Platelet-Rich Fibrin in Coverage of Gingival Recession: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis sought to evaluate the efficacy of platelet-rich fibrin (PRF) membranes versus subepithelial connective tissue grafts (SCTGs) in the coverage of Miller class I and II gingival recessions. After the inclusion and exclusion criteria were applied, the quality of seven articles (Cohen's Kappa = 0.9) was evaluated using the Jadad scale. The MEDLINE/PubMed, Cochrane, and Web of Science databases were consulted, and manual searches were performed in the most popular periodontics journals. The studies included considered a total of 122 patients, 203 surgical fields on which SCTGs were used, and 205 surgical fields on which PRF was used. The parameters analyzed were probing depth, clinical attachment level, gingival recession, and keratinized mucosa. The minimum follow-up period accepted was 6 months. A statistically significant difference between the SCTG and PRF groups was found only in the case of keratinized mucosa. However, gingival recession, clinical attachment level, and probing depth parameters in the PRF group were found to be statistically equal to those of the SCTG group (the gold standard) (p ≥0.05). PRF membranes were determined to be a promising alternative to autogenous gingival grafts in the treatment of Miller class I and II gingival recessions.

A new technique for tongue brushing and halitosis reduction: the X technique.

The tongue is one of the primary sources of halitosis. The manual or mechanical removal of biofilm is known to decrease oral malodor. OBJECTIVE: To evaluate a new tongue hygiene technique hereby referred to as "the X technique" and its effects on both halitosis and the number of microorganisms based on microbiological parameters and diagnostic features of the breath. MATERIAL AND METHODS: The study included thirty patients divided into a control group (patients without systematized guidelines of lingual hygiene, but who performed the mechanical cleaning of tongue dorsum, each in its own way), the 3R group (instructed to perform the movements of the X technique for 3 repetitions at each brushing), and the 6R group (instructed to perform 6 repetitions of the technique at each brushing). After two weeks, a new data collection was performed. RESULTS: Patients in the 6R group presented the lowest score on the organoleptic assessment scale at the second consultation, followed by the 3R group and the controls. Regarding the self-perception of breath by the method of Visual Analog Scale (VAS), the control group did not perceive improvements in oral malodor; the results of the 3R group and the 6R group were similar. CONCLUSION: These results indicate that the X technique improves both measurements and perceptions of halitosis. Microbiological analyses revealed greatest reduction in the 6R group. The findings show that the X technique reduces both organoleptic scores and the number of bacterial colonies, and improves users' perceptions of their breath.

Application of botulinum toxin type A in gummy smile: case report / Aplicação da toxina botulínica tipo A em sorriso gengival: relato de caso

ABSTRACT Gummy smile is one of the major complaints of patients, due to its influence on the self-esteem. It is known that it has a multifactorial cause and can be present in the excessive vertical growth of the maxilla, excessive labial contraction, short upper lip and extrusion of the anterior teeth. The use of the botulinum toxin can be associated with additional treatments or be applied individually, according to the need of each patient. The goal of this research study was to present a clinical case using botulinum toxin type A as an alternative therapy to correct the gummy smile. A 22-year-old patient, presenting vertical maxillary growth, reporting aesthetic discomfort while smiling, chose for an alternative treatment therapy with the application of botulinum toxin to correct the accentuated gingival display. The results show that the toxin is a satisfactory treatment option and its indication is considered a fast, effective, easy and safe treatment method, being a more conservative approach compared to surgical procedures.

