RESUMO
Pain, bad taste, and impaired daily activity after implant therapy are common sequelae. Concentrated growth factors (CGF) are a platelet concentrate with a favourable effect on wound healing, but there is still no evidence regarding its potential benefits for reducing postoperative pain and symptoms. Therefore, aim of this prospective comparative study was to determine the effect of CGF on quality of life (QoL) of patients after implant therapy. Fifty-two consecutive patients with one missing mandibular molar were included in the study and alternatively assigned to two groups. Control group received standard implant treatment, and test group received CGF associated with implants. Standard periapical radiographs were taken before and after procedure. Post-operative care consisted of 0.2% chlorhexidine digluconate solution twice daily for 10 days. A QoL questionnaire (OHIP-14) for bad taste, pain and limitation in daily activities was filled and returned one week post-operatively. Daily pain was also assessed through Visual Analogue Scale (VAS) on a 1-100 scale. Parametric test (chi-square) was performed to compare the results of the questionnaire between the two groups using STATA statistical software. All patients correctly filled and returned the questionnaire. Significantly higher proportions of patients of test group reported no bad taste, pain, and limited activity, (24/26, 13/26, and 25/26, respectively) respect to control. Postoperative pain with VAS score was significantly lower in the test group on day 1, 2, and 3 as compared to control. CGF positively influenced QoL when associated with implant rehabilitation of mandibular molars, minimizing post-operative discomfort.
Assuntos
Dor Pós-Operatória , Qualidade de Vida , Estudos de Coortes , Humanos , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Estudos ProspectivosRESUMO
The objective of the research was to evaluate the location, size, variability, and morphologic features of mental foramen (MF) and the inferior alveolar nerve canal (IAN) on cone-beam CT. We evaluated the morphologic findings of mental foramen (MF) and inferior alveolar nerve (IAN) canal of 88 mandibular hemiarches of 65 Caucasian subjects (35 males, 30 females; age range 25-75 years) using cone beam CT. The most common horizontal position of MF was type 3 (53.4%), followed by type 4 (39.8%), type 1 (2.3%), type 2 (2.3%), and type 5 (2.3%). Regarding the vertical position, in 71.6% of cases (63/88) we found type 3 position, followed by type 2 (22.7%) and type 1 (5.7%). MF presented as oval in 51.1% and round in 42%, with double oval and triple foramens having been observed in 5.7% and 1.1% respectively. In 36.9% of cases, we found an anterior loop of the IAN. The mean depth of MF was 6.12±1.65mm; width and height were 3.7±0.83mm and 3.14±0.78mm. Width and height of the IAN distal to MF were 2.27±0.53mm and 2.74±0.51mm, while those of the incisive nerve canal mesial to MF were 1.37±0.44mm and 1.54±0.58mm, respectively. An increase in the width of MF was correlated to oval shape (r=0.45; P < 0.01), and there was a low but significant correlation (r=0.23; P < 0.05) between the round shape of MF and the size of the IAN. MF shape appears to be correlated to MF width and size of the IAN. The individual anatomical variability of this structure is a factor that must be considered when dealing with mandibular surgery.
Assuntos
Forame Mentual , Adulto , Idoso , Computadores , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Nervo Mandibular/diagnóstico por imagem , Pessoa de Meia-IdadeRESUMO
Geographic tongue (GT), a form of inverse psoriasis, is frequently linked to plaque psoriasis. The objective of the study is to evaluate IL-17 blocker (secukinumab) effect on GT severity. This reallife, multicenter, retrospective observational pilot study evaluated patients with plaque psoriasis and concomitant GT that started in label treatment with secukinumab. Patients were evaluated twice (T0=baseline and T1=after 16 weeks) by a dentist and a dermatologist collecting data on cutaneous Psoriasis Area Severity Index (PASI) and oral statuses using Hume's classification of the Geographic Tongue Severity Index (GTASI). Twenty-nine psoriatic patients with GT treated with secukinumab were enrolled for the study. Seventeen patients display type I GT, 6 type II and 6 type III with an overall GTASI of 25.52±9.57 at the baseline (T0). No correlation was found between delta GTASI and delta PASI (r=-0.27, p=0.1551). GTASI decrement from T0 to T1 was statistically significant ([95%CI -26.64 to -19.56], t=-13.36, p<0.0001). Secukinumab may enter in GT therapeutic armamentarium as the first biologic IL-17 blocker in patients with concomitant moderate-to-severe plaque psoriasis.
