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1.
Cient. dent. (Ed. impr.) ; 16(2): 99-104, mayo-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183719

RESUMO

El angioedema hereditario (AEH) es una enfermedad genética rara de transmisión autosómica dominante, en la que existe un déficit de la encima C1-INH. Cursa con episodios recurrentes y autolimitados de edema, causados por aumento de la permeabilidad vascular. Tiene unas importantes implicaciones para los profesionales de la salud bucodental, ya que determinados procedimientos odontológicos y quirúrgicos pueden desencadenar episodios de angioedema, potencialmente mortales al producirse edema en las vías respiratorias superiores. El objetivo de este trabajo es aportar información y recomendaciones a los odontólogos a la hora de tratar a estos pacientes con el fin de minimizar las complicaciones. Los resultados han aportado un total de 48 pacientes y se realizaron un total de 90 intervenciones, siendo el tratamiento más frecuente las extracciones dentales. El AEH tipo I es el más frecuente de los tres tipos con una incidencia de entorno al 85% y el tipo III es el menos común y conocido, ya que se ha identificado en los últimos años. La profilaxis a corto plazo es un método preventivo que ha de realizarse en todos los pacientes con AEH antes de cualquier intervención quirúrgica odontológica. El tratamiento de estos pacientes implica, en la mayoría de las ocasiones, una profilaxis a largo y corto plazo con el fin de disminuir los ataques. Siendo aconsejable realizar los procedimientos odontológicos-quirúrgicos en ambiente hospitalario


Hereditary angioedema (HAE) is a rare genetic disease of autosomal dominant transmission, in which there is a deficit of C1-INH enzyme. It runs with recurrent and self-limited episodes of edema to increase vascular permeability. There are some important complications for oral health professionals because many dental and surgical procedures can trigger angioedema episodes which can be a potentially life-threating condition due to edema in the upper respiratory tract. The objective of this research is to provide information and recommendations to dentists for treating these patients in order to minimize complications. 48 patients have been reported and a total of 90 interventions were performed, being extractions the most frequent treatment. HAE type 1 is the most frequent of the three types with an 85% of incidence, and type III is the least common and known, it has been identified in recent years. Shortterm prophylaxis is a preventive method that must be done in all HAE patients before any dental surgery. The treatment of these patients implies, in most cases, a long- and short-term prophylaxis in order to reduce attacks. It is recommended to realize dental-surgical procedures in a hospital environment


Assuntos
Humanos , Angioedemas Hereditários/diagnóstico , Angioedemas Hereditários/cirurgia , Profilaxia Dentária/métodos , Enzimas/deficiência , Permeabilidade Capilar , Angioedemas Hereditários/classificação
2.
Braz Oral Res ; 33: e033, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31269113

RESUMO

The aim of this study was to evaluate the effect of periodontal treatment on the salivary cytokine levels and clinical parameters of individuals with cerebral palsy (CP) with gingivitis. A non-randomized, clinical trial was conducted in individuals diagnosed with spastic CP. Thirty-eight individuals were enrolled in the study and were categorized according to gingival index scores between 0-1 or 2-3, assigned to groups G2 or G1, respectively. Periodontal treatment comprised oral hygiene instructions, conventional mechanical treatment and 0.12% chlorhexidine applied as an adjunct. Clinical parameters and saliva samples were collected at baseline and at the 15-day follow-up visit. Bleeding on probing and periodontal screening and recording were determined. Non-stimulated saliva samples were obtained, and the salivary flow rate, the osmolality and the levels of cytokines IL-1ß, IL-6, IL-8, IL-10, TNF-α and IL-12p70 were evaluated by a cytometric bead array. The Wilcoxon test, the Mann-Whitney test, Spearman correlation analysis, Poisson regression analysis and an adjusted analysis were performed (α = 0.05). The groups differed significantly in periodontal clinical parameters at baseline and at follow-up. Salivary flow rate and osmolality were similar in both groups at both timepoints. However, TNF-α and IL-1ß levels were higher in G1 than in G2 at baseline. Mechanical treatment resulted in improved clinical parameters for both groups. Furthermore, mechanical treatment resulted in a significant reduction in salivary IL-1ß and IL-8 levels for both groups after treatment. Periodontal treatment performed in individuals with CP and gingivitis reduces the levels of TNF-α, IL-1ß, IL-6 and IL-8.


