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1.
J Orofac Orthop ; 2024 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-39102072

RESUMO

PURPOSE: This two-arm parallel randomized controlled trial aimed to evaluate and compare periodontal changes due to rapid maxillary expansion (RME) using tooth-bone-borne and tooth-borne devices in growing patients via clinical examinations and cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Forty-two eligible patients (aged 11-14 years; transverse maxillary deficiency, posterior crossbite) were screened and divided into two groups based on the treatment received (randomization was performed using computer-generated numeric sequences): hybrid hyrax tooth-bone-borne group (TBB) and hyrax tooth-borne group (TB). The primary outcome was the change in cortical bone thickness (by CBCT). In addition, the clinical attachment level (CAL), gingival recession, and bleeding were assessed. Both examinations were performed before and 3 months after the activation phase. Intergroup comparisons were performed using analysis of covariance (ANCOVA; P < 0.05). RESULTS: Twenty-one patients (12 girls and 9 boys; mean initial age, 13.3 years) were included in the TBB group and 21 (5 girls and 16 boys; mean initial age, 13.2 years) were included in the TB group. The TB group exhibited a decrease in buccal bone thickness in the first premolars and first molars at all three evaluated levels. Specifically, tooth 14 at 3 mm from the enamel-cement junction showed a significant width reduction (0.7 mm; p < 0.001), accompanied by a notable increase in palatal cortical thickness at 6 mm of enamel-cement junction (1.13 mm; p < 0.001). CONCLUSIONS: RME resulted in buccal bone thickness reduction at the first premolar with hyrax treatment. In the molar region, both devices resulted in cortical bone alterations that were less pronounced in the TBB group.

2.
Int J Mol Sci ; 25(15)2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39125663

RESUMO

Oral bacteria are implicated not only in oral diseases but also in gut dysbiosis and inflammatory conditions throughout the body. The periodontal pathogen Aggregatibacter actinomycetemcomitans (Aa) often occurs in complex oral biofilms with Streptococcus gordonii (Sg), and this interaction might influence the pathogenic potential of this pathogen. This study aims to assess the impact of oral inoculation with Aa, Sg, and their association (Aa+Sg) on alveolar bone loss, oral microbiome, and their potential effects on intestinal health in a murine model. Sg and/or Aa were orally administered to C57Bl/6 mice, three times per week, for 4 weeks. Aa was also injected into the gingiva three times during the initial experimental week. After 30 days, alveolar bone loss, expression of genes related to inflammation and mucosal permeability in the intestine, serum LPS levels, and the composition of oral and intestinal microbiomes were determined. Alveolar bone resorption was detected in Aa, Sg, and Aa+Sg groups, although Aa bone levels did not differ from that of the SHAM-inoculated group. Il-1ß expression was upregulated in the Aa group relative to the other infected groups, while Il-6 expression was downregulated in infected groups. Aa or Sg downregulated the expression of tight junction genes Cldn 1, Cldn 2, Ocdn, and Zo-1 whereas infection with Aa+Sg led to their upregulation, except for Cldn 1. Aa was detected in the oral biofilm of the Aa+Sg group but not in the gut. Infections altered oral and gut microbiomes. The oral biofilm of the Aa group showed increased abundance of Gammaproteobacteria, Enterobacterales, and Alloprevotella, while Sg administration enhanced the abundance of Alloprevotella and Rothia. The gut microbiome of infected groups showed reduced abundance of Erysipelotrichaceae. Infection with Aa or Sg disrupts both oral and gut microbiomes, impacting oral and gut homeostasis. While the combination of Aa with Sg promotes Aa survival in the oral cavity, it mitigates the adverse effects of Aa in the gut, suggesting a beneficial role of Sg associations in gut health.


Assuntos
Aggregatibacter actinomycetemcomitans , Perda do Osso Alveolar , Microbioma Gastrointestinal , Camundongos Endogâmicos C57BL , Streptococcus gordonii , Animais , Perda do Osso Alveolar/microbiologia , Perda do Osso Alveolar/etiologia , Perda do Osso Alveolar/patologia , Perda do Osso Alveolar/metabolismo , Camundongos , Biofilmes/crescimento & desenvolvimento , Boca/microbiologia , Modelos Animais de Doenças , Masculino , Gengiva/microbiologia , Gengiva/metabolismo
3.
Artigo em Inglês | MEDLINE | ID: mdl-39037121

RESUMO

BACKGROUND: The aim of this case study is to present the rationality and scientific evidence of a new design for a double (DA) and triple (TA) dental abutment-implant with their specific new concept of biodynamic optimized peri-implant tissue (BOPiT). METHODS: The innovative design of these abutments with a paraboloid geometry was based on BOPiT, simultaneously involving the principles of mechanobiology, biotensegrity, and mechanotransduction. Thus, 37 consecutive individuals/43 cases rehabilitated with single dental implant using the innovative DA (n = 28) and TA (n = 15) on 43 implants were included in this case study. The DA and TA support 2 or 3 dental crowns on a single implant, respectively. Clinic and radiographic examinations were presented at T1 (loading after 4 months) and T2 [final examination with an average follow-up time of 7.2 years (>3 to 12 years)]. RESULTS: At T2, mean scores for plaque index, peri-implant bleeding on probing, and peri-implant probing depth were low, depicting healthy peri-implant conditions. All radiographic images showed insignificant annual marginal bone loss (0.022 ± 0.05 mm) when compared to T1, reflecting great bone stability. CONCLUSION: DA and TA, based on the BOPiT concept, represent an advantageous, simple and non-invasive mechanism for the longevity and healthy regulation of the peri-implant tissues.