RESUMO O sorriso gengival, é uma das grandes queixas dos pacientes, devido a sua influência na auto estima do mesmo. Sua causa é multifatorial, podendo estar presente no excesso de crescimento vertical da maxila, contração labial excessiva, lábio superior curto e extrusão dos dentes anteriores. A aplicação da toxina botulínica pode ser associada a outros tratamentos ou isoladamente, de acordo com a necessidade de cada paciente. O objetivo desse trabalho foi apresentar um caso clinico utilizando a toxina botulínica tipo A como uma alternativa terapêutica para a correção do sorriso gengival. Paciente, 22 anos, apresentando crescimento vertical da maxila, relatando desconforto estético ao sorrir, optou pela alternativa terapêutica, com a aplicação da toxina botulínica para correção da exposição gengival acentuada. Os resultados encontrados mostram que a toxina é um tratamento satisfatório e sua indicação é considerada um tratamento rápido, eficaz, fácil e seguro. Um método mais conservador quando comparado aos procedimentos cirúrgicos.

A new technique for tongue brushing and halitosis reduction: the X technique

Abstract The tongue is one of the primary sources of halitosis. The manual or mechanical removal of biofilm is known to decrease oral malodor. Objective: To evaluate a new tongue hygiene technique hereby referred to as "the X technique" and its effects on both halitosis and the number of microorganisms based on microbiological parameters and diagnostic features of the breath. Material and Methods: The study included thirty patients divided into a control group (patients without systematized guidelines of lingual hygiene, but who performed the mechanical cleaning of tongue dorsum, each in its own way), the 3R group (instructed to perform the movements of the X technique for 3 repetitions at each brushing), and the 6R group (instructed to perform 6 repetitions of the technique at each brushing). After two weeks, a new data collection was performed. Results: Patients in the 6R group presented the lowest score on the organoleptic assessment scale at the second consultation, followed by the 3R group and the controls. Regarding the self-perception of breath by the method of Visual Analog Scale (VAS), the control group did not perceive improvements in oral malodor; the results of the 3R group and the 6R group were similar. Conclusion: These results indicate that the X technique improves both measurements and perceptions of halitosis. Microbiological analyses revealed greatest reduction in the 6R group. The findings show that the X technique reduces both organoleptic scores and the number of bacterial colonies, and improves users' perceptions of their breath.

Biomateriais utilizados na artroplastia parcial ou total da articulação temporomandibular: uma revisão de literatura / Biomaterials used in partial or total temporomandibular joint arthroplasty: a review of the literature

Introdução: as disfunções da articulação temporomandibular constituem uma variedade de doenças que compreendem disfunções nos músculos da mastigação, nas estruturas articulares ou em ambos. Em alguns casos a melhora da disfunção pode decorrer apenas de tratamento clínico conservador, porém, quando os resultados não são favoráveis, o tratamento cirúrgico deve ser considerado. A reconstrução articular parcial ou total é uma das formas de tratamento cirúrgico disponível. Objetivo: objetivo deste trabalho foi realizar uma revisão bibliográfica sobre os principais biomateriais disponíveis para a reconstrução da articulação temporomandibular. Método: o trabalho foi realizado na base de dados da Pubmed, Scielo e Periódicos Capes. Os descritores empregados foram: artoplastia temporomandibular, prótese articular, disfunção temporomandibular. As referências foram avaliadas quanto à relevância correlacionadas ao tema proposto. Foram selecionados os artigos em português e inglês, publicados no período de Janeiro 1971 a outubro de 2017. Considerações finais: existe a recomendação de haver uma continuidade de esforços para melhorar o material aloplástico para que os resultados obtidos com essa técnica se tornem o tratamento padrão para a DTM severa, contudo é importante não se esquecer de esgotar as modalidades terapêuticas conservadoras antes de se prosseguir para qualquer tipo de cirurgia. Nos casos onde uma prótese articular total é indicada, que os princípios biomecânicos sejam respeitados e que estudos clínicos metodologicamente adequados sejam realizados para fundamentarem esta condição de maneira referendada para a substituição aloplástica da ATM.

