Uma opção terapêutica para o aumento da faixa de gengiva inserida: o enxerto de tecido conjuntivo livre

Several periodontal procedures have been described in the literature to correct mucogingival alterations or to achieve root coverage. The epithelized free gingival graft is a well established periodontal surgery to increase the width of keratinized gingiva with good stability in the long term follow up. However, this procedure is not commonly used in aesthetic areas since the grafted tissue presents differences of color and contrast. The free connective tissue graft emerges as a viable option to increase attached gingiva in areas where aesthetics results are required. The removal of an epithelized free gingival graft from the hard palate region creates a sore and raw surgical wound that slowly repairs, while the connective tissue graft produces only a line of incision that can be easily sutured promoting a more confortable outcome for the patient. This paper aims to report a case where a free connective tissue graft was used to increase the width of attached gingiva in a tooth with gingival recession. This technique presented satisfactory esthetics results, with a better contrast and color matching with the surrounding tissues.

Effect of the association between citric acid and EDTA on root surface etching

Objective: This study aims to compare the clot stabilization on root surfaces conditioned with citric acid and ethylenediaminetetraacetic acid (EDTA). Materials and methods: Scaled root samples (n = 100) were set in five groups: group I?control group (saline solution); group II (24% EDTA); group III (25% citric acid); group IV (EDTA + citric acid); group V (citric acid + EDTA). Fifty samples were assessed using the root surface modification index (RSMI). The other 50 received a blood drop after conditioning. Clot formation was assessed using blood elements adhesion index (BEAI). A blind examiner evaluated photomicrographs. Statistical analysis considered p < 0.05. Results: Groups-III and G-V attained the best results for RSMI and BEAI in comparison to control. The worst results for clot stabilization were seen in group-II. EDTA employment before citric acid (group-IV) reduced clot formation in comparison to citric acid use alone (group-III). Conclusion: Root conditioning with citric acid alone and before EDTA had the best results for smear layer removal and clot stabilization. EDTA inhibited clot stabilization on root surface and must have a residual activity once it has diminished clot adhesion to root even after citric acid conditioning. Thus, EDTA can be used to neutralize citric acid effects on periodontal cells without affecting clot stabilization. Clinical significance: To demonstrate that citric acid use on root surfaces previously affected by periodontal disease may favor clot stabilization and may have a beneficial effect on surgical outcomes. Also, EDTA can be used to neutralize citric acid effects on periodontal cells.

Cirurgia estética para remoção de hiperplasia gengiva: granuloma piogênico

The pyogenic granuloma, a lesion considered hyperplastic regenerative inflammatory reaction is a finding commonly found in the oral cavity, affecting large numbers of individuals, being more prevalent in females. But its pathogenesis is not well defined and may be associated with numerous factors that stimulate tissue proliferation. Correct diagnosis and treatment plan are essential for success in approach, restoring function and aesthetics to the periodontal tissues. In agreement with the literature, the most common treatment and greater predictability is surgical removal, which involves resection of the lesion, together with its base inserted into the underlying tissue, periosteum and bone tissue. However, the excision can promote aesthetic defects, particularly in anterior regions where it is most affected. This article reports on the importance of a correct surgical approach for removal of pyogenic granuloma in the region of the interdental papilla between teeth 42 and 43, resulting in a good anatomical result and aesthetic.

Dimensões das furcas de primeiros pré-molares superiores e sua relação com curetas periodontais

The aim of this in vitro study was to comparatively evaluate the mesio and distal furcation entrance measurements of first maxillary premolar. The measurements were compared with different curette blades. A caliper was used by an examinator to acquire the measurements of root trunk (TR); 1 mm (D1) and 2 mm (D2) both below the furcation entrance. For this study Gracey, Mini Gracey, Padua Lima (PL) and Goldman Fox 4 curettes (Millenium) were selected. Measurements of DT - total distance of the active blade length, DI - width of the active blade, DM - width of the medium part of the active blade were obtained for the curettes. The measurements were obtained in both the coronary face and in the lateral face. The data TR, D1 and D2 presented normal distribution and were statistically analyzed by paired t-test. Statistically significant differences were found in the mesial root trunk region (TR) of both premolars. The mean of the measurements was greater than the distal. Mean and standard deviation were obtained, and both Gracey and Mini Gracey showed mean measurements compatible with the closer furcation entrance (D1 - 1 mm). Goldman Fox 4 showed adaptation only in the mesial face, and Padua Lima showed no access to any of the faces. Thereby it is concluded that the access of the furcation is narrow (D1). The mesial face of the root trunk (TR) showed mean measurement greater than distal face. Gracey and Mini Gracey curettes demonstrated to be compatible for both faces, mesial and distal of the first maxillary premolars studied.

