RESUMO
Objective: This study aims to analyze the survival time of molar tooth according to furcation involvement (FI) classification among periodontally treated patients under a supportive periodontal care program. Materials and Methods: A retrospective study was con-ducted among 77 periodontitis patients with 240 molars who had undergone periodontal therapy that were followed up with supportive periodontal therapy (SPT) for at least five years. Periodontitis patients' data were retrieved from the periodontic clinical record. The clinical parameters of all involved molars and treatment modality were recorded at baseline and SPT. Results: A total of 69 (28.8%) molars were extracted during active periodontal therapy, while 17 (7.1%) were lost during SPT. The 5-year survival rate of molars was 83.5% (95% confidence interval [CI], 76.9-88.4) for FI=0 (n=141), 81.0% (95% CI, 56.9-92.4) for FI=I (n=18), 50.0% (95% CI, 33.8-64.2) for FI=II (n=21), and 25.0% (95% CI, 6.9-48.8) for FI=III (n=4). Additionally, the 10-year survival rate for molars with FI = III was 12.5% (95% CI, 1.0-39.2), which was lower than that of molars with FI = 0 (77.1%; 95% CI, 69.7-83.0). Conclusions: The presence of a high degree of FI classifica-tion, especially Class III, is associated with a lower survival rate of molars among periodontally treated patients. Retention of molars is possible on a long-term basis through a maintenance program of periodontal therapy.
Objetivo: Este estudio tiene como objetivo analizar el tiempo de supervivencia de los molares según la clasificación de implicación de la furcación (IF) entre pacientes tratados periodontalmente bajo un programa de cuidado periodontal de apoyo. Materiales y Métodos: Se realizó un estudio retrospectivo entre 77 pacientes con periodontitis con 240 molares que habían sido sometidos a terapia periodontal y fueron seguidos con terapia periodontal de soporte (TPS) durante al menos cinco años. Los datos de los pacientes con periodontitis se recuperaron de la Historia Clínica de Periodoncia. Los parámetros clínicos de todos los molares involucrados y la modalidad de tratamiento se registraron al inicio y en el TPS. Resultado: Se extrajeron un total de 69 (28,8%) molares durante la terapia periodontal activa, mientras que 17 (7,1%) se perdieron durante la TPS. La tasa de supervivencia de los molares a 5 años fue del 83,5% (intervalo de confianza [IC] del 95%, 76,9-88,4) para FI=0 (n=141), del 81,0% (IC del 95%, 56,9-92,4) para FI=I ( n=18), 50,0% (IC 95%, 33,8-64,2) para FI=II (n=21) y 25,0% (IC 95%, 6,9-48,8) para FI=III (n=4). Además, la tasa de supervivencia a 10 años para los molares con FI = III fue del 12,5 % (IC del 95 %, 1,0-39,2), que fue inferior a la de los molares con FI = 0 (77,1 %; IC del 95 %, 69,7-83,0). Conclusión: La presencia de un alto grado de clasificación FI, especialmente Clase III, se asocia con una menor tasa de supervivencia de los molares entre los pacientes tratados periodontalmente. La retención de los molares es posible a largo plazo mediante un programa de mantenimiento de terapia periodontal.