Assuntos
Glossite Migratória Benigna , Psoríase , Anticorpos Monoclonais , Anticorpos Monoclonais Humanizados , Humanos , Psoríase/tratamento farmacológico , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Geographic tongue (GT) represents a localized type of psoriasis inversa and its burden of dermatological and oral comorbidities frequently conditions its severity and diagnosis. Currently, no epidemiological studies have evaluated GT muco-cutaneous comorbidities. We aimed to study oral and dermatological comorbidities in a large sample of GT patients. In this multicenter, cross-sectional study, involving 4 primary referral centers in Italy, we evaluated adult GT patients, who were assessed by board certified dermatologists and dentists for 5 months and collected demographics and medical history. GT was evaluated using Hume's classification together with Geographic tongue severity index (GTASI) to score its severity. The prevalence of oral and dermatological comorbidities was recorded. In the sample we enrolled 137 GT patients (M/F= 5:1) with a mean age of 48,2 ± 14,7 yoa and 33.6% had GT family history. The clinical evaluation found 96 (70.1%) GT type I, 7 (5.1%) type II, 13 (9.5%) type IIIa, 19 (13.9%) type IIIb, 2 (1.5%) type IV, following Hume's classification. The mean GTASI score was 23,7 ± 14,2 and the vast majority displayed a severe form of GT. Eighty-nine patients had oral comorbidities (burning mouth syndrome, caries, parulid and lichen planus) and 80 had dermatological concurrent conditions (plaque psoriasis, inverse psoriasis and atopic dermatitis). In GT patients, both dermatological and dental evaluation should be mandatory to identify previously undiagnosed mucocutaneous comorbidities.
Assuntos
Glossite Migratória Benigna , Psoríase , Adulto , Estudos Transversais , Glossite Migratória Benigna/epidemiologia , Humanos , Itália/epidemiologia , Prevalência , Psoríase/epidemiologiaRESUMO
PURPOSE: To assess the clinical and radiographic success rate of microsurgical endodontic treatment of upper molar teeth in relationship with the maxillary sinus, with 12 months follow-up. METHODS: Patients treated with microsurgical endodontic treatment of upper molar teeth in the period between 2017 and 2019 were recruited from two dental clinics according to specific selection criteria. The outcomes were determined based on clinical and radiographic results taken three, six and 12 months post-operatively, compared with those taken immediately before and after surgery. Clinical and radiographic outcomes were recorded. The distance between the most apical part of the root and of the lesion to the maxillary sinus was measured on CBCT images before the surgery. Patient-related outcomes were recorded. RESULTS: Out of 35 patients evaluated, 21 were selected according with the selection criteria for a total of 27 roots and 29 canals treated. After 12 months, 18 patients showed a complete healing whereas three demonstrated incomplete healing. Consequently, the success rate in this study was 85.7% after one year. In 28.5% (6 patients) there was a perforation of the Schneiderian membrane that didn't seem to affect the outcome. All patients kept the molar one year later. The pain level decreased significantly over the time during the first week after surgery. CONCLUSION: Microsurgical Endodontic treatment of the upper molar teeth should be considered a valid and predictable treatment option even in case of Schneiderian membrane perforation. Future clinical studies with a larger sample size are needed to compare the results obtained.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Seio Maxilar , Humanos , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Mucosa Nasal , Estudos Retrospectivos , Raiz DentáriaRESUMO
