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OBJECTIVES: The objective of this long-term retrospective study was to evaluate the fracture rate and the risk factors associated with the fracture of 3.3 mm narrow diameter implants (NDIs). MATERIALS AND METHODS: A total of 524 records of patients rehabilitated with 3.3 mm NDIs between 1997 and 2015 were assessed. Data on patients, implants, and prostheses were collected, and descriptive analysis of the variables was performed. NDIs were separated into 2 groups: "fractured" and "non-fractured", and a multilevel logistic regression model was applied to identify the risk factors associated with NDI fracture. RESULTS: Eighty-four patients were removed from the analysis for interrupting follow-up or presenting failures other than fractures. Of the 440 patients included (64.66 ± 13.4 years), 272 were females (61.8%), and 168 males (38.2%), and mean follow-up time was 129 ± 47.1 months. Of the 1428 NDIs, 15 (1.05%) in 9 patients (2.04%) fractured during the studied period. Ten fractures (66.66%) happened in 6 patients (66.66%) showing signs of parafunction. NDI with modified sandblasted, large grit, acid-etched surface was the only implant variable to show a protective statistical significance (p = .0439). CONCLUSIONS: NDI fracture was a rare event in the studied sample. NDIs manufactured with modified sandblasted, large grit, acid-etched surface may provide extra protection against NDI fracture. Patient-specific factors and implant characteristics should be carefully considered to limit the risk of fracture of 3.3 mm NDIs.
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OBJECTIVES: To investigate long-term alveolar ridge bone changes in patients treated with the split-crest technique (SCT) with simultaneous implant placement. MATERIALS AND METHODS: Alveolar ridge width (ARW) was measured with a caliper immediately before (ARW1) and after SCT (ARW2) with a caliper. Existing CBCT scans taken at least 5 years postoperatively were used to assess the healed ARW (ARWF), buccal bone thickness (BBT), and lingual/palatal bone thickness (L/PBT) at 0, 3, and 5 mm apically from implant platform level (IPL). The distance between IPL and buccal bone crest (IPL-BBC) was also measured. Findings were compared with Wilcoxon and Student's t tests (p < .05). RESULTS: Records of thirty patients with 85 implants were included. Eleven patients (31 implants) presented CBCT scans taken in two separate occasions, resulting in 116 measurements. Tomographic follow-up ranged from 5 to 18 years (11.5 ± 4.18 years). Mean ARW increased from 3.2 ± 0.6 to 6.6 ± 0.48 mm after SCT, but significantly reduced overtime to 4.46 ± 0.83 mm (ARWF) (p < .0001). Mean BBT was 0.5 ± 0.9, 1.3 ± 0.9, and 2.0 ± 1.2 mm, while mean L/PBT was 0.9 ± 0.7, 1.6 ± 0.9, and 2.1 ± 1.0 mm at 0, 3, and 5 mm from IPL, respectively. IPL-BBC distance varied up to 8.7 mm (1.4 ± 2.0 mm), with 56/116 measurements (51/85 implants) showing IPL-BBC = 0 mm. CONCLUSION: Although SCT with simultaneous implant placement can predictably increase ARW postoperatively, ARW tended to significantly reduce over time, due to reductions in BBT and L/PBT, especially coronally. Nonetheless, 60% of the implants still presented some buccal bone at IPL.
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This article forms part of the themed issue on dental implants, with the general dentist being the main intended reader and with particular relevance to primary care dental professionals. It aims to describe the various characteristics of the implant in health, address contemporary developments in implant dentistry and offer some novel insights on the prevention of peri-implant diseases. A healthy implant exhibits specific histological, clinical and radiographic characteristics. Understanding such aspects leads to proper diagnosis and measures to maintain tissue integrity and prevent the development and progression of peri-implant diseases. Moreover, internationally and widely accepted definitions and recommendations based on expert consensus have been put forward to guide day-to-day clinical practice. This information should provide general practitioners with the means necessary to achieve the best possible outcome for their patients.