4.
J Periodontol ; 95(10): 963-976, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38923568

RESUMO

BACKGROUND: The aim of this study was to evaluate the incidence of preloading crestal bone loss (PLCBL) and to identify the patient-related and implant-related factors associated with PLCBL. METHODS: This retrospective cohort examined the dental records of patients who received at least one dental implant. PLCBL was defined as a reduction ⩾0.5 mm and severe PLCBL (primary variable) as a reduction ⩾1.5 mm in mesial and/or distal bone level, measured from the day of implant placement to uncovering or abutment installation/crown delivery. The incidence of PLCBL and patient and implant variables were recorded. Bivariate analysis and binary logistic regression identified factors associated with PLCBL ⩾0.5 mm and ⩾1.5 mm. RESULTS: A total of 746 dental implants placed in 361 patients from January 2011 to July 2021 was included in the analyses. Of the implants assessed, 24.4% (n = 182) exhibited PLCBL ⩾ 0.5 mm and 10.5% (n = 78) presented severe PLCBL (i.e., ⩾1.5 mm). Males (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.11-3.07), patients with diabetes (OR = 3.33, 95% CI = 1.73-6.42), and those allergic to penicillin (OR = 3.13, 95% CI = 1.57-6.22) were more likely to experience severe PLCBL (p < 0.05). Implants placed in the anterior area (OR = 2.08, 95% CI = 1.16-3.73), with bone-level platform-abutment connection (OR = 4.73, 95% CI = 1.94-11.49) and inserted supracrestally (OR = 3.77, 95% CI = 1.84-7.72), presented a greater risk of developing severe PLCBL (p < 0.05). Implants placed in a previously grafted area presented a lower likelihood of developing severe PLCBL (OR = 0.489, 95% CI = 0.28-0.84). CONCLUSION: The incidence of PLCBL ⩾ 0.5 mm and ⩾1.5 mm was 24.4% and 10.5%, respectively. Male sex, diabetes, allergy to penicillin, anterior location, bone-level platform-abutment connection, and supracrestal implant placement are potential risk factors for severe PLCBL. A previously grafted area is a potential protective factor.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Humanos , Masculino , Estudos Retrospectivos , Feminino , Pessoa de Meia-Idade , Perda do Osso Alveolar/epidemiologia , Incidência , Idoso , Adulto , Fatores de Risco , Implantação Dentária Endóssea/métodos , Fatores Sexuais , Idoso de 80 Anos ou mais
5.
J Oral Implantol ; 50(4): 317-321, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38703005

RESUMO

We evaluated the effect of periosteal-releasing incisions on flap displacement in anterior maxillary sites following implant placement and simultaneously guided bone regeneration. Thirty patients, each requiring a single dental implant and guided bone regeneration in the maxillary esthetic zone, were recruited. After full-thickness flap elevation, the displacement of the flap was measured under a standardized tension of 1 Ncm. Then, a 2-step periosteal releasing incision was placed in the internal aspect of the flap, and the displacement was remeasured using the same standardized tension. Keratinized tissue width and mucosal thickness at the surgical site were recorded. Patient-reported outcomes were assessed at the 7- and 14-day recall visits. Flap displacement (primary outcome) was calculated before and after periosteal-releasing incisions. Multivariable linear regression models were used to evaluate the influence of mucosal thickness on flap displacement and adjusted for Keratinized tissue width. Primary wound closure was achieved in all patients. The mean difference in flap coronal displacement before and after the periosteal-releasing incisions was 8.2 mm (p < .0001). Adjusted regression models showed no association between mucosal thickness and keratinized tissue width with the amount of flap displacement (p = .770). Patient-reported outcome measures for pain, swelling, and bleeding amounted to 1.28 ± 1.93, 1.36 ± 1.87, and 0.0 ± 0.0 at 7 days and 0.11 ± 0.57, 0.56 ± 1.03, and 0.0 ± 0.0 at 14 days, respectively. Periosteal-releasing incisions using the 2-step procedure described here are a predictable technique to obtain coronal flap displacements >8 mm without increased surgical complications.