Assuntos
Biomarcadores/análise , Paralisia Cerebral/complicações , Gengivite/complicações , Gengivite/reabilitação , Periodontite/terapia , Saliva/química , Adolescente , Criança , Citocinas/análise , Profilaxia Dentária/métodos , Feminino , Gengivite/microbiologia , Humanos , Interleucina-10 , Interleucina-1beta/análise , Interleucina-6/análise , Masculino , Concentração Osmolar , Índice Periodontal , Distribuição de Poisson , Saliva/imunologia , Saliva/microbiologia , Fator de Necrose Tumoral alfa/análise
3.
Photobiomodul Photomed Laser Surg ; 37(5): 276-281, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31084563

RESUMO

Objective: The aim of this study was to determine if a single photobiomodulation treatment can reduce oral erythema and edema following routine dental prophylaxis in canines. Background: Photobiomodulation therapy has been documented to accelerate healing time through mitigation of erythema and edema in human and veterinary patients. Methods: Canine patients were randomly assigned into three groups: CG (Control, n = 9, mock gingiva treatment without irradiation), LTG (left side treated, n = 8, irradiation of left upper and lower dental arcade), and RTG (right side treated, n = 7, irradiation of right upper and lower dental arcade). Immediately following anesthetized dental prophylaxis, the canines in the RTG and LTG received four points of irradiation (GaAlInP-650 nm, continuous wave, 0.1 W, 0.2 W/cm2, 100 sec, 10 J, 20 J/cm2). Erythema and edema along the gingival surface of each dental arcade were scored 24 h after treatment by a blinded veterinary evaluator. Analysis of variance and Bonferroni correction were used for data analysis. Results: Using a composite evaluation, there was significantly lower inflammation scores for the RTG (p = 0.017) and LTG (p = 0.025) relative to the CG at the location of the lower right dental arcade. Evaluating erythema individually, a significant reduction was found in the LTG (p = 0.049) when compared with the CG for the lower left dental arcade. Conclusions: Despite the limitations in this study, the canines who received a single photobiomodulation treatment demonstrated some degree of reduction in oral inflammation and erythema following dental prophylaxis.


Assuntos
Profilaxia Dentária/efeitos adversos , Edema/terapia , Eritema/terapia , Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade , Doenças Periodontais/terapia , Animais , Cães , Edema/etiologia , Eritema/etiologia , Feminino , Gengiva , Masculino
4.
Braz Oral Res ; 33: e017, 2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30892412

RESUMO

In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer's protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey's tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.


Assuntos
Profilaxia Dentária/métodos , Cavidade Pulpar , Níquel , Irrigantes do Canal Radicular/uso terapêutico , Titânio , Terapia por Ultrassom/métodos , Humanos , Irrigação Terapêutica/instrumentação , Irrigação Terapêutica/métodos
5.
Med Oral Patol Oral Cir Bucal ; 24(2): e136-e144, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30818305

RESUMO

BACKGROUND: The aim of this present article was to evaluate the scientific evidence on the efficacy of daily hygiene and professional prophylaxis for treatment of desquamative gingivitis. MATERIAL AND METHODS: The present systematic review was conducted following the PRISMA protocol. Searches were carried out in Pubmed, Embase, Web of Science and Cochrane Library up to July 2018, randomized clinical trials and cohort studies on desquamative gingivitis (DG), and oral diseases joined to DG. RESULTS: After screening, we found that nine publications met the eligibility criteria eight cohort studies and one randomized control trial. The diagnosis of the diseases corresponded to oral lichen planus (n=185), mucous membrane pemphigoid (n=13); plasma cell gingivitits (n=15) and pemphigus vulgar (n=11). The follow-up was between a week and a year after instructing patients. Dental daily hygiene and professional prophylaxis, at least with supragingival scaling and polishing have significantly improved the extension of the lesion and reduced the activity of DG, and gingival bleeding in all patients. Furthermore, these techniques have also reduced pain and gingival plaque. CONCLUSIONS: In conclusion the studies presented support the efficacy of maintaining personal and professional oral hygiene in patients with GD, reducing the clinical signs of the disease, regardless of its pathogenesis.


Assuntos
Profilaxia Dentária/métodos , Gengivite/terapia , Higiene Bucal/métodos , Biópsia , Bases de Dados Factuais , Placa Dentária/terapia , Índice de Placa Dentária , Polimento Dentário/métodos , Raspagem Dentária/métodos , Humanos , Líquen Plano Bucal/diagnóstico , Penfigoide Mucomembranoso Benigno/diagnóstico , Pênfigo/diagnóstico , Índice Periodontal
6.
Int J Dent Hyg ; 17(2): 192-198, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30714331

