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Made available in DSpace on 2021-06-25T12:24:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-11-09 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Background The aim of this study was to evaluate the clinical, radiographic and patient-centered results of enamel matrix derivative (EMD) therapy in intrabony defects in aggressive periodontitis (AgP) patients and compare them with those in chronic periodontitis (CP) patients. Methods Sixty intrabony defects in AgP and CP patients associated with >= 6 mm residual probing pocket depth (PPD) were included and randomly assigned to one of three groups: AgP+CS (conservative surgery) (n = 20); AgP+CS/EMD (n = 20); CP+CS/EMD (n = 20). Clinical parameters were measured at baseline and after 6 and 12 months. Defect resolution (DR) and bone filling (BF) were used for radiographic analysis. The quality of life was recorded at baseline and 6 months using OHIP-14 and VAS scale in the early post-therapy period. Results PPD and relative clinical attachment level (rCAL) improved for all groups during follow-up (P 0.05). No radiographic differences were observed among groups at any time point (P > 0.05). All the groups reported a positive impact on OHIP-14 total score, without differences among them. Conclusions EMD therapy of intrabony defects promotes additional benefits in AgP patients, presenting a similar regeneration rate compared to CP patients, and has proven to be a viable therapy for the treatment of individuals with AgP. Univ Estadual Campinas, Dept Prosthesis & Periodontol, Piracicaba, Brazil State Univ Sao Paulo, Dept Diag & Surg, Sao Jose Dos Campos, Brazil State Univ Sao Paulo, Dept Diag & Surg, Sao Jose Dos Campos, Brazil FAPESP: 2015/19731-0 CAPES: 001

The present study aimed to evaluate clinical and microbiological effects of surgical and nonsurgical periodontal therapy in generalized aggressive periodontitis (GAgP) treatment. Sixteen GAgP patients were included in this randomized split-mouth design clinical trial. Maxillary quadrants were allocated into two groups: Nonsurgical Therapy (NST) and Surgical Therapy (ST). The following clinical parameters were assessed: plaque index (PI), bleeding on probing index (BoP), probing depth (PD), clinical attachment level (CAL) and gingival margin position (GMP). Concentrations of Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) in the subgingival biofilm were also determined. Clinical and microbiological parameters were assessed at baseline (n=16), 3 (n=15), 6 (n=15) and 12 months (n=8) after treatment. ST was able to promote higher PD reduction compared to NST in deep pockets at 12 months (p0.05). Moreover, microbiological evaluation showed no statistical difference in levels of Aa and Pg for both groups at all follow-up periods. Surgical therapy promoted similar clinical benefits to GAgP therapy. Moreover, both therapies failed to reduce Aa and Pg levels at different follow-up times. Resumo O presente estudo teve como objetivo avaliar os efeitos clínicos e microbiológicos de terapia periodontal cirúrgica e não cirúrgica no tratamento da periodontite agressiva generalizada (PAgG). Dezesseis pacientes portadores de PAgG foram incluídos neste estudo clínico, prospectivo, randomizado, de boca dividida. Os quadrantes superiores de cada paciente foram alocados em dois grupos: um grupo de terapia não-cirúrgica (NST) e um grupo de terapia cirúrgica (ST). Os parâmetros clínicos avaliados foram: índice de placa (PI), sangramento à sondagem índice (BoP), profundidade de sondagem (PD), nível clínico de inserção (CAL) e posição da margem gengival (GMP). Também foram determinadas as concentrações de Porphyromonas gingivalis (Pg) e Aggregatibacter actinomycetemcomitans (Aa) no biofilme subgengival. Os parâmetros clínicos e microbiológicos foram avaliados no início, 3, 6 e 12 meses após o tratamento. A terapia cirúrgica foi capaz de promover maior redução de PD em comparação com NST em bolsas profundas aos 12 meses (p

Objective: Tumor necrosis factor-alpha (TNF-α) is a major mediator of the immune-inflammatory response and may play an important role in the pathogenesis and progression of chronic periodontitis. Polymorphisms in the promoter of the TNFA gene have been associated with some types of inflammatory diseases. The present study investigated the association between a single-nucleotide polymorphism (SNP) of the TNFA (G-308A) gene and chronic periodontitis in Brazilians. Methods: One hundred and thirteen (113) over 25 years were divided according to the severity level of periodontal disease: 44 healthy individuals (control group), 31 subjects with moderate and 38 patients with severe periodontitis. Genomic DNA was obtained from epithelial cells. The samples were analyzed for TNFA (G-308A) polymorphism using polymerase chain reaction-restriction fragment length polymorphism techniques. The significance of the differences in the genotype frequencies of the polymorphism was assessed by Chi-square test (p

To determine the efficacy of two oral hygiene regimens in the reduction of dentin hypersensitivity (DH) on subjects undergoing non-surgical periodontal treatment (NST), over a period of 8 weeks.60 subjects that were randomly assigned to: Test group - NST followed in-office application of an arginine-based professional paste and toothbrushing with arginine-based toothpaste at home (n= 30) and Control group - NST followed in-office application of a fluoride-free prophylaxis paste and toothbrushing with a toothpaste based on sodium monofluorophosphate 0.76%, at home (n= 30). Air blast sensitivity assessments were made using the Schiff scale. The sensitivity parameters were measured at baseline, 1, 4 and 8 weeks.After 1 week, DH reduction was statistically significant for the test group (63.6%) compared to baseline, while no significant reduction was observed for the Control group (4.8%). After 4-8 weeks, the reductions were 81.6%/86.3% for the test group and 9.5%/14.2% for the Control group. When comparing the two groups, the test group showed a superior DH reduction in all evaluation periods (P0.05). Within the limits of the present study, it was concluded that the test oral hygiene regimen can effectively reduce dentin hypersensitivity during the most critical period after non-surgical periodontal treatment (up to 8 weeks).The arginine-based approach provided significantly greater dentin hypersensitivity (DH) relief after non-surgical periodontal treatment (NST) when compared to the control. The combination of the in-office paste application with the daily used toothpaste may be a useful tool to reduce DH, an unpleasant and common condition that affects a large number of subjects, particularly during the initial weeks following NST.

The aim of this pilot study was to assess the release of locally delivered doxycycline by poly (l-lactide-co-glycolide) (PLGA) microspheres in the periodontal pocket of patients with chronic periodontitis, treated by non-surgical periodontal therapy. Nineteen sites of non-adjacent teeth of four different patients were evaluated. Five milligram of PLGA microspheres loaded with 16 doxycycline hyclate (DOX) was administered per periodontal site. To quantify DOX released into the periodontal pocket, gingival crevicular fluid (GCF) was collected from the sites on days 2, 5, 7, 10, 15, and 20 after DOX application, and high-performance liquid chromatography was performed. Data were statistically assessed by ANOVA/Tukey test. At days 2, 5, and 7, the DOX concentration was stably sustained (23.33 ± 1.38, 23.4 ± 1.82, and 22.75 ± 1.33 μg/mL, respectively), with no significant differences over these assessment times (p > 0.05). At days 10 and 15, a tendency was observed toward a decrease in DOX concentration (21.74 ± 0.91 and 20.53 ± 4.88 μg/mL, respectively), but a significant decrease in GCF drug concentration (19.69 ± 4.70 μg/mL) was observed only on day 20. The DOX delivery system developed demonstrated a successful sustained release after local administration, as an adjunct to non-surgical periodontal therapy.

