Application of highly ozonated sunflower oil does not improve palatal wound healing: A randomized controlled clinical trial.

BACKGROUND: Ozone is a molecule that plays an important role in dentistry, specially for wound healing. The aim of the present study was to clinically and immunologically evaluate the effect of ozonated oil on the healing of palatal wounds. METHODS: This is a prospective, longitudinal, triple-blind, randomized, placebo-controlled clinical trial. The groups were divided as follows: Test group (n = 14): after removal of the free gingival graft (FGG), the palatal wound was treated with ozonized seed sunflower oil with a peroxide index between 510 and 625 meq O2 /kg; Control group (n = 14): after removal of the FGG, the palatal wound was treated with non-ozonated sunflower oil (placebo). The treatments were applied three times a day, for 7 days. RESULTS: There were no significant differences in the measurements of wound area (mm2 ) between the test and control groups in the different periods evaluated (0, 3, 7, and 14 days; p > 0.05). The intra-group analysis showed a significant decrease in wound size over the course of days (0, 3, 7, and 14 days; p < 0.05). Vascular endothelial growth factor (VEGF; pg/mL) presented a significant reduction at 7 days (p < 0.05) compared to day 3 in the test group (p < 0.05). There was a statistical difference for malondialdehyde (MDA; pg/mL) in the test group between 3 and 7 days post-treatment (p < 0.05) and between test and control groups on the 7th day (p < 0.05). CONCLUSIONS: The application of highly ozonated sunflower oil did not improve the remaining scar area of the palate, decreasing the VEGF and increasing the oxidative stress marker MDA.

Myeloperoxidase as inflammatory marker of periodontal disease: experimental study in rats.

RATIONALE: Previous studies have used myeloperoxidase (MPO) as an inflammatory marker to estimate the accumulation of neutrophils in inflamed regions. OBJECTIVE: The aim of this experimental study was to quantify the levels of MPO related to experimental periodontal disease in rats. METHODS: Periodontal disease was induced in a group of rats using placement of a ligature around molar teeth. A group of rats without ligature placement served as a control. Measurements were made on the 3(rd), 7(th), 15(th) and 30(th) day from baseline. Gingival tissues were taken for quantification of MPO levels by ELISA. RESULTS: The rats with induced periodontal disease showed statistically higher MPO levels (p < 0.05) when compared to control rats. A significant increase in the levels of MPO released on days 7 and 30 was observed, with higher levels in the group with induced periodontitis. CONCLUSION: The levels of MPO were found to be higher in rats with induced periodontal disease, confirming the hypothesis that MPO may serve as an inflammatory marker for periodontitis.

Frequency of Porphyromonas gingivalis fimA in smokers and nonsmokers after periodontal therapy.

Porphyromonas gingivalis is one of the most important Gram-negative anaerobe bacteria involved in the pathogenesis of periodontitis. P. gingivalis has an arsenal of specialized virulence factors that contribute to its pathogenicity. Among them, fimbriae play a role in the initial attachment and organization of biofilms. Different genotypes of fimA have been related to length of fimbriae and pathogenicity of the bacterium. OBJECTIVES: The aim of this study was to identify 5 types of fimA genotype strains in smokers and nonsmokers with periodontitis, before and after periodontal therapy. MATERIAL AND METHODS: Thirty-one patients with periodontitis harboring P. gingivalis were selected: 16 nonsmokers (NS) and 15 smokers (SM). Clinical and microbiological parameters were evaluated at baseline and 3 months after periodontal treatment, namely: plaque index, bleeding on probe, probing depth, gingival recession and clinical attachment level. The frequency of P. gingivalis and fimA genotype strains were determined by polymerase chain reaction. RESULTS: Type I fimA was detected in the majority of SM and NS at baseline, and the frequency did not diminish after 3 months of treatment. The frequency of type II genotype was higher in SM than NS at baseline. After 3 months, statistical reduction was observed only for types II and V fimA genotypes in SM. The highest association was found between types I and II at baseline for NS (37.5%) and SM (53.3%). CONCLUSION: The most prevalent P. gingivalis fimA genotypes detected in periodontal and smoker patients were genotypes I and II. However, the presence of fimA genotype II was higher in SM. Periodontal treatment was effective in controlling periodontal disease and reducing type II and V P. gingivalis fimA.

Determination of the Influence of Chronic Periodontitis on Pulp Sensibility by Means of Electric and Thermal Cold Testing.

