RESUMO
BACKGROUND: Association between periodontal disease and dyslipidemia was recently reported in healthy adults. However, a systematic evaluation of concomitant periodontal diseases and lipid profile was not carried out in juvenile dermatomyositis (JDM). A cross-section study was performed in 25 JDM patients and 25 healthy controls, assessing demographic data, periodontal evaluation, fasting lipoproteins and anti-lipoprotein lipase antibodies. Disease parameters, laboratorial tests and treatment were also evaluated in JDM patients. RESULTS: The mean current age was similar in patients and controls (11.5 ± 3.75 vs. 11.2 ± 2.58 years,p = 0.703). Regarding lipid profile, the median triglycerides [80(31-340) vs. 61(19-182)mg/dL,p = 0.011] and VLDL[16(6-68) vs. 13(4-36)mg/dL,p = 0.020] were significantly higher in JDM patients versus controls. Gingival vasculopathy pattern was significantly higher in the former group (60% vs. 0%,p = 0.0001), as well as the median of gingival bleeding index (GBI) [24.1(4.2-69.4) vs. 11.1(0-66.6)%,p = 0.001] and probing pocket depth (PPD) [1.7(0.6-2.4) vs.1.4(0-2.12)mm,p = 0.006]. Comparison between JDM patients with and without dyslipidemia revealed that the median of dental plaque index (PI) [100(26.7-100) vs. 59(25-100)%,p = 0.022], PPD[1.9(0.6-2.4) vs. 1.4(1.2-1.8)mm,p = 0.024] and clinical attachment level (CAL) [1.31(0.7-1.7) vs. 0.8(0.6-1.7)mm,p = 0.005] were significantly higher in patients with dyslipidemia. Further analysis between JDM patients with and without gingivitis revealed that the median of current age [12.4 (8.3-18.4) vs. 9.2 (5.5-17.5) years, p = 0.034] and disease duration [7.09 ± 3.07 vs. 3.95 ± 2.1 years, p = 0.008] were significantly higher in the former group. CONCLUSION: Our study showed that gingival inflammation seems to be related to dyslipidemia in JDM patients, suggesting underlying mechanisms for both complications.
Assuntos
Dermatomiosite/complicações , Dislipidemias/complicações , Doenças Periodontais/complicações , Adolescente , Estudos de Casos e Controles , Criança , Estudos Transversais , Índice de Placa Dentária , Dermatomiosite/sangue , Dislipidemias/sangue , Feminino , Hemorragia Gengival/sangue , Hemorragia Gengival/complicações , Hemorragia Gengival/diagnóstico , Bolsa Gengival/sangue , Bolsa Gengival/diagnóstico , Gengivite/sangue , Gengivite/complicações , Gengivite/diagnóstico , Humanos , Lipase Lipoproteica/antagonistas & inibidores , Lipoproteínas VLDL/sangue , Masculino , Doenças Periodontais/sangue , Doenças Periodontais/diagnóstico , Triglicerídeos/sangueRESUMO
The study characterized the oral health condition and main self-reported reasons for tooth extraction in an adult population. The cross-sectional study examined 248 adults aged 20-64 years, representative of the population of Piracicaba, São Paulo, Brazil. The oral examination conducted in households used the DMFT and CPI indexes, use and necessity of prosthodontics according to the WHO criteria and the presence of visible biofilm. Demographic and socioeconomic data were collected along with reasons for tooth extraction through a questionnaire. Descriptive analysis was stratified by age in groups: 20-44 and 45-64 years old. The average DMFT was 20.37 (EP = 0.50), P = 3.34 (EP = 0.33) for young adults and P = 13.41 (EP = 1.45) for the older adults. Gingival pockets (CPI ≥ 3) were found on 20.5% of young adults and 53.0% of the older ones. While 38.8% used upper prosthesis, 46.7% needed lower prosthesis. Pain was the most prevalent self-reported reason for tooth extraction (37.5%), being this choice primarily because of lack of another treatment option (52%) and done in the private sector (47.2%). We concluded that young adults (20-44 years old) showed less missing teeth, periodontal diseases, and need for prosthetic use. Pain and lack of options of other treatments were the main self-reported reasons for performing tooth extractions.