Introduction: temporomandibular joint dysfunctions are a variety of diseases that include dysfunctions in masticatory muscles, joint structures, or both. In some cases the improvement of the dysfunction may only result from conservative clinical treatment, however, when the results are not favorable the surgical treatment should be considered. Partial or total joint reconstruction is one of the forms of surgical treatment available. Objective: the objective of this work was to perform a bibliographic review on the main biomaterials available for the reconstruction of the temporomandibular joint. Method: work was carried out in the database of Pubmed, Scielo and Capes Periodicals. The descriptors employed were: temporomandibular arthroplasty, joint prosthesis, temporomandibular dysfunction. The references were evaluated regarding the relevance correlated to the proposed theme. The articles in Portuguese and English, published between January 1971 and October 2017, were selected. Final remarks: there is a recommendation for continuity of efforts to improve the alloplastic material so that the results obtained with this technique become the treatment standard for severe TMD, but it is important to remember to exhaust the conservative therapeutic modalities before proceeding for any type of surgery. In cases where a total joint prosthesis is indicated, biomechanical principles are respected and methodologically adequate clinical studies are performed to support this condition in a manner recommended for the alloplastic replacement of TMJ.

Biomateriais utilizados em artroplastia de quadril / Biomaterials used in hip arthroplasty

Introdução: a artroplastia de quadril é um procedimento cirúrgico utilizado com frequência na recuperação do quadril lesado, sendo necessário a utilização de biomateriais na confecção das próteses que farão a nova função dessa articulação. Os biomateriais mais frequentemente utilizados em reconstruções de quadril podem ser agrupados em: metálicos, poliméricos, cerâmicos e compósitos. Objetivo: discorrer sobre tipos de biomateriais utilizados nos implantes das artroplastias de quadril, apresentando suas características, vantagens e falhas, descritas na literatura. Método: foi realizado uma revisão da literatura nas bases de dados eletrônicos: PubMED/Medline, Lilacs e Scielo. Conclusão: os materiais utilizados em artroplastia de quadril evoluíram muito nos últimos 20 anos, especialmente considerando a resistência ao desgaste. Porém, não é somente o tipo de material implantado que determina os resultados em artroplastia do quadril. Bons resultados dependem de uma cirurgia bem indicada, bem planejada, bem realizada e do uso de material adequado.

Introduction: hip arthroplasty is a surgical procedure frequently used in the recovery of the injured hip, and it is necessary to use biomaterials in the preparation of prostheses that will perform a new function of this joint. The biomaterials most used in hip reconstructions can be grouped into metallic, polymeric, ceramic and composite. Objective: to describe the types of biomaterials used in hip arthroplasty implants, presenting their characteristics, advantages and failures, descriptions in the literature. Method: a literature review was performed in the electronic databases: PubMED / Medline, Lilacs and Scielo. Conclusion: the materials used in hip arthroplasty have evolved a lot in the last 20 years, considering the resistance to wear. However, it is not the type of implanted material that determines the results in hip arthroplasty. Good results depend on well-indicated, well-planned, well-performed surgery and use of the right material.

Diagnóstico e tratamento cirúrgico do freio labial com inserção marginal: relato de caso / Diagnosis and surgical treatment of labial frenulum with marginal insertion: a case report

O freio labial é uma estrutura presente em todos os indivíduos que em alguns casos pode apresentar-se mal posicionado, gerando efeitos adversos importantes, como formação de diastemas, mal adaptação de prótese, inibição dos movimentos dos lábios e língua, inflamação gengival, retração gengival e perda óssea. O presente estudo foi realizado com objetivo de relatar o diagnóstico e tratamento de um caso clínico de freio labial inferior com inserção marginal, causando retração gengival. Paciente de 39 anos de idade, gênero feminino, apresentou-se com acúmulo de biofilme e retração gengival entre os incisivos centrais inferiores. Após o exame clínico e a constatação da presença de freio labial inferior com inserção na gengiva marginal e ausência de gengiva queratinizada, optou-se pelo tratamento cirúrgico por meio da frenectomia labial inferior. Após o período de 45 dias do procedimento cirúrgico, o processo de reparo estava adequado, a paciente não relatou sintomatologia dolorosa, não havia sinais de infecção e houve uma melhora na qualidade de gengiva inserida. Pode-se concluir que, desde que bem indicada, através de um diagnóstico correto, a frenectomia labial pode resultar em um bom prognóstico e melhora da qualidade da gengiva inserida. (AU)

