Combination of leukocyte and platelet-rich fibrin and demineralized bovine bone graft enhanced bone formation and healing after maxillary sinus augmentation: a randomized clinical trial.

BACKGROUND AND OBJECTIVE: The resorption of alveolar ridge bone and maxillary sinus pneumatization are challenges to implant-supported prosthetic rehabilitation. Bone regeneration using bone substitutes and growth factors are alternatives for maxillary sinus augmentation (MSA). Therefore, we sought to evaluate the effects of the association between leukocyte and platelet-rich fibrin (L-PRF) and deproteinized bovine bone mineral (DBBM) in MSA procedures. MATERIALS AND METHODS: Thirty-six maxillary sinuses from 24 individuals were included in this randomized clinical trial. The maxillary sinuses were randomly grafted with LPRF and DBBM (test group) or grafted only with DBBM (positive control). Dental implants were installed in the test group following two periods of evaluation: after 4 (DBBM+LPRF4) and 8 (DBBM+LPFR8) months of sinus graft healing, while the control group received implants only after 8 months. Cone beam computed tomography (CBCT) was taken 1 week after surgery (T1) and before implant placement (T2). Bone samples were collected during implant placement for histomorphometric and immunohistochemical (IHC) analysis. The primary implant stability was assessed by resonance frequency analysis. RESULTS: CBCT analysis demonstrated a significant decrease in bone volume from T1 to T2 in all groups without differences among them. Histologically, the test group showed significantly increase in bone neoformation in both periods of evaluation (LPRF+DBBM4: 44.70±14.01%; LPRF+DBBM8: 46.56±12.25%) compared to the control group (32.34±9.49%). The control group showed the highest percentage of residual graft. IHC analysis showed increased staining intensity of osteocalcin (OCN), vascular endothelial growth factor (VEGF), and runt related transcription factor 2 (RUNX-2) in LPRF+DBBM4 group, and osteopontin (OPN) in the L-PRF+DBBM8. Primary implant stability was successfully achieved (above 60 in implant stability quotient) in all the evaluated groups. CONCLUSION: Combination of L-PRF and DBBM increased and accelerated new bone formation allowing early implant placement probably due to the higher protein expression of RUNX2, VEGF, OCN, and OPN. These data suggest that the use of L-PRF might be an interesting alternative to use in combination with DBBM for augment the maxillary sinuses allowing the installation of appropriate length implants in shorter period of time. CLINICAL RELEVANCE: This study showed improvement in bone neoformation and accelerated healing when associating L-PRF and DBBM for maxillary sinus augmentation procedures. TRIAL REGISTRATION: This study was registered before participant recruitment in Brazilian Registry of Clinical Trials (ReBEC - RBR-95m73t).

Chlorin-based photosensitizer under blue or red-light irradiation against multi-species biofilms related to periodontitis.

In our previous study, Chlorin-e6 (Ce6) demonstrated a significant reduction of microorganisms' viability against single-species biofilm related to periodontitis once irradiated by red light (660 nm). Also, higher bacteria elimination was observed under blue light (450 nm) irradiation. However, the use of blue light irradiation of Ce6 for antimicrobial administration is poorly explored. This study evaluated the effect of chlorin-e6-mediated antimicrobial photodynamic therapy (aPDT) using different wavelengths (450 or 660 nm) against multi-species biofilms related to periodontitis. Streptococcus oralis, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans composed the mature biofilm developed under proper conditions for five days. aPDT was performed using different concentrations of Ce6 (100 and 200 µM), wavelengths (450 or 660 nm), and comparisons were made after qPCR assay and confocal laser scanning microscopy (CLSM) analysis. The greatest bacterial elimination was observed in the groups where Ce6 was used with blue light, for S. orallis (2.05 Log10 GeQ mL-1, p < 0.0001) and P. gingivalis (1.4 Log10 GeQ mL-1, p < 0.0001), aPDT with red light showed significant bacteria reduction only for S. orallis. aPDT with blue light demonstrated statistically higher elimination in comparison with aPDT with red light. The aPDT did not show a statistically significant effect when tested against A. actinomycetemcomitans and F. nucleatum (p=0.776 and 0.988, respectively). The aPDT using blue light showed a promising higher photobiological effect, encouraging researchers to consider it in the irradiation of Ce6 for further investigations.

Accuracy of partially and fully guided surgical techniques for immediate implant placement: An in vitro assessment.