It was previously reported the clinical results of placing subgingival resin-modified glass ionomer restoration for treatment of gingival recession associated with non-carious cervical lesions. The aim of this study was to evaluate the influence of this treatment on the subgingival biofilm and gingival crevicular fluid (GCF) inflammatory markers.Thirty-four patients presenting the combined defect were selected. The defects were treated with either connective tissue graft plus modified glass ionomer restoration (CTG+R) or with connective tissue graft only (CTG). Evaluation included bleeding on probing and probing depth, 5 different bacteria targets in the subgingival plaque assessed at baseline, 45, and 180 days post treatments, and 9 inflammatory mediators were also assessed in the GCF.The levels of each target bacterium were similar during the entire period of evaluation (p 0.05), both within and between groups. The highest levels among the studied species were observed for the bacterium associated with periodontal health. Additionally, the levels of all cyto/chemokines analyzed were not statistically different between groups (p 0.05).Within the limits of the present study, it can be concluded that the presence of subgingival restoration may not interfere with the subgingival microflora and with GCF inflammatory markers analyzed.This approach usually leads to the placement of a subgingival restoration. There is a lack of information about the microbiological and immunological effects of this procedure. The results suggest that this combined approach may be considered as a treatment option for the lesion included in this study.

Objectives: To evaluate the effects of a 1% hyaluronic acid (HA) gel in combination with an absorbable collagen sponge (ACS) in the healing of critical-size calvaria defects in rats. Material and methods: Thirty-two adult Wistar rats were used. Two 5-mm-diameter critical-size defects were created and the treatments were randomly distributed as follows: (1) 1% HA; (2) 1% HA gel-soaked ACS; (3) control (blood clot); and (4) ACS. The animals were sacrificed 60 days post-surgery, when biopsies were collected and processed for histology and histometric analysis. Bone fill was measured as the difference between the initial and the final defect sizes. Non-parametric tests were used to analyze differences between treatments (α=1%) and a t-test for body weight gain in each treatment group (α=5%). Results: Histological analysis showed bone formation on the edges of the defects, although very limited, and a thin layer of connective tissue occupying the midportion of the defects in the control and the ACS groups. Defects filled with a 1% HA gel and 1% HA gel+ACS had a thicker layer of connective tissue and more new bone formed in the margins of the defects. Linear histometric measures showed no significant differences in the initial defect sizes between the groups (P>0.05). The association 1% HA gel+ACS (0.96 ± 0.14 mm) had significantly greater bone fill than the control (0.5 ± 0.02 mm) and ACS (0.56 ± 0.05 mm)-treated groups (P=0.0043 and 0.0173, respectively). Treatment with a 1% HA gel (0.7 ± 0.14 mm) showed no significant differences when compared with the other treatments. Conclusion: Within the limits of this study, a 1% HA gel associated with a collagen scaffold can improve new bone formation in critical-size defects. However, this treatment never resulted in complete closure of the defects and healing in the major portion of the defects was characterized by fibrous tissue. To cite this article: de Brito Bezerra B, Brazao MAM, de Campos MLG, Casati MZ, Sallum EA, Sallum AW. Association of hyaluronic acid with a collagen scaffold may improve bone healing in critical-size bone defects. Clin. Oral Impl. Res. 23, 2012; 938–942 doi: 10.1111/j.1600-0501.2011.02234.x

OBJECTIVE: The aim of this controlled clinical trial was to evaluate the effect of topically applied povidone-iodine (PVP-I) used as an adjunct to non-surgical treatment of interproximal class II furcation involvements. MATERIAL AND METHODS: Thirty-two patients presenting at least one interproximal class II furcation involvement that bled on probing with probing pocket depth (PPD) >5 mm were recruited. Patients were randomly chosen to receive either subgingival instrumentation with an ultrasonic device using PVP-I (10%) as the cooling liquid (test group) or identical treatment using distilled water as the cooling liquid (control group). The following clinical outcomes were evaluated: visible plaque index, bleeding on probing (BOP), position of the gingival margin, relative attachment level (RAL), PPD and relative horizontal attachment level (RHAL). BAPNA (N-benzoyl-L-arginine-p-nitroanilide) testing was used to analyze trypsin-like activity in dental biofilm. All parameters were evaluated at baseline and 1, 3 and 6 months after non-surgical subgingival instrumentation. RESULTS: Six months after treatment, both groups had similar means of PPD reduction, RAL and RHAL gain (p>0.05). These variables were, respectively, 2.20±1.10 mm, 1.27±1.02 mm and 1.33±0.85 mm in the control group and 2.67±1.21 mm, 1.50±1.09 mm and 1.56±0.93 mm in the test group. No difference was observed between groups at none of the posttreatment periods, regarding the number of sites showing clinical attachment gain >2 mm. However, at 6 months posttreatment, the test group presented fewer sites with PPD >5 mm than the control group. Also at 6 months the test group had lower BAPNA values than control group. CONCLUSION: The use of PVP-I as an adjunct in the non-surgical treatment of interproximal class II furcation involvements provided limited additional clinical benefits.

Casarin RCV, Ribeiro EDP, Nociti Jr FH, Sallum AW, Ambrosano GMB, Sallum EA, Casati MZ: Enamel matrix derivative proteins for the treatment of proximal class II furcation involvements: a prospective 24-month randomized clinical trial. J Clin Periodontol 2010; doi: 10.1111/j.1600-051X.2010.01614.x. Abstract Objective: This study aimed to evaluate the response of proximal furcations treated with enamel matrix derivative proteins (EMD) in a 24-month follow-up. Materials and Methods: Twelve patients presenting bilateral class II proximal furcation with vertical probing depth (PD)5 mm and bleeding on probing were selected. The furcations were assigned to: a control group (n=12), open flap debridement (OFD)+EDTA and a test group (n=12) – OFD+EDTA+EMD. The gingival margin position, PD, relative vertical and horizontal clinical attachment level (RVCAL and RHCAL), vertical and horizontal bone level (VBL and HBL) and furcation closure were evaluated before treatment and after 6, 12 and 24 months. Results: After follow-up, no statistical difference could be seen between groups. At 24 months, the test group showed 1.9 ± 1.6 mm PD reduction whereas the control group showed 1.0 ± 1.3 mm PD reduction. RHCAL gains of the control and the test group were 0.7 ± 1.3 and 1.4 ± 0.9 mm, respectively. However, at 24 months, the test group only presented five remaining class II furcations versus 10 furcations in the control group (p

