RESUMO
OBJECTIVE: To evaluate cytokine levels of interleukin (IL)-1ß, IL-4, IL-6, IL-17a, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ in the gingival crevicular fluid (GCF) of periodontal sites in individuals with Down syndrome (DS) and analyze their relationship with clinical periodontal parameters. MATERIALS AND METHODS: A cross-sectional study was conducted with 49 DS patients and 32 individuals without DS (non-DS group). Periodontal probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP), and visible plaque index (VPI) were evaluated. The periodontal sites were classified as shallow, moderate, and deep. GCF was collected in all shallow sites and, when present, in moderate and deep sites for the analysis of cytokine levels. The cytokines, IL-1ß, IL-4, IL-6, IL-17a, TNF-α, and IFN-γ, were quantified using the Luminex® automatic analyzer system. RESULTS: The DS group presented greater severity of periodontitis compared to the non-DS group (P = 0.005). The DS group showed a significant direct correlation of IL-1ß and an inverse correlation of IFN-γ and IL-14 with all periodontal variables. In the analysis stratified by periodontal pocket depth, we observed a higher level of IFN-γ, IL-17a, IL-1ß, and IL-6 in the shallow sites, and IL-17a, IL-1ß, and IL-6 in deep pockets of DS group individuals. Multivariate models showed that higher levels of IL-1ß, IL-4, IL-6, and IL-17a were associated with Down syndrome even after adjusting for periodontal status, sex, and age. CONCLUSION: The findings suggest that people with DS have greater periodontal impairment and higher levels of cytokines in GCF, even in sites having clinical periodontal parameters similar to those of individuals without DS. These data reiterate the concept of an altered and less effective immune response in the population with DS in the face of a periodontal microbial challenge. CLINICAL RELEVANCE: Elevated periodontal inflammation burden can be observed with higher cytokine levels in the gingival crevicular fluid of people with Down syndrome, especially IL-1, IL-4, IL-6, and IL-17, regardless of the stage of periodontitis.
Assuntos
Citocinas , Síndrome de Down , Líquido do Sulco Gengival , Índice Periodontal , Humanos , Líquido do Sulco Gengival/química , Estudos Transversais , Masculino , Feminino , Síndrome de Down/metabolismo , Citocinas/metabolismo , Citocinas/análise , Adulto , Índice de Placa Dentária , AdolescenteRESUMO
BACKGROUND AND OBJECTIVE: Systemic metabolic status and periodontitis can be related in patients with Down syndrome (DS). The objective of this study was to identify metabolic indicators (anthropometric measurements, blood pressure, and serum markers) related to severity and extent of periodontitis in DS patients. METHODS: A cross-sectional study was conducted with 49 patients with DS. Periodontal evaluation included the periodontal probing depth (PPD), clinical attachment level (CAL), gingival bleeding index (GBI), and visible plaque index (VPI). Periodontitis severity was classified by the stages system. The extent of periodontitis was assessed as the percentage of sites with CAL ≥3 mm, CAL ≥4 mm, PPD ≥4 mm, and PPD ≥5 mm. The metabolic condition of the participants was determined by analyzing anthropometric parameters, blood pressure, and serum markers. Data were analyzed using the Mann-Whitney test, Spearman's correlation coefficient, and multivariate regression analysis. RESULTS: Periodontitis stage 3/4 was detected in 32.7% of patients, with high values of VPI (54.6 ± 35.8) and GBI (42.4 ± 33.3). The severity of periodontitis was related to higher mean corpuscular hemoglobin (ß = .291, p = .028) and mean corpuscular volume values (ß = .293, p = .046). Arm circumference measurements were inversely related to CAL ≥3 mm (ß = -.408, p = .023), PPD ≥4 mm (ß = -.475, p = .006), and PPD ≥5 mm (ß = -.443, p = .010). CONCLUSIONS: The findings suggest that the severity and extent of periodontitis may be related to some metabolic parameters in DS patients.