Assuntos
Maxila , Periósteo , Humanos , Periósteo/cirurgia , Masculino , Feminino , Pessoa de Meia-Idade , Maxila/cirurgia , Regeneração Óssea , Implantação Dentária Endóssea/métodos , Regeneração Tecidual Guiada Periodontal/métodos , Retalhos Cirúrgicos/cirurgia , Adulto , Medidas de Resultados Relatados pelo Paciente , Idoso , Implantes Dentários para Um Único Dente
6.
Heliyon ; 10(10): e31067, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38807891

RESUMO

The açai juice contains high concentrations of phenolic compounds, including cyanidin-3-glucoside and others flavonoids. The aim of this study was to evaluate the impact of açai supplementation on healthy mandibular alveolar bone in male albino rats of the Wistar strain. 24 rats were divided into 3 groups, in which one group received a daily dose of saline solution and the other two groups were treated with daily doses of clarified açai juice for 14 or 28 days. After the experiment, hemimandibles were collected and analyzed using Scanning Electron Microscopy (SEM), histological assessments, and micro-CT. Results showed changes in the integrity of the alveolar bone as seen in SEM, increased osteocyte density and higher collagen matrix area in the açai group compared to the control group as seen in histological analysis, and increased bone volume, trabecular thickness and number, and cortical bone as seen in micro-CT analysis. The space between bone trabeculae showed no difference among the groups. These results suggest that açai supplementation may have a structural change effect on alveolar bone, but further research is needed to confirm these findings in humans and to determine the exact mechanisms behind these effects.

7.
J Periodontal Res ; 59(4): 758-770, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38699835

RESUMO

BACKGROUND AND OBJECTIVE: Osteoporosis is associated with bone microarchitecture alterations, and the depletion of estrogen during menopause is a major contributing factor to its development. The literature highlights the noteworthy role of gut microbiota in bone metabolism, particularly in the progression of osteoporosis. Periodontal disease leads to alveolar bone loss, which may be influenced by estrogen deficiency, and this mechanism is intricately associated with an imbalance in systemic microbiota. The aim of this study was to evaluate the effects of Bifidobacterium animalis subsp. lactis HN019 (B. lactis HN019) and Lacticaseibacillus casei 01 (L. casei 01) administrations on an osteoporosis animal model. MATERIALS AND METHODS: Thirty-three female rats were randomly divided into three groups: control (C-OVX), C-OVX-HN019 and C-OVX-LC01. All animals were ovariectomized. In groups C-OVX-HN019 and C-OVX-LC01, the probiotics were administered for 4 months. All animals were euthanized after 16 weeks from ovariectomy. Microtomographic, histopathological and immunohistochemical examinations were conducted on periodontal tissues, whereas histomorphometry, histopathological and immunohistochemical analyses were carried out on the intestine. The levels of estradiol were assessed in blood using an immunoenzymatic assay. The data were subjected to statistical analyses (p < .05). RESULTS: The C-OVX-LC01 group exhibited a significant reduction in alveolar bone porosity and an increase in connective tissue density compared to C-OVX (p < .05). The C-OVX-HN019 and C-OVX-LC01 groups presented reduced expression of TRAP and RANKL compared to the C-OVX (p < .05). The C-OVX group presented villi defects, mild neutrophil infiltration, decrease in both villous height and intestinal crypts and reduced expression of intestinal junctional epithelium markers e-cadherin and claudin 01 compared to C-OVX-HN019 and C-OVX-LC01 (p < .05). The C-OVX group had lower estradiol levels than C-OVX-HN019 and C-OVX-LC01 (p < .05). CONCLUSION: The probiotic therapy promoted a reduction in alveolar bone destruction and intestinal permeability as well as an increase in estradiol levels in ovariectomized rats. Specifically, the probiotic strain Lacticaseibacillus casei 01 exhibited greater effectiveness compared to Bifidobacterium animalis subsp. lactis HN019, indicating strain-dependent outcomes.


Assuntos
Estradiol , Osteoporose , Ovariectomia , Probióticos , Animais , Estradiol/sangue , Probióticos/uso terapêutico , Probióticos/farmacologia , Feminino , Ratos , Osteoporose/patologia , Perda do Osso Alveolar/patologia , Perda do Osso Alveolar/prevenção & controle , Modelos Animais de Doenças , Lacticaseibacillus casei , Bifidobacterium animalis , Microtomografia por Raio-X , Processo Alveolar/patologia , Intestinos/patologia , Intestinos/microbiologia , Microbioma Gastrointestinal , Ratos Wistar
8.
J Endod ; 50(5): 590-595, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38428806

RESUMO

INTRODUCTION: The aim of this observational study was to evaluate bone growth at the recipient site of autotransplanted teeth using cone-beam computed tomography (CBCT) images and to compare it to the control tooth. METHODS: Bone growth was measured on CBCT images obtained from the anterior region of the maxilla, which received a single transplant of immature premolars due to early loss of the central incisor. The results were compared to the bone growth of contralateral central incisor that served as control. The sample consisted of 13 autotransplanted teeth and 13 control teeth. It was determined the thickness of the buccal bone of the marginal ridge, the thickness of the palatal bone of the marginal ridge, the height of the maxillary bone, and the thickness of the maxillary bone at its mid-height. The measurements were analyzed statistically, adopting a significance level of 5%. RESULTS: The mean interval between the dental autotransplantation surgery and the CBCT scan was 16.2 years. The mean thickness of the buccal bone of the marginal ridge, thickness of the palatal bone of the marginal ridge, height of the maxillary bone, and thickness of the maxillary bone at its mid-height were, respectively, 0.85, 0.94, 19.6, and 8.85 mm for autotransplanted teeth and 0.79, 1.09, 18.88, and 8.5 mm for control teeth. There were no significant differences in the bone measurements between autotransplanted and control teeth (P > .05). CONCLUSIONS: The growth of maxillary bone in the region that received the autotransplanted tooth was proportional to that of maxillary bone that supports the contralateral tooth. Thus, autogenous transplantation is efficient in maintaining the bone architecture at the recipient site.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Transplante Autólogo , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Masculino , Feminino , Maxila/diagnóstico por imagem , Adolescente , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/transplante , Criança , Incisivo/diagnóstico por imagem , Processo Alveolar/diagnóstico por imagem
9.
J Appl Microbiol ; 135(2)2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38323434