Background: This prospective clinical study aims to evaluate the influence of cigarette smoking on free gingival graft (FGG) healing, by assessing FGG dimensional changes and donor-site wound healing. Methods: Twelve non-smokers and 10 smokers treatment planned for FGG to augment keratinized tissue dimensions in the mandibular incisor area completed the study. All subjects received standardized FGG of same dimensions. Probing depth, gingival margin position, clinical attachment level, keratinized tissue (KT) width, gingival thickness, and FGG dimensions (width, length, and area) were assessed and recorded before surgery, and 7, 15, 30, 60, and 90 days postoperatively. The palatal donor area was evaluated for immediate bleeding and complete wound epithelialization. Differences between the two groups (smokers and non-smokers) were statistically analyzed. Results: FGG dimensions changed significantly postoperatively. At 90 days postoperatively, FGG width, length, and area were respectively reduced by 31%, 22%, and 44% in nonsmokers and by 44%, 25%, and 58% in smokers (no significant differences between groups; P >0.05). Significant KT increases were observed in both non-smokers and smokers (5.4 and 4.8 mm, respectively). Donor-site immediate bleeding was significantly more prevalent in non-smokers (75%) compared to smokers (30%) (P = 0.04). At 15 days postoperatively, donorsite complete epithelialization was much more prevalent in non-smokers (92%) than in smokers (20%) (P

The objective of this prospective, controlled clinical trial was to evaluate the long-term outcomes of subepithelial connective tissue graft (SCTG) or semilunar coronally positioned flap (SCPF) for the treatment of Miller Class I gingival recession defects.Seventeen patients with bilateral Miller Class I gingival recessions (or =4.0 mm) in maxillary canines or premolars were selected. The recessions were randomly assigned to receive SCPF or SCTG. Recession height (RH), recession width (RW), width of keratinized tissue (WKT), thickness of keratinized tissue (TKT), probing depth (PD), and clinical attachment level (CAL) were measured at baseline and at 6 and 30 months post-surgery. Patient satisfaction with esthetics and root sensitivity was also evaluated.The root-coverage outcomes obtained at 6 months were maintained throughout the study. At the 30-month examination, the average percentage of root coverage was 89.25% for SCPF and 96.83% for SCTG (P0.05); complete root coverage was observed in 58.82% and 88.24% of patients, respectively. SCTG maintained a statistically significant increase in TKT (P0.05) at 30 months. At this time, there were no significant differences between the two groups with regard to RH, RW, WKT, PD, and CAL. The evaluation of the esthetic outcome by the patient showed a preference for the SCTG treatment. Furthermore, in this group, no patient complained of residual or additional root hypersensitivity. In the SCPF group, three patients had this complaint at 30 months.SCPF and SCTG can be successfully used to treat Class I gingival recession, presenting outcomes with long-term stability. However, patient-oriented outcomes, such as esthetics and root sensitivity, favor SCTG therapy.

OBJECTIVES: The aim of this study was to evaluate the influence of the crown shape on the outcomes of root coverage procedures. MATERIAL AND METHODS: Eighty patients with Miller class I gingival recessions in maxillary canines or premolars were selected. The recession areas were treated using the subepithelial connective tissue grafting. The following clinical parameters were analyzed: crown length (CL) and width (CW), recession height and width, probing depth, clinical attachment level, width and thickness of the keratinized tissue and percentage of root coverage achieved. These measurements were recorded at baseline and 6 months after the surgical procedure. The CW/CL ratio was calculated for each tooth and the median obtained (0.83). Patients were then ranked into two groups, according to the shape of the tooth with gingival recession: Group A - square crown shape (CW/CL values above 0.83) and Group B - long and narrow crown shape (CW/CL values below 0.83). RESULTS: No statistically significant differences (p>0.05) were found between groups in any of the clinical parameters at baseline. After 6 months, both groups presented improved clinical outcomes for all parameters analyzed compared to baseline (p>0.05). The mean percentages and standard deviations of root coverage achieved in Group A and Group B was 91.37 (16.75) and 85.49 (23.55), respectively (p>0.05). CONCLUSIONS: Crown shape did not influence the root coverage obtained with the subepithelial connective tissue graft technique.

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 aim of the present study was to histometrically evaluate bone healing in the absence of bone defects and in the presence of surgically created bone defects treated by guided bone regeneration at oxidized and turned implant surfaces.Three months after dental extractions, standardized buccal dehiscence defects (height: 5 mm; width: 4 mm) were surgically created following implant site preparation in the mandible of 10 dogs. Oxidized-surface implants (OSI) and turned-surface implants (TSI) were inserted bilaterally, and the bone defects were treated by guided bone regeneration. After 3 months of healing, the animals were sacrificed, blocks were dissected, and undecalcified sections were obtained and processed for histometric analysis. The percentage of bone-to-implant contact (BIC) and bone density (BD) was evaluated inside the threads on the buccal (regenerated bone) and lingual sides (pristine bone) of the implants. Data were evaluated using two-way analysis of variance (P0.05).New bone formation could be observed in OSI and TSI in the region of the defect creation. The BIC values observed in OSI for pristine and regenerated bone were 57.03% +/- 21.86% and 40.86% +/- 22.73%, respectively. TSI showed lower values of BIC in pristine bone (37.39% +/- 23.33%) and regenerated bone (3.52% +/- 4.87%). The differences between OSI and TSI were statistically significant. BD evaluation showed no statistically significant differences between OSI and TSI in pristine and regenerated bone.The oxidized implant surface promoted a higher level of BIC than the turned implant surface at pristine and regenerated bone.

The aim of this study was to evaluate the clinical and laboratory changes 3 months after full-mouth scaling and root planing in subjects with and without diabetes mellitus.This study was performed using 10 subjects with type 2 diabetes mellitus who required insulin therapy (DM) and 10 healthy adult control subjects (NDM) with generalized chronic periodontal disease. Both groups were treated with full-mouth scaling and root planing and given oral hygiene instructions. Clinical parameters, including plaque index (PI), gingival index (GI), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL), were measured at four sites per tooth. Subgingival plaque samples were obtained from sites with the deepest PD (or =5 mm) and with furcations in each subject. Samples were also tested for the presence of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and Tannerella forsythia (previously T. forsythensis) by polymerase chain reaction. Glycemic control (glycosylated hemoglobin [HbA1c] and fasting glucose levels) and clinical and microbiologic assessments were recorded at baseline and 3 months after periodontal treatment.Data revealed statistical changes (Por =0.05; analysis of variance [ANOVA]) in clinical variables (PI, GI, PD, GR, and CAL) between baseline and 3 months in both groups. Conversely, no improvement in the fasting glucose level or glycosylated hemoglobin (Por =0.05; ANOVA) was found after treatment. Besides some reduction in the bacterial frequency 3 months after treatment, no statistically significant difference was found between the groups.Clinical and laboratory responses were similar in DM and NDM groups 3 months after full-mouth scaling and root planing.