Assuntos
Síndrome de Down , Periodontite , Biomarcadores , Estudos Transversais , Síndrome de Down/complicações , Humanos , Índice Periodontal , Periodontite/complicaçõesRESUMO
OBJECTIVE: Investigate the impact of resveratrol (RESV) on peri-implant repair and its effect on bone-related markers in rats with induced diabetes mellitus (DM). MATERIAL AND METHODS: Ninety rats were divided into: DM + RESV (n = 18); DM + placebo (PLAC) (n = 18); DM + insulin (INS) (n = 18); DM + RESV + INS (n = 18); Non-DM (n = 18). Diabetes was induced by streptozotocin. One screw-shaped titanium implant was inserted in each tibiae of animals. Treatments were administered during 30 days. After, one of the implants was removed for counter-torque and the peri-implant tissue was collected for mRNA quantification of BMP-2, OPN, Runx2, Lrp-5, Osx, ß-catenin, Dkk1, OPG, and RANKL by Real-time PCR. The other tibia was submitted to MicroCT analysis to measure: bone volume (BV/TV), trabecular thickness (Tb.Th) and bone-implant contact (BIC). RESULTS: Higher counter-torque values were observed for implant removal in DM + RESV, DM + RESV + INS and Non-DM groups when compared to DM + PLAC (p < .05). Augmented Tb.Th was observed in DM + RESV and Non-DM when compared to DM + PLAC group (p < .05), whereas higher BIC was detected in DM + RESV, DM + RESV + INS and Non-DM animals when compared to DM + PLAC (p < .05). Levels of RANKL were downregulated by the RESV and/or INS therapy, whereas only the association of RESV and INS upregulated the levels of Runx2 (p < .05). CONCLUSIONS: The therapy with RESV may favour peri-implant bone repair improving bone formation around implants.
Assuntos
Implantes Dentários , Diabetes Mellitus , Animais , Implantes Dentários/efeitos adversos , Expressão Gênica , Osseointegração , Ratos , Ratos Wistar , Resveratrol , Titânio , Torque , Microtomografia por Raio-XRESUMO
OBJECTIVE: To compare the effect of a single-tufted toothbrush combined or not with a conventional toothbrush to control dental biofilm in healthy orthodontic patients. MATERIALS AND METHODS: Twenty orthodontic patients were randomly assigned to receive three different treatments: Group 1-conventional toothbrush; Group 2-single-tufted toothbrush and Group 3-combination of single-tufted and conventional toothbrushes. Stained plaque index (SPI), visible plaque index (VPI) and gingival bleeding index (GBI) were recorded. The data were analysed by Kolmogorov-Smirnov test. Wilcoxon test was used for intragroup comparison and Friedman test for the intergroup comparison (α = 5%). RESULTS: Intragroup analysis showed that VPI and SPI significantly decreased (P < 0.05) after 72 hour in Group 3. Anterior and posterior teeth did not show any significant statistical differences after 72 hour (P > 0.05), but VPI values in the labial surfaces were different to Group 3 (P < 0.05) in comparison with the other groups after 72 hour. Group 3 showed a statistically significant reduction (P < 0.05) for SPI in the interproximal surfaces when compared with Group 1. CONCLUSION: The combination of single-tufted and conventional toothbrushes was effective for controlling dental biofilm formation in orthodontic patients.
Assuntos
Biofilmes/crescimento & desenvolvimento , Higiene Bucal/instrumentação , Aparelhos Ortodônticos/microbiologia , Escovação Dentária/instrumentação , Adulto , Índice de Placa Dentária , Feminino , Humanos , Masculino , Índice Periodontal , Estudos Prospectivos , Estatísticas não Paramétricas , Fatores de Tempo , Adulto JovemRESUMO
Both Systemic Lupus Erythematosus (SLE) and periodontal disease (PD) present a similar immunological profile mainly characterized by altered cytokine levels. In this study we sought to investigate the salivary levels of inflammatory cytokines and their association with PD in SLE patients. 60 patients with SLE and 54 systemically healthy individuals underwent a full periodontal clinical examination. They were then grouped according to their periodontal status. Stimulated saliva was collected in order to evaluate the salivary levels of interferon (IFN-γ), Interleukin (IL)-10, IL-17, IL-1ß, and IL-4. Systemically healthy individuals with periodontitis (group P) presented higher levels of cytokines when compared to systemically healthy individuals, with no periodontal disease (group S) (p<0.05). Additionally, in the P group, patients presented similar levels of cytokines to those of the patients with SLE, regardless of the presence of PD (p>0.05), for most of the analyzed cytokines. There was a positive correlation in SLE patients, including IL-1ß and all periodontal clinical parameters (p<0.05), and between IL-4 and gingival bleeding index and the presence of biofilm (p<0.05). Thus, our results confirmed, that patients with PD showed higher salivary levels of cytokines and, in SLE patients, the increased levels of salivary cytokines were observed even in the absence of periodontitis. IL-1ß and IL-4 salivary levels were also positively correlated with periodontal status indicating their potential as markers of the amount and extent of periodontal damage in patients with SLE.