STATEMENT OF PROBLEM: Optimal implant positioning is essential to achieving predictable results. Computer-guided surgery has been reported to be an accurate technique for implant placement in healed sites, but the accuracy of guided techniques for immediate implant placement into fresh sockets is still unclear. PURPOSE: The purpose of this experimental randomized split-mouth study in pig jaws was to determine the accuracy of partially and fully guided surgical techniques for immediate implant placement into fresh sockets and to compare 2 different methods of implant position deviations analysis. MATERIAL AND METHODS: Twenty implants were installed in 10 pig jaws using 2 different techniques: partially guided (n=10) and fully guided (n=10). Cone beam computed tomography and digital scanning were performed before and after the surgical procedure to plan the virtual implant position and fabricate the surgical guide, as well as to determine implant position deviations. Two methods were used to evaluate implant deviations: tomographic and digital scanning. The Shapiro-Wilk test of normality was used. Deviation comparisons were carried out by using paired t tests (α=.05), and intraclass correlation coefficient (ICC) was computed to assess the agreement between the 2 methods of implant deviation analysis. RESULTS: In the tomographic analysis, the partially guided technique resulted in significantly higher global apical and lateral coronal deviations (2.25 ±0.59 mm; 0.96 ±0.55 mm) than fully guided (1.52 ±0.89 mm; 0.75 ±0.52 mm) (P<.01 and P<.05, respectively). The analysis performed using digital scanning showed significantly higher angular, global apical, and lateral apical deviations in the partially guided (6 ±3.28 degrees; 2.49 ±1.03 mm; 2.16 ±1.07 mm) technique than in the fully guided (3.32 ±1.84 degrees; 1.5 ±0.58 mm; 0.98 ±0.67 mm) (P<.05). An ICC of 0.522 between the 2 methods of implant deviation analysis was obtained. CONCLUSIONS: The partially guided technique was less accurate than the fully guided technique for immediate implant placement into fresh sockets. A moderate concordance was observed between cone beam computed tomography and digital scanning analyses, suggesting that more studies are required to validate and to define the most reliable method of measuring implant deviation.

Possibilidades reabilitadores para pacientes com erosão dental: uma revisão de casos clínicos / Rehabilitation possibilities for patients with dental erosion: a clinical case review / Posibilidades rehabilitadoras para pacientes con erosión dental: revisión de casos clínicos

Objetivo: revisar na literatura as possibilidades reabilitadoras para pacientes com erosão dental. Método: screeningda literatura que seguiu os princípios do check listSANRA. A pesquisa foi realizada nas bases de dados da BVS (LILACS e BBO), Scielo, Cochrane Library e via buscador de pesquisa PubMed. Foram incluídos estudos na língua inglesa, relatos de casos clínicos disponíveis na íntegra. Foram realizadas buscas por artigos publicados até fevereiro de 2022 e sem restrição cronológica. Resultados:entre44 artigos identificados, 10 foram selecionados. A maioria dos estudos (40%) foram publicados no Brasil, seguido dos Estados Unidos (20%) e Itália (20%). As possibilidades de reabilitação identificadas foram o uso de coroas de cerâmica, laminados cerâmicos e restauração direta com resina composta. Conclusão:foi possível verificar que a reabilitação dos elementos dentários com materiais diretos (resinas compostas) ou indiretos (cerâmica ou cerômeros) tem demonstrado resultados satisfatórios,conforme os casos clínicos investigados.

Objective: to review the literature on rehabilitative possibilities for patients with dental erosion.Method: literature screening thatfollowed the principles of the SANRA check list. The search was performed in the BVS (LILACS and BBO), Scielo, Cochrane Library and PubMed databases. English language studies and clinical case reports available in full were included. Articles published until February 2022 and without chronological restriction were searched.Results: among 44 articles identified, 10 were selected. Most studies (40%) were published in Brazil, followed by the United States (20%) and Italy (20%). The rehabilitation possibilities identified were the use of ceramic crowns, ceramic laminates and direct restoration with composite resin.Conclusion: it was possible to verify that the rehabilitation of dental elements with direct materials (composite resins) or indirect (ceramics or ceromers) has shown satisfactory results, according to the clinical cases investigated.

