Proinflammatory Cytokine Expression in Apical Periodontitis from Diabetic Patients.

Diabetes mellitus has been regarded as a condition capable of influencing the evolution of periapical lesions. Therefore, this study evaluated the immunoexpression of IL-1ß, TNF-α, and IL-17 in apical periodontitis from type 2 diabetic patients through immunohistochemistry. Twenty-six periapical lesions were selected, and the images obtained through immunohistochemistry reactions were analyzed. The statistical significance was set at p < 0.05. IL-1ß expression was considered focal (54%), weak to moderate (38%), and strong (8%) in diabetics, and focal (46%), weak to moderate (31%), and strong (23%), in controls. TNF-α was focal (85%) and weak to moderate (15%) in diabetics, and focal (92%) and weak to moderate (8%), in controls. IL-17 was focal (8%), weak to moderate (46%), and strong (46%) in diabetics, and focal (62%), weak to moderate (8%), and strong (30%), in controls. The quantitative analysis revealed greater expression of IL-17, with a significant difference between IL-17 × IL-1ß × TNF-α(p=0.0009) in the diabetic group. The cytokines IL-1ß and TNF-α did not express statistical differences between the tested groups. The IL-17 showed higher immunoexpression in the diabetic group (p=0.047), which may suggest higher bone resorption activity in chronic apical periodontitis in this group of patients.

Response letter: Neuropsychiatric presentation of Covid-19-related encephalitis: Case report.

Covid-19-related encephalitis is a heterogeneous syndrome characterized by a combination of clinical, laboratory, and imaging features related to inflammation of the brain, where the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is presumably the causative agent. We reported a case of Covid-19-related encephalitis presenting with neuropsychiatric symptoms, including intense agitation. Reverse-transcriptase polymerase-chain-reaction in cerebrospinal fluid was positive for SARS-CoV-2. Our case expands the literature about neurologic manifestations of Covid-19 and emphasizes the possibility of prominent behavioral symptoms as the initial manifestation.

Efeito agudo do método reequilíbrio toracoabdominal em lactentes com diagnóstico de bronquiolite / Acute effect of thoracic-abdominal rebalance method in infants diagnosed with bronchiolitis

Nos lactentes, o sistema imunológico ainda é imaturo, o que torna as crianças mais suscetíveis ao vírus sincicial respiratório, o principal causador da bronquiolite. O Reequilíbrio Toraco-abdominal (RTA) é um método de terapia manual que atua sobre o sistema respiratório por meio de uma leitura global em situações de doenças. Objetivos: Avaliar os efeitos do método RTA, comparado à fisioterapia tradicional (FT) em lactentes com bronquiolite. Metodologia: Pesquisa experimental e prospectiva, na qual 24 lactentes foram divididos em dois grupos, FT (n = 12) e RTA (n = 12). Parâmetros fisiológicos (frequência respiratória, frequência cardíaca, saturação de pulso de oxigênio e ausculta pulmonar), desconforto respiratório e desequilíbrio da biomecânica respiratória foram avaliados antes e após os manuseios. Resultados: A idade média foi de 13 (± 11,07) semanas no grupo FT e no grupo RTA 13,3 (± 8,41) semanas. Após os manuseios, obteve diferença estatística no grupo do RTA comparado ao da FT nos seguintes parâmetros: observamos uma diminuição significativa da frequência cardíaca (p = 0,02) e da frequência respiratória (p = 0,0002), no quesito esforço respiratório em tórax superior (p = 0,004) e tórax inferior (p = 0,017) e no escore de Wood-Downes em moderada com (p = 0,0001). Conclusão: O RTA mostrou-se mais eficaz que as técnicas da FT em relação aos benefícios ao lactente. (AU)

Incidência de alterações posturais em indivíduos participantes de ação social no município de Nova Iguaçu, RJ / Incidence of postural changes in individuals participating in social action at Nova Iguaçu City, RJ

O presente estudo tem como objetivo principal estimar a incidência de alterações postural em indivíduos participantes da ação social UNIG Portas Abertas, ocorrida no campus da Universidade Iguaçu, novembro de 2018 e maio de 2019. É um estudo transversal e descritivo. Foram avaliados 75 indivíduos. A avaliação postural foi realizada através do posturógrafo, com os participantes em posição ortostática, com os pés descalços e cabelos presos. As análises foram feitas na vista anterior, posterior e lateral. Os resultados mostraram que 89,5% da amostra apresentou algum tipo de alteração postural. As principais alterações posturais encontradas foram: desvio na altura das mãos (52,6%), hiperlordose lombar (47,3%), desvio na altura da crista ilíaca, gibosidade torácica, ombro retraído e joelho recurvatum (36,8%). (AU)

