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1.
J Evid Based Dent Pract ; 21(3): 101612, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34479674

RESUMO

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Sanz-Sánchez I, Montero E, Citterio F, Romano F, Molina A, Aimetti M. Efficacy of access flap procedures compared to subgingival debridement in the treatment of periodontitis. A systematic review and meta-analysis. J Clin Periodontol. 2020 Jul;47 Suppl 22:282-302. doi:10.1111/jcpe.13259. PMID: 31,970,821. SOURCE OF FUNDING: This systematic review was self-funded. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.


Assuntos
Periodontite , Procedimentos Cirúrgicos Reconstrutivos , Desbridamento , Raspagem Dentária , Humanos , Periodontite/cirurgia , Retalhos Cirúrgicos
2.
BMJ Case Rep ; 14(8)2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344652

RESUMO

Patients with rapidly progressing periodontitis may require extractions of teeth with poor periodontal prognosis. Although replacement with a dental implant is a popular choice, teeth autotransplantation remains a viable option. Herein, we report a case of a 23-year-old patient with rapidly progressing periodontitis resulting in severe clinical attachment loss on the left maxillary first molar, which required extraction. The tooth was replaced by tooth autotransplantation of the unerupted immature left mandibular third molar, which was delivered carefully without compromising the periodontal ligament. Cone beam computed tomography and three-dimensional printing of the third molar donor tooth significantly aided the tooth autotransplantation procedure. Recovery was uneventful. At the 1-year follow-up, healthy periodontal parameters and radiographic features were noted, and the autotransplanted tooth remained vital. This case showed that tooth autotransplantation is a viable option for replacing tooth loss due to rapidly progressing periodontitis.


Assuntos
Periodontite , Dente , Adulto , Humanos , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Periodontite/complicações , Periodontite/diagnóstico por imagem , Periodontite/cirurgia , Impressão Tridimensional , Transplante Autólogo , Adulto Jovem
3.
Georgian Med News ; (314): 77-82, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34248031

RESUMO

The method of dental implantation in patients with generalized periodontitis is one of the priority areas requiring in-depth study. The aim of the study was to increase the efficiency of dental implantation in prosthetic rehabilitation of patients with generalized periodontitis. A study of 240 patients with chronic generalized periodontitis and partial edentulous upper and lower jaw was carried out, who subsequently underwent complex periodontal treatment and dental implantation. The patients were divided into groups depending on the severity of generalized periodontitis (I, II, III) and the method of treatment. Evaluation of the results of the effectiveness of the proposed method of surgical treatment of patients with generalized periodontitis of the first stage of development with one-stage and staged dental implantation and targeted osteotropic therapy showed that after 12 months all implants (100%) were preserved. In patients with grade II generalized periodontitis, who underwent periodontal treatment and dental implantation in stages, the safety of implants was 92.1%, and in patients who underwent one-stage dental implantation with surgical treatment of periodontal disease, the safety of implants was 89,4%. In patients with stage III generalized periodontitis who underwent staged periodontal treatment and dental implantation, the safety of implants was 80,2%, and in patients who underwent one-stage dental implantation and periodontal treatment - 51,7%.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Boca Edêntula , Periodontite , Implantação Dentária , Humanos , Índice Periodontal , Periodontite/cirurgia
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(6): 576-580, 2021 Jun 09.
Artigo em Chinês | MEDLINE | ID: mdl-34098674