RESUMO

Arthritis and periodontitis are inflammatory diseases that share several immunopathogenic features. The expansion in the study of virus-induced arthritis has shed light on how this condition could impact other parts of the human body, including the mouth. Viral arthritis is an inflammatory joint disease caused by several viruses, most notably the alphaviruses Chikungunya virus (CHIKV), Sindbis virus (SINV), Ross River virus (RRV), Mayaro virus (MAYV), and O'nyong'nyong virus (ONNV). These viruses can induce an upsurge of matrix metalloproteinases and immune-inflammatory mediators such as Interleukin-6 (IL6), IL-1ß, tumor necrosis factor, chemokine ligand 2, and receptor activator of nuclear factor kappa-B ligand in the joint and serum of infected individuals. This can lead to the influx of inflammatory cells to the joints and associated muscles as well as osteoclast activation and differentiation, culminating in clinical signs of swelling, pain, and bone resorption. Moreover, several data indicate that these viral infections can affect other sites of the body, including the mouth. The human oral cavity is a rich and diverse microbial ecosystem, and viral infection can disrupt the balance of microbial species, causing local dysbiosis. Such events can result in oral mucosal damage and gingival bleeding, which are indicative of periodontitis. Additionally, infection by RRV, CHIKV, SINV, MAYV, or ONNV can trigger the formation of osteoclasts and upregulate pro-osteoclastogenic inflammatory mediators, interfering with osteoclast activation. As a result, these viruses may be linked to systemic conditions, including oral manifestations. Therefore, this review focuses on the involvement of alphavirus infections in joint and oral health, acting as potential agents associated with oral mucosal inflammation and alveolar bone loss. The findings of this review demonstrate how alphavirus infections could be linked to the comorbidity between arthritis and periodontitis and may provide a better understanding of potential therapeutic management for both conditions.


Assuntos
Infecções por Alphavirus , Artrite , Vírus Chikungunya , Periodontite , Humanos , Infecções por Alphavirus/tratamento farmacológico , Infecções por Alphavirus/patologia , Vírus Chikungunya/fisiologia , Mediadores da Inflamação/uso terapêutico , Ligantes , Ross River virus/fisiologia
10.
Int J Oral Maxillofac Surg ; 53(3): 231-238, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37468344

RESUMO

This study evaluated the association between keratinized mucosa (KM) and peri-implant health of external hexagon implants in the posterior region in 84 patients with 242 implants. Modified plaque index (MPI), modified sulcular bleeding index (MSBI), probing depth (PD), keratinized mucosa (KM) width, and peri-implant bone loss were evaluated. The implants were divided according to the KM: (1) absence of KM, (2) KM width >0 and <2 mm, and (3) KM width ≥2 mm. Of the 242 implants evaluated, 63 (26.0%) had no KM band, 56 (23.1%) had KM width <2 mm, and 123 (50.8%) had KM width ≥2 mm. One hundred and sixty-seven (69.0%) were used in multiple unit restorations and 75 (31.0%) in single tooth restorations; 66.9% were placed in the mandible and 33.1% in the maxilla. For single tooth and multiple unit implant restorations, MPI (P=0.069 and P=0.387, respectively), MSBI (P=0.695 and P=0.947, respectively), PD (P=0.270 and P=0.258, respectively), and mesial bone loss (P=0.121 and P=0.239, respectively) were not affected by the KM width. On the distal surface, bone loss was influenced by the absence of KM when single tooth implant restorations were used (P=0.032). No association was found between KM width and the peri-implant tissue health.


Assuntos
Implantes Dentários , Humanos , Estudos de Coortes , Maxila/cirurgia , Mucosa , Mandíbula
11.
Clinics (Sao Paulo) ; 79: 100316, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38091630

RESUMO

OBJECTIVES: This experimental study focused on the intra- and inter-rater reproducibility of vertical bone level (VBL) measurements at strategic mini-implants (MI) using digital panoramic radiographs (PR). STUDY DESIGN: VBLs of 152 MIs for removable partial denture stabilization at 50 randomly chosen PRs from a clinical trial were digitally evaluated by three ratters. Rater deviations exceeding 0.5 mm were re-examined. The intra-class correlation coefficient (ICC) was applied to estimate reliability. The smallest detectable change (SDC) was interrelated to the minimal clinically important change of 0.2 mm. RESULTS: The first measurement round revealed intra- and inter-rater ICCs of > 0.8. However, 28 sites (9 %) were unreadable, and 97 sites (32 %) revealed differences between observers of ≥ 0.5 mm. Following a consensus session and re-training, an additional 8 sites were excluded and all remaining VBL differences were ≤ 0.5 mm. Thus, the SDCs with 95 % credibility were improved from 0.73 to 0.31 mm in the intra-rater and from 1.52 to 0.34 mm in the inter-rater statistics. Given a 50 % credibility for this special setting, both the intra- and inter-rater SDCs were 0.11 mm. CONCLUSIONS: Digital PR can be reliably utilized to determine VBLs around MIs under conditions of at least two trained observers, mutual calibration sessions, and exclusion of unquantifiable radiographs. GERMAN CLINICAL TRIALS REGISTER ID: DRKS00007589, www.germanctr.de.