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Implantes Dentários , Peri-Implantite , Humanos , Implantes Dentários/efeitos adversos , Peri-Implantite/diagnóstico por imagem , Peri-Implantite/prevenção & controle , Peri-Implantite/diagnóstico , Implantação Dentária Endóssea/métodosRESUMO
PURPOSE: The objective of this retrospective study was to evaluate the effect of the interproximal contour of single external hexagon implant restorations on the prevalence of peri-implantitis. MATERIAL AND METHODS: Records of 96 patients and 148 external hexagon (EH) implants with time in function ranging from 1 to 17 years were included in the study. The most recent clinical and radiographic data were collected from records and the prevalence of peri-implantitis was defined according to the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions. Marginal bone level (MBL), emergence angle (EA), emergence profile (EP), and crown/implant platform horizontal ratio (CIHR) were obtained from periapical radiographs. Dichotomous variables at the patient- and implant level were compared with association tests. Mann-Whitney U-Test was performed to compare continuous quantitative values between the studied groups. Binomial logistic regression was conducted to identify risk indicators associated with the peri-implantitis event at the patient- and implant level, with the significance level set at 5% for all tests. RESULTS: Nineteen patients (19.2%) and 24 implants (16.2%) with a mean time in function of 5.0 ± 4.7 years were classified as having peri-implantitis. No statistically significant differences concerning gender, mean age, implant location in the jaw, or time in function were observed between patients with or without peri-implantitis (p > 0.05). Of 24 implants with peri-implantitis 10 (41.7%) displayed EA ≤ 30° (16.4%) while 14 (58.3%) presented EA > 30° with no statistical difference between the groups (p > 0.05). No statistically significant associations were identified between EA, EP, or CIHR and the prevalence of peri-implantitis. CONCLUSION: The findings seem to indicate that the EA, EP, and CIHR of single restorations over external hexagon implants are not associated with the presence of peri-implantitis. However, prospective studies with larger samples are required to better ascertain such an association in the long term.
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Peri-Implantite , Humanos , Peri-Implantite/etiologia , Peri-Implantite/epidemiologia , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Prevalência , Adulto , Idoso , Planejamento de Prótese DentáriaRESUMO
Following tooth extraction, a sequence of events takes place in order to close the wound and restore tissue homeostasis, a process called socket healing. The outcome of socket healing includes a marked reduction of the ridge dimensions. The amount of tissue loss that occurs during healing is influenced by several local and systemic factors. Thus, the aim of the present review was to describe the effect of anatomical characteristics of the alveolar process and basal bone on the socket healing outcome. The studies included showed that the quantity (number) and quality (composition) of socket walls exhibited a significant influence on the ridge diminution. A damaged socket (3 walls or less), as well as a thin buccal bone wall, which quickly resorbs negatively affected the healing outcome. Periodontally compromised sockets appeared to promote more extensive dimensional changes. Angulation between tooth and basal bone in addition to basal bone dimensions may also have altered the wound environment and influenced socket healing. The findings from the present review suggest that some anatomical characteristics of the alveolar process and basal bone have an effect on socket healing.
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Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Humanos , Alvéolo Dental/cirurgia , Processo Alveolar , Extração Dentária/métodos , Cicatrização , Aumento do Rebordo Alveolar/métodosRESUMO
The aim of this systematic review was to evaluate the benefit of ridge preservation (RP) with minimally invasive (MI) approaches with or without concomitant implant placement on morbidity, esthetics, and patient-related outcomes. Three Internet sources were used to search for appropriate papers. The search strategy was designed to include any clinical study published on RP with MI approaches such as flapless surgery, socket shield and socket sealing techniques and, use of biological agents. Characteristics of the individual studies, regarding methodological aspects, quantitative and qualitative data were extracted. The potential risk of bias was estimated, and the acquired evidence was graded. Independent screening of 860 reports resulted in 26 included original articles. Nine publications evaluated MI approaches for RP without concomitant implant placement. Eleven studies evaluated interventions for RP with immediate implant placement (IIP). Six studies compared RP with IIP vs RP without IIP. This systematic review found that MI approaches in most of the studies failed to improve clinical variables regarding morbidity, esthetics, and patient-related outcomes. Based on the limited number of studies analyzed and the methodological discrepancies observed, it is not possible to confirm that MI approaches promote a significant benefit when applied to RP procedures.