RESUMO

To explore the technical process and the therapeutic effect of using sequential surgical guide with independent intellectual property rights assisting immediate implantation and restoration of the full arch, with the support from the periodontal splint for mobile supporting teeth, patients with severe periodontitis who planned to undergo immediate full arch implantation were recruited from August 2019 to December 2020 at the Department of Prosthodontics, Department of Periodontology, Department of Implantology and First Clinical Division, Peking University School and Hospital of Stomatology. Through the procedure of collecting preoperative maxillofacial data, making systematic diagnostic design, making periodontal splints fixation, producing surgical guide, and carrying out guided surgery for full arch immediate implantation, eight cases were included. By registering the postoperative cone-beam CT (CBCT) with the preoperative data, the difference between the actual three-dimensional position of the implants and the virtual design was observed, and the accuracy of the implant placement position guided by the sequential guide was statistically analyzed using SPSS 25.0 software. Analysis indicators include coronal and apical global displacement, coronal horizontal and vertical displacement, apical horizontal and vertical displacement, and angular deviation. Results revealed that the 8 patients [2 males and 6 females, aged (49.0±9.3) years (38-65 years)] of recruited cases included 7 cases of maxilla and 1 cases of mandible. A total of 48 implants, of which 44 implants were placed upright and 4 were placed tilted, 16 implants in the anterior region and 32 implants in the posterior region. No guide plate fracture or damage to important anatomical structures were reported. The overall displacement at the coronal point [(0.83±0.48) mm] and the global displacement at the apical point [(1.36±0.57) mm] were within the clinically acceptable safety range, and the horizontal displacement and vertical displacement at the coronal point, horizontal displacement and vertical displacement at the apical point, and the angle deviation of implants axial have no statistic significant difference in the anterior and posterior region (P>0.05). Periodontal splints combined with sequential surgical guides to assist patients with severe periodontitis for immediate full arch implantation and immediate restoration can expand the indications of guide assisted implant surgery. It meets the safety requirements in clinical applications.


Assuntos
Implantes Dentários , Periodontite , Cirurgia Assistida por Computador , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endo-Óssea , Feminino , Humanos , Imageamento Tridimensional , Masculino , Periodontite/cirurgia
5.
Artigo em Inglês | MEDLINE | ID: mdl-33819334

RESUMO

The efficacy of the socket preservation procedure using deproteinized bovine bone mineral, bioabsorbable collagen membrane, and collagen sponge on molar extraction sites with severe periodontitis was assessed at 6 postoperative months, before implant placement. Results revealed excellent soft tissue healing without loss of keratinized tissue and no statistically significant differences in socket marginal bone changes in 20 molar extraction sockets. High levels of primary implant stability were recorded. Socket preservation using a minimally invasive surgical technique provides good soft and hard tissue healing as well as anticipated stability of implant placement at sites of extracted molars with severe periodontitis.


Assuntos
Perda do Osso Alveolar , Periodontite , Perda do Osso Alveolar/prevenção & controle , Perda do Osso Alveolar/cirurgia , Animais , Bovinos , Humanos , Dente Molar/cirurgia , Periodontite/cirurgia , Extração Dentária , Alvéolo Dental/cirurgia
6.
Cient. dent. (Ed. impr.) ; 18(1): 51-56, feb. 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-201771

RESUMO

La fluorosis dental es una condición irreversible originada durante el desarrollo dental que genera pigmentaciones intrínsecas, alteraciones en el esmalte manifestadas a manera de manchas blancas, amarillas o marrones, que perjudican la estética y repercuten en el desenvolvimiento social. El presente reporte de caso clínico describe la combinación de los procedimientos de microabrasión y blanqueamiento dental, como alternativas en la eliminación de pigmentaciones dentales. Después del diagnóstico de la patología, verificación de ausencia de lesiones pulpares y caries, una explicación minuciosa a la paciente y obtención del consentimiento informado, se realizó limpieza de las superficies dentales y, bajo aislamiento absoluto, se procedió a realizar la técnica de microabrasión mediante ácido clorhídrico al 6,6% siguiendo las instrucciones del fabricante. Concluido el procedimiento y, observando que era posible mejorar aún más la estética, se decidió ejecutar el procedimiento de blanqueamiento dental, a base de peróxido de hidrógeno al 40% en el consultorio, seguido por peróxido de carbamida al 10% aplicado en el domicilio. Al finalizar el tratamiento se observó uniformidad en el color dental, conjugados con una evidente mejora en la calidad de vida y relación social de la paciente. La combinación de procedimientos, como el reportado en este caso, constituye una excelente alternativa de tratamiento para eliminar pigmentaciones fluoróticas moderadas