RESUMO

INTRODUCTION: Periodontal therapy disrupts the biofilm harbouring calculus that triggers inflammation. The explorer is primarily used for calculus detection, and the ultrasonic instrument is primarily used for calculus removal. The efficiency in dental hygiene care may improve if the ultrasonic instrument could be used in both calculus detection and removal. PURPOSE: The purpose of this study was to validate the effectiveness of calculus detection between the Thinsert® ultrasonic insert and the 11/12 explorer. METHODS: Upon IRB approval, this validation study involved three dental hygiene faculty from the Ohio State University Dental Hygiene Program and 30 patient participants from the Ohio State University community. Using both instruments, calculus was evaluated on Ramfjord index teeth and on four possible surfaces per tooth. Data were analysed to evaluate for interrater reliability, intrarater reliability, sensitivity, and specificity. RESULTS: For interrater reliability, the average measure of intraclass coefficient (ICC) value was 0.782 with a 95% confidence interval (CI) of 0.749-0.810 (F(1439, 2878)  = 4.852, P < 0.01). For intrarater reliability, mean Kappa averages were in the full agreement range (κ = 0.726, n = 2160, P < 0.01). When using the Thinsert® for calculus detection, the sensitivity was 75%, specificity was 97%, PPV was 81%, and NPV was 94%. CONCLUSION: Since calculus evaluation was comparable when using the ODU 11/12 explorer and the Thinsert®, efforts can be focused on developing the tactile sensitivity when using the Thinsert® ultrasonic instrument in the assessment, treatment, and maintenance of periodontal disease and the support of oral health. The efficiency in dental hygiene care may improve by using the Thinsert® ultrasonic instrument in both the detection and removal of calculus.


Assuntos
Cálculos Dentários/diagnóstico , Cálculos Dentários/terapia , Higienistas Dentários , Profilaxia Dentária/instrumentação , Profilaxia Dentária/métodos , Raspagem Dentária/instrumentação , Higiene Bucal/instrumentação , Ultrassom , Humanos , Doenças Periodontais/diagnóstico , Doenças Periodontais/prevenção & controle , Doenças Periodontais/terapia
7.
Wiad Lek ; 72(1): 89-94, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30796869

RESUMO

OBJECTIVE: Introduction: In the modern literature, a variety of treatment regimens for periodontal diseases in pregnant women have been suggested and recommended for use in practical public health. And yet the concept of "dental diseases prevention in pregnancy" does not fully reflect the essence of the necessary measures to maintain the dental health of women during this period. The aim: The aim of the present paper is to study the scientific literature on the issue of preventing periodontal diseases in pregnancy. PATIENTS AND METHODS: Materials and methods: The subject under discussion was considered on the basis of 59 sources on this issue, using the method of content analysis, comparative and contrastive, analytical and biblio-semantic methods. RESULTS: Review and conclusions: The analysis of scientific literature justifies the need for an integrated approach to treatment and prophylactic measures during the entire pregnancy period. Furthermore, the review of literature sources allows us to advocate the need to improve the existing approaches and to develop new individual programs for primary and secondary prevention of periodontal diseases in pregnant women, taking into account pathogenesis and the peculiarity of their course. Diagnosis of dental status in pregnant women with assessment of early and long-term clinical observations provides a prognostic model of the course and outcome of dental diseases. Meanwhile, the introduction of the follow-up observation for the maternity leave group enhances the dental health of pregnant women and prevents multiple pathological conditions of the unborn child.


Assuntos
Profilaxia Dentária , Saúde Bucal , Doenças Periodontais/prevenção & controle , Complicações na Gravidez/prevenção & controle , Assistência à Saúde , Feminino , Humanos , Gravidez
8.
Am J Case Rep ; 20: 151-153, 2019 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-30713335

RESUMO

BACKGROUND Infective endocarditis (IE) has a high mortality rate, even when treated with appropriate antibiotic therapy and surgical intervention. Right-sided endocarditis is in itself rare, with some studies reporting an incidence of 5-10%. The majority of these cases involve the tricuspid valve, and isolated pulmonary valve endocarditis (PVE) is an extremely rare entity affecting less than 2% of patients with infective endocarditis. Identification and early management are crucial to prevent long-term complications and reduce mortality. CASE REPORT We present a patient with a history of essential hypertension and no underlying valvular disease, who underwent dental cleaning and subsequently developed low-grade fever, myalgia, and malaise. This occurred during the flu season, and was initially diagnosed and treated as flu, without any improvement. The patient was later found to be bacteremic with S. mitis, with no identifiable source, and a normal transthoracic echocardiogram (TTE). He was later hospitalized, had a transesophageal echocardiogram, and was found to have a large pulmonic valve vegetation. CONCLUSIONS This case presents an interesting and rare finding of endocarditis, isolated to the pulmonic valve, in an otherwise healthy individual with no predisposing risk factors. The lack of peripheral stigmata, as well as an unremarkable initial outpatient TTE, made the diagnosis more difficult. It should also be noted that current guidelines do not specifically address right-sided endocarditis, and do not specify the role of surgical intervention.