Objective: The aim of the present randomized, double-blind study was to evaluate the clinical response of proximal furcations treated with enamel matrix derivative proteins (EMD). Material and Methods: Fifteen patients, each with a pair of contralateral class-II proximal furcation involvements, presenting probing depths (PDs) 5 mm and bleeding on probing (BOP) were selected. The patients were randomly assigned to: control group (n=15) – open flap debridement (OFD)+24% ethylenediaminetetraacetic acid (EDTA) conditioning; test group (n=15) – OFD+24% EDTA conditioning+EMD application. Plaque index (PI), BOP, PD, gingival margin position (GMP), relative vertical and horizontal clinical attachment level (RVCAL and RHCAL), vertical and horizontal bone level (VBL and HBL) and furcation closure were evaluated immediately before and 2, 4 and 6 months after the surgeries. Results: At 6 months, the RVCAL gains of the control and test group were 0.39 ± 1.00 and 0.54 ± 0.95 mm, while the RHCAL gains were 1.21 ± 2.28 and 1.36 ± 1.26 mm (p>0.05). The VBL and HBL gains of the control group were 1.04 ± 1.12 and 1.00 ± 1.79 mm, and 0.82 ± 1.82 and 1.17 ± 1.38 mm for the test group (p>0.05). In addition, a statistical difference was observed in the number of the remaining class-II furcations between the test and control groups (p

The aim of this study was to histometrically evaluate the healing process of gingival recessions treated with platelet-rich plasma (PRP) in combination with a subepithelial connective tissue graft (SCTG) and to compare it to that obtained with SCTG alone.Six mongrel dogs were used in the experiment. Gingival recessions (5 x 7 mm) were surgically created and exposed to plaque accumulation for 1 month. Contralateral defects were randomly assigned to the test group (SCTG + PRP) or the control group (SCTG). Dogs were sacrificed 45 days after the surgeries, and the blocks containing the experimental specimens were processed for histologic analysis. The histometric parameters evaluated were length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone, and defect extension.A greater length of new cementum was observed in the sites treated with PRP (2.18 +/- 0.78 mm) compared to the control group (1.19 +/- 0.62 mm) (Por =0.05). No statistically significant differences were observed in the remaining parameters. The extension of total epithelium (sulcular and junctional epithelium) was 2.04 +/- 0.57 mm for the test group and 2.49 +/- 0.82 mm for the control group. The new connective tissue adjacent to the root without cementum formation was 0.29 +/- 0.28 mm and 0.23 +/- 0.18 mm for the test and control groups, respectively. Bone position was -0.57 +/- 0.95 mm for the test group and -0.46 +/- 1.34 mm for the control group.Within the limits of this study, the combination of PRP with SCTG was more effective in promoting new cementum formation than the graft alone.

The aim of this randomized clinical trial was to evaluate the treatment of gingival recession associated with non-carious cervical lesions by a coronally advanced flap alone (CAF) or in combination with a resin-modified glass ionomer restoration (CAF+R).Nineteen subjects with bilateral Miller Class I buccal gingival recessions associated with non-carious cervical lesions were selected. The recessions were assigned randomly to receive CAF or CAF+R. Bleeding on probing (BOP), probing depth (PD), relative gingival recession (RGR), clinical attachment level (CAL), non-carious cervical lesion height (CLH), and dentin sensitivity (DS) were measured at baseline; 45 days; and 2, 3, and 6 months postoperatively. Keratinized tissue width (KTW) and keratinized tissue thickness (KTT) were measured at baseline and 6 months. The height of the non-carious cervical lesion located on the root and crown were estimated, allowing calculation of root coverage.Both groups showed statistically significant gains in CAL and soft tissue coverage. The differences between groups were not statistically significant for BOP, PD, RGR, CAL, KTW, and KTT after 6 months. The percentages of CLH covered were 56.14% +/- 11.74% for CAF+R and 59.78% +/- 11.11% for CAF (P0.05). The root and crown surfaces affected by the non-carious cervical lesion were 1.67 +/- 0.31 mm and 0.96 +/- 0.29 mm, respectively, for CAF+R and 1.59 +/- 0.37 mm and 1.01 +/- 0.33 mm, respectively, for CAF. The estimated root coverage was 88.02% +/- 19.45% for CAF+R and 97.48% +/- 15.36% for CAF (P0.05). CAF+R reduced DS significantly compared to CAF (P0.05).Both procedures provided similar soft tissue coverage after 6 months. Despite the fact that a greater reduction in DS was observed after CAF+R, longitudinal observations are necessary to confirm these results.

Background: Smoking adversely affects the short-term outcomes of coronally positioned flap (CPF) root coverage procedures, but the long-term stability of this procedure in smokers has not been studied. The objective of this study was to evaluate the effect of smoking on the long-term outcomes of CPF in recession treatment. Methods: CPF was used to treat a Miller Class I defect in a maxillary canine or premolar in 10 current smokers (≥10 cigarettes daily for ≥5 years) and 10 non-smokers (never smokers). At baseline and 6, 12, and 24 months, clinical parameters, including probing depth (PD), clinical attachment level (CAL), recession depth (RD), and width of keratinized tissue (KT), were determined. Results: Intragroup analysis showed that CPF failed to maintain the gingival margin at the initially achieved position. RD significantly increased in smokers (from 0.84 ± 0.49 to 1.28 ± 0.58 mm) and in non-smokers (from 0.22 ± 0.29 to 0.50 ± 0.41 mm) between 6 and 24 months. Further analysis showed that 50% of smokers and 10% of non-smokers lost between 0.5 and 1.0 mm of root coverage in the same period. Intergroup analysis showed that smokers had significantly greater residual recession (P = 0.001) at 24 months. Both smokers and non-smokers lost CAL and experienced decreases in KT. Conclusions: The long-term stability of CPF outcomes is less than desirable, particularly in smokers. Two years after a CPF procedure, smokers have significantly greater residual recession compared to non-smokers both statistically and clinically.

Despite the common occurrence of localized gingival enlargements, which often represent reactive lesions, the temporal and spatial association of such a lesion with a central jaw lesion has not been reported. The purpose of this case report is to present the exceptional combination of a peripheral ossifying fibroma and a central odontogenic fibroma. The differential diagnosis and management of each lesion is reviewed.A 45-year-old black female presented with a chief complaint of a painless protuberance in the left mandible of 1-year duration. Clinical and radiographic examination revealed a gingival enlargement localized between teeth #21 and #23 and a multilocular radiolucent lesion with radiopaque foci in the same area. Excisional biopsy of the gingival lesion and incisional biopsy of the central lesion were performed, and specimens were submitted for histopathological analysis.Biopsy of the gingival lesion revealed stratified squamous epithelium and highly cellular fibroblastic component presenting central areas of calcification, features consistent with a diagnosis of peripheral ossifying fibroma. The central lesion was characterized by cellular fibrous tissue admixed with rests of odontogenic epithelium and few calcification areas, features consistent with a diagnosis of central odontogenic fibroma/World Health Organization type. Subsequently, the central lesion was enucleated. After 1-year follow-up, no recurrence has been observed.The combination of a rare central lesion with a common gingival lesion may present unique diagnostic and therapeutic challenges. Clinician awareness regarding the possibility of such a combined presentation and its implications will help to ensure optimal treatment outcomes.