Dental fluorosis is an irreversible condition caused during dental development that generates intrinsic pigmentation, enamel alterations manifested as white, yellow, or brown spots, which impair aesthetics and have an impact on social development. This clinical case report describes the combination of microabrasion and teeth whitening procedures, as alternatives in the elimination of dental pigmentations. After the diagnosis of the pathology, verification of absence of pulpal lesions and caries, a thorough explanation to the patient and obtaining informed consent; dental surfaces were cleaned and, under absolute isolation, the microabrasion technique was performed using 6.6% hydrochloric acid following the manufacturer's instructions. Once the procedure was concluded and observing that it was possible to improve the aesthetics even further, it was decided to perform the teeth whitening procedure, based on 40% hydrogen peroxide, in the dental office, followed by 10% carbamide peroxide applied at home. At the end of the treatment, uniformity in tooth color was observed, combined with an evident improvement in the quality of life and social relationship of the patient. The combination of procedures, such as that reported in this case, constitutes an excellent treatment alternative to eliminate moderate fluorotic pigmentation


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Microabrasão do Esmalte/métodos , Fluorose Dentária/terapia , Clareamento Dental/métodos , Periodontite/cirurgia , Resultado do Tratamento , Estética Dentária
7.
J Clin Periodontol ; 48(5): 668-678, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33555608

RESUMO

AIM: Evaluation of the effectiveness of regenerative treatment of intra-bony defects in combination with consecutive orthodontic tooth movements in stage IV periodontitis. MATERIAL AND METHODS: A total of 526 intra-bony defects in 48 patients were analysed after regenerative therapy using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic tooth movement initiated 3 months after surgery. Changes in radiographic bone levels (BL) and probing pocket depths (PPD) were evaluated after 1 year and up to 4 years. RESULTS: Tooth loss amounted to 0.57%. Mean BL gain was 4.67 mm (±2.5 mm) after 1 year and 4.85 mm (±2.55 mm) after up to 4 years. Mean PPD was significantly reduced from 6.00 mm (±2.09 mm) at baseline to 3.45 mm (±1.2 mm) after 1 year, and to 3.12 mm (±1.36 mm) after 2-4 years. Pocket closure (PPD ≤4 mm) was accomplished in 87% of all defects. Adjunctive antibiotic therapy did not show any statistically significant impact on treatment outcomes. CONCLUSIONS: Within the limits of this retrospective study design, the findings suggest that the combination of regenerative treatment and consecutive orthodontic tooth movements resulted in favourable results up to 4 years.


Assuntos
Perda do Osso Alveolar , Periodontite , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/cirurgia , Animais , Bovinos , Estudos de Coortes , Seguimentos , Regeneração Tecidual Guiada Periodontal , Humanos , Perda da Inserção Periodontal/cirurgia , Periodontite/cirurgia , Estudos Retrospectivos , Técnicas de Movimentação Dentária , Resultado do Tratamento
8.
PLoS One ; 16(1): e0245111, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33411801

RESUMO

The use of inappropriate methods for estimating the effects of covariates in survival data with frailty leads to erroneous conclusions in medical research. This study evaluated the performance of 13 survival regression models in assessing the factors associated with the timing of complications in implant-supported dental restorations in a Swedish cohort. Data were obtained from randomly selected cohort (n = 596) of Swedish patients provided with dental restorations supported in 2003. Patients were evaluated over 9 years of implant loss, peri-implantitis or technical complications. Best Model was identified using goodness, AIC and BIC. The loglikelihood, the AIC and BIC were consistently lower in flexible parametric model with frailty (df = 2) than other models. Adjusted hazard of implant complications was 45% (adjusted Hazard Ratio (aHR) = 1.449; 95% Confidence Interval (CI): 1.153-1.821, p = 0.001) higher among patients with periodontitis. While controlling for other variables, the hazard of implant complications was about 5 times (aHR = 4.641; 95% CI: 2.911-7.401, p<0.001) and 2 times (aHR = 2.338; 95% CI: 1.553-3.519, p<0.001) higher among patients with full- and partial-jaw restorations than those with single crowns. Flexible parametric survival model with frailty are the most suitable for modelling implant complications among the studied patients.


