Periodontal therapy for hopeless mandibular anterior teeth: a retrospective case report with a multidisciplinary approach and a 20-year follow-up

Introduction: This case report presents the intentional periodontal maintenance of two periodontal hopeless lower central incisors with a multidisciplinary approach and 20-year follow-up. Case presentation: A 36-year-old male, in 2001, was diagnosed with aggressive periodontitis, gingival swelling, bleeding, and mandibular central incisors with mobility and poor prognosis. Following periodontal therapy (phase I), root canal treatment, and occlusal adjustment, #31 and #41 were gently extracted to remove the granulation tissues, calculus, and infected cementum from the root surface. Then, tetracycline-HCl was applied for 5 minutes on the root surfaces. The teeth were repositioned into the sockets and splinted with a lingual bar. At 3 months, the bar was removed, and a free gingival autogenous graft was done to improve the local keratinized tissue width. Mobility scores, pocket depths, and clinical attachment levels were recorded, and radiographs were taken at 1, 5, and 20 years. The 5-year follow-up showed that the teeth were clinically and radiographically in function. There was a reduction in probing depth and a gain in clinical attachment and radiographic alveolar bone levels. After 20 years, #41 was stable, but #31 had external root resorption, leading to a new treatment plan (dental implants) and extraction. Conclusion: The clinical result of this case was satisfactory for 20 years. Intentional periodontal maintenance of the teeth may be an alternative treatment, even considering the high level of complexity.

Factors associated with the performance and achieving goals of specialized periodontal procedures in Brazilian dental specialties centers.

BACKGROUND: The Brazilian Dental Specialty Centers (CEO, in Portuguese) represent the strategy of the National Oral Health Policy to provide secondary-level dental care. They offer more complex procedures, such as the treatment of periodontitis. This study aims to investigate the factors associated with the performance and the achievement goals of specialized procedures and the achievement gols of periodontics in CEO. METHODOLOGY: Analytical and cross-sectional study using secondary data. The database of the second cycle of the External Evaluation of the National Program for Improving Access and Quality in CEO (PMAQ-CEO, in Portuguese), was utilized, which assessed 1,042 CEO on-site in 2018. The data were analyzed using multiple Poisson regression, estimating the prevalence ratio (PR) (p < 0.05). RESULTS: A third of the CEO (n = 305) performed all specialized procedures, with a higher prevalence observed in those with more than one bicarbonate jet prophylaxis unit (RP = 2.12; 95% CI: 1.160-3.881; p = 0.015) and when they had a higher percentage of specialist professionals (RP = 1.004; 95% CI: 1.002-1.006; p < 0.001). The periodontics goal was achieved by 617 (59.2%) CEO, with a higher prevalence among those who had a manager with supplementary training (PR = 1.21; 95% CI: 1.100-1.335; p < 0.001) and with a higher workload for the periodontist dentist (PR = 1.15; 95% CI: 1.103-1.201; p < 0,001). CONCLUSION: Although most CEOs do not perform allspecialized periodontics procedures, more than half achieved the established goals. The provision of specialized periodontics services in CEO and the achievement of goals are influenced by the quantity and professional qualifications, as well as the availability of equipment.

Ibero-Panamerican Federation of Periodontology Delphi study on the trends of periodontology and periodontics by the year 2030. A Latin American consensus.

BACKGROUND AND OBJECTIVE: As elsewhere in the world, the prevalence of periodontitis in stages I-II is high in the Latin American population, this scenario emphasizes the need for identification of urgent needs for allocating adequate resources to provide diagnosis, prevention, and treatment of these diseases. The aim of this Delphi study was to predict the trends in periodontology/periodontics in the Latin American region by the year 2030. METHODS: A steering committee and an advisory group of experts in periodontology/periodontics were selected from 16 countries. An open questionnaire of 60 questions was validated and used following the Delphi methodology. RESULTS: Two hundred and twenty-five experts from Latin America answered the two rounds of the questionnaire. Moderate to strong consensus was reached on 45 questions (75%). The prediction was that the prevalence of gingivitis and periodontitis in stages I and II will be maintained, the importance of the link with systemic diseases will increase, and the impact of prevention and periodontal treatment will also increase, mainly in the private sector. There was a strong consensus that plastic and regenerative surgical procedures will increase, as well as the demand for training in the specialty of periodontology. CONCLUSIONS: The present study has provided relevant and useful information on predictions in periodontology/periodontics in Latin America, with important level of consensus among experts. It has been predicted that periodontitis will still be a highly prevalent disease, and its links with other medical conditions should demand more attention by health authorities to develop adequate prevention and management policies and strategies.

Estudos de própolis em odontologia: ensaio clínico randomizado sobre o efeito da suplementação com própolis coadjuvante à terapia periodontal não cirúrgica em indivíduos com diabetes mellitus tipo 2 e revisão bibliométrica sobre o uso de própolis na odontologia / Propolis studies in dentistry: randomized clinical trial about the effect of the supplementation with propolis coadjuvant to non-surgical periodontal therapy in individuals with type 2 diabetes mellitus and bibliometric review about the use of propolis in dentistry