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Processo Alveolar , Aumento do Rebordo Alveolar , Humanos , Alvéolo Dental/cirurgia , Extração DentáriaRESUMO
OBJECTIVES: The aim of this cross-sectional study was to evaluate the effect of brushing discomfort (BD) on peri-implant health in sites exhibiting inadequate keratinized mucosa (KM) width. MATERIAL AND METHODS: Patients presenting with at least one implant exhibiting KM <2 mm and in function for ≥1 year were eligible for inclusion. BD was assessed with the visual analogue scale (VAS), and implants were classified into two groups: Absence (aBD; VAS = 0) or Presence (pBD; VAS > 0) of BD. Bleeding on probing (BoP), modified plaque index (mPI), probing depth (PD), clinical attachment level (CAL), suppuration (Sup), and marginal bone level (MBL) were recorded. Mann-Whitney, chi-square test, and a multilevel model were used for analysis. RESULTS: Fifty-nine patients with 155 dental implants were analyzed, of which 60 presented no BD, and 95 presented some level of BD. BoP, PD, CAL, and MBL were significantly higher in the pBD than in the aBD group (p < .05). The prevalence of peri-implant diseases at implant level was also higher in the pBD group than in the aBD group. However, after controlling for confounding factors, only mPI showed an effect on BoP. In addition, difficulty to perform oral hygiene was statistically higher in the pBD group. CONCLUSIONS: The findings of the present study suggest that although BD around implants exhibiting KM <2 mm did not influence tissue inflammation, it could represent a symptom of peri-implant diseases. Further clinical trials assessing the long-term effect of BD must be considered to better ascertain its effects on peri-implant health.
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Implantes Dentários , Mucosa Bucal , Escovação Dentária , Humanos , Estudos Transversais , Peri-Implantite/epidemiologia , Peri-Implantite/etiologia , Mucosa Bucal/patologia , Índice Periodontal , Manejo da DorRESUMO
OBJECTIVE: The objective of this four-year cohort prospective study was to evaluate the effect of inadequate access to peri-implant hygiene on marginal bone level (MBL). MATERIAL AND METHODS: Forty-one partially edentulous patients (16 males and 25 females, aged 49.8 ± 11.9 years) who had implants with at least one year in function were selected. Patients were clinically and radiographically evaluated at three different times: baseline (T0), 2-year (T1), and 4-year (T2) follow-up intervals. At baseline, implants were classified and allocated into two groups: those presenting adequate access (ACC) and inadequate access (no-ACC) to peri-implant hygiene. A linear mixed-effects model for clustered longitudinal data was used to analyze MBL, probing depth (PD), plaque index (PI), and bleeding on probing (BoP). RESULTS: Of 131 implants, 74 were considered as having ACC, and 57 as having no-ACC at T0. Implants in the no-ACC group presented a statistically greater mean MBL measurement at T2 than implants in the ACC group (p = .011). In the no-ACC group, a significant reduction in PD from T0 to T1 (p = .019) and from T0 to T2 (p = .010) was observed. Regardless of the group, PI significantly increased at both T1 (p = .00001) and T2 (p = .00004). Regardless of time, the prevalence of BoP was significantly higher in the no-ACC group than in the ACC group (p = .012). CONCLUSION: Inadequate access to peri-implant hygiene frequently resulted in more peri-implant inflammation and MBL over time. Proper accessibility to peri-implant hygiene should be carefully considered during planning of implant restoration, and patients properly motivated into maintenance care.
