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Introduction: This case report presents the intentional periodontal maintenance of two periodontal hopeless lower central incisors with a multidisciplinary approach and 20-year follow-up. Case presentation: A 36-year-old male, in 2001, was diagnosed with aggressive periodontitis, gingival swelling, bleeding, and mandibular central incisors with mobility and poor prognosis. Following periodontal therapy (phase I), root canal treatment, and occlusal adjustment, #31 and #41 were gently extracted to remove the granulation tissues, calculus, and infected cementum from the root surface. Then, tetracycline-HCl was applied for 5 minutes on the root surfaces. The teeth were repositioned into the sockets and splinted with a lingual bar. At 3 months, the bar was removed, and a free gingival autogenous graft was done to improve the local keratinized tissue width. Mobility scores, pocket depths, and clinical attachment levels were recorded, and radiographs were taken at 1, 5, and 20 years. The 5-year follow-up showed that the teeth were clinically and radiographically in function. There was a reduction in probing depth and a gain in clinical attachment and radiographic alveolar bone levels. After 20 years, #41 was stable, but #31 had external root resorption, leading to a new treatment plan (dental implants) and extraction. Conclusion: The clinical result of this case was satisfactory for 20 years. Intentional periodontal maintenance of the teeth may be an alternative treatment, even considering the high level of complexity.

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BACKGROUND: The Brazilian Dental Specialty Centers (CEO, in Portuguese) represent the strategy of the National Oral Health Policy to provide secondary-level dental care. They offer more complex procedures, such as the treatment of periodontitis. This study aims to investigate the factors associated with the performance and the achievement goals of specialized procedures and the achievement gols of periodontics in CEO. METHODOLOGY: Analytical and cross-sectional study using secondary data. The database of the second cycle of the External Evaluation of the National Program for Improving Access and Quality in CEO (PMAQ-CEO, in Portuguese), was utilized, which assessed 1,042 CEO on-site in 2018. The data were analyzed using multiple Poisson regression, estimating the prevalence ratio (PR) (p < 0.05). RESULTS: A third of the CEO (n = 305) performed all specialized procedures, with a higher prevalence observed in those with more than one bicarbonate jet prophylaxis unit (RP = 2.12; 95% CI: 1.160-3.881; p = 0.015) and when they had a higher percentage of specialist professionals (RP = 1.004; 95% CI: 1.002-1.006; p < 0.001). The periodontics goal was achieved by 617 (59.2%) CEO, with a higher prevalence among those who had a manager with supplementary training (PR = 1.21; 95% CI: 1.100-1.335; p < 0.001) and with a higher workload for the periodontist dentist (PR = 1.15; 95% CI: 1.103-1.201; p < 0,001). CONCLUSION: Although most CEOs do not perform allspecialized periodontics procedures, more than half achieved the established goals. The provision of specialized periodontics services in CEO and the achievement of goals are influenced by the quantity and professional qualifications, as well as the availability of equipment.

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BACKGROUND AND OBJECTIVE: As elsewhere in the world, the prevalence of periodontitis in stages I-II is high in the Latin American population, this scenario emphasizes the need for identification of urgent needs for allocating adequate resources to provide diagnosis, prevention, and treatment of these diseases. The aim of this Delphi study was to predict the trends in periodontology/periodontics in the Latin American region by the year 2030. METHODS: A steering committee and an advisory group of experts in periodontology/periodontics were selected from 16 countries. An open questionnaire of 60 questions was validated and used following the Delphi methodology. RESULTS: Two hundred and twenty-five experts from Latin America answered the two rounds of the questionnaire. Moderate to strong consensus was reached on 45 questions (75%). The prediction was that the prevalence of gingivitis and periodontitis in stages I and II will be maintained, the importance of the link with systemic diseases will increase, and the impact of prevention and periodontal treatment will also increase, mainly in the private sector. There was a strong consensus that plastic and regenerative surgical procedures will increase, as well as the demand for training in the specialty of periodontology. CONCLUSIONS: The present study has provided relevant and useful information on predictions in periodontology/periodontics in Latin America, with important level of consensus among experts. It has been predicted that periodontitis will still be a highly prevalent disease, and its links with other medical conditions should demand more attention by health authorities to develop adequate prevention and management policies and strategies.