Assuntos
Radiografia Panorâmica , Humanos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Ensaios Clínicos como Assunto
12.
Clinics ; Clinics;79: 100316, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1528430

RESUMO

Abstract Objectives: This experimental study focused on the intra- and inter-rater reproducibility of vertical bone level (VBL) measurements at strategic mini-implants (MI) using digital panoramic radiographs (PR). Study design: VBLs of 152 MIs for removable partial denture stabilization at 50 randomly chosen PRs from a clinical trial were digitally evaluated by three ratters. Rater deviations exceeding 0.5 mm were re-examined. The intra-class correlation coefficient (ICC) was applied to estimate reliability. The smallest detectable change (SDC) was interrelated to the minimal clinically important change of 0.2 mm. Results: The first measurement round revealed intra- and inter-rater ICCs of > 0.8. However, 28 sites (9 %) were unreadable, and 97 sites (32 %) revealed differences between observers of ≥ 0.5 mm. Following a consensus session and re-training, an additional 8 sites were excluded and all remaining VBL differences were ≤ 0.5 mm. Thus, the SDCs with 95 % credibility were improved from 0.73 to 0.31 mm in the intra-rater and from 1.52 to 0.34 mm in the interrater statistics. Given a 50 % credibility for this special setting, both the intra- and inter-rater SDCs were 0.11 mm. Conclusions: Digital PR can be reliably utilized to determine VBLs around MIs under conditions of at least two trained observers, mutual calibration sessions, and exclusion of unquantifiable radiographs. German Clinical Trials Register ID:DRKS00007589, www.germanctr.de

13.
RGO (Porto Alegre) ; 72: e20240001, 2024. tab
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1550639

RESUMO

ABSTRACT One of the most common dental procedures is tooth extraction; however, the bone defect resulting from the process is only partially restored, leading to considerable bone loss. To rehabilitate a fully or partially edentulous patient, we must handle these sites with delicate surgical procedures. There is a large literature presenting attempts to overcome the negative effects of a dental extraction, with the aim of reducing tissue volume loss or restoring the alveolar architecture. In this context, Partial Extraction Therapy (PET) represents a subgroup of interventions to prevent bone loss after extraction using the tooth itself to prevent alveolar bone loss. This literature review aims to make a survey of the published articles on PET, with an emphasis on socket shield technique, and to explain the other techniques such as root burial, pontic-shield and proximal socket-shield, their indications and counter indications in order to deepen the knowledge of these techniques. To identify the included or considered studies, we adopted a detailed search strategy for MEDLINE and Cochrane Library focused in the last 31 years, whose language was English, Spanish or Portuguese. This text presents an analysis of current data regarding the alternatives for alveolar preservation and the installation of immediate implants in these areas, presenting the possibility of a different surgical technique. However, due to the immaturity and lack of conclusive scientific evidence regarding the predictability of the procedures, it is considered that the use of the socket shield technique must be done in an extremely cautious way.


RESUMO Um dos procedimentos odontológicos mais comuns é a extração dentária, contudo, , o defeito ósseo decorrente do processo é apenas parcialmente restaurado, levando a uma perda ossea volumétrica consideravel. Para reabilitar um paciente totalmente ou parcialmente desdentado, devemos manusear estes sitios com intervenções cirúrgicas delicadas. Há uma vasta literatura apresentando tentativas de transpor os efeitos negativos de uma extração dentária, com o objetivo de diminuir a perda volumétrica tecidual ou restaurar a arquitetura alveolar. Neste contexto, a Terapia de Extração Parcial (TEP) representa um subgrupo de intervenções para prevenir a perda óssea após exodontia, usando o próprio dente para prevenir a perda óssea alveolar. Essa revisão de literatura tem por objetivo fazer um levantamento dos artigos publicados sobre as TEP, com ênfase na técnica de socket shield, e explanar a cerca das demais técnicas como sepultamento radicular, pontic-shield e proximal socket-shield, suas indicações e contra-indicações, a fim de aprofundar o conhecimento dessas técnicas. Para a identificação dos estudos inclui?dos ou considerados, adotamos a estrate?gia de busca detalhada para os bancos MEDLINE e Biblioteca Cochrane nos u?ltimos 31 anos, cujo idioma fosse o ingle?s, espanhol ou o portugue?s. Este texto, apresenta uma análise de dados atuais a respeito das alternativas para a preservação alveolar e instalação de implantes imediatos nestas áreas, apresentando a possibilidade de uma técnica cirúrgica diferenciada. No entanto, devido a imaturidade e falta de comprovação cientifica contundente a respeito da previsibilidade dos procedimentos, considera-se que o emprego da técnica de socket shield deve ser feito de forma cautelosa.

