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To compare 2 different resin composites and 2 adhesive systems used in a new restorative protocol (partial restoration) to treat non-carious cervical lesions associated with gingival recession type 1 (RT1).Eighty combined defects (CDs) were treated with a partial restoration and periodontal plastic surgery for root coverage. The CDs were randomly assigned to one of the following groups: NP + TE (n = 20), nanofilled composite and 2-step total-etch adhesive system; NP + UA (n = 20), nanofilled composite and universal adhesive system; MH + TE (n = 20), microhybrid composite and 2-step total-etch adhesive; MH + UA (n = 20), microhybrid composite and universal adhesive. Restorations were assessed using the United States Public Health Service (USPHS) criteria at 1 week (baseline) and 6, 12, and 24 months. Survival rate, periodontal parameters, dentin hypersensitivity (DH), and aesthetics were also evaluated.After 24 months, only the MH + TE group did not lose any restoration, with no significant differences between groups. For surface roughness parameter, MH presented 83.3% of the restorations scoring Bravo, whereas NP presented 48.5% of the restorations scoring Bravo. All groups presented restorations with marginal discoloration. All periodontal parameters behaved similarly, regardless of the restorative material. All groups presented significant reductions of dentin hypersensitivity and improved aesthetic perceptions (p 0.05).Both resin composites and adhesives tested can be combined for partial restorations to treat CDs.This new restorative-surgical protocol to treat CDs presents satisfactory outcomes. The partial restorations can be successfully executed with both combinations of adhesives and resin composites evaluated in this investigation. TRN : ClinicalTrial.gov: NCT03215615; registration date July 12, 2017.

OBJETIVO: A peri-implantite é uma doença biofi lme-dependente que afeta os tecidos ao redor do implante dentário, caracterizando-se por infl amação da mucosa peri-implantar e perda óssea progressiva. A fi brina rica em plaquetas é conhecida pelas propriedades de acelerar o processo de cicatrização de feridas e atividade antimicrobiana. Estudos vêm sendo realizados com a aplicação de fi brina rica em plaquetas no campo da implantodontia. No entanto, existem poucas evidências sobre os benefícios no tratamento da peri-implantite. MATERIAL E MÉTODOS: O presente relato de caso descreve o tratamento de defeitos de peri-implantite no segundo quadrante (região de incisivo lateral e canino) na prótese parcial fi xa implantossuportada de uma paciente de 59 anos de idade. O diagnóstico foi baseado na profundidade de sondagem (PS) > 6 mm e nível de perda óssea (NPO) de 5 e 3 mm nas regiões de incisivo lateral e canino. Além disso, uma deiscência em tecido mole vestibular de 1,5 e 3 mm foi observada nas regiões de incisivo lateral e canino, respectivamente. Foi realizada cirurgia a retalho para descontaminação da superfície do implante por meio de implantoplastia associada a membranas de fi brina rica em plaquetas, seguido de medicação antimicrobiana adjuvante por sete dias. RESULTADOS: Uma melhora clínica relevante foi observada em relação à profundidade de sondagem (< 4 mm) após quatro meses. Além disso, nenhum sangramento e supuração à sondagem foram observados. O ganho médio de largura da mucosa queratinizada foi de 1,1 mm após quatro meses de acompanhamento. Em adição, a margem vestibular da mucosa peri-implantar apresentou mínima recessão (0,5 mm cada) após o procedimento cirúrgico. A largura da mucosa queratinizada também aumentou ao fi m do acompanhamento. CONCLUSÃO: A cirurgia a retalho para descontaminação da superfície do implante por meio de implantoplastia associada a membranas de fi brina rica em plaquetas apresentou bons resultados clínicos no tratamento da peri-implantite.

