Aplicação do laser Er,Cr:YSGG em periodontia e implantodontia: revisão de literatura

Lasers are widely used tools in many therapeutic modalities in medical lasers and can be divided into low and high intensity. For the treatment of periodontal disease, lowintensity lasers are related to reduce the number of bacteria and to induce inflammatory and analgesic properties. The high intensity lasers can be used in surgical procedures, improving hemostasis, promoting more accurate cuts, removal of dental calculus as well as thermomechanical and photochemical interactions with tissue. The high-intensity laser Erbium impregnated with chromium: YSGG laser has shown satisfactory results when applied in endodontic, restorative denstistry, surgical procedures and non-surgical periodontal treatment. The purpose of this review is to evaluate the studies that investigated the effects of Er, Cr: YSGG laser on the morphology and biocompatibility of titanium and root surfaces irradiated with these lasers, even beyond the effect on the treatment of periodontitis and periimplantitis.

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 multidisciplinar: relato de casos clínicos

Introduction: Adult patients are more prone to periodontal disease mainly caused by poor plaque control. In these patients, orthodontic movement is not contraindicated, but it is necessary to evaluate their periodontal status so that we can establish the appropriate treatment plan. Objective: The objective of this article is to describe and discuss the clinical cases of severely periodontally compromised individuals in need of oral rehabilitation. Methods: The study consisted of orthodontic treatment of two cases with periodontal involvement. After clinical and radiographic examinations, the cases were analyzed by a multidisciplinary team of Orthodontics, Periodontics and Prosthodontics, in order to provide the patient with the best possible esthetic, functional and stability outcomes. Periodontal treatment consisted of supra and subgingival scaling prior to orthodontic treatment, and regular maintenance performed on a quarterly basis throughout orthodontic movement. Activation was carried out every 45 to 50 days, with light forces. Retention remains to the present day, even after completion of the rehabilitation. Conclusion: Multidisciplinary oral rehabilitation treatment yields satisfactory results. The interaction between Orthodontics and Periodontics reveals that patients with reduced, but healthy periodontium, can receive orthodontic treatment as long as the forces applied do not exceed patient's biological limits.

Porphyromonas endodontalis in chronic periodontitis: a clinical and microbiological cross-sectional study

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

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.

Dificuldades relatadas por estudantes de odontologia diante de procedimentos relacionados à periodontia

Objective: This study aimed at evaluating the difficulties reported by last-year dentistry course students regarding basic and surgical periodontal procedures. Methods: A proposed questionnaire with 24 questions, 14 related to basic periodontal procedures and 10 to surgical procedures, was applied to 45 undergraduate students with jobs involving these procedures, during the practical activities of the Integrated Clinic Discipline, a compulsory subject in the curriculum of the course, taught to last-year students. Students were asked about their own perceptions of the difficulties in implementing the various steps related to the treatments. The degree of individual difficulty was determined according to the Likert scale: 0 = none, 1 = mild, 2 = moderate, 3 = high, 4 = very high. Exploratory analysis of data was applied, and the difficulty level was also dichotomized into none to mild (scores 0 and 1) and moderate to very high (scores 2–4). Results: Regarding the basic periodontal treatment, bone level probing was the procedure with the highest number of student difficulties (57.5%). As for the difficulties reported by students regarding the stages of periodontal surgery, only the procedures related to anesthesia and suture removal had no report of doubts. Conclusion: Periodontal surgery was the procedure involving the most prevalent questions reported as moderate to very high, and the indication for the most suitable surgical technique was the stage with the highest percentage of questions (66.6%) among the undergraduates.

Análise dos troncos radiculares, abertura da raízes e projeções cervicais de esmalte de furcas de molares superiores e inferiores: Estudo in vitro

Periodontal treatment of teeth with furcation lesions often have unpredictable results due to several factors that may hinder therapy or influence the progress of periodontal disease. Of these, the length of the root trunk may contribute to the early injury of the furcations or even cause complications for the application of the treatment; the opening of the roots can guide the type of treatment to be instituted and cervical enamel projections may hinder the instrumentation of the region or even act as a retention plate niche. Thus, the purpose of this study was measured using a digital caliper, root logs database 400 molar both the 1st and the 2nd and both upper and lower as well as analyze using appropriate index type projection cervical enamel and through appropriate classification the opening of the roots in order to guide the diagnosis and treatment plan. We conclude that there is variation in measures of root trunk between the faces of the teeth examined and that greater cervical enamel projection (ECP) correlates with a decrease in the length of the root trunk in the sample evaluated as the first molars have higher occurrence of roots with a degree of opening larger than the second molars.