Assuntos
Implantes Dentários/efeitos adversos , Fragilidade , Modelos Biológicos , Peri-Implantite , Periodontite , Complicações Pós-Operatórias/mortalidade , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peri-Implantite/etiologia , Peri-Implantite/mortalidade , Periodontite/mortalidade , Periodontite/cirurgia , Suécia/epidemiologia
9.
Sci Rep ; 10(1): 21311, 2020 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-33277607

RESUMO

Assessment of the efficacy of a single 810 nm diode laser application as an adjunctive treatment modality during the first intervention of non-surgical periodontal therapy (NPT). 25 patients diagnosed with chronic periodontitis underwent a split-mouth randomised control trial. The periodontal pockets of the test quadrants were treated with an 810 nm diode laser as an adjunct to NPT (Picasso GaAlAs; AMD Lasers). The laser was set at 1.0 W continuous wave, 400 µm tip, 796 W/cm2 peak power density and a 32 J/cm2 energy density. Therapeutic outcomes were evaluated based on the clinical parameters, which included probing pocket depth, recession, clinical attachment level, full mouth plaque score, full mouth bleeding on probing and tooth mobility. The baseline bacterial collection was completed from the periodontal pockets and then re-evaluated at 6 weeks. Clinical parameters demonstrated no statistical difference, with the exception of a statistically significant (P < 0.05) reduction in bleeding on probing for the test side. The test side resulted in a statistical increase of Capnocytophaga species and Treponema denticola. The single application of the diode laser did not significantly improve the bacterial nor the clinical parameters in patients with chronic periodontitis.Trial registration number: PACTR201909915338276.


Assuntos
Lasers Semicondutores/uso terapêutico , Periodontite/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desbridamento Periodontal , Periodontite/microbiologia
10.
Tokai J Exp Clin Med ; 45(4): 189-194, 2020 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-33300589

RESUMO

Brain abscesses occur in 0.3-1.3 per 100,000 worldwide each year with 0.4-0.9 in Japan alone. Most of the causes are direct infection from a nearby infectious lesion and are rarely caused by an odontogenic infection. Here, we reported a case of brain abscess suspected to be associated with odontogenic infection. The patient was a 55-year-old woman. Blurred eyes and pain in the left eye noted, for which she consulted an ophthalmologist, but her eyes were normal. She was conscious and was able to converse clearly, but she could not read the letters and had difficulty in writing at the time of admission. A brain abscess was diagnosed based on the head magnetic resonance imaging (MRI) and clinical course, and a small craniotomy abscess drainage was performed. A. cardiffensis and P. micra were detected in the abscess, suggesting the involvement of periodontal disease bacteria. After the surgery, antimicrobial treatment was performed for about 2 months. At the same time, perioperative treatment was performed. On the 70th day after the surgery, tooth extraction, which was considered as the source of infection, was performed. The patient was discharged 74 days after surgery. A good turning point was obtained without relapse of symptoms.


Assuntos
Actinomycetaceae , Antibacterianos/administração & dosagem , Infecções Bacterianas/etiologia , Infecções Bacterianas/microbiologia , Abscesso Encefálico/etiologia , Abscesso Encefálico/microbiologia , Infecções Bacterianas do Sistema Nervoso Central/etiologia , Infecções Bacterianas do Sistema Nervoso Central/microbiologia , Firmicutes , Periodontite/complicações , Periodontite/microbiologia , Actinomycetaceae/patogenicidade , Infecções Bacterianas/diagnóstico por imagem , Infecções Bacterianas/terapia , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/terapia , Infecções Bacterianas do Sistema Nervoso Central/diagnóstico por imagem , Infecções Bacterianas do Sistema Nervoso Central/terapia , Craniotomia/métodos , Drenagem/métodos , Feminino , Firmicutes/patogenicidade , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Periodontite/cirurgia , Assistência Perioperatória , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Extração Dentária , Resultado do Tratamento
11.
Rev. ADM ; 77(5): 252-256, sept.-oct. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1146848