This study evaluated the use of a xenogeneic acellular dermal matrix (XADM) combined with a modified coronally advanced flap (MCAF) and partial resin composite filling (anatomic crown plus 1 mm of the root surface) to treat multiple Type 1 gingival recessions associated with B+ noncarious cervical lesions (NCCLs). The study included 24 recessions in 10 patients. Bleeding on probing, probing depth, combined defect height, relative gingival recession, clinical attachment level, esthetics, and dentin hypersensitivity were recorded. After 6 months, the treatment provided statistically significant outcomes: It reduced the combined defect height by 2.02 ± 0.65 mm, increased clinical attachment level by 1.96 ± 0.83 mm, and increased keratinized tissue thickness by 0.46 ± 0.47 mm, and shallow probing depths were seen. Significant dentin hypersensitivity reduction and esthetic improvements were observed. Therefore, XADM associated with MCAF and partial restoration might be a promising alternative to autogenous grafts used to treat multiple gingival recessions associated with B+ NCCLs.

There are few studies comparing xenogeneic acellular dermal matrixes (XDMs) with connective tissue graft (CTG) to treat single gingival recession (GR). The present study involved a reanalysis of previous studies and comparison of CTG or XDM to treat single RT1/GR.Fifty patients from three previous randomized clinical trials treated either by CTG (n = 25) or XDM (n = 25) were evaluated after 6-month. Clinical, patient-centered, and esthetic parameters were assessed. Pearson's correlation and regression analyses were also performed.Greater recession reduction (RecRed), percentage of root coverage (%RC), and complete root coverage (CRC) were observed in the CTG group (p ≤ 0.02). Gingival thickness (GT) and keratinized tissue width (KTW) gains were higher in the CTG group. The CTG group showed better esthetic at 6-month. Logistic analyses reported that GT([OR] = 1.647CTG was superior for treating RT1/GR, providing better root coverage outcomes and tissue gains over time. GT, PH, and graft type were classified as predictors of CRC.CTG presented better outcomes to treat single RT1 gingival recession when compared to the XDM.

Made available in DSpace on 2022-05-01T10:19:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Xenogeneic matrices (XMs) have been increasingly used for root coverage procedures. This study compared the use of two types of XM (collagen matrix [CM] and xenogeneic acellular dermal matrix [XDM]) associated with the coronally advanced flap technique (CAF) to treat single gingival recessions. Methods: Seventy-five patients presenting single RT1 gingival recession were treated by CAF (control group, n = 25), CAF+CM (test group 1, n = 25), or CAF+XDM (test group 2, n = 25) and completed 6-month follow-up. Clinical, patient-centered, and esthetic assessments were performed and intra- and intergroup differences were analyzed. Results: At 6 months, the mean recession reduction for CAF, CAF+CM, and CAF+XDM was 2.4 ± 0.8 mm, 2.4 ± 0.9 mm and 2.1 ± 0.8 mm, respectively (P > 0.05). The corresponding mean percentage of root coverage was 78.9% ± 26.2% for CAF, 78.0% ± 28.5% for CAF+CM, and 65.6% ± 26.9% for CAF+XDM (P > 0.05). Dentin hypersensitivity and esthetic conditions showed significantly improvements in all groups. Test groups presented significant gains in gingival thickness (GT; CAF+CM: 0.4 ± 0.3 mm; CAF+XDM: 0.4 ± 0.2 mm) compared to the control group (CAF: 0.0 ± 0.1 mm; P

With society trending toward the avoidance of artificial components, so-called "natural" products have been gaining space and people's attention in recent years. Activated charcoal-based dental products are a prominent example of this movement because of their promise of removal of extrinsic stains or whitening of teeth by a natural means. Such products have gained popularity among patients, and companies have explored this market, launching charcoal-based and activated charcoal-based dentifrices, mouthrinses, toothbrushes, and whitening products that can be easily found at nearby stores and on the internet.1.