Assuntos
Humanos , Masculino , Feminino , Perda de Dente/etiologia , Defeitos da Furca/patologia , Dente Molar/patologia , Periodontite , Estudos Retrospectivos , Malásia/epidemiologiaRESUMO
ABSTRACT Objective: To assess the effectiveness of platelet-rich fibrin (PRF) with decalcified freeze-dried bone allograft (DFDBA) compared to DFDBA alone in mandibular grade-II furcation defects. Material and Methods: A quasi-experimental study was conducted on nine patients with chronic periodontitis, each having two almost identical mandibular grade II furcation defects. Test sites (left mandibular first molars) were treated with open flap debridement (OFD), DFDBA, and PRF, whereas control sites (right mandibular first molars) received OFD and DFDBA alone. Clinical parameters (plaque index (PI), gingival index (GI), vertical clinical attachment level (VCAL) and horizontal clinical attachment level (HCAL) into the furcation defect) and radiographic measurements (mean alveolar bone defect) were done at baseline and after six months postoperatively. Results: The gain in relative horizontal clinical attachment level (RHCAL) in the test sites was 2.94±0.52 mm compared to 1.33±0.35 mm in control sites (p=0.01). Improvement in mean alveolar bone defect (MABD) (was 1.21±0.5 mm2 at test sites compared to 1.15±0.7 mm2 at control sites) probing pocket depth (PPD), recession, relative vertical attachment level (RVCAL), and percentage of bone fill was found in the test sites compared to control, which statistically insignificant. Conclusion: The test sites had better outcomes than control sites, which was significant for the parameter RHCAL. Therefore, combining the biological benefits of autologous PRF with DFDBA is an efficient and economical treatment modality for the management of mandibular grade II furcation defects.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Fator de Crescimento Derivado de Plaquetas , Defeitos da Furca/patologia , Periodontite Crônica/patologia , Aloenxertos , Estatísticas não Paramétricas , Ensaios Clínicos Controlados não Aleatórios como AssuntoRESUMO
Root resection (RR) is a therapeutic option for furcation lesions grade II and III, fracture of one of the roots and root caries. The aim of the study was to evaluate in each selected period (5, 8 and 10 years) the percentage of maintenance of molars that underwent RR therapy with furcation lesions grade II and III or with root fractures. Subjects received the therapy with RR in molars with periodontitis, with furcation lesion grades II or III, and with fractures, caries or endodontic reason, in one of the roots. The supportive periodontal therapy was made for at least one annual session during the assessed time. For the clinical therapy to be considered successful, the tooth is remaining in functional loading, without mobility above grade I, pocket depth ≥ 4 mm, absence of bleeding on probing or exudate, fractures and root caries. Were evaluated the files of 37 patients, 15 males and 22 females, with a mean age of 51.4 (SD = ± 12.46), with a total of 44 teeth with RR, 27 upper and 17 lower molars. The survival rates after the RR was 97.73 % for 05 years of evaluation (44 teeth), 95.35 % for the 08 years (43 teeth) and 97.57 % for the 10 years (41 teeth). 35 teeth were restored with total crows isolated or abutment of fixed prosthesis. The survival rates after 10-years was 90.91 %, and there was no statistical difference between the types of restorations performed and the tooth survival rate.
La resección de la raíz (RR) es una opción terapéutica para lesiones de furca de grado II y III, fractura de una de las raíces y caries de la raíz. El objetivo del estudio fue evaluar en cada período seleccionado (5, 8 y 10 años) el porcentaje de mantenimiento de los molares que se sometieron a terapia RR con lesiones de furca de grado II y III o con fracturas de raíz. Los sujetos recibieron la terapia con RR en molares con periodontitis, con lesión de furca de grado II o III, y con fracturas, caries o razón endodóntica, en una de las raíces. La terapia periodontal de apoyo se realizó durante al menos una sesión anual durante el tiem- po evaluado. Para que la terapia clínica se considere exitosa, el diente permanece en carga funcional, sin movilidad por encima del grado I, profundidad de bolsillo ≥ 4 mm, ausencia de sangrado al sondaje o exudado, fracturas y caries de raíz. Se evaluaron los archivos de 37 pacientes, 15 hombres y 22 mujeres, con una edad média de 51,4 (DE = ± 12,46), con un total de 44 dientes con RR, 27 molares superiores y 17 inferiores. Las tasas de supervivencia después del RR fueron del 97,73 % durante 5 años de evaluación (44 dientes), 95,35 % para los 8 años (43 dientes) y 97,57% para los 10 años (41 dientes). Se restauraron 35 dientes con cuervos totales aislados los pilares de prótesis fija. Las tasas de supervivencia después de 10 años fueron del 90,91 %, y no hubo diferencia estadística entre los tipos de restauraciones realizadas y la tasa de supervivencia dental.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Raiz Dentária/cirurgia , Defeitos da Furca/cirurgia , Dente Molar/cirurgia , Fraturas dos Dentes/cirurgia , Resultado do Tratamento , Prótese Dentária , Defeitos da Furca/patologia , Ápice Dentário , Periodontite Crônica/cirurgia , Movimento Mesial dos DentesRESUMO