Assuntos
Endocardite Bacteriana/diagnóstico , Valva Pulmonar/microbiologia , Profilaxia Dentária , Ecocardiografia , Endocardite Bacteriana/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Valva Pulmonar/diagnóstico por imagem , Infecções Estreptocócicas/complicações , Streptococcus mitis/isolamento & purificação
9.
J Dent Educ ; 83(2): 161-172, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30709991

RESUMO

Successfully educating dental providers and patients about the link between human papillomavirus (HPV) and oropharyngeal cancer requires coordinated efforts to increase HPV-related prevention practices. The aim of this study was to identify, using a systems perspective, the multi-level determinants related to how dental providers can promote HPV prevention in dental practices. Data for this qualitative study were collected in 2015-16 from focus groups with dentists (four focus groups, n=33), focus groups with dental hygienists (four focus groups, n=48), and in-depth interviews with dental opinion leaders (n=13). Results were triangulated and mapped along micro, meso, and macro system levels. At the micro level, participants identified patient characteristics and low self-efficacy as influential determinants when discussing HPV prevention. At the meso level, relationships among dentists, dental hygienists, and the physical practice environment were factors affecting dental providers' HPV prevention efforts. At the macro level, professional organizations impacted how dental providers interacted with their patients on this topic. These results suggest that improving HPV prevention among dental providers requires a multi-level approach that considers the distinctive context of dental settings, dental training, and perceptions of professional roles. The findings suggested that the macro- and meso-level determinants may be challenging to modify due to the distinctive culture and practice models of dentistry. Nevertheless, the association between HPV and oral cancer requires an expansion of prevention strategies used in dental practices. Improving dental providers' self-efficacy to communicate HPV prevention through continuing education and integration of skill-guided training in dental and dental hygiene curricula could facilitate this process.


Assuntos
Profilaxia Dentária , Odontologia , Infecções por Papillomavirus/prevenção & controle , Papel Profissional , Humanos , Pessoa de Meia-Idade
10.
Spec Care Dentist ; 39(2): 89-96, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30604877

RESUMO

AIM: We aimed to describe time requirements and costs associated with professional dental cleaning (PDC) performed by a dental nurse in one German nursing home, and to reveal potential differences in required time for demented versus nondemented and mobile versus immobile residents. METHODS AND RESULTS: We performed a retrospective, cross-sectional analysis of treatment time and costs, including a transparent, easily adaptable path of action that allows implementation of PDC in nursing homes. Total mean (±SD) treatment time for one session per resident was documented, including differences in demented and immobile residents, and projected treatment costs (€/$) per resident. We found no differences in required time for one PDC (37 ± 11 minutes) in residents with or without dementia (P = 0.803) or, immobile versus mobile residents (P = 0.396). Mean projected treatment costs of PDC were €14.98/$17.07 per resident per cleaning session, resulting in total costs of €13.5 million ($15.4 million). CONCLUSION: Cognitive status and mobility does not affect the mean time required to perform PDC by a dental nurse in nursing home residents. Main cost factor is working time of dental staff; consumable supplies have less impact. Our data may stimulate to include PDC as initial step toward implementation of long-term oral hygiene strategies.


Assuntos
Assistência Odontológica para Idosos , Profilaxia Dentária , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Demência/complicações , Assistência Odontológica para Idosos/economia , Profilaxia Dentária/economia , Feminino , Alemanha , Humanos , Masculino , Limitação da Mobilidade , Estudos Retrospectivos , Fatores de Tempo
11.
Clin Oral Investig ; 23(2): 707-713, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29754197

RESUMO

OBJECTIVES: To determine the impact of general and oral health status of nursing home residents in Germany on efficacy and acceptance of professional dental cleaning performed by a dental nurse. MATERIALS AND METHODS: Participants (N = 41; mean age 83 ± 8 years) living in a nursing home were included. Personal and general health, oral health, oral hygiene habits, and needs were investigated. Individual acceptance regarding professional dental cleaning via different devices (scaler, interdental brushes, ultrasonic cleaning) was assessed, as was the efficacy of this method using after-cleaning indices. RESULTS: Oral health among nursing home residents was impaired and independent from dementia status. Most residents (33/41) performed oral hygiene procedures independently and showed better index values than those in need of external help. Residents requiring help with oral hygiene showed increased risk profiles (higher age, more often immobile, demented, more xerostomia). The dental cleaning procedure required a mean time of 37 ± 11 min, was widely accepted (36/41), and achieved clean results (plaque index 0.1 ± 0.5, oral hygiene index 0.2 ± 1.6, Volpe-Manhold index 0.4 ± 1.6); food residues were reduced to 0 independent from cognitive status. Regarding the cleaning methods, scalers were accepted best without difference between demented and non-demented residents. CONCLUSIONS: Professional dental cleaning in nursing homes is an accepted and efficacious oral hygiene procedure among nursing home residents. CLINICAL RELEVANCE: Professional dental cleaning is an efficacious and accepted method as a first step in line with strategies to improve oral health and should be considered in nursing home residents.


