RESUMO
Objective: This parallel, randomized, examiner-blind clinical trial aimed to evaluate the efficacy of two different toothbrushes (manual and sonic) on plaque control in adolescents. Material and Methods: This study enrolled 56 volunteers, randomly allocated to two different groups: group A (n = 28) for the manual toothbrush (Curaprox 5460 Ultra Soft®) and group B (n = 28) for the sonic toothbrush (Edel White®). Mean age was 17.2 ± 1.1 years. A calibrated periodontist performed a periodontal evaluation to assess the presence of plaque with the Turesky Modification of the Quigley Hein Plaque Index (PI) and the gingival inflammation with the Silness & Löe Gingival Index (GI). Adolescents received instructions about the mechanical control of plaque at baseline (T0), with a reexamination after 3 months (T1) and 6 months (T2). Non-parametric Mann Whitney test was used to compare the differences between the two toothbrush groups and the Friedman test was used for the comparisons between times. Results: There has been PI reduction concerning the study times (T0, T1 and T2, p<0.05), but not between the groups A and B (p>0.05). As for GI there has been no significant difference between the groups and between the study times (p>0.05). Conclusion: Both toothbrushes were efficient in the control of supragingival plaque (visible biofilm).
Assuntos
Humanos , Masculino , Feminino , Adolescente , Doenças Periodontais/diagnóstico , Escovação Dentária/métodos , Ensaio Clínico Controlado Aleatório , Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/etiologia , Brasil , Inquéritos e Questionários , Adolescente , Estatísticas não ParamétricasRESUMO
Os pacientes adultos que procuram tratamento periodontal, geralmente trazem consigo outras situações bucais debilitantes, principalmente perdas e posicionamento inadequado dos dentes. Lançar mão dos mais variados recursos para resolver um determinado caso, torna-se uma necessidade. Através de um caso clínico, foi possível mostrar que o tratamento ortodôntico, ainda que para resolver problemas localizados, pode ser um recurso auxiliar importante na solução de sequelas no periodonto. Uma paciente de 43 anos, apresentava uma recessão severa na região do 31 e 41, ambos extruídos. Após controle periodontal, foi realizado o enxerto gengival livre. Dois meses depois foi dado início à mecânica ortodôntica, com aparelho fixo autoligado e forças leves. Como última etapa, buscou-se o recobrimento radicular, com a técnica de tunelização associada ao deslocamento coronário com tecido conjuntivo interposto. O procedimento demonstrou ser uma alternativa terapêutica razoável para a gravidade do caso (AU)
The adult patients who search for a periodontal treatment usually have others debilitating oral situations, especially losses and inadequate teeth positions. Taking advantages of the most varied resources to solve a particular case becomes a necessity. Through a clinical case, it was possible demonstrate that orthodontic treatment, even solving localized problems also can be an important auxiliary resource to solve sequels in the periodontium. A 43 years old woman with a severe recession in region of 31 and 41elements and both were extruded. After periodontal control, the FGG technique was performed. Two months later the orthodontic mechanicalwas performed, with self-ligating system and little forces. As last step was tried the root coverage, using the tunneling technique: coronary displacement with interposed connective tissue. The technique showed being a reasonable alternative facing the severity of the case.(AU)
Assuntos
Humanos , Feminino , Adulto , Doenças Periodontais/cirurgia , Técnicas de Movimentação Dentária/instrumentação , Retração Gengival/cirurgia , Ortodontia , Tecido ConjuntivoRESUMO
Excessive gingival display (EGD) is a challenge for dentists attempting to provide their patients a pleasant smile. EGD associated with hyperactivity of the smile elevator muscles can be treated with various surgical techniques; regardless of which technique is used, to achieve a predictable result with long-term stability limiting upper lip movement when the patient smiles, a firm muscle containment is imperative. This report describes an innovative suture procedure associated with a lip repositioning technique aimed at maintaining the traction and containment of the smile elevator muscles. This case demonstrates a successful and stable result for excessive gingival exposure, addressing and satisfying a patient's esthetic concerns.
