Condições de saúde bucal das gestantes atendidas na atenção primária do município de Botucatu-SP e seu conhecimento sobre a inportãncia da saúde bucal na gestação

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

Desenvolvimento de um novo sistema dinâmico para avaliação da liberação de fármacos

Pós-graduação em Biociências - FCLAS

Implementação de aparato experimental para medição de instabilidades tipo Roll Waves em fluidos não- newtonianos

Pós-graduação em Engenharia Mecânica - FEIS

Síntese de nanopartículas de sulfeto de cobre, preparação e estabilidade coloidal de fluidos trocadores de calor em meio aquoso

Pós-graduação em Química - IQ

Association between post-orthodontic treatment gingival margin alterations and symphysis dimensions

Orthodontic therapy is known to be associated with the development of gingival recession. Several factors may be involved in the causal chain of this outcome, including anatomical and behavioral aspects. Among the anatomical aspects, the dimensions of the mandibular symphysis could play a predisposing role. This study evaluated the relationship between the mandibular symphysis dimensions prior to orthodontic therapy and the development of gingival recessions on the lower incisors and cuspids. Records from 189 orthodontically treated adolescents were evaluated, including radiographs, casts and intra-oral photographs. Symphysis dimensions were assessed by cephalograms. Gingival margin alterations were determined in photographs and cast models. Association between gingival margin alterations and symphysis dimensions was tested by chi-square (α=0.05). Occurrence of gingival recession increased after orthodontic therapy. No association was observed on average of symphysis dimensions and the occurrence of gingival recessions. It may be concluded that pretreatment symphysis dimensions may not be used as predictors of gingival recession after orthodontic therapy.

Innovation in pediatric surgery: the use of ultrasonic CVD tips: case report

The non-eruption of teeth due to highly keratinized gingival mucosa is a frequent event in the pediatric dentistry, which harms the oral aesthetics and function. A surgical excision of the involved area is indicated, exposing the non-erupted tooth. This procedure involves anesthesia and cutting instruments that may increase the fear and anxiety in young patients. The use of new technologies has avoided these instruments and has promoted more comfort to the patients. This study presents clinical cases in which gingivectomy was performed using the innovative method with an ultrasound-activated CVD tip. It was concluded that this method presented effectiveness, promoted more comfort, and less fear to the patients, making its use a viable alternative to pediatric surgery.

Relação entre materiais dentários e o complexo dentino-pulpar

Despite the strong valorization of the esthetics and its relationship with restorative materials, the biological principles of any clinical procedure are extremely important to maintain the vitality of the dentin-pulp complex. Dentin and pulp tissue are susceptible to different kinds of irritants such as toxins from microorganisms, traumatic procedures of cavity preparation, as well as toxic components released by restorative materials applied in non recommended clinical situations. Initially, the pulp responds to irritation by starting an inflammatory reaction which involves outward movement of dentinal fluid and intratubular deposition of immunoglobulins, upregulation of odontoblast activities, presence of immune cells and their cytokines as well as local expression of neuropeptides and chemokines. After these initial events, the inflammation process can be resolved associated or not to sclerotic dentin formation and reactionary dentin deposition. If high intensity offensive stimuli are applied to the dentin-pulp complex, death of odontoblasts takes place and consequently pulp ageing or even partial necrosis of this tissue may occurs. Thereby, clinicians need to be aware about the physiological and pathological features of the dentin-pulp complex as well as the possible biological consequences of different clinical procedures. In this way, the dentists should be able to carry out minimally aggressive operative techniques and to select the more appropriate restorative materials for each specific clinical situation in order to obtain excellent clinical results associated to the maintenance of pulp vitality.

Estudio histológico del processo de reparación alveolar después de la aplicación tópica de la solucioón anestésica prilocaína 3 % con felipressina o,o3 ui/ml

The aim of this study was to evaluate the local anesthetic solution, composed by Prilocaine 3% and felipressin 0,03 UI/ml, influence on the alveolar repair process in rats after dental extraction. This research was previously approved by the Ethic Committee in Research of the Masters Degree Program in Oral and Maxillofacial Surgery of the Marília University (UNIMAR), Marília, São Paulo, Brazil. It was an experimental, randomly controlled study, with bifactorial analysis (group control versus experimental group, in function of the postoperative times (2 X 4)). For the accomplishment of this study 32 rats were used (Rattus norvegicus, albinus, Wistar), males, adults, weighing between 280 and 320 grams. The animals were selected and divided into Group I (control) and Group II (Citocain 3%® - Prilocaine 3% with felipressin 0,03UI/ml) with 16 rats each; being four animals of the Group I and four of the Group II, destined to the euthanasia in the postoperative periods of 3rd, 7th, 15th and 24th days. The histological analysis with base in the developed methodology, allowed us to conclude that the anesthetic solution of Citocain 3%® applied with gauze compress on the surgical dental wound, produced tissue events that committed the basic biological principles, that are responsible for the regeneration of the gingival epithelium and the alveolar process repair in rats. The Group I presented better results in the alveolar repair when compared to the Group II.