A periodontite e o diabetes mellitus tipo 2 (DM2) são doenças relacionadas e prevalentes. A busca por terapias coadjuvantes ao tratamento periodontal em indivíduos diabéticos almeja melhores resultados. A própolis verde (PV) tem sido discutida como uma possibiidade por suas propriedades antibacterianas, anti-inflamatórias e antioxidantes, que justificam sua aplicação em várias patologias odontológicas. Este estudo apresenta duas propostas de investigação: 1) Ensaio clínico randomizado (ECR) avaliando a terapia coadjuvante com PV na terapia periodontal não cirúrgica (TPNC) de pacientes com DM2; 2) Revisão bibliométrica (RB) mapeando os 100 artigos mais citados sobre o uso de própolis na odontologia. O ECR incluiu 22 indivíduos com DM2 e periodontite estágios II e III, randomizados em dois grupos: controle e teste. Dados sociodemográficos e periodontais foram coletados. Avaliou-se proteína c-reativa (PCR), hemoglobina glicada (HbA1c) e glicemia em jejum. Todos os indivíduos foram submetidos à TPNC. O grupo teste recebeu suplementação com PV durante 60 dias após a TPNC e o grupo controle recebeu placebo. Os grupos foram avaliados após 60 e 90 dias. A amostra se mostrou equilibrada para os parâmetros sociodemográficos, laboratoriais e para sangramento à sondagem (SS) e nível de inserção clínico (NIC). Os grupos mostraram melhora significativa no SS (p < 0,05), profundidade de sondagem (PS) (p<0,01) e NIC (p<0,05) após a TPNC. Não houve diferenças significativas para os mesmos parâmetros entre os grupos. Os parâmetros laboratoriais não mostraram alteração significativa intragrupo nem intergrupos. Para esta amostra, o tratamento coadjuvante com PV comparado ao placebo não mostrou diferenças significativas. A RB analisou o uso e aplicação de própolis nas diferentes áreas de especialidades odontológicas. A busca foi realizada no Web Of Science (WoS) e um crossmatch do número de citações (NC) foi realizado no Scopus e no Google Scholar. Os artigos encontrados foram avaliados quanto aos autores, instituições, região, idade, desenho de estudo, periódico, palavras-chave e altmetria. O NC no WoS mostrou uma forte correlação positiva com o NC no Google Scholar (0,890; p<0,001) e no Scopus (0,963;p<0,001). Os artigos foram publicados entre 1990 e 2021. O artigo mais recente teve a maior densidade de citações. Foram identificadas 10 áreas de interesse da odontologia e a área com o maior número de publicações (NP) foi a periodontia, enquanto a área com maior NC foi a cariologia. O Brasil foi o país mais produtivo, e a Universidade Estadual de Campinas (UNICAMP) liderou o ranking em NC, empatando com a Universidade Federal de Minas Gerais (UFMG) em NP. Cinquenta e cinco periódicos foram identificados e apenas 10 tiveram NP>3. O Escore de Atenção Altmétrico (EAA) foi igual a zero em 62 artigos. Não houve correlação entre o NC dos artigos e o EAA (p=0,446). O interesse pela aplicação de própolis na odontologia é bem difundido pelo mundo e aumenta gradativamente.

Periodontitis and type 2 diabetes mellitus (T2DM) are related and prevalent diseases. The search for coadjuvant therapies aims for better results. Green propolis (GP) has been discussed as a possibility due to its antibacterial, anti-inflammatory and antioxidant properties that justify its application in various pathologies in dentistry. This study presents two investigation proposals: 1) Randomized clinical trial (RCT) evaluating the adjuvant therapy with GP in the non-surgical periodontal treatment (NSPT) in individuals with T2DM; 2) Bibliometric review (BR) mapping the dental literature concerning the 100 most cited papers about the use of propolis in dentistry. The RCT included 22 individuals with T2DM and periodontitis stages II and III, randomized in two groups: test and control. Sociodemographical and periodontal data were collected. C-reactive protein (CRP), glycated hemoglobin (HbA1c) and fasting plasma glucose were measured. All the subjects underwent NSPT. Individuals in the test group received supplementation with green propolis during 60 days after NSPT and the control group received placebo. Both groups were evaluated after 60 and 90 days. The sample was balanced for the paramethers sociodemographic, laboratorial and for bleeding on probing (BoP) and clinical attachment level (CAL). Both groups showed a significant improvement in BoP (p<0.05), probing pocket depth (p<0.01) (PPD) and CAL level (p<0.05) after the NSPT. There were no significant differences for the same parameters between the groups. The laboratorial parameters did not show statistically significant difference intragroup or intergroup. For this sample, the use of the adjuvant treatment with GP compared to placebo did not show significant differences. The BR analyzed the use and application of propolis in the different specialties within dentistry. The search was performed in Web of Science and a crossmatch of the number of citations (NC) was performed in Scopus and Google Scholar. The papers were evaluated for author, institutions, region, age, study design, journal, keywords and altmetrics. The NC in the Web of Science showed a strong positive correlation with the NC in the Google Scholar (0.890;p<0.001) and Scopus (0.963;p<0.001). The papers were published between 1990 and 2021. The most recent paper had the greatest density of citations. Ten specialties were identified among the included papers. The specialty with the greatest number of papers (NP) was periodontology, and the subject with the greatest NC was cariology. Brazil was the most producing country and the Universidade Estadual de Campinas (UNICAMP) led the ranking in NC, reaching a tie with Universidade Federal de Minas Gerais (UFMG) in NP. Fifty-five journals were identified and only 10 had NP>3. Altmetric Attention Score (AAS) was zero in 62 papers. There was no correlation between NC and AAS (p=0.446). The interest about propolis in dentistry is widespread around the world, and increases gradually.

Evaluation of characteristics of periodontal probes

Aim: This study aimed to evaluate the millimeter distances and active tip diameters of different periodontal probes. Methods: Two types of periodontal probes were analyzed (North Carolina (15-UNC) and PCP-12). Two manufacturers were selected for each probe type. Digital images of the probes were obtained and the distances were measured using a software program. The diameter of the active tip was measured using a digital caliper. Both variables were measured by two trained and calibrated examiners. The data were analyzed using the Bland-Altman method and two-way ANOVA with Tukey's post-hoc test. Statistical significance was set at p<0.05. Results: A comparison of measurements between the 15UNC and PCP-12 probes showed a significant difference in all millimeter markings. The 15-UNC probe showed differences between the 3 and 12 mm markings. The PCP-12 probe only showed differences between the marks at the 12 mm mark. The 15-UNC probe had a similar active tip diameter between the two manufacturers. The PCP-12 probe showed a significant difference between the two manufacturers. Both types of probes had similar active tip diameters when compared by the two manufacturers. Conclusion: There was no standardization in relation to millimeter marks and tip diameters of the two types of periodontal probes produced by the two different manufacturers. The probe types exhibited little variability

Discriminant validity of the current gingivitis classification in adolescents: a cohort study.