Assuntos
Estética Dentária , Músculos Faciais/cirurgia , Gengivectomia/métodos , Lábio/cirurgia , Sorriso/fisiologia , Técnicas de Sutura , Adulto , Feminino , Humanos , Lábio/anatomia & histologia , Satisfação do PacienteRESUMO
Objetivo: revisar o estresse como fator predisponente à instalação e desenvolvimento da doença periodontal, avaliando seus mecanismos biológicos e aspectos psicossociais. Material e métodos: uma revisão da literatura sobre o assunto foi realizada nas bases de dados PubMed e Scielo, utilizando as palavras-chave: estresse psicológico, doenças periodontais e cortisol. Resultados: a relação entre o estresse e a doença periodontal tem sido estudada desde a metade do século passado e apresenta-se de variadas formas clínicas, representando grandes impactos negativos em dimensões humanas e sociais. A maioria dos estudos publicados até o momento evidencia como os mecanismos do estresse influenciam a doença periodontal alterando a resposta inflamatória, imunológica e promovendo mudanças comportamentais. Conclusão: o estresse tem sido apontado como um possível fator de risco que infl uencia a instalação e a progressão das doenças periodontais. Contudo, os resultados obtidos ainda não estão defi nitivamente entendidos e estabelecidos.
Objective: to review stress as predisposing factor to installation and development of periodontal disease evaluating its biological mechanism and psychosocial aspects. Material and methods: a literature review about the subject was made through PubMed and Scielo databases using the keywords "psychological stress", "periodontal disease", and "cortisol". Results: the relation between stress and periodontal disease has been studied since the second half of the last century. The condition of stress is presented with various clinical forms and represent a negative impact in human and social dimension. It is discussed that the physiopathology mechanism of stress influences periodontal disease modifying infl ammatory and immunological responses and promote behavior changes. Conclusion: stress has been linked as the possible risk factor that infl uences installation and progression of periodontal disease. However the results are not yet definitively understood and established.
Assuntos
Humanos , Masculino , Feminino , Esgotamento Profissional/complicações , Hidrocortisona/análise , Doenças Periodontais/etiologia , Saliva , Estresse Psicológico/complicaçõesRESUMO
Este estudo tratou de uma abordagem de cunho quantitativo, que teve como objetivo avaliar parte do conhecimento dos profi s- sionais médicos, cirurgiões-dentistas e enfermeiros atuantes no programa de estratégia de saúde da família das cidades de Patos, Santa Luzia e São Mamede, no estado da Paraíba, sobre a relação bidirecional entre as duas doenças. Para a coleta dos dados, utilizou-se um formulário contendo questões relativas a dados sociodemográficos, diabetes e doença periodontal. Um total de 138 profissionais foi convidado a participar da pesquisa, sendo que 110 preencheram o termo de consentimento livre e esclarecido. Dos profissionais envolvidos neste estudo, 92,7% (n=101) informaram possuir conhecimento sobre doença periodontal; um total de 62,6% (n=67) da amostra afi rmou que o tratamento periodontal auxilia no controle glicêmico em pacientes diabéticos. Entre os participantes, 98,2% (n=108) afirmaram questionar fatores relacionados a diabetes durante a anamnese. A realização de um trabalho conjunto e multidisciplinar entre diferentes classes profissionais da saúde irá proporcionar uma melhor identificação e tratamento de pacientes com diabetes, predispostos ao desenvolvimento de doença periodontal.
