science foi orientada pelos seguintes tópicos: definição de mucosite e peri-implantite, prevalência, obtenção do diagnóstico, fatores de risco, modalidades de tratamento e terapia de suporte. Os resultados da busca indicaram: 1) a mucosite peri-implantar pode ocorrer em 80% dos indivíduos, e a peri-implantite em até 56%; 2) não há uma única ferramenta para o diagnóstico das doenças peri-implantares, mas sim uma associação destas; 3) a etiologia da peri-implantite parece ser multifatorial, e alguns indivíduos parecem ser mais propensos ao seu desenvolvimento do que outros; 4) a mucosite pode se resolver apenas com a remoção e desinfecção não cirúrgica dos fatores locais, enquanto que na peri-implantite a terapia cirúrgica é adotada quando os sítios afetados não respondem à terapia básica; e 5) a terapia de suporte é imprescindível na determinação do sucesso a longo prazo no tratamento das doenças peri-implantares.

As the mucositis and peri-implantitis are the most recurrent lesions around implants and these increasingly frequent in the dental office, a comprehensive understanding of its main etiological factors, prevention methods and treatment modalities is necessary for proper clinic conduct. This literature review aims, in a clearly and synthesized form, identify and highlight the main causes of mucositis and peri-implantitis described in the literature, guide the dentist in getting the diagnosis, inform the reader about the main types of treatment and highlight the importance of supportive therapy for maintenance of the peri-implant health. The electronic search in Scopus databases, PubMed and Web of Science was guided by the following topics: definition of mucositis and peri-implantitis, prevalence, diagnosis, risk factors, treatment modalities and supportive therapy. The search results indicated that: 1) peri-implant mucositis can occur in 80% of individuals, peri-implantitis up to 56%; 2) there isn't a unique tool for the diagnosis of peri-implant disease, but a association of tools; 3) etiology of peri-implantitis appears to be multifactorial, and some individuals appear to be more prone to their development than others; 4) mucositis can be solved only with the non-surgical removal and disinfection of factors, while in peri-implantitis surgical therapy is used where the affected sites do not respond to primary therapy; and 5) supportive therapy is essential in determining the long-term success in the treatment of peri-implant diseases.

Dentin hypersensitivity reduction using an arginine-based approach after non-surgical periodontal treatment.

PURPOSE: To determine the efficacy of two oral hygiene regimens in the reduction of dentin hypersensitivity (DH) on subjects undergoing non-surgical periodontal treatment (NST), over a period of 8 weeks. METHODS: 60 subjects that were randomly assigned to: Test group - NST followed in-office application of an arginine-based professional paste and toothbrushing with arginine-based toothpaste at home (n= 30) and Control group - NST followed in-office application of a fluoride-free prophylaxis paste and toothbrushing with a toothpaste based on sodium monofluorophosphate 0.76%, at home (n= 30). Air blast sensitivity assessments were made using the Schiff scale. The sensitivity parameters were measured at baseline, 1, 4 and 8 weeks. RESULTS: After 1 week, DH reduction was statistically significant for the test group (63.6%) compared to baseline, while no significant reduction was observed for the Control group (4.8%). After 4-8 weeks, the reductions were 81.6%/86.3% for the test group and 9.5%/14.2% for the Control group. When comparing the two groups, the test group showed a superior DH reduction in all evaluation periods (P< 0.05). Within the limits of the present study, it was concluded that the test oral hygiene regimen can effectively reduce dentin hypersensitivity during the most critical period after non-surgical periodontal treatment (up to 8 weeks). CLINICAL SIGNIFICANCE: The arginine-based approach provided significantly greater dentin hypersensitivity (DH) relief after non-surgical periodontal treatment (NST) when compared to the control. The combination of the in-office paste application with the daily used toothpaste may be a useful tool to reduce DH, an unpleasant and common condition that affects a large number of subjects, particularly during the initial weeks following NST.

Enamel matrix protein derivative and/or synthetic bone substitute for the treatment of mandibular class II buccal furcation defects. A 12-month randomized clinical trial.