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Perda do Osso Alveolar , Implantes Dentários , Adulto , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Osso e Ossos , Implantes Dentários/efeitos adversos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Estudos ProspectivosRESUMO
BACKGROUND: The triclosan-containing dentifrices are effective in controlling biofilm formation and maintaining gingival health; however, there is limited information on their effects during the periodontal maintenance phase. Therefore, the aim of this study was to evaluate the clinical effects of a toothpaste containing 0.3% triclosan on the periodontal parameters of subjects that have been treated for peri-implantitis and were enrolled in a regular maintenance program. METHODS: Subjects presenting at least one implant with peri-implantitis and received surgical anti-infective therapy were selected. Sixty days post-surgery (baseline), subjects were randomized into two groups: (1) toothpaste containing 0.3% triclosan + 2.0% PVM/MA copolymer + 1450 ppm fluoride (test) or (2) toothpaste containing 1450 ppm fluoride (control), and were instructed to brush with the assigned toothpaste twice/day for 2 years. They received clinical monitoring at baseline, 3, 6, 12, 18, and 24 months, and professional maintenance every 3 months. RESULTS: Eighty-eight subjects with natural teeth were enrolled in the study (Test, n = 39; Control, n = 49). The test group showed a greater reduction in the percentage of sites exhibiting bleeding on probing (primary outcome) and lower levels of plaque in comparison with the control group after 24 months (P < 0.05). The mean percentage of sites with probing depth ≥5 mm was reduced over the course of the study only in the test group (P < 0.05). CONCLUSION: A toothpaste containing 0.3% triclosan was more effective than a regular fluoride toothpaste in improving the periodontal clinical condition around natural teeth of periodontally healthy subjects enrolled in a regular maintenance program for 2 years.
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Anti-Infecciosos Locais , Placa Dentária , Dentifrícios , Peri-Implantite , Triclosan , Método Duplo-Cego , Fluoretos , Humanos , Fluoreto de Sódio , Cremes DentaisRESUMO
OBJECTIVE: The purpose of the present prospective follow-up study was to evaluate the long-term influence of the peri-implant keratinized mucosa (KM) on marginal bone level (MBL), peri-implant tissues health, and brushing discomfort. MATERIAL AND METHODS: Eighty patients were initially recruited during their maintenance visit from January to October 2013 and allocated in two groups according to KM width around implants: Wide Group (KM ≥ 2 mm) and Narrow Group (KM < 2 mm). In the four-year follow-up examination (T4), marginal bone level (MBL), modified plaque index (mPI), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BoP), and brushing discomfort (BD) were reassessed and compared to the initial assessments (T0). Mann-Whitney, Wilcoxon signed-rank test, and a multilevel model were used for the statistical analysis. RESULTS: Fifty-four patients with 202 implants returned at T4. Mean mPI (0.91 ± 0.60), BoP (0.67 ± 0.21), and BD (12.28 ± 17.59) were higher in the Narrow Group than in the Wide Group (0.54 ± 0.48, 0.56 ± 0.26, and 4.25 ± 8.39, respectively). Marginal bone loss was higher in the Narrow Group (0.26 ± 0.71) than in the Wide Group (0.06 ± 0.48). Multilevel analysis suggested that KM width and time in function had a statistically significant effect on MBL. CONCLUSIONS: The findings of the present study indicate that KM width had an effect on MBL, plaque accumulation, tissue inflammation, and brushing discomfort over the studied period. Thus, the presence of a KM ≥ 2 mm around implants appears to have a protective effect on peri-implant tissues.
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Implantes Dentários , Mucosa Bucal/patologia , Escovação Dentária/efeitos adversos , Adulto , Índice de Placa Dentária , Feminino , Seguimentos , Humanos , Queratinas , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/diagnóstico por imagem , Medição da Dor , Índice Periodontal , Radiografia Dentária , Estatísticas não ParamétricasRESUMO
OBJECTIVE: To evaluate the effects of a toothpaste containing 0.3% triclosan in volunteers that have been treated for peri-implantitis and were enrolled in a maintenance program. MATERIAL AND METHODS: Subjects presenting at least one implant with peri-implantitis were selected. They received anti-infective surgical therapy, and sixty days post-surgery (baseline) were randomized into two groups, brushing twice/day for 2 years (a) with a toothpaste containing 0.3% triclosan+2.0% PVM/MA copolymer (GantrezTM )+1,450 ppm fluoride (test) or (b) with a toothpaste containing 1,450 ppm fluoride (control). They received clinical and microbiological monitoring at baseline, 3, 6, 12, 18, and 24 months, and professional maintenance every 3 months. RESULTS: A total of 102 subjects were enrolled (test: 48; control: 54). The control group showed loss of clinical attachment (CA) around treated implants over the course of the study (p < 0.05), while the test group was stable for this parameter. The difference between groups (0.55 mm) for CA change between baseline and 24 months (primary outcome variable) was statistically significant (p < 0.05). Red complex pathogens were only reduced in the test group at 24 months. The implants with no history of peri-implantitis in the test group had a significant reduction in the percentage of sites with bleeding on probing and in mean probing depth, throughout the study (p < 0.05). This improvement was not observed in the control group. CONCLUSION: A toothpaste containing 0.3% triclosan was more effective than a toothpaste without triclosan in maintaining a healthy peri-implant environment around treated implants and implants with no history of peri-implantitis during a 2-year maintenance program (ClinicalTrials.govNCT03191721).