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Aim: This study aimed to evaluate the millimeter distances and active tip diameters of different periodontal probes. Methods: Two types of periodontal probes were analyzed (North Carolina (15-UNC) and PCP-12). Two manufacturers were selected for each probe type. Digital images of the probes were obtained and the distances were measured using a software program. The diameter of the active tip was measured using a digital caliper. Both variables were measured by two trained and calibrated examiners. The data were analyzed using the Bland-Altman method and two-way ANOVA with Tukey's post-hoc test. Statistical significance was set at p<0.05. Results: A comparison of measurements between the 15UNC and PCP-12 probes showed a significant difference in all millimeter markings. The 15-UNC probe showed differences between the 3 and 12 mm markings. The PCP-12 probe only showed differences between the marks at the 12 mm mark. The 15-UNC probe had a similar active tip diameter between the two manufacturers. The PCP-12 probe showed a significant difference between the two manufacturers. Both types of probes had similar active tip diameters when compared by the two manufacturers. Conclusion: There was no standardization in relation to millimeter marks and tip diameters of the two types of periodontal probes produced by the two different manufacturers. The probe types exhibited little variability

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A periodontite e o diabetes mellitus tipo 2 (DM2) são doenças relacionadas e prevalentes. A busca por terapias coadjuvantes ao tratamento periodontal em indivíduos diabéticos almeja melhores resultados. A própolis verde (PV) tem sido discutida como uma possibiidade por suas propriedades antibacterianas, anti-inflamatórias e antioxidantes, que justificam sua aplicação em várias patologias odontológicas. Este estudo apresenta duas propostas de investigação: 1) Ensaio clínico randomizado (ECR) avaliando a terapia coadjuvante com PV na terapia periodontal não cirúrgica (TPNC) de pacientes com DM2; 2) Revisão bibliométrica (RB) mapeando os 100 artigos mais citados sobre o uso de própolis na odontologia. O ECR incluiu 22 indivíduos com DM2 e periodontite estágios II e III, randomizados em dois grupos: controle e teste. Dados sociodemográficos e periodontais foram coletados. Avaliou-se proteína c-reativa (PCR), hemoglobina glicada (HbA1c) e glicemia em jejum. Todos os indivíduos foram submetidos à TPNC. O grupo teste recebeu suplementação com PV durante 60 dias após a TPNC e o grupo controle recebeu placebo. Os grupos foram avaliados após 60 e 90 dias. A amostra se mostrou equilibrada para os parâmetros sociodemográficos, laboratoriais e para sangramento à sondagem (SS) e nível de inserção clínico (NIC). Os grupos mostraram melhora significativa no SS (p < 0,05), profundidade de sondagem (PS) (p<0,01) e NIC (p<0,05) após a TPNC. Não houve diferenças significativas para os mesmos parâmetros entre os grupos. Os parâmetros laboratoriais não mostraram alteração significativa intragrupo nem intergrupos. Para esta amostra, o tratamento coadjuvante com PV comparado ao placebo não mostrou diferenças significativas. A RB analisou o uso e aplicação de própolis nas diferentes áreas de especialidades odontológicas. A busca foi realizada no Web Of Science (WoS) e um crossmatch do número de citações (NC) foi realizado no Scopus e no Google Scholar. Os artigos encontrados foram avaliados quanto aos autores, instituições, região, idade, desenho de estudo, periódico, palavras-chave e altmetria. O NC no WoS mostrou uma forte correlação positiva com o NC no Google Scholar (0,890; p<0,001) e no Scopus (0,963;p<0,001). Os artigos foram publicados entre 1990 e 2021. O artigo mais recente teve a maior densidade de citações. Foram identificadas 10 áreas de interesse da odontologia e a área com o maior número de publicações (NP) foi a periodontia, enquanto a área com maior NC foi a cariologia. O Brasil foi o país mais produtivo, e a Universidade Estadual de Campinas (UNICAMP) liderou o ranking em NC, empatando com a Universidade Federal de Minas Gerais (UFMG) em NP. Cinquenta e cinco periódicos foram identificados e apenas 10 tiveram NP>3. O Escore de Atenção Altmétrico (EAA) foi igual a zero em 62 artigos. Não houve correlação entre o NC dos artigos e o EAA (p=0,446). O interesse pela aplicação de própolis na odontologia é bem difundido pelo mundo e aumenta gradativamente.