14.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1569831

RESUMO

Introducción: El uso de la fotobioestimulación en la cirugía oral como acelerador de la cicatrización de tejidos se ha incrementado a nivel mundial; sin embargo, la evidencia científica es insuficiente respecto a la energía mínima necesaria para incentivar la cicatrización del alveolo dentario. Objetivo: Determinar el efecto de la fotobiomodulación con diferentes valores de energía sobre la reparación alveolar, posterior a la extracción dental en ratas albinas. Métodos: Treinta y seis ratas albinas hembras se asignaron de forma aleatoria a cuatro grupos: tres con aplicación de láser a 2, 4 y 6 Joules de energía y uno sin aplicación de láser. Se aplicó láser infrarrojo Arseniuro de Galio-Aluminio a 808 nm y 100 miliwatts de forma puntual, perpendicular y única al alveolo dentario. El hueso maxilar se diseccionó y las muestras se tiñeron con hematoxilina eosina para su posterior análisis por conteo celular de osteoblastos a nivel del tercio medio alveolar. Resultados: A los siete días después de la exposición no se observó formación de osteoblasto en el grupo control, pero sí en los grupos experimentales con niveles de energía de 2, 4 y 6 Joules, que mostraron formación de células osteoblásticas similares. Solo el grupo de 4 Joules presentó mayor número de osteoblastos que el grupo control sin irradiación (p = 0,008). A los 14 días la formación de osteoblastos fue similar entre los grupos, sin diferencias significativas (p > 0,05). Conclusiones: La fotobiomodulación tuvo efecto positivo sobre la cicatrización del hueso alveolar en los diferentes parámetros de energía evaluados. El uso de una menor energía es igual de beneficioso, modula la respuesta celular, induce la proliferación osteoblástica y reduce el tiempo de reparación ósea(AU)


Introduction: The use of photobiostimulation in oral surgery as an accelerator of tissue healing has increased worldwide; however, scientific evidence is insufficient regarding the minimum energy needed to encourage healing of the dental alveolus. Objective: To determine the effect of photobiomodulation with different energy values on alveolar repair after tooth extraction in albino rats. Methods: Thirty-six female albino rats were randomly assigned to four groups: three with laser application at 2, 4 and 6 Joules of energy and one without laser application. Gallium-aluminum arsenide infrared lasers at 808 nm and 100 milliwatts were applied pointwise, perpendicularly and uniquely to the tooth socket. The maxillary bone was dissected and the samples were stained with hematoxylin eosin for subsequent analysis by osteoblast cell count at the level of the alveolar middle third. Results: Seven days after exposure, osteoblast formation was not observed in the control group, but was observed in the experimental groups with energy levels of 2, 4 and 6 Joules, which showed similar osteoblast cell formation. Only the 4 Joules group showed a greater number of osteoblasts than the control group without irradiation (p = 0.008). At 14 days, osteoblast formation was similar between groups, with no significant differences (p > 0.05). Conclusions: Photobiomodulation had a positive effect on alveolar bone healing in the different energy parameters evaluated. The use of lower energy is equally beneficial, modulates cellular response, induces osteoblastic proliferation and reduces bone repair time(AU)


Assuntos
Animais , Padrões de Referência , Cirurgia Bucal , Alvéolo Dental , Terapia com Luz de Baixa Intensidade , Lasers , Contagem de Células
15.
J. appl. oral sci ; J. appl. oral sci;32: e20230344, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1534759

RESUMO

Abstract Objective: This study aimed to investigate the effects of systemic administration of P. eurycarpa Yalt. plant extract on alveolar bone loss and oxidative stress biomarkers in gingival tissue in a rat model of experimental periodontitis. Methodology: 32 male Wistar albino rats, weighing 200-250 g, were divided into four groups (n=8): Healthy control (HC), Experimental periodontitis control (EPC), Experimental periodontitis 400 mg/kg (EP400), Experimental periodontitis 800 mg/kg (EP800). Experimental periodontitis was induced using the ligating method. Distilled water was administered to the HC and EPC groups and the plant extract was administered to the EP400 and EP800 groups by oral gavage at doses of 400 mg/kg and 800 mg/kg, respectively. The rats were sacrificed on the 15th day. The values of glutathione peroxidase GSH-Px, malondialdehyde (MDA), superoxide dismustase (SOD), interleukin-1β (IL-1β), interleukin-10 (IL-10), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) in the gingival tissues were analyzed by ELISA tests. Alveolar bone loss was assessed using micro-CT images of the maxilla. Results: Although the IL-1β, TOS, OSI results of the healthy control group were lower than those of the other groups, the TAS values were higher (p<0.05). No significant difference was found in the biochemical parameters among the EPC, EP400, and EP800 groups (p>0.05). Alveolar bone loss was significantly reduced in the extract groups compared to the EPC group (p<0.001). Conclusion: Within the limitations of this study, it was observed that the systemic P. eurycarpa extract application reduced alveolar bone loss in a rat model of experimental periodontitis. Further studies are needed to elucidate the beneficial effects of P. eurycarpa.