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Anti-Infecciosos Locais/uso terapêutico , Peri-Implantite/tratamento farmacológico , Cremes Dentais/uso terapêutico , Triclosan/uso terapêutico , Anti-Infecciosos Locais/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peri-Implantite/diagnóstico por imagem , Peri-Implantite/terapia , Índice Periodontal , Radiografia Dentária , Triclosan/administração & dosagemRESUMO
OBJECTIVE: The aim of this study was to compare the level of brushing discomfort (BD) during oral hygiene and peri-implant clinical variables between patients presenting implant sites with a band ≥2 mm and <2 mm of keratinized mucosa (KM). MATERIALS AND METHODS: Participating patients were recruited during routine maintenance follow-up visits from January to October 2013. Based on the presence of KM, patients were allocated into two groups: implant sites with ≥2 mm of KM (Wide Group); and implant sites with <2 mm of KM (Narrow Group). Patients were clinically assessed, and plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BoP) data were collected from three sites at the buccal aspect of each implant. Subsequently, patients received standardized oral hygiene instructions and cleaning devices and were asked to clean around the experimental implant sites. All patients reported on the level of BD using the visual analog scale (VAS). Non-paired Student's t-test, Wilcoxon's signed-rank test, and chi-square tests were performed to analyze the outcome variables (P < 0.05). RESULTS: Eighty patients with a total of 270 implant sites were included. Implant sites in the Narrow Group exhibited higher levels of BD (P < 0.001), PI (P = 0.0021), and BoP (P = 0.017) than implant sites in the Wide Group. CONCLUSION: Implant sites with a band of <2 mm of KM were shown to be more prone to brushing discomfort, plaque accumulation, and peri-implant soft tissue inflammation when compared to implant sites with ≥2 mm of KM.
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Implantes Dentários , Mucosa Bucal/patologia , Escovação Dentária/efeitos adversos , Índice de Placa Dentária , Feminino , Humanos , Queratinas , Masculino , Pessoa de Meia-Idade , Medição da Dor , Índice PeriodontalRESUMO
O objetivo do presente estudo foi avaliar a eficácia do papel grau cirúrgico reutilizado durante o processo de esterilização. Foram utilizadas embalagens de papel grau cirúrgico de 10x10cm: Grupo I - um ciclo de esterilização e Grupo II - dois ciclos de esterilização em autoclave. Para análise microbiológica, os envelopes acondicionaram um indicador biológico, com esporos de Geobacillus stearothermophilus e foram submetidos ao ciclo de esterilização em autoclave. Após o ciclo, os indicadores biológicos foram encubados a 60ºC por 48 horas. Como controle, foram incubados indicadores biológicos que não passaram pelo processo de esterilização. Após o período de encubação foi realizada a leitura visual do crescimento bacteriano. Para avaliar alterações físicas, os papéis foram analisados com microscopia eletrônica de varredura em aumentos de até 500x. Não foi observado crescimento bacteriano nos Grupos I e II. Os indicadores biológicos utilizados como controle apresentaram crescimento bacteriano e não foi observada diferença entre os grupos quanto ao padrão das fibras dos papéis. Pode-se dizer que a embalagem de grau cirúrgico reutilizada por pelo menos uma vez permite a esterilização de artigos médicos/odontológicos.