INTRODUCTION: The purpose of this study was to evaluate the in vivo response of periradicular tissues after sealing of furcation perforations with Biodentine, mineral trioxide aggregate (MTA), and gutta-percha by means of histopathologic and indirect immunofluorescence analyses. METHODS: Thirty teeth of 3 dogs were divided into 3 groups: Biodentine (n = 14 teeth), MTA (negative control, n = 10 teeth), and gutta-percha (positive control, n = 6 teeth). After endodontic treatment, perforations were made on the center of the pulp chamber floor and filled with the materials. After 120 days, the animals were killed, and blocks containing the teeth and periradicular tissues were processed histotechnically for histopathologic semiquantitative (new mineralized tissue formation and bone resorption at the perforation site) and quantitative (thickness and area of newly formed mineralized tissue and number of inflammatory cells) analyses and RUNX2 immunofluorescence assay. Data were analyzed by χ2, Fisher exact test, Mann-Whitney test, one-way analysis of variance, Kruskal-Wallis test, and Dunn posttest (α = 0.05). RESULTS: MTA and Biodentine induced the formation of significantly more new mineralized tissue (P < .0001) than gutta-percha, which did not induce the formation of mineralized tissue in any case. Complete sealing of the perforations was more frequent with MTA, which formed mineralized tissue with greater thickness and area. Biodentine and MTA exhibited no bone resorption in the furcation region, fewer inflammatory cells, and greater RUNX2 immunostaining intensity than gutta-percha. CONCLUSIONS: Although MTA presented higher frequency of complete sealing and greater thickness and area of newly formed mineralized tissue, Biodentine also had good histopathologic results and can be considered as an adequate furcation perforation repair material.
Assuntos
Compostos de Cálcio/farmacologia , Cavidade Pulpar/patologia , Defeitos da Furca/terapia , Agentes de Capeamento da Polpa Dentária e Pulpectomia/farmacologia , Silicatos/farmacologia , Compostos de Alumínio/farmacologia , Animais , Cavidade Pulpar/efeitos dos fármacos , Cães , Combinação de Medicamentos , Técnica Indireta de Fluorescência para Anticorpo , Defeitos da Furca/patologia , Guta-Percha/farmacologia , Óxidos/farmacologia , Periodonto/efeitos dos fármacos , Periodonto/patologiaRESUMO
BACKGROUND AND OBJECTIVE: Occlusal trauma (OT) and smoking are both factors that alter alveolar bone metabolism and therefore could synergistically act on alveolar bone loss. The aim of this experimental study was to evaluate the influence of short-term cigarette smoke inhalation (CSI) on inter-radicular alveolar bone loss promoted by primary OT in a rat model. MATERIAL AND METHODS: Forty-eight animals were randomly assigned to one of three groups based on treatment type: OT + CSI (n = 16), animals were exposed to CSI three times per day, for 8 min per exposure, and they concomitantly received unilateral vertical augmentation creating an occlusal interference inducing experimental OT; OT (n = 16), animals received only unilateral vertical augmentation; negative control (NC; n = 16), animals maintained for equal periods to achieve periodontal baseline values of periodontal ligament dimension. Each group was divided into two subgroups (n = 8) based on treatment length: 7 or 14 d. RESULTS: After 7 d, the OT + CSI group exhibited significantly higher bone loss compared to the NC group (p = 0.0022). After 14 d, the OT (p < 0.0001) and OT + CSI (p < 0.0001) groups presented significantly higher bone loss compared to the NC group, and OT + CSI resulted in significantly higher bone loss than OT alone (p = 0.0241). The number of tartrate-resistant acid phosphatase-positive cells on the linear surface of the bone crest after 7 d was significantly higher in the OT + CSI group as compared to the NC and OT groups (p < 0.0001 and p = 0.0045, respectively) and remained significantly higher in the OT + CSI group after 14 d, compared to the OT group (p < 0.0001). CONCLUSION: Short-term CSI increases early bone loss in association with OT after 7 d, and this worsens in severity after 14 d of exposure.