Assuntos
Assistência Odontológica para Idosos , Profilaxia Dentária , Casas de Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Idoso de 80 Anos ou mais , Feminino , Alemanha , Humanos , Masculino , Índice de Higiene Oral , Fatores de Risco
12.
Clin Oral Investig ; 23(4): 1921-1930, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30232627

RESUMO

OBJECTIVES: To investigate tissue health around implants with newly attached superstructures over 12 months of preventive maintenance appointments and instrumentation when necessary. MATERIAL AND METHODS: In a randomized, split-mouth study 32 implants (8 participants with 4 implants each) received followed-up care every 3 months after superstructure attachment. Implants and superstructures were randomly assigned to four treatment groups and treated if necessary: (1) titanium curettes (TC), (2) stainless steel ultrasonic tip (PS), (3) erythritol air-polishing powder (EP), or (4) rubber cup polishing (CON). Probing depths (PDs), bleeding on probing (BOP), modified gingival (mucosal) bleeding index (GBI) around implants, and full-mouth Plaque Control Record (PCR) were measured every 3 months. Clinical attachment levels (CALs) and height of keratinized mucosa (KM)/gingival margins (GMs) for implants/teeth and PD, BOP, and GBI for teeth were documented at baseline, 6 months, and 12 months. Matrix metalloproteinase 8 (MMP-8) and periopathogens were measured at baseline and 12 months. RESULTS: Participants exhibited minimal signs of periodontal inflammation with statistically significant PD improvement (3.0 ± 0.2 to 2.8 ± 0.3 mm; p = 0.022) and overall CAL (4.3 ± 0.8 to 4.0 ± 0.7 mm; p = 0.048) after 1 year. Implants showed no statistically significant differences (p > 0.05) between or within groups at baseline or 12 months for any parameter, except MMP-8 decreased significantly for PS (14.50 ± 17.58 to 4.63 ± 7.56 ng; p = 0.044), and after 12 months, PCR showed a significant difference between TC and PS (p = 0.018). CONCLUSIONS: Treatment was necessary as inflammation was observed around newly placed superstructures within the first year of maintenance care. All tested treatment modalities yielded comparable clinical improvements. CLINICAL RELEVANCE: Early assessment and diagnosis of mucositis and regular maintenance can promote long-lasting implant health.


Assuntos
Implantes Dentários , Profilaxia Dentária/métodos , Titânio , Idoso , Índice de Placa Dentária , Polimento Dentário , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Mucosite/prevenção & controle , Índice Periodontal , Prostodontia
13.
Gen Thorac Cardiovasc Surg ; 67(2): 197-202, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30291542

RESUMO

In brief, perioperative oral intervention consists of elimination of odontogenic foci and maintenance of oral hygiene in patients undergoing surgery. The importance of oral intervention before, during, and after medical treatments is well-known, especially in cancer patients, because odontogenic foci such as untreated deep dental caries or periodontitis can cause systemic infection in patients with myelosuppression resulting from chemotherapy. Although perioperative oral intervention is currently recommended for patients with cardiovascular disease, its efficacy in this population has not been established. This article consists of three sections: first, we review the current knowledge about the association between dental disease and cardiovascular disease to show the importance of oral hygiene maintenance and the risks of invasive dental procedures in patients with cardiovascular disease; second, we introduce pertinent, but limited evidence concerning the effect of oral care in preventing postoperative pneumonia; and finally, we present the optimal strategy for perioperative oral intervention in cardiovascular surgery patients.


Assuntos
Procedimentos Cirúrgicos Cardiovasculares , Profilaxia Dentária/métodos , Medicina Bucal/métodos , Equipe de Assistência ao Paciente , Assistência Perioperatória/métodos , Complicações Pós-Operatórias/prevenção & controle , Humanos
14.
Quintessence Int ; 50(2): 104-113, 2019 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-30574612

RESUMO

It is challenging for clinicians to carry out successful periodontal therapy and maintain a full dentition in young patients with generalized bone loss of 90%. Due to advanced attachment loss and the young age of patients, fixed or removable prosthetic treatment options are compromised. Implant therapy would be complex and expensive. The presented case shows the successful conservative periodontal therapy of advanced generalized aggressive periodontitis in a 29-year-old female. A conservative approach was applied and maintained all teeth with patient satisfaction both functionally and esthetically. This case was followed over 5 years.