OBJECTIVES: To compare the prevalence of gingivitis estimated by the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classification with the other case definitions and assess the ability of this classification system in discriminating sociodemographic and clinical factors associated with the presence of gingivitis in a cohort study. MATERIALS AND METHODS: A multistage random sample of 1134 12-year-old adolescents was submitted to a full-mouth examination according to the Community Periodontal Index. Socioeconomic and clinical variables were collected at baseline. Gingivitis was considered according to the following criteria: (a) ≥ 10% of bleeding sites (the 2018 EFP/AAP criteria); (b) ≥ 15% of bleeding sites; and (c) the mean full-mouth bleeding sites. Adjusted multilevel Poisson regression assessed the association between independent variables at baseline and each definition of gingivitis at 2-year follow-up. RESULTS: Seven hundred forty-two 14-year-old adolescents were re-revaluated at follow-up. The prevalence of gingivitis was 28.7% according to 10% of bleeding threshold. The 2018 EFP/AAP criteria and other definitions showed higher prevalence and mean of gingivitis for low-household income adolescents and for those with higher levels of dental plaque and untreated dental caries. Nonetheless, the highest strengths of association were observed for the threshold of ≥ 15% of bleeding sites. CONCLUSION: The 2018 EFP/AAP case definition of gingivitis showed a similar discriminant validity compared to the 15% threshold and the mean full-mouth bleeding sites. CLINICAL RELEVANCE: The 2018 EFP/AAP classification allows the discrimination of important risk factors and should be used for the establishment of priorities for large-scale therapeutic programs.

Manifestaciones periodontales de la Granulomatosis de Wegener: Reporte de un caso clínico / Periodontal manifestations of Wegener's granulomatosis: Case report

La granulomatosis de Wegener o granulomatosis con Poliangitis (GPA) es una enfermedad caracterizada por inflamación y necrosis de las paredes de los vasos sanguíneos. Es de etiología desconocida, baja prevalencia y alta agresividad. Esta enfermedad puede comprometer los tejidos bucales causando agrandamiento e inflamación del tejido gingival. Se reporta el caso de un paciente de género masculino que manifiesta aumento de volumen de la encía e inflamación asociado al diagnóstico de granulomatosis de Wegener. La lesión fue eliminada quirúrgicamente y el diagnóstico se logró al combinar los hallazgos serológicos del test ANCA, manifestaciones periodontales y análisis histopatológico. El paciente fue tratado con metotrexato y corticoesteroides y no presenta recidiva de la lesión luego de 2 años de control. En este artículo se analizan las manifestaciones periodontales asociadas a la GPA resaltando la importancia de un adecuado diagnóstico de lesiones periodontales caracterizadas por agradamiento gingival e inflamación.

Wegener's granulomatosis or granulomatosis with polyangiitis (GPA) is a disease characterized by inflammation and necrosis of the blood vessel walls. It is of unknown etiology, low prevalence and high degree of aggressiveness. This disease can compromise the oral tissues, causing enlargement and inflammation of the gingival tissues. The case of a male patient who presented rapidly growing gingival tissue enlargement and inflammatory characteristics associated with the diagnosis of Wegener's granulomatosis is reported. The lesion was removed surgically and the diagnosis was achieved by combining the serological findings of the ANCA test, periodontal manifestations and histopathological analysis of the lesion. The patient was treated with methotrexate and corticosteroids and the lesion did not reappear after 2 years of control. In this article, the periodontal manifestations associated with GPA are analyzed, highlighting the importance of an adequate diagnosis of periodontal lesions characterized by gingival enlargement and inflammation.

Restauração transcirúrgica: inter-relação periodontia e dentística / Transsurgical restoration: interrelationship between periodontics and dentistry

Tendo em vista a importância da relação Dentística Restauradora e Periodontia na Odontologia atual, o presente estudo demonstrou o relato de um caso clínico realizado no Complexo Odontológico do Centro Universitário da Serra Gaúcha (FSG), retratando um procedimento de restauração transcirúrgica em um paciente cujo elemento 13 estava comprometido com uma cavidade subgengival disto-palatino, sendo a resina composta o material restaurador de escolha. Este estudo teve como objetivo apresentar um caso clínico demonstrando a técnica de restauração transcirúrgica e a integração do planejamento entre Periodontia e Dentística Restauradora realizado na Clínica de Odontologia do Centro Universitário da Serra Gaúcha -FSG. Este trabalho mostrou a importância da realização de uma técnica cirúrgica e restauradora correta por parte dos cirurgiões-dentistas, assim como na verificação de que os tecidos periodontais podem reagir de forma positiva à presença de materiais restauradores adesivos posicionados subgengivalmente(AU)

In view of the importance of the restorative dentistry and periodontics relationship in current dentistry, the present study demonstrated the report of a clinical case carried out in the Dental Complex of the Centro Universitário da Serra Gaúcha - FSG, portraying a transsurgical restoration procedure in a patient whose element 13 was compromised with a subgingival cavity of this-palatine, the composite resin being the restorative material of choice. This study aimed to present a clinical case demonstrating the technique of transsurgical restoration and the integration of planning between Periodontics and Restorative Dentistry carried out at the Dentistry Clinic of the University Centro Universitário da Serra Gaúcha - FSG. This study showed the importance of performing a correct surgical and restorative technique by dentists, as well as in verifying that periodontal tissues can react positively to the presence of adhesive restorative materials positioned subgingival(AU)

Consistency of recommendations of clinical practice guidelines in periodontology: a systematic review.