The labial frenulumis a structure present in all individuals that in some cases may be poorly positioned, generating important adverse effects such as diastema formation, maladaptation of prosthesis, inhibition of lip and tongue movements, gingival inflammation, gingival retraction and bone loss. The present study was carried out with the objective of reporting the diagnosis and treatment of a clinical case of lower labial brake with abnormal insertion, causing gingival retraction. A 39-year-old female patient presented with biofilm accumulation and gingival retraction between the lower central incisors. After the clinical examination and observation of the presence of a lower labial frenulum with marginal gingival insertion and absence of keratinized gingiva, surgical treatment was chosen by means of the inferior labial frenectomy. After the 45-day period of the surgical procedure, the repair process was adequate, the patient did not report painful symptoms, there were no signs of infection and there was an improvement in the quality of attached gingiva. It can be concluded that, since well indicated through a correct diagnosis, the lip frenectomy can result in a good prognosis and improvement of the quality of the attached gingiva. (AU)

Clinical Comparison of the Subepithelial Connective Tissue versus Platelet-Rich Fibrin for the Multiple Gingival Recession Coverage on Anterior Teeth Using the Tunneling Technique.

The aim of this study was to evaluate and compare, clinically, the efficiency of the subepithelial connective tissue graft (SCTG) and platelet-rich fibrin (L-PRF) using the tunnel technique to cover the multiple gingival recessions on anterior teeth, in the same patient. Within the limits of this study, we conclude that both SCTG and L-PRF proved to be reliable options for the treatment of gingival recessions, efficiently supporting the biological and aesthetic demand, stimulating the periodontal tissues' health, and bringing reliable and highly predictable results.

Comparison of Two Screw-Retained Free Gingival Grafting Techniques.

Free gingival graft is a predictable technique for increasing the amount of attached gingiva and root coverage; however, its use is limited for cosmetic reasons. To overcome this issue, this study sought to compare 2 free gingival graft techniques that use oral screws to attach grafts. Free gingival graft was performed on teeth 44 to 46 using the traditional technique, while on the opposite side, on teeth 34 to 36, partly epithelialized free gingival grafts were performed. The partly epithelialized free gingival grafts were found to provide better cosmetic results relative to the completely epithelialized free gingival graft, and the use of stabilizing screws was found to be simple and effective.

Biomateriais utilizados em substituição ao enxerto autógeno de gengiva / Biomaterials used in replacement of gingival autograft

A utilização de biomateriais na tentativa de reparar ou substituir tecidos perdidos não é recente e evoluiu juntamente com os avanços da medicina regenerativa visando à maior qualidade de vida da população. Na Odontologia a compreensão dos aspectos biomiméticos envolvidos após implantação de biomateriais como substitutos de tecido mole é de suma importância na prática clínica, uma vez que o enxerto autógeno de gengiva, considerado padrão ouro, possui inúmeras limitações em relação à dimensão da área a ser reparada, tempo cirúrgico e dor pós-operatória na loja doadora. Esta revisão tem como objetivo reunir estudos que propõem a utilização de substitutos ao enxerto autógeno de palato, ressaltando suas aplicabilidades, contraindicações, disponibilidade no mercado, além de resultados clínicos.(AU)

The use of biomaterials to repair or replace lost tissues is not new and has evolved with advances in regenerative medicine aimed at higher quality of life of the population. In dentistry, the understanding of biomimetic aspects after implantation of biomaterials used as soft tissue replacements is significant in practice, since the autograft gum considered the gold standard has many limitations regarding the size of the area to berepaired surgical time and postoperative pain in the donor area.This review aims to bring together studies that propose substitutes to autograft palate, highlighting its applicability, contraindications, availability in the market, and clinical outcomes. (AU)

MMP1-1607 polymorphism increases the risk for periapical lesion development through the upregulation MMP-1 expression in association with pro-inflammatory milieu elements.