Made available in DSpace on 2021-06-25T22:23:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-12-16 Introduction: Gingival recession (GR) is a prevalent problem that is related to esthetic demands and dentin hypersensitivity. Frequently, GR is associated with non-carious cervical lesion (NCCLs) forming a combined defect (CD), which requires restorative and surgical treatment. Connective tissue graft procedures allow predictable root coverage but can result in patient discomfort. Case Presentation: This first case report describes multiple GRs associated with B+ NCCL at teeth #4 and #6 of a 27-year-old patient with a thin periodontal phenotype. The aim of this report was to evaluate the 6-month outcome of a new volume-stable collagen matrix (VCMX) combined with modified coronally advanced flap (MCAF) and partial restoration to treat CDs. After 6 months, significant improvement was observed regarding CD coverage (69.05%), recession reduction (2.25 mm), gingival thickness gain (0.74 mm), and keratinized tissue width gain (0.75 mm). In addition, excellent esthetic evaluation and patient comfort were achieved by using the biomaterial. Conclusion: VCMX associated with MCAF and partial restoration may be an option to treat multiple recession defects plus B+ NCCLs. Sao Paulo State Univ UNESP, Inst Sci & Technol, Div Periodont, Ave Eng Francisco Jose Longo 777, Sao Jose Dos Campos, SP, Brazil Sao Paulo State Univ UNESP, Inst Sci & Technol, Div Periodont, Ave Eng Francisco Jose Longo 777, Sao Jose Dos Campos, SP, Brazil

Made available in DSpace on 2020-12-12T02:48:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Background: This study was conducted to assess the clinical, immunological, and patient-centered outcomes of microcurrent electrotherapy on palatal wound healing. Methods: This was a parallel, double-masked randomized clinical trial, in which 53 patients with ridge preservation indications were selected and randomly assigned to one of two groups. In the control (sham) group (n = 27), palatal wounds, after free gingival grafts (FGG) harvest, received sham application of electrotherapy. In the test (electrotherapy treatment [EE]) group (n = 26), palatal wounds, after FGG harvest, received application of microcurrent electrotherapy protocol. Clinical parameters, patient-centered outcomes, and inflammatory markers were evaluated, up to 90 days postoperatively. Results: The EE group achieved earlier wound closure (P

Made available in DSpace on 2022-05-01T09:30:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: This study was conducted to evaluate the clinical, immunologic, and patient-centered outcomes of enamel matrix protein derivative (EMD) on excisional wounds in palatal mucosa. Materials: Forty-four patients in need of ridge preservation were randomly allocated into two groups: control group (n = 22): open palatal wound after free gingival graft (FGG) harvest and EMD group (n = 22): open palatal wound after FGG harvest that received 0.3 ml of EMD. Clinical and patient-centered parameters were analyzed for 3 months post-treatment. Wound fluid levels of inflammatory markers were assessed 3 and 7 days postoperatively. Results: No significant inter-group difference was observed in remaining wound area and re-epithelialization. EMD and control groups achieved wound closure and re-epithelialization 30 days postoperatively (p .05). EMD appeared to selectively modulate wound fluid levels of monocyte chemoattractant protein-1, macrophage inflammatory protein-1α, matrix metallopeptidase 9, and tissue inhibitor of metalloproteinases-2. Conclusion: Within the limits of the present study, it can be concluded that EMD application to excisional palatal wounds using the investigated protocol does not provide clinical healing benefits, despite an apparent modulation of selected inflammatory markers. São Paulo State University (UNESP) Division of Periodontics Institute of Science and Technology Division of Operative Dentistry Department of General Dentistry University of Maryland School of Dentistry Department of Prosthodontics and Periodontics Division of Periodontics Piracicaba Dental School College of Dentistry Division of Periodontology The Ohio State University (OSU) College of Dentistry - Lexington University of Kentucky São Paulo State University (UNESP) Division of Periodontics Institute of Science and Technology