The aim of this systematic review was to evaluate the methodological quality and the consistency of recommendations of clinical practice guidelines (CPGs) in Periodontology. An electronic search was conducted in two databases, MEDLINE and EMBASE, eight CPGs databases, and home pages of scientific societies in Periodontology up to April 2022. Three reviewers independently assessed methodological quality using the AGREE II instrument. In addition, we evaluated the consistency of the recommendations. Eleven CPGs were included, and the topics developed focused on prevention, diagnosis, risk factors, surgical and non-surgical periodontal treatment, antimicrobial therapy, root coverage, and maintenance. We found that the AGREE domains 2 (Stakeholder involvement) and 5 (Applicability) obtained the lowest scores. Domains 1 (Scope and purpose), 3 (Rigor of development) and 4 (Clarity of presentation) obtained the highest scores among the evaluated CPGs. The clinical recommendations for treatment of periodontal diseases were mostly consistent. Overall, the quality of CPGs used in periodontics was high. There was consistency of recommendations in specific fields. These findings may help researchers to promote CPGs focused on different fields of periodontics that have not yet been developed. Furthermore, the clinician will be able to make better clinical decisions.

Anne Haffajee: An inspirational role model.

This article honors Dr. Anne Haffajee's career, her highest research standards, scholarly integrity, and inspirational mentorship. Anne-as she liked to be called-was one of the most productive clinical scientists of her time. Gifted with the unique combination of knowledge in the fields of clinical research, oral ecology, data analysis, and computer programing, her work triggered unprecedented advances in the diagnosis, progression, and treatment of periodontitis. Anne's pivotal clinical trials elucidated the effects of non-surgical and surgical periodontal therapies. In addition to her scholarly achievements, Anne played an important role in mentoring young scientists, many of whom have developed independent leadership careers in periodontal research. She always found time to help her mentees, and ultimately became a warm-hearted friend to many of them, including myself. Anne was consistently devoted to contributing to the future of clinical investigation, and more specifically concerned about the lack of interest by (1) funding agencies in supporting such studies and by (2) the new generation of investigators in pursuing a career in the area. She passed away prematurely, in 2013, at the age of 65. Undoubtedly, her work and legacy assured the continuity of high-standard clinical studies in periodontics and the survival of a whole generation of clinical researchers.

Antibiotics prescribing habits of Brazilian general dental practitioners during periodontal treatments / Hábitos de prescrição de antibióticos de dentistas brasileiros durante tratamentos periodontais

Introdução: O tratamento periodontal envolve procedimentos que visam reduzir a carga bacteriana, envolvendo ou não o uso de antibióticos locais ou sistêmicos. Objetivo: O objetivo deste estudo foi avaliar o conhecimento dos cirurgiões-dentistas brasileiros sobre a prescrição de antibióticos durante o tratamento periodontal. Material e método: Foi disponibilizado um questionário online solicitando aplicação sistêmica de prescrição de antibióticos locais ou sistêmicos (frequência e sequência com tratamento periodontal mecânico) e em relação a diferentes doenças periodontais. A utilização de serviços de diagnóstico microbiano e dados demográficos dos voluntários também foram elucidados. Os dados foram analisados estatisticamente (Teste Binomial, p<0,05). Resultado: Trezentos e noventa e três voluntários responderam ao questionário. Vinte e três por cento do sexo masculino e 76,2% do sexo feminino. A idade média foi de 27,7 anos. A minoria (19,2%) dos voluntários relatou indicar antibióticos sistêmicos para tratamento de gengivite ou periodontite estágios I e II (antiga periodontite crônica leve e moderada). A maioria dos profissionais indica para tratar abscesso periodontal, gengivite ou periodontite ulcerativa necrosante, periodontite em imunodeficiências graves, periodontite agressiva antiga e periodontite estágios III e IV (periodontite crônica grave antiga). Raramente (2,5%) a prescrição foi sem a associação com terapia mecânica. Os exames microbiológicos como método auxiliar de diagnóstico raramente (3,1%) são solicitados por falta de informação ou custo. As respostas mais frequentes sobre o número de vezes que os profissionais relataram prescrever antibióticos sistêmicos como parte do tratamento periodontal por trimestre foram "pelo menos uma vez", seguido de "2 vezes". Conclusão: Pode-se concluir que os cirurgiões-dentistas brasileiros possuem conhecimento sobre a correta prescrição de antibióticos na terapia periodontal

Introduction: Periodontal treatment involves procedures aimed to reduce bacterial load, involving or not the use of local or systemic antibiotics. Objective: The purpose of this study was to assess Brazilian dentists' knowledge about antibiotics prescription during periodontal treatment. Material and method: An online questionnaire was available asking for systemic application of local or systemic antibiotics prescription (frequency, and sequence with mechanical periodontal treatment) and in relation to different periodontal diseases. The use of microbial diagnostic services and volunteers' demographic data were also elucidated. Data were statistically analyzed (Binomial Test, p<0.05). Result: Three hundred and ninety-three volunteers answered the questionnaire. Twenty-three percent males and 76.2% females. Average age was 27.7 years. Minority (19.2%) of the volunteers reported to indicate systemic antibiotics to treat gingivitis or periodontitis stages I and II (old slight and moderate chronic periodontitis). Majority of the professionals indicate it to treat periodontal abscess, necrotizing ulcerative gingivitis or periodontitis, periodontitis in severe immunodeficiencies, old aggressive periodontitis, and periodontitis stages III and IV (old severe chronic periodontitis). Rarely (2.5%) the prescription was without the combination with mechanical therapy. Microbiological tests as an auxiliary diagnostic method are rarely (3.1%) requested due to lack of information or cost. Most frequent answers about the number of times professionals reported prescribing systemic antibiotics as part of periodontal treatment per trimester was "at least once", followed by "2 times". Conclusion: It can be concluded that Brazilian dentists have knowledge about the correct prescription of antibiotics in periodontal therapy