O português, o desprazer e a anedonia / Portuguese, displeasure, anhedonia

A língua portuguesa, indubitavelmente, fora muito ferida nas últimas décadas. Em associação, a anedonia (lentificação da capacidade de sentir interesse e prazer), pairou na leitura de artigos científicos e\ou trabalhos de mestrado e doutorado. Os pesquisadores, salvo raras exceções, encontram-se "disfuncionais" no que tange aos comportamentos associados à recompensa ou a domínios de valência positiva, quando se inclinam para a leitura. Um primeiro parágrafo já é capaz de desconstruir a ideia de um trabalho brilhante, tipo aqueles ovos de Colombo. Realmente a língua portuguesa, quando bem aplicada, nos antecipa, nos motiva e faz eclodir um retorno "límbico" do "valeu a pena"... (AU)

Association between Body Composition and Dysphagia in Patients with Amyotrophic Lateral Sclerosis.

BACKGROUND: The influence of changes in body composition on swallowing in patients with Amyotrophic Lateral Sclerosis (ALS) is unknown. Understanding the interrelation between body compartments and dysphagia may establish specific treatments related to both nutritional aspects as to myofunctional ones designed to delay swallowing loss. AIM: The aim of the study was to evaluate the relationship between body composition and dysphagia during the course of the disease. METHODS: The protocol of this study included assessments carried out quarterly for one year and included: analysis of body composition by multi-frequency segmental bioimpedance, nutritional diagnosis, maximum strength test of the tongue and lips, analysis of swallowing using the Functional Oral Intake Score (FOIS) and Swallowing Rating Scale of the American Speech-Language-Hearing Association (ASHA), speech intelligibility and analysis of disease severity. To measure the degree of relationship between quantitative variables, Spearman's correlation was used. RESULTS: Thirty-four patients were evaluated, 28 Spinal Group and 6 Bulbar Group. The results did not show any significant differences in the analysis of body composition between the groups. Positive associations were found between body compartments and swallowing analysis. The phase angle showed a strong correlation between the FOIS scales (r = 0.74, p < 0.01), ASHA (r = 0.77, p < 0.01) and tongue (r = 0.66, p < 0.01). CONCLUSIONS: Changes in body compartments were related to swallowing functionality and speech intelligibility in ALS patients, emphasizing the importance of analyzing body compartments for decision making by the interdisciplinary team. Although these preliminary data were collected in a small sample size, they serve to motivate future studies in this area.

Rebalancing thoraco-abdominal method does not increase immediate pain assessed by Neonatal Infant Pain Scale: a randomized clinical trial / O método reequilíbrio tóraco-abdominal não aumenta a dor avaliada pela Neonatal Infant Pain Scale: estudo clínico randomizado

Objective: To compare in neonates with transitory tachypnea if chest rebalancing thoraco-abdominal method (RTA) increased immediate pain. Methods: This was a randomized controlled clinical trial. Forty-nine neonates with transitory tachypnea and aged < 72 hours were included to receive either conventional physiotherapy (CP) or RTA method. Participants received usual care and one 15- minute session of chest physiotherapy. Neonatal Infant Pain Scale (NIPS), peripheral oxygen saturation, heart rate, respiratory rate, axillary temperature before and after chest physiotherapy were recorded. Kruskal-Wallis ANOVA and Mc Nemar test were used to compare differences between measures. The relative risk (RR) for pain after interventions was calculated using a Poisson regression model (robust estimation). A significance level of 5% (p < 0.05) was adopted for all analyses. Results: RTA was not associated to pain. After chest physiotherapy, NIPS reduced (2 versus 3, p < 0.001) and number of neonates with pain reduced (10.2% versus 28.6%, p = 0.02). RR for pain after chest physiotherapy in comparison to before was 0.3 (95% CI 0.15-0.41; p = 0.02); respiratory frequency decreased after chest physiotherapy (58 versus 70, p < 0.001) and peripheral oxygen saturation increased (98% versus 96%, p < 0.001). Conclusion: In neonates with transitory tachypnea, in the first 72 hours of life, RTA did not influence pain evaluation, chest physiotherapy was safe and reduced immediate pain. (AU)