Health professionals ethical and legal liability on patient’s inadequate clarification in order to obtain free and informed consent

It is required that patients are provided information about therapeutic possibilities, showing the risks, benefits, prognosis and costs of each possible and indicated alternative. This is an ethical and legal resolution. However, health professionals possess the clinical/technical/scientific knowledge and determine what information will be (or not) provided. The patient in question decides to undergo a treatment, providing his/her free and informed consent on the basis of the data presented. Unfortunately, some professionals may not provide all the information necessary for making an informed decision or, after obtaining the consent of the patient, may provide him information that causes the patient to give up on the treatment initially accepted. Such information, if relevant, and not a supervening fact, should have been provided initially. However, the information may not be entirely true, and bring the patient, for instance, to decide based on inadequately presented risks. The craniofacial rehabilitation of the temporomandibular joint (TMJ) by means of TMJ prosthesis, is indicated in many situations. Often, patients in need of such prostheses have aesthetic and functional problems and the rehabilitation expectations run high. This work presents a case and discusses ethical and legal issues, including the liability of partial and inadequate information to a patient.

Influence of training status and eNOS haplotypes on plasma nitrite concentrations in normotensive older adults: a hypothesis-generating study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

In vitro evaluation of Biosilicate® dissolution on dentin surface: a SEM analysis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Comparação in vitro da eficácia de diferentes formulações do gel de EDTA 24% no condicionamento da superfície radicular

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

The smear layer created by scaling and root planing is physiologically eliminated in a biphasic process

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Guia prático de medicina baseada em evidências

Neste livro são expostos, para uso de profissionais da área, os princípios básicos e conceitos fundamentais, além dos procedimentos necessários para a prática da Medicina Baseada em Evidências (MBE). A MBE é uma prática relativamente nova, criada em 1992, pelo cientista epidemiologista Gordon Guyatt, na canadense McMaster University. Trata-se da utilização e do desenvolvimento de métodos rigorosos que respondam a questões clinicas sobre efetividade, eficiência e segurança de determinado tratamento e prevenção, bem como sobre a sensibilidade e especificidade de testes diagnósticos de certa doença na área de saúde. A MBE propõe realizar pesquisas de boa qualidade metodológica e livres de vieses e conflitos de interesse, de forma que as respostas sejam adequadas para auxiliar na tomada de decisão clínica. Segundo a MBE, a melhor forma de saber se uma medicação específica é eficaz no tratamento de determinada doença é a revisão sistemática de ensaios clínicos randomizados, que mapeiam os estudos publicados e não publicados realizados mundialmente sobre o assunto. Tal revisão deve ainda contar com metodologia rigorosa que busque, por exemplo, explicar resultados contraditórios sobre a mesma questão e comparar estudos com diferentes amostras para detectar possível diferença estatística. De forma didática e detalhada, mas mantendo todo o rigor científico, esta obra tem caráter de manual. Ao longo dos capítulos, seus autores explicam conceitos e apresentam o passo a passo da utilização da MBE para os profissionais de saúde.

Avaliação das lesões encefálicas e fenotipagem de linfócitos T e células dentríticas em linfócitos de cães com leishmaniose visceral

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Acúmulo de nutrientes e decomposição do palhiço de cana em função de doses de vinhaça

Understanding the influence of vinasse application on trash decomposition and its effects on soil chemical attributes and sugar cane culture is essential for the good management of the production system. The objective of this study was to assess the time of decomposition and nutrient cycling of the green ratoon cane's trash, and their effects on soil fertility and technological components of crops, in terms of vinasse doses. The study was developed in the northwest region of Sao Paulo State - Brazil, under Eutrophic Ultisol, using the RB855453 variety. The experimental design was randomized blocks with split plot in time. The treatments were composed of four doses of vinasse (0, 50, 100 and 200 m(3) ha(-1)). There was a 20.9% reduction in the amount of crop residue remaining after one year review. The vinasse doses increased the ratoon cane's yield, without interfering in the raw material quality. The green cane system, in which the trash is deposited on the soil and vinasse application, changes the dynamics of the trash decomposition and modifies the soil fertility, contributing positively to the crop yield.

Antihypertensive therapy in preeclampsia is not modulated by VEGF polymorphisms

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)