Objetivo: revisar la literatura sobre las posibilidades rehabilitadoras para pacientes con erosión dental.Método: screeningbibliográfico que siguió los principios de la check listSANRA. La búsqueda se realizó en las bases de datos BVS (LILACS y BBO), Scielo, Cochrane Library y PubMed. Se incluyeron estudios en inglés, informes de casos clínicos disponibles en su totalidad. Se realizaron búsquedas de artículos publicados hasta em Febrero de 2022 y sin restricción cronológica.Resultados: de los 44 artículos identificados, se seleccionaron 10. La mayoría de los estudios (40%) se publicaron en Brasil, seguido de Estados Unidos (20%) e Italia (20%). Las posibilidades de rehabilitación identificadas fueron el uso de coronas cerámicas, laminados cerámicos y restauración directa con resina compuesta.Conclusión:se pudo comprobar que la rehabilitación de elementos dentales con materiales directos (resinas compuestas) o indirectos (cerámicas o cerómeros) ha mostrado resultados satisfactorios, según los casos clínicos investigados.

Impact of smoking on protein levels of beta-defensins in periodontal disease.

Antimicrobial peptides (AMPs) are important components of the host response against invading pathogens. In addition to their direct antimicrobial activity, they can also participate in the immune system modulation. However, the role of AMPs in the etiopathogenesis of periodontal disease and the risk factors that may influence their expression in the oral cavity are not fully understood. The aim of this study was to determine the impact of smoking on beta-defensin (hBD) 1 and 2 levels analyzing samples from periodontitis patients. Fifty patients with periodontitis, 25 smokers and 25 non-smokers, and 20 periodontally healthy patients were recruited. After periodontal clinical evaluation, gingival crevicular fluid (GCF) samples were collected from healthy sites of patients without periodontal disease and from healthy and diseased sites of patients with periodontitis. Peptides quantification was performed by sandwich ELISA technique. Smokers showed reduced GCF hBD 1 levels and increased hBD 2 levels compared to non-smokers in diseased sites (p <0.05). Higher levels of hBD 1 were observed in healthy sites of patients without periodontal disease than in healthy sites of patients with periodontitis (p<0.0001). Diseased sites of non-smokers presented higher levels of hBD 2 than healthy sites (p <0.05). These results reveal that protein levels of hBDs 1 and 2 can be impaired by cigarette smoking in the presence of periodontal disease.

Impact of smoking on protein levels of beta-defensins in periodontal disease

Abstract Antimicrobial peptides (AMPs) are important components of the host response against invading pathogens. In addition to their direct antimicrobial activity, they can also participate in the immune system modulation. However, the role of AMPs in the etiopathogenesis of periodontal disease and the risk factors that may influence their expression in the oral cavity are not fully understood. The aim of this study was to determine the impact of smoking on beta-defensin (hBD) 1 and 2 levels analyzing samples from periodontitis patients. Fifty patients with periodontitis, 25 smokers and 25 non-smokers, and 20 periodontally healthy patients were recruited. After periodontal clinical evaluation, gingival crevicular fluid (GCF) samples were collected from healthy sites of patients without periodontal disease and from healthy and diseased sites of patients with periodontitis. Peptides quantification was performed by sandwich ELISA technique. Smokers showed reduced GCF hBD 1 levels and increased hBD 2 levels compared to non-smokers in diseased sites (p <0.05). Higher levels of hBD 1 were observed in healthy sites of patients without periodontal disease than in healthy sites of patients with periodontitis (p<0.0001). Diseased sites of non-smokers presented higher levels of hBD 2 than healthy sites (p <0.05). These results reveal that protein levels of hBDs 1 and 2 can be impaired by cigarette smoking in the presence of periodontal disease.

Resumo Peptídeos antimicrobianos (PAMs) são componentes importantes da resposta do hospedeiro contra patógenos invasores. Além de sua atividade antimicrobiana direta, eles também podem participar da modulação do sistema imunológico. No entanto, o papel dos PAMs na etiopatogenia da doença periodontal e os fatores de risco que podem influenciar a sua expressão na cavidade oral não são totalmente compreendidos. O objetivo deste estudo foi determinar o impacto do tabagismo nos níveis de beta-defensina (hBD) 1 e 2 analisando amostras de pacientes com periodontite. Cinquenta pacientes com periodontite, 25 fumantes e 25 não fumantes e 20 pacientes periodontalmente saudáveis foram recrutados. Após avaliação clínica periodontal, amostras de fluido crevicular gengival (FCG) foram coletadas de sítios saudáveis de pacientes sem doença periodontal e de sítios saudáveis e doentes de pacientes com periodontite. A quantificação dos peptídeos foi realizada pela técnica de ELISA sanduíche. Fumantes apresentaram níveis reduzidos de hBD 1 no FCG e níveis aumentados de hBD 2 em comparação com não fumantes em locais doentes (p <0,05). Níveis mais elevados de hBD 1 foram observados em sítios saudáveis de pacientes sem doença periodontal do que em sítios saudáveis de pacientes com periodontite (p<0,0001). Os sítios doentes de não fumantes apresentaram níveis mais elevados de hBD 2 do que os sítios saudáveis (p<0,05). Esses resultados revelam que os níveis das hBDs 1 e 2 podem ser prejudicados pelo tabagismo na presença de doença periodontal.