The objective of this study was to evaluate clinically the effectiveness of a chlorhexidine gluconate chip in sites still showing signs of disease during periodontal maintenance therapy.Forty-two maintenance non-smoking patients (previously treated with non-surgical scaling and root planing [SRP]), presenting at least one probing depth (PD) of 5 to 8 mm, and bleeding on probing (BOP) at single-rooted teeth were assigned randomly to two groups: treated with a chlorhexidine gluconate chip (CHIP group) and treated with SRP (SRP group). Patients were assessed for plaque index, gingival index, BOP, PD, clinical attachment level (CAL), and gingival recession at baseline, 6 weeks, and 3 and 6 months.Both treatments resulted in improvements in all parameters evaluated. After 6 months, a reduction in PD of 2.64 +/- 0.02 mm and 2.12 +/- 0.02 mm was observed for CHIP and SRP groups, respectively (P0.05). The observed gain in CAL was 2.19 +/- 0.87 mm and 2.07 +/- 1.53 mm for CHIP and SRP groups, respectively (P0.05). In deep pockets, PD reduction was 3.60 +/- 0.70 mm for CHIP group and 2.83 +/- 0.62 mm for SRP group (P = 0.01).Both treatments were equally effective in periodontal health reestablishment in inflamed single-root sites of maintenance patients. However, for deep pockets, the chlorhexidine gluconate chip was more effective than SRP in reducing PD.

This study aims to clinically evaluate the treatment of mandibular class II furcation defects with enamel matrix derivative (EMD) and/or a bone substitute graft made of β-tricalcium phosphate/hydroxyapatite (βTCP/HA). Forty-one patients, presenting a mandibular class II buccal furcation defect, probing pocket depth (PPD) ≥4 mm and bleeding on probing, were included. They were randomly assigned to the groups: 1—EMD (n = 13); 2—βTCP/HA (n = 14); 3—EMD + βTCP/HA (n = 14). Plaque index (PI), gingival index (GI), relative gingival margin position (RGMP), relative vertical and horizontal attachment level (RVCAL and RHCAL), and PPD were evaluated at baseline and 6 and 12 months. The mean horizontal clinical attachment level gain was considered the primary outcome variable. No significant intragroup differences were observed for RGMP, but significant changes were observed for RVCAL, RHCAL, and PPD for all groups (p

To determine the efficacy in reducing dentin hypersensitivity (DHS) of a combined in-office and home-use desensitizing system, each product containing 8% arginine and calcium carbonate (Test), following a dental scaling procedure, compared to the combination of a conventional prophylactic paste and a potassium nitrate dentifrice (Control), in a group of patients with known dentin hypersensitivity.An 8-week clinical study, with 50 subjects, was conducted in Piracicaba, São Paulo, Brazil, using a double-blind/two treatment design. Air blast sensitivity assessments were used to compare the efficacy of the two approaches using both the Schiff scale as well as a Visual Analogue Scale (VAS).Immediately after prophylaxis, the Test treatment provided significant reduction in DHS when compared to baseline values (VAS = 26.2% and Schiff = 29.1%), while for Control treatment this difference was not statistically significant (VAS = 8.1% and Schiff = 6.6%). The comparison between groups after prophylaxis showed a greater DHS reduction for the Test treatment (P0.05). The reductions in DHS after 2, 4 and 8 weeks were significant for both groups, however, when considering Schiff scale, the Test treatment provided greater DHS reduction after 2 weeks (44.5% for Test versus 27.7% for Control) and 4 weeks (55.2% for Test and 40.5% for Control), while after 8 weeks there was no significant difference between groups (71.1% for Test versus 61.1% for Control).

The aim of this study was to investigate the effect of a selective cyclooxygenase-2 inhibitor, meloxicam, on bone healing around titanium implants in rats.Thirty-one adult male Wistar rats were included in this study, and one screw-shaped titanium implant was inserted in the tibiae of each rat. The animals were randomly assigned to one of the following groups for daily subcutaneous injections: control (N = 14): saline solution; and test (N = 17): 3 mg/kg of meloxicam, each administered daily for 60 days. After the treatment, animals were sacrificed, and undecalcified sections were obtained. Bone-to-implant contact (BIC) and bone area (BA) within the limits of implant threads and bone density (BD) in a 500 mum-wide zone lateral to the implants were obtained and arranged for cortical (zone A) and cancellous (zone B) bone regions.Intergroup comparisons demonstrated that meloxicam significantly reduced bone healing around implants. For zone A, significant differences were observed regarding BIC (47.01 +/- 10.48 A; 35.93 +/- 12.25 B), BA (86.42 +/- 3.66 A; 61.58 +/- 12.09 B), and BD (96.86 +/- 0.96 A; 91.06 +/- 3.05 B) for control and test groups, respectively (P0.05). For zone B, data analysis also showed significant differences among groups for BIC (30.76 +/- 13.80 A; 16.86 +/- 11.48 B), BA (34.83 +/- 8.18 A; 25.66 +/- 9.16 B), and BD (15.76 +/- 7.05 A; 7.73 +/- 4.61 B) for control and test groups, respectively (P0.05).Meloxicam may negatively influence bone healing in the cortical and cancellous bone around titanium implants inserted in rats after continuous administration.

Although wound healing has been reported to be impaired with aging, very little is known about its effect on periodontal tissues. Therefore, the aim of this study was to evaluate, histologically in rats, the influence of aging on a spontaneous periodontal healing model.Twenty-four male Wistar rats were used and assigned to the following groups: control (n = 12; 2 mo old) and aged (n = 12; 18 mo old). Fenestration defects (4 x 3 x 1 mm) were created bilaterally at the buccal aspect of the distal root of the first mandibular molars, and the mandibulae were retrieved 3 and 6 wk postoperatively. The percentage of bone fill and density of newly formed bone, new cementum formation (NC), and the extension of the remaining defect (ERD) were histometrically obtained.Intragroup analysis demonstrated that, except for cementum, all histological parameters significantly improved over time (p0.05). Intergroup analysis additionally showed that the defects were initially similar in size, and that at 3 wk aging negatively influenced newly formed bone (86.38 +/- 2.99% and 73.06 +/- 3.21%, p0.001, for groups control and aged, respectively), BF (75.84 +/- 16.53% and 57.70 +/- 22.28%, p = 0.014) and ERD (0.41 +/- 0.20 mm and 1.17 +/- 0.37 mm, p0.001). At 6 wk, aging negatively influenced newly formed bone (88.12 +/- 2.90% and 78.19 +/- 5.35%, p0.001, for groups control and aged, respectively) and ERD (0.01 +/- 0.006 mm and 0.34 +/- 0.18 mm, p = 0.003), but not BF (98.15 +/- 2.43% and 87.87 +/- 11.63%, p0.05). No new cementum was formed along the root surface in the above groups.Within the limits of the present study, data analysis suggests that aging may impair, but not prevent, periodontal healing.

The purpose of this randomized clinical trial was to compare the outcome of gingival recession therapy using the semilunar coronally positioned flap (SCPF) or the subepithelial connective tissue graft (SCTG).Seventeen patients with bilateral Miller Class I buccal gingival recessions (or=4 mm) in maxillary canines or premolars were selected. The recessions were randomly assigned to receive either the SCPF or the SCTG. Recession height (RH), recession width (RW), width of keratinized tissue (WKT), thickness of keratinized tissue (TKT), probing depth (PD), and clinical attachment level (CAL) were measured at baseline and 6 months post-surgery. Patient satisfaction with esthetics, root sensitivity, and postoperative pain was also evaluated.The average percentages of root coverage for SCPF and SCTG were 90.95% and 96.10% (P0.05), respectively, and the complete root coverage observed was 52.94% and 76.47%, respectively. The SCTG showed a statistically significant increase in TKT (P0.05). There were no significant differences between the two groups with regard to RH, RW, WKT, PD, and CAL. The esthetic condition after both treatments was considered satisfactory by the patients.The findings from this study indicate that SCPF and SCTG can be successfully used to treat Class I gingival recession.