Assuntos
Saúde Bucal/estatística & dados numéricos , Doenças Periodontais/epidemiologia , Extração Dentária/estatística & dados numéricos , Odontalgia/epidemiologia , Adulto , Fatores Etários , Brasil/epidemiologia , Estudos Transversais , Prótese Dentária/estatística & dados numéricos , Feminino , Bolsa Gengival/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , Perda de Dente/epidemiologia , Adulto JovemRESUMO
Resumo O presente estudo caracterizou a condição de saúde bucal e os principais motivos autorrelatados da extração dentária em uma população de adultos. Estudo transversal que examinou 248 adultos de 20-64 anos, representativos da população de Piracicaba (SP). O exame bucal domiciliar utilizou os índices CPOD, CPI, uso e necessidade de prótese dentária segundo critérios da OMS e presença de biofilme visível. Foram coletados dados demográficos, socioeconômicos e motivos da extração dentária por meio de questionário. A análise descritiva foi estratificada pela idade em 20-44 e 45-64 anos. O CPOD médio foi 20,37, P = 3,34 nos adultos jovens e P = 13,41 nos mais velhos. Bolsa periodontal (CPI ≥ 3) foi encontrada em 20,5% dos adultos jovens e 53,0% dos mais velhos. Enquanto 38,8% usavam prótese superior, 46,7% necessitavam de prótese inferior. A dor foi o motivo autorrelatado mais prevalente para realização da extração dentária, sendo esta escolha principalmente pela falta de outra opção de tratamento e no serviço privado. Conclui-se que os adultos jovens (20-44 anos) apresentaram menos dentes perdidos e doença periodontal, uso e necessidade de prótese. Dor e falta de opção de outros tratamentos foram os principais motivos autorrelatados para realização das extrações dentárias.
Abstract The study characterized the oral health condition and main self-reported reasons for tooth extraction in an adult population. The cross-sectional study examined 248 adults aged 20-64 years, representative of the population of Piracicaba, São Paulo, Brazil. The oral examination conducted in households used the DMFT and CPI indexes, use and necessity of prosthodontics according to the WHO criteria and the presence of visible biofilm. Demographic and socioeconomic data were collected along with reasons for tooth extraction through a questionnaire. Descriptive analysis was stratified by age in groups: 20-44 and 45-64 years old. The average DMFT was 20.37 (EP = 0.50), P = 3.34 (EP = 0.33) for young adults and P = 13.41 (EP = 1.45) for the older adults. Gingival pockets (CPI ≥ 3) were found on 20.5% of young adults and 53.0% of the older ones. While 38.8% used upper prosthesis, 46.7% needed lower prosthesis. Pain was the most prevalent self-reported reason for tooth extraction (37.5%), being this choice primarily because of lack of another treatment option (52%) and done in the private sector (47.2%). We concluded that young adults (20-44 years old) showed less missing teeth, periodontal diseases, and need for prosthetic use. Pain and lack of options of other treatments were the main self-reported reasons for performing tooth extractions.
Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Doenças Periodontais/epidemiologia , Extração Dentária/estatística & dados numéricos , Odontalgia/epidemiologia , Saúde Bucal/estatística & dados numéricos , Fatores Socioeconômicos , Brasil/epidemiologia , Prevalência , Estudos Transversais , Inquéritos e Questionários , Perda de Dente/epidemiologia , Fatores Etários , Prótese Dentária/estatística & dados numéricos , Bolsa Gengival/epidemiologia , Pessoa de Meia-IdadeRESUMO
Antecedentes: La técnica en rollo modificado se ha utilizado ampliamente para mejorar el aspecto estético de las deficiencias de los rebordes alveolares durante el tratamiento de rehabilitación y, así, disminuir el dolor posoperatorio. Objetivo: Describir un caso clínico en el que se realizó un aumento del reborde alveolar por medio de una técnica en rollo modificada que presentó un absceso durante las primeras semanas posoperatorias. Se describe también manejo clínico del caso. Resultados: Después del diagnóstico clínico y microbiológico, se realizó tratamiento antibiótico. En el control a los cuatro meses se observó resolución completa del absceso.
Background: The modified roll technique has been widely used to improve the aesthetics of the alveolar ridge deficiencies during the rehabilitation treatment and, in turn, to reduce the postoperative pain. Objective: To describe a clinical case of an alveolar ridge augmentation with the modified roll technique in which an abscess appeared during the first postoperative weeks. The clinical management of the case is also detailed herein. Results: After a clinical and microbiological diagnosis, the patient was indicated an antibiotic treatment. In the postoperative four-month checkup, a full solution of the abscess was observed.
Assuntos
Abscesso/complicações , Aumento do Rebordo Alveolar , Bolsa Gengival/complicações , Patologia BucalRESUMO
BACKGROUND: Angiotensin-converting enzyme (ACE) downregulates the activity of bradykinin, a potent proinflammatory and immunostimulatory peptide liberated from an internal portion of kininogens. Here, we asked whether periodontitis is worsened in patients under antihypertensive treatment with ACE inhibitors. METHODS: Periodontal parameters were recorded from 30 individuals taking ACE inhibitors (case) and 35 taking a non-ACE inhibitor medication (control). Data were analyzed by nonparametric and parametric statistical tests. RESULTS: Most sociodemographic figures were similar in both groups. However, family income was statistically higher in the control group, and the percentage of sites with visible plaque (PL) was statistically higher in the case group (P = 0.043 and P = 0.005, respectively). The prevalence of individuals with chronic periodontitis varied from 31.5% in the control group to 63.4% in the case group (P = 0.001). Patients in the case group presented a 3.2-fold higher risk of having sites with pocket depth ≥5 mm and a 2.9-fold higher risk of having sites with clinical attachment loss ≥5 mm in comparison with those in the control group (P = 0.009 and P = 0.001, respectively; adjusted for family income and visible PL). CONCLUSION: Angiotensin-converting enzyme inhibitors may increase the prevalence and extent of chronic periodontitis in Brazilian patients.