Impact of the COVID-19 pandemic on publication rate in periodontology and implantology in Turkey / Impacto da pandemia de COVID-19 na taxa de publicação em periodontia e implantodontia na Turquia

Objective: The aim of the present study was to evaluate the impact of the COVID-19 pandemic on the number of publications in the field of periodontology and implantology in Turkey. Material and Methods: A sensitive search strategy was developed to identify relevant articles, focusing on the periodontology and implantology research fields published two years before and after the declaration of the pandemic (March 2020). The search was performed through Web of Science, Medline, SCOPUS and CENTRAL databases. A three-stage screening (titles, abstract, full-text) was carried out in duplicate and independently by two reviewers. Results: A total of 382 studies were identified before the pandemic and 307 studies during the pandemic. While there was a downward trend in the number of observational studies (185 vs 168), the number of clinical trials (CCT/RCT) slightly increased compared to the pre-pandemic period (72 vs 74). Conclusion: Limited to the selected period of time (two years) and field, publication rate on periodontology and implantology in Turkey was decreased during the pandemic. Although the present research highlights current trends, large-scale investigations are needed to probe consequences of COVID-19 pandemic on research activities in the long-run (AU).

Objetivo: O objetivo do presente estudo foi avaliar o impacto da pandemia de COVID-19 no número de publicações na área de periodontia e implantodontia na Turquia. Material e Métodos:Foi desenvolvida uma estratégia de busca sensível para identificar artigos relevantes, com foco nas áreas de pesquisa em periodontia e implantodontia publicados dois anos antes e depois da declaração da pandemia (março de 2020). A busca foi realizada nas bases de dados Web of Science, Medline, SCOPUS e CENTRAL. Uma triagem de três etapas (títulos, resumo, texto completo) foi realizada em duplicata e de forma independente por dois revisores. Resultados: Foram identificados 382 estudos antes da pandemia e 307 estudos durante a pandemia. Embora tenha havido uma tendência de queda no número de estudos observacionais (185 vs 168), o número de ensaios clínicos (CCT/RCT) aumentou ligeiramente em comparação com o período pré-pandêmico (72 vs 74). Conclusão: Limitada ao período de tempo selecionado (dois anos) e área, a taxa de publicação em periodontia e implantodontia na Turquia diminuiu durante a pandemia. Embora a presente pesquisa destaque as tendências atuais, são necessárias investigações em larga escala para investigar as consequências da pandemia de COVID-19 nas atividades de pesquisa a longo prazo.(AU)

Factores etiológicos de abscesos periodontales: Una patología emergente. Informe de tres casos / Etiological factors of periodontal abscesses: an emerging pathology. A three-case report

Introducción: La presencia de abscesos periodontales es la tercera emergencia dental más frecuente (6%-14%). Objetivo: Reportar información sobre diferentes factores etiológicos de absceso periodontal en tres pacientes. Descripción de casos: Primer caso, mujer de 52 años quien acudió a consulta por sangrado espontáneo, al examen clínico se evidenció sangrado al sondaje (SS), presencia de bolsas periodontales (BP) y cálculos (C); como tratamiento se realizó raspado y alisado radicular (RAR), complementado con detoxificación con tetraciclina y tratamiento farmacológico posoperatorio. Segundo caso, hombre de 27 años quien acudió a consulta por agrandamiento de encía, se observó (SS), y (BP); se retiró la lesión y se realizó (RAR). Tercer caso, hombre de 21 años quien acudió a consulta de control, al examen clínico se evidenció presencia de cálculos en órganos dentarios y bolsas periodontales en órganos dentarios 16-17; se utilizó (RAR) complementado con detoxificación con tetraciclina y tratamiento farmacológico posoperatorio. Conclusión: La etiología del absceso periodontal en el primer y último caso se basó en la falta de profundidad durante el raspado y alisado radicular, y en el segundo estuvo relacionado a impactación de alimentos. El identificar la etiología permite determinar diagnóstico, pronóstico y tratamiento ideal.

Introduction: Periodontal abscesses are the third most frequent dental emergency (6%-14%). Objective: To describe different etiological factors of periodontal abscesses in three patients. Case description: The first case was a 52-year-old woman who sought treatment due to spontaneous bleeding. During the examination, she revealed bleeding on probing (BP), presence of periodontal pockets (PP), and calculi (C). Scaling and root planning (SRP) was performed as treatment, which was complemented with detoxification with tetracycline and postoperative pharmacological treatment. The second case was a 27-year-old man who came to the clinic due to gum enlargement and showed BP and PP. The lesion was treated and SRP was performed. Finally, the third patient was a 21-year-old male who sought a follow-up consultation. The clinical examination showed the presence of dental calculi and periodontal pockets in teeth 16 and 17. SRP complemented with detoxification with tetracycline and postoperative pharmacology were used as treatments. Conclusion: The etiology of the periodontal abscesses in the first and third cases was based on the lack of depth during root scaling and planning. The cause in the second case was effects of food. Identifying this etiology is useful to achieve proper diagnosis, prognosis and treatment of periodontal abscesses.

Application of lasers in dentistry: a bibliometric study of the top 100 most-cited papers.