Gengivite Plasmocitária induzida por uso de pimenta

The aim of this case report is present a case in which the patient had plasma cell gingivitis induced by consumption of pepper. Patient A.M.S., male, 23 years, presented himself at the Clinic of Periodontology, complaining of severe pain, bleeding gums and tooth mobility. Interview was conducted not observing anything relevant. In oral evaluation, we observed in the anterior swollen gums, bleeding, suppuration and great touch, and tooth mobility. Being an aggressive framework in relation to patient age, we performed the following laboratory tests: complete blood count, blood sugar, and coagulation, and biopsy in the anterior inferior, because a diagnosis of lymphoma. At the end of antibiotic therapy, a significant improvement of clinical symptoms, pain relief, less swollen gums and reduce the suppuration and mobility. Laboratory tests showed no change. Fifteen days later, the patient returned with worsening of clinical status. The pathological diagnosis was plasma cell gingivitis and then performed a new history by placing greater emphasis on dietary habits, and the patient reported consumption of pepper in their meals, and relate this to clinical presentation. After elimination of pepper diet the patient showed remission of clinical data.

Associação da raspagem com antibioticoterapia em um caso de periodontite agressiva generalizada

The treatment of aggressive periodontitis is a challenge to the clinician, therefore the search for effective treatment protocols of this disease is important. The aim of this case report was demonstrate the effectiveness of the combination of systemic antibiotics with non-surgical periodontal therapy in the treatment of generalized aggressive periodontitis. a 27-year-old patient (RCS), smoker for 11 years (10 cigarettes/day on average), with no systemic alteration, attended the periodontal clinic with a complaint abnormal dental position. After the clinical examination, the diagnosis of generalized aggressive periodontitis was defined. The non-surgical periodontal treatment was executed associated with administration of amoxicillin plus metronidazole for ten days. Clinical parameters (Clinical Attachment level, marginal gingival level, periodontal probing depth, bleeding on probing, plaque index and gingival index) and radiographic parameters (distance between the cemento-enamel junction and the bone crest) were evaluated before and after non-surgical periodontal treatment, after antibiotic therapy and three, six and 12 months after the treatment. After one year follow-up, the results showed improvement in clinical and radiographic parameters with stabilized and decreased tooth mobility and absence of tooth loss. It was concluded that the association of non-surgical periodontal therapy with the administration of amoxicillin/metronidazole was effective in the treatment of generalized aggressive periodontitis.

Tratamento de recessões gengivais múltiplas: uma abordagem mais conservadora

Periodontal therapy has undergone significant changes in recent decades. While in the past the only goal was to restore gingival health, with no concern about the possible consequences of the disease treatment, currently the procedures are performed in a less invasive manner, to maintain aesthetic periodontal results or even recover them. Gingival recession is an alteration frequently found in patients and may be a complaint for causing various complications. For their treatment, several surgical techniques are reported in the literature. The techniques that are more predictable are those that associate a subepithelial connective tissue graft and a coronally repositioned flap. The original technique consists in performing two vertical incisions for an extensive release of the flap and its stabilization in a coronal position. Although this procedure is extremely widespread in the literature, the search for less invasive surgeries without the use of vertical incisions are the current aim of periodontal plastic surgeries, since they present several advantages. The aim of this paper is to demonstrate a case where adjacent, deep and multiple recessions were present resulting in aesthetic problems, which was resolved by a less invasive approach using a surgical technique in envelope and a subepithelial connective tissue graft.

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.

Detecção de Periodontopatógenos, Glicoproteína Emmprin (Cd-147) e sua correlação com MMP-2 e MMP-9

Periodontitis is an infectious disease characterized by the secretion of a variety of inflammatory mediators that lead to destruction of tooth supporting tissues, including the possible loss of alveolar bone, in association with infection with multiple species of bacteria. It is estimated that more than 400 species colonize the biofilm and some oral species related to periodontal disease is present in the subgingival including P. gingivalis, T. forsythia and T. denticola. However, other organisms may be related of this disease, as Filifactor allocis and Prevotella tannerae. These microorganisms and subproducts such as endotoxins released into the extracellular lead to the stimulation of metalloproteinase inducer glycoprotein (EMMPRIN, CD-147), which stimulates the release of MMPs by host cells, like fibroblasts and endothelial cells, thus leading to tissue destruction. The objective of this study was to detect F. allocis, P. tannerae, T. denticola and the glycoprotein EMMPRIN (CD-147) and its correlation with MMP-2 and MMP-9 in subgingival fluid samples of patients with chronic periodontitis. Fluids were collected from healthy and disease subgingival sites of 20 healthy individuals before basic periodontal treatment and after of 60 days of treatment. Their DNAs were extracted and portions of the 16S gene were amplified and performed conventional PCR. For immunological analysis and quantification of EMMPRIN (CD-147), MMP-2 and MMP-9 was used ELISA-Sandwich. Results demonstrated that the disease group showed significantly high amounts of T. denticola, F. alocis and P. tannerae when compared with health sites. MMP-2 and MMP-9 were detected in high concentrations with statistically significantly reduction after periodontal treatment to MMP-2, but without correlation with EMMPRIN.

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.

Importância do tratamento estético periodontal na reabilitação protética

Gingival recession is a common deformity that affects a large number of people. This condition is frequently associated with esthetic complains and may lead to dental hypersensitivity. Thus, various surgical procedures have been proposed to provide root coverage. Since the 1950s, free and pedicle gingival grafts have been greatly used for treating gingival recession. However, after the 1985 Miller gingival recession classification, and with the development of other appropriated techniques that use subepithelial connective tissue grafts, gingival recession treatments have resulted in more predictable outcomes, especially with respect to Class I and II sites, i.e., in the absence of interproximal bone loss. This article reported the importance of aesthetical periodontal treatment in the prosthetic rehabilitation of a patient with a class I gingival recession with 3 mm of vertical extension in the superior canine. The treatment plan consisted of root coverage using subepithelial connective tissue graft (SCTG) associated with construction of new prosthesis.