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Some groups have avoided early microsurgical flaps in electrical burns under the pretext of injury to the microvasculature, which could increase vascular thrombosis. However, this option frequently results in amputation of the extremity. This study aims to evaluate the early application of microsurgical flaps for the treatment of electrical burns of extremities. A case series was retrospectively evaluated including patients with electrical trauma in extremities undergoing early microsurgical reconstruction. Data were obtained from medical charts, including age, trauma location, flap type and microvascular anastomosis, the need for other procedures, postoperative complications, the length of hospital stay after the flap surgery, and patient outcomes. Five microsurgical flaps were performed in less than 30 days to trauma, one anterolateral thigh flap to cover skin failure in upper limb, and four radial forearm flaps to cover failure in feet. The patient ages had a mean of 25.8 years (from 12 to 42 years). The microsurgical procedure occurred from 21 to 27 days after the burn, with a mean of 24.2 days. Hospital discharge had a mean of 26.6 days (from 19 to 35 days after the surgery). Only one patient required reintervention for re-anastomosis. All patients had a good flap viability, avoiding amputation of the affected extremity and with a proper preservation of function. The early application of microsurgical flaps for patients with electrical burns of extremities may provide adequate, sturdy, and stable skin coverage, contributing to the treatment of noble structures exposed and avoiding amputation of the extremities.

Objective: The aim of this study was to investigate the effect of periodontal therapy on the circulating concentration of high-sensitivity capsule-reactive protein (hs-CRP), fibrinogen (FIB), interleukin (IL)-4, IL-6, IL-8, IL-10 and tumour necrosis factor-a (TNF-a) and on the metabolic control in type 2 diabetes mellitus (T2DM) patients. Material and Methods: Twenty-three T2DM patients with chronic periodontitis were enrolled in this study. Periodontal clinical parameters, namely visible plaque index, gingival bleeding index, bleeding on probing, probing depth and clinical attachment levels, were evaluated. Blood samples for plasma were collected and assessed for the levels of hs-CRP, FIB, IL-4, IL-6, IL-8, IL-10 and TNF-a. The glycated haemoglobin (HbA1c) and fasting plasma glucose were also measured. All parameters were evaluated before and 3 months after non-surgical periodontal therapy. Results: All clinical parameters were significantly improved 3 months after the periodontal therapy. A univariate comparison showed a tendency towards a decrease of the measured biomarkers, most pronounced for TNF-a and FIB, after therapy. Periodontal treatment also reduced HbA1c and hs-CRP levels, albeit not significantly. Conclusions: The clinically successful non-surgical periodontal therapy tended to reduce systemic inflammation and the concentration of some circulating cytokines.

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:23:38Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:46:14Z : No. of bitstreams: 1 2-s2.0-48249142840.pdf: 370036 bytes, checksum: 568b90976a301ccfd1400e3d5f12be19 (MD5) Made available in DSpace on 2014-05-27T11:23:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-08-04 The patient's diet has been considered an important etiological factor of dentin hypersensitivity. The frequent ingestion of acidic substances can promote the loss of dental structure or remove the smear layer. The purpose of this study was to evaluate the degree of smear layer removal and dentinal tubules exposure by different natural orange juices. Extracted human teeth were submitted to manual scaling in order to develop the smear layer. Seventy dentin samples were obtained and distributed into the following groups: Control, lime orange, lime, valência orange, navel orange, mandarin, and tangerine. Each group included 2 methods of application: Topical and topical + friction. After preparation for SEM analysis, photomicrographs were assessed by a blind calibrated examiner using an index system. The Kruskal-Wallis test indicated a significant influence of the orange juices on smear layer removal. Significant difference was observed between navel orange, valência orange, mandarin and the control group (p < 0.05). These orange juices resulted in greater removal of the smear layer and greater opening of dentinal tubules. The comparison between the application methods for each group using the Mann-Whitney test showed that friction increased smear layer removal significantly only for lime orange and lime. The data suggest that certain natural orange juices are more effective in terms of smear layer removal and dentinal tubules exposure than others. Department of Diagnosis and Surgery School of Dentistry at Araraquara São Paulo State University (UNESP), Rua Humaitá 1680, Araraquara, SP 14801-360 Department of Diagnosis and Surgery School of Dentistry at Araraquara São Paulo State University (UNESP), Rua Humaitá 1680, Araraquara, SP 14801-360