16.
Braz. j. oral sci ; 23: e240338, 2024. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1537125

RESUMO

Demineralized freeze-dried bone allograft (DFDBA) contains bone morphogenetic proteins (BMPs), hence is osteoinductive. Autologous platelet concentrates exhibit a higher quantity of growth factors. Both these biomaterials aid in bone regeneration when placed in three-wall intrabony defects. However, their efficacy when used alone and in conjugation is not clear. Aim: To assess clinical and radiographic efficacy of injectable platelet-rich fibrin (i-PRF) with microsurgical access flap in the treatment of three-wall intrabony defects in chronic periodontitis patients. Methods: Thirty sites with three-wall intrabony defects were randomly assigned to control and test group by computer generated method. The test group obtained i-PRF mixed with DFDBA while the control group received only DFDBA. Clinical parameters such as site-specific Plaque index (PI), Radiographic intrabony defect depth (IBDD), modified- Sulcular bleeding index (mSBI), Clinical attachment level (CAL), and Probing pocket depth (PPD) were measured at baseline, three and six months. Results: Intragroup comparison within the control group and test group exhibited statistically highly significant variation of mean PI, mSBI, PPD, CAL, and IBDD score from baseline to 3 months and from 3-6 months (p<0.001). However, intergroup comparison demonstrated no statistically significant variation of mean IBDD at all 3 intervals (p>0.05). Conclusion: i-PRF combined with DFDBA enhanced the radiographic and clinical parameters as opposed to DFDBA alone. The role of i-PRF is promising in its capacity for easy obtainability and increased potential to aid in regeneration


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Regeneração Óssea , Perda do Osso Alveolar , Periodontite Crônica , Aloenxertos , Fibrina Rica em Plaquetas
17.
J. appl. oral sci ; J. appl. oral sci;32: e20240018, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1558232

RESUMO

Abstract Objective This study aimed to validate the integrated correlation between the buccal bone and gingival thickness of the anterior maxilla, and to gain insight into the reference plane selection when measuring these two tissues before treatment with implants. Methodology Cone beam computed tomography (CBCT) and model scans of 350 human subjects were registered in the coDiagnostiX software to obtain sagittal maxillary incisor sections. The buccal bone thickness was measured at the coronal (2, 4, and 6 mm apical to the cementoenamel junction [CEJ]) and apical (0, 2, and 4 mm coronal to the apex plane) regions. The buccal gingival thickness was measured at the supra-CEJ (0, 1mm coronal to the CEJ) and sub-CEJ regions (1, 2, 4, and 6 mm apical to the CEJ). Canonical correlation analysis was performed for intergroup correlation analysis and investigation of key parameters. Results The mean thicknesses of the buccal bone and gingiva at different levels were 0.64~1.88 mm and 0.66~1.37 mm, respectively. There was a strong intergroup canonical correlation between the thickness of the buccal bone and that of the gingiva (r=0.837). The thickness of the buccal bone and gingiva at 2 mm apical to the CEJ are the most important indices with the highest canonical correlation coefficient and loadings. The most and least prevalent subgroups were the thin bone and thick gingiva group (accounting for 47.6%) and the thick bone and thick gingiva group (accounting for 8.6%). Conclusion Within the limitations of this retrospective study, the thickness of the buccal bone is significantly correlated with that of the buccal gingiva, and the 2 mm region apical to the CEJ is a vital plane for quantifying the thickness of these two tissues

18.
Braz. oral res. (Online) ; 38: e049, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1564192

RESUMO

Abstract The objective of this study was to analyze the influence of insertion torque, bone type, and peri-implant bone loss on implant stability quotient (ISQ) of cylindrical external hexagon (EH) and Morse Taper (MT) implants. Forty-four single implants were placed in the edentulous areas of 20 patients who met the inclusion and exclusion criteria. Immediately after implant placement (t1) and after osseointegration (four and six months for mandible and maxilla, respectively) (t2), insertion torque, resonance frequency, and peri-implant bone loss were measured using probing depths and digital periapical radiography. A significant difference was noted in the ISQ values between t1 and t2 in type III bone for EH and MT implants. No significant difference in bone loss values was observed when comparing bone types for EH or MT in all evaluated sites. Based on marginal bone loss assessed using radiography, there was no significant difference between the MT and EH groups. A positive correlation between torque and ISQ t1 value was observed for MT (correlation: 0.439; p = 0.041) and EH (correlation: 0.461; p = 0.031) implants. For EH and MT implants, the greater the insertion torque, the greater was the ISQ value (moderately positive correlation). A weak negative correlation was found between bone type and ISQ t1 for MT implants. Contrarily, no correlation was observed between bone type and ISQ t1 for EH implants. In all cases, bone loss around the implants was clinically normal.