The aim of this study was to evaluate the efficacy of surgical paper reused during the sterilization process. Packagings of surgical paper 10x10 cm were used: Group I - a cycle of sterilization and Group II - two cycles of autoclaving. For microbiological analysis, biological indicator Geobacillus stearothermophilus spores were packed in the envelopes that were submitted to autoclave sterilization cycle. After the cycle, the biological indicators were incubated at 60°C for 48 hours. For the control group biological indicators that did not undergo sterilization process were incubated. After incubation period visual reading of bacterial growth was carried out. To evaluate physical changes, the roles were analyzed with scanning electron microscope 500 x augmentation. No bacterial growth was observed in Groups I and II. Bacterial growth was observed in the control group and there was no difference among groups regarding the fiber pattern of the paper. It can be said that the surgical grade packaging reused once allows the sterilization of medical/dental articles.
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Técnicas Microbiológicas/métodos , Esterilização/instrumentação , Embalagem de ProdutosRESUMO
INTRODUCTION: The characterization of microbial communities infecting the endodontic system in each clinical condition may help on the establishment of a correct prognosis and distinct strategies of treatment. The purpose of this study was to determine the bacterial diversity in primary endodontic infections by 16S ribosomal-RNA (rRNA) sequence analysis. METHODS: Samples from root canals of untreated asymptomatic teeth (n = 12) exhibiting periapical lesions were obtained, 16S rRNA bacterial genomic libraries were constructed and sequenced, and bacterial diversity was estimated. RESULTS: A total of 489 clones were analyzed (mean, 40.7 ± 8.0 clones per sample). Seventy phylotypes were identified of which six were novel phylotypes belonging to the family Ruminococcaceae. The mean number of taxa per canal was 10.0, ranging from 3 to 21 per sample; 65.7% of the cloned sequences represented phylotypes for which no cultivated isolates have been reported. The most prevalent taxa were Atopobium rimae (50.0%), Dialister invisus, Prevotella oris, Pseudoramibacter alactolyticus, and Tannerella forsythia (33.3%). CONCLUSIONS: Although several key species predominate in endodontic samples of asymptomatic cases with periapical lesions, the primary endodontic infection is characterized by a wide bacterial diversity, which is mostly represented by members of the phylum Firmicutes belonging to the class Clostridia followed by the phylum Bacteroidetes.
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Bactérias/classificação , Cavidade Pulpar/microbiologia , Doenças Periapicais/microbiologia , RNA Bacteriano/genética , RNA Ribossômico 16S/genética , Adolescente , Adulto , Bactérias/genética , Bactérias/isolamento & purificação , Bacteroidetes/classificação , Bacteroidetes/genética , Bacteroidetes/isolamento & purificação , Clostridium/classificação , Clostridium/genética , Clostridium/isolamento & purificação , Biblioteca Genômica , Humanos , Consórcios Microbianos/genética , Pessoa de Meia-Idade , RNA Bacteriano/análise , RNA Ribossômico 16S/análise , Ruminococcus/classificação , Ruminococcus/genética , Ruminococcus/isolamento & purificação , Análise de Sequência de RNA/métodos , Adulto JovemRESUMO
AIM: To investigate the diversity, levels and proportions of Archaea in the subgingival biofilm of generalized aggressive periodontitis (GAgP; n=30) and periodontally healthy (PH; n=30) subjects. MATERIALS AND METHODS: Diversity was determined by sequencing archaeal 16S rRNA gene libraries from 20 samples (10/group). The levels and proportions of Archaea were analysed by quantitative PCR (qPCR) in four and two samples/subject in GAgP and PH groups, respectively. RESULTS: Archaea were detected in 27/28 subjects and 68% of the sites of the GAgP group, and in 26/30 subjects and 58.3% sites of the PH group. Methanobrevibacter oralis was found in all 20 samples studied, Methanobacterium curvum/congolense in three GAgP and six PH samples, and Methanosarcina mazeii in four samples from each group. The levels and proportions of Archaea were higher in GAgP than in PH, whereas no differences were observed between the two probing depth category sites from the GAgP group. CONCLUSION: Archaea were frequently found in subjects with periodontal health and GAgP, especially M. oralis. However, the higher levels and proportions (Archaea/total prokaryotes) of this domain observed in GAgP in comparison with PH subjects indicate a possible role of some of these microorganisms as an environmental modifier in GAgP.