Assuntos
Citocinas/metabolismo , Inflamação/metabolismo , Lúpus Eritematoso Sistêmico/metabolismo , Doenças Periodontais/metabolismo , Saliva/metabolismo , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Interferon gama/metabolismo , Interleucina-17/metabolismo , Interleucina-1beta/metabolismo , Interleucina-4/metabolismo , Masculino , Pessoa de Meia-Idade , Periodontite/metabolismoRESUMO
The case report aimed at treating a fenestration-type defect with multidisciplinary conventional and advanced surgical techniques. Fenestrations are isolated areas in which the exposed root surface is covered only by the periosteum and gingiva, but the remaining cortical bone remains intact. Root coverage is indicated in cases of root hypersensitivity, treatment of shallow caries lesions, cervical abrasions, and esthetic and cosmetic needs. In this case report, after proper hygiene instruction and dental biofilm control, a fenestration-type defect was treated using guided tissue regeneration (anorganic bovine matrix and resorbable membrane) and a connective tissue grafts, associated to an endodontic apicoectomy. After reevaluation, the remaining gingival recession was treated with a second gingival connective tissue graft covered with q double papillae type in order to reconstruct the periodontal tissues of the involved tooth. In this clinical case, the interaction between the different areas of dentistry has made it possible to correct a fenestration-type defect, following procedures based on scientific evidence, restoring periodontal health, esthetics, self-esteem, and meeting the patient's expectations regarding her initial complaint. This case report shows the important role of interdisciplinary approach to treating a patient with a complex periodontal defect that required different types of knowledge and abilities to achieve the best results based on the current status of dentistry possibilities.
Assuntos
Perda do Osso Alveolar/cirurgia , Dente Canino/cirurgia , Regeneração Tecidual Guiada Periodontal/métodos , Equipe de Assistência ao Paciente , Raiz Dentária/cirurgia , Adulto , Animais , Apicectomia/métodos , Matriz Óssea/transplante , Bovinos , Tecido Conjuntivo/transplante , Gengiva/transplante , Retração Gengival/cirurgia , Xenoenxertos/transplante , Humanos , Maxila/cirurgia , Membranas Artificiais , Retalhos Cirúrgicos/cirurgiaRESUMO
To compare different criteria for the diagnosis of periodontitis and to evaluate the association of this condition with prematurity, this case-control study was conducted on 283 mothers of infants, divided into two groups based on gestational age (cases: <37 weeks, controls: ≥37 weeks), with 71 cases and 212 controls. The periodontal evaluation included probing depth (PD), clinical attachment level (CAL), plaque index, and bleeding on probing (BOP). Participants were classified regarding periodontitis per 14 criteria based on different periodontal parameters. The criterion selected as the gold standard was the presence of at least four teeth with one or more sites with a PD ≥ 4 mm, CAL ≥ 3 mm, and BOP at the same site. The prevalence of periodontal disease ranged from 8.1% to 55.1%. Moreover, compared to the gold standard, the sensitivities of the other criteria were 100%, while specificity ranged from 50.4% to 96.4%. Periodontitis, defined by six of the selected criteria, was associated with prematurity after multivariate adjustment, with OR ranging from 1.85 to 2.69 and 95% CI from 1.01 to 5.56; one of them was the gold standard mentioned above. Measurements using the clinical parameters of PD, CAL, and bleeding at the same site (criteria 5, 6, 7, 8), CPI (criterion 10), and at least four teeth with a PD ≥ 4 mm and CAL ≥ 3 mm (criterion 11) to define periodontitis showed a statistically significant association (p < 0.05). Given this study's limitations, we can conclude that the diagnostic criteria for a periodontitis definition using a PD ≥ 4 mm and CAL ≥ 3 mm in two or more teeth, with BOP at the same site, seem stronger when detecting an association between periodontitis and prematurity.