INTRODUCTION: Communication between pulp and periodontal tissue has been well established. However, it is unknown when periodontal disease begins to affect the clinical response of pulp tissue. The aim of this study was to assess the influence of periodontal severity on pulp sensibility by means of electric and thermal cold testing. METHODS: The teeth assessed in this study were allocated into 3 groups considering radiographic alveolar bone loss (ABL) as follows: slight periodontitis (SP, ABL ≤7 mm without reaching the apex, n = 25), moderate periodontitis (ABL >7 mm without reaching the apex, n = 23), and severe periodontitis (SvP, ABL >7 reaching the apex, n = 8). Gingival recession (GR), probing depth (PD), and clinical attachment level (CAL) were also measured. RESULTS: The results showed higher levels of PD and CAL in the SvP group compared with the SP group (P < .05), with no significant difference in GR (P > .05). The SvP group showed significant ABL compared with the other groups (P > .05). The SP group showed a significant number of teeth with a positive pulp response, whereas the SvP group showed a significant number of teeth with a negative pulp response (P < .05); no significant differences were observed between the thermal cold and electric tests (P > .05). CONCLUSIONS: Within the limits of this study, it can be concluded that pulp clinical involvement with a negative response to thermal cold and electric testing occurs only in the most advanced stage of chronic periodontitis with apical involvement.

Prevalence of different types of accessory canals in the furcation area of third molars.

BACKGROUND: Although there are several studies that show the prevalence and diameter of accessory root canals in the furcation area, there is a scarceness of studies that observe the trajectory and different types of cavo-interradicular canals. The aim of this study was to verify the prevalence of the different morphologic types of accessory canals in the furcation region in an attempt to show their trajectories. METHODS: Forty submerged mandibular third molars were used, which were extracted and decalcified so that the microtomy procedure in the mesio-distal axial plane could be performed, obtaining semiserial sections with thicknesses of 5 microm. The sections were stained with hematoxylin and eosin and observed under optical microscopy. RESULTS: All of the morphologic types were found, whereas the proper accessory canals, type-A canals, were present in 10% of the specimens. The most prevalent canals were the sealed ones (type D), with a prevalence of 87.5%, followed by the blind ones (type B), with a prevalence of 75%. The loop accessory canals (type C), observed in only 5% of the teeth, were the least prevalent ones. CONCLUSIONS: Different morphologic types of accessory canals were found in the furcation area of submerged mandibular molars. The histologic method was effective to show the canal trajectories.

Lipid profile and high-sensitivity C-reactive protein levels in obese and non-obese subjects undergoing non-surgical periodontal therapy.

Periodontal treatment may improve the metabolic control of dyslipidemia. The aim of this study was to evaluate the lipid profile and high-sensitivity C-reactive protein (hs-CRP) levels in obese and non-obese patients undergoing periodontal therapy. Patients with generalized chronic periodontitis were divided into obese (n = 28) and non-obese groups (n = 26). The periodontal parameters (visible plaque index, gingival bleeding index, probing depth, clinical attachment level, and bleeding on probing), anthropometric measurements (body mass index, waist circumference, and body fat), and serum analyses (triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, fasting glucose, glycated hemoglobin, and hs-CRP) were measured at baseline and 90 days after periodontal treatment. The results showed that the obese subjects presented alterations in triglycerides, total cholesterol, low-density lipoprotein, and hs-CRP at baseline when compared with non-obese patients (P < 0.05). Periodontal treatment could improve the periodontal parameters in both groups similarly (P > 0.05). Obese subjects showed a significant decrease in the levels of triglycerides, total cholesterol, low-density lipoprotein, and hs-CRP post-therapy (P < 0.05), while non-obese patients showed improvement only in hs-CRP (P < 0.05). In conclusion, periodontal treatment could improve the periodontal parameters and circulating hs-CRP in obese and non-obese subjects. Lipid profile was modified only in obese patients post-therapy. (J Oral Sci 58, 423-430, 2016).