RESUMO

Una de las causas de la evolución de la periodontitis es la formación de defectos óseos y pérdida de inserción clínica. Una manera de eliminar el defecto intraóseo y su bolsa periodontal es eliminar las paredes de hueso que componen el defecto para colocar el complejo dentogingival en una posición más apical. La cirugía ósea es un procedimiento periodontal resectivo que involucra la modificación del tejido óseo del soporte dental, la cual es una modalidad del tratamiento periodontal quirúrgico que puede utilizarse para eliminar eficazmente los defectos óseos periodontales para estabilizar la inserción periodontal. El objetivo del presente estudio es realizar una revisión de la literatura sobre las consideraciones actuales, técnicas y principios de la cirugía ósea resectiva en el paciente periodontalmente comprometido (AU)


One of the causes of the evolution of periodontitis is the formation of bone defects and loss of clinical attachment, where one way to eliminate the intraosseous defect and its periodontal pocket is to eliminate the bone walls that make up the defect to place the dentogingival complex in a more apical position. Bone surgery is periodontal surgery that involves the modification of the supporting bone tissue of the teeth, which is a modality of surgical treatment that can be used to effectively eliminate periodontal defects and stabilize the periodontal insertion. The aim of the present study is to conduct a literature review about the considerations, techniques and principles of resective bone surgery in the periodontally compromised patient (AU)


Assuntos
Humanos , Periodontite/cirurgia , Perda do Osso Alveolar/cirurgia , Processo Alveolar/cirurgia , Osteotomia/métodos , Bolsa Periodontal/cirurgia , Retalhos Cirúrgicos , Aumento da Coroa Clínica/métodos
12.
J Clin Periodontol ; 47(10): 1237-1247, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32652610

RESUMO

BACKGROUND: The aim of this study was to retrospectively assess bone volumes, healed ridge topography and possibility to plan prosthetically guided implants (PGI) at least 6 months after extraction or exfoliation of first molars as a consequence of terminal periodontitis (EEFMP). MATERIALS AND METHODS: 45 subjects with stage III-IV periodontitis providing 74 extraction sites (maxillary = 51 and mandibular = 23) were included. The degree of residual periodontal support on each root was assessed by combining periodontal and radiographic data. Digital planning of PGI with 4.8/4.1 mm diameter, 8 mm long, root-form dental implant and need for bone augmentation (BA) were performed using CBCT with a radiographic stent. Possibility of standard implant placement (STANDARD) and need for simultaneous or staged BA were assessed. RESULTS: Planning PGI placement was possible in all cases. For a 4.8 mm diameter implant, STANDARD was possible in 37.8% of the sites, 33.8% required BA at the time of implant placement, and 28.4% required staged BA before PGI. The use of 4.1 mm rather than 4.8 mm diameter implant allowed STANDARD in an additional 8.1% of cases that originally required simultaneous BA/osteotome sinus floor elevation (OSFE). The level of periodontal bone loss did not predict the complexity of implant placement, but significant differences were observed comparing maxillary with mandibular sites. CONCLUSION: PGI planning at sites with first molar loss due to terminal periodontitis is possible but poses great challenge to rehabilitation, often requiring advanced augmentation procedures and sinus augmentation.


Assuntos
Implantes Dentários , Periodontite , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Estudos de Viabilidade , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/cirurgia , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Periodontite/diagnóstico por imagem , Periodontite/cirurgia , Estudos Retrospectivos
13.
J Clin Periodontol ; 47(6): 768-776, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32249446

RESUMO

BACKGROUND: Periodontal regeneration can change tooth prognosis and represents an alternative to extraction in teeth compromised by severe intra-bony defects. The aim of this study was to compare periodontal regeneration (PR) with tooth extraction and replacement (TER) in a population with attachment loss to or beyond the apex of the root in terms of professional, patient-reported and economic outcomes. METHODS: This was a 10-year randomized controlled clinical trial. 50 stage III or stage IV periodontitis subjects with a severely compromised tooth with attachment loss to or beyond the apex were randomized to PR or TER with either an implant- or a tooth-supported fixed partial denture. Subjects were kept on a strict periodontal supportive care regimen every 3 months and examined yearly. Survival and recurrence analysis were performed. RESULTS: 88% and 100% survival rates were observed in the PR and TER groups. Complication-free survival was not significantly different: 6.7-9.1 years for PR and 7.3-9.1 years for TER (p = .788). In PR, the observed 10-year attachment gain was 7.3 ± 2.3 mm and the residual probing depths were 3.4 ± 0.8 mm. Recurrence analysis showed that the 95% confidence interval of the costs was significantly lower for PR compared with TER throughout the whole 10-year period. Patient-reported outcomes and oral health-related quality-of-life measurements improved in both groups. CONCLUSIONS: Periodontal regeneration can change the prognosis of hopeless teeth and is a less costly alternative to tooth extraction and replacement. The complexity of the treatment limits widespread application to the most complex cases but provides powerful proof of principle for the benefits of PR in deep intra-bony defect.