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Periodontite Agressiva/microbiologia , Archaea/classificação , Periodonto/microbiologia , Adulto , Archaea/isolamento & purificação , Biofilmes , Contagem de Colônia Microbiana , DNA Arqueal/análise , Placa Dentária/microbiologia , Feminino , Hemorragia Gengival/microbiologia , Humanos , Masculino , Methanobacterium/classificação , Methanobacterium/isolamento & purificação , Methanobrevibacter/classificação , Methanobrevibacter/isolamento & purificação , Methanosarcina/classificação , Methanosarcina/isolamento & purificação , Methanosarcinales/classificação , Methanosarcinales/isolamento & purificação , Perda da Inserção Periodontal/microbiologia , Bolsa Periodontal/microbiologia , Porphyromonas gingivalis/isolamento & purificação , RNA Arqueal/análise , RNA Ribossômico 16S/análise , Adulto JovemRESUMO
O objetivo deste estudo foi comparar a contagem e a prevalência dos microrganismos do complexo vermelho (Treponema denticola, Porphyromonas gingivalis e Tannerella forsythia) e do complexo azul (Actinomyces gerencseriae, Actinomyces israelli e Actinomyces naeslundii) na microbiota subgengival em indivíduos tabagistas e não-tabagistas com doença periodontal crônica. Foram selecionados 50 voluntários com periodontite crônica (25 tabagistas T e 25 não-tabagistas NT). Os indivíduos foram submetidos a exame clínico periodontal e microbiológico. Os parâmetros clínicos avaliados foram profundidade de sondagem, nível clínico de inserção, placa supragengival visível, sangramento gengival, sangramento à sondagem e supuração. De cada indivíduo foram coletadas entre 6 e 12 amostras de biofilme subgengival, avaliadas para seis espécies bacterianas por meio da técnica Checkerboard DNA-DNA Hybridization. Os resultados clínicos foram semelhantes entre os grupos (T e NT). A exceção foi o percentual de sítios com sangramento gengival, sendo que o grupo T apresentou uma média inferior (9,54 ± 15,31) comparada ao grupo NT (39,44 ± 25,13 p < 0,001). A única diferença microbiológica foi a contagem de A. gerencseriae diminuída no grupo de tabagistas (p < 0,05). Em conclusão, os perfis clínico-microbiológicos de indivíduos tabagistas e não-tabagistas com periodontite crônica podem ser considerados semelhantes.
The aim of the present study was to compare the levels and the prevalence of bacterial red complex (Treponema denticola, Porphyromonas gingivalis and Tannerella forsythia) and blue complex (Actinomyces gerencseriae, Actinomyces israelli and Actinomyces naeslundii) in the subgingival microbiota of smokers and non-smokers with chronic periodontitis. Fifty subjects wiyh chronic periodontitis were enrolled (25 smokers - S and 25 non smokers - NS). Subjects received clinical and microbiological examination. The clinical parameters evaluated were probing depth, clinical attachment level, visible plaque index, gingival bleeding index, bleeding on probing and suppuration. Six to twelve subgingival biofilm samples were collected per subject, and evaluated for six bacterial species using the Checkerboard DNA-DNA hybridization technique. The clinical results were similar between the groups (S and NS). The exception was the percent of sites with gingival bleeding. The S group showed a lower mean (9.54 ± 15.31) compared with the NS group (39.44 ± 25.13 - p <0.001). The only microbiological difference was the reduced level of A. gerencseriae in smoking group (p < 0,05). In conclusion, the clinical- microbiological profiles of non-smoking and smoking subjects with chronic periodontitis were similar.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Periodontite Crônica , Periodontite Crônica/microbiologia , Tabagismo , Biofilmes , PeriodontoRESUMO
AIM: The aim of this study was to evaluate the clinical and microbiological effects of scaling and root planing (SRP) alone or combined with metronidazole (MTZ) or with MTZ and amoxicillin (AMX) in the treatment of smokers with chronic periodontitis. METHODS: A double-blind, placebo-controlled, randomized clinical trial was conducted in 43 subjects who received SRP alone (n=15) or combined with MTZ (400 mg 3 x per day, n=14) or with MTZ+AMX (500 mg 3 x per day, n=14) for 14 days. Clinical and microbiological examinations were performed at baseline and 3 months post-therapy. Subgingival samples were analysed by checkerboard DNA-DNA hybridization. RESULTS: Subjects receiving MTZ+AMX showed the greatest improvements in mean probing depth and clinical attachment level. Both antibiotic therapies led to additional clinical benefits over SRP alone in initially shallow, intermediate, and deep sites. The SRP+MTZ+AMX therapy led to the most beneficial changes in the subgingival microbial profile. These subjects showed significant reductions in the mean counts and proportions of periodontal pathogens such as Tannerella forsythia, Porphyromonas gingivalis and Treponema denticola, and the greatest increase in proportions of host-compatible species. CONCLUSION: Significant advantages are observed when systemic antibiotics are combined with SRP in the treatment of smokers with chronic periodontitis. The greatest benefits in clinical and microbiological parameters are achieved with the use of SRP+MTZ+AMX.