OBJECTIVE: In this study, we evaluated the association between the MMP1-1607 polymorphism (rs1799750) and pro-inflammatory milieu elements with MMP-1 mRNA levels in vivo. MATERIAL AND METHODS: MMP1-1607 SNP and the mRNA levels of MMP-1, TNF-a, IFN-g, IL-17A, IL-21, IL-10, IL-4, IL-9, and FOXp3 were determined via RealTimePCR in DNA/RNA samples from patients presenting periapical granulomas (N=111, for both genotyping and expression analysis) and control subjects (N=214 for genotyping and N=26 for expression analysis). The Shapiro-Wilk, Fisher, Pearson, Chi-square ordinal least squares regression tests were used for data analysis (p<0.05 was considered statistically significant). RESULTS: The MMP1-1607 1G/2G and 1G/2G+2G/2G genotypes were significantly more prevalent in the patients than in controls, comprising a risk factor for periapical lesions development. MMP-1 mRNA levels were higher in periapical lesions than in healthy periodontal ligament samples, as well as higher in active than in inactive lesions. The polymorphic allele 2G carriers presented a significantly higher MMP-1 mRNA expression when compared with the 1G/1G genotype group. The ordered logistic regression demonstrated a significant correlation between the genetic polymorphism and the expression levels of MMP-1. Additionally, the pro- and anti-inflammatory cytokines IL-17A, IFN-g, TNF-a, IL-21, IL-10, IL-9, and IL-4 were significant as complementary explanatory variables of MMP-1 expression. CONCLUSION: The MMP1-1607 SNP was identified as a risk factor for periapical lesions development, possibly due to its association with increased MMP-1 mRNA levels in periapical lesions. The MMP-1 expression is also under the control of the inflammatory milieu elements, being the cytokines TNF-a, IL-21, IL-17A, and IFN-g associated with increased MMP-1 levels in periapical lesions, while IL-10, IL-9, or IL-4 presented an inverse association.

MMP1-1607 polymorphism increases the risk for periapical lesion development through the upregulation MMP-1 expression in association with pro-inflammatory milieu elements

ABSTRACT Increased matrix metalloproteinases (MMPs) activity is a hallmark of periapical granulomas. However, the factors underlying the MMPs expression modulation in healthy and diseased periapical tissues remains to be determined. Objective In this study, we evaluated the association between the MMP1-1607 polymorphism (rs1799750) and pro-inflammatory milieu elements with MMP-1 mRNA levels in vivo. Material and Methods MMP1-1607 SNP and the mRNA levels of MMP-1, TNF-a, IFN-g, IL-17A, IL-21, IL-10, IL-4, IL-9, and FOXp3 were determined via RealTimePCR in DNA/RNA samples from patients presenting periapical granulomas (N=111, for both genotyping and expression analysis) and control subjects (N=214 for genotyping and N=26 for expression analysis). The Shapiro-Wilk, Fisher, Pearson, Chi-square ordinal least squares regression tests were used for data analysis (p<0.05 was considered statistically significant). Results The MMP1-1607 1G/2G and 1G/2G+2G/2G genotypes were significantly more prevalent in the patients than in controls, comprising a risk factor for periapical lesions development. MMP-1 mRNA levels were higher in periapical lesions than in healthy periodontal ligament samples, as well as higher in active than in inactive lesions. The polymorphic allele 2G carriers presented a significantly higher MMP-1 mRNA expression when compared with the 1G/1G genotype group. The ordered logistic regression demonstrated a significant correlation between the genetic polymorphism and the expression levels of MMP-1. Additionally, the pro- and anti-inflammatory cytokines IL-17A, IFN-g, TNF-a, IL-21, IL-10, IL-9, and IL-4 were significant as complementary explanatory variables of MMP-1 expression. Conclusion The MMP1-1607 SNP was identified as a risk factor for periapical lesions development, possibly due to its association with increased MMP-1 mRNA levels in periapical lesions. The MMP-1 expression is also under the control of the inflammatory milieu elements, being the cytokines TNF-a, IL-21, IL-17A, and IFN-g associated with increased MMP-1 levels in periapical lesions, while IL-10, IL-9, or IL-4 presented an inverse association.