Made available in DSpace on 2022-05-01T08:44:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Evaluate the use of collagen matrix (CM) as adjunctive to coronally advanced flap (CAF versus CAF + CM) to treat gingival recession (GR) associated with non-carious cervical lesion–combined defects (CDs). Methods: Sixty-two patients presenting 62 CDs (RT1 GR and non-carious cervical lesion (NCCLs) were randomly allocated to either CAF group (n = 31): partial restoration of the NCCL and CAF; or to CAF + CM group (n = 31): partial restoration of the NCCL and CAF associated with CM. Clinical, esthetic, patient-centered outcomes, and restorative parameters were assessed. Results: After 12 months, CD coverage were 55.2% for CAF and 54.4% for CAF + CM (P = 0.8). Recession reduction were 1.9 ± 0.8 mm for CAF and 2.0 ± 0.7 mm for CAF + CM (P = 0.6). CAF+CM resulted in higher increase in keratinized tissue (KT) width (CAF: 0.3 ± 0.7 mm; CAF + CM: 0.9 ± 0.8 mm; P = 0.004) and KT thickness gain (CAF: 0.1 ± 0.3 mm; CAF + CM: 0.7 ± 0.2 mm; P = 0.001). Both treatments presented low postoperative pain and resulted in esthetics improvements. In addition, no restoration was lost, 27.4% showed a reduction of the superficial polishing, and 8% showed marginal staining, but still clinically acceptable. Conclusion: Partial resin composite restoration (with the apical limit up to 1 mm of the estimated CEJ) and CAF alone or combined with CM are suitable for treating CDs. The use of CM provided additional benefits in terms of KT width and thickness gain. (NCT03341598). UNESP Sao Paulo State University Division of Periodontology College of Dentistry Division of Operative Dentistry Department of General Dentistry University of Maryland School of Dentistry UNESP Sao Paulo State University Division of Operative Dentistry College of Dentistry College of Dentistry—Lexington University of Kentucky UNESP Sao Paulo State University Division of Periodontology College of Dentistry UNESP Sao Paulo State University Division of Operative Dentistry College of Dentistry

Made available in DSpace on 2021-06-25T12:22:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-10-23 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Background Periodontal disease and diabetes mellitus (DM) are highly prevalent and interrelated diseases, resulting in altered host response microbiota. Thus, this study aimed to evaluate the impact of DM on local levels of lipopolysaccharide (LPS) and lipoteichoic acid (LTA) and their relationship with cytokines and matrix metalloproteinases' (MMPs) profile. Methods This case-control study included diabetic (n = 15) and non-diabetic (n = 15) subjects presenting Stage 3-4, Grade C, Periodontitis. Gingival crevicular fluid (GCF) was collected, and LPS and LTA levels were analyzed by enzyme-linked immunosorbent assay (ELISA), while IFN-gamma, IL-10, IL-17, IL-1 beta, IL-4, MMP-2, and MMP-9 were measured by LUMINEX/MAGpix. Mann-Whitney and Spearman's correlation tests were used to compared and to correlate variables (p < 0.05). Results Higher levels of LTA, LPS, IL-10, IL-1 beta, and MMP-2 (p < 0.05) and lower levels of IL-17 were found in the DM group (p < 0.05). Non-diabetic subjects presented higher LPS, IFN-gamma, IL-17, and MMP-2 levels and lower IL-10 concentration (p < 0.05). No significant correlation was seen between LPS and cytokine profile in non-diabetic. Local levels of LTA were positively correlated with IL-17 and MMP-2 and negatively with IL-10. Conclusion LTA and LPS drove the inflammatory profile through the modulation of cytokines and MMPs in a different manner in DM and non-diabetic subjects. Univ Estadual Campinas, Dent Sch Piracicaba, Dept Prosthodont & Periodont, Campinas, Brazil Sao Paulo State Univ, Div Periodontol, Coll Dent, FOSJC, Sao Paulo, Brazil Sao Paulo State Univ, Div Periodontol, Coll Dent, FOSJC, Sao Paulo, Brazil FAPESP: 2015/502640 FAPESP: 2018/12208-9 CAPES: 001