A microscopic analysis of the effects of root surface scaling with different power parameters of er,cr: YSGG laser

The aim of this study was to evaluate the effects of different power parameters of an Erbium, Cromium: Yttrium, Scandium, Gallium, Garnet laser (Er,Cr:YSGG laser) on the morphology, attachment of blood components (ABC), roughness, and wear on irradiated root surfaces. Sixty-five incisive bovine teeth were used in this study, 35 of which were used for the analysis of root surface morphology and ABC. The remaining 30 teeth were used for roughness and root wear analysis. The samples were randomly allocated into seven groups: G1: Er,Cr:YSGG laser, 0.5 W; G2: Er,Cr:YSGG laser, 1.0 W; G3: Er,Cr:YSGG laser, 1.5 W; G4: Er,Cr:YSGG laser, 2.0 W; G5: Er,Cr:YSGG laser, 2.5 W; G6: Er,Cr:YSGG laser, 3.0 W; G7: scaling and root planning (SRP) with manual curettes. The root surfaces irradiated by Er,Cr:YSGG at 1.0 W and scaling with manual curettes presented the highest degrees of ABC. The samples irradiated by the Er,Cr:YSGG laser were rougher than the samples treated by the manual curette, and increasing the laser power parameters caused more root wear and greater roughness on the root surface. The Er,Cr:YSGG laser is safe to use for periodontal treatment, but it is not appropriate to use irradiation greater than 1.0 W for this purpose. Microsc. Res. Tech. 78:529–535, 2015. © 2015 Wiley Periodicals, Inc.

Adesão de células sanguineas em raízes biomodificadas de pacientes fumantes

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Down-regulation of protease activated receptor 2, interleukin-17 and other pro-inflammatory genes by subantimicrobial doxycycline dose in a rat periodontitis model

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação da perda óssea alveolar em pacientes encaminhados à especialista em periodontia: estudo radiográfico

The aim of this study was to evaluate the mean of alveolar bone loss (%) in radiographies of patients referred to specialist for periodontal treatment. Full mouth series of periapical radiographies (paralelism technique) were used. A total of 9808 proximal surfaces in 4804 teeth of 213 patients (90 males and 123 females), mean age, 44.3 years, were assessed. The alveolar bone loss was measured in relation to root lenght expressed as an average similar to Schei 's technique (1959) without the use of ruler. The references used were the distances cement-enamel juntion (CEJ) - alveolar crest (AC) and CEJ- dental apex taken with a digimatic caliper. The results showed that the mean values of alveolar bone loss (%ABL) was 22.39%. Men showed higher mean values of %ABL than women; the %ABL increased with the age, but the difference among age groups was no statistical significant (p>0.05); the mean values of %ABL of distal surfaces was higher than mesial surfaces (p<0.01), ríght quadrants exhibited higher %ABL values than left quadrants (p<0.01); maxillary sites showed mean values of %ABL higher than mandibular sites; the highest mean values of %ABL was found in molar group, followed by incisor groups, and premolar group; the canine group exhibited lower mean values of %ABL; the differences among the groups was considered statitistically significant (p<0.01). lt was suggested the usage of this technique in the dentistry offices and radiological services for the patient 's documentation and assortment and for later comparison about alveolar bone level

Felypressin Increases Blood Pressure During Dental Procedures in Hypertensive Patients

Background: Felypressin has been added to local anesthetic to increase the length of the anesthetic effect and reduce toxicity during dental procedures. However, the effect on blood pressure remains uncertain, and this may be highly relevant in the dental treatment of hypertensive patients. Objective: To investigate the effect of felypressin on blood pressure in hypertensive patients with controlled BP. Methods: 71 subjects with these characteristics and in need of periodontal treatment were studied. After 10 minutes of rest, local anesthesia (prilocaine) was infiltrated with and without addition of felypressin. Then, a deep subgingival scaling was performed. Blood pressure was measured by an automated oscillometric device (DIXTAL DX2010). Ten minutes after the administration of the anesthetic, peak anesthetic action was recorded. The State-Trait Anxiety Inventory (STAI) was used to assess the patients' trait anxiety. Results: Systolic blood pressure increased after anesthesia, regardless of association with felypressin, throughout the dental procedure (p<0.05) and this response can be explained, at least in part, by the trait anxiety levels of the subjects. However, a further increase in diastolic blood pressure was observed when prilocaine was associated with felypressin (p<0.05), but this response did not change with trait anxiety levels. Conclusion: Felypressin increased the diastolic blood pressure of hypertensive patients with controlled blood pressure. Patients with high trait anxiety presented increases in systolic blood pressure upon some procedures, suggesting that an increase in blood pressure might also be related to fear or anxiety. (Arq Bras Cardiol 2012;99(2):724-731)