This study consisted of a quantitative nature approach, which aimed to assess part of the knowledge of the medical professionals, dental surgeons and nurses who work in family health strategy program from the cities of Patos, Santa Luzia and São Mamede in the state of Paraiba, on the bidirectional relationship between the two diseases. For the data collection a questionnaire containing questions regarding socio- demographic data, diabetes and periodontal diease was applied to participants. A total of 138 professionals were invited to participate, with 110 filling in the informed consent form. From the professionals involved in this study, 92.7% (n=101) reported having knowledge about periodontal disease, a total of 62.6% (n=67) of the sample reported that periodontal treatment helps in glycemic control in diabetic patients. Among the participants, 98. 2% (n=108) reported questioning factors related to diabetes during anamnesis. The conducting of a collaborative and multidisciplinary work among different health professionals classes will provide better identification and treatment of diabetic patients predisposed to the development of periodontal disease.
Assuntos
Humanos , Diabetes Mellitus , Estratégias de Saúde Nacionais , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Doenças PeriodontaisRESUMO
Mucograft(r) is a resorbing porcine matrix composed of type I and type III collagen, used for soft tissue augmentation in guided tissue bony regeneration procedures. This in vitro study aimed to evaluate the biological behavior of Mucograft(r) in human gingival fibroblasts, as well as the ability of the matrix to induce production of extracellular matrix. Six resorbing Mucograft(r) matrices (MCG) were cut into 3 x 2 mm rectangles and 5 x 5 mm squares and were placed in 96- and 24-well plates, respectively. The control group (CTRL) consisted of cells plated on polystyrene without the MCG. After one, two, three and seven days, cell proliferation and viability were assessed using the Trypan exclusion method and MTT test, respectively. Type III collagen (COL 3A1) and vimentin (VIM) expression were also evaluated at 10 and 14 days, using Western blotting. Statistical analysis, using ANOVA with post hoc Bonferroni test, revealed that human gingival fibroblasts from MCG showed similar results (p>0.05) for proliferation and viability as the cells cultured on CTRL. After 14 days, a significant decrease in COL 3A1 expression (p<0.05) was observed when cultured with the MCG. VIM expression showed no significant difference at any time period (p>0.05). Although no increase in extracellular matrix secretion was observed in this in vitro study, Mucograft(r) presented cellular compatibility, being an option for a scaffold whenever it is required.
Resumo A Mucograft(r) é uma matriz reabsorvível, de origem suína, composta de colágenos do tipo I e III, utilizada para aumento de tecido mole em regeneração óssea guiada. Este estudo in vitro teve como objetivo avaliar o comportamento biológico da Mucograft(r), em fibroblastos gengivais humanos, bem como a indução da síntese de matriz extracelular. Seis matrizes reabsorvíveis de Mucograft(r) (MCG) foram cortadas em retângulos e quadrados medindo 3 x 2 mm e 5 x 5 mm e alocadas em placas de 96 e 24 poços, respectivamente. O grupo controle (CTRL) consistiu no plaqueamento celular em poliestireno, sem MCG. Após um, dois, três e sete dias, a proliferação e a viabilidade celular foram avaliadas utilizando o corante vital azul de Trypan e o teste MTT, respectivamente. Além disso, a expressão de colágeno tipo III (COL 3A1) e vimentina (VIM) foi avaliada após 10 e 14 dias, por meio de Western-blotting. Após análise estatística (Anova e pós teste de Bonferroni), pode-se observar que os fibroblastos gengivais humanos, cultivados sobre MCG, apresentaram proliferação e viabilidade semelhantes em comparação às células que foram cultivadas apenas no poliestireno (CTRL). Após 14 dias, notou-se uma diminuição significativa da expressão de COL 3A1 (p<0,05) quando as células foram cultivadas sobre a MCG. A expressão da VIM não mostrou diferença significativa em nenhum dos períodos estudados (p>0,05). No presente estudo in vitro pode-se concluir que apesar de não ter sido observado aumento da síntese de matriz extracelular, a Mucograft(r) apresentou compatibilidade celular, sendo uma opção de biomaterial em casos que o arcabouço é necessário.