Frequency of Porphyromonas gingivalis fimA in smokers and nonsmokers after periodontal therapy

Abstract Porphyromonas gingivalis is one of the most important Gram-negative anaerobe bacteria involved in the pathogenesis of periodontitis. P. gingivalis has an arsenal of specialized virulence factors that contribute to its pathogenicity. Among them, fimbriae play a role in the initial attachment and organization of biofilms. Different genotypes of fimA have been related to length of fimbriae and pathogenicity of the bacterium. Objectives The aim of this study was to identify 5 types of fimA genotype strains in smokers and nonsmokers with periodontitis, before and after periodontal therapy. Material and Methods Thirty-one patients with periodontitis harboring P. gingivalis were selected: 16 nonsmokers (NS) and 15 smokers (SM). Clinical and microbiological parameters were evaluated at baseline and 3 months after periodontal treatment, namely: plaque index, bleeding on probe, probing depth, gingival recession and clinical attachment level. The frequency of P. gingivalis and fimA genotype strains were determined by polymerase chain reaction. Results Type I fimA was detected in the majority of SM and NS at baseline, and the frequency did not diminish after 3 months of treatment. The frequency of type II genotype was higher in SM than NS at baseline. After 3 months, statistical reduction was observed only for types II and V fimA genotypes in SM. The highest association was found between types I and II at baseline for NS (37.5%) and SM (53.3%). Conclusion The most prevalent P. gingivalis fimA genotypes detected in periodontal and smoker patients were genotypes I and II. However, the presence of fimA genotype II was higher in SM. Periodontal treatment was effective in controlling periodontal disease and reducing type II and V P. gingivalis fimA.

Root coverage stability of the subepithelial connective tissue graft and guided tissue regeneration: a 30-month follow-up clinical trial.

OBJECTIVES: The aim of this study was to compare the long-term clinical effects produced by subepithelial connective tissue graft (SCTG) and guided tissue regeneration combined with demineralized freeze-dried bone allograft (GTR-DFDBA) in the treatment of gingival recessions in a 30-month follow-up clinical trial. METHODS: Twenty-four defects were treated in 12 patients who presented canine or pre-molar Miller class I and/or II bilateral gingival recessions. GTR-DFDBA and SCTG treatments were performed in a randomized selection in a split-mouth design. The clinical measurements included root coverage (RC), gingival recession (GR), probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KTW). These clinical parameters were evaluated at baseline and after 6, 18 and 30months post-surgery. RESULTS: The changes in RC, GR, PD and CAL did not show significant differences between groups (p>0.05). Both procedures promoted similar RC (GTR-DFDBA: 87% and SCTG: 95.5%) and similar reduction in GR (GTR-DFDBA: 3.25mm and SCTG: 3.9mm), PD (GTR-DFDBA: 1.6mm and SCTG: 1.2mm) and CAL (GTR-DFDBA: 4.9mm and SCTG: 5.0mm). The increase in KTW was significantly higher (p=0.02) in the SCTG group (3.5mm) than in the GTR-DFDBA group (2.4mm). CONCLUSIONS: Both techniques for treatment of gingival recession (SCTG and GTR-DFDBA) lead to favourable and long-term stable results, but SCTG promoted a more favourable increase in keratinized tissue.

The role of obesity as a modifying factor in patients undergoing non-surgical periodontal therapy.

BACKGROUND: Earlier studies have shown an association between obesity and periodontitis, which is mediated by cytokine production. The aim of this study is to assess the role of obesity as a modifying factor on periodontal clinical parameters and on circulating proinflammatory cytokine levels in subjects undergoing non-surgical periodontal treatment. METHODS: Twenty-seven obese subjects and 25 normal-weight subjects were enrolled in this study. Subjects in both groups had generalized chronic periodontitis. The periodontal parameters measured before and 3 months after non-surgical periodontal therapy were: visible plaque index, bleeding gingival index, bleeding on probing, probing depth, and clinical attachment level. In addition, subjects underwent anthropometric measurements and serum analyses of fasting glucose, glycated hemoglobin, interleukin-1ß, interleukin-6, tumor necrosis factor-α, and interferon-γ. RESULTS: Periodontal therapy significantly decreased visible plaque index, bleeding gingival index, bleeding on probing, probing depth of 4 to 6 mm, probing depth ≥7 mm, clinical attachment level of 4 to 6 mm, and clinical attachment level ≥7 mm in both groups (P ≤0.05). Circulating proinflammatory cytokines significantly decreased in obese and normal-weight subjects after periodontal treatment (P ≤0.05). However, interleukin-6 and tumor necrosis factor-α levels remained higher in obese subjects 3 months after treatment (P ≤0.05). CONCLUSION: Obesity does not seem to play a negative role by interfering in the improvement of the periodontal clinical response or decreasing circulating proinflammatory cytokine levels after periodontal treatment.