Objetivo: Comparar em recém-nascidos com taquipneia transitória se o método reequilíbrio tóraco-abdominal (RTA) aumentou a dor imediatamente após. Métodos: Estudo de ensaio clínico randomizado. Quarenta e nove recémnascidos com diagnóstico de taquipneia transitória com menos de 72 horas de vida, foram incluídos para receber fisioterapia respiratória. Os participantes receberam os cuidados usuais e uma sessão de fisioterapia convencional ou do método reequilíbrio tóraco-abdominal. Foram registradas a escala NIPS (Neonatal Infant Pain Scale), a saturação periférica de oxigênio, a frequência cardíaca, a frequência respiratória e a temperatura axilar antes e depois da fisioterapia. Para as comparações entre as medidas, foram utilizados o teste de ANOVA de Kruskal-Wallis e o teste de McNemar. O risco relativo de dor após os procedimentos foi calculado usando o modelo de regressão de Poisson (estimação robusta). Foi considerado o nível de significância de 5% para todas as análises (p < 0,05). Resultados: O método RTA não foi associado a dor. Após a fisioterapia respiratória, a escala NIPS reduziu (2 versus 3, p < 0,001) e a proporção de recém-nascidos com dor também reduziu (10,2% versus 28,6%, p = 0,02). O risco relativo de dor após a fisioterapia respiratória em comparação a antes, foi de 0,3 (IC 95% 0,15-0,41; p = 0,02), a frequência respiratória diminuiu (58 versus 70, p < 0,001) e a saturação periférica de oxigênio aumentou (98% versus 96%, p < 0,001). Conclusão: Em recém-nascidos com taquipneia transitória nas primeiras 72 horas de vida, o método RTA não influenciou a avaliação da dor, a fisioterapia respiratória foi segura e reduziu a dor imediatamente após. (AU)

A inserção da realidade virtual aplicada na recuperação físico-funcional de membros superiores após acidente vascular encefálico: uma revisão sistemática / The insertion of virtual reality applied in the physical and functional recuperation of upper limbs after a stroke: a systematic review

Uma das principais causas de morte e limitação funcional em todo o mundo é o Acidente Vascular Encefálico (AVE), causando alterações significativas sobre as atividades de vida diária do indivíduo. O AVE ocorre a partir de comprometimentos vasculares, ocasionando danos cognitivos e musculares, sendo necessário o tratamento fisioterapêutico para a recuperação da função. A realidade virtual se tornou uma aliada da fisioterapia para a recuperação de pacientes pós-AVE, como forma de tornar o tratamento mais interativo e atraente para o paciente. O presente estudo teve como objetivo verificar a eficácia do uso da realidade virtual na recuperação funcional dos membros superiores em pacientes com sequelas de AVE, por meio de uma revisão sistemática. Os estudos utilizados foram buscados em duas bases de dados, onde aqueles selecionados deveriam obedecer aos critérios de inclusão e exclusão pré-determinados. Os resultados obtidos mostraram que a realidade virtual em conjunto com a fisioterapia pode proporcionar resultados significantes para a melhora funcional do membro superior afetado, o que acarreta melhora e bem estar geral do paciente. (AU)

One of the main causes of death and functional limitation worldwide is the stroke, causing significant changes in the individual's daily activities. Stroke occurs from vascular impairments, causing cognitive and muscle damage, requiring physiotherapeutic treatment to recover function. Virtual reality has become a complement of physiotherapy for the recovery of post-stroke patients, with a way of making treatment more interactive and attractive to the patient. The present study aimed to verify the effectiveness of the use of virtual reality in the functional recovery of the upper limbs in patients with stroke sequelae, through a systematic review. The studies used were searched on two scientific bases, where those selected should obey the predetermined inclusion and exclusion criteria. The results obtained showed that virtual reality in conjunction with physical therapy can provide significant results for the functional improvement of the upper limb affected, which leads to improvement and general well-being of the patient. (AU)

Análise cinemática da marcha com medidas normalizadas e não-normalizadas em indivíduos hígidos: um estudo experimental / Kinematic gait analysis with normalized and non-normalized measurements in healthy individuals: an experimental study