Supragingival plaque control is a requisite for the success of any periodontal procedure. However, little is know about the effect of this procedure alone on periodontitis. The aim of this study was to determine the effect of supragingival plaque control on clinical and biochemical parameters of chronic periodontitis. Twenty-five subjects exhibiting at least 4 pockets > 5mm, non-smokers and with no relevant systemic diseases, were selected for the study. The clinical and biochemical assessments were done before and 21 days after removal of plaque retentive factors, extraction of affected teeth and instruction in oral hygiene. The statistical analysis was done with the Student paired t-test (p

Although a harmful effect of smoking on titanium implants has been documented, only a few studies have investigated the benefits of smoking cessation. Thus, this study histologically investigated whether smoking cessation influences bone healing around titanium implants and comparatively evaluated temporary versus complete cessation protocols.Sixty-six male Wistar rats were randomly assigned to one of four groups: control (N = 16); CSI, intermittent cigarette smoke inhalation (CSI) throughout the entire 150-day experiment (N = 17); P-CSI, CSI 83 days prior to implant placement (N = 17); or R-CSI, CSI for 83 days, cessation 7 days before and 21 weeks after implant placement, and return to CSI for 39 days (N = 16). The animals were sacrificed and the degree of bone-to-implant contact (BIC) and the bone area (BA) within the limits of the implant threads obtained for cortical (zone A) and cancellous bone (zone B).Intergroup analysis (Kruskal-Wallis test, alpha = 0.05) demonstrated a significant effect of CSI on BA (P0.05) and that temporary or complete CSI cessation protocols resulted in values similar to those of the control group (P0.05) 88.91% +/- 4.29%; 80.66% +/- 6.55%; 84.27% +/- 6.96%; 85.71% +/- 4.7% in zone A, and 51.28% +/- 6.49%; 38.69% +/- 10.78%; 48.87% +/- 8.47%; 49.47% +/- 8.04%; in zone B for groups CTRL, CSI, P-CSI, and R-CSI, respectively.Within the limits of the present investigation, temporary and complete CSI cessation reversed the effect of smoke exposure on bone healing around titanium implants in both cortical and cancellous bone.

OBJECTIVES The aim of this study was to investigate the influence of cementum removal on periodontal repair. MATERIAL AND METHODS Forty subjects with chronic periodontitis and presenting, at least, two proximal sites in anterior teeth (upper or lower) with probing depth > or =5 mm were selected. After oral hygiene instructions and ultrasonic supragingival instrumentation, the subjects were randomly assigned for one of the following groups: CIC, scaled with Gracey curettes; CIUS, scaled with ultrasonic device; CDC, calculus deattachment with Gracey curettes and brushing with saline solution; and CDUS, calculus deattachment with ultrasonic device and brushing with saline solution. Full-thickness flaps were reflected and the instrumentation was performed with a clinical microscope. Probing depth (PD), relative gingival margin level (RGML) and relative attachment level (RAL) were registered at five experimental periods: baseline and 30, 60, 90 and 120 days postoperative. RESULTS All the approaches were able to markedly reduce the PD values from the baseline to the other evaluation periods (p

Anti-inflammatory agents have been reported as a bone loss mediator in periodontitis. This study aimed to investigate in rats the impact of a selective cyclooxygenase-2 inhibitor (meloxicam) on bone loss in ligature-induced periodontitis and its post-treatment effect after administration withdrawal.Seventy-five adult male Wistar rats were included. After anesthesia, a mandibular first molar was randomly assigned to receive the cotton ligature in the sulcular position, while the contralateral tooth was left unligated. The animals were randomly assigned to one of the following five treatment groups (15 animals each), including daily subcutaneous injections: 1) saline solution for 15 days; 2) saline solution for 45 days; 3) 3 mg/kg of meloxicam for 15 days; 4) 3 mg/kg of meloxicam for 45 days; or 5) 3 mg/kg of meloxicam for 15 days followed by saline solution for 30 days. The animals were sacrificed and the specimens routinely processed. The volume of bone loss was histometrically measured and statistical analysis performed.Intergroup comparisons demonstrated that the drug may significantly reduce periodontitis-related bone loss (group 3: 5.83 +/- 2.04); however, this effect is less evident when the drug is administered in a short period (group 4: 3.59 +/- 1.57). Moreover, after drug withdrawal, no residual effect was observed (6.86 +/- 3.59, 6.09 +/- 2.66, groups 2 and 5, respectively) (P0.05).Within the limits of the present study, it can be concluded that selective cyclooxygenase-2 inhibitors may reduce bone loss associated with experimental periodontitis and that no remaining effect can be expected after its withdrawal.

The goal of this investigation was to histologically and histometrically evaluate the healing process of dehiscence-type defects treated by enamel matrix derivative (EMD) and/or guided tissue regeneration (GTR).Seven mongrel dogs were used. Buccal osseous dehiscences were surgically created on the mesial roots of the mandibular third and fourth premolars. The defects were exposed to plaque accumulation for 3 months. After this period, the defects were randomly assigned to one of the treatments: open flap debridement (OFD), enamel matrix derivative (EMD), GTR with bioabsorbable membrane (GTR), and the combination of both procedures (EMD + GTR). After 4 months of healing, the dogs were sacrificed and the blocks were processed. The histometric parameters evaluated included gingival recession, epithelial length, connective tissue adaptation, new cementum, and new bone.A superior length of new cementum was observed in the sites treated by EMD (3.7 mm) and EMD + GTR (3.8 mm) in comparison with OFD (2.4 mm) (P0.05). No statistically significant differences were found in the remaining histometric parameters.Within the limits of this study, it can be concluded that EMD alone or in combination with GTR barriers may effectively promote new cementum formation. The combination of both therapies may not provide additional benefits.

The aim of the present study was to verify nicotine effects on alveolar bone changes induced by occlusal trauma during a periodontitis experimental model in rats.Thirty adult male rats were used. The animals were randomly assigned to one of three groups receiving daily intraperitoneal injections: A, nicotine solution (0.44 mg/ml) and occlusal overload; B, saline solution and occlusal overload; or C, saline solution. Rats from groups A and B underwent bilateral amputation of the second and third molar cusps to simulate an occlusal overload. The first molars were then randomly assigned to receive a cotton ligature in the sulcular area, while the contralateral tooth was left unligated. The animals were sacrificed 30 days later. The resected mandibles were processed, and histomorphometric measurements were performed in the alveolar bone adjacent to the furcation area of the first molars.Nicotine enhanced the bone loss induced by occlusal trauma (P0.001) on the ligated teeth of group A (12.27 +/- 4.4 mm2), when compared to groups B (8.43 +/- 3.51 mm2) and C (4.43 +/- 2.17 mm2). Alveolar bone loss (P0.01) was also observed in the contralateral teeth of groups A (nicotine + trauma) and B (saline + trauma), when compared to group C (saline only).Within the limits of the study, it is concluded that nicotine may influence the alveolar bone changes induced by occlusal trauma by enhancing bone loss.