The Effectiveness of L-PRF in the Treatment of Schneiderian Membrane Large Perforations: Long-Term Follow-Up of a Case Series.

The perforation of the Schneiderian membrane (SM) is a common surgical complication during the sinus floor augmentation (SFA) procedure. Different approaches have been proposed to completely closer the SM perforation and to avoid graft contamination or migration and postoperative sinus infection. In this context, the leukocyte and platelet-rich fibrin (L-PRF) membranes have been proposed for SM perforation treatment because of their natural adhesive property and resistance. Thus, this case series aims to evaluate the effectiveness of L-PRF in the treatment of SM large perforations during SFA. A total of 9 SM perforations were treated in this case series. The L-PRF membranes were interposed on the perforated SM until the rupture could not be visualized. The maxillary sinus cavities were filled with deproteinized bovine mineral bone (Bio-oss, Geistlich, Switzerland), and a collagen membrane was positioned to cover the lateral access window. After 8 months, 13 implants were placed, achieving satisfactory primary stability. The osseointegration of all implants and absence of infection signs/mucus in the maxillary sinus were observed in cone beam computed tomography or panoramic radiography qualitative analysis after 3-5 years of follow-up. It can be concluded that the use of L-PRF can be considered a viable alternative for the repair of large SM perforations.

Gingival Crevicular Fluid Levels of Human Beta-defensin 2 and 3 in Healthy and Diseased Sites of Individuals with and without Periodontitis.

OBJECTIVE: Human beta-defensins (hBDs) play an important role in the susceptibility to periodontitis. This study aimed to evaluate the levels of hBD-2 and hBD-3 in gingival crevicular fluid (GCF) of individuals with and without periodontitis. METHODS: Twenty periodontally healthy individuals (H) and 20 with periodontitis (P) were recruited. GCF samples were collected from healthy sites (Hh; n=20) from H individuals; and from healthy sites (Ph; n=20), sites with gingival inflammation but no attachment loss (Pg; n=20) and sites with inflammation and attachment loss (Pp; n=20) from P individuals. Levels of hBDs (pg/mL) were determined using ELISA. Comparisons between individuals and among sites were performed through hierarchical linear modelling. RESULTS: GCF levels [median(Q3-Q1)] of hBD-2 were: Hh=4.80 (0.00-30.69); Ph=33.29 (28.04-38.25); Pg=27.56 (23.14-35.50); and Pp=26.20 (23.20-42.54); and of hBD-3 were: Hh=0.00 (0.00-0.00); Ph=978.44 (760.48-1268.12); Pg=938.19 (806.75- 1266.38); and Pp=613.63 (325.50-854.68). Periodontitis at the individual level was associated with higher levels of hBD-2 (p=0.023) and hBD-3 (p greater than 0.001). No influence of site phenotype was observed on hBDs levels. CONCLUSION: Individuals with periodontitis presented higher levels of hBD-2 and hBD-3 in the GCF. These levels seemed to be influenced by periodontitis at the individual level but not by periodontal site.

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

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

Implant-based factor as possible risk for peri-implantitis.

Peri-implantitis is currently a topic of major interest in implantology. Considered one of the main reasons of late implant failure, there is an emerged concern whether implant characteristics could trigger inflammatory lesion and loss of supporting bone. The purpose of this narrative review is to provide an evidence based overview on the influence of implant-based factors in the occurrence of peri-implantitis. A literature review was conducted addressing the following topics: implant surface topography; implant location; occlusal overload; time in function; prosthesis-associated factors (rehabilitation extension, excess of cement and implant-abutment connection); and metal particle release. Although existing data suggests that some implant-based factors may increase the risk of peri-implantitis, the evidence is still limited to consider them a true risk factor for peri-implantitis. In conclusion, further evidences are required to a better understanding of the influence of implant-based factors in the occurrence of peri-implantitis. Large population-based studies including concomitant analyses of implant- and patient-based factors are required to provide strong evidence of a possible association with peri-implantitis in a higher probability. The identification of these factors is essential for the establishment of strategies to prevent peri-implantitis.