OBJECTIVE: This study aims to clinically evaluate the treatment of mandibular class II furcation defects with enamel matrix derivative (EMD) and/or a bone substitute graft made of ß-tricalcium phosphate/hydroxyapatite (ßTCP/HA). MATERIALS AND METHODS: Forty-one patients, presenting a mandibular class II buccal furcation defect, probing pocket depth (PPD) ≥4 mm and bleeding on probing, were included. They were randomly assigned to the groups: 1-EMD (n = 13); 2-ßTCP/HA (n = 14); 3-EMD + ßTCP/HA (n = 14). Plaque index (PI), gingival index (GI), relative gingival margin position (RGMP), relative vertical and horizontal attachment level (RVCAL and RHCAL), and PPD were evaluated at baseline and 6 and 12 months. The mean horizontal clinical attachment level gain was considered the primary outcome variable. RESULTS: No significant intragroup differences were observed for RGMP, but significant changes were observed for RVCAL, RHCAL, and PPD for all groups (p < 0.05). After 12 months, the mean horizontal clinical attachment level gain was 2.77 ± 0.93 mm for EMD, 2.64 ± 0.93 mm for ßTCP/HA, and 2.93 ± 0.83 mm for EMD + ßTCP/HA, with no significant differences among the groups. At the end of the study, 85.3 % of the sites were partially closed; however, no complete closure was observed. CONCLUSION: EMD + ßTCP/HA does not provide a significant advantage when compared to the isolated approaches. All three tested treatments promote significant improvements and partial closure of class II buccal furcation defects. Based on its potential to induce periodontal regeneration, EMD may be considered an attractive option for this type of defect, but complete closure remains an unrealistic goal. CLINICAL RELEVANCE: The partial closure of buccal furcation defects can be achieved after the three tested approaches. However, the combined treatment does not provide a significant benefit when compared to the isolated approaches.

Estado atual da peri-implantite / Current status of periimplantitis

Os implantes osseointegrados vêm sendo utilizados com grande frequência na prática odontológica, mostrando uma alta taxa de sucesso. No entanto, atreladas a essa alta previsibilidade de sucesso, estão as suas complicações. Dentre elas está a peri-implantite, que se apresenta como uma infecção microbiana que compromete os tecidos peri-implantares, afetando tecidos moles e duros, levando à reabsorção óssea e consequentemente à perda do implante. Várias modalidades de tratamento têm sido propostas para a peri-implantite, no entanto, não existe ainda na literatura um protocolo bem definido. Sendo assim, o objetivo do presente artigo é fazer uma revisão da literatura acerca do estado atual da peri-implantite, no que diz respeito à etiologia, prevenção e tratamento dessa patologia peri-implantar (AU).

Osseointegrated implants are being used with great frequency in dentistry practice, showing a high success rate. However linked to this high success predictability are its complications. Among them is periimplantitis, that is presented as a microbial infection which affects the peri-implant tissues affecting soft and hard tissues, leading to bone resorption and therefore to implant loss. Many treatment modalities have been proposed to periimplantitis, however, until now, it does not exist a well-defined protocol in literature. Thus the purpose of this article is to review the literature about periimplantitis current status, regarding the etiology, prevention and treatment of this peri-implant disease (AU).

Efficacy of a combined in-office/home-use desensitizing system containing 8% arginine and calcium carbonate in reducing dentin hypersensitivity: an 8-week randomized clinical study.

PURPOSE: To determine the efficacy in reducing dentin hypersensitivity (DHS) of a combined in-office and home-use desensitizing system, each product containing 8% arginine and calcium carbonate (Test), following a dental scaling procedure, compared to the combination of a conventional prophylactic paste and a potassium nitrate dentifrice (Control), in a group of patients with known dentin hypersensitivity. METHODS: An 8-week clinical study, with 50 subjects, was conducted in Piracicaba, São Paulo, Brazil, using a double-blind/two treatment design. Air blast sensitivity assessments were used to compare the efficacy of the two approaches using both the Schiff scale as well as a Visual Analogue Scale (VAS). RESULTS: Immediately after prophylaxis, the Test treatment provided significant reduction in DHS when compared to baseline values (VAS = 26.2% and Schiff = 29.1%), while for Control treatment this difference was not statistically significant (VAS = 8.1% and Schiff = 6.6%). The comparison between groups after prophylaxis showed a greater DHS reduction for the Test treatment (P < 0.05). The reductions in DHS after 2, 4 and 8 weeks were significant for both groups, however, when considering Schiff scale, the Test treatment provided greater DHS reduction after 2 weeks (44.5% for Test versus 27.7% for Control) and 4 weeks (55.2% for Test and 40.5% for Control), while after 8 weeks there was no significant difference between groups (71.1% for Test versus 61.1% for Control).

Characterization of the release profile of doxycycline by PLGA microspheres adjunct to non-surgical periodontal therapy.