Assuntos
Implantes Dentários , Periodontite , Prótese Parcial Fixa , Humanos , Periodontite/cirurgia , Regeneração , Análise de Sobrevida
14.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(4): 266-270, 2020 Apr 09.
Artigo em Chinês | MEDLINE | ID: mdl-32268628

RESUMO

With the popularization and application of implant technology and its good clinical effect, clinicians focus on exploring diagnosis and treatment strategies that can reduce the difficulty and risk of implant treatment, decrease the treatment complications of patients, and improve the surgical acceptance of patients. The technology of alveolar ridge preservation has become the focus of clinical attention. Clinical trials also confirmed that alveolar ridge preservation technology could effectively slow down the absorption of alveolar crest after tooth extraction, so as to maintain the alveolar crest volume shape. Most previous reviews about alveolar ridge preservation focused on surgical procedures, materials application and selection of related procedures. The effect of various causes of tooth extraction on alveolar ridge preservation has not been reviewed. In this review article, the differences between alveolar ridge preservation in non-periodontitis and periodontitis teeth were analyzed histologically and morphologically, so as to provide a decision-making strategies for clinical application of alveolar ridge preservation at various tooth extraction sites.


Assuntos
Perda do Osso Alveolar , Processo Alveolar , Aumento do Rebordo Alveolar , Periodontite , Extração Dentária , Processo Alveolar/cirurgia , Humanos , Periodontite/cirurgia , Alvéolo Dental
15.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(4): 271-275, 2020 Apr 09.
Artigo em Chinês | MEDLINE | ID: mdl-32268629

RESUMO

With the increase of adult patients seeking for orthodontic treatment, the influence of periodontal tissue on orthodontic treatment has gradually become the focus. For patients with periodontitis, it is essential to controlling the severity of periodontitis prior to orthodontic treatment. Periodontal disease can cause additional bone loss and make the orthodontic treatment complicated. Reducing the risk of orthodontic treatment in this situation is our major concern. In addition to periodontitis, orthodontic treatment may also cause gingival recession. On the other hand, the alveolar bone defects such as bone fenestration and bone dehiscence are common in some patients without periodontitis. For these patients, we should take more care of the interrelationship between bone defects and orthodontic treatment. This article briefly demonstrates the risk considerations of periodontal supporting tissue in orthodontic therapy focusing on the influence of periodontitis, gingival recession and alveolar bone fenestration and dehiscence.


Assuntos
Perda do Osso Alveolar , Retração Gengival , Periodontite , Procedimentos Cirúrgicos Reconstrutivos , Técnicas de Movimentação Dentária , Adulto , Retração Gengival/etiologia , Retração Gengival/cirurgia , Humanos , Periodontite/etiologia , Periodontite/cirurgia , Periodonto , Fatores de Risco
16.
J Clin Periodontol ; 47(6): 747-755, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32163634

RESUMO

AIM: The aim of this study was to compare surgical treatment of periodontal intra-bony defects (IBD) with or without the adjunct of enamel matrix derivative (EMD) in terms of acute-phase responses in healthy patients. METHODS: Thirty-eight periodontitis-affected subjects, one IDB each, were randomized to minimally invasive periodontal surgery (MIS) with or without EMD. Periodontal parameters were recorded at baseline and 6-months. Blood samples were collected at baseline, 1, 7 and 180 days after treatment. RESULTS: At 24 hr, the group treated MIS with EMD showed lower values of C-reactive protein (CRP; p < .01) as no inflammatory perturbation was noticed. Conversely, MIS group resulted in an acute inflammatory response at 24 hr (p < .05) that regressed to its baseline values at day 7. The EMD group showed a higher number of cases without residual BOP or PPD ≥ 5mm 6 months after surgery (p < .05), and post-surgical gingival recession was lower (p < .05). CONCLUSIONS: The adjunctive application of EMD during surgical treatment resulted in a minor increase in serum CRP 24-hr after surgery. These findings suggest a possible systemic anti-inflammatory effect of EMD. Within its limitations, this pilot trial confirmed better clinical periodontal outcomes in the EMD group. NCT03590093.