Assuntos
Doenças Periodontais , Periodontite , Feminino , Humanos , Recém-Nascido , Lactente , Estudos de Casos e Controles , Recém-Nascido Prematuro , Periodontite/diagnóstico , Periodontite/epidemiologia , Periodontite/complicações , Doenças Periodontais/complicações , MãesRESUMO
A successful esthetic outcome for implant-supported dentures depends on the careful manipulation of peri-implant tissue as well as the precise placement of the implant. In addition, careful surgical and prosthetic planning is essential for esthetically important areas, especially in partially edentulous cases. This study describes a clinical case that presented absent maxillary central incisors in which prior prosthetic planning was used to perform provisional restorations, that was used to condition the gingival tissues and guide implant installation. These procedures made it possible to achieve a dentogingival contour, interdental papillae, and an emergence profile in the edentulous area. The techniques outlined here proved to be sufficient and support the peri-implant tissues to create a more esthetic final prosthesis.
Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Gengiva/anatomia & histologia , Planejamento de Assistência ao Paciente , Coroas , Dente Suporte , Implantação Dentária Endóssea/métodos , Prótese Parcial Imediata , Prótese Parcial Temporária , Feminino , Humanos , Incisivo , Arcada Parcialmente Edêntula/reabilitação , Arcada Parcialmente Edêntula/cirurgia , Propriedades de SuperfícieRESUMO
The rotational path of insertion concept for removable partial dentures (RPDs) can be used in esthetically demanding situations. This clinical report describes the treatment of a patient with an anterior maxillary edentulous area using a rotational path RPD. To optimally improve gingival esthetics and to allow proximal retention on the surveyors, a crown-lengthening surgical procedure was performed prior to prosthetic treatment on all teeth involved in this rehabilitation. When correctly planned and fabricated, this prosthesis allows excellent functional and esthetic results, minimizes tooth preparation, and reduces the tendency toward plaque accumulation.
Assuntos
Planejamento de Dentadura , Prótese Parcial Removível , Estética Dentária , Gengiva/anatomia & histologia , Incisivo , Adulto , Aumento da Coroa Clínica , Dente Suporte , Placa Dentária/prevenção & controle , Retenção de Dentadura , Feminino , Humanos , Arcada Parcialmente Edêntula/reabilitação , Maxila/patologia , Planejamento de Assistência ao Paciente , Preparo Prostodôntico do DenteRESUMO
Periodontal ligament cells (PDLC) play a major role in periodontal tissues homeostasis and destruction. Most age-associated diseases seem to be closely related to an underlying chronic inflammatory state. Thus, the present study aimed at evaluating in PDLC the effect of aging on the basal levels of inflammatory and bone-related genes. Primary PDLC cultures were obtained from subjects aged 15-20 years (control- n=5), and subjects aged more than 60 years (test- n=5). Proliferation, cell viability and total secreted protein assays were performed, and mRNA levels were quantitatively assessed for interleukin (IL)-1beta, IL-4, IL-6 and IL-8, and for receptor activator of nuclear factor-kappaB ligand (RANKL) and osteoprotegerin (OPG) by real time PCR. Data analysis demonstrated that aging negatively influenced cell proliferation, whereas cell viability and total secreted protein were not affected (p>0.05). Gene expression analysis showed that mRNA levels for RANKL and IL-8 were not affected by aging (p>0.05) whereas, mRNA levels for IL-4 was significantly lower in aged cells (p<0.05) and OPG, IL-1beta and IL-6 mRNA levels were higher (p<0.05). Data analysis suggests that aging decreased the ability of PDLC to proliferate and modulated the expression of important inflammatory and bone-related genes in periodontal ligament cells, favoring a proinflammatory and an antiresorptive profile.