The aim of this pilot study was to assess the release of locally delivered doxycycline by poly (l-lactide-co-glycolide) (PLGA) microspheres in the periodontal pocket of patients with chronic periodontitis, treated by non-surgical periodontal therapy. Nineteen sites of non-adjacent teeth of four different patients were evaluated. Five milligram of PLGA microspheres loaded with 16 doxycycline hyclate (DOX) was administered per periodontal site. To quantify DOX released into the periodontal pocket, gingival crevicular fluid (GCF) was collected from the sites on days 2, 5, 7, 10, 15, and 20 after DOX application, and high-performance liquid chromatography was performed. Data were statistically assessed by ANOVA/Tukey test. At days 2, 5, and 7, the DOX concentration was stably sustained (23.33 ± 1.38, 23.4 ± 1.82, and 22.75 ± 1.33 µg/mL, respectively), with no significant differences over these assessment times (p > 0.05). At days 10 and 15, a tendency was observed toward a decrease in DOX concentration (21.74 ± 0.91 and 20.53 ± 4.88 µg/mL, respectively), but a significant decrease in GCF drug concentration (19.69 ± 4.70 µg/mL) was observed only on day 20. The DOX delivery system developed demonstrated a successful sustained release after local administration, as an adjunct to non-surgical periodontal therapy.

Avaliação da utilização da esponja de chitosan/tricálcio fosfato no reparo de defeitos ósseos em calvária de ratos: desenho split-mouth / Evaluation of a chitosan/tricalcium phosphate sponge on the repair of rat calvarial bone defects: split-mouth design

Objetivo: avaliar o efeito da esponja de chitosan/tricálcio fosfato, biopolímero natural não tóxico e biodegradável, no reparo de defeitos de tamanho crítico em calvária de ratos. Material e métodos: 20 ratos machos adultos (Wistar) receberam dois defeitos ósseos de tamanho crítico na região parietal (broca trefina 5 mm de diâmetro interno), sendo um dos defeitos preenchido com esponja de chitosan (grupo-teste) e o outro com osso autógeno particulado (grupo-controle positivo). Cortes histológicos foram executados após 60 dias. Resultados: nos defeitos preenchidos com o chitosan, observou-se média de 37,8% de remanescentes da esponja. Em uma análise linear destes defeitos, o preenchimento ósseo ocorreu em uma média de 0,57 ± 0,38 mm. Nos defeitos preenchidos com osso autógeno (controle positivo), foi registrada média de 5,02 mm de osso vital. Comparando os dois grupos experimentais em termos percentuais, observou-se que no grupo-teste o preenchimento com tecido ósseo foi menor do que no grupo-controle (7,8% e 68,8%), respectivamente (teste de Tukey, p < 0,001). Conclusão: a esponja de chitosan/tricálcio fosfato tem um efeito pequeno sobre o reparo ósseo em defeitos de calvária de ratos, quando comparada ao osso autógeno.

Healing patterns after subgingival placement of a resin-modified glass-ionomer restoration: a histometric study in dogs.

The aim of this study was to evaluate, clinically and histometrically, the effects of subgingival placement of a resin-modified glass-ionomer restoration during flap surgery. Nine dogs were included in this study. The mandibular canines were randomly assigned to receive either a transgingival resin-modified glass-ionomer restoration (test group) or no restoration (control group). The apical margins of the restorations in the test group and a reference notch on those in the control group were placed at the level of the bone crest. Clinical parameters were recorded 7 days before sacrifice. The dogs were sacrificed after 107 days, and undecalcified sections were obtained for histologic evaluation. Clinically, both groups presented significant clinical attachment loss and an increase in probing depth, but differences between groups were not statistically significant (P > .05). Histologically, a significant difference between groups was observed for length of epithelium (test, 4.05 ± 0.57 mm; control, 3.36 ± 0.63 mm; P = .01). The test group showed more bone resorption (2.02 ± 1.47 mm) when compared with the control group (0.74 ± 0.37 mm) (P = .048). It can be concluded that even with the claimed favorable properties of resin-modified glass ionomer, the presence of the restoration within the biologic width causes increased migration of the apical epithelium and bone resorption.

Randomized controlled clinical trial evaluating connective tissue graft plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesion: 2-year follow-up.

