RESUMO
OBJECTIVES: Myofibroblasts constitute a specific cell phenotype involved in connective tissue healing. Diabetes alters the wound healing response. However, it is not clear whether diabetes modifies the involvement of myofibroblasts in periodontal wounds. MATERIALS AND METHODS: Type I diabetes was induced in rats through streptozotocin injection, and periodontal wounds were performed. Wound healing was evaluated histologically at 2, 5, 7, and 15 days by measuring epithelial migration, neutrophil infiltration, and collagen and biofilm formation. Distribution of myofibroblasts was evaluated through immunofluorescence for α-smooth muscle actin. Data analyses were performed using the Shapiro-Wilk, ANOVA, or Kruskal-Wallis tests. RESULTS: Diabetic wounds were characterized by delayed epithelial closure, increased neutrophil infiltration, biofilm formation, and reduced collagen formation. Quantification of the myofibroblasts showed a significant reduction at 5 and 7 days in wounds of diabetic rats and an increase at 15 days when compared to wounds of non-diabetic rats. CONCLUSIONS: Diabetic wound healing was associated with decreased epithelial and connective tissue healing, increased levels of inflammation, and biofilm formation. Myofibroblast differentiation was delayed in diabetic periodontal wounds at early time points. However, myofibroblasts persisted at later time points of healing. The present study suggests that diabetes alters the involvement of myofibroblasts during periodontal wound healing.
Assuntos
Diabetes Mellitus Experimental , Miofibroblastos , Cicatrização , Animais , Colágeno , Miofibroblastos/fisiologia , Periodontia , Ratos , EstreptozocinaRESUMO
OBJECTIVES: This randomized split-mouth clinical trial investigated the influence of implant macrogeometry on bone properties and peri-implant health parameters during the healing process. MATERIAL AND METHODS: Ninety-nine implants were placed bilaterally in posterior mandibles of 23 patients that received at least four dental implant macrogeometries: standard geometry, Integra (IN) and three geometries inducing "healing chamber": Duo (D), Compact (C), and Infra (IF). Insertion torque (IT) and implant stability quotient (ISQ) were measured. Peri-implant health were monitored by visible plaque index (VPI), peri-implant inflammation (PI), and presence of calculus (CC). Data were collected during 90 days. Data were assessed for normality using the asymmetry and kurtosis coefficients followed by the Shapiro-Wilk test. A one-way ANOVA was used to investigate differences in IT and linear bone dimensions between the macrogeometry groups. The repeated measurements ANOVA test or ANOVA-R was used for analysis of ISQ, VPI, and PI. Tukey-Kramer test or Student's t test was used for comparisons between the groups or within each macrogeometry. RESULTS: Macrogeometry did not significantly influence IT and ISQ values. The minimum ISQ was recorded after 7 days (71.95 ± 12.04, p = 0.0001). Intermediate ISQ was found after 14 days, when the ISQ reached values that are statistically identical to primary stability. The VPI showed significantly higher scores for the D (0.88 ± 1.03) and IN (0.72 ± 0.94) implants after 7 days. The PI was only influenced by the healing time significantly decreasing from 7 (1.07 ± 0.89) to 21 days (0.18 ± 0.18). CONCLUSION: Implant macrogeometry did not influence IT nor ISQ values. The relationship between IT and SS was more evident for the Duo implant, but only in the final stage of healing process. CLINICAL RELEVANCE: Show to the clinician that the macrogeometry and drilling protocols did not interfere in the clinical behavior of the implants during the healing process. However, the IT, primary and secondary stability, is quite dependent of the surgeon experience.