Assuntos
Amoxicilina/uso terapêutico , Anti-Infecciosos/uso terapêutico , Periodontite Crônica/terapia , Raspagem Dentária , Metronidazol/uso terapêutico , Fumar/efeitos adversos , Adulto , Bactérias/classificação , Bactérias/efeitos dos fármacos , Periodontite Crônica/etiologia , Periodontite Crônica/microbiologia , Contagem de Colônia Microbiana , Terapia Combinada , Depósitos Dentários/tratamento farmacológico , Depósitos Dentários/microbiologia , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Resultado do TratamentoRESUMO
O Fibroma Ossificante Periférico (FOP) é uma hiperplasia inflamatória, causada pela proliferação de células mesenquimais do ligamento periodontal induzidas por irritantes locais. Este relato de caso documentou um FOP em uma paciente periodontal, discutindo os aspectos clínicos e histológicos no diagnóstico diferencial. Além disso, foi proposto um modelo para o manejo clínico desta patologia, enfatizando a necessidade da remoção total da lesão, curetagem dos tecidos adjacentes, eliminação dos irritantes locais e implementação de uma terapia de manutenção.
Peripheral Ossifying Fibroma (POF) is an inflammatory hyperplasia, produced by mesenchymal cells of the periodontal ligament and associated with local irritants such as calculus and plaque accumulation. This case report documented an extensive POF in a periodontal patient, discussing the clinical and histological aspects to be considered in the differential diagnosis as well a rational model for clinical management. Furthermore, this report emphasized the need of total lesion removal, curettage of the adjacent tissues and supportive periodontal therapy for prevention of its recurrence.
Assuntos
Humanos , Feminino , Adulto , Fibroma Ossificante , Hiperplasia Gengival , Ligamento Periodontal , PeriodontiteRESUMO
O objetivo deste estudo transversal foi avaliar a presença do complexo vermelho em indivíduos com periodontite crônica e indivíduos periodontalmente saudáveis. Foram selecionados 30 indivíduos, sendo 15 periodalmente saudáveis e 15 com periodontite crónica. Os parâmetros clínicos de profundidade de sondagem (PS), nível clínico de inserção (NCI), presença ou ausência de sangramento à sondagem, placa supragengival visível e supuração, foram avaliados em seis sítios por dente.Amostras de placa subgengival foram coletadas de nove sítios mésio-vestibulares, no grupo saudável, e de seis sítios com PS e NIC ≥5 mm e três sítios com PS e NIC ≤4 mm no grupo com periodontite crónica. As amostras foram avaliadas pelo teste Checkerboarad DNA-DNA Hybridizatíonpaïa a presença de Tannerela forsythia, Treponema dentícola e Porphyromonas gingivalis. Diferenças microbiológicas entre os dois grupos foram avaliadas por meio do teste U de MannWhitney. O grupo de indivíduos periodontalmente saudáveis apresentou níveis médios de contagem (x105±DP) de T. forsythia, T.denticola, fg/ng/Vã/fs