Objectives: The aim of this study was to evaluate clinically the immediate effect of trauma from instrumentation after scaling and root planing with different instruments. Material and Methods: Ten subjects with moderate chronic periodontitis, presenting probing depths ranging from 3.5 to 6.5 mm on anterior teeth, upper and/or lower, were selected. Teeth were randomly assigned to one of the following groups: MC group – scaled and planed with Gracey mini-curettes (MiniFiveTM); CC group – scaled and planed with Gracey conventional curettes. The selected teeth were probed with a computerized electronic probe, guided by an occlusal stent, and then 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. Results: Intra-group analysis revealed statistically significant differences between RAL immediately before and after instrumentation in both groups (0.68±0.32 for MC group; and 0.83±0.41 for CC group –p

The aim of this study was to evaluate the influence of the administration and withdrawal of cyclosporin A/nifedipine on the bone density in a lateral area adjacent to implants placed in rabbits. Two screw-type titanium implants were placed bilaterally in twenty-eight New Zealand rabbits. The animals were assigned to one of the following groups and received daily subcutaneous injections for 14 days: Groups A and C: vehicle (dimethyl sulfoxide); Groups B and D: CsA (10 mg/kg) plus nifedipine (50 mg/kg). The animals in Groups A and B were sacrificed 14 days postoperatively and, in Groups C and D, 42 days postoperatively. After sacrifice, the tibiae were removed and undecalcified sections were obtained. Bone density was obtained in a 500 mm-wide zone lateral to the implant surface. Intergroup analysis showed no significant difference (p > 0.05) in the degree of bone density between control and test groups either on day 14 or on day 42. Thus, it appears that a short-term immunosuppressive therapy may not present a negative influence on the density of the pre-existing bone around titanium implants placed in rabbits.O objetivo deste trabalho foi avaliar a influência da administração de ciclosporina A (CsA)/nifedipina e sua interrupção na densidade óssea em uma região lateral à superfície de implantes de titânio inseridos em coelhos. Dois implantes de titânio comercialmente puros foram inseridos bilateralmente em vinte e oito coelhos. Os animais foram aleatoriamente divididos em um dos seguintes grupos experimentais, recebendo injeções diárias subcutâneas por 14 dias: Grupos A e C: veículo (dimetil sulfóxido); Grupos B e D: CsA (10 mg/kg) e nifedipina (50 mg/kg). Os animais pertencentes aos Grupos A/B e C/D foram sacrificados 14 e 42 dias após a colocação dos implantes, respectivamente. Após o sacrifício, as tíbias foram removidas para a obtenção de secções não-descalcificadas. A densidade óssea foi obtida em uma zona de 500 mm lateral à superfície do implante através de análise histométrica. A análise intergrupo não revelou diferenças para os grupos teste e controle em 14 e 42 dias (p > 0,05). Dentro dos limites deste estudo podemos concluir que a associação CsA/nifedipina, administrada em um curto prazo, não apresenta uma influência negativa na densidade do osso preexistente ao redor de implantes de titânio inseridos em coelhos.

This study evaluated the influence of estrogen and calcitonin administration on tibial bone density in a lateral area adjacent to implants placed in ovariectomized rats (OVX).One screw-type titanium implant was placed bilaterally in the ovariectomized rats, and the animals assigned to one of the following groups: group 1 (n = 15): sham surgeries; group 2 (n = 15): OVX; group 3 (n = 14): OVX subcutaneously administered with calcitonin (CT) 4 days/week (16 IU/kg); group 4 (n = 14): OVX administered daily with 17beta estradiol (20 microg/kg). After 60 days, the animals were sacrificed and undecalcified sections obtained. Blood samples were collected to measure serum levels of alkaline phosphatase and calcium at the time of sacrifice. Bone density was measured in a 500 microm wide mineralized zone lateral to the implant.Alkaline phosphatase levels in groups 2 and 3 (P0.05) were statistically higher than groups 1 and 4 (P0.05), and calcium serum levels were higher in group 2 than the other groups (P0.05). Regarding bone density, the data were grouped separately for cortical (zone A) and cancellous (zone B) bone. In zone A, intergroup analysis revealed no significant difference among groups (P0.05). However, in zone B, the animals that received estrogen administration (group 4) presented a higher bone density than groups 2 and 3 (P0.05).It appears that estrogen therapy may prevent the negative influence of endogenous estrogen deficiency on bone density around titanium implants placed in ovariectomized rats.

Immunosuppressive agents have been recognized as a factor affecting the soft tissues of the periodontium. However, little is known about their effect on periodontitis progression. The aim of the present study was to investigate the influence of cyclosporin A (CsA) administration, associated or not with nifedipine, on the bone loss resulting from a ligature-induced periodontitis in rats. Twenty-four adult male Wistar rats were used. After anesthesia, the mandibular first molar was randomly assigned to receive the cotton ligature in the sulcular area while the contralateral tooth was left unligated. The animals were randomly assigned to one of the following treatments: Group A - saline solution; Group B - CsA (10 mg/kg); Group C - nifedipine (50 mg/kg); Group D - CsA (10 mg/kg) plus nifedipine (50 mg/kg). Forty-five days later, the animals were sacrificed and the specimens routinely processed for serial decalcified sections. Intergroup analysis did not reveal significant differences regarding the bone loss volume in the ligated teeth between the experimental treatments (0.46 ± 0.11, 0.63 ± 0.32, 0.53 ± 0.14, 0.50 ± 0.18, for groups A, B, C and D, respectively - p > 0.05). However, intragroup analysis showed a greater bone loss volume in the ligated teeth than in the unligated ones (p < 0.05). Within the limits of the present study, the conclusion was that the administration of CsA, associated or not with nifedipine, may not influence bone loss in ligature-induced periodontitis in rats.O uso de agentes imunossupressores tem sido reconhecido como um fator que afeta os tecidos moles do periodonto. Entretanto, pouco se sabe sobre o seu efeito na progressão da periodontite. O objetivo do presente estudo foi investigar a influência da ciclosporina (CsA), associada ou não à nifedipina, na perda óssea resultante da periodontite induzida por ligaduras em ratos. Vinte e quatro ratos Wistar machos, adultos, foram incluídos no estudo. Após anestesia, foram colocadas ligaduras de fio de algodão ao redor do primeiro molar inferior direito ou esquerdo, aleatoriamente escolhido. O dente contralateral foi deixado sem ligadura. Os animais foram aleatoriamente escolhidos para receber um dos seguintes tratamentos: Grupo A - solução salina; Grupo B - CsA (10 mg/kg); Grupo C - nifedipina (50 mg/kg); Grupo D - CsA (10 mg/kg) e nifedipina (50 mg/kg). Após 45 dias, os animais foram sacrificados para a análise histométrica. A análise intergrupos não revelou diferenças significativas quanto ao volume da perda óssea entre os diferentes tratamentos (0,46 ± 0,11; 0,63 ± 0,32; 0,53 ± 0,14; 0,50 ± 0,18, para os grupos A, B, C e D respectivamente - p > 0,05). Entretanto, a análise intragrupo mostrou um maior volume de perda óssea nos dentes com ligadura, quando comparados aos dentes sem ligadura (p < 0,05). Dentro dos limites deste estudo, conclui-se que a administração de CsA, associada ou não à nifedipina, não influenciou a perda óssea alveolar na periodontite induzida por ligaduras em ratos.