Periodontitis and type 2 diabetes mellitus (T2DM) are related and prevalent diseases. The search for coadjuvant therapies aims for better results. Green propolis (GP) has been discussed as a possibility due to its antibacterial, anti-inflammatory and antioxidant properties that justify its application in various pathologies in dentistry. This study presents two investigation proposals: 1) Randomized clinical trial (RCT) evaluating the adjuvant therapy with GP in the non-surgical periodontal treatment (NSPT) in individuals with T2DM; 2) Bibliometric review (BR) mapping the dental literature concerning the 100 most cited papers about the use of propolis in dentistry. The RCT included 22 individuals with T2DM and periodontitis stages II and III, randomized in two groups: test and control. Sociodemographical and periodontal data were collected. C-reactive protein (CRP), glycated hemoglobin (HbA1c) and fasting plasma glucose were measured. All the subjects underwent NSPT. Individuals in the test group received supplementation with green propolis during 60 days after NSPT and the control group received placebo. Both groups were evaluated after 60 and 90 days. The sample was balanced for the paramethers sociodemographic, laboratorial and for bleeding on probing (BoP) and clinical attachment level (CAL). Both groups showed a significant improvement in BoP (p<0.05), probing pocket depth (p<0.01) (PPD) and CAL level (p<0.05) after the NSPT. There were no significant differences for the same parameters between the groups. The laboratorial parameters did not show statistically significant difference intragroup or intergroup. For this sample, the use of the adjuvant treatment with GP compared to placebo did not show significant differences. The BR analyzed the use and application of propolis in the different specialties within dentistry. The search was performed in Web of Science and a crossmatch of the number of citations (NC) was performed in Scopus and Google Scholar. The papers were evaluated for author, institutions, region, age, study design, journal, keywords and altmetrics. The NC in the Web of Science showed a strong positive correlation with the NC in the Google Scholar (0.890;p<0.001) and Scopus (0.963;p<0.001). The papers were published between 1990 and 2021. The most recent paper had the greatest density of citations. Ten specialties were identified among the included papers. The specialty with the greatest number of papers (NP) was periodontology, and the subject with the greatest NC was cariology. Brazil was the most producing country and the Universidade Estadual de Campinas (UNICAMP) led the ranking in NC, reaching a tie with Universidade Federal de Minas Gerais (UFMG) in NP. Fifty-five journals were identified and only 10 had NP>3. Altmetric Attention Score (AAS) was zero in 62 papers. There was no correlation between NC and AAS (p=0.446). The interest about propolis in dentistry is widespread around the world, and increases gradually.

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OBJECTIVES: To compare the prevalence of gingivitis estimated by the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classification with the other case definitions and assess the ability of this classification system in discriminating sociodemographic and clinical factors associated with the presence of gingivitis in a cohort study. MATERIALS AND METHODS: A multistage random sample of 1134 12-year-old adolescents was submitted to a full-mouth examination according to the Community Periodontal Index. Socioeconomic and clinical variables were collected at baseline. Gingivitis was considered according to the following criteria: (a) ≥ 10% of bleeding sites (the 2018 EFP/AAP criteria); (b) ≥ 15% of bleeding sites; and (c) the mean full-mouth bleeding sites. Adjusted multilevel Poisson regression assessed the association between independent variables at baseline and each definition of gingivitis at 2-year follow-up. RESULTS: Seven hundred forty-two 14-year-old adolescents were re-revaluated at follow-up. The prevalence of gingivitis was 28.7% according to 10% of bleeding threshold. The 2018 EFP/AAP criteria and other definitions showed higher prevalence and mean of gingivitis for low-household income adolescents and for those with higher levels of dental plaque and untreated dental caries. Nonetheless, the highest strengths of association were observed for the threshold of ≥ 15% of bleeding sites. CONCLUSION: The 2018 EFP/AAP case definition of gingivitis showed a similar discriminant validity compared to the 15% threshold and the mean full-mouth bleeding sites. CLINICAL RELEVANCE: The 2018 EFP/AAP classification allows the discrimination of important risk factors and should be used for the establishment of priorities for large-scale therapeutic programs.

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Tendo em vista a importância da relação Dentística Restauradora e Periodontia na Odontologia atual, o presente estudo demonstrou o relato de um caso clínico realizado no Complexo Odontológico do Centro Universitário da Serra Gaúcha (FSG), retratando um procedimento de restauração transcirúrgica em um paciente cujo elemento 13 estava comprometido com uma cavidade subgengival disto-palatino, sendo a resina composta o material restaurador de escolha. Este estudo teve como objetivo apresentar um caso clínico demonstrando a técnica de restauração transcirúrgica e a integração do planejamento entre Periodontia e Dentística Restauradora realizado na Clínica de Odontologia do Centro Universitário da Serra Gaúcha -FSG. Este trabalho mostrou a importância da realização de uma técnica cirúrgica e restauradora correta por parte dos cirurgiões-dentistas, assim como na verificação de que os tecidos periodontais podem reagir de forma positiva à presença de materiais restauradores adesivos posicionados subgengivalmente(AU)

