Adjunct effect of the antimicrobial photodynamic therapy to an association of non-surgical and surgical periodontal treatment in modulation of gene expression

Background: This study has evaluated the effect of antimicrobial photodynamic therapy (aPDT) used in conjunction with non-surgical and surgical periodontal treatment (PT) in modulating gene expression during periodontal wound healing. Methods: Fifteen patients with chronic periodontitis, presenting bilaterally lower molars with class III furcation lesions and scheduled for extraction, were selected. In initial therapy, scaling and root planing (SRP) was performed in the Control Group (CG), while SRP + aPDT were performed in the Test Group (TG). 45 days later, flap surgery plus SRP, and flap surgery plus SRP + aPDT were performed in the CG and TG, respectively. At 21 days post-surgery, the newly formed granulation tissue was collected, and Real-time PCR evaluated the expression of the genes: tumor necrosis factor-?, interleukin-1?, interleukin-4, interleukin-10, matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase-2 (TIMP-2), osteoprotegerin (OPG), receptor activator of nuclear factor- ?B ligand (RANKL), type I collagen, alkaline phosphatase, osteopontin, osteocalcin, and bone sialoprotein. Results: There were statistically significant differences between the groups in relation to mRNA levels for MMP-2 (TG = 3.26 ± 0.89; CG = 4.23 ± 0.97; p = 0.01), TIMP-2/MMP-2 ratio (TG = 0.91 ± 0.34; CG = 0.73 ± 0.32; p = 0.04), OPG (TG = 0.84 ± 0.45; CG = 0.30 ± 0.26; p = 0.001), and OPG/RANKL ratio (TG = 0.60 ± 0.86; CG = 0.23 ± 0.16; p = 0.04), favoring the TG. Conclusion: The present data suggest that the aPDT associated to nonsurgical and surgical periodontal therapy may modulate the extracellular matrix and bone remodeling by up regulating the TIMP- 2/MMP-2 and OPG/RANKL mRNA ratio, but the clinical relevance needs to be evaluated in further studies.

Management of a complex dentoalveolar trauma: a case report

This paper describes the case of a 12-year-old male patient who presented a severe lateral luxation of the maxillary central incisors due to a bicycle fall. Treatment involved suture of the soft tissues lacerations, and repositioning and splinting of the injured teeth, followed by endodontic treatment and periodontal surgery. After a 2-year follow-up, clinical and radiographic evaluation revealed that the incisors presented satisfactory esthetic and functional demands.

A influência do sorriso gengival no vedamentos labial

Ideally the smile should expose minimal gingival, therefore patients with gummy smile and passive eruption altered or excessive marginal gingivae, usually excessive gingival display because incomplete anatomical crown exposure is present. If the maxillary incisor show at rest is optimal, active upper incisor intrusion should not be iniciated. To achieve a smile with minimal gingival exposure, the anatomic crown should be fully exposed by surgical crown lengthening. Precise determination of the location of cementoenamel junction prior to surgery, precise placement of incisions and correct establish of biological width are necessary in order to achive this goal. One protocol is decribed and clinical results from 15 brazilian subjects, after three years post surgery are showed

Efeito do condicionamento radicular com ácido cítrico, citrato de sódio, EDTA e tetraciclina na adesão de elementos sanguíneos. Estudo por meio de microscopia eletrônica de varredura. -

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos do condicionamento radicular com diferentes agentes para a adesão de plasma rico em plaquetas e de células sanguíneas: estudo in vitro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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.

Comparação de dois tipos de retalho para enxerto de tecido conjuntivo no tratamento de recessões gengivais: estudo clínico controlado randomizado

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

Multidisciplinary approach for crown-root fracture treatment after trauma: case report

The development of an accurate diagnosis and appropriate treatment plan can be a complex task, especially in cases of dentoalveolar trauma. The authors present a case report of crown-root fracture caused by trauma and highlight the importance of a multidisciplinary approach for the treatment. An eighteen year-old boy had a bicycle accident resulting in dental trauma. The upper right first molar showed a complicated crownroot fracture and the lower left second pre-molar showed an uncomplicated crown-root fracture. Endodontic treatment, controlled tooth extrusion, periodontal surgery for recovery of biological width, and porcelain crown and onlay restorations were performed. Esthetic and functional results were achieved. At the two-year follow-up it was observed that the tooth/onlay interface of the upper right first molar was stained and the onlay of the left lower second pre-molar was fractured. Therefore, the interface stained was repaired and a porcelain crown was made for the lower second premolar. The clinical case presented herein leads to the conclusion that a multidisciplinary treatment plan is extremely important for a proper resolution in cases of dentoalveolar trauma.