Assuntos
Envelhecimento/genética , Osso e Ossos/fisiologia , Regulação da Expressão Gênica , Inflamação/genética , Ligamento Periodontal , Adolescente , Idoso , Proliferação de Células , Sobrevivência Celular , Células Cultivadas , Feminino , Humanos , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Interleucina-4/genética , Interleucina-4/metabolismo , Interleucina-6/genética , Interleucina-6/metabolismo , Interleucina-8/genética , Interleucina-8/metabolismo , Masculino , Pessoa de Meia-Idade , Osteoprotegerina/genética , Osteoprotegerina/metabolismo , Ligamento Periodontal/citologia , Ligamento Periodontal/fisiologia , Ligante RANK/genética , Ligante RANK/metabolismo , RNA Mensageiro/metabolismo , Adulto JovemRESUMO
The majority of patients eligible for periodontal regenerative therapies are aged subjects. Since periodontal ligament cells (PDLC) are essential for periodontal regeneration, the aim of the present study was to determine the effect of cellular aging on PDLC, including genes associated with extracellular matrix metabolism and growth-associated factors. PDLC cultures were obtained from subjects aged 15 to 20 years and subjects aged more than 60 years. Proliferation, cell viability, mineralization assays, and mRNA levels were assessed for type I and III collagen, platelet-derived growth factor (PDGF)-1, basic fibroblast growth factor (bFGF), metalloproteinase (MMP)-2 and-8, and tissue inhibitor of metalloproteinases (TIMP)-1 and-2. Data analysis demonstrated that aging negatively influenced cell proliferation and mineral nodule formation (p < 0.05). Gene expression analysis further showed that mRNA levels for bFGF, PDGF-1, and TIMP-2 were not affected by aging (p > 0.05). In addition, mRNA levels for type I and III collagen were significantly lower in aged cells (p < 0.05), whereas MMP-2 and-8 and TIMP-1 mRNA levels were higher (p < 0.05). Within the limits of the present study, data analysis suggests that aging modulates important biological properties of periodontal ligament cells, diminishes the potential for mineral nodule formation, and favors extracellular matrix degradation.
Assuntos
Envelhecimento/fisiologia , Proteínas da Matriz Extracelular/metabolismo , Ligamento Periodontal/fisiologia , Calcificação de Dente/fisiologia , Adolescente , Idoso , Proliferação de Células , Sobrevivência Celular , Células Cultivadas , Feminino , Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Ligamento Periodontal/citologia , Adulto JovemRESUMO
This paper is concerned about dental-derived stem cells and their characterization in vitro and in vivo. Additionally, since conventional periodontal techniques remain insufficient to attain complete and reliable periodontal regeneration, the potential of dental-derived stem cells in promoting periodontal tissue regeneration is also reviewed.
Assuntos
Células-Tronco Adultas/citologia , Ligamento Periodontal/fisiologia , Regeneração , Células-Tronco Adultas/fisiologia , Diferenciação Celular , Humanos , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/fisiologia , Doenças Periodontais/terapia , Ligamento Periodontal/citologia , Engenharia TecidualRESUMO
Experimental studies have shown that the potential of periodontal regeneration seems to be limited by the regenerative capacity of the cells involved. The regeneration of damaged periodontal tissues is mediated by various periodontal cells and is regulated by a vast array of extracellular matrix informational molecules that induce both selective and nonselective responses in different cell lineages and their precursors. In this paper, we first review periodontal ligament tissue and its different cell subpopulations including fibroblasts and paravascular stem cells, and their functions during the development and homeostasis of periodontal tissues. Because conventional periodontal regeneration methods remain insufficient to obtain a complete and reliable periodontal regeneration, the concept of periodontal tissue engineering has been based on the generation of the conditions necessary to improve the healing of periodontal tissues. Additionally, the potential of periodontal ligament cells for use in periodontal tissue engineering to overcome the limitations of conventional periodontal regenerative therapies is discussed, followed by an update of the recent progress and future directions of research utilizing periodontal ligament cells for predictable periodontal regeneration.
