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Aim: Patient’s adherence to the periodontal treatment is fundamental to the success of the therapy. Lack of response to the clinician’s instructions is influenced by various factors, including gender, age and psychosocial profile. The aim of the present study was to evaluate the relationship between self-perceived symptoms of generalized aggressive periodontitis and compliance with the oral hygiene instructions. Methods: Twenty-six subjects presenting a generalized aggressive form of periodontal disease were selected. The subjects answered a questionnaire to rate the perceived symptoms of periodontal disease with a sensitivity scale, in which a numeric score is attributed to each mentioned symptom. The percentage of sites with pocket probing depth (PPD) e” 5mm as well as the plaque index (PI) and gingival index (GI) were evaluated and the patients received a full mouth prophylaxis. One month later, the patients were re-evaluated for PI, GI, and PPD, and their percent reductions were correlated with the numeric score attributed to the aggressive periodontitis symptoms. Spearman’s correlation and Wilcoxon’s test were used with a significance level of 5%. Results: The greater the self-perception of some of the symptoms, the greater the adherence to the oral hygiene instructions. A positive correlation was observed between the reduction of GI and self perception of bleeding on tooth brushing (p=0.04, r=0.27) and redness and swelling of gums (p=0.04, r=0.26). Conclusions: The self-perception of symptoms of generalized aggressive periodontitis could have an influence on the patient’s response to the oral hygiene instructions.

This article reviews developmental and structural characteristics of cementum, a unique avascular mineralized tissue covering the root surface that forms the interface between root dentin and periodontal ligament. Besides describing the types of cementum and cementogenesis, attention is given to recent advances in scientific understanding of the molecular and cellular aspects of the formation and regeneration of cementum. The understanding of the mechanisms involved in the dynamic of this tissue should allow for the development of new treatment strategies concerning the approach of the root surface affected by periodontal disease and periodontal regeneration techniques.

The aim of the present study was to determinate the incidence of these defects and the therapeutic approaches employed in 105 patients attended in a Brazilian dental school. One-hundred five periodontal charts of patients attended at the Dental Clinic of the Unicamp Dental School were examined, in order to find furcation lesions in molar and premolar teeth (upper and/or lower). The results showed that these 105 subjects exhibited 216 teeth with furcation involvements (131 at the upper jaw and 85 at the lower jaw). It represented a percentual score of furcation defects by jaw: 60.6% at the upper jaw and 39.4% at the lower jaw. The incidence of furcation lesions was higher at the first molar in all of the quadrants and the higher incidence of these defects was on the tooth #16 (34%) and the upper buccal furcation defect was the more incident in this sample (28.2%). The predominant type of furcation lesion at the upper jaw was the class I defect (61.5%) and the more prevalent defect in the lower jaw was class I (65.8%). Considering both the archs, the class I defect appeared in 60.2% of the cases, class II´s, 30.1%, and class III´s, 9.7%. The more used therapeutic approach for furcation involvements was scaling and root planing (69.9%). These data suggest that the upper teeth are more affected by furcation lesions than the lower teeth; the furcation lesions are more frequent on the first molar in all of the quadrants; the class I is the more frequent type of furcation lesion; and the more frequently used approach to treat furcation involvement was scaling and root planing.

The use of dental implants in the rehabilitation of partially and fully edentulous patients is an efficient method even though failures do occur. Papers have speculated on the cause of failure. Bone quality and quantity, shorter implants, smoking and systemic health, surgical trauma, contamination during implant surgery, peri-implantitis, and overloading throughout the prosthesis have been associated with failures. The aim of the present review is to analyze the possible causes of implant failure.