Evaluation of L-PRF combined with deproteinized bovine bone mineral for early implant placement after maxillary sinus augmentation: A randomized clinical trial.

PURPOSE: To investigate the effectiveness of adding leukocyte and platelet-rich fibrin (L-PRF) to deproteinized bovine bone mineral (DBBM) for early implant placement after maxillary sinus augmentation. MATERIALS AND METHODS: Twelve patients requiring two-stage bilateral maxillary sinus augmentation were enrolled to the study. The elevated sinus cavities were randomly grafted with DBBM + L-PRF (test) or DBBM alone (control) in a split-mouth design. Implants were placed in the augmented sites after 4 months in the test group and 8 months in the control group. Bone biopsies were collected during implant placement for histomorphometric evaluation. Resonance frequency analysis was performed immediately after implant placement and at implant loading in both groups. Cone-beam computed tomography was obtained preoperatively and postoperatively for evaluation of graft volume changes. RESULTS: Both procedures were effective for maxillary sinus augmentation. Cone-beam computed tomography analysis did not reveal differences in graft volume between test and control group at any of the evaluated time points (P > .05). Histological evaluation demonstrated increased percentage of newly formed bone for the test group (44.58% ± 13.9%) compared to the control group (30.02% ± 8.42%; P = .0087). The amount of residual graft in the control group was significantly higher (13.75% ± 9.99%) than in the test group (3.59 ± 4.22; P = .0111). Implant stability quotient (ISQ) immediately after implant placement was significantly higher in the control group (75.13 ± 5.69) compared to the test group (60.9 ± 9.35; P = .0003). The ISQ values at loading did not differ between the groups (P = .8587). Implant survival rate was 100% for both groups. CONCLUSION: The addition of L-PRF to the DBBM into the maxillary sinus allowed early implant placement (4 months) with increased new bone formation than DBBM alone after 8 months of healing.

Implant-based factor as possible risk for peri-implantitis

Abstract Peri-implantitis is currently a topic of major interest in implantology. Considered one of the main reasons of late implant failure, there is an emerged concern whether implant characteristics could trigger inflammatory lesion and loss of supporting bone. The purpose of this narrative review is to provide an evidence based overview on the influence of implant-based factors in the occurrence of peri-implantitis. A literature review was conducted addressing the following topics: implant surface topography; implant location; occlusal overload; time in function; prosthesis-associated factors (rehabilitation extension, excess of cement and implant-abutment connection); and metal particle release. Although existing data suggests that some implant-based factors may increase the risk of peri-implantitis, the evidence is still limited to consider them a true risk factor for peri-implantitis. In conclusion, further evidences are required to a better understanding of the influence of implant-based factors in the occurrence of peri-implantitis. Large population-based studies including concomitant analyses of implant- and patient-based factors are required to provide strong evidence of a possible association with peri-implantitis in a higher probability. The identification of these factors is essential for the establishment of strategies to prevent peri-implantitis.

Effectiveness of Clinpro XT in Reducing Dentin Permeability and its Resistance to Acid Challenges.

PURPOSE: To evaluate the efficacy of Clinpro XT in reducing dentin permeability and the stability of this effect after different acid challenges. MATERIALS AND METHODS: Sixty-five roots of extracted human third molars were used. From each tooth, one dentin specimen was prepared and connected to a fluid filtration system to measure the dentin permeability after each of the following steps: sample preparation; treatment with 37% phosphoric acid; application of Clinpro XT; three acid challenges. Specimens were randomly assigned to 5 groups (n = 13) according to the acidic solution applied: Coca-Cola, natural lemon juice, wine vinegar, white wine and Red Bull energy drink. An additional 10 third molars were used to evaluate the degree of occlusion of the dentinal tubules and the surface roughness. RESULTS: Clinpro XT statistically significantly reduced dentin permeability after just a single application. No statistically significant increase in dentin permeability could be detected after three consecutive challenges. The application of Clinpro XT promotes the occlusion of dentinal tubules and reduces the surface roughness. CONCLUSION: The Clinpro XT is effective in reducing dentin permeability. This effect persists even after acid challenges.

Early Placement of Dental Implants in Maxillary Sinus Grafted With Leukocyte and Platelet-Rich Fibrin and Deproteinized Bovine Bone Mineral.