O objetivo deste estudo foi analisar as possíveis relações entre a variável antropométrica comprimento dos membros inferiores e de passada na marcha, com valores naturais e normalizados, em velocidade auto-selecionada e acrescida de 50%, em indivíduos adultos jovens. Foram avaliados 32 sujeitos hígidos adultos entre 18-25 anos. Os deslocamentos corporais nas duas velocidades foram registrados através da técnica de cineantropometria, utilizando o software Skillspector® para quantificar o comprimento da passada entre as médias dos dados normalizadas e não-normalizadas, do segmento direito e do segmento esquerdo. A comparação entre os valores médios das passadas normalizadas e não-normalizadas, nas diferentes velocidades, foi realizada por meio do teste t student (p < 0,05), assim como o grau de associação entre o comprimento da passada e o comprimento do membro inferior, realizada pelo teste de correlação de Pearson (p < 0,05). Sendo assim, nosso estudo constatou uma correlação positiva entre as variáveis estudadas, nas duas velocidades e, uma diferença entre a passada com dados normalizados e não normalizados, em ambas as velocidades. (AU)

The aim of this study was to analyze the possible relationships between the anthropometric variable length of the lower limbs and gait stride, with natural and normalized values, at self-selected speed and increased by 50%, in young adult individuals. 32 healthy adult subjects aged 18-25 years were evaluated. Body movements at both speeds were recorded using the kinanthropometry technique, using the Skillspector® software to quantify the stride length between the normalized and nonnormalized data averages for the right and left segments. The comparison between the mean values of normalized and non-normalized strides, at different speeds, was performed using the Student t test (p < 0.05), as well as the degree of association between stride length and lower limb length, performed by the Pearson correlation test (p < 0.05). Thus, our study found a positive correlation between the variables studied, at both speeds, and a difference between the stride with normalized and non-normalized data, at both speeds. (AU)

Repetitive transcranial magnetic stimulation changes cognitive/motor tasks performance: An absolute alpha and beta power study.

The voluntary movement demands integration between cognitive and motor functions. During the initial stages of motor learning until mastery of a new motor task, and during a demanding task that is not automatic, cognitive and motor functions can be perceived as independent from each other. Areas used for actually performing motor tasks are essentially the same used by Motor Imagery (MI). The main objective of this study was to investigate inhibition effects on cognitive functions of motor skills induced by low-frequency (1 Hz) Repetitive Transcranial Magnetic Stimulation (rTMS) at the sensory-motor integration site (Cz). In particular, the goal was to examine absolute alpha and beta power changes on frontal regions during Execution, Action observation, and Motor Imagery of finger movement tasks. Eleven healthy, right-handed volunteers of both sexes (5 males, 6 females; mean age 28 ± 5 years), with no history of psychiatric or neurological disorders, participated in the experiment. The execution task consisted of the subject flexing and extending the index finger. The action observation task involved watching a video of the same movement. The motor imagery task was imagining the flexion and extension of the index finger movement. After performing the tasks randomly, subjects were submitted to 15 min of low-frequency rTMS and performed the tasks again. All tasks were executed simultaneously with EEG signals recording. Our results demonstrated a significant interaction between rTMS and the three tasks in almost all analyzed regions showing that rTMS can affect the frontal region regarding Execution, Action observation, and Motor Imagery tasks.

Avaliação da mortalidade no pós-operatório de fraturas de fêmur em idosos com comorbidades prévias / Evaluation of postoperative mortality of femoral fractures in elderly with previous comorbidities

Introdução: Queda é o acidente que ocorre com maior frequência no idoso, sendo a principal causa de morte naqueles com mais de 65 anos. As fraturas do quadril ocupam um papel de grande importância, gerando grande problema de ordem clínica envolvendo pacientes e familiares e de ordem econômica para a sociedade. Objetivo: Coletar dados de questionário da admissão e correlacionar a presença de comorbidades prévias a mortalidade em 30 dias do pós-cirurgia. Métodos: Estudo retrospectivo observacional não randomizado com 216 pacientes com fraturas cirúrgicas do quadril com 61 anos ou mais de idade atendidos no setor de emergência do Centro Hospitalar São Lucas na cidade de Niterói, RJ, no período de 30/03/2016 a 20/03/2018. Resultados: A incidência de óbito após a cirurgia do quadril é igual a 6,9% no primeiro mês. O paciente com fratura no quadril tem comorbidades cardiovasculares (75,9%). O óbito está associado à comorbidade hepática em 13,3% e ao baixo peso em 33,3%. O fato de ter duas ou mais comorbidades não está significativamente associado ao óbito. Conclusão: As comorbidades hepáticas, o baixo peso e a presença de disfunções cardiovasculares são importantes preditores prognósticos na mortalidade do paciente com mais de 61 anos após cirurgia de fratura do fêmur no primeiro mês. (AU)