Profilaxia antimicrobiana em medicina dentária: uma revisão da literatura

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Valoración periodontal de caninos incluidos en situación vestibular a los tres años del tratamiento orotodóncico-quirúrgico

Para demostrar que los parámetros periodontales no se alteran por la fenestración con colgajo de reposición apical de los caninos incluidos, se seleccionaron 12 pacientes con canino incluido por vestibular y el canino contralateral correctamente erupcionado. El tratamiento fue ortodóncico-quirúrgico, con colgajo de reposición apical (9 casos) o de reposición apical lateral (3 casos). Tres años después de finalizar el tratamiento ortodóncico, se valoró el estado periodontal de los caninos mediante: índice de plata, índice gingival, sangrado al sondaje, profundidad de sondaje y anchura de encía queratinizada. No se hallaron diferencias estadísticamente significativas entre el grupo experimental (caninos fenestrados) y el control (caninos contralaterales).

Periodontal health and esthetic results in impacted teeth exposed by apically positioned flap technique

Objectives: This study evaluates the periodontal health status and the esthetic results of teeth subjected to orthodontic traction, after their exposure by an apically positioned flap. Study design: Fifteen patients were included in the study, ages between 11 and 28 years old. The fenestrated teeth and their homologous contralateral normally erupted teeth, used as control, were evaluated. Results: Statistically significant differences were found in the position of the gingival margin (p = 0.005), with an average distance between cemento-enamel junction (CEJ) and gingival margin of 2.47 mm (SD 1.19) in control teeth and of 1 mm (SD 1.31) in the operated teeth, and in the depth of palatal probing (p = 0.031), with 2.1 mm (SD 0.9) for the experimental teeth and 1.7 mm (SD 0.8) for the control teeth. The gingival index, the bleeding during probing and the probing depth did not show statistically significant differences. The patient"s subjective esthetic evaluation was more favorable for the control teeth in most of the cases. Conclusions: The surgical approach for the impacted teeth by means of the apically positioned flap resulted to be a predictable technique allowing the maintenance of the periodontal health on a long-term basis.

Influência da perda de massa óssea sobre a doença periodontal induzida: estudo radiográfico e densitométrico em ratas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência do consumo crônico de etanol 20% na doença periodontal induzida em ratas com deficiência estrogênica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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.

Tratamento estético periodontal: revisão de literatura sobre alguns tipos de cirurgias

Currently, periodontal aesthetics has been prized for harmony of the smile. The clinical crown lengthening, gingival excess or altered passive eruption, is effectively corrected by periodontal surgery. The purpose of this paper is to show, through a literature review, some types of surgery on clinical crown lengthening and root coverage. Clinical crown lengthening is done to Change the size of the anterior teeth and to optimize the cosmetic result of treatment with new coronal restoration and other cosmetic dental care. In general, the treatment plan and the choice of operative technique begin with careful clinical examination. Recessions tissue can be defined as a displacement of the gingival margin toward the junction mucogingival exposing the root surface. These, when present, impacting on patient comfort by providing the occurrence of cervical dentin hypersensitivity, and the esthetic, the amendment of the gum line. Successful treatment of recessions is based on knowledge of its etiology and assessment of predictability of surgical techniques that aim to root coverage. Through literature review, we can conclude that the types of surgery most often used are: 1) to increase the clinical crown, gingivectomy, flap surgery and gingivoplasty osteotomy, and 2) for root coverage, the use will depend on the amount of gum keratinized and especially the classification of Miller.