OBJECTIVE: This study was designed to evaluate, histomorphometrically, the association of platelet-rich plasma (PRP) and bioactive glass (BG) in the treatment of periodontal intrabony defects. MATERIAL AND METHODS: Nine mongrel dogs were included in the study. Three-wall intrabony defects were surgically created at the mesial and distal aspect of first mandibular molar and exposed to plaque accumulation for 1 month. The defects were randomly assigned to the groups: control, BG, PRP, PRP+BG. Dogs were sacrificed 90 days after the surgeries. The histometric parameters evaluated were: length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone, defect extension and area of new bone filling the defect. RESULTS: A superior area of new bone was observed in PRP+BG and BG (13.80±2.32 mm² and 15.63±2.64 mm², respectively) when compared to the other groups (8.19±1.46 mm² and 8.81±1.47 mm² for control and PRP, respectively). No statistically significant differences were observed in the remaining parameters. CONCLUSIONS: Within the limits of this study, it may be concluded that PRP failed to provide statistically significant improvements in the histometric parameters.

This study aimed to evaluate the effects of a flavor-containing dentifrice on the formation of volatile sulphur compounds (VSCs) in morning bad breath. A two-step, blinded, crossover, randomized study was carried out in 50 dental students with a healthy periodontium divided into two experimental groups: flavor-containing dentifrice (test) and non-flavor-containing dentifrice (control). The volunteers received the designated dentifrice and a new toothbrush for a 3 X/day brushing regimen for 2 periods of 30 days. A seven-day washout interval was used between the periods. The assessed parameters were: plaque index (PI), gingival index (GI), organoleptic breath scores (ORG), VSC levels (as measured by a portable sulphide monitor) before (H1) and after (H2) cleaning of the tongue, tongue coating (TC) wet weight and BANA test from TC samples. The intra-group analysis showed a decrease in ORG, from 3 to 2, after 30 days for the test group (p < 0.05). The inter-group analysis showed lower values in ORG, H1 and H2 for the test group (p < 0.05). There was no difference between the amount of TC between groups and the presence of flavor also did not interfere in the BANA results between groups (p > 0.05). These findings suggest that a flavor-containing dentifrice seems to prevent VSCs formation in morning bad breath regardless of the amount of TC in periodontally healthy subjects.

The goal of this investigation was to evalute the healing process of class III furcation defects treated with resorbable membranes. Five mongrel dogs were used. Class III furcation defects were surgically created and exposed to plaque accumulation for 3 months. After this period, the defects were randomly assigned to one of the treatments: ATR= non-sutured resorbable barriers (Atrisorb ®), GUI= resorbable barriers stabilized with sutures (Guidor®), OFD= open flap debridement and NTC= non-treated control. After 3 months, the dogs were sacrificed and the blocks were processed. The histometric parameters evaluated included linear and area measurements. The defects treated with membranes presented a superior length of new cementum when compared to NTC (P

OBJECTIVE: The purpose of this study was to evaluate the root surface roughness after instrumentation with hand curette and diamond-coated sonic and universal ultrasonic tips. MATERIALS AND METHODS: Forty root surfaces of human teeth were randomly assigned to four treatment groups: control group (without instrumentation), curette instrumentation, ultrasonic instrumentation with universal tip and sonic instrumentation with diamond-coated tip. Each sample was instrumented with fifteen strokes. Before and after instrumentation, surface roughness was measured. In addition, the root surface topography was examined after treatment under the scanning electron microscope. RESULTS: Significant statistical differences (p 0.05). CONCLUSION: The diamond-coated tip with sonic scaler instrumentation and ultrasonic instrumentation produce similar root surface roughness, higher than curette instrumentation.OBJETIVO: O objetivo do presente estudo foi avaliar a rugosidade radicular obtida após instrumentação por aparelho sônico com pontas diamantadas, curetas e ultrassom. MATERIAL E MÉTODOS: Quarenta superfícies radiculares, devidamente polidas e incluídas em resina acrílica, foram dividas em 4 grupos de tratamento: grupo controle (sem instrumentação) e instrumentação com cureta Gracey 5/6, ultrassom ou aparelho sônico com ponta diamantada. Em cada amostra foram realizados 15 movimentos de raspagem. Antes e após esta instrumentação foi utilizado um rugosímetro para a medição da rugosidade radicular. Além disso, a topografia da superfície radicular foi avaliada após o tratamento com microscopia eletrônica de varredura. RESULTADOS: Diferenças estatisticamente significantes (p0.05). CONCLUSÃO: A instrumentação sônica com pontas diamantadas promove uma rugosidade radicular equivalente à instrumentação com ultrassom, sendo essa rugosidade superior àquela apresentada pela instrumentação manual.