Assuntos
Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Anti-Hipertensivos/efeitos adversos , Periodontite Crônica/induzido quimicamente , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Estudos de Casos e Controles , Periodontite Crônica/patologia , Feminino , Bolsa Gengival/induzido quimicamente , Bolsa Gengival/patologia , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: In the last few years unusual microorganisms have been isolated from subgingival biofilm, as possible initiators or contributors to periodontal disease, especially in patients who show no improvement during treatment. AIMS: To study the Candida invasion of the connective tissue in relation to subgingival biofilm presence. METHODS: A total of 55 immunocompetent patients of both sexes, between 21 and 55 years of age, non-smokers, without previous antimicrobial treatment, suffering periodontal diseases, were studied. Soft tissues, supragingival and subgingival plaque samples, and periodontal pocket biopsies were taken. Microscopic studies, cultures, assimilation profiles, and DNA amplifications were performed. RESULTS: In 35% of the samples, different species of Candida were isolated in cultures, especially Candida albicans. Hyphae invasions in the connective tissue were observed, in association with anaerobic microorganisms (Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans) in patients with periodontitis. CONCLUSIONS: Different species of Candida could be part of the periodontal plaque and could play an important role in the adherence to soft tissues, allowing deep invasion. They also could infect gingival pockets in patients with gingivitis, even in healthy locations, playing a commensal or opportunist role.
Assuntos
Candidíase Invasiva/microbiologia , Candidíase Bucal/microbiologia , Periodontite Crônica/microbiologia , Tecido Conjuntivo/microbiologia , Placa Dentária/microbiologia , Gengivite/microbiologia , Adulto , Bactérias Anaeróbias/isolamento & purificação , Infecções por Bacteroidaceae/microbiologia , Infecções por Bacteroidaceae/patologia , Biofilmes , Candida/isolamento & purificação , Candida/patogenicidade , Candidíase Invasiva/patologia , Candidíase Bucal/patologia , Periodontite Crônica/patologia , Coinfecção , Tecido Conjuntivo/patologia , Feminino , Bolsa Gengival/microbiologia , Gengivite/patologia , Humanos , Hifas , Masculino , Pessoa de Meia-Idade , Infecções Oportunistas/microbiologia , Infecções Oportunistas/patologia , Bolsa Periodontal/microbiologia , Porphyromonas gingivalis/isolamento & purificação , Prevotella intermedia/isolamento & purificação , Especificidade da Espécie , Simbiose , Virulência , Adulto JovemRESUMO
Introduction: Patients seem to adhere better to short-term periodontal treatment schemes. Besides, time-reduced treatments are more cost-effective. However, the degree of benefits related to this type of treatment still requires additional investigations. Aim: The present short-term study evaluated clinical and microbiological outcomes, from baseline to 3-months, of chronic periodontitis subjects treated by the one-stage full-mouth disinfection protocol. Material and Method: Sixteen chronic periodontitis subjects (mean-age 49.87 ± 8.22) who met inclusion/exclusion criteria were included. A calibrated examiner measured whole-mouth plaque and gingival indices, periodontal pocket depth and clinical attachment level at baseline and at 3-months. Subgingival samples were also collected from the 5 most diseased periodontal sites to determine total bacterial load and levels of P. gingivalis and S. oralis by real time qPCR. Periodontal treatment consisted of full-mouth manual debridement plus wide intraoral use of chlorhexidine in gel and solution. Additionally, after debridement, individuals rinsed 0.12% chlorhexidine at home twice a day for the following 2 months. Data monitored were compared by paired Student-t test (p<0.05). Result: Statistical analysis revealed that, in general, one-stage full-mouth disinfection treatment provided significant clinical and microbiological improvements at 3-months. Total bacterial load showed one of the most pronounced reductions from baseline to 3-months (p=0.0001). Also, subgingival levels P. gingivalis and S. oralis reduced overtime. Conclusion: After a short period of monitoring, chronic periodontitis subjects showed clinical and microbial improvements following one-stage full-mouth disinfection treatment.