Aim of this retrospective study was to evaluate the one-year clinical and radiographic outcomes of implants with a triangular shaped neck inserted immediately after tooth extraction in esthetic zones. Patients in which immediate postextraction implants were placed and restored in the anterior maxilla, who underwent a Cone Beam Computed Tomograpy (CBCT) at baseline and after 12-16 months were included. The socket was preserved using deproteinized bovine bone to fill the buccal gap, and a resorbable collagen membrane. One-year implant survival and prosthesis success were evaluated. Hard and soft tissue stability was assessed by measuring various parameters on CBCT images. Clinical evaluation was also performed and Pink Esthetic Score (PES) assessed. Data from baseline and one-year follow-up were statistically compared using paired tests and a significance threshold of p=0.05. Twenty patients (13 males, 7 females, mean age 50.42±11.35 years) were included. Each contributed with one implant. No implant was lost. A significant improvement in PES was detected. Excellent hard and soft tissue preservation was observed after one year of function. Immediate placement of implants with a triangular shaped neck after tooth extraction, can be a suitable solution even for areas with a high aesthetic demand, such as the anterior maxilla.
Assuntos
Implantes Dentários , Carga Imediata em Implante Dentário , Maxila , Adulto , Animais , Bovinos , Estética Dentária , Feminino , Seguimentos , Xenoenxertos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Extração Dentária , Alvéolo Dental , Resultado do TratamentoRESUMO
This study investigates the characteristics of load transmission to bone of alternative treatments for posterior maxilla edentulism with relatively limited available bone volume. Implant shape (conical and cylindrical), augmentation technique and the effect of bone-graft stiffness were taken into consideration. The finite element models of the atrophic sinus implanted with short implant were compared to two grafted-sinus models implanted with longer implants, engaged bicortically. Bone-graft stiffness was varied to describe different stages of graft-maturation (from short-term to long-term). Stress and load distributions due to axial and bending loads were compared on the bony structures. In the short-term, axial force is supported almost equally by the cortical layers and the trabecular core, while a bending load is mainly supported by the crestal cortical layer and secondarily by the cortical floor, the bone-graft supported a negligible load. Bicortical engagement produces higher load transfer to the cortical floor under axial load. In the long-term, as the stiffness of the bone-graft increases, the load is transferred progressively towards the grafted region, progressively unloading other structures, particularly the internal cortical layer.
Assuntos
Transplante Ósseo , Implantes Dentários , Seio Maxilar/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Humanos , Maxila/cirurgiaRESUMO
AIM: To compare the impact of rotary and reciprocating instrumentation on postoperative quality of life (POQoL) after single-visit primary root canal treatment. METHODOLOGY: A randomized controlled clinical trial was designed and carried out in a University endodontic practice in northern Italy. Healthy subjects with asymptomatic irreversible pulpitis, symptomatic irreversible pulpitis or pulp necrosis with or without apical periodontitis (symptomatic or asymptomatic) scheduled for primary root canal treatment were enrolled. Single-visit root canal treatment was performed with ProTaper™ S1-S2-F1-F2 (rotary group, n = 23) and WaveOne™ Primary (reciprocating group, n = 24). Irrigation was performed with 5% NaOCl and 10% EDTA. Root canal filling was performed with the continuous-wave technique and ZOE sealer. POQoL indicators were evaluated for 7 days post-treatment. The variation of each indicator over time was compared using anova for repeated measures (P < 0.05). The impact of each variable on POQoL was analysed with a multivariate logistic regression model (P < 0.05). RESULTS: Pain curves demonstrated a more favourable time-trend in the rotary group (mean, P = 0.077; maximum, P = 0.015). Difficulty in eating (P = 0.017), in performing daily activities (P = 0.023), in sleeping (P = 0.021) and in social relations (P = 0.077), was more evident in the reciprocating group. Patients' perception of the impact of treatment on POQoL was more favourable in the rotary group (P = 0.006). Multirooted tooth type and pre-existing periradicular inflammation were associated with a decrease in POQoL. CONCLUSION: Reciprocating instrumentation affected POQoL to a greater extent than rotary instrumentation.