Assuntos
Periodontite Agressiva/terapia , Adulto , Periodontite Agressiva/diagnóstico por imagem , Antibacterianos/uso terapêutico , Terapia Combinada , Dispositivos para o Cuidado Bucal Domiciliar , Profilaxia Dentária , Raspagem Dentária , Feminino , Humanos , Índice Periodontal , Radiografia Panorâmica , Aplainamento Radicular , Resultado do Tratamento
15.
Clin Oral Investig ; 23(1): 327-335, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29658069

RESUMO

OBJECTIVES: To investigate discoloration reduction and changes of surface properties of a CAD/CAM resin composite after 14 days´ storage in red wine and polishing with nine different prophylactic polishing pastes (PPPs). MATERIALS AND METHODS: Rectangular discs (N = 172) were fabricated and polished (P4000) using GC Cerasmart (GC Europe) to investigate different polishing protocols with 1-4 related descending PPPs (22 in total): Cleanic/CLE-Kerr, CleanJoy/CLJ-Voco, Clean Polish/Super Polish/SPO-Kerr, Clinpro Prophy Paste/CPP-3M, Détartrine/DET-Septodont, Nupro/NUP-Dentsply Sirona, Prophy Paste CCS/CCS-Directa, Proxyt/PXT-Ivoclar Vivadent, and Zircate/ZIR Prophy Paste-Dentsply Sirona. Surface properties (roughness values (RV)/Ra, Rz, Rv, surface free energy (SFE), surface gloss (G), and discoloration (ΔE)) were analyzed before and after storage and additional polishing. Data were examined using Kolmogorov-Smirnov test, three-way ANOVA followed by Tukey-B post hoc, Mann-Whitney U, and Kruskal-Wallis H tests (α < 0.05). RESULTS: Regarding RV, CLE, followed by CCS, and CPP showed the highest values; the lowest presented SPO and DET (p < 0.001). No impact of PPP was observed on ΔE values (p = 0.160). The lowest SFE presented DET, followed by SPO; highest showed CCS followed by NUP and CPP (p < 0.001). Within G, lowest values were observed for CLE and NUP, followed by CCS, ZIP, and CLJ (p < 0.001); the highest presented SPO (p < 0.001). Polishing showed generally a positive impact on SFE values (p < 0.001-p = 0.007), except ZIP (p = 0.322) and CLE (p = 0.083). G increased and RV decreased after polishing (p < 0.001), except SPO, with no significant change for G (p = 0.786). CONCLUSIONS: Polishing with PPPs improves the surface properties and is generally recommended. The choice of PPP has a minor role in removing discolorations. Multi-step systems should be carried out conscientiously. CLINICAL RELEVANCE: The proper selection of PPP is essential for the clinical outcome of surface properties of prosthetic restorations. Not every polishing paste leads to the same final surface quality.


Assuntos
Resinas Compostas/química , Polimento Dentário/métodos , Profilaxia Dentária/métodos , Restauração Dentária Permanente , Cremes Dentais/química , Projeto Auxiliado por Computador , Teste de Materiais , Propriedades de Superfície , Descoloração de Dente/prevenção & controle , Vinho
16.
Wiad Lek ; 72(12 cz 1): 2378-2382, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32124757

RESUMO

OBJECTIVE: The aim: carry out analysis of regular dental checkups in Kyiv in state and private dental establishments. PATIENTS AND METHODS: Materials and methods: The analysis was conducted using the statistical reports (approved standard №20) which have been obtained in Kyiv and Ukraine from 2008 till 2017. The method of copying data with using statistical estimation methods was applied. RESULTS: Results: The authors have established significant dental preventive measures decline in Kyiv state dental establishments from 2008 till 2017. A tendency toward increased private dental sector within the dental prevention has been noted. CONCLUSION: Conclusions: The obtained results will be used to substantiate concepts of municipal stomatological dental care improvement as well as to introduce the university clinic model.