Introdução: Os pacientes parecem aderir melhor ao tratamento periodontal de curto prazo. Além disso, tratamentos de tempo curto possuem melhor custo-benefício. No entanto, os benefícios associados a este tipo de tratamento ainda requerem investigações adicionais. Objetivo: O presente estudo avaliou longitudinalmente indivíduos com periodontite crônica clínica e microbiologicamente tratados pelo protocolo one-stage full-mouth disinfection. Material e Método: Dezesseis indivíduos (49,87 ± 8,22), que se enquadraram nos critérios de inclusão/exclusão foram incluídos. Um examinador calibrado, avaliou índice de placa e gengival, profundidade de bolsa e nível clínico de inserção pré e pós terapia. Amostras subgengivais coletadas dos cinco sítios periodontais mais doentes estabeleceram a carga bacteriana total e níveis de P. gingivalis e S. oralis por qPCR. One-stage full-mouth disinfection foi realizado com instrumentos manuais associado a gel de clorexidina e solução. Após, os indivíduos utilizaram clorexidina 0,12% para bochecho, duas vezes ao dia, durante os dois meses. Dados foram comparados pelo teste pareado t de Student (p<0,05). Resultado: A análise estatística revelou que o tratamento proporcionou melhorias clínicas e microbianas significativas em três meses. A carga bacteriana total evidenciou reduções mais pronunciadas do pré para o pós-tratamento (p=0,0001). Similarmente, P. gingivalis e S. oralis mostraram redução no pós-tratamento. Conclusão: Após 3 meses de monitoramento, indivíduos com periodontite crônica apresentaram melhora clínica e microbiana com o protocolo one stage full-mouth disinfection.
Assuntos
Terapêutica , Clorexidina , Porphyromonas gingivalis , Streptococcus oralis , Periodontite Crônica , Microbiologia , Doenças Periodontais , Índice Periodontal , Índice de Placa Dentária , Bolsa GengivalRESUMO
The aim of this study was to evaluate whether there is a positive correlation between the width of the zone of gingival keratinized tissue and its thickness. Maxillary right canines, lateral incisors, and central incisors of 60 patients (30 men, 30 women) between the ages of 20 and 35 years were examined. Using an endodontic spacer with a rubber cursor and a digital caliper of 0.01-mm resolution, the values of the width of the zone of gingival keratinized tissue and gingival thickness were obtained. It was observed that the lateral incisor has the largest mean zone of gingival keratinized tissue (5.54 ± 1.09 mm), followed by the central incisor (4.62 ± 1.02 mm) and canine (4.32 ± 1.33 mm). The mean gingival thickness was greater in the central incisor (1.17 ± 0.20 mm), followed by the lateral incisor (1.04 ± 0.24 mm) and canine (0.87 ± 0.27 mm). No statistically significant difference was verified for the mean width of the zone of gingival keratinized tissue and gingival thickness between men and women. A positive correlation between gingival thickness and width of the zone of gingival keratinized tissue was observed in the maxillary canine (Pearson r = 0.398, P < .05), lateral incisor (Pearson r = 0.369, P < .05), and central incisor (Pearson r = 0.492, P < .05). In patients 20 to 35 years of age, there was a positive correlation between gingival thickness and width of the zone of gingival keratinized tissue for the maxillary right canine, lateral incisor, and central incisor.
Assuntos
Gengiva/anatomia & histologia , Queratinas , Maxila/anatomia & histologia , Adulto , Dente Canino/anatomia & histologia , Feminino , Bolsa Gengival/patologia , Humanos , Incisivo/anatomia & histologia , Masculino , Mucosa Bucal/anatomia & histologia , Método Simples-Cego , Adulto JovemRESUMO
Both oral cavity and subgingival pocket are ecological niches conducive to hosting microorganisms that may act as opportunistic pathogens, such as Staphylococcus aureus and especially methicillin-resistant Staphylococcus aureus (MRSA). Early detection of MRSA is a matter of concern to Public Health. The aim of our study was to determine phenotypic and genotypic detection of methicillin resistance of S. aureus in oral mucosa and subgingival pocket in 102 patients with gingivitis-periodontitis. The prevalence of S. aureus was 10.8% (n = 11) in subgingival pocket and 19.6% (n = 20) in oral mucosa. We obtained 31 isolates of S. aureus of which 13 were mecA positive and 18 were mecA negative. Detection of mecA gene by PCR was used as the reference method to compare the results of phenotypic methods to determine methicillin resistance. Early, accurate detection of S. aureus through phenotyping and genotyping methods is crucial for assessing the colonization and preventing the spread of MRSA.