This case report aimed to describe the effects of leukocyte and platelet-rich fibrin (L-PRF) associated with demineralized bovine bone mineral (DBBM) and absorbable collagen membrane (CM) on bone regeneration in maxillary sinus augmentation. A 59-year-old male patient was referred to the Department of Periodontology for implant rehabilitation of his edentulous upper jaw. The treatment plan involved maxillary sinus augmentation followed by implant installations. A split-mouth design was employed in which the right maxillary sinus was filled using L-PRF, DBBM, and CM; the left side was filled with DBBM and CM. After 4 and 8 months postoperatively, 2 dental implants were installed in each of the right and left maxillary sinuses. Cone-beam computerized tomography (CBCT) was taken before and after sinus augmentation for evaluation of tridimensional bone volume alterations. Bone biopsies were harvested from the implant sites for histomorphometric evaluation. Resonance frequency analysis was employed immediately after implant placement and before prosthetic rehabilitation for evaluation of implant stability. Implants were loaded 10 months after sinus augmentation. CBCT analysis showed a higher resorption rate in the right side of the maxillary sinus (L-PRF + DBBM) compared to the left side (22.25% and 8.95%, respectively). Implant stability quotients were above 68 in all time-points for both groups. Histomorphometric analysis showed a high amount of newly formed bone when L-PRF was used compared with DBBM alone (2 118 102 and 975 535 mm3, respectively). Taken together, both techniques were effective for maxillary sinus augmentation, however the addition of L-PRF to the graft allowed early implant placement and accelerated bone healing in the conditions studied.

Associação entre beta-defensinas e periodontite / Association between beta-defensins and periodontitis: literature review

Objetivo: as beta-defensinas humanas (hBDs) podem ter um papel-chave na susceptibilidade às doenças na cavidade bucal. Além do efeito antimicrobiano direto, as hBDs aumentam a imunidade adaptativa. O objetivo deste estudo foi realizar uma revisão de literatura científica sobre a relação entre beta-defensinas (hBD) e periodontite. Material e métodos: foi realizada uma pesquisa bibliográfica na base de dados PubMed sobre a expressão de hBDs em indivíduos com periodontite. Os termos beta defensins e periodontitis foram utilizados nessa busca. Resultados: foram selecionados, por um revisor, sete artigos para serem incluídos nessa revisão de literatura: dois estudos de intervenção e cinco estudos transversais. Conclusão: o número de estudos sobre a expressão de beta-defensinas em indivíduos com periodontite é reduzido. O conhecimento sobre o papel das beta-defensinas na periodontite pode trazer um maior entendimento de sua etiopatogenia, além de possibilitar novos indicadores de risco e terapias. Estudos adicionais são necessários para a elucidação da relação entre esses peptídeos antimicrobianos e a periodontite.

Objective: human beta-defensins (hBDs) may play a key role in the susceptibility to diseases in the oral cavity. In addition to the direct antimicrobial effect, hBDs enhance adaptive immunity. The objective of this study was to investigate the literature on the relationship between hBD and periodontitis. Material and methods: a literature review was conducted in the PubMed database on the expression of hBDs in subjects with periodontitis. The terms "beta-defensins" and "periodontitis" were used in this search. Results: seven articles were selected being: two intervention studies and fi ve cross-sectional studies. Conclusion: the number of studies on the expression of beta-defensins in individuals with periodontitis is reduced. Knowledge about the role of beta-defensins in periodontitis may lead to a better understanding of their etiopathogenesis, in addition to providing new risk indicators and therapies. Additional studies are needed to elucidate the relationship between these antimicrobial peptides and periodontitis.

Survival/Success of Dental Implants with Acid-Etched Surfaces: A Retrospective Evaluation After 8 to 10 Years

Abstract The aim of this study was to conduct a retrospective evaluation of the survival and success rates of dental implants with acid-etched surfaces after 8-10 years of function. Forty-four patients who received 183 implants 8-10 years ago were evaluated. Clinical examinations were performed around the implants and natural teeth. The following parameters were measured: visible plaque index (VPI), marginal bleeding index (MBI), probing depth (PD), bleeding on probing (BOP) and clinical attachment level (CAL). To considerer an implant as a success case, the following criteria were considered: absence of peri-implant infection and suppuration, absence of implant mobility, absence of persistent pain and dysesthesia and absence of radiolucency around the implant. Overall, 178 implants were categorized as surviving (97.3%), 155 were categorized as successful (84.7%), 5 implants (2.7%) were lost (1 in the maxilla and 4 in the mandible), and 3 implants were not under functional load (2.0 %). 20 implants were diagnosed with peri-implantitis. Thus, the survival rate was 97% and the success rate was 85%. In conclusion, implants with acid-etched surfaces showed high survival and success rates after a period of 8 to 10 years of function.