Various surgical procedures have been proposed as effective treatment methods for recession defects. The purpose of this study was to evaluate the clinical outcome of root coverage comparing the coronally positioned flap (CPF) with and without guided tissue regeneration (GTR) using a titanium-reinforced expanded polytetrafluoroethylene barrier in paired gingival recession defects.Procedures were performed in 10 patients having bilateral buccal recession defectsor = 2.0 mm on maxillary canines and first premolars. Mucoperiosteal flaps were raised and root surfaces were scaled, planed, and conditioned. Randomly assigned sites received either GTR + CPF or CPF treatment. Clinical parameters measured at baseline and at 6 months after the procedure included gingival recession depth (GRD), clinical attachment level (CAL), probing depth (PD), keratinized gingival width (KGW), and alveolar crest level (ACL).GRD decreased from 3.4 +/- 0.6 mm to 1.9 +/- 1.2 mm with GTR (45% root coverage) and from 3.3 +/- 0.4 mm to 1.3 +/- 0.7 mm with CPF (60% root coverage). The difference in GRD decrease between procedures was significant. CAL, KGW, and PD differences between procedures were not significant. ACL mean gain was significant (1.0 +/- 0.6 mm in the GTR group and 0.2 +/- 0.3 mm in the CPF group; P0.05).Both GTR and CPF procedures result in root coverage. The amount of root coverage obtained with CPF was greater than that observed with GTR, although GTR resulted in significantly greater ACL gain.

Immunosuppressive agents have been recognized as a factor affecting the soft tissues of the periodontium. However, little is known about their effect on periodontitis progression. The aim of the present study was to investigate the influence of cyclosporin A (CsA) administration, associated or not with nifedipine, on the bone loss resulting from a ligature-induced periodontitis in rats. Twenty-four adult male Wistar rats were used. After anesthesia, the mandibular first molar was randomly assigned to receive the cotton ligature in the sulcular area while the contralateral tooth was left unligated. The animals were randomly assigned to one of the following treatments: Group A - saline solution; Group B - CsA (10 mg/kg); Group C - nifedipine (50 mg/kg); Group D - CsA (10 mg/kg) plus nifedipine (50 mg/kg). Forty-five days later, the animals were sacrificed and the specimens routinely processed for serial decalcified sections. Intergroup analysis did not reveal significant differences regarding the bone loss volume in the ligated teeth between the experimental treatments (0.46 ± 0.11, 0.63 ± 0.32, 0.53 ± 0.14, 0.50 ± 0.18, for groups A, B, C and D, respectively - p > 0.05). However, intragroup analysis showed a greater bone loss volume in the ligated teeth than in the unligated ones (p < 0.05). Within the limits of the present study, the conclusion was that the administration of CsA, associated or not with nifedipine, may not influence bone loss in ligature-induced periodontitis in rats. O uso de agentes imunossupressores tem sido reconhecido como um fator que afeta os tecidos moles do periodonto. Entretanto, pouco se sabe sobre o seu efeito na progressão da periodontite. O objetivo do presente estudo foi investigar a influência da ciclosporina (CsA), associada ou não à nifedipina, na perda óssea resultante da periodontite induzida por ligaduras em ratos. Vinte e quatro ratos Wistar machos, adultos, foram incluídos no estudo. Após anestesia, foram colocadas ligaduras de fio de algodão ao redor do primeiro molar inferior direito ou esquerdo, aleatoriamente escolhido. O dente contralateral foi deixado sem ligadura. Os animais foram aleatoriamente escolhidos para receber um dos seguintes tratamentos: Grupo A - solução salina; Grupo B - CsA (10 mg/kg); Grupo C - nifedipina (50 mg/kg); Grupo D - CsA (10 mg/kg) e nifedipina (50 mg/kg). Após 45 dias, os animais foram sacrificados para a análise histométrica. A análise intergrupos não revelou diferenças significativas quanto ao volume da perda óssea entre os diferentes tratamentos (0,46 ± 0,11; 0,63 ± 0,32; 0,53 ± 0,14; 0,50 ± 0,18, para os grupos A, B, C e D respectivamente - p > 0,05). Entretanto, a análise intragrupo mostrou um maior volume de perda óssea nos dentes com ligadura, quando comparados aos dentes sem ligadura (p < 0,05). Dentro dos limites deste estudo, conclui-se que a administração de CsA, associada ou não à nifedipina, não influenciou a perda óssea alveolar na periodontite induzida por ligaduras em ratos.

The goal of this investigation was to histometrically evaluate the effect of enamel matrix derivative (EMD) on bone healing after guided bone regeneration (GBR) in dehiscence-type osseous defects around dental implants; i.e., in the absence of periodontal ligament cells.Six mongrel dogs were used. The second, third, and fourth mandibular premolars (p2, p3, and p4) and first molars (ml) were extracted. After 3 months, 2 implant osteotomies were prepared in each side of the mandible, dehiscence-type defects were created on the buccal aspect of each implant osteotomy (3.5 mm x 5.0 mm), and titanium implants were placed (3.75 mm x 8.5 mm). The surgically-created defects were randomly assigned to one of the treatments: EMD, GBR, EMD+GBR, or control. After 2 months, 4 additional defects were created and treated. The animals were sacrificed 3 months after the placement of the first implants, thus allowing the healing periods of 1 and 3 months. Undecalcified sections were obtained for the histometric evaluation including the percentage of bone-to-implant contact and new bone area on the implant threads related to the defect.No statistically significant differences were observed among the groups in the evaluated parameters after 1 month of healing. After 3 months, no statistically significant differences were observed among the groups for the percentage of bone-to-implant contact. The values for the new bone area were: 55.5+/-11.8, 53.8+/-16.3, 62.1+/-18.4, and 36.9+/-25.1 for EMD, GBR, EMD+GBR, and control, respectively. The difference between EMD+GBR and control was statistically significant (P0.05).Within the limits of this study, it can be concluded that EMD may positively influence bone healing after GBR around titanium implants. EMD alone, however, had no statistically significant effect.

This study investigated the influence of nicotine on bone density around titanium implants inserted in rabbits. Thirty-two New Zealand rabbits were included. After anesthesia, the tibiae surfaces were exposed and two screw-shaped, commercially available, pure titanium implants of 7.0 mm in length and 3.75 mm in diameter were placed bilaterally. A total of 128 implants were inserted: 64 blasted with Al2O3 particles (group 1) and 64 with a machined surface finish (group 2). The animals were randomly assigned to one of four treatment subgroups, and daily subcutaneous injections of nicotine were administered. After 42 days, the animals were killed and undecalcified sections were prepared. The bone density was measured in the cortical passage of the implant. Statistical analysis (two-way analysis of variance) revealed no significant difference neither regarding the effect of nicotine nor the effect of surface design on bone density around the implants (P > 0.05). Within the limits of the present study, it can be assumed that daily nicotine administration may not statistically influence bone density around titanium implants.