Zimmermann-Laband syndrome is a rare autosomal dominant disorder that is characterized by gingival fibromatosis, ear, nose, bone, and nail defects, and hepatosplenomegaly.This case report describes the clinical presentation and periodontal findings in a 13-year-old female patient with previously undiagnosed Zimmermann-Laband syndrome.Clinical and radiographic findings and genetic counseling confirmed the diagnosis of Zimmermann-Laband syndrome. The most striking oral findings were the presence of gingival enlargement involving both the maxillary and mandibular arches, anterior open bite, non-erupted teeth, and two supernumerary teeth. Periodontal treatment consisted of gingivectomy in four quadrants. Histopathologic evaluation of excised tissue supported the diagnosis of gingival fibromatosis. The patient was referred for appropriate orthodontic treatment and genetic counseling, and has been closely followed for the earliest signs of hepatosplenomegaly.Dental practitioners should be alert for developmental abnormalities that may occur in patients with gingival fibromatosis as this may indicate the presence of a rare disorder like Zimmermann-Laband syndrome. A comprehensive medical history and physical systemic evaluation are essential for correct diagnosis and treatment of these cases.

Made available in DSpace on 2015-08-06T16:14:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-05-16. Added 1 bitstream(s) on 2015-08-06T16:44:22Z : No. of bitstreams: 1 S1806-83242014000100222.pdf: 304243 bytes, checksum: f47d249a3f64f15026aad6f8e5561b7d (MD5) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) The present study investigated the effect of non-surgical periodontal treatment (SRP) on the composition of the subgingival microbiota of chronic periodontitis (CP) in individuals with type 2 diabetes (DM2) with inadequate metabolic control and in systemically healthy (SH) individuals. Forty individuals (20 DM2 and 20 SH) with CP underwent full-mouth periodontal examination. Subgingival plaque was sampled from 4 deep sites of each individual and tested for mean prevalence and counts of 45 bacterial taxa by the checkerboard method. Clinical and microbiological assessments were performed before and 3 months after SRP. At baseline, those in the DM2 group presented a significantly higher percentage of sites with visible plaque and bleeding on probing compared with those in the SH group (p

However according to Mongini (1977), the occurrence of dysfunctional problems of the stomatognathic system may be related to the termination of orthodontic treatment. Other authors have demonstrated the need for occlusal therapy after termination of orthodontic treatment in order to eliminate the risk of bone reabsorption, muscular pain and TMJ disorders resulting from occlusal trauma (Salzman, 1974; Runge et al., 1989; Gianelly, 1989, Kundinger et al., 1991).

Studies on gingivitis in children and adolescents are scarce and the results are inconclusive. The aim of this study was to assess the prevalence and extension of gingivitis and associated factors in Brazilian schoolchildren.Cross-sectional data from 1,211 schoolchildren 8 to 12 years old from Southern Brazil in 20 public and private schools were analyzed. Socioeconomic, demographic, and oral hygiene habits were assessed by questionnaires answered by parents and children. Buccal examination assessed presence of plaque, crowding, and gingivitis. Data were analyzed using Poisson regression [prevalence ratio (PR); 95% confidence interval (CI)].Prevalence of visible plaque was 89.7% (95% CI 88.0-91.3) and gingival bleeding on probing was 78.4% (95% CI 76.1-81.0). The mean and median numbers of sites with gingival bleeding were 3.10 and 2 (SD ± 3.22), respectively. In multivariate adjusted analysis, the presence of a greater number of sites with plaque was significantly associated with gingivitis (PR 1.26; 95% CI 1.07-1.47) and its extension (PR 1.96; 95% CI 1.53-2.51). Lighter-skinned black children had a lower probability of having severe gingivitis (PR 0.69; 95% CI 0.48-0.98) compared with white children. This association was observed after adjusting for other variables.Gingivitis was associated with higher number of sites with plaque and with skin color, reflecting the influence of biological and demographic factors on this oral condition.