Human beta-defensin 2 and protease activated receptor-2 expression in patients with chronic periodontitis

Objective: Some previous studies have shown that gingipains, trypsin-like proteases produced by Porphyromonas gingivalis, up-regulate human beta defensin-2 (HBD-2) mRNA expression through protease-activated receptor-2 (PAR(2)) in gingival epithelial cells. This study aimed at investigating salivary HBD-2 levels and crevicular PAR(2) mRNA expression in human chronic periodontitis and evaluating whether periodontal treatment affected this process. Methods: Salivary and gingival crevicular fluid (GCF) samples were collected from periodontally healthy (control) and chronic periodontitis patients at baseline and 50 days after nonsurgical periodontal treatment. Salivary HBD-2, and GCF TNF-alpha levels were analysed by ELISA, and PAR(2) mRNA at the GCF was evaluated by RT-PCR. Results: P. gingivalis was significantly (p < 0.05) more prevalent in patients with chronic periodontitis when compared to controls. This prevalence decreased after periodontal therapy (p < 0.0001). The control group showed statistically significant lower levels of HBD-2, TNF-alpha, and PAR(2) expression when compared to the chronic periodontitis group. In addition, periodontal treatment significantly reduced PAR(2) expression and HBD-2 levels in chronic periodontitis patients (p < 0.001). Conclusions: Our results suggest that salivary HBD-2 levels and PAR(2) mRNA expression from GCF are higher in subjects with chronic periodontitis than in healthy subjects, and that periodontal treatment decreases both HBD-2 levels and PAR(2) expression. (C) 2012 Elsevier Ltd. All rights reserved.

Consensus Report: 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals

Tobacco use has been identified as a major risk factor for oral disorders such as cancer and periodontal disease. Tobacco use cessation (TUC) is associated with the potential for reversal of precancer, enhanced outcomes following periodontal treatment, and better periodontal status compared to patients who continue to smoke. Consequently, helping tobacco users to quit has become a part of both the responsibility of oral health professionals and the general practice of dentistry. TUC should consist of behavioural support, and if accompanied by pharmacotherapy, is more likely to be successful. It is widely accepted that appropriate compensation of TUC counselling would give oral health professionals greater incentives to provide these measures. Therefore, TUC-related compensation should be made accessible to all dental professionals and be in appropriate relation to other therapeutic interventions. International and national associations for oral health professionals are urged to act as advocates to promote population, community and individual initiatives in support of tobacco use prevention and cessation (TUPAC) counselling, including integration in undergraduate and graduate dental curricula. In order to facilitate the adoption of TUPAC strategies by oral health professionals, we propose a level of care model which includes 1) basic care: brief interventions for all patients in the dental practice to identify tobacco users, assess readiness to quit, and request permission to re-address at a subsequent visit, 2) intermediate care: interventions consisting of (brief) motivational interviewing sessions to build on readiness to quit, enlist resources to support change, and to include cessation medications, and 3) advanced care: intensive interventions to develop a detailed quit plan including the use of suitable pharmacotherapy. To ensure that the delivery of effective TUC becomes part of standard care, continuing education courses and updates should be implemented and offered to all oral health professionals on a regular basis.

Efficacy of taurolidine against periodontopathic species--an in vitro study

The antimicrobial effect of taurolidine was tested against periodontopathic species in comparison to chlorhexidine digluconate in the presence or absence of serum. Minimal inhibitory concentrations (MIC), microbiocidal concentrations (MBC), as well as killing were determined against 32 different microbial strains including 3 Porphyromonas gingivalis, 3 Aggregatibacter actinomycetemcomitans, and 15 potentially superinfecting species with and without 25% v/v human serum. The MIC(50) of taurolidine against the tested microbial strains was 0.025% and the MIC(90) 0.05%. The respective values for the MBCs were 0.05% and 0.1%. Addition of 25% serum (heat-inactivated) did not change the MIC and MBC values of taurolidine. In contrast, MICs and MBCs of chlorhexidine (CHX) increased by two steps after addition of serum. Taurolidine killed microorganisms in a concentration and time-dependent manner, the killing rate of 1.6% taurolidine was 99.08% ± 2.27% in mean after 2 h. Again, killing activity of taurolidine was not affected if serum was added, whereas addition of inactivated serum clearly reduced the killing rate of all selected bacterial strains by CHX. Therefore, taurolidine possesses antimicrobial properties which are not reduced in the presence of serum as a main component in gingival crevicular fluid and wound fluid. Taurolidine may have potential as an antimicrobial agent in non-surgical and surgical periodontal treatment.