Assuntos
Bolsa Gengival/microbiologia , Mucosa Bucal/microbiologia , Periodontite/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Adulto JovemRESUMO
Streptococcus mutans and Aggregatibacter actinomycetemcomitans are oral pathogens associated with dental caries and periodontitis, respectively. The aim of this study was to determine the colonization of these two microorganisms in the dental plaque of a group of Haitian adolescents using two different polymerase chain reaction (PCR) methods, standard PCR, and quantitative real-time PCR (qPCR) assays. Fifty-four pooled supra-gingival plaque samples and 98 pooled sub-gingival plaque samples were obtained from 104 12- to19-year-old rural-dwelling Haitians. The total genomic DNA of bacteria was isolated from these samples, and all participants also received caries and periodontal examinations. Caries prevalence was 42.2%, and the mean decayed, missing, and filled surface (DMFS) was 2.67 ± 5.3. More than half of the adolescents (53.3%) experienced periodontal pockets (Community Periodontal Index score ≥3). S. mutans was detected in 67.3% by qPCR and 38.8% by PCR of the supra-gingival plaque samples (p < 0.01), and 36.6% by qPCR and 8.1% by PCR of the sub-gingival samples (p < 0.01). A. actinomycetemcomitans was detected in 85.1% by qPCR and 44.0% by PCR of the sub-gingival samples (p < 0.01), but the prevalence was similar, 67.3% by qPCR and 59.2% by PCR, in the supra-gingival plaque samples. Neither age nor gender was significantly correlated to the bacterial colonization. The results demonstrated a moderate-to-high prevalence of S. mutans and A. actinomycetemcomitans in the Haitian adolescent population, and qPCR is more sensitive than standard PCR in field conditions. These findings suggest that qPCR should be considered for field oral epidemiologic studies and may be necessary in investigations having major logistic challenges.
Assuntos
Aggregatibacter actinomycetemcomitans/isolamento & purificação , Placa Dentária/microbiologia , Reação em Cadeia da Polimerase/métodos , Streptococcus mutans/isolamento & purificação , Adolescente , Criança , Índice CPO , DNA Bacteriano/análise , Cárie Dentária/classificação , Cárie Dentária/microbiologia , Restauração Dentária Permanente/estatística & dados numéricos , Feminino , Bolsa Gengival/classificação , Bolsa Gengival/microbiologia , Haiti , Humanos , Masculino , Índice Periodontal , Bolsa Periodontal/classificação , Bolsa Periodontal/microbiologia , Saúde da População Rural , Perda de Dente/classificação , Adulto JovemRESUMO
La cavidad bucal y el interior de la bolsa subgingival constituyen nichos ecológicos propicios para albergar microorganismos que podrían actuar como patógenos oportunistas, como el Staphylococcus aureus y enparticular S. aureus resistente a la meticilina (SARM). La detección temprana de portadores reviste importancia para la salud pública. El objetivo de nuestro trabajo fue determinar por métodos fenotípicos y genotípicos la meticilino resistencia de cepas de S. aureus aisladas de mucosa bucal y bolsa subgingival y bolsa subgingival de 102 pacientes con enfermedad gingivoperiodontal. Se observó una prevalencia de S. aureus en bolsa subgingival del 10,8 por ciento (n=11) y en mucosa bucal del 19,5 por ciento (n=20). Se obtuvieron 31 aislamientos de S. aureus de los cuales 13 fueorn mec A positivos y 18 eran mec A negativos. La detección del gen mec A por PCR se utilizó como método de referencia para comparar los resultados de métodos fenotípicos para determinar la resistencia a meticilina. La detección rápida y exacta de S. aureus por métodos microbiológicos fenotípicos y genotípicos es relevante para evaluar la colonización y prevenir la propagación del SARM.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Pessoa de Meia-Idade , Bolsa Gengival/microbiologia , Mucosa Bucal/microbiologia , Periodontite/microbiologia , Staphylococcus aureus/isolamento & purificação , Staphylococcus aureus , Staphylococcus aureus/genética , Resistência a Meticilina , Testes de Sensibilidade MicrobianaRESUMO
BACKGROUND: The present study evaluates the influence of local anatomy on the reduction in relative gingival recession (Delta RGR) and gain of clinical attachment level (Delta CAL) achieved by coronally advanced flap alone (CAF), CAF plus restoration (CAF + R), subepithelial connective tissue graft alone (CTG), and CTG plus restoration (CTG + R), to treat Miller Class I gingival recessions associated with non-carious cervical lesions. METHODS: A total of 78 defects in maxillary canines or premolars were included, and received one of the following treatments: CAF, CAF + R, CTG, or CTG + R. Delta RGR and Delta CAL after 6 months were associated with cervical lesion height (CLH), cervical lesion width, cervical lesion depth (CLD), keratinized tissue width, keratinized tissue thickness, papillae width, papillae height, bone level (BL), and post-surgical position of the gingival margin using stepwise multivariate linear regression. RESULTS: CLH was statistically associated with Delta RGR when CAF (P = 0.02) and CTG + R (P = 0.0002) were analyzed and statistically associated with Delta RGR when overall data (P = 0.005) from both CTG groups were analyzed. CLD was significantly associated with Delta RGR in the CAF group (P = 0.0045). BL was statistically associated with Delta RGR when evaluating the CTG group (P = 0.02). It was also significantly associated with Delta CAL when considering the CTG (P = 0.01) and the overall data (P = 0.04) from CAF (CAF and CAF + R). CONCLUSIONS: It can be concluded that CLD may influence Delta RGR when CAF is performed to treat combined defects. Additionally, BL may not negatively influence Delta RGR when the CTG technique is used.