Effect of gingivitis treatment on the breath of chronic periodontitis patients.

PURPOSE: The present study assessed halitosis after treatment of gingivitis by using different diagnostic modalities. MATERIALS AND METHODS: A total of 27 patients (47 ± 7 years old; 14 women, 13 men) diagnosed with chronic periodontitis underwent supragingival mechanical debridement (day 0). Measurement of volatile sulfur compounds (VSC), visual analogue scale (VAS) and organoleptic assessment, visible plaque index (VPI) and gingival bleeding index (GBI) were obtained at baseline (prior to treatment of gingivitis) and then after 30, 90, and 180 days. The Friedman test was used to compare outcome data at days 0, 30, 90, and 180. Post-hoc comparison (tongue cleaning and non-cleaning) was performed using the Student t test for VSC and VAS and the Mann-Whitney test for organoleptic measurements. The level of significance was set at 5%. RESULTS: VSC and VAS means (days 0 and 180) were, respectively, 463.41 ppb (± 496.12 ppb) and 245.96 ppb (± 301.51 ppb) and 6.28 cm (± 2.23 cm) and 5.03 cm (± 2.01 cm). The frequency of high organoleptic scores (3 to 5) declined from 96.29% (day 0) to 81.48% (day 30), with a reduction of around 50% at day 180. Post-hoc comparison did not reveal any significant differences between the indicators analysed. CONCLUSION: Supragingival plaque control reduced halitosis in patients with periodontitis, but tongue cleaning vs no tongue cleaning did not yield different results.

Mecanismos envolvidos na resposta imune e inflamatória frente à implantação de membrana de cortical óssea bovina no tecido subcutâneo de camundongos: caracterização histomorfométrica, imunoenzimática e molecular / Mechanisms involved in immune and inflammatory response to implantation of bovine bone cortical membrane in subcutaneous tissue of mice: characterization histomorphometric, imunoenzimatic and molecular

Os avanços relacionados à ciência dos biomateriais e engenharia tecidual buscam esclarecer os mecanismos envolvidos na resposta biológica associada ao uso desses dispositivos e sua interação com o sistema imune. Neste estudo, avaliou-se a resposta imune e inflamatória desenvolvida em camundongos frente à implantação de membrana de cortical óssea bovina no tecido subcutâneo, em implantação única e sequencial de duas membranas, assim como os possíveis mecanismos envolvidos no processo de reconhecimento e reabsorção desse biomaterial, de acordo com análise histomorfométrica, enzimática e molecular. Após a implantação da membrana, sinais de reabsorção que antes eram notados em pontos isolados, aos poucos se unem até sua completa degradação, observada somente após 15 dias. Todo o processo de reabsorção da membrana é acompanhado por uma reação inflamatória de magnitude moderada, seguida pelo declínio do número de leucócitos, surgimento de células gigantes multinucleadas e formação de uma cápsula de tecido conjuntivo fibroso. A cinética de TNF-α e MMP-2, MMP-8, MMP-9 e MMP-13 apresentou um padrão de produção decrescente, entretanto os níveis dos inibidores de metaloproteinases (TIMPs) e TGF-β parecem atuar de forma inversa. A velocidade de reabsorção após duas implantações consecutivas da membrana foi maior quando comparada ao grupo de animais que sofreu apenas uma implantação, porém os resultados do teste de hipersensibilidade do tipo tardia (DTH) demonstraram que a membrana é biocompatível, pois não elicitou resposta imunológica exacerbada após uma segunda implantação, confirmando então a natureza não imunogênica desse biomaterial. Finalmente, os animais CD14KO e MyD88KO apresentaram uma reabsorção mais lenta da membrana implantada, quando comparados aos animais C57Bl/6 (WT)...