Resumo O objetivo deste estudo foi avaliar retrospectivamente a taxa de sobrevivência e sucesso de implantes com superfície tratada por ataque ácido após 8-10 anos de função. Um total de 44 pacientes que receberam 183 implantes há 8-10 anos foram avaliados. Foi realizado exame clínico de todos os dentes e implantes presentes na cavidade bucal. Os seguintes parâmetros foram avaliados: índice de placa visível (IPV), índice de sangramento gengival (ISG), profundidade de sondagem (PS), sangramento à sondagem (SS), nível clínico de inserção (NCI). Para a classificação de sucesso dos implantes foram considerados os seguintes critérios: ausência de infecção peri-implantar com supuração, ausência de mobilidade, ausência de dor persistente ou disestesia e ausência de radiolucência contínua ao redor do implante. Após avaliação, 178 (97.3%) implantes foram classificados como sobreviventes, 155 (84.7%) aderiram aos critérios de sucesso, 5 implantes (2.7%) foram perdidos (1 na maxila e 4 na mandíbula) e 3 implantes (2.0%) não estavam em função. 20 (11%) implantes foram diagnosticados com peri-implantite. Dessa forma, a taxa de sobrevivência foi de 97% e a taxa de sucesso de 85%. Pode-se concluir que os implantes com superfície tratada por ataque ácido apresentaram altas taxas de sobrevivência e sucesso após 8-10 em função.

Avaliação in vitro de novos produtos na diminuição da permeabilidade dentinária antes e após desafios ácidos / In vitro evaluation of new products in regarding dentin permeability reduction before and after acid challenge model

Objetivo: avaliar in vitro a efetividade de aplicações sucessivas de diferentes produtos utilizados para o tratamento da hipersensibilidade dentinária cervical na redução da permeabilidade dentinária, assim como avaliar a resistência destes produtos a desafios ácidos. Material e métodos: foram utilizados 72 terceiros molares humanos íntegros para a preparação de 72 amostras, que foram ligadas a um sistema de pressão hidráulica para mensurar a permeabilidade dentinária após os seguintes passos: 1) preparação da amostra; 2) tratamento com ácido fosfórico a 37% durante 30 segundos; 3) cinco aplicações dos produtos testados; 4) primeiro desafio ácido; 5) segundo desafio ácido; e 6) terceiro desafio ácido. As amostras foram divididas aleatoriamente em seis grupos (n=12), de acordo com os tratamentos propostos: Desensibilize Nano P, Clinpro XT, dentifrício Colgate Sensitive Pró-Alívio, dentifrício Duraphat, dentifrício Sensodyne Repair e após restauração com resina composta (grupo-controle). Conclusão: que todos os produtos testados foram capazes de promover a redução da permeabilidade dentinária significativamente, sendo que os grupos Clinpro XT, Desensibilize Nano P e controle mantiveram esses níveis reduzidos estatisticamente até o terceiro desafio ácido, enquanto que os dentifrícios Duraphat, Sensodyne Repair e Colgate Sensitive Pró-Alívio mantiveram essas reduções estatisticamente significativas até o segundo desafio ácido.

Objective: to evaluate in vitro the effectiveness of successive applications of different products used for the treatment of cervical dentinal hypersensitivity, reducing dentin permeability, as well as to evaluate the resistance of these products, acids challenges. Material and methods: 72 intact human third molars were used for the preparation of 72 samples were bound to a hydraulic pressure system to measure the dentin after the following steps: 1) sample preparation; 2) treatment with 37% phosphoric acid for 30 seconds; 3) 5 applications of the products tested; 4) first challenge acid; 5) second challenge acid; 6) third challenge acid. The samples were randomly divided into 6 groups (n=12) according to the proposed treatments: Desensibilize Nano P, Clinpro XT, toothpaste Colgate Sensitive Pro-Relief, Duraphat toothpaste, toothpaste Sensodyne Repair and after restoration with composite resin (control group). Conclusion: all products tested were able to significantly promote the reduction of dentin, and the Clinpro XT groups Desensibilize Nano P and control these reduced levels remained statistically to the third challenge acid, while toothpaste Duraphat, Sensodyne Repair and Colgate Sensitive Pro-Relief kept these statistically significant reductions to the second challenge acid.