Assuntos
Técnicas de Cultura de Células/métodos , Regeneração Tecidual Guiada Periodontal/métodos , Ligamento Periodontal/citologia , Ligamento Periodontal/fisiologia , Engenharia Tecidual/métodos , Animais , Técnicas de Cultura de Células/tendências , Células Cultivadas , Regeneração Tecidual Guiada Periodontal/tendências , Humanos , Engenharia Tecidual/tendênciasRESUMO
BACKGROUND: It has been shown that cigarette smoke inhalation (CSI) and estrogen deficiency (OVX) may affect bone quality around titanium implants; however, their association has not been evaluated. Therefore, this study aimed to verify the effects of CSI associated with OVX on bone healing around titanium implants. METHODS: The tibia surface of 45 female Wistar rats was surgically exposed, and screw-shaped titanium implants were placed. The animals were randomly assigned to OVX (ovariectomized rats; n = 15), SHAM (sham-operated rats; n = 15), and CSI + OVX (4 months of intermittent cigarette smoke inhalation, starting 2 months before implant placement in ovariectomized rats; n = 15). The implants were placed at the time of OVX or SHAM surgery. After 60 days, the animals were sacrificed and undecalcified sections obtained. The percentages of mineralized tissue (bone density [BD]) in a 500-microm-wide zone lateral to the implant, bone filling (BF) within the limits of the threads, and bone-to-implant contact (BIC) were measured in cortical (zone A) and cancellous (zone B) bone. RESULTS: In zone A, the CSI + OVX group showed a significant difference regarding BIC and BD (P <0.05) compared to the other groups. In zone B, data analysis showed that the CSI + OVX group presented the lowest percentage of BD and BIC, followed by the OVX and SHAM groups, respectively (P <0.05). CONCLUSION: Within the limits of the present study, it can be concluded that cigarette smoke inhalation amplified the deleterious effects of estrogen deficiency, affecting both preexisting and newly formed bone in the cortical and cancellous bone around titanium implants.
Assuntos
Estrogênios/deficiência , Implantes Experimentais , Osseointegração/fisiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Animais , Densidade Óssea , Feminino , Ovariectomia , Ovário/fisiologia , Distribuição Aleatória , Ratos , Ratos Wistar , Tíbia , TitânioRESUMO
OBJECTIVE: Periodontal disease is a set of inflammatory infections that affect the supporting structures of the dentition. Patients with visual impairment (VI) may have more difficulty in cleaning and maintaining oral health. The purpose of this study was to investigate the possible relationship between periodontal status and degree of VI in institutionalized individuals. MATERIALS AND METHODS: Fifty-two visually impaired individuals were included in this cross-sectional study. The periodontal parameters assessed were clinical attachment level (CAL), probing depth (PD), and visible plaque index. The degree of VI was established as: Group 1 (mild or moderate VI), Group 2 (severe or profound VI), and Group 3 (completely blind); and the types of VI were considered as congenital and acquired. Fisher's exact, Kruskal-Wallis, Mann-Whitney, and Spearman correlation coefficient test were used. The level of significance was set at 5%. RESULT: Only plaque index was higher on proximal surfaces of subjects with mild/moderate VI when compared to the other degrees of VI (P = 0.01). Furthermore, we observed higher values for interproximal CAL (P = 0.01), total PD (P = 0.04), and interproximal PD in subjects with acquired VI when compared to subjects with congenital VI (P = 0.01). CONCLUSIONS: These findings suggest that periodontal status may be more related to the type of disability than with the degree of VI. Acquired VI people presented a worse periodontal health than the group with congenital VI.
RESUMO
BACKGROUND: The aim of this clinical study was to evaluate the association of locally delivered doxycycline (10%) with scaling and root planing in the periodontal treatment of smokers. METHODS: Forty-three patients with chronic periodontitis and a minimum of four pockets (> or = 5 mm) on anterior teeth that bled on probing were selected. Patients were randomly assigned to scaling and root planing (SRP) or scaling and root planing followed by local application of doxycycline (SRP-D). Plaque, bleeding on probing, gingival recession, relative attachment level (RAL), and probing depth (PD) were recorded at baseline, 45 days, and 3 and 6 months. Differences between baseline and each period were considered for analysis. RESULTS: At 6 months, no difference was found between groups regarding plaque, bleeding reduction, gingival recession or PD (P > 0.05). However, RAL gain was greater for SRP-D (1.63 +/- 0.93 mm) than for SRP (1.04 +/- 0.71 mm) (P = 0.025). In addition, deep pockets (> or = 7 mm) showed a significant reduction (3.78 +/- 1.41 versus 2.60 +/- 1.28 mm, P = 0.039) and RAL gain (2.54 +/- 1.27 mm versus 1.29 +/- 0.95 mm, P = 0.01) when doxycycline was applied. The proportion of sites showing RAL gain of 1 to 2 mm was 36.8% versus 21.7% for SRP-D and SRP, respectively (P = 0.01). CONCLUSION: The use of locally delivered doxycycline may constitute an important adjunct for the treatment of severe periodontal disease in smokers.