Assuntos
Necrose da Polpa Dentária/terapia , Dor Pós-Operatória , Pulpite/terapia , Qualidade de Vida , Preparo de Canal Radicular/instrumentação , Adolescente , Adulto , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Preparo de Canal Radicular/métodos , Autorrelato , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVES: The aim of this study was to make a comparative evaluation of professional oral hygiene with or without the adjunct of glycine air-powder system for the treatment of peri-implant mucositis. METHODS: After the application of inclusion and exclusion criteria, patients were divided in two groups: in control group, patients were treated with professional oral hygiene manoeuvres (POH) while in the test group, glycine air-powder system (SGA) was adjuncted to professional oral hygiene. Probing depth (PD), bleeding index (BI) and plaque index (PI) were measured at baseline, and 3 and 6 months after the treatment. RESULTS: A total of 30 patients (15 per group) were selected for the study. In POH e SGA group, PD was, 2.86 ± 0.37 and 3.00 ± 0.36 mm at baseline, 2.90 ± 0.53 and 2.62 ± 0.50 mm after 3 months, 2.96 ± 0.56 and 2.41 ± 0.54 mm after 6 months, respectively, significantly lower in SGA group in the last follow-up visit. In both groups, both PI and BI decreased over time. CONCLUSIONS: The present reports showed that both techniques were useful for the treatment of peri-implant mucositis. In the test group (with glycine powder), a significant reduction of probing depth was observed.
Assuntos
Implantes Dentários , Glicina/uso terapêutico , Desbridamento Periodontal/métodos , Estomatite/terapia , Idoso , Índice de Placa Dentária , Prótese Dentária Fixada por Implante , Prótese Total Inferior , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal/educação , Satisfação do Paciente , Índice Periodontal , Bolsa Periodontal/terapia , Resultado do Tratamento , Escala Visual AnalógicaRESUMO
OBJECTIVE: The aim of this study was to compare the use of two chlorhexidine-based antimicrobial agents as an adjunct to mechanical therapy for the treatment of peri-implant mucositis. MATERIALS AND METHODS: Thirty patients with peri-implant mucositis were included in the study and randomized in two groups. In addition to mechanical therapy, group A was treated with chlorhexidine 0.2% mouthwash, while group B was treated with chlorhexidine 1% gel. Probing depth, plaque index and bleeding index were recorded at each scheduled follow-up visit: ten days, 1 month and 3 months after giving the patients the assigned formulation. Patients had to fill in a questionnaire investigating their satisfaction and ease of use of the product. RESULTS: A total of 23 patients (13 in group A and 10 in group B) attended all the follow-up visits. Chlorhexidine 0.2% mouthwash and chlorhexidine 1% gel were equally useful in the treatment of peri-implant mucositis leading to the reduction in inflammatory parameters. Probing depth decreased over time in both groups. Patients showed preference for gel formulation even if they found it more difficult to use. CONCLUSIONS: Adjunctive treatment with different chlorhexidine formulations was beneficial to the treatment of peri-implant mucositis. Besides, no differences could be found between 0.2% mouthwash and 1% gel.