Anti-inflammatory agents have been reported to regulate bone healing. The aim of this study was to investigate the effect of a selective cyclooxygenase-2 inhibitor (meloxicam) on bone healing in calvarial defects in rats. Thirty-six adult male Wistar rats were included. After anesthesia, a linear incision was made through the skin of the scalp, a full-thickness flap was reflected and a 4 mm round defect was made with a trephine drill. The animals were randomly assigned to one of the following 4 treatment groups (9 animals each), including daily subcutaneous injections: A: saline solution for 15 days; B: saline solution for 45 days; C: 3 mg/kg of meloxicam for 15 days and D: 3 mg/kg of meloxicam for 45 days. The animals were sacrificed and the specimens, routinely processed. The bone filling was histometrically measured and statistical analysis, performed. Intergroup comparisons demonstrated that the meloxicam groups presented a significant reduction in bone healing when compared to their respective controls (group A, 44.5 ± 5.75%, against group C, 57.5 ± 7.25%, p < 0.05; group B, 40.25 ± 13.75%, against group D, 52.25 ± 17.25%). Within the limits of the present study, it can be concluded that selective cyclooxygenase-2 inhibitors may reduce bone healing in calvarial defects in rats after continuous administration.Agentes antiinflamatórios têm sido descritos como reguladores do reparo ósseo. O objetivo deste estudo foi investigar o efeito de um inibidor seletivo da cicloxigenase-2 (meloxicam) no reparo ósseo em defeitos de calvárias de ratos. Trinta e seis ratos machos Wistar foram incluídos no estudo. Após anestesia, incisão linear e rebatimento de retalho de espessura total, um defeito de 4 mm de diâmetro foi criado na calvária dos animais com broca trefina. Os mesmos foram aleatoriamente distribuídos em um dos 4 grupos de tratamento (9 animais por grupo), recebendo injeções subcutâneas diárias de: A: soro fisiológico por 15 dias; B: soro fisiológico por 45 dias; C: 3 mg/kg de meloxicam por 15 dias; D: 3 mg/kg de meloxicam por 45 dias. Os animais foram sacrificados e os espécimes rotineiramente processados. Medidas do preenchimento ósseo foram histometricamente realizadas e analisadas estatisticamente. Comparações intergrupos demonstraram que os grupos com meloxicam apresentaram uma redução significativa no reparo ósseo quando comparados com os respectivos grupos-controle (grupo A, 44,5 ± 5,75%, contra grupo C, 57,5 ± 7,25%, p < 0,05; grupo B, 40,25 ± 13,75%, contra grupo D, 52,25 ± 17,25%). Dentro dos limites do presente estudo, pode ser concluído que os inibidores seletivos da cicloxigenase-2 podem reduzir o reparo ósseo em defeitos em calvárias de ratos após sua administração contínua.