This bibliometric study analyzed the 100 most-cited papers about the use of lasers and their modalities in dentistry. A search strategy was created using specific keywords related to the topic. A comprehensive search was then conducted in the Web of Science Core Collection (WoS-CC) database up to July 2021. Papers that addressed the application of any type of laser and its modalities in dentistry were included. Each paper was cross-matched with the number of citations on Scopus and Google Scholar. The following data were extracted from papers: title, number of citations, authorship, country, year of publication, journal, study design, subject, laser type, and oral health outcomes. The VOSviewer software was used to generate bibliometric networks. The total number of citations ranged from 120 to 4,124 and 23 papers received more than 200 citations. Papers were published from 1964 to 2015. Most papers were from Europe (42%) and Anglo-Saxon America (27%). The USA was the country with more top 100 papers (25%). Papers were published mainly in Lasers in Surgery and Medicine (15%) and Lasers in Medical Science (7%). VOSviewer maps demonstrated the existence of national and international research collaborations among institutions and authors. Most studies had a laboratory design (57%) and were about restorative dentistry (32%) and periodontics (21%). This bibliometric study of the top 100 most-cited papers on lasers in dentistry allowed a quantitative and qualitative analysis of this very promising research field, revealing a net of collaboration and the importance of this topic in dentistry.

Investigating oral and systemic pathways between unhealthy and healthy dietary patterns to periodontitis in adolescents: A population-based study.

AIM: To investigate pathways between unhealthy and healthy dietary patterns and periodontitis in adolescents (18-19 years of age). MATERIALS AND METHODS: This population-based study (n = 2515) modelled direct and mediated pathways (via biofilm and obesity) from patterns of healthy diet (fruits, fibre, vegetables, and dairy) and unhealthy diet (sugars, snacks, and salty/fast foods) with initial periodontitis (bleeding on probing [BoP], probing depth [PD] ≥ 4 mm, clinical attachment loss [CAL] ≥ 4 mm), moderate periodontitis (BoP, PD ≥ 5 mm, and CAL ≥ 5 mm), and European Federation of Periodontology and the American Academy of Periodontology (EFP-AAP) periodontitis definitions, adjusting for sex, socio-economic status, smoking, and alcohol, through structural equation modelling (α = 5%). RESULTS: Higher values of healthy diet were associated with lower values of initial periodontitis (standardized coefficient [SC] = -0.160; p < .001), moderate periodontitis (SC = -0.202; p < .001), and EFP-AAP periodontitis (p < .05). A higher value of unhealthy diet was associated with higher values of initial periodontitis (SC = 0.134; p = .005) and moderate periodontitis (SC = 0.180; p < .001). Biofilm mediated the association between higher values of unhealthy diet and all periodontal outcomes (p < .05). CONCLUSIONS: Our findings suggest that both healthy and unhealthy dietary patterns may contribute to reduced or increased extent and severity of periodontitis by local and systemic mechanisms, preceding the effect of other established causes such as smoking and obesity, in younger population.

Prevention of oral cancer through the implementation of a teledentistry platform for the elderly / Prevención del cáncer oral mediante la implementación de una plataforma de teleodontología para adultos mayores

Objective: To contribute to early diagnosis of lesions in older patients, including potentially malignant lesions or those suspected of oral cancer by support of a web-based teledentistry platform. Material and Methods:This report contains information from 27 patients with oral lesions out of a total of 135 who received mobile dental care. Specialists who participated in the study involved professionals from the disciplines of periodontics, temporomandibular disorders, oral implantology, oral radiology, oral pathology and geriatrics. Referral consultations were carried out synchronously or asynchronously. Clinical information sent to oral pathology specialists involved a medical history and a traditional description of the lesion which considered size, color, limits, symptomatology, type of surface, consistency, location, and evolution. This information was complemented with a three-dimensional representation of the lesion, simulating an extra/intra oral clinical examination including a marker tool that allows to perform the anatomical-referencing of oral lesions. Results:27 consultations from 26 patients were evaluated for oral pathology lesions. 12 lesions were diagnosed as reactive, 5 were infectious lesions, 4 of vascular etiology, 3 pigmented lesions (amalgam tattoo and smoking-related melanosis) and 3 potentially malignant lesions. The most frequent location was the tongue with 8 cases, followed by the gingiva and jugal mucosa, each with 5 cases. Four lesions required biopsy and histopathological report. Conclusion: A teledentistry platform including digital representations of oral lesions using different digital markers, also associated with a mobile system to provide dental care, constitutes an excellent tool to treat patients that present oral lesions with potential cancer risk.

Objetivo: Contribuir al diagnóstico precoz de lesiones en pacientes mayores, incluyendo lesiones potencialmente malignas o con sospecha de cáncer oral mediante el apoyo de una plataforma de teleodontología basada en la web.Material y Métodos: Este informe contiene información de 27 pacientes con lesiones orales de un total de 135 que recibieron atención odontológica móvil. Los especialistas que participaron en el estudio incluyeron profesionales de las disciplinas de periodoncia, trastornos temporomandibulares, implantología oral, radiología oral, patología oral y geriatría. Las interconsultas se realizaron de forma sincrónica o asincrónica. La información clínica enviada a los especialistas en patología oral involucró una historia clínica y una descripción tradicional de la lesión que consideró tamaño, color, límites, sintomatología, tipo de superficie, consistencia, localización y evolución. Esta información se complementó con una representación tridimensional de la lesión, simu-lando un examen clínico extra/intraoral incluyendo una herramienta marcadora que permite realizar la referenciación anatómica de las lesiones orales. Resultados: Se evaluaron 27 consultas de 26 pacientes por lesiones de patología bucal. Se diagnosticaron 12 lesiones como reactivas, 5 lesiones infecciosas, 4 de etiología vascular, 3 lesiones pigmentadas (tatuaje de amalgama y melanosis por tabaquismo) y 3 lesiones potencialmente malignas. La localización más frecuente fue lengua con 8 casos, seguida de encía y mucosa yugal con 5 casos cada una. Cuatro lesiones requirieron biopsia e informe histopatológico. Conclusión: Una plataforma de teleodontología que incluye representaciones digitales de lesiones orales utilizando diferentes marcadores digitales, también asociada a un sistema móvil para brindar atención odontológica, constituye una excelente herramienta para tratar pacientes que presentan lesiones orales con riesgo potencial de cáncer.