Assuntos
Anti-Infecciosos Locais/administração & dosagem , Clorexidina/administração & dosagem , Implantes Dentários/efeitos adversos , Estomatite/tratamento farmacológico , Idoso , Projeto do Implante Dentário-Pivô , Placa Dentária/tratamento farmacológico , Placa Dentária/terapia , Índice de Placa Dentária , Raspagem Dentária , Feminino , Seguimentos , Géis , Hemorragia Gengival/tratamento farmacológico , Hemorragia Gengival/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/administração & dosagem , Satisfação do Paciente , Índice Periodontal , Bolsa Periodontal/tratamento farmacológico , Bolsa Periodontal/terapia , Estomatite/terapiaRESUMO
OBJECTIVE: The aim of this study was to evaluate the effect of mouthrinses containing 0.05% chlorhexidine + 0.05% fluoride solution on early dental plaque regrowth. MATERIALS AND METHODS: Thirty periodontally healthy subjects were included in the study. A crossover 4-day plaque regrowth protocol was adopted. The test product was initially used in 15 patients, while a placebo was administered to the other 15 patients. Then, after a washout period, each patient used the other product. No other oral hygiene manoeuvre was allowed. Full-mouth plaque and bleeding scores (FMPS and FMBS) were evaluated at baseline and after 4 days. RESULTS: All subjects completed the study. The mean age was 27 ± 8.4 years. Five patients were smokers with a mean daily consumption of 1 ± 2.5 cigarettes. FMPS at baseline was 8.0 ± 4.4 for control group and 7.9 ± 3.8 for test group, without significant difference. After the 4-day plaque regrowth the mean FMPS significantly increased to 31.9 ± 16.5 and 36.3 ± 16.1 for control and test group, respectively (no significant difference between the two groups). CONCLUSIONS: The test product was safe and well tolerated by subjects. The similar outcomes of the two experimental groups suggest that the two products have an equivalent effect on early dental plaque regrowth. Studies with longer follow-up are needed to clarify whether there is a beneficial long-term effect of daily rinses with the tested solution.
Assuntos
Clorexidina/uso terapêutico , Placa Dentária/prevenção & controle , Fluoretos/uso terapêutico , Antissépticos Bucais/uso terapêutico , Adulto , Clorexidina/análogos & derivados , Clorexidina/química , Estudos Cross-Over , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Fluoretos/química , Humanos , Masculino , Antissépticos Bucais/química , Índice Periodontal , Prevenção Secundária , Fumar , Adulto JovemRESUMO
This study evaluated the electromyographic (EMG) characteristics of masticatory muscles in patients with fixed implant-supported prostheses according to All-on-Four(®) principles and in control healthy dentate subjects. Twenty-six subjects aged 50-74 years were examined. Eighteen were edentulous and had been successfully rehabilitated with (i) mandibular All-on-Four(®) implant-supported fixed prostheses and maxillary complete dentures (10 patients) and (ii) mandibular and maxillary All-on-Four(®) implant-supported fixed prostheses (eight patients). Eight reference subjects had natural dentition. Surface EMG recordings of the masseter and temporalis muscles were performed during maximum voluntary teeth clenching and during unilateral gum chewing. All values were standardised as percentage of a maximum clenching on cotton rolls. During clenching, a good global neuromuscular equilibrium was found in all participants. During chewing, all groups had similar values of working-side muscle activities and of chewing frequency. No significant differences in the analysed EMG parameters were found between the patients with mandibular and maxillary All-on-Four(®) implant-supported prostheses and the reference subjects. In contrast, standardised pooled muscle activities and standardised muscular activities per cycle were larger in patients with a maxillary removable prosthesis than in control subjects (Kruskal-Wallis test, P < 0·01). Also, patients wearing a complete maxillary denture showed a poor neuromuscular coordination with altered muscular pattern and lower values of the index of masticatory symmetry than dentate control subjects (P < 0·01). EMG outcomes suggest that All-on-Four(®) implant-supported prostheses may be considered a functionally efficient treatment option for the rehabilitation of edentulous patients with reduced residual bone volume.
Assuntos
Prótese Dentária Fixada por Implante , Eletromiografia , Músculos da Mastigação/fisiologia , Idoso , Análise de Variância , Estudos de Casos e Controles , Feminino , Humanos , Itália , Masculino , Músculo Masseter/fisiologia , Pessoa de Meia-Idade , Estatísticas não Paramétricas , Músculo Temporal/fisiologiaRESUMO
AIM: Occlusal loading has to be considered a key factor influencing bone resorption due to the stress transmitted to surrounding tissues by the implant-abutment structure. The aim of this study was to evaluate, through a photo-elastic investigation, the patterns of tensions distribution of two different implant shapes, which were cylindrical and conical. METHODS: A 100N load was applied to two implant-abutment structures (with and without a metal-ceramic crown) incorporated in photo-elastic resin. Modification in light refraction were recorded and analyzed through a computerized software. Measurements of stripe extension and position were evaluated. RESULTS: Stress distribution around tapered implant was evaluated to be more uniform than in cylindrical one which demonstrated a high stress concentration at the more cervical region and in the apical region. The presence of a metal-ceramic crown caused an increase in tensions at the implant-resin interface. CONCLUSION: Conical implants distributed stresses to a larger and well-defined volume of resin and this can cause a decrease of forces acting at the interface. This could be due to the "wedge effect" of this fixture shape which could be considered superior in terms of stress distribution than cylindrical one.
Assuntos
Implantes Dentários , Planejamento de Prótese Dentária , Análise do Estresse Dentário , Teste de MateriaisRESUMO
OBJECTIVE: The aim of this prospective study was to assess the outcomes of an implant maintenance protocol for implants supporting a full-arch rehabilitation. MATERIALS AND METHODS: Sixty-one patients (28 women and 33 men) treated with immediately loaded full-arch rehabilitation, both mandibular and maxillary, supported by a combination of two tilted and two axial implants, were included in the study. Patients were scheduled for follow-up visits every 6 months for +2 years, then yearly up to 4 years. Each patient received professional oral hygiene treatment and detailed oral hygiene instructions. During each visit, modified plaque index, bleeding index and probing depth were assessed. The presence of peri-implant tissue inflammation was also evaluated. RESULTS: Mean observation time, considering both mandible and maxilla, was 18.3 months ranging from 6 months to 5 years. Both plaque and bleeding indexes frequency decreased over time. Probing depth was stable (2.46 ± 0.5 mm at 4 years). Only three implants were lost due to peri-implantitis (1.4% at 12 months), whereas the incidence of peri-implant mucositis was less than 10% in each considered period. CONCLUSIONS: The adoption of a systematic hygienic protocol is effective in keeping low the incidence of peri-implant mucositis as well as in controlling plaque accumulation and clinical attachment loss.
Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Prótese Total , Carga Imediata em Implante Dentário , Higiene Bucal , Peri-Implantite/prevenção & controle , Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico , Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Falha de Restauração Dentária , Feminino , Seguimentos , Gengivite/prevenção & controle , Educação em Saúde Bucal , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal/instrumentação , Educação de Pacientes como Assunto , Índice Periodontal , Bolsa Periodontal/prevenção & controle , Estudos Prospectivos , Estomatite/prevenção & controle , Escovação Dentária/instrumentação , Resultado do TratamentoRESUMO
In certain clinical conditions when endodontic treatment is either impractical or unlikely to improve the previous results, tooth extraction and replacement with a dental implant becomes a viable alternative. Although the presence of active infection has long been considered a major contraindication to the insertion of implants immediately following tooth extraction, several articles assessing this treatment modality reported excellent and promising results. The aim of this literature review is to evaluate and discuss the clinical outcome of implants placed immediately following extraction in endodontically infected sockets. A Medline and EMBASE search was performed to identify articles published from 1966 to 2010 using the keywords "dental implants", "immediate implant", "extraction socket", "infected teeth", "infected site", "infected socket". No restrictions were placed regarding the study design. Only clinical articles with at least 6 months of follow-up were included. The available relevant literature concerning this topic was limited, and based on relatively low level of evidence study designs with limited follow-up periods. However, the data analysis of the selected articles showed that an immediate implant insertion in endodontically infected sites following tooth extraction and careful debridement of the socket, could be a predictable viable technique. Additional large scaled, well-designed studies are required in order to further assess the clinical applications of this treatment alternative.
Assuntos
Implantação Dentária/métodos , Doenças da Polpa Dentária/microbiologia , Alvéolo Dental/microbiologia , Desbridamento , Implantes Dentários , Humanos , Fatores de Tempo , Extração DentáriaRESUMO
BACKGROUND: The aim of the study was to evaluate the use of enamel matrix derivative (EMD) alone or in association with deproteinized bovine bone mineral (DBBM) for the treatment of partially contained intrabony defects. METHODS: A total of 20 two-walled intrabony defects belonging to nine patients were included. Ten defects were treated with EMD alone (test group 1) and the other 10 were treated with EMD and DBBM (test group 2), applying either modified papilla preservation technique or simplified papilla preservation technique. RESULTS: Twelve months after surgery, in the test group 1, PD was 2.8 ± 0.8 mm, REC was 2.3 ± 2.4 mm and CAL was 5.0 ± 2.8 mm, significantly reduced from baseline values (P < 0.05). Likewise, in test group 2, PD, REC and CAL reduced to 3.0 ± 0.7 mm, 3.9 ± 1.5 mm and 6.9 ± 1.1 mm respectively, from baseline values at 12 months (P < 0.05). No significant differences between groups were found. CONCLUSIONS: The results showed that the use of EMD alone and the use of a combination of EMD and DBBM for the treatment of partially contained defects showed comparable clinical and radiographic outcomes after 12 months.
Assuntos
Perda do Osso Alveolar , Substitutos Ósseos/uso terapêutico , Periodontite Crônica , Proteínas do Esmalte Dentário , Regeneração Tecidual Guiada Periodontal/métodos , Perda do Osso Alveolar/cirurgia , Animais , Regeneração Óssea , Bovinos , Periodontite Crônica/cirurgia , Proteínas do Esmalte Dentário/uso terapêutico , Seguimentos , Defeitos da Furca/cirurgia , Humanos , Perda da Inserção Periodontal , Bolsa Periodontal , Resultado do TratamentoRESUMO
Objectives The aim of this study was to evaluate the patients' willingness to pay (WTP) values and preference for the treatment of a tooth with very poor prognosis, among two options: root canal therapy and crown positioning or tooth extraction, implant insertion and crown positioning.Methods A total of 103 patients were recruited from a private dental clinic and interviewed. A questionnaire measured individuals' preferences among the two alternative treatments for a tooth with poor prognosis and the maximum amount of money they would be willing to pay for their choice with a starting bid of [euro]2,000 in [euro]100 increment/decrement. Demographic data, patient choice, median values and WTP association with socio-demographic factors (Student ttest and one-way ANOVA) and correlation between variables (Pearson chi-square test) were revealed.Results Seventy-six percent of patients expressed a preference for root canal therapy, while the remaining 24% chose the dental surgery. A fair agreement between previous experience and current therapeutic choice was found (P = 0.0001). The WTP median value was [euro]2,000 and 46% of participants would pay an additional sum of money for the therapy (median: [euro]300). The preferred treatment was influenced by previous experience, but no association was found between WTP values and socio-demographic factors.Conclusion Patients tend to prefer a conservative approach for the treatment of a tooth with poor prognosis and are willing to pay an additional fee to receive their treatment choice.
Assuntos
Coroas , Implantação Dentária , Preferência do Paciente/economia , Tratamento do Canal Radicular , Extração Dentária , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Autorrelato , Adulto JovemRESUMO
The "Slidex MRSA Detection" test (Denka Seiken, Japan) is a latex agglutination assay able to detect PBP2a. We evaluated its ability to differentiate mecA-positive from mecA-negative coagulase-negative staphylococci. We included 100 coagulase-negative staphylococci clinical isolates belonging to 9 species, 54 mecA positive and 46 mecA negative, as characterized by PCR. The specificity achieved using the manufacturer's instructions was 100%, but the sensitivity was only 57%. To increase sensitivity, we introduced modifications into the standard protocol. Using either large inocula or oxacillin induction before test performance, we achieved 100% sensitivity.
Assuntos
Testes de Fixação do Látex/métodos , Oxacilina/farmacologia , Resistência às Penicilinas , Proteínas de Ligação às Penicilinas/análise , Staphylococcus/efeitos dos fármacos , Resistência às Penicilinas/genética , Kit de Reagentes para Diagnóstico/microbiologia , Sensibilidade e Especificidade , Especificidade da Espécie , Staphylococcus/classificação , Staphylococcus/genéticaRESUMO
This study investigated the behavioral and psychological differences between 39 uninfected children born to human immunodeficiency virus (HIV)-seropositive mothers (HIV-seroreverter [SR]) and 78 children with no family history of HIV infection. Caretakers completed the Child Behavior Checklist and the Gittelman modification of the Conners' Parent's Questionnaire, whereas children completed the Children's Manifest Anxiety Scale and the Children's Depression Inventory. In 14 SR children and 28 controls, narrative task was also evaluated. The personalities of SR children, as measured by the caretaker-completed scales, revealed significantly more problems of social adjustment and attention and more externalizing symptoms than did the personalities of control children. On the child-completed scales, SR children showed significantly more anxiety and depression than did controls. Caretakers reported consistently fewer symptoms of anxiety and depression in the children than did the children themselves. Difficulties in verbal recall included aspects of depressive and anxious feelings; on the narrative task measure, SR children showed poorer skill in free verbal recall than did control children, and they simplified episodes with mixed emotions. In addition, ambiguous episodes elicited significantly more negative feelings in SR children than in controls. These findings show that there is a great necessity for assisting SR children. It will be important to determine whether these children will remain at risk for emotional consequences in their adult lives.
Assuntos
Comportamento Infantil/psicologia , Desenvolvimento Infantil , Soropositividade para HIV/psicologia , Adulto , Ansiedade/psicologia , Criança , Estudos de Coortes , Depressão/psicologia , Feminino , Seguimentos , Soropositividade para HIV/transmissão , Humanos , Transmissão Vertical de Doenças Infecciosas , Rememoração Mental/fisiologia , Gravidez , Complicações Infecciosas na Gravidez/fisiopatologia , Ajustamento Social , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: The aim of this retrospective investigation was to evaluate the postoperative quality of life after endodontic surgery in maxillary molars when a sinus membrane perforation occurred and platelet concentrates were used. MATERIALS AND METHODS: Included patients were treated by microsurgical endodontic treatment in molar and premolar maxillary regions between 2007 and 2010. Patients who fulfilled the inclusion criteria were screened. Data from the quality of life questionnaire were analyzed. The use of plasma rich in growth factors (PRGF) (test group) was compared with a control group when a Schneiderian membrane perforation occurred during endodontic surgery performed with a modern technique in maxillary molars and premolars. RESULTS: A total of 20 patients (12 in the control group and eight in the test group) fulfilled the inclusion criteria. No differences were evaluated at baseline for clinical parameters. Significantly improved patients' quality of life was observed in the test group considering symptoms as swelling, bad breath or taste, and pain. Functional activities were less impaired in the test group and swelling was significantly higher in the control group. In the test group, pain was significantly lower than the control group during the first 6 days after surgery and also, the consumption of painkillers was lower for patients belonging to the test group even if it was not statistically significant. DISCUSSION: In general, a small sinus membrane perforation (less than 6 mm) during endodontic surgery did not cause severe complications. The use of platelet concentrates could be effective in reducing the impact on patients' quality of life, decreasing pain and surgery side effects as well as swelling.