Objective: To evaluate the effect of periodontal therapy on clinical parameters as well as on total salivary peroxidase (TSP) activity and myeloperoxidase (MPO) activity in the gingival crevicular fluid (GCF) of patients with type 2 diabetes mellitus (DM2) and of systemically healthy individuals. Material and Methods: Twenty DM2 subjects with inadequate metabolic control (test group) and 20 systemically healthy individuals (control group), both groups with chronic periodontitis, were enrolled. Periodontal clinical parameters, namely periodontal probing depth (PD), clinical attachment level (CAL), visible plaque index (VPI), bleeding on probing (BOP), gingival bleeding index (GBI) and presence of suppuration (SUP), as well as TSP activity and GCF MPO activity, were assessed before and 3 months after non-surgical periodontal therapy. Results: At baseline and 3 months post-treatment, the test group presented a higher percentage of sites with VPI and BOP (p

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:24:34Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:30:38Z : No. of bitstreams: 1 2-s2.0-71149105128.pdf: 405505 bytes, checksum: f6e989c2935a25039ae27ec7fa82a8e5 (MD5) Made available in DSpace on 2014-05-27T11:24:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-12-09 The aim of this study was to evaluate the influence of diltiazem in combination with a sucrose-rich diet on gingival alterations in rats. One hundred and twenty male Holtzman rats were randomly assigned to 10 groups (n = 12), being 2 control groups treated with saline and 8 test groups treated with diltiazem in daily doses of 5, 25, 50 and 100 mg/kg during 40 or 60 days. Afterwards, the mandibles were removed for macroscopic, histologic and histometric analyses of the buccal gingiva of the mandibular right first molar. No macroscopic characteristic of gingival overgrowth was observed in any of the groups. The microscopic analysis showed characteristics of normality with inflammatory cells only adjacent to the crevicular epithelium in all groups for both periods. The histometric analysis showed significant differences only for the epithelial tissue area in the 40-day period (Kruskal-Wallis; P = 0.032). Comparing the periods, significant differences regarding the connective and epithelial tissue areas were observed only in the group treated with a 25 mg/kg dose (Mann-Whitney; P = 0.004 and P = 0.007, respectively). Oral administration of diltiazem in combination with a sucrose-rich diet did not induce gingival alterations in rats. © 2009 Sociedade Brasileira de Pesquisa Odontológica. Department of Diagnostics and Surgery School of Dentistry at Araraquara São Paulo State University Department of Physiology and Pathology School of Dentistry at Araraquara São Paulo State University Department of Diagnostics and Surgery School of Dentistry at Araraquara São Paulo State University Department of Physiology and Pathology School of Dentistry at Araraquara São Paulo State University

Gingival fibromatosis is a rare condition characterized by a generalized enlargement of the buccal and lingual aspects of the attached and marginal gingiva.This case report describes the periodontal management of a 13-year-old female patient with gingival fibromatosis associated with Zimmermann-Laband syndrome. The patient presented with gingival enlargement involving the maxillary and the mandibular arches, anterior open bite, and non-erupted teeth. Periodontal treatment included gingivectomy in all four quadrants.Histopathologic evaluation of the excised tissue supported the diagnosis of gingival fibromatosis. A significant improvement in esthetic appearance and eruption of the non-erupted teeth were obtained. The patient was referred for appropriate orthodontic treatment and has been closely followed for the earliest signs of recurrence of gingival enlargement.The successful therapy for gingival fibromatosis depends on correctly identifying the etiological factors and improving the impaired function and esthetic appearance through surgical intervention and adjunctive orthodontics. Maintaining treatment results depends on preservation of periodontal health.

The administration of calcium channel blockers has been associated with gingival overgrowth. However, there are few studies in humans or animals that evaluated the effect of diltiazem on gingival tissues. The present study assessed the influence of diltiazem, at different dosages and treatment duration, on gingival tissues of rats, using clinical, histological and histometric analyses. Eighty young male rats were separated into eight groups according to the dosage and duration of treatment. Rats were treated for 20 or 40 days with a daily subcutaneous injection of 5, 20 or 50 mg/kg of body weight of diltiazem. The results confirmed that diltiazem did not induce gingival overgrowth in rats. For all animals, the evaluation did not show gingival alterations regardless of the dosages and periods of treatment. The histometric analysis showed no significant change in the area of epithelium and connective tissues, although after 40 days of treatment a decrease in the area of connective tissue was observed, without statistically significant difference from control groups. Within the limits of this study, we suggest that diltiazem did not induce gingival overgrowth.