The objective of this study was to investigate the histometric impact of nicotine on bone regeneration of surgically created alveolar ridge defects in dogs. Sixteen mongrel dogs were used. One defect was surgically created unilaterally in the mandible, and left to heal spontaneously. The animals were randomly assigned to one of the following groups: Group 1 - control (n = 8) and Group 2 - subcutaneous nicotine administration (2 mg/kg) twice a day (n = 8). After 4 months, the animals were sacrificed and the specimens routinely processed for semi-serial decalcified sections. Bone height (BH), bone width (BW), bone density (BD), and bone area (BA) of the newly-formed bone were evaluated. Intergroup analysis (Mann-Whitney rank sum test) showed that regardless of the presence of nicotine, no significant differences were observed regarding bone width (BW), bone area (BA) and bone height (BH) (p > 0.05). On the other hand, it was demonstrated that nicotine administration significantly influenced the proportion of mineralized tissue within the limits of the newly-formed bone (BD) (p < 0.001). Within the limits of the present study, it can be concluded that nicotine might affect but not prevent bone healing in defects left to heal spontaneously.O objetivo do presente estudo foi avaliar histometricamente a influência da nicotina sobre a regeneração óssea de defeitos criados cirurgicamente em rebordos alveolares edêntulos de cães. Defeitos ósseos foram criados cirurgicamente em um dos lados da mandíbula de dezesseis cães e foram deixados para que curassem espontanea-mente. Os animais foram aleatoriamente designados para um dos seguintes grupos: Grupo 1 - controle (n = 8) e Grupo 2 - administração subcutânea de nicotina (2 mg/kg) duas vezes ao dia durante 4 meses (n = 8). Os animais foram sacrificados, e secções semi-seriadas descalcificadas, obtidas. Os parâmetros histométricos avaliados foram altura, largura, área e densidade do tecido ósseo neoformado. A análise intergrupos (Mann-Whitney "rank sum test") demonstrou que a administração de nicotina não influenciou altura, largura e área de tecido ósseo neoformado (p > 0,05). Entretanto, a administração de nicotina influenciou significativamente a densidade do tecido ósseo neoformado (p < 0,001). Dentro dos limites do presente estudo, pode-se concluir que a nicotina pode afetar, mas não impedir a regeneração de defeitos ósseos criados cirurgicamente em mandíbulas edêntulas de cães.

The presence of furcation lesions is associated with bone resorption and lack of insertion in the inter-radicular space, and is a condition that considerably increases the risk of dental loss, particularly in the absence of adequate treatment. In this context, the object of some of the therapies is to keep teeth with furcation lesions that are important to dental planning, to re-establish an anatomy that enables the patient to remove dental biofilm from the compromised area. However, the long term maintenance and treatment of molars with Class III furcation lesions continues to be a challenge to dentists during periodontal therapy, since the anatomy of the inter-radicular region makes it difficult for both professionals and patients to gain access to perform adequate and efficient control of dental biofilm. The impossibility of obtaining appropriate decontamination of the area involved during the root scraping process, including by means of surgical access, demands thatdentists have adequate knowledge to determine the correct therapeutic approach during the treatment of teeth with advance inter-radicularbone loss. The aim of the present study was to discuss the treatments available for Class III furcation lesions and relate clinical procedures that could be performed for the treatment of this type of defect.

The aim of this study was to clinically evaluate the effect of immediate trauma from instrumentation after scaling and root planing with different instruments. Ten subjects with moderate chronic periodontitis, presenting probing depths of 3.5-6.5mm on anterior teeth, maxillary and/or mandibular, were selected. Teeth were randomly assigned to one of the following groups: PF group - scaled and planed with Hirschfeld periodontal files; CC group - scaled and planed with Gracey conventional curettes. The selected teeth were probed with a computerised electronic probe, guided by an occlusal stent and subjected to scaling and root planing. Immediately following instrumentation, teeth were probed again. The difference between relative attachment level (RAL) immediately before and after instrumentation was considered as trauma from instrumentation. Intra-group analysis revealed statistically significant differences between RAL immediately before and after instrumentation in both groups (1.28 +/- 1.13 for PF group; and 0.83 +/- 0.41 for CC group - p<0.05). However, inter-group analysis did not show statistically significant difference in trauma from instrumentation caused by the different instruments (p=0.063). Within the limits of this study, it was concluded that root instrumentation causes a mean immediate attachment loss of 1.06mm, with no differences between instrumentation with periodontal curettes or periodontal files.