Assuntos
Assistência Odontológica , Profilaxia Dentária , Humanos , Ucrânia
17.
Cochrane Database Syst Rev ; 12: CD004625, 2018 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-30590875

RESUMO

BACKGROUND: Many dentists or hygienists provide scaling and polishing for patients at regular intervals, even for those at low risk of developing periodontal disease. There is debate over the clinical and cost effectiveness of 'routine scaling and polishing' and the optimal frequency at which it should be provided for healthy adults.A 'routine scale and polish' treatment is defined as scaling or polishing, or both, of the crown and root surfaces of teeth to remove local irritational factors (plaque, calculus, debris and staining), which does not involve periodontal surgery or any form of adjunctive periodontal therapy such as the use of chemotherapeutic agents or root planing. Routine scale and polish treatments are typically provided in general dental practice settings. The technique may also be referred to as prophylaxis, professional mechanical plaque removal or periodontal instrumentation.This review updates a version published in 2013. OBJECTIVES: 1. To determine the beneficial and harmful effects of routine scaling and polishing for periodontal health.2. To determine the beneficial and harmful effects of routine scaling and polishing at different recall intervals for periodontal health.3. To determine the beneficial and harmful effects of routine scaling and polishing for periodontal health when the treatment is provided by dentists compared with dental care professionals (dental therapists or dental hygienists). SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 10 January 2018), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 12), MEDLINE Ovid (1946 to 10 January 2018), and Embase Ovid (1980 to 10 January 2018). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: Randomised controlled trials of routine scale and polish treatments, with or without oral hygiene instruction, in healthy dentate adults without severe periodontitis. We excluded split-mouth trials. DATA COLLECTION AND ANALYSIS: Two review authors screened the results of the searches against inclusion criteria, extracted data and assessed risk of bias independently and in duplicate. We calculated mean differences (MDs) (or standardised mean differences (SMDs) when different scales were reported) and 95% confidence intervals (CIs) for continuous data. We calculated risk ratios (RR) and 95% CIs for dichotomous data. We used a fixed-effect model for meta-analyses. We contacted study authors when necessary to obtain missing information. We rated the certainty of the evidence using the GRADE approach. MAIN RESULTS: We included two studies with 1711 participants in the analyses. Both studies were conducted in UK general dental practices and involved adults without severe periodontitis who were regular attenders at dental appointments. One study measured outcomes at 24 months and the other at 36 months. Neither study measured adverse effects, changes in attachment level, tooth loss or halitosis.Comparison 1: routine scaling and polishing versus no scheduled scaling and polishingTwo studies compared planned, regular interval (six- and 12-monthly) scale and polish treatments versus no scheduled treatment. We found little or no difference between groups over a two- to three-year period for gingivitis, probing depths, oral health-related quality of life (all high-certainty evidence) and plaque (low-certainty evidence). The SMD for gingivitis when comparing six-monthly scale and polish treatment versus no scheduled treatment was -0.01 (95% CI -0.13 to 0.11; two trials, 1087 participants), and for 12-monthly scale and polish versus no scheduled treatment was -0.04 (95% CI -0.16 to 0.08; two trials, 1091 participants).Regular planned scale and polish treatments produced a small reduction in calculus levels over two to three years when compared with no scheduled scale and polish treatments (high-certainty evidence). The SMD for six-monthly scale and polish versus no scheduled treatment was -0.32 (95% CI -0.44 to -0.20; two trials, 1088 participants) and for 12-monthly scale and polish versus no scheduled treatment was -0.19 (95% CI -0.31 to -0.07; two trials, 1088 participants). The clinical importance of these small reductions is unclear.Participants' self-reported levels of oral cleanliness were higher when receiving six- and 12-monthly scale and polish treatments compared to no scheduled treatment, but the certainty of the evidence is low.Comparison 2: routine scaling and polishing at different recall intervalsTwo studies compared routine six-monthly scale and polish treatments versus 12-monthly treatments. We found little or no difference between groups over two to three years for the outcomes of gingivitis, probing depths, oral health-related quality of life (all high-certainty evidence) and plaque (low-certainty evidence). The SMD for gingivitis was 0.03 (95% CI -0.09 to 0.15; two trials, 1090 participants; I2 = 0%). Six- monthly scale and polish treatments produced a small reduction in calculus levels over a two- to three-year period when compared with 12-monthly treatments (SMD -0.13 (95% CI -0.25 to -0.01; 2 trials, 1086 participants; high-certainty evidence). The clinical importance of this small reduction is unclear.The comparative effects of six- and 12-monthly scale and polish treatments on patients' self-reported levels of oral cleanliness were uncertain (very low-certainty evidence).Comparison 3: routine scaling and polishing provided by dentists compared with dental care professionals (dental therapists or hygienists)No studies evaluated this comparison.The review findings in relation to costs were uncertain (very low-certainty evidence). AUTHORS' CONCLUSIONS: For adults without severe periodontitis who regularly access routine dental care, routine scale and polish treatment makes little or no difference to gingivitis, probing depths and oral health-related quality of life over two to three years follow-up when compared with no scheduled scale and polish treatments (high-certainty evidence). There may also be little or no difference in plaque levels over two years (low-certainty evidence). Routine scaling and polishing reduces calculus levels compared with no routine scaling and polishing, with six-monthly treatments reducing calculus more than 12-monthly treatments over two to three years follow-up (high-certainty evidence), although the clinical importance of these small reductions is uncertain. Available evidence on the costs of the treatments is uncertain. The studies did not assess adverse effects.