Performance of the 2017 AAP/EFP case definition compared with the CDC/AAP definition in population-based studies.

BACKGROUND: Classification of the periodontal conditions is indispensable for epidemiological data in order to guide situational awareness and therapeutic strategies. The new classification of periodontal diseases and conditions introduced by the American Academy of Periodontology and the European Federation of Periodontology (AAP/EFP), however, has not yet been applied to population-based studies. The aim of the present study was to compare the prevalence of periodontitis between the AAP/EFP and the CDC/AAP classification system and to evaluate the accuracy of the new AAP/EFP classification system against the CDC/AAP case definition for population-based studies. METHODS: Epidemiological data from two cross-sectional studies were obtained. One of them was a population-based study on Chilean adults (1.456 individuals; 35-44 years; 65-74 years) and the other one a sample of adolescents (1.070 individuals; 15-19 years) from five countries; Argentina, Chile, Colombia, Ecuador, and Uruguay. All participants had undergone full-mouth periodontal examination by calibrated examiners. Epidemiological datasets were analyzed according to the AAP/EFP and the CDC/AAP case definitions. The accuracy of the AAP/EFP definition was examined by assessing the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating curve (ROC) using the CDC/AAP case definition as the reference standard. RESULTS: According to the AAP/EFP, the prevalence of periodontitis in adolescents was 75.6%. The majority of the adolescents were classified either as Stage I (39.2%) or Stage II (28.2%). By using the CDC/AAP classification the prevalence of periodontitis in adolescents was 27.2%. The most common form of periodontitis with the CDC/AAP classification was moderate periodontitis (15.3%) followed by mild periodontitis (11.4%). The AAP/EFP revealed high sensitivity in moderate (95.7%) and severe periodontitis (100%) as well as a moderate (75%) to high specificity (92%) in moderate and severe periodontitis, respectively. The PPV was 41.6% in moderate and 5.7% in severe periodontitis whereas the NPV was high in both categories (moderate = 99%; severe = 100%). The AUC was 0.91 (95% CI = 0.89-0.93). In adults, the prevalence of periodontitis was 99% according to the AAP/EFP. The majority of adults were classified as Stage IV (81.3%) whereas Stage III amounted to 12.8%. By using the CDC/AAP classification, the prevalence of periodontitis in adults was 88.3% and the most common form of periodontitis was moderate periodontitis (57.2%) followed by severe periodontitis (29.7%). In adults, the AAP/EFP revealed high sensitivity for moderate (99.7%) and severe periodontitis (100%), but low specificity for both categories (moderate = 6.8%; severe = 8.3%). The PPV was 88.7% in moderate and 31.7% in severe periodontitis. The NPV was high in both categories (moderate = 76.5%; severe = 100%). The AUC was 0.57 (95% CI = 0.53-0.62). CONCLUSIONS: This study revealed a clear discrepancy in the prevalence of periodontitis between the AAP/EFP and the CDC/AAP classification when using epidemiological data. The 2017 AAP/EFP classification system performs well when compared to the CDC/AAP case definition in identifying adolescents with periodontitis. The AAP/EFP system seems less accurate in adults with high prevalence of periodontitis.

Level of patient comfort and measurement reproducibility of three different probes: A cross-sectional study.

OBJECTIVE: To determine the comfort level and reproducibility assessment of the probing pocket depth obtained with three different probes. METHODS: A cross-sectional clinical study was conducted in accordance with the STROBE standards. Three different types of periodontal probes were selected: (1) University of North Carolina (UNC) probe, (2) World health organization (WHO) probe and (3) UNC12 COLORVUE probe. Three experienced and calibrated periodontists performed periodontal clinical assessments (probing depth) and pain assessment with the visual analogue scale (VAS). RESULTS: The clinical evaluations were carried out in 13 volunteers who attended the dental clinic of the Universidad Científica del Sur (Lima, Peru). A total of 2106 periodontal clinical measurements were obtained (702 measurements per examiner). Each examiner evaluated 234 sites for each type of probe. When patient comfort values during the periodontal evaluation performed with the 3 types of probes were compared, the patients evaluated with the UNC12 COLORVUE probe perceived less pain with a mean value of 0.61, followed by the WHO probe and the UNC probe. When evaluating the clinical measurements, the UNC probe was observed to obtain the greatest mean depth on probing 1.4 + 0.5 mm, while with the UNC12 Colorvue probe, the values obtained were 1.1 + 0.3 mm, and with the WHO probe, 1.2 + 0.4 mm. CONCLUSIONS: Based on the periodontal probe used, experience of the examiner and the patient, we can conclude that the UNC12 Colorvue probe was the instrument that promoted the greatest comfort or the slightest response to pain, followed by the WHO probe. However, the use of the WHO probe resulted in obtaining the lowest reproducibility among depths on probing. The UNC probe produced the highest response to pain in the patients.

Inter-relação periodontia-dentística: correção do arco côncavo regular gengival e reabilitação estética e funcional - relato de caso / Periodontics-dental interrelationship: correction of the regular concave gingival arch and aesthetic and functional rehabilitation - case report

É crescente a quantidade de pessoas que vão até o cirurgião-dentista na busca de tratamentos dentários estéticos que harmonizem seu sorriso. Atualmente os avanços nas tecnologias dos materiais odontológicos e a qualidade consequente possibilitam obter excelentes resultados nos tratamentos estéticos restauradores. As coroas do tipo cerâmicas, também chamadas de metal free, são indicadas para modificação e ou reabilitação da anatomia e adequação da cor dos dentes e, quando associadas às cirurgias de plástica gengival, podem ter um resultado lindo e harmônico, o que resulta em maior satisfação do paciente quanto ao resultado final. Entretanto, deve-se realizar um correto planejamento, avaliar a real indicação e um minucioso planejamento multidisciplinar para que resulte em sucesso e longevidade desses procedimentos. O presente trabalho tem o objetivo de apresentar um caso clínico de reabilitação em dentes anteriores, envolvendo cirurgia estética gengival e coroas totais cerâmicas, relatando as indicações e as técnicas dos procedimentos realizados.