19.
Rev. Odontol. Araçatuba (Impr.) ; 44(3): 74-80, set.-dez. 2023. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1553234

RESUMO

A extração do elemento dentário promove uma série de eventos biológicos que resultam no colapso da estrutura alveolar, ocasionando a perda óssea volumétrica na região de extração. Preservar esse alvéolo dentário é imprescindível para uma boa reabilitação dentária do paciente. Objetivo: Realizar uma revisão de literatura abordando os objetivos, opções técnicas, vantagens e desvantagens da preservação óssea alveolar pós extração. Materiais e métodos: Foi feita uma revisão de literatura utilizando as bases de dados Biblioteca Virtual em Saúde (BVS), PubMed e Google acadêmico, usando os descritores "extração dentária", "perda do osso alveolar", "regeneração óssea". Foram incluídos 34 artigos. Resultados: A preservação alveolar pós extração começa desde a realização de uma técnica cirúrgica menos invasiva até a colocação de enxertos do tipo autógenos, alógenos, xenógenos, aloplásticos e biomateriais promotores de cicatrização e reparação tecidual. Conclusão: Existe na literatura atual uma vasta gama de textos científicos que abordam técnicas de preservação alveolar pós exodontia, com distintas respostas teciduais. Todavia, nenhum biomaterial listado nesta revisão contém todas as características que proporcionam regeneração completa do osso alveolar após exodontia(AU)


The extraction of the dental element promotes a series of biological events that results in the collapse of the alveolar structure, causing volumetric bone loss in the region of extraction. Preserving this dental alveolus is essential for a good dental rehabilitation of the patient. Objective: To conduct a literature review addressing the objectives, technical options, advantages and disadvantages of post-extraction alveolar bone preservation. Materials and methods: A literature review was carried out using the Virtual Health Library (VHL), PubMed and academic Google databases, using the descriptors "tooth extraction", "alveolar bone loss", "bone regeneration". 34 articles were included. Results: Post-extraction alveolar preservation starts from the performance of a less invasive surgical technique to the placement of autogenous, allogeneic, xenogeneic, alloplastic and biomaterials that promote healing and tissue repair. Conclusion: There´s is a wide range of scientific texts in the current literature that address post-extraction alveolar preservation techniques with different tissue responses. However, none of the biomaterials listed in this review contain all the characteristics that provide complete regeneration of alveolar bone after extraction(AU)


Assuntos
Procedimentos Cirúrgicos Bucais , Alvéolo Dental
20.
Odontol.sanmarquina (Impr.) ; 26(4): e25753, oct.-dic. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1551273

RESUMO

Objetivo. Evaluar el efecto del tratamiento con ácido zoledrónico e hidroxocobalamina sobre la microarquitectura ósea alveolar en ratones con periodontitis y osteoporosis inducidas. Métodos. Diseño experimental en fase preclínica. Se incluyeron 16 ratones hembras a quienes se les indujo osteoporosis mediante la ovariectomía total y también se indujo la periodontitis por inflamación por ligadura de seda negra 5/0 en el segundo molar maxilar, todos los protocolos fueron sometidos durante anestesia general. Los ratones se distribuyeron en 4 grupos: control, tratamiento con ácido zoledrónico, tratamiento con hidroxocobalamina y tratamiento combinado. A las 16 semanas, se realizó la autanasia, se realizó la disección para la evaluación mediante microtomografía; determinando la densidad mineral ósea (BMD), el volumen de hueso (BV/TV), espesor trabecular (Tb. Th), número de trabéculas (Tb.N), separación trabecular (Tb.Sp); se realizó el análisis descriptivo y bivariado mediante ANOVA de 1 vía considerando un 95% de nivel de confianza. Resultados. El grupo que recibió tratamiento combinado de ácido zoledrónico e hidroxocobalamina presentó mayor densidad mineral ósea (DMO), mayor volumen óseo (BV/TV) y menor separación trabecular (Tb.Sp) en comparación con el grupo de control (p<0,05). Conclusiones. El tratamiento combinado de ácido zoledrónico e hidroxocobalamina mejora las características microarquitectónicas óseas en ratones con osteoporosis y periodontitis inducidas.


Objective. Evaluate the effect of zoledronic acid and hydroxocobalamin treatment on alveolar bone microarchitecture in mice with induced periodontitis and osteoporosis. Methods. Experimental design in preclinical phase. Sixteen female mice were included in which osteoporosis was induced by total ovariectomy and periodontitis was also induced by inflammation by 5/0 black silk ligation of the maxillary second molar, all protocols were performed under general anesthesia. The mice were distributed into 4 groups: control, treatment with zoledronic acid, treatment with hydroxocobalamin and combined treatment. At 16 weeks, euthanasia was performed, dissection was performed for evaluation by microtomography; determining bone mineral density (BMD), bone volume (BV/TV), trabecular thickness (Tb.Th), number of trabeculae (Tb.N), trabecular separation (Tb.Sp); descriptive and bivariate analysis was performed using 1-way ANOVA with a 95% confidence level. Results. The group that received combined treatment of zoledronic acid and hydroxocobalamin presented higher bone mineral density (BMD), higher bone volume (BV/TV) and lower trabecular separation (Tb.Sp) compared to the control group (p<0.05). Conclusions. Combined treatment with zoledronic acid and hydroxocobalamin improves bone microarchitectural features in mice with induced osteoporosis and periodontitis.

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