Advances related to the biomaterials science and tissue engineering seek to clarify the mechanisms involved in the biological response associated with the use of those devices and their interaction with the immune system. This study evaluated the inflammatory and immune response developed in mice after implantation bovine bone cortical membrane in subcutaneous tissue, in both, unique and sequential implantation of 2 membranes, as the mechanisms involved in this biomaterial recognition and resorption process, on regards to histomorphometric, enzymatic and molecular analysis. After membrane implantation, previously observed signs of resorption in isolated spots, gradually unite until their complete degradation after 15 days. The whole membrane resorption process is accompanied by a moderate inflammatory reaction, followed by a decline in the leukocytes number, appearance of multinucleated giant cells and formation of a capsule of fibrous connective tissue. The kinetics of TNF-α, MMP-2, MMP-8, MMP-9 e MMP-13 showed a pattern of decreasing production, however, levels of metalloproteinases inhibitors (TIMPs) and TGF-β seem to act in reverse way. The resorption rate after two successive membrane implantations was higher when compared to the group which suffered only one implantation, however, the results of delayed test hypersensity (DTH) demonstrated that the membrane is biocompatible, that is, it does not elicited too high immune response after a second position, confirming the non immunogenic nature of this biomaterial. Eventually, CD14KO and MyD88KO strains showed a slower membrane resorption when compared to animals C57Bl/6, demonstrating that the CD14 and MyD88 molecules are involved in biomaterial recognition and play an important role in bovine cortical bone membrane resorption process, indicating that PAMPs and/or DAMPs are involved in biological response generated by this biomaterial.

Incidence, morphology and morphometry of the foramen of Vesalius: complementary study for a safer planning and execution of the trigeminal rhizotomy technique.

BACKGROUND: The foramen of Vesalius (FV) is located in the greater wing of the sphenoid bone between the foramen ovale (FO) and the foramen rotundum in an intracranial view. The FO allows the passage of the mandibular branch of trigeminal nerve, which is the target of the trigeminal radiofrequency rhizotomy. OBJECTIVE: We analyzed its location, morphology, morphometry and interrelation among other foramina. MATERIALS AND METHODS: 400 macerated adult human skulls were examined. A digital microscope (Dino-Lite plus) was used to capture images from the FV. A digital caliper was used to perform the measurements of the distance between the FV and other foramina (FO, foramen spinosum and the carotid canal) in an extracranial view of the skull base. RESULTS: In the 400 analyzed skulls, the FV was identified in 135 skulls (33.75%) and absent on both sides in 265 skulls (66.25%). The FV was observed present bilaterally in 15.5% of the skulls. The incidence of unilateral foramen was 18.25% of the skulls of which 7.75% on right side and 10.5% on left side. The diameter of the FV was measured and we found an average value of 0.65 mm, on right side 0.63 mm and on the left side 0.67 mm. We verified that positive correlations were statistically significant among the three analyzed distances. CONCLUSIONS: This study intends to offer specific anatomical data with morphological patterns (macroscopic and mesoscopic) to increase the understanding of the FV features as frequency, incidence and important distances among adjacent foramina.

Effect of tongue cleansing on morning oral malodour in periodontally healthy individuals.