The number of people who go to the dentist in search of aesthetic dental treatments that harmonize their smile is increasing. Currently, advances in the technologies of dental materials and the consequent quality make it possible to obtain excellent results in aesthetic restorative treatments. Ceramic-type crowns, also called free metal, are indicated for modification and/or rehabilitation of the anatomy and adequacy of the color of the teeth and, when associated with gingival plastic surgery, can have a beautiful and harmonious result, which results in greater patient satisfaction with the end result. However, it is necessary to carry out a correct planning, evaluate the real indication and a detailed multidisciplinary planning to result in the success and longevity of these procedures. The present work aims to present a clinical case of rehabilitation in anterior teeth, involving gingival aesthetic surgery and all-ceramic crowns, reporting the indications and techniques of the procedures performed.

Confecção, caracterização e avaliação do efeito de membranas à base de fibroína carregadas ou não com neurotensina em feridas abertas em palato: estudo clínico randomizado / Manufacturing, characterization, and evaluation of silk fibroin-based membranes with or without neurotensin on palatal wound healing: in vitro and randomized clinical trial

A utilização de enxertos autógenos provenientes do palato para reconstrução de tecidos gengivais, apesar de serem considerados o padrão-ouro, causam grande morbidade e dor pós-operatória. Assim, com o intuito de reduzir essas complicações, alguns biomateriais podem ser explorados, acelerando a cicatrização e trazendo maior conforto ao paciente. Dessa forma, os objetivos do presente estudo foram: confeccionar e caracterizar membranas à base de fibroína de seda sem carregamento (F) ou carregadas com neurotensina (FN) e avaliar clinicamente seus efeitos no reparo de feridas abertas no palato. Para a primeira parte, as membranas foram confeccionadas e caracterizadas quanto à espessura, propriedades mecânicas, textura superficial, permeabilidade ao vapor de água, degradação enzimática, citotoxicidade, genotoxicidade e intumescimento. Para a segunda parte, sessenta e um pacientes com necessidade de exodontia e preservação alveolar foram randomizados em três grupos: Controle: exodontia e selamento do alvéolo com EGL removido do palato; Grupo F: exodontia com EGL e inserção da membrana F na ferida palatina; Grupo FN: exodontia com EGL e membrana FN na ferida palatina. A reparação da área doadora palatina foi avaliada por parâmetros clínicos centrados nos pacientes. A partir dos resultados de caracterização, pode-se constatar a homogeneidade das membranas, alta resistência mecânica e maior intumecimento, permeabilidade e rugosidade superficial, características favoráveis para feridas intraorais. Em adição, não apresentaram citotoxicidade (HFF-1, HaCaT e fibroblastos gengivais humanos) e genotoxicidade (HaCaT) in vitro. Em relação aos resultados clínicos, em 14 dias FN mostrou maior diminuição de ARF (p<0,001) e melhor ET (p = 0,022) do que F e GC; ao analisar-se o ICPF, ambos os biomateriais F e FN apresentaram melhores resultados em 14 dias comparados ao GC (p= 0,009 e p = 0,001 respectivamente); não houve diferença entre os grupos em relação ao ED (p= 0,312) e ET (p = 0,120). OHIP em F e FN se mostrou superior a GC a partir do 5º dia, NA e DPO mantiveram-se mais baixas em F e FN. Conclui-se que o uso de membranas à base de fibroína de seda carregadas ou não com NT apresenta benefícios clínicos no reparo de feridas e na qualidade de vida dos pacientes (AU)

The use of autogenous grafts from the palate for gingival tissue reconstruction, despite being considered the gold standard, causes great morbidity and postoperative pain. Thus, in order to reduce these complications, biomaterials can be explored, accelerating healing and bringing greater comfort to the patient. The objectives of the present study were: to manufacture and characterize unloaded (F) or neurotensinloaded (FN) silk fibroin-based membranes and to clinically evaluate their effects on the repair of palatal open wounds. For the first part, the membranes were made and characterized in terms of thickness, mechanical properties, surface texture, water vapor permeability, enzymatic degradation, cytotoxicity, genotoxicity and swelling. For the second part, sixty-one patients in need of extraction and alveolar preservation were randomized into three groups: Control: extraction and alveolar socket sealing with FGG removed from the palate; Group F: extraction with FGG and F membrane incorporation in the palatal wound; Group FN: extraction with EGL and FN membrane in the palatal wound. Palatal donor site repair was assessed by patient-centered and clinical parameters. From the characterization results, membranes' high homogeneity, mechanical resistance, swelling, permeability and surface roughness, can be verified, being favorable characteristics for intraoral wounds. In addition, they showed no cytotoxicity (HFF-1, HaCaT and human gingival fibroblasts) and genotoxicity (HaCaT) in vitro. Regarding the clinical results, at 14 days FN showed a greater decrease in ARF (p<0.001) and better ET (p = 0.022) than F and GC; when analyzing the ICPF, both biomaterials F and FN showed better results at 14 days compared to GC (p=0.009 and p=0.001 respectively); there was no difference between the groups regarding ED (p=0.312) and ET (p=0.120). OHIP in F and FN was superior to GC from the 5th day, NA and DPO remained lower in F and FN. It is concluded that the use of silk fibroinbased membranes loaded or not with NT has clinical benefits in wound repair and in the quality of life of patients (AU)