Assuntos
Perda do Osso Alveolar/etiologia , Oclusão Dentária Traumática/complicações , Fumar/efeitos adversos , Fosfatase Ácida/análise , Perda do Osso Alveolar/patologia , Processo Alveolar/patologia , Animais , Biomarcadores/análise , Modelos Animais de Doenças , Progressão da Doença , Defeitos da Furca/etiologia , Defeitos da Furca/patologia , Isoenzimas/análise , Masculino , Distribuição Aleatória , Ratos , Ratos Wistar , Fosfatase Ácida Resistente a Tartarato , Fatores de TempoRESUMO
OBJECTIVE: This study was designed to evaluate the potential adjunctive benefits of platelet-rich plasma (PRP) when used with guided-tissue regeneration (GTR) and bioactive glass (BG) in the treatment of Class II furcation lesions. MATERIAL AND METHODS: Bilateral Class II furcation lesions were surgically created and allowed to become chronic in the mandibular third premolars of 9 dogs. The defects were randomly assigned to: A) GTR+BG and B) GTR+BG+PRP. Similar defects were created in the maxillary third premolars and received the same treatments after 45 days. Dogs were sacrificed 90 days after the first treatment. The histometric parameters evaluated were: connective tissue adaptation, new cementum, new bone, mineralized bone area, non-mineralized bone area, and residual BG particle area. RESULTS: Data analysis showed a superior length of new cementum and a greater mineralized bone area for group B in both periods (p<0.05). The non-mineralized bone area was greater in the control group (p<0.05) in both periods. CONCLUSION: Within the limits of this study, it can be concluded that the use of PRP in the treatment of Class II furcation defects may enhance the amount of new cementum and provide a more mineralized bone in a shorter period of time.
Assuntos
Cerâmica/uso terapêutico , Defeitos da Furca/cirurgia , Regeneração Tecidual Guiada Periodontal/métodos , Plasma Rico em Plaquetas , Animais , Regeneração Óssea/fisiologia , Substitutos Ósseos/uso terapêutico , Cães , Feminino , Defeitos da Furca/patologia , Modelos Animais , Doenças Periodontais/cirurgia , Distribuição Aleatória , Fatores de Tempo , CicatrizaçãoRESUMO
OBJECTIVE: This study was designed to evaluate the potential adjunctive benefits of platelet-rich plasma (PRP) when used with guided-tissue regeneration (GTR) and bioactive glass (BG) in the treatment of Class II furcation lesions. MATERIAL AND METHODS: Bilateral Class II furcation lesions were surgically created and allowed to become chronic in the mandibular third premolars of 9 dogs. The defects were randomly assigned to: A) GTR+BG and B) GTR+BG+PRP. Similar defects were created in the maxillary third premolars and received the same treatments after 45 days. Dogs were sacrificed 90 days after the first treatment. The histometric parameters evaluated were: connective tissue adaptation, new cementum, new bone, mineralized bone area, non-mineralized bone area, and residual BG particle area. RESULTS: Data analysis showed a superior length of new cementum and a greater mineralized bone area for group B in both periods (p<0.05). The non-mineralized bone area was greater in the control group (p<0.05) in both periods. CONCLUSION: Within the limits of this study, it can be concluded that the use of PRP in the treatment of Class II furcation defects may enhance the amount of new cementum and provide a more mineralized bone in a shorter period of time.
Assuntos
Animais , Cães , Feminino , Cerâmica/uso terapêutico , Defeitos da Furca/cirurgia , Regeneração Tecidual Guiada Periodontal/métodos , Plasma Rico em Plaquetas , Regeneração Óssea/fisiologia , Substitutos Ósseos/uso terapêutico , Defeitos da Furca/patologia , Modelos Animais , Doenças Periodontais/cirurgia , Distribuição Aleatória , Fatores de Tempo , CicatrizaçãoRESUMO
UNLABELLED: Furcation involvement in periodontal disease has been a challenge for the dentist. OBJECTIVE: The aim of this study was to investigate root dimensions in the furcation area of 233 mandibular first molars. MATERIAL AND METHODS: Digital photomicrographs were used to obtain the following measurements on the buccal and lingual surfaces of each tooth: root trunk height (RT), horizontal interadicular distance obtained 1 mm (D1) and 2 mm (D2) below the fornix and interadicular angle (IA). RESULTS: Mean ± standard deviation of buccal and lingual furcation measurements were, respectively, 1.37 ± 0.78 mm and 2.04 ± 0.89 mm for RT; 0.86 ± 0.39 mm and 0.71 ± 0.42 mm for D1; 1.50 ± 0.48 mm and 1.38 ± 0.48 mm for D2; 41.68 ± 13.20° and 37.78 ± 13.18° for IA. Statistically significant differences were found between all measured parameters for buccal and lingual sides (p<0.05, paired t test). CONCLUSIONS: In conclusion, the lingual furcation of mandibular first molars presented narrower entrance and longer root trunk than the buccal furcation, suggesting more limitation for instrumentation and worse prognosis to lingual furcation involvements in comparison to buccal lesions.