Introduction: Falls are the leading cause of accidents and death in those aged 65 and above. The high incidence of these injuries impact patients, their families and it represents an economic problem for society. Objective: Collect data from the admission survey and correlate previous comorbidities to mortality in 30 days after surgery. Methods: Retrospective observational non-randomized study. 216 patients were included, aged 61 years or older, who were admitted at the emergency department of the Centro Hospitalar São Lucas in Niterói city, Rio de Janeiro. All the participants were candidates of hip fracture surgery between 03/30/2016 and 03/20/2018. Results: The mortality after hip surgery was 6.9% in the first month. Patients who underwent hip surgery had, previously, cardiovascular diseases (75.9%). Death was associated with liver comorbidity in 13.3% and low weight in 33.3%. The fact of having two or more comorbidities was not associated with death. Conclusion: Liver and cardiovascular diseases and low weight are important prognostic predictors in mortality of patients over 61 years of age after femoral fracture surgery in the first month. (AU)

Muito além do consultório: uma análise multifacetada da marcha em pacientes neurológicos / Beyond the office: a multifaceted gait analysis in neurological patients

Introdução: A marcha pode ser definida como um padrão cíclico, na postura bípede, que utiliza os membros inferiores para propulsão do corpo. No campo da Neurologia, a marcha no exame físico representa sinais na avaliação neurológica, que auxiliam no fechamento de diagnósticos. No ambiente clínico, em especial nos consultórios, o refinamento da avaliação da marcha fica restrita a experiência do clínico, pois o espaço muitas vezes é reduzido, o tempo inadequado para avaliação. Poucos relatos na literatura abordaram a referida questão. Objetivo: Discutir os principais pontos da análise de marcha de interesse dos neurologistas, no consultório. Metodologia: Nessa revisão narrativa, foram levantados 32 artigos e, aplicados os critérios de elegibilidade, foram selecionados 6 artigos. A avaliação da marcha no consultório deve respeitar critérios, pois pode acarretar vieses dos parâmetros da marcha e dificultar a análise global. Conclusão: Por isso, há necessidade de maiores discussões, no âmbito do consultório, para melhor avaliar os parâmetros da marcha. (AU)

Introduction: Gait can be defined as a cicle pattern in biped posture that use to lower limb to body propulse. In Neurology, the physical exam of gait represents a neurological signal. This fact can help in the diagnosis conclusion. In a clinical setting and medical office, the critical evaluation is restricted to the physician´s expertise. The space of doctor´s room is often reduced and inappropriate time for evaluation. Objective: This study aimed to discuss the main points of gait analysis in neurological outpatients. Methods: In this narrative review, 32 articles were analyzed, and after included criteria, 6 articles were selected. In neurology medical office must respected criteria to no promote bias of gait parameter and complicate global assessment. Conclusion: Therefore, there is a need for further discussions, within the scope to better assess the gait parameters. (AU)

Reabilitação do polegar reimplantado: avaliação dos resultados funcionais em uma unidade de saúde no Rio de Janeiro / Rehabilitation of the replanted thumb: evaluation of functional results in a health unit in Rio de Janeiro

Introdução: O polegar é o dedo de maior importância funcional da mão, por isso a justificativa de reimplantação e reabilitação do mesmo. Objetivo: Realizar uma análise retrospectiva dos resultados, via revisão de prontuários de pacientes submetidos à reimplante de polegar, realizados pelo Serviço SOS-Reimplante do Hospital Estadual Adão Pereira Nunes. Metodologia: Trata-se de um estudo retrospectivo com amostra de conveniência, abrangendo o período entre janeiro de 2010 a dezembro de 2015, realizado através de prontuários de pacientes submetidos a processo de reimplante de polegar, atendidos no Serviço de Terapia Ocupacional/TO-Mão no Hospital estadual Adão Pereira Nunes, em Duque de Caxias, Rio de Janeiro. Foram coletadas informações sociodemográficas, além de força muscular, sensibilidade e tempo de reabilitação. Resultados: Foram revisados 63 prontuários de pacientes submetidos a procedimento de reimplante de polegar, na faixa etária de 18 a 65 anos. Quanto ao local do acidente, 76,1% dos casos foi decorrente de acidente de trabalho e 23,2% acidentes domésticos. Ao observamos à lateralidade da lesão, 92% dos pacientes eram destros, enquanto o polegar com maior número de lesões foi o esquerdo, com um total de 82,5% pacientes. Quanto ao nível da lesão, 25,3% pacientes sofreram lesão na falange proximal, 20,8% pacientes sofreram lesão na região da interfalangeana, e 53,9% dos pacientes apresentaram lesão na falange distal. Dentre os reencaminhados para nova avaliação, 28,5% pacientes, foram submetidos a outros procedimentos cirúrgicos. Houve ganho de força em global em 88,2% dos pacientes em de sensibilidade. Conclusão: A maioria dos pacientes que sofreram reimplante do polegar conseguiram obter ganho de força muscular e sensibilidade, conseguirem retornar as suas atividades laborais, com um tempo de reabilitação que variou de 4 a 14 meses. (AU)