Assuntos
Perda do Osso Alveolar , Proteínas do Esmalte Dentário , Retração Gengival , Periodontite , Perda do Osso Alveolar/cirurgia , Proteínas do Esmalte Dentário/uso terapêutico , Seguimentos , Retração Gengival/cirurgia , Regeneração Tecidual Guiada Periodontal , Humanos , Inflamação/prevenção & controle , Perda da Inserção Periodontal/cirurgia , Periodontite/cirurgia , Resultado do Tratamento
17.
Lasers Med Sci ; 35(7): 1567-1575, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32215767

RESUMO

The objective of this study was to evaluate the clinical and biochemical efficacy of erbium, chromium:ytrium-scandium-gallium-garnet (Er,Cr:YSGG) laser treatment, in addition to non-surgical periodontal treatment (NSPT), in periodontitis patients. This was a single-centre, split-mouth, randomized, controlled 6-month clinical trial. Twenty-seven patients with moderate to advanced periodontitis were included in the study. The patients were randomly assigned to a debridement and laser treatment group or control group (debridement alone). Clinical measurements were performed at baseline and 1, 3 and 6 months post-treatment. The following parameters were measured: plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BoP), gingival crevicular fluid (GCF) volume and IL-1ß and MMP-8 levels in GCF. There were statistically significant clinical improvements in both groups, with no significant between-group differences in PD, CAL, PI and BoP clinical measurements (p < 0.05). As compared with the control group, the GI 1 and 3 months post-treatment and BoP 1 month post-treatment were significantly improved in the laser group (p < 0.05). There was also a significant reduction in IL-1 ß levels in both groups at baseline versus those 1, 3 and 6 months later (p < 0.05) There was no statistically significant difference in IL-1ß and MMP-8 levels between groups (p < 0.05). Both the treatment modalities resulted in significant improvements in clinical parameters. Within the limitations of this study, Er,Cr:YSGG laser treatment applied in addition to NSPT is indicated to reduce clinical inflammation.


Assuntos
Terapia a Laser , Lasers de Estado Sólido/uso terapêutico , Periodontite/cirurgia , Adolescente , Adulto , Idoso , Feminino , Líquido do Sulco Gengival , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Adulto Jovem
18.
Microb Pathog ; 143: 104128, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32165332

RESUMO

Growing evidence supports that the Epstein-Barr virus (EBV) is a putative periodontal pathogen, but little is known regarding EBV behavior in periodontitis. Here, EBV infection was monitored in saliva and periodontal pocket (PP), at baseline and 3 months after periodontal non-surgical therapy (p-NST) in 20 patients diagnosed with periodontitis. After the treatment, the patients with the improved periodontal condition (good responders) showed a significant decrease in salivary EBV load. In contrast, in poor responders, EBV load was slightly increased. Moreover, after the therapy, most patients showed clear signs of EBV infection in a deep PP (≥5 mm) selected as a study site. To investigate how EBV can persist in a PP, we further investigate cellular sites of viral replication in PP. We identified large amounts of infiltrated EBV-infected cells, mostly overlapping with CD138+ plasma cells (PC). EBV-infected PCs formed high-density clusters within the infiltrate and along the periodontal epithelium which were commonly associated with CD3+ T-cells and CD20+ B-cells to evoke diffuse ectopic lymphoid-like structures. Taking together, this study provides new insights to support a model where the periodontal condition may play a major role in oral EBV shedding. Since PC harbors the late productive phases of EBV replication, the periodontal condition may favor B-cell differentiation with possible amplification of periodontal EBV infection and viral spreading. PCs have long been recognized as pathogenic markers in inflammatory lesions. Our finding sheds new light on the role of EBV infection and PC in periodontitis.