Assuntos
Defeitos da Furca/patologia , Dente Molar/anatomia & histologia , Raiz Dentária/anatomia & histologia , Humanos , Mandíbula , Odontometria , Tamanho do Órgão , Valores de ReferênciaRESUMO
Furcation involvement in periodontal disease has been a challenge for the dentist. OBJECTIVE: The aim of this study was to investigate root dimensions in the furcation area of 233 mandibular first molars. MATERIAL AND METHODS: Digital photomicrographs were used to obtain the following measurements on the buccal and lingual surfaces of each tooth: root trunk height (RT), horizontal interadicular distance obtained 1 mm (D1) and 2 mm (D2) below the fornix and interadicular angle (IA). RESULTS: Mean± standard deviation of buccal and lingual furcation measurements were, respectively, 1.37±0.78 mm and 2.04±0.89 mm for RT; 0.86±0.39 mm and 0.71±0.42 mm for D1; 1.50±0.48 mm and 1.38±0.48 mm for D2; 41.68±13.20° and 37.78±13.18° for IA. Statistically significant differences were found between all measured parameters for buccal and lingual sides (p<0.05, paired t test). CONCLUSIONS: In conclusion, the lingual furcation of mandibular first molars presented narrower entrance and longer root trunk than the buccal furcation, suggesting more limitation for instrumentation and worse prognosis to lingual furcation involvements in comparison to buccal lesions.
Assuntos
Humanos , Defeitos da Furca/patologia , Dente Molar/anatomia & histologia , Raiz Dentária/anatomia & histologia , Mandíbula , Odontometria , Tamanho do Órgão , Valores de ReferênciaRESUMO
OBJECTIVES: To evaluate the influence of furcation anatomy and bone defect morphology on the treatment of Class II proximal furcations treated with enamel matrix derivative (EMD) proteins. METHOD AND MATERIALS: Eighteen Class II proximal furcations were treated with open-flap debridement + 24% EDTA conditioning + EMD proteins. Probing depth, gingival margin position, relative vertical and horizontal clinical attachment level, and vertical and horizontal bone levels were evaluated immediately before and 6 months after the surgeries. The changes in these parameters were correlated with vertical defect depth, number of walls, depth defect, interdental distance, root divergence, furcation distance, horizontal measure, root trunk, and furcation height, using the Pearson and Spearman rank correlation tests (a = 5%). RESULTS: The depth defect correlated with gingival margin position (r = 0.52; P = .03), probing depth (r = 0.63; P = .005), and horizontal bone level (r = -0.46; P = .05). The furcation height also correlated with gingival margin position (r = 0.53; P = .02) and horizontal bone level (r = -0.57; P = .01). Moreover, the number of walls of vertical defect positively influenced relative vertical clinical attachment level (r = 0.47; P = .05). CONCLUSIONS: Within the limits of this study, furcation anatomy and defect morphology influence the clinical response of EMD protein therapy in Class II proximal furcation involvements.