Assuntos
Antibacterianos/uso terapêutico , Raspagem Dentária , Doxiciclina/uso terapêutico , Periodontite/terapia , Aplainamento Radicular , Fumar , Administração Tópica , Adulto , Análise de Variância , Antibacterianos/administração & dosagem , Doença Crônica , Índice de Placa Dentária , Doxiciclina/administração & dosagem , Feminino , Seguimentos , Hemorragia Gengival/tratamento farmacológico , Hemorragia Gengival/terapia , Retração Gengival/tratamento farmacológico , Retração Gengival/terapia , Humanos , Masculino , Perda da Inserção Periodontal/tratamento farmacológico , Perda da Inserção Periodontal/terapia , Bolsa Periodontal/tratamento farmacológico , Bolsa Periodontal/terapia , Periodontite/tratamento farmacológico , Estudos Prospectivos , Método Simples-CegoRESUMO
Two case reports are presented in which the radiographic characteristics induced initially incorrect diagnoses. Only after combined clinical and radiographic examinations were the appropriate diagnoses achieved. This article demonstrates the need for close cooperation between periodontists and endodontists to diagnose periradicular lesions accurately.
Assuntos
Erros de Diagnóstico , Doenças Periapicais/diagnóstico , Bolsa Periodontal/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Intermittent administration of parathyroid hormone (PTH) promotes new bone formation in patients with osteoporosis and bone fractures. It was shown previously that PTH also reduces periodontitis-related bone loss. The aim of this study is to evaluate the effect of treatment with PTH on periodontal healing in rats. METHODS: Fenestration defects were created at the buccal surface of the distal root of the mandibular first molars, and both periodontal ligament (PDL) and cementum were removed. Animals were then assigned to two groups (eight animals per group): group 1: control, placebo administration; and group 2: test, human PTH (hPTH) 1-34 administration at a concentration of 40 µg/kg. For both groups, the animals were injected every 2 days, and the animals were sacrificed at 14 and 21 days after surgery. Specimens were harvested and processed for routine decalcified histologic sections. The following parameters were assessed: 1) remaining bone defect extension (RBDE); 2) newly formed bone density (NFBD); 3) total callus area (TCA); 4) osteoclast number (ON) in the callus region; and 5) newly formed dental cementum-like tissue (NFC). Birefringence of root PDL reattachment was also evaluated. RESULTS: Birefringence analysis showed root PDL reattachment for both groups 21 days after treatment. Intermittent hPTH 1-34 administration decreased RBDE (P <0.01) and increased NFBD (P <0.01), TCA (P <0.01), area of NFC (P <0.01), and ON in the callus region (P <0.01). CONCLUSION: Within the limits of the present study, intermittent administration of hPTH 1-34 led to an enhanced periodontal healing process compared with non-treated animals.
Assuntos
Perda do Osso Alveolar/tratamento farmacológico , Hormônio Paratireóideo/uso terapêutico , Fosfatase Ácida/análise , Administração Metronômica , Animais , Densidade Óssea/efeitos dos fármacos , Calo Ósseo/efeitos dos fármacos , Calo Ósseo/patologia , Contagem de Células , Cementogênese/efeitos dos fármacos , Cemento Dentário/efeitos dos fármacos , Cemento Dentário/patologia , Injeções Subcutâneas , Isoenzimas/análise , Masculino , Doenças Mandibulares/tratamento farmacológico , Osteoclastos/efeitos dos fármacos , Osteoclastos/patologia , Osteogênese/efeitos dos fármacos , Hormônio Paratireóideo/administração & dosagem , Ligamento Periodontal/efeitos dos fármacos , Ligamento Periodontal/patologia , Placebos , Ratos , Ratos Wistar , Fosfatase Ácida Resistente a Tartarato , Fatores de Tempo , Raiz Dentária/efeitos dos fármacos , Raiz Dentária/patologia , Cicatrização/efeitos dos fármacosRESUMO
ABSTRACT Objective: To evaluate the association of glycemic control and cytokine production in type 2 diabetic subjects with chronic periodontitis Methods: Gingival biopsies were performed in 40 patients, divided into four groups: systemically healthy subjects without periodontal disease (S); systemically healthy patients with chronic periodontitis (P); patients with well-controlled type 2 diabetes mellitus (DM) with chronic periodontitis (C); poorly controlled type 2 diabetes mellitus with chronic periodontitis (D). The production of interleukin (IL) -4, -6, -10, -17 and interferon (IFN) -γ was quantified by ELISA. Results: The production of IL-4, IL-10, IL-17 and INF-γ was higher on group D when compared to other groups (p <0.05), which in turn were similar (p ≥0.05). In addition, there was no difference in the production of IL-6 in any of the evaluated groups (p≥0.05). Conclusion: Were observed significantly elevated levels of pro-inflammatory and anti-inflammatory cytokines in patients with poorly controlled type 2 diabetes and chronic periodontitis, demonstrating that glycemic control may be associated to the immune inflammatory response of sites with chronic periodontitis.