Objectives: To evaluate the effect of bleaching on colour, gloss, translucency, and microhardness of two types of resin composites (Charisma Classic and Filtek Z350 XT), previously aged. Materials and methods: Forty specimens of each material were artificially aged for 300 hours (UV-accelerated aging). Specimens were then treated with 35% hydrogen peroxide (Whiteness HP) in four 15-minutes sessions, totaling one hour of bleaching. Colour coordinates CIE L*a*b* and parameters of translucency (PT) were measured using a spectrophotometer (CM2600d – Konica Minolta), surface gloss readings were performed with a glossmeter (Novo-Curve – Rhopoint TM), and microhardness was assessed using a hardness device (FM-700, Future-Tech). Measurements have been performed after artificial aging as well as after the first and last bleaching protocol. Data were analyzed by two-way ANOVA and two-way repeated measures ANOVA, followed by Tukey’s test (5%). Results: The bleaching procedures of aged resin composites decreased the gloss and increased the translucency, but did not alter colour and microhardness. Conclusion: Bleaching procedures should be used carefully when resin composite restorations are present.

The aim of this exploratory trial was to compare the 3-month effect of two antimicrobials on the salivary levels of Streptococcus mutans (SM) in children.Ninety school children aged 6-10 years participated. They were divided into two groups according to treatment used: 1% chlorhexidine gel (CHX) or 30% silver diamine fluoride (SDF). Saliva for SM colony forming unit (CFU)/ml counting was harvested in four periods: baseline (prior to antimicrobials); P1 (24 h after antimicrobial therapy); P30 (30 days after antimicrobial therapy); and P90 (90 days after antimicrobial therapy). CFU/ml data was submitted to repeated measures by analysis of variance (ANOVA).Only the time factor influenced the results (p0.001), with a reduction of SM for all evaluated periods in comparison to the baseline. No influence of antimicrobials or interactions of factors were detected (p0.05). P30 presented the lowest levels of SM and at P90, SM levels were similar to P1 but still lower than the baseline observations. SDF and CHX presented a similar effect on SM within each period of evaluation (p = 0.65).It was concluded that 30% SDF presents similar antimicrobial effects as 1% CHX over time. SDF might be used as an adjunctive therapy for controlling dental caries in children.

Made available in DSpace on 2020-12-12T01:08:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-12-01 BACKGROUND: To assess the clinical and microbiological responses of amoxicillin + metronidazole (AMX + MET) versus clarithromycin (CLM) as adjuncts to one-stage full-mouth ultrasonic debridement (FMUD) in the treatment of generalized aggressive periodontitis (GAgP). METHODS: For this parallel, double-masked, pilot randomized clinical trial, 46 patients with GAgP were selected and randomly assigned into two groups: AMX+MET group (n = 23): FMUD associated with AMX (500 mg three times a day) and MET (400 mg three times a day) for 7 days; and CLM group (n = 23): FMUD associated with CLM (500 mg twice a day) for 7 days. Clinical parameters were evaluated at baseline, 3, and 6 months post-treatment. The levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum from subgingival biofilm were determined by quantitative polymerase chain reaction. RESULTS: Both treatments significantly improved all clinical parameters compared with baseline and promoted a significant reduction of A. actinomycetemcomitans and P. gingivalis counts (P > 0.05). CLM succeeded in decreasing T. forsythia at 6 months (P 0.05). CONCLUSIONS: The results suggest that CLM is not superior than AMX + MET in the treatment of GAgP. However, this antibiotic led to good clinical outcomes and may be a possible alternative to AMX+MET in the treatment of severe periodontitis in young patients. Future studies with larger sample sizes are needed to confirm this statement (NCT02969928). Division of Periodontics Institute of Science and Technology São Paulo State University (Unesp) Department of Prosthodontics and Periodontics Division of Periodontics Piracicaba Dental School University of Campinas (Unicamp) Division of Periodontics Institute of Science and Technology São Paulo State University (Unesp)