Assuntos
Proteínas do Esmalte Dentário/uso terapêutico , Defeitos da Furca/classificação , Regeneração Tecidual Guiada Periodontal/métodos , Condicionamento Ácido do Dente/métodos , Adulto , Perda do Osso Alveolar/patologia , Perda do Osso Alveolar/cirurgia , Quelantes/uso terapêutico , Periodontite Crônica/patologia , Periodontite Crônica/cirurgia , Desbridamento , Ácido Edético/uso terapêutico , Feminino , Seguimentos , Defeitos da Furca/patologia , Defeitos da Furca/cirurgia , Gengiva/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Dente Molar/patologia , Perda da Inserção Periodontal/patologia , Perda da Inserção Periodontal/cirurgia , Bolsa Periodontal/patologia , Bolsa Periodontal/cirurgia , Estudos Prospectivos , Retalhos Cirúrgicos , Raiz Dentária/patologia , Resultado do TratamentoRESUMO
Introdução - O presente estudo avaliou a influência de diferentes soluções irrigadoras na capacidade seladora do MTA quando utilizado em perfurações na região de furca de molares inferiores extraídos. Material e Métodos - Trinta molares inferiores humanos foram submetidos à abertura endodôntica convencional e tiveram o centro do assoalho perfurado propositalmente com broca esférica diamantada. Os espécimes foram divididos em 3 grupos (n = 10) de acordo com as soluções utilizadas: G1-soro fisiológico; G2-NaOCl a 1% e G3-EDTA 17%. Foi realizado o preenchimento da perfuração com MTA Angelus cinza e o selamento coronário provisório. Em seguida,realizou-se a impermeabilização da superfície externa, exceto na região de furca, e imersão em corante nanquim por 72 horas. A mensuração, em milímetros, da infiltração linear foi realizada por meio do software Image Tool. Resultados - Os resultados demonstraram que a solução de EDTA 17% permitiu menor infiltração, sendo estatisticamente diferente do NaOCl a 1% e do soro fisiológico(p < 0,05). Conclusão - De acordo com os resultados, pode-se concluir que a solução de EDTA parece ser a melhor escolha para irrigação final em casos de perfuração de furca.
Introduction - This study assessed the influence of different final irrigation on the sealing ability of MTA-Angelus in furcal perforations of extracted human molar teeth. Material and Methods - Thirty human mandibular molars were conventionally accessed and perforations were purposely created in the center of the pulp chamber floor by using a round diamond bur. The specimens were divided into 3 groups (n = 10) according to the irrigation: G1-saline solution; G2-1% sodium hypochlorite; G3-17% EDTA. Teeth were repaired with Angelus'gray MTA and the crowns were sealed.Then the impermeabilization of the external surface was made except in the furcal region, and they were immersed into Indian Ink for 72 hours. The leakage was measured, in millimeters, by Image Tool software. Results - The results showed lower leakage index for EDTA group that was statistically different from 1% NaOCl and saline solution groups (p < 0.05). Conclusion - According to results it can be concluded that in cases of furcal perforation EDTA solution seems to be the best choice of final irrigation.
Assuntos
Defeitos da Furca/patologia , Irrigantes do Canal Radicular/análise , Materiais Restauradores do Canal Radicular/análiseRESUMO
BACKGROUND: The authors conducted a study to evaluate the radiographic characteristics of Class II mandibular furcation involvements as prognostic indicators of healing after nonsurgical periodontal therapy. METHODS: Twenty-three patients with chronic periodontitis (Class II furcation involvements in mandibular molars, probing pocket depth [PPD] of 5 millimeters or greater and bleeding on probing [BOP]) were selected to receive nonsurgical periodontal treatment. The authors evaluated visible plaque index, BOP, position of the gingival margin, PPD, relative attachment level (RAL) and relative horizontal attachment level. On radiographs, the authors measured root trunk, bone attachment level in the furcation region, lesion height (Lh), furcation width at alveolar crest level inside furcation (Fw) and 2 mm apical to the fornix (Fw2), and the perpendicular distance from the horizontal line connecting mesial and distal radiographic alveolar crest to furcation fornix. They analyzed all data using linear multiple regression. RESULTS: Six months after treatment, the furcations showed a mean RAL gain of 1.08 mm (+/- 1.25 mm) and a PPD decrease of 2.74 mm (+/- 1.58 mm). The authors found a statistically significant influence between Fw and PPD (P = .0044), Fw2 and PPD (P = .0014), Lh and PPD (P = .0241), and Fw2 and RAL (P = .0037). CONCLUSIONS: Within the limitations of this study, the results suggest that Fw, Fw2 and Lh may influence the response of Class II mandibular furcations to nonsurgical periodontal therapy and may serve as prognostic indicators for this therapy. Thus, narrower and shorter root furcations would be expected to have better outcomes.
Assuntos
Periodontite Crônica/terapia , Raspagem Dentária , Defeitos da Furca/diagnóstico por imagem , Defeitos da Furca/terapia , Adulto , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/terapia , Desbridamento , Índice de Placa Dentária , Raspagem Dentária/instrumentação , Defeitos da