Assuntos
Gengiva/patologia , Retração Gengival/cirurgia , Colo do Dente/patologia , Desgaste dos Dentes/terapia , Adulto , Idoso , Processo Alveolar/patologia , Dente Pré-Molar/patologia , Tecido Conjuntivo/transplante , Dente Canino/patologia , Índice de Placa Dentária , Restauração Dentária Permanente/métodos , Inserção Epitelial/patologia , Feminino , Seguimentos , Gengiva/transplante , Bolsa Gengival/classificação , Retração Gengival/classificação , Retração Gengival/complicações , Cimentos de Ionômeros de Vidro , Humanos , Masculino , Maxila/patologia , Pessoa de Meia-Idade , Índice Periodontal , Cimentos de Resina , Retalhos Cirúrgicos , Abrasão Dentária/terapia , Erosão Dentária/terapia , Desgaste dos Dentes/classificação , Desgaste dos Dentes/complicações , Resultado do Tratamento , Adulto JovemRESUMO
La unidad dentogingival es una unidad funcional compuesta por un tejido conectivo fibroso supracrestal, epitelio de unión y surco gingival, cuyo ancho es de 2.73 mm, medida que debe mantenerse para obtener éxito en los procedimientos restaurativos. Algunas situaciones clínicas invaden el anchobiológico, provocando alteraciones en el periodonto, en estos casos, se requiere la técnica quirúrgica de aumento de corona clínica para mejorar las condiciones anatómicas y facilitar los procedimientos restaurativos, sin embargo los estudios sobre las alteraciones en la posición del margen gingival durante la cicatrización después del procedimiento reportan resultados contradictorios. El objetivo de este estudio fue evaluar los cambios en la posición del margen gingival después de aumento de corona clínica a los 3 y 6 meses. Se evaluaron 28 dientes en 9 pacientes de la clínica odontológica de la Universidad Cooperativa de Colombia -Pasto, que asistieron durante el año 2007 y requirieron aumento de corona clínica. Los resultados demuestran una tendencia a migración coronal del margen gingival así: al primer mes en un 56.8%, al tercer mes en un 39.2% y al sexto mes en un 39.8%. Seis meses después de realizar aumento de corona clínica se observa una tendencia a migración coronal del margen gingival. El mayor valor de migración coronal se presentó en el primer mes de cicatrización, este valor disminuyó entre el tercer y sexto mes. La estabilidad del margen gingival se obtiene entre el tercer y sexto mes postquirúrgico.
The dentogingival functional unit is composed of supracrestal fibrous connective tissue, epithelium and gingival sulcus union, whose width is 2.73 mm, which must be maintained for success of restorative procedures. Some clinical situations invade the biological space, causing alterations in the periodontium. In these cases, surgery is required to increase clinical crown in order to improve the anatomy and facilitate restorative procedures. Clinical studies however, have shown contradictory results on the modification of the position of the gingival margin during healing after a clinical crown lengthening. The objective of this study was to evaluate the changes in the position of the gingival margin after a clinical crown lengthening 3 and 6 months postoperatively. 28 different teeth from 9 patients who attended the Colombian Cooperative University Dental Clinics in Pasto subjected to clinical crown lengthening procedures, were evaluated. Results indicated a higher tendency for crown migration of the gingival margin as follows: 56.8% during the first month, 32.9% at the third month and 39.8% at six months. Six months after undergoing clinical crown lengthening procedures, a migration trend of the gingival margin was observed. During the first month of healing, the highest value of crown migration was present. This value decreased during the third and sixth months respectively. The stability of the gingival margin is achieved between the third and sixth months post surgically.
Assuntos
Humanos , Aumento da Coroa Clínica , Bolsa Gengival , Procedimentos Cirúrgicos Operatórios , GengivaRESUMO
BACKGROUND: The appearance of gingival tissues plays an important role in the esthetics of the anterior maxillary region of the mouth. The gingival zenith (GZ) is defined as the most apical point of the marginal gingival scallop; however, its quantitative orientation in the apico-coronal (AC) and mesio-distal (MD) directions has not been reported. Thus, this study aimed to quantify the specific spatial displacement of the GZ in the maxillary anterior dentition. METHODS: Bilateral measurements, taken with a digital caliper in maxillary stone casts from periodontally healthy volunteers, were recorded to the nearest 1/100th millimeter in the canine (C), lateral incisor (LI), and central incisor (CI) teeth to evaluate the MD displacement of the GZ in relation to the long axis of the crowns and the AC displacement of the GZ of LI teeth in relation to CI and C teeth. Intermeasurement differences were analyzed with the chi(2) or paired t test, with significance set at alpha <0.05. RESULTS: The GZ was distally displaced between 0.06 and 0.96 mm in 12%, 70%, and 96% of the C, LI, and CI teeth, respectively. The majority of the population (70%) presented with the GZ of LI teeth positioned 0.75 +/- 0.60 mm coronally to the GZ of the ipsilateral C and CI. CONCLUSIONS: The GZ is not universally displaced toward the distal aspect. The frequency and magnitude of distal displacement is tooth-dependent and larger in CI than in LI, which, in turn, is larger than in C. Consideration of these findings may improve clinical management of the dentogingival complex and enhance periodontal and restorative procedures in the anterior maxillary dentition.