Assuntos
Humanos , Materiais Biocompatíveis , Colágeno Tipo I , Colágeno Tipo III , Gengiva/citologia , Proliferação de Células , Fibroblastos/citologia , Técnicas In VitroRESUMO
Objetivo: analisar o nível de conhecimento de 200 cirurgiões- -dentistas atuantes na área de Periodontia, sobre sua responsabilidade civil. Material e métodos: uma amostra estabelecida por conveniência, composta por 200 cirurgiões-dentistas atuantes na área de Periodontia, de todas as regiões do Brasil. Esses profissionais responderam um questionário autoaplicável, constituído por 25 perguntas objetivas, com o intuito de obter algumas informações sobre o conhecimento destes a respeito de responsabilidade civil. Foram excluídos os profissionais que não estavam atuando na Odontologia, embora possuíssem titulação. Resultados: a pesquisa buscou analisar de forma estatística o conhecimento dos profissionais quanto à sua responsabilidade civil, análise esta feita com base nos dados obtidos em pesquisa de campo, por meio de levantamento de questionários. Os resultados mostraram, na maioria dos assuntos, que mais da metade dos profissionais respondeu de forma incorreta, demonstrando a necessidade de conhecerem mais o assunto. A pesquisa também mostrou que o número de profissionais que conhecem e possuem seguro de responsabilidade civil é significativamente superior no grupo que já concluiu curso de pós-graduação. Conclusão: os resultados demonstraram a necessidade de um melhor conhecimento por parte dos profissionais com prática em Periodontia, referente ao assunto responsabilidade civil, fato reconhecido por 89% dos profissionais pesquisados ao responderem positivamente quando questionados se sentem necessidade de um programa de atualização sobre responsabilidade civil. A necessidade de conhecimento do assunto pode prevenir eventuais problemas judiciais, pois o profissional, sabendo o que pode ocorrer, tomará os cuidados necessários.
Objective: this study aimed to analyze the level of knowledge of two hundred dentists working in the area of periodontics, about their civil liability. Materials and methods: a sample established for convenience, consisting of two hundred dentists working in the area of periodontics, from all regions of Brazil. These professionals answered a self-administered questionnaire, consisting of twenty-five objective questions, in order to obtain some information about the knowledge of these regarding civil liability. Were excluded the professionals who were not working in dentistry, although possessed titration. Results: the research sought to analyze statistical form the knowledge of professionals as to its civil liability, this analysis is made on the basis of the data obtained in field research, through survey questionnaires. The results showed, in most subjects, more than half of the professionals answered incorrectly, demonstrating the need for professionals more aware of the issue. The survey also showed that the number of professionals who know and have civil liability insurance is significantly higher in the group that has already completed graduate course. Conclusion: the results showed the need for a better knowledge on the part of professionals with practice in periodontics, referring to the civil liability issue, a fact recognized by 89% of professionals surveyed to respond positively when asked if they feel the need of an upgrade program on civil liability. The need for knowledge of the subject can prevent any legal problems, because the professional, knowing what may occur, it shall take the necessary care.
Assuntos
Humanos , Cirurgiões/legislação & jurisprudência , Responsabilidade Civil , PeriodontiaRESUMO
Mucograft(r) is a resorbing porcine matrix composed of type I and type III collagen, used for soft tissue augmentation in guided tissue bony regeneration procedures. This in vitro study aimed to evaluate the biological behavior of Mucograft(r) in human gingival fibroblasts, as well as the ability of the matrix to induce production of extracellular matrix. Six resorbing Mucograft(r) matrices (MCG) were cut into 3 x 2 mm rectangles and 5 x 5 mm squares and were placed in 96- and 24-well plates, respectively. The control group (CTRL) consisted of cells plated on polystyrene without the MCG. After one, two, three and seven days, cell proliferation and viability were assessed using the Trypan exclusion method and MTT test, respectively. Type III collagen (COL 3A1) and vimentin (VIM) expression were also evaluated at 10 and 14 days, using Western blotting. Statistical analysis, using ANOVA with post hoc Bonferroni test, revealed that human gingival fibroblasts from MCG showed similar results (p>0.05) for proliferation and viability as the cells cultured on CTRL. After 14 days, a significant decrease in COL 3A1 expression (p<0.05) was observed when cultured with the MCG. VIM expression showed no significant difference at any time period (p>0.05). Although no increase in extracellular matrix secretion was observed in this in vitro study, Mucograft(r) presented cellular compatibility, being an option for a scaffold whenever it is required.