In view of the importance of the restorative dentistry and periodontics relationship in current dentistry, the present study demonstrated the report of a clinical case carried out in the Dental Complex of the Centro Universitário da Serra Gaúcha - FSG, portraying a transsurgical restoration procedure in a patient whose element 13 was compromised with a subgingival cavity of this-palatine, the composite resin being the restorative material of choice. This study aimed to present a clinical case demonstrating the technique of transsurgical restoration and the integration of planning between Periodontics and Restorative Dentistry carried out at the Dentistry Clinic of the University Centro Universitário da Serra Gaúcha - FSG. This study showed the importance of performing a correct surgical and restorative technique by dentists, as well as in verifying that periodontal tissues can react positively to the presence of adhesive restorative materials positioned subgingival(AU)

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La granulomatosis de Wegener o granulomatosis con Poliangitis (GPA) es una enfermedad caracterizada por inflamación y necrosis de las paredes de los vasos sanguíneos. Es de etiología desconocida, baja prevalencia y alta agresividad. Esta enfermedad puede comprometer los tejidos bucales causando agrandamiento e inflamación del tejido gingival. Se reporta el caso de un paciente de género masculino que manifiesta aumento de volumen de la encía e inflamación asociado al diagnóstico de granulomatosis de Wegener. La lesión fue eliminada quirúrgicamente y el diagnóstico se logró al combinar los hallazgos serológicos del test ANCA, manifestaciones periodontales y análisis histopatológico. El paciente fue tratado con metotrexato y corticoesteroides y no presenta recidiva de la lesión luego de 2 años de control. En este artículo se analizan las manifestaciones periodontales asociadas a la GPA resaltando la importancia de un adecuado diagnóstico de lesiones periodontales caracterizadas por agradamiento gingival e inflamación.

Wegener's granulomatosis or granulomatosis with polyangiitis (GPA) is a disease characterized by inflammation and necrosis of the blood vessel walls. It is of unknown etiology, low prevalence and high degree of aggressiveness. This disease can compromise the oral tissues, causing enlargement and inflammation of the gingival tissues. The case of a male patient who presented rapidly growing gingival tissue enlargement and inflammatory characteristics associated with the diagnosis of Wegener's granulomatosis is reported. The lesion was removed surgically and the diagnosis was achieved by combining the serological findings of the ANCA test, periodontal manifestations and histopathological analysis of the lesion. The patient was treated with methotrexate and corticosteroids and the lesion did not reappear after 2 years of control. In this article, the periodontal manifestations associated with GPA are analyzed, highlighting the importance of an adequate diagnosis of periodontal lesions characterized by gingival enlargement and inflammation.

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The aim of this systematic review was to evaluate the methodological quality and the consistency of recommendations of clinical practice guidelines (CPGs) in Periodontology. An electronic search was conducted in two databases, MEDLINE and EMBASE, eight CPGs databases, and home pages of scientific societies in Periodontology up to April 2022. Three reviewers independently assessed methodological quality using the AGREE II instrument. In addition, we evaluated the consistency of the recommendations. Eleven CPGs were included, and the topics developed focused on prevention, diagnosis, risk factors, surgical and non-surgical periodontal treatment, antimicrobial therapy, root coverage, and maintenance. We found that the AGREE domains 2 (Stakeholder involvement) and 5 (Applicability) obtained the lowest scores. Domains 1 (Scope and purpose), 3 (Rigor of development) and 4 (Clarity of presentation) obtained the highest scores among the evaluated CPGs. The clinical recommendations for treatment of periodontal diseases were mostly consistent. Overall, the quality of CPGs used in periodontics was high. There was consistency of recommendations in specific fields. These findings may help researchers to promote CPGs focused on different fields of periodontics that have not yet been developed. Furthermore, the clinician will be able to make better clinical decisions.

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This article honors Dr. Anne Haffajee's career, her highest research standards, scholarly integrity, and inspirational mentorship. Anne-as she liked to be called-was one of the most productive clinical scientists of her time. Gifted with the unique combination of knowledge in the fields of clinical research, oral ecology, data analysis, and computer programing, her work triggered unprecedented advances in the diagnosis, progression, and treatment of periodontitis. Anne's pivotal clinical trials elucidated the effects of non-surgical and surgical periodontal therapies. In addition to her scholarly achievements, Anne played an important role in mentoring young scientists, many of whom have developed independent leadership careers in periodontal research. She always found time to help her mentees, and ultimately became a warm-hearted friend to many of them, including myself. Anne was consistently devoted to contributing to the future of clinical investigation, and more specifically concerned about the lack of interest by (1) funding agencies in supporting such studies and by (2) the new generation of investigators in pursuing a career in the area. She passed away prematurely, in 2013, at the age of 65. Undoubtedly, her work and legacy assured the continuity of high-standard clinical studies in periodontics and the survival of a whole generation of clinical researchers.

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