BACKGROUND: The aim of this clinical study is to evaluate the 2-year term results of gingival recession (GR) associated with non-carious cervical lesions (NCCLs) treated by connective tissue graft (CTG) alone or in combination with a resin-modified glass ionomer restoration (CTG+R). METHODS: Thirty-six patients with Miller Class I buccal GR associated with NCCLs completed the follow-up. The defects were randomly assigned to receive either CTG or CTG+R. Bleeding on probing (BOP), probing depth (PD), relative GR, clinical attachment level (CAL), and cervical lesion height coverage were measured at baseline, 6 months, 1 year, and 2 years after treatment. RESULTS: Both groups showed statistically significant gains in CAL and soft-tissue coverage. The differences between groups were not statistically significant in BOP, PD, relative GR, or CAL after 2 years. Cervical lesion height coverage was 79.31% ± 18.51% for CTG and 71.95% ± 13.25% for CTG+R (P >0.05). Estimated root coverage was 91.56% ± 11.74% for CTG and 93.29% ± 7.97% for CTG+R (P >0.05). CONCLUSIONS: Within the limits of the present study, it can be concluded that both procedures provide comparable soft tissue coverage after 2 years of follow-up.

Connective tissue graft plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesions: microbiological and immunological results.

OBJECTIVES: It was previously reported the clinical results of placing subgingival resin-modified glass ionomer restoration for treatment of gingival recession associated with non-carious cervical lesions. The aim of this study was to evaluate the influence of this treatment on the subgingival biofilm and gingival crevicular fluid (GCF) inflammatory markers. MATERIALS AND METHODS: Thirty-four patients presenting the combined defect were selected. The defects were treated with either connective tissue graft plus modified glass ionomer restoration (CTG+R) or with connective tissue graft only (CTG). Evaluation included bleeding on probing and probing depth, 5 different bacteria targets in the subgingival plaque assessed at baseline, 45, and 180 days post treatments, and 9 inflammatory mediators were also assessed in the GCF. RESULTS: The levels of each target bacterium were similar during the entire period of evaluation (p > 0.05), both within and between groups. The highest levels among the studied species were observed for the bacterium associated with periodontal health. Additionally, the levels of all cyto/chemokines analyzed were not statistically different between groups (p > 0.05). CONCLUSION: Within the limits of the present study, it can be concluded that the presence of subgingival restoration may not interfere with the subgingival microflora and with GCF inflammatory markers analyzed. CLINICAL RELEVANCE: This approach usually leads to the placement of a subgingival restoration. There is a lack of information about the microbiological and immunological effects of this procedure. The results suggest that this combined approach may be considered as a treatment option for the lesion included in this study.

Curcumina como promissor agente fotossensibilizador para uso em periodontia / Curcumin as a promising photosensitizing agent for use in Periodontics

A terapia fotodinâmica (TFD) tem sido utilizada com sucesso em Odontologia e, atualmente, tem sido proposta como alternativa dentro da terapia periodontal. Não existe, porém, um consenso sobre o melhor protocolo clínico de TFD em Periodontia, sendo necessárias pesquisas de novos fotossensibilizadores com finalidade de potencializar o efeito antimicrobiano da TFD sobre o biofilme periodontal e, consequentemente, sobre os parâmetros clínicos periodontais. Dessa forma, sugere-se, nesta revisão da literatura, a curcumina como uma potencial droga fotossensibilizadora para uso em Periodontia. Porém, são necessários estudos que validem um protocolo para seu uso clínico e confirmem sua eficácia no controle das doenças periodontais.

Manutenção longitudinal do tratamento de peri-implantite / Long term clinical outcome of peri-implantitis treatment: a clinical report

O alto número de reabilitações orais com implantes, associadas à ausênciade uma correta terapia de manutenção, tem contribuído para o aparecimentode diversos casos de peri-implantite. Juntamente com este fato, odiagnóstico das doenças peri-implantares parece ser dificultado pelo desconhecimento,ou medo, dos cirurgiões-dentistas no exame das estruturasperi-implantares. O objetivo deste relato de caso clínico foi apresentaruma situação em que diagnóstico e tratamento da peri-implantite permitirama continuação e o sucesso da reabilitação oral com implantes. Dentrodas limitações do caso clínico apresentado concluiu-se que uma vez diagnosticadaa peri-implantite, a aplicação não cirúrgica de iodo povidine 10%,associado à abordagem cirúrgica, para a descontaminação da superfíciedos implantes e correção tecidual peri-implantar, por meio de enxerto detecido conjuntivo, e uma rigorosa terapia de suporte periodontal tornaramo resultado clínico satisfatório após 18 meses de acompanhamento, em setratando de estabilização do processo patológico.