Assuntos
Implantação Dentária Endóssea/métodos , Implantes Dentários , Planejamento de Prótese Dentária , Cicatrização/fisiologia , Adulto , Retenção em Prótese Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osseointegração/fisiologia , Estudos Prospectivos , Radiografia PanorâmicaRESUMO
AIM: The search for effective protocols to reduce the incidence of root resorption and allow periodontal ligament repair is still challenging, given the unpredictable outcome of late tooth replantation. The aim of this study was to assess the effects of both high-power diode laser irradiation (DL) and basic fibroblast growth factor (FGF) on the periodontal healing of replanted teeth after extended extra-oral dry time. METHODS: Maxillary incisors of 50 male rats were extracted and assigned to three experimental and two control groups (n = 10). DL: root surfaces treated with DL (810 nm, continuous mode, 1.0 W, 30 s), FGF: topical application of FGF gel to the root surface and in the alveolar wound, DL + FGF: DL and topical application of FGF gel, C+: no treatment after extraction and immediate replantation and C-: no treatment after extraction and replantation after 60 min. In the experimental groups, the specimens were kept dry for 60 min, the pulps were removed and the canals were filled with calcium hydroxide paste prior to tooth replantation. The animals were euthanized after 60 days. The specimens were processed for radiographic, histological and immunohistochemical analyses. RESULTS: The radiographic analysis showed fewer resorptive areas in DL + FGF (P < 0.05). The histological and immunohistochemical analyses showed that the DL group had lower mean values of ankylosis, replacement and inflammatory resorption when compared to C-, not differing statistically from C+. DL + FGF produced significantly more collagen fibers (type I and type III) than C-, not differing from C+ in the case of type I fibers (P < 0.05). CONCLUSIONS: DL, with or without FGF, reduced the occurrence of external root resorption and ankylosis. Periodontal healing was favored and some fiber reinsertion occurred only when FGF was used.
Assuntos
Fatores de Crescimento de Fibroblastos/farmacologia , Lasers Semicondutores , Reabsorção da Raiz/prevenção & controle , Reimplante Dentário , Cicatrização/fisiologia , Animais , Imuno-Histoquímica , Masculino , Ratos , Ratos Wistar , Fatores de Tempo , Avulsão Dentária/cirurgiaRESUMO
This study evaluated retrospectively the effect of fusidic acid on the management of desquamative gingivitis (DG). The study population consisted of 15 patients with DG. Patients were requested to make topical application of 2% fusidic acid ointment 4 times a day for 6 weeks. Clinical assessments were recorded at baseline, at 6 weeks and 12 months after beginning the therapy. Patients' examination involved lesion size area, pain score and impact on daily activities. All patients presented lesions in maxilla; in 9 patients (60.0%) lesions were predominately at the anterior region and 6 (40.0%) at the posterior region of maxilla. Treatment significantly (p<0.05) reduced the pain intensity (from 5.4±1.12 to 1.16±0.97) and its periodicity (from 53.33% with pain>3 x/week to 13.33%), and the lesion size in 72.47% (±4.12) immediately after 6 weeks of treatment. Improvements were sustained for 12 months compared to baseline (p<0.001). It also reduced the impact of disease in daily activities (eating and oral hygiene performance), and improved the emotional condition of patients, who reported better social relationships and habits. Topical application of fusidic acid may be a possible alternative local palliative therapy for desquamative gingivitis treatment.
.Este estudo avaliou retrospectivamente o efeito do ácido fusídico sobre o manejo da gengivite descamativa (DG). A população do estudo consistiu de 15 pacientes com DG. Os pacientes foram solicitados a fazer aplicação tópica de pomada de ácido fusídico 2% 4 vezes ao dia, durante 6 semanas. As avaliações clínicas foram registradas no início do estudo, em 6 semanas e 12 meses após o início da terapia. O exame dos pacientes envolveu tamanho da área da lesão, intensidade da dor e impacto nas atividades diárias. Todos os pacientes apresentaram lesões na maxila; em 9 pacientes (60,0%) as lesões foram predominantemente na região anterior e em 6 (40,0%) na região posterior da maxila. O tratamento significantemente (p<0,05) reduziu a intensidade da dor (de 5,4±1,12 para 1,16±0,97) e a sua periodicidade (de 53,33% com dor>3x/semana para 13,33%), e o tamanho da lesão em 72,47% (±4,12) imediatamente após 6 semanas de tratamento. As melhorias foram sustentadas por 12 meses, quando comparado aos valores iniciais (p<0,001). Também reduziu o impacto da doença nas atividades diárias (alimentação e desempenho de higiene oral), e melhorou a condição emocional dos pacientes, que relataram melhores relações e hábitos sociais. A aplicação tópica de ácido fusídico pode ser uma alternativa para terapia local paliativa no tratamento de gengivite descamativa.
.Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Ácido Fusídico/uso terapêutico , Gengivite/tratamento farmacológico , SeguimentosRESUMO
Extensive gingival recessions associated with cervical abrasions are common among the population. Several different surgical and/or restorative therapies have been proposed to correct these lesions. This manuscript reports the treatment of multiple gingival recessions associated to cervical abrasions. The procedure involved the utilization of subepithelial connective tissue graft (SCTG) combined with coronally advanced flap onto a previously restored root surface. At the postoperative follow-up visits, the success of the restorative/surgical approach was confirmed by the absence of bleeding to probing and periodontal pockets as well as presence of gingival tissue with normal color, texture and contouring. After 18 months of follow-up, the clinical conditions are stable with satisfactory root coverage and periodontal health. An excellent esthetical outcome was achieved and the patient is satisfied with case resolution.
RESUMO
The purpose of this revision is to describe the actual knowledge about Human Papiloma Virus (HVP) and its relation with the oral cavity and periodontium, supported by a bibliographic revision. A descriptive and documental investigation was conducted mainly by national and international literature (journals, books) and interviews with specialists. The HPV has a frequency between 36% and 74% among the population, and every day a huge number on any existing group is been diagnosed, is been described around 80 types. The HPV lesion related with bucal cavity and the periodontum are: papilloma, condyloma, focal epithelial hyperplasia, carcinoma verrugoso, leukoplakia, lichen planus, also has close relationship with HIV positive patiens. Among the periodontal treatments applied on this lesions are: Gingivectomy. Also, on this study a clinic case is reported, a nine years old male patient, assisted to the Periodontics Postgrade at the University of Zulia, School of Dentistry, having a previous history the presence of a oral lesion related with the HPV. Conclusions: so having this point on mind is important to identify these conditions to determine the right treatment plan and establish the sequence of the treatment chosen to improve the oral and periodontal health of the patient. Is important that the general dentist, the periodontist and the other specialties identify this pathologies and the consequences that might bring along if prevention is not done time, and always having the biosecurity norms present at the treatment time.
El propósito de esta revisión es describir los conocimientos actuales sobre el Virus Papiloma Humano (VPH) y su relación en la cavidad bucal y en el periodonto, soportado en una revisión bibliografica. Para ello se realizó una investigación descriptiva y documental principalmente con literatura nacional e internacional (revistas, libros) y entrevistas a especialistas en la materia. El VPH tiene una frecuencia entre 36% y el 74% de la población, y cada día se diagnostica un gran número en cualquier grupo etario, se describen alrededor de 80 tipos. Las lesiones del VPH relacionadas con la cavidad bucal y en el periodonto son: papiloma, condiloma acuminado, hiperplasia epitelial focal, carcinoma verrugoso, leucoplasia, liquen plano, además, tiene una estrecha relación con pacientes VIH positivos. Entre los tratamientos periodontales aplicados en estas lesiones se citan: la gingivectomía quirúrgica, electroquirúrgica, láser y quimioquirúrgica, siendo la mas utilizada la gingivectomía quirúrgica. Además, en el estudio se reporta un caso clínico de un paciente masculino, De 9 años de edad que asistió al área clínica del Postgrado de Periodoncia en la Facultad de Odontología de la Universidad del Zulia, teniendo como antecedentes la presencia de una lesión en boca relacionada con el Virus Papiloma Humano. De allí la importancia de identificar estas condiciones para determinar un correcto plan de tratamiento y establecer la secuencia del tratamiento elegido para mejorar la salud bucal y periodontal del paciente. Conclusión: Es importante que el Odontólogo General, el Periodoncista y los demás especialistas identifiquen estas patologías y las consecuencias que ocasiona si no se previene a tiempo, poniendo siempre en práctica las normas de bioseguridad al momento de trabajar.