Certain elements of a patient's diet may be associated with dentin hypersensitivity. The intent of this study was to evaluate the degree of removal of the smear layer from dentin surfaces by various fruit juices. A smear layer was created on extracted human teeth by manual scaling. The roots were reduced and distributed into 8 experimental groups. Distilled water was the negative control. The juices were applied by 2 methods: topical application and topical application with friction. Specimens were photomicrographed and graded according to an index of smear layer removal. With topical application, all but 2 of the tested substances resulted in significantly greater removal of the smear layer and opening of dentinal tubules than was the case with the negative control (p = 0.05); the exceptions were Gala apple and Italian grape juices, which were no different from the control. For the active application (with friction), most substances removed more smear layer than the control (p0.05); Gala apple, Italian grape and orange juices were similar to the control. For each of the tested substances, removal of the smear layer did not differ with the method of application (topical vs. friction; p0.05). It is concluded that natural fruit juices can remove the smear layer from dentin surfaces, and the efficacy of this removal varies with the type of juice.

Dentin hypersensitivity is a common painful condition observed in clinics. Dietary habits have been much associated with its development and persistence during and following periodontal treatment. The aim of this in vitro study was to evaluate the influence of vinegars on the removal of smear layer and exposure of dentinal tubules. Extracted human teeth were submitted to manual scaling with Gracey curettes in order to remove the cementum as well as to form a smear layer. Dentin samples with 3 mm² were obtained and distributed into six experimental groups: one control and five types of vinegars (alcohol, apple, rice, white wine and balsamic). Each group included two methods of vinegar application: topical and friction. After routine preparation for SEM analysis, photomicrographs were assessed by a calibrated and blind examiner using an appropriate index system. Kruskal-Wallis test indicated a significant influence of vinegars on smear layer removal. There was a statistically significant difference between groups treated with apple, white and rice vinegars and the control group (p < 0.05). Nevertheless, Mann-Whitney test indicated that removal of smear layer did not vary with the method of application (topical versus friction) for any of the tested substances. We can conclude that the contact of vinegar may remove smear layer and expose dentinal tubules, regardless of the type of application. However, balsamic vinegar was associated with less removal of smear layer after both methods of application. A hipersensibilidade dentinária cervical é uma condição dolorosa muito comum nos consultórios. A dieta tem sido bastante associada ao seu aparecimento, assim como a sua persistência após o tratamento periodontal. o objetivo deste trabalho foi avaliar in vitro a influência dos vinagres na remoção de "smear layer" e exposição dos túbulos dentinários. Dentes de humanos foram instrumentados com curetas Gracey para a remoção do cemento e formação de "smear layer". Foram obtidas amostras de dentina com 3 mm², divididas entre o grupo controle (água destilada) e cinco grupos de vinagre: branco, maçã, arroz, vinho branco e balsâmico. Cada grupo incluiu duas formas de aplicação da substância, tópica ou por fricção. Após o preparo para observação em MEV (microscopia eletrônica de varredura), as fotomicrografias foram avaliadas por um examinador previamente calibrado utilizando um índice apropriado. O teste de Kruskal-Wallis indicou influência significativa dos vinagres na remoção de "smear layer". Foi constatada uma diferença estatística significante entre os grupos maçã, branco e arroz e o grupo controle (p < 0,05). O teste de Mann-Whitney, porém, indicou que a remoção de "smear layer" não variou para nenhuma das substâncias segundo a forma de aplicação. Conclui-se que os vinagres podem remover "smear layer" da superfície radicular e expor túbulos dentinários, não sendo influenciados pelo tipo de aplicação. Dentre os tipos de vinagres testados, o balsâmico esteve associado a menor remoção de "smear layer" após ambas as formas de aplicação.