Assuntos
Materiais Biocompatíveis , Colágeno Tipo III , Colágeno Tipo I , Gengiva/citologia , Proliferação de Células , Fibroblastos/citologia , Humanos , Técnicas In VitroRESUMO
BACKGROUND: The purpose of this study was to evaluate the antibacterial effects of photodynamic action of methylene blue (MB) against Aggregatibacter actinomycetemcomitans organized on biofilm. METHODS: After the biofilm growth in 96 flat-bottom well plate, the following groups were used: control group, untreated by either laser or photosensitizer (PS); MB group or dark toxicity group, which was exposed to MB alone (100µM) for 1min (pre-irradiation time); laser group, irradiated with laser for 5min in the absence of PS and three antimicrobial photodynamic inactivation (APDI) groups, with three exposure times of 1, 3 and 5min of irradiation, corresponding to fluences of 15, 45, and 75J/cm(2) respectively. The results were compared to the control group for statistical proposes. Scanning electronic microscope analysis was used to access structural changes in biofilm. RESULTS: Red laser alone and MB alone were not able to inactivate bacterial biofilm. APDI groups showed differences when compared to the control group and they were dependent on the exposure time. No statistically significant differences were observed among the APDI groups at 1 and 3min of irradiation. On the other hand, 5min of APDI showed 99.85% of bacterial reduction (p=0.0004). In addition, the biofilm loose its structure following 5min APDI. CONCLUSIONS: The results of this study suggest that A. actinomycetemcomitans biofilm can be inactivated by MB mediated APDI.
Assuntos
Aggregatibacter actinomycetemcomitans/efeitos dos fármacos , Aggregatibacter actinomycetemcomitans/fisiologia , Biofilmes/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Azul de Metileno/administração & dosagem , Fotoquimioterapia/métodos , Apoptose/efeitos dos fármacos , Apoptose/efeitos da radiação , Biofilmes/efeitos da radiação , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos da radiação , Relação Dose-Resposta à Radiação , Luz , Fármacos Fotossensibilizantes/uso terapêuticoRESUMO
A novel activated human T cell-secreted cytokine, referred as secreted osteoclastogenic factor of activated T cells (SOFAT), that induce osteoclastogenesis in a RANKL-independent manner was recently described. This study evaluated the role of SOFAT in periodontal tissues and periodontitis. Gingival biopsies were harvested from systemically healthy non-periodontitis (n=15) and chronic periodontitis patients (n=15). The mRNA and protein levels of SOFAT were measured by qPCR and by enzyme-linked immunosorbent assay, respectively. Moreover, RAW 264.7 cells were cultured with SOFAT or Receptor activator of nuclear factor-kB ligand (RANKL) and stained for tartrate-resistant acid phosphatase (TRAP). Also, mice received a palatal injection between the first and second upper molar of SOFAT (100 ng/ml) or saline solution (0.9%). The upper jaw was removed, histologically processed and stained with hematoxilin and eosin to observe the presence of osteoclast-like cells. The mRNA and protein levels of SOFAT were significantly higher in the gingival tissue of the periodontitis group when compared to non-periodontitis one (p<0.05). In addition, SOFAT potently induced TRAP-positive multinucleated cell formation by RAW 264.7 cells as well as induced the formation of osteoclast-like cells in the periodontal ligament in mice. The present study demonstrated that SOFAT may play an important role in periodontitis.