Assuntos
Dente Canino/anatomia & histologia , Gengiva/anatomia & histologia , Incisivo/anatomia & histologia , Placa Dentária/patologia , Inserção Epitelial/anatomia & histologia , Feminino , Hemorragia Gengival/patologia , Bolsa Gengival/patologia , Retração Gengival/patologia , Humanos , Masculino , Maxila , Modelos Dentários , Odontometria , Colo do Dente/anatomia & histologia , Coroa do Dente/anatomia & histologia , Adulto JovemRESUMO
AIM: Evaluation of the treatment of gingival recessions with coronally positioned flap with or without acellular dermal matrix allograft (ADM) after a period of 24 months. METHODS: Thirteen patients with bilateral gingival recessions were included. The defects were randomly assigned to one of the treatments: coronally positioned flap plus ADM or coronally positioned flap alone. The clinical measurements were taken before the surgeries and after 6, 12 and 24 months. RESULTS: At baseline, the mean values for recession height were 3.46 and 3.58 mm for the defects treated with and without the graft, respectively (p>0.05). No significant differences between the groups were observed after 6 and 12 months in this parameter. However, after 24 months, the group treated with coronally positioned flap alone showed a greater recession height when compared with the group treated with ADM (1.62 and 1.15 mm, respectively--p<0.05). A significant increase in the thickness of keratinized tissue was observed in the group treated with ADM as compared with coronally positioned flap alone (p<0.05). CONCLUSIONS: ADM may reduce the residual gingival recession observed after 24 months in defects treated with coronally positioned flap. In addition, a greater gingival thickness may be achieved when the graft is used.
Assuntos
Materiais Biocompatíveis/uso terapêutico , Colágeno/uso terapêutico , Gengivoplastia/métodos , Retalhos Cirúrgicos , Adulto , Feminino , Seguimentos , Gengiva/patologia , Bolsa Gengival/patologia , Bolsa Gengival/cirurgia , Retração Gengival/patologia , Retração Gengival/cirurgia , Humanos , Queratinas , Masculino , Perda da Inserção Periodontal/patologia , Perda da Inserção Periodontal/cirurgia , Estudos Prospectivos , Retalhos Cirúrgicos/patologia , Resultado do TratamentoRESUMO
The purposes of this study were to compare the gingival blood flow (GBF) in test sites (teeth retaining fixed partial dentures) and control sites (contralateral natural teeth) and investigate whether there is any relationship between clinical indices and GBF values. Twelve healthy subjects (6 females and 6 males) aged 20 to 54 years were enrolled this study. The GBF was measured from the middle point of the marginal gingiva in the test and control sites using laser Doppler flowmetry (LDF). Additionally, plaque index, gingival index and probing depth measurements were recorded. Statistically significant difference (p<0.05) was found between the test and control sites for marginal GBF. In contrast, no significant difference (p>0.05) was found between test and control sites with respect to the clinical indices, except for plaque index. The findings of this study suggest that there is a significant relation between resin-bonded fixed partial dentures with margins located subgingivally and marginal GBF. Clinical indices are helpful to collect information about the clinical health status of gingival tissues, but GBF is a good tool to measure gingival tissue blood flow and assess periodontal health. In conclusion, laser Doppler flowmetry can be used together with clinical indices to evaluate the marginal gingival health.
Assuntos
Gengiva/irrigação sanguínea , Fluxometria por Laser-Doppler , Adulto , Dente Suporte , Índice de Placa Dentária , Prótese Parcial Fixa , Feminino , Hemorragia Gengival/classificação , Bolsa Gengival/classificação , Gengivite/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Fluxo Sanguíneo Regional/fisiologiaRESUMO
The purposes of this study were to compare the gingival blood flow (GBF) in test sites (teeth retaining fixed partial dentures) and control sites (contralateral natural teeth) and investigate whether there is any relationship between clinical indices and GBF values. Twelve healthy subjects (6 females and 6 males) aged 20 to 54 years were enrolled this study. The GBF was measured from the middle point of the marginal gingiva in the test and control sites using laser Doppler flowmetry (LDF). Additionally, plaque index, gingival index and probing depth measurements were recorded. Statistically significant difference (p<0.05) was found between the test and control sites for marginal GBF. In contrast, no significant difference (p>0.05) was found between test and control sites with respect to the clinical indices, except for plaque index. The findings of this study suggest that there is a significant relation between resin-bonded fixed partial dentures with margins located subgingivally and marginal GBF. Clinical indices are helpful to collect information about the clinical health status of gingival tissues, but GBF is a good tool to measure gingival tissue blood flow and assess periodontal health. In conclusion, laser Doppler flowmetry can be used together with clinical indices to evaluate the marginal gingival health.
