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.

Haplotypes of susceptibility to chronic periodontitis do not influence MMP-8 levels or the outcome of non-surgical periodontal therapy

Introduction: Chronic periodontitis (CP) is a multifactorial condition, presenting immunoinflammatory reaction, in which a myriad of molecules including cytokines and matrix metalloproteinases (MMPs) interplays, making the system extremely intricate. There is scarce information regarding interconnections of biological influence among IL-4, IL-8 and MMP-8, mainly considering genetic polymorphisms, and also, whether this can influence the outcome of periodontal therapy. Previously, we reported that variants in the interleukin 4 (IL4) and interleukin 8 (IL8) genes were associated with CP in Brazilians. The aim of this study was to investigate, in individuals with different genetic backgrounds with regard to the IL4 or IL8 haplotypes, differences in the immunological levels of MMP-8 in gingival crevicular fluid (GCF) before and after non-surgical periodontal treatment. A total of 141 patients participated of this study, classified as susceptible or not to CP, according to the presence of haplotypes formed by polymorphysms in the IL4 or IL8 genes. All individuals received non-surgical periodontal therapy and follow–up continued for 45 days. The GCF samples were collected at baseline and on the 45th day. The MMP-8 levels were determined by ELISA. Results: No association was found between genetic backgrounds and MMP-8 levels in GCF or the outcome of non-surgical periodontal therapy. Conclusions: In this longitudinal clinical study, the presence of IL4 or IL8 haplotypes previously associated with CP did not influence the outcome of non-surgical periodontal therapy and the MMP-8 levels in the GCF. Additional studies are necessary to determine the mechanisms by which the IL4 or IL8 haplotypes affect individual susceptibility to CP.

Estudo microbiológico comparativo entre sabão de clorexidina 2% e um novo sabão antisséptico para lavagem pré-operatória das mãos

Objective: To evaluate, by means of a microbiologic study, two kinds of soaps suggested by surgeons for presurgical handwashing, comparing a well-known antibacterial soap with a new soap formulated from vegetable oils. Materials and methods: Ten volunteers performed handwashing according to previously established protocols for routine antisepsis in operating rooms using 3 different soaps: a common, commercially marketed soap, serving as the control group (Group 1), with no antibacterial characteristics; a soap with 2% chlorhexidine (Group II); and a new soap formulated from vegetable oils at a concentration of 20%, known as surfactant, which was designed by the Chemistry Institute (Unesp/Araraquara – Grupo de Materiais Fotônicos) (Group III). The microbiological samples were collected immediately before and after handwashing and one hour later with the volunteer wearing surgical gloves. Results: ANOVA revealed that the following significant differences are found in the number of bacterial colonies: between soap types (a smaller number of colonies in the Group II soap), between periods (reduction in the number of colonies in the Group II soap), and the significant effect of the soap versus time interaction. Conclusion: The 2% chlorhexidine soap performed better in reducing the number of bacterial colonies on the hands immediately after handwashing and after one hour with the use of surgical gloves, when compared to the 20% surfactant soap.

Prevalence of Candida spp. during radiographic examination in Diabetes mellitus patients

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Microbiological changes after periodontal therapy in diabetic patients with inadequate metabolic control

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Encontrabilidade da informação

Coordenação de Aperfeiçoamento de Pessoal de Ensino Superior (CAPES)

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.

Toxoplasmosis: morphological and morphometric evaluation of spinal cord neurons from nonsymptomatic seropositive dogs

The aim of this work was to analyze the neuron morphology and morphometry of cervical, thoracic and lumbar areas of nonsymptomatic seropositive dogs’ spinal cord for toxoplasmosis. Twenty indefinite-breed adult dogs were used; ten dogs were healthy, with negative serology for toxoplasmosis, and were used as the control group (group 1), and ten dogs were nonsymptomatic but seropositive for toxoplasmosis (group 2). After the microtomy, with interval of 100 micrometers (µm), the histological 5-µm-thick cuts were dyed by hematoxylin-eosin and Masson's trichrome techniques. The glass slides were analyzed under light microscope to examine the neuron morphology. The parameters considered for the morphometric analysis were area, perimeter, maximum diameter, minimum diameter and shape factor of cytoplasm and nucleus of neuron. The results were statistically analyzed by Student’s t test at 5% probability level. The morphological characteristics between the two groups were similar and according to literature. The morphometric results showed that there were changes in neurons size and structure, and increase and loss of star shape were noticed in seropositive animals. The results suggest that the neurons of these dogs, yet nonsymptomatic, can have lost their conductor function.

Intrauterine growth restricted rats exercised at pregnancy: maternal-fetal repercussions

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Expression of Vascular Endothelial Growth Factor (VEGF) in Macrophages, Fibroblasts, and Endothelial Cells in Pterygium Treated with 5-Fluorouracil

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

Refractive errors in a Brazilian population: age and sex distribution

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

Application of mesoporous SBA-15 silica functionalized with 4-amino-2-mercaptopyrimidine for the adsorption of Cu(II), Zn(II), Cd(II), Ni(II), and Pb(II) from water

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