Assuntos
Infecções por Vírus Epstein-Barr/complicações , Herpesvirus Humano 4 , Periodontite/virologia , Plasmócitos/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desbridamento Periodontal , Bolsa Periodontal/patologia , Bolsa Periodontal/virologia , Periodontite/patologia , Periodontite/cirurgia , Plasmócitos/patologia , Saliva/virologia , Carga Viral
19.
Biomed Res Int ; 2020: 1592910, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32090068

RESUMO

Background: Endo-periodontal lesions are bacterial infectious diseases involving both the periodontal and pulp tissues with poor outcomes. It is hard for clinicians to predict their prognosis. The aim of this study is to investigate the factors affecting the prognosis of endo-periodontal lesions. Methods: A total of 140 teeth diagnosed with grade 2-3 endo-periodontal lesions in patients with periodontitis were recruited in this study. They were divided into high and low responder groups, according to the clinical symptoms and parameters of the teeth involved after nonsurgical treatment of both the endodontic and periodontal components. Clinical parameters and symptoms were compared before and after treatment, and gender, age, smoking, and all clinical parameters were compared between high and low responder groups using univariate analyses. Logistic regression was applied to evaluate the independent effects on endo-periodontal lesion prognosis. Results: Compared with the clinical parameters at baseline, the values of tooth mobility (TM), periapical index (PAI), and discomfort when chewing were decreased after endodontic therapy, and the values of periodontal probing depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI), TM, simplified oral hygiene index (OHI-S), full-mouth periodontitis severity, PAI, and discomfort when chewing were decreased after periodontal therapy. Univariate analysis revealed that smoking, PD, CAL, TM, PAI, clinical crown-root ratio (CR), full-mouth periodontitis severities, and the number of root canals were significantly different between the high and low responder groups (P < 0.05). The logistic regression analysis showed that smoking, PD, CAL, full-mouth periodontitis severities, and the number of root canals remained significantly associated with grade 2-3 endo-periodontal lesions in patients with periodontitis (P < 0.05). The logistic regression analysis showed that smoking, PD, CAL, full-mouth periodontitis severities, and the number of root canals remained significantly associated with grade 2-3 endo-periodontal lesions in patients with periodontitis (. Conclusions: and Practical Implications. High PD and CAL, multirooted teeth, smoking, and serious full-mouth periodontitis indicated a poor prognosis for teeth with grade 2-3 endo-periodontal lesions.


Assuntos
Periodontite/cirurgia , Periodonto/patologia , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Dente/patologia
20.
J Biol Regul Homeost Agents ; 34(1 Suppl. 1): 161-164, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32064851

RESUMO

INTRODUCTION: CBCT combined to intra-oral scansion are the means to build an endodontic surgical guide to perform an easier and safer access to the apex in endodontic micro-surgery. . METHODS: A 38-year-old woman presented chronic apical periodontitis, which involved the three roots of 16 that was treated by endodontic therapy several years ago elsewhere. The palatine channel was retreated, the mesio- and disto- buccal roots were instead treated with apicoectomy. A surgical template was printed by a 3D printer to obtain greater precision in the surgical access. CONCLUSIONS: Endodontic microsurgery has evolved over the years. New tools have been introduced to improve therapy, even if the basic principles have not changed. In fact, according to the literature, it is necessary to cut at least 3 mm of root to be sure of eliminating the anatomical variations and the accessory channels. Several Authors have devoted themselves to creating an endodontic surgical template, some in vitro and others in vivo. The present paper introduces a new method that allows a more conservative osteotomy and greater precision the surgical access. Further investigation are needed to test and improve the effectiveness of the treatment but this technique seems very promising because it is less invasive for the patient and simplifies the work for the dentist who can perform micro-surgery in an easier and faster way.


Assuntos
Apicectomia , Periodontite/cirurgia , Impressão Tridimensional , Cirurgia Assistida por Computador , Adulto , Endodontia/métodos , Feminino , Humanos , Microcirurgia , Raiz Dentária
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