Os objetivos deste estudo foram comparar o fluxo sangüíneo gengival (FSG) em sítios teste (dentes retentores de próteses parciais fixas) e sítios controle (dentes naturais contralaterais) e investigar se há alguma relação entre os índices clínicos (IC) e os valores de FSG. Doze indivíduos saudáveis (6 mulheres e 6 homens) com idades entre 20 a 54 anos participaram deste estudo. O FSG foi medido no ponto médio da gengina marginal em ambos os sítios teste e controle utilizando dopplerfluxometria a laser (DFL). Além disso, as medidas referentes ao índice de placa, índice gengival e profundidade de sondagem foram registradas. Foi observada diferença estatisticamente significante (p<0.05) entre os grupos teste e controle para os valores de FSG. Por outro lado, não houve diferença estatisticamente significante (p>0.05) entre os sítios teste e controle com relação aos índices clínicos, exceto para o índice de placa. Os achados deste estudo sugerem que existe uma relação significante entre próteses parciais fixas retidas por resina com margens localizadas subgengivalmente e o FSG marginal. Embora os índices clínicos sejam úteis para coletar informações sobre as condições clínicas dos tecidos gengivais, o FSG é uma ferramenta importante para medir o fluxo sanguíneo tissular gengival e avaliar a saúde periodontal. Em conclusão, a dopplerfluxometria a laser pode ser usada juntamente com índices clínicos para avaliar a saúde gengival marginal.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gengiva/irrigação sanguínea , Fluxometria por Laser-Doppler , Dente Suporte , Índice de Placa Dentária , Prótese Parcial Fixa , Hemorragia Gengival/classificação , Bolsa Gengival/classificação , Gengivite/classificação , Índice Periodontal , Fluxo Sanguíneo Regional/fisiologiaRESUMO
BACKGROUND AND OBJECTIVE: As the periodontal lesion develops, the junctional epithelium migrates apically in conjunction with the dissolution of the most coronal Sharpey's fibers. Because matrix metalloproteinase-9 (MMP-9) has been identified in migrating epithelial cells and invading tumors, we propose that this enzyme is produced by gingival keratinocytes in advanced periodontal lesions. METHODS: To test this idea, biopsies of inflamed gingival tissues were obtained from patients with advanced periodontitis. Healthy gingival tissue samples were utilized as controls. The presence and activity of MMP-9 was evaluated by combining indirect immunofluorescence of gingival tissue samples and gelatin zymography of gingival epithelium separated from connective tissue. RESULTS AND CONCLUSIONS: The staining pattern showed the presence of MMP-9 in junctional and pocket gingival epithelial cells, polymorphonuclear neutrophils (PMNs) and as a scattered deposit along connective tissues of periodontitis-affected gingival tissues. Gelatin zymography permitted the identification of pro-MMP-9 in surcular/pocket epithelium derived from inflamed gingival tissues. Lower levels of MMP-9 were detected in epithelium not exposed to inflammation. These observations suggest a role for MMP-9 in gingival epithelial response to periodontal infection.
Assuntos
Gengiva/enzimologia , Metaloproteinase 9 da Matriz/análise , Periodontite/enzimologia , Adulto , Idoso , Tecido Conjuntivo/enzimologia , Eletroforese em Gel de Poliacrilamida , Inserção Epitelial/enzimologia , Células Epiteliais/enzimologia , Epitélio/enzimologia , Técnica Indireta de Fluorescência para Anticorpo , Bolsa Gengival/enzimologia , Humanos , Queratinócitos/enzimologia , Pessoa de Meia-Idade , Neutrófilos/enzimologia , Bolsa Periodontal/enzimologiaRESUMO
The aim of this study was to identify the presence of superinfecting microorganisms (Gram-negative enteric rods and Candida sp.) in heart transplant patients and correlate this with gingival overgrowth. Thirty patients (10 females, 20 males--mean age 45 years) were examined. All were under cyclosporin-A (CsA) therapy. Patients who had taken any antibiotics 3 months prior the study or had been submitted to periodontal therapy were not enrolled. Patients were required to have at least 6 teeth. The plaque index (PI), gingival index (GI), pocket depth (PD) and clinical attachment level (CAL) were recorded. Microbiological samples were taken from sulcus/pocket (s/p) and from stimulated saliva (ss) and submitted to analysis. Patients were divided into two groups: the ones with gingival overgrowth (GO) and those without gingival overgrowth (WGO). After statistical analysis (chi-square test, Student's t-test, Fisher test, p < or = 0.05), we concluded that there was no statistical difference between groups in the parameters of gender, CsA dosage, time since transplantation, PI, GI, PD and CAL. Gram-negative rods from either the sulcus/pocket or saliva samples were not found. Candida sp. was detected (s/p-30% and ss-30%). Stimulated saliva samples analysis determined that the presence of Candida sp. was associated with patients without gingival overgrowth.