Introduction: The thumb is the greatest functional finger of the hand, which is justifies its replantation and rehabilitation. Objective: To carry out a retrospective analysis of the medical records of patients undergoing thumb reimplantation, performed by the SOS-Reimplantation Service of the State Hospital Adão Pereira Nunes. Methodology: This is a retrospective study with a convenience sample, covering the period between January 2010 and December 2015, conducted thorough medical records of patients undergoing the process of thumb replantation, attended at the Occupational Therapy Service / TO - Hand at the Adão Pereira Nunes State Hospital, in Duque de Caxias, Rio de Janeiro. Sociodemographic information was collected, in addition to muscle strength, sensitivity, and rehabilitation time. Results: 63 medical records of patients who underwent thumb reimplantation procedure, aged 18 to 65 years, were reviewed. As for the accident site, 76.1% of the cases were due to occupational accidents and 23.2% to domestic accidents. When observing the laterality of the lesion, 92% of the patients were righthanded, while the thumb with the largest number of lesions was left, with a total of 82.5% patients. As for the level of the lesion, 25.3% of patients suffered an injury to the proximal phalanx, 20.8% of patients suffered an injury to the interphalangeal region, and 53.9% of the patients had lesions to the distal phalanx. Among those referred for further evaluation, 28.5% of patients underwent other surgical procedures. There was overall strength gain in 88.2% of patients in sensitivity. Conclusion: Most patients who underwent thumb reimplantation were able to obtain gains in muscle strength and sensitivity, being able to return to their work activities, with a rehabilitation time that varied from 4 to 14 months. (AU)

Neuropsychiatric presentation of Covid-19-related encephalitis: Case report.

Covid-19-related encephalitis is a heterogeneous syndrome characterized by a combination of clinical, laboratory, and imaging features related to inflammation of the brain, where the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is presumably the causative agent. We reported a case of Covid-19-related encephalitis presenting with neuropsychiatric symptoms, including intense agitation. Reverse-transcriptase polymerase-chain-reaction in cerebrospinal fluid was positive for SARS-CoV-2. Our case expands the literature about neurologic manifestations of Covid-19 and emphasizes the possibility of prominent behavioral symptoms as the initial manifestation.

Improvement of Periodontal Parameters with the Sole Use of Free Gingival Grafts in Orthodontic Patients: Correlation with Periodontal Indices. A 15-Month Clinical Study.

The aim of this study was to evaluate the changes in periodontal parameters solely using free gingival grafts during orthodontic treatment without any oral hygiene re-enforcement. METHODS: A total of 19 patients underwent periodontal examination before orthodontic treatment. Patients received oral hygiene instruction and professional hygiene therapy. Where needed; full periodontal treatment was completed. Only periodontally stable patients were included in the study. Periodontal indices and keratinized tissue were recorded at time 0 (T0) (delivery of orthodontic appliances), and at three months (T1) during orthodontic therapy; when surgery was performed. At T1; orthodontically treated sites with minimum keratinized tissue (≤1 mm) received a free gingival graft to enhance the band of keratinized tissue. At three months after surgery (T2), new measurements were recorded. The orthodontics-treated sites after three months (T1) were used as control. The same sites were used as a test three months after mucogingival correction (T2). Between T1 and T2; orthodontics was suspended; no professional oral hygiene was performed; and no additional oral hygiene instructions were given to the patient. No oral hygiene procedures were administered for 15 months (T3), when the final recordings were taken. RESULTS: The results showed that there was a worsening of gingival index (GI) and plaque index (PI) of the treated sites between T0 and T1 during initial orthodontics treatment; whereas there was an improvement of the gingival inflammation at T2 when compared with T1. At T2; there was also a statistically significant improvement in GI and PI compared with T0. A T3 improvement in periodontal parameters was sustained. A non-parametric test (Wilcoxon signed-rank test) was used for statistical analysis. CONCLUSIONS: Augmentation of the width of keratinized gingiva; as the sole treatment; favors the improvement of GI and PI during orthodontic therapy.