PURPOSE: The aim of this randomised single-blind, cross-over trial was to assess the effect of tongue cleansing on morning oral malodour in periodontally healthy subjects. MATERIALS AND METHODS: Ten systemically healthy non-smoker subjects (6 males, 4 females), 24-38 years of age, completed two 4-day periods of oral hygiene cessation with a 7-day wash-out period. In one of these test periods, subjects were instructed to clean their tongues with a tongue scraper 2-3 times a day. Participants presented at least 20 teeth, without cavities, overhanging restorations/prostheses or periodontitis, and had no history of previous periodontal therapy or use of antibiotics in the 3 months prior to the study. Volatile sulphur compounds (VSC; Interscan Halimeter) and organoleptic scores were measured in exhaled mouth air once a day, early in the morning, by one examiner. Comparisons were performed using Wilcoxon's signed rank test and Friedman's test (alpha = 0.05). RESULTS: VSC levels at baseline were 206.3 ppb (SD 139.8) and 191.4 ppb (SD 127.7) for periods of usage and non-usage of the scraper respectively (p > 0.05). VSC levels did not change significantly during the 4 days, independent of tongue cleansing (Friedman, p > 0.05). Only at day 3 did the use of the tongue scraper lead to a significantly lower level of VSC compared with controls (131.1 ppb and 199.3 ppb respectively). No significant differences in organoleptic scores were observed between groups at baseline. During the whole experimental period, there were also no significant changes in organoleptic scores when individuals used or did not use the tongue scraper. CONCLUSION: Tongue cleansing with a scraper was unable to prevent morning oral malodour in the absence of tooth cleaning in periodontally healthy individuals.

Estudo das correlações entre diferentes recursos diagnósticos do hálito em pacientes portadores de periodontite crônica sob tratamento da gengivite / Study of the correlations between different diagnosis methods of halitosis

Diferentes recursos de diagnóstico do hálito têm sido propostos na literatura tanto para pesquisa como para uso clínico, sendo que o padrão ouro é a medição organoléptica. Estudar possíveis correlações entre os métodos poderia contribuir para a definição do potencial de uso de cada um ou da associação dos mesmos. O presente estudo objetivou correlacionar diferentes sistemas de medição do hálito. Participaram do estudo 27 pacientes com periodontite crônica. Medições do hálito foram realizadas antes e após o tratamento da gengivite, através dos seguintes recursos: determinação da presença de compostos sulfurados voláteis (CSV) por um monitor portátil, auto-percepção através da Escala Visual Analógica (EVA) e determinação organoléptica (ORL) através da escala de Rosenberg (ROSENBERG et al., 1991a). Correlações de Pearson foram realizadas entre ORL-CSV, ORL-EVA e CSV-EVA. Foram observadas correlações significativas entre ORL-CSV (r = 0,521), ORL-EVA (r = 0,358) e CSV-EVA (r = 0,254). Pode-se concluir que em pacientes periodontais sob tratamento da gengivite, a auto-percepção dos pacientes e a medição de CSV estão correlacionadas ao padrão ouro (medição organoléptica). Entretanto, o coeficiente de correlação observado entre a percepção do paciente e as medidas de CSV foi pequeno, indicando que medições organolépticas se fazem necessárias para a análise do hálito.

O efeito do tratamento da gengivite sobre o hálito de pacientes portadores de periodontite crônica / Effect of gingivitis treatment on breath of chronic periodontitis patients

A presente dissertação objetivou correlacionar diferentes recursos de diagnóstico do hálito e analisar os efeitos do controle de placa supragengival sobre as medições do hálito. Para tanto, medições organolépticas (ORL), de compostos sulfurados voláteis (CSV) e de auto-percepção (EVA) foram realizadas em 27 pacientes (14 mulheres e 13 homens) portadores de periodontite crônica. O tratamento da gengivite foi realizado através de controle de placa supragengival. Análises do hálito foram realizadas ao exame inicial, 30, 90 e 180 dias após início do programa. Correlações significativas foram observadas entre ORL-CSV, ORL-EVA e EVA-CSV, sendo a última fraca. Em relação aos períodos experimentais, houve uma clara diminuição em todas as medições do hálito ao longo do tempo. Em análise post-hoc, subdividiu-se a amostra em dois grupos (relacionados ao hábito de limpar ou não a língua). Não foram observadas diferenças entre esses grupos. Pôde-se concluir que embora existam correlações significativas entre os recursos de diagnóstico do hálito, a medição organoléptica (padrão-ouro) deve ser sempre realizada. Além disso, um programa de controle de placa supragengival é eficaz em reduzir medidas relacionadas ao hálito, independentemente da limpeza da língua.