Assuntos
Polimento Dentário/efeitos adversos , Profilaxia Dentária/efeitos adversos , Doenças Periodontais/prevenção & controle , Adulto , Cálculos Dentários/terapia , Placa Dentária/terapia , Raspagem Dentária/efeitos adversos , Gengivite/prevenção & controle , Humanos , Satisfação do Paciente , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
18.
Odontología (Ecuad.) ; 20(2): 68-89, 20181231.
Artigo em Espanhol | LILACS | ID: biblio-987670

RESUMO

En junio de 2018 se propuso una nueva clasificación de enfermedades y condiciones periodontales y peri-im-plantares, en una reunión realizada conjuntamente por la Academia Americana de Periodoncia y la Federación Europea de Periodoncia, con el objetivo de actualizar la clasificación de 1999 en uso durante los últimos 19 años. El objetivo del artículo es introducir esta nueva clasificación para que tanto clínicos e investigadores pue-dan aplicarla. La nueva clasificación incorporará nuevos conceptos a medida que se reporten nuevos resultados sobre estudios que sean realizados en el futuro.


A new classification of periodontal and peri-implant diseases and conditions was proposed in June 2018, in a meeting jointly held by the American Academy of Periodontology and European Federation of Periodontology, with the aim to update the 1999 classification in use for 19 years. The article aimed at introducing the most re-cent periodontal and peri-implant classification to clinicians and scientific investigators. The new classification has an in-built plan for periodic revisions while upcoming studies are carried out.


Uma nova classificação das condições e doenças periodontais e peri-implantares foi proposta em junho de 2018, em um encontro que reuniu a Academia Americana de Periodontia e a Federação Europeia de Periodontia, que teve como objetivo atualizar a classificação de 1999, amplamente utilizada nos últimos 19 anos. Este artigo tem como objetivo introduzir a mais nova classificação periodontal e peri-implantar aos clínicos e pesquisadores. A nova classificação possui um planejamento para revisões periódicas a medida que novos estudos são realizados.


Assuntos
Patologia Bucal , Doenças Periodontais , Periodontia , Periodontite , Peri-Implantite , Gengivite , Estomatite , Classificação Internacional de Doenças , Revisão , Profilaxia Dentária , Doenças da Gengiva
19.
Bull Tokyo Dent Coll ; 59(4): 229-236, 2018 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-30333368

RESUMO

The purpose of this study was to determine the distribution of healthy elderly individuals undergoing regular dental check-ups and identify any environmental or associated oral factors. A cross-sectional questionnaire survey was used to interview 216 individuals attending 2 welfare facilities for the elderly, of whom 160 were included in the final analysis. Items comprised age, sex, number of residual teeth, frequency of teeth/denture cleaning, subjective chewing ability, denture use, oral status, regular dental check-ups, visitation of the same dentist, number of dental visits in the past year, General Oral Health Assessment Index (GOHAI) (Japanese version) score, living situation, and use of routine medication. Individuals undergoing regular dental check-ups were defined as those with a primary dentist whom they saw for dental check-ups at least once a year. The rate of individuals undergoing regular dental check-ups was 75.0% in men aged 60-74 years, 58.8% in women aged 60-74 years, 70.0% in men aged 75 years or over, and 45.3% in women aged 75 years or over. Logistic regression analysis revealed a higher number of residual teeth (odds ratio [OR]=2.664 in comparison with those with fewer than 20 teeth, p=0.0427); cleaning teeth/dentures 3 or more times per day (OR=2.546 in comparison with cleaning them twice per day or less, p=0.0157); and a higher GOHAI score (OR=2.742 in comparison with those with a GOHAI score of less than 58, p=0.0263) as factors significantly correlated with undergoing regular dental check-ups. In conclusion, the results revealed that individuals undergoing regular dental check-ups had 20 or more residual teeth, cleaned their teeth/denture 3 or more times per day, and had a higher GOHAI score. This indicates that the best predictive factor for undergoing regular dental check-ups in healthy elderly individuals is their GOHAI score.


Assuntos
Assistência Odontológica para Idosos/estatística & dados numéricos , Prótese Parcial Removível/psicologia , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida , Idoso , Atitude Frente a Saúde , Estudos Transversais , Profilaxia Dentária/estatística & dados numéricos , Higienizadores de Dentadura , Prótese Total/psicologia , Feminino , Humanos , Japão , Modelos Logísticos , Masculino , Mastigação/fisiologia , Pessoa de Meia-Idade , Razão de Chances , Inquéritos e Questionários
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