Survival/Success of Dental Implants with Acid-Etched Surfaces: A Retrospective Evaluation After 8 to 10 Years.

The aim of this study was to conduct a retrospective evaluation of the survival and success rates of dental implants with acid-etched surfaces after 8-10 years of function. Forty-four patients who received 183 implants 8-10 years ago were evaluated. Clinical examinations were performed around the implants and natural teeth. The following parameters were measured: visible plaque index (VPI), marginal bleeding index (MBI), probing depth (PD), bleeding on probing (BOP) and clinical attachment level (CAL). To considerer an implant as a success case, the following criteria were considered: absence of peri-implant infection and suppuration, absence of implant mobility, absence of persistent pain and dysesthesia and absence of radiolucency around the implant. Overall, 178 implants were categorized as surviving (97.3%), 155 were categorized as successful (84.7%), 5 implants (2.7%) were lost (1 in the maxilla and 4 in the mandible), and 3 implants were not under functional load (2.0 %). 20 implants were diagnosed with peri-implantitis. Thus, the survival rate was 97% and the success rate was 85%. In conclusion, implants with acid-etched surfaces showed high survival and success rates after a period of 8 to 10 years of function.

Prevalence and Possible Risk Factors of Peri-implantitis: A Concept Review.

AIM: The purpose of this review is to estimate the prevalence of peri-implantitis, as well as to determine possible risk factors associated with its development in patients treated with oral implants. BACKGROUND: Although implant therapy has been identified as a successful and predictable treatment for partially and fully edentulous patients, complications and failures can occur. Peri-implantitis is considered a biologic complication that results in bone loss around implants and may lead to implant treatment failure. RESULTS: A great variation has been observed in the literature regarding the prevalence of peri-implantitis according to the diagnostic criteria used to define peri-implantitis. The prevalence ranges from 4.7 to 43% at implant level, and from 8.9 to > 56% at patient level. Many risk factors that may lead to the establishment and progression of peri-implantitis have been suggested. There is strong evidence that presence and history of periodontitis are potential risk factors for peri-implantitis. Cigarette smoking has not yet been conclusively established as a risk factor for peri-implantitis, although extra care should be taken with dental implant in smokers. Other risk factors, such as diabetes, genetic traits, implant surface roughness and presence of keratinized mucosa still require further investigation. CONCLUSION: Peri-implantitis is not an uncommon complication following implant therapy. A higher prevalence of peri-implantitis has been identified for patients with presence or history of periodontal disease and for smokers. Until now, a true risk factor for peri-implantitis has not been established. Supportive maintenance program is essential for the long-term success of treatments with oral implants. CLINICAL SIGNIFICANCE: The knowledge of the real impact of peri-implantitis on the outcome of treatments with oral implants as well as the identification of risk factors associated to this inflammatory condition are essential for the development of supportive maintenance programs and the establishment of prevention protocols.

The smear layer created by scaling and root planing is physiologically eliminated in a biphasic process.

Mechanical instrumentation of the root surface causes the formation of a smear layer, which is a physical barrier that can affect periodontal regeneration. Although different procedures have been proposed to remove the smear layer, there is no information concerning how long the smear layer persists on root surfaces after instrumentation in vivo. This study assessed the presence of the smear layer on root surfaces over a 28-day period after subgingival instrumentation with hand instruments. Fifty human teeth that were referred for extraction because of advanced periodontal disease were scaled and root planed (SRP) by a single experienced operator. Ten teeth were randomly assigned to be extracted 7, 14, 21, and 28 days after SRP. Another 10 teeth were extracted immediately after instrumentation (Day 0, control group). The subgingival area of the instrumented roots was evaluated with scanning electron microscopy. Representative photomicrographs were assessed by a blinded and calibrated examiner according to a scoring system. A rapid and significant (p < 0.05, Z test) initial reduction in the amount of smear layer was observed at 7 days, and a further significant (p < 0.05) decrease was observed 28 days after SRP. Interestingly, even 28 days after SRP, the smear layer was still present on root surfaces. This study showed that the physiological elimination of the smear layer occurred in a biphasic manner: a rapid initial reduction was observed 7 days after instrumentation, which was followed by a slow process leading to a significant decrease 28 days after instrumentation.