RESUMO Objetivo: Avaliar a associação do controle glicêmico e a produção de citocinas em indivíduos diabéticos tipo 2 com doença periodontal crônica. Métodos: Foram realizadas biópsias gengivais de 40 pacientes, distribuídos nos seguintes grupos: sistemicamente saudáveis sem doença periodontal (S); pacientes sistemicamente saudáveis com periodontite crônica (P); pacientes com diabetes mellitus (DM) tipo 2 controlado com periodontite crônica (C); pacientes com diabetes mellitus tipo 2 não controlado com periodontite crônica (D). Foram quantificadas através de ELISA, a produção das interleucinas (IL) -4, -6, -10, -17 e interferon (IFN) -γ. Resultados: A produção de IL-4, IL-10, IL-17 e INF-γ foi maior no grupo D quando comparada aos demais grupos (p<0.05), que por sua vez foram similares entre si (p≥0.05). Além disso, não houve diferença na produção de IL-6 em nenhum dos grupos avaliados (p≥0.05). Conclusão: Foram observados níveis significativamente elevados de citocinas pró-inflamatórias e anti-inflamatórias nos pacientes com diabetes mellitus tipo 2 não controlado e com periodontite crônica, demonstrando que o controle glicêmico pode estar associado com a resposta imunoinflamatória de sítios com periodontite crônica.
RESUMO
Objective: To evaluate the association of glycemic control and cytokine production in type 2 diabetic subjects with chronic periodontitis. Methods: Gingival biopsies were performed in 40 patients, divided into four groups: systemically healthy subjects without periodontal disease (S); systemically healthy patients with chronic periodontitis (P); patients with well-controlled type 2 diabetes mellitus (DM) with chronic periodontitis (C); poorly controlled type 2 diabetes mellitus with chronic periodontitis (D). The production of interleukin (IL) -4, -6, -10, -17 and interferon (IFN) -g was quantified by ELISA. Results: The production of IL-4, IL-10, IL-17 and INF-g was higher on group D when compared to other groups (p <0.05), which in turn were similar (p ³0.05). In addition, there was no difference in the production of IL-6 in any of the evaluated groups (p³0.05). Conclusion: Were observed significantly elevated levels of pro-inflammatory and anti-inflammatory cytokines in patients with poorly controlled type 2 diabetes and chronic periodontitis, demonstrating that glycemic control may be associated to the immune inflammatory response of sites with chronic periodontitis.
Objetivo: Avaliar a associação do controle glicêmico e a produção de citocinas em indivíduos diabéticos tipo 2 com doença periodontal crônica. Métodos: Foram realizadas biópsias gengivais de 40 pacientes, distribuídos nos seguintes grupos: sistemicamente saudáveis sem doença periodontal (S); pacientes sistemicamente saudáveis com periodontite crônica (P); pacientes com diabetes mellitus (DM) tipo 2 controlado com periodontite crônica (C); pacientes com diabetes mellitus tipo 2 não controlado com periodontite crônica (D). Foram quantificadas através de ELISA, a produção das interleucinas (IL) -4, -6, -10, -17 e interferon (IFN) -g. Resultados: A produção de IL-4, IL-10, IL-17 e INF-g foi maior no grupo D quando comparada aos demais grupos (p<0.05), que por sua vez foram similares entre si (p³0.05). Além disso, não houve diferença na produção de IL-6 em nenhum dos grupos avaliados (p³0.05). Conclusão: Foram observados níveis significativamente elevados de citocinas pró-inflamatórias e anti-inflamatórias nos pacientes com diabetes mellitus tipo 2 não controlado e com periodontite crônica, demonstrando que o controle glicêmico pode estar associado com a resposta imunoinflamatória de sítios com periodontite crônica.