Longitudinal clinical evaluation of adjunct minocycline in the treatment of chronic periodontitis

Background: the clinical benefits of minocycline in combination with thorough scaling and root planing (SRP) have been examined in multicenter studies. The aim of this longitudinal investigation was to evaluate the clinical response to scaling and root planing combined with the use of locally delivered minocycline microspheres for 720 days in individuals with advanced chronic periodontitis.Methods: A total of 26 individuals aged 26 to 69 years (mean: 46.8 +/- 12.1 years) were included in this double-blind randomized clinical trial. After randomization, 13 individuals were selected for the test group (TG) and treated with SRP plus subgingival minocycline at baseline and 90, 180, and 270 days, and 13 individuals were selected for the control group (CG) and received SRP plus vehicle at the same time-points. Two homologous sites with probing depth (PD) >= 6 mm were chosen in each subject. To evaluate the clinical response after treatment, PD, plaque index (PI), and gingival index (GI) were assessed at baseline and 90, 180, 270, 360, and 720 days.Results: No statistical differences were found between test and control groups in relation to PD at the different timepoints. The mean values of PD demonstrated a higher reduction in the test group at 270 and 360 days. No statistical differences were observed at 90, 180, and 720 days between TG and CG (P < 0.05; Wilcoxon test). There were no statistically significant differences between TG and CG concerning PI and GI (P < 0.05; analysis of variance and t test) at all evaluated timepoints.Conclusion: Our findings demonstrated that both therapies reduced mean PD from 90 to 360 days; however, SRP combined with the use of subgingival minocycline showed a higher reduction at 270 and 360 days following therapy.

Clinical evaluation of tinnitus in patients with sleep bruxism: prevalence and characteristics

Evaluation of the prevalence and characteristics of tinnitus in a Brazilian series of sleep bruxism patients. In this descriptive study, 100 patients (80 women and 20 men) were selected through the self-report of grinding teeth during sleep, confirmed by room mate or family member. They were evaluated according to a systematized approach: a questionnaire for orofacial pain and the Portuguese version of the Research Diagnostic Criteria for Temporomandibular Disorders. The patients were divided into two groups: group A, 54 patients with complaint of tinnitus and group B, 46 patients without tinnitus complaint. The mean age was 37.85 (13-66 years) and 34.02 years (20-59 years), respectively, for groups A and B (P = 0.1164). There was statistically significant difference between the two groups, with higher prevalence for the group A, in relation to: presence of chronic facial pain (P = 0.0007); number of areas painful to palpation in the masticatory and cervical muscles (P = 0.0032); myofascial pain in the masticatory muscles (P = 0.0003); absence of teeth without prosthetic replacement (P = 0.0145) and indices of depression (P = 0.0234). Structural alterations of the TMJ, like disc displacement and vertical dimension loss did not differ for the two groups. Tinnitus frequency was higher in patients with sleep bruxism and chronic facial pain. Myofascial pain, number of areas painful to palpation in the masticatory and cervical muscles, higher levels of depression and tooth absence without prosthetic replacement were more frequent in the group with tinnitus.

Clinical evaluation of abutment teeth of removable partial denture by means of the Periotest method

Prosthodontics should be one of the means of establishing conditions for the maintenance of periodontal health. The forces applied to the abutment teeth and their effects are very important considerations in the design and construction of the removable partial dentures. This 6-month follow-up clinical study evaluated the degree of mobility of abutment teeth of distal extension and tooth supported removable partial dentures by using Periotest. Two types of clasp design were selected for evaluation. In cases with unilateral and bilateral distal-extension, a clasp design including a T clasp of Roach retentive arm, a rigid reciprocal arm and a mesial rest were used. For the abutments of tooth-supported removable partial dentures, a second clasp design with a cast circumferential buccal retentive arm, a rigid reciprocal clasp arm and a rest adjacent to the edentulous ridges was selected. A total of 68 abutment teeth was analysed. Periotest values were made at the time of denture placement (control) and at 1, 3 and 6 months after the denture placement. The statistical analysis was performed using Friedman test. All analysis was performed at a 0.05 level of significance. The results revelled that no significant changes in tooth mobility were observed during the 6-months follow-up (P > 0.05). In conclusion, our findings suggest that adequate oral hygiene instructions, careful prosthetic treatment planning and regular recall appointments play an important role in preventing changes in abutment tooth mobility caused by removable partial denture placement.

Clinical evaluation of the association of noncarious cervical lesions, parafunctional habits, and TMD diagnosis

Objective: To verify a potential association between the presence of noncarious cervical lesions, parafunctional habits, and temporomandibular disorder (TMD) diagnosis. Method and Materials: Sample-size calculation provided a value of 130 participants with a confidence level of 95% and an error margin of 5%. A population of 132 volunteers (30 men: mean age, 23.7 +/- 3.05 years; 102 women: mean age, 24.9 +/- 5.86 years) underwent an oral examination and was interviewed by a trained dentist. The following parameters were registered: personal details, TMD diagnosis, parafunctional habits, and noncarious cervical lesion presence. The population was then divided into a noncarious cervical lesion group and a control group and subjected to the t test, chi-square test, Fisher exact test, and Spearman correlation (alpha = .05). Results: Noncarious cervical lesions were present in 39% of the population, with the largest concentrations found in the maxillary premolars (32%). The data showed a significant association between noncarious cervical lesion presence, tooth clenching (P = .03), and nail biting (P = .02), as well as a relation with TMD diagnosis (Fonseca Index [P = .01] and Research Diagnostic Criteria for TMD (RDC/TMD) [P = .004] ). In the noncarious cervical lesion group, direct rank correlation was found between maxillary premolars and clenching (P = .03), mandibular canines and nail biting (P = .05), and mandibular incisors and parafunctional habits without dental contacts (P = .02). Conclusion: Parafunctional habits and TMD presence should be taken into account in the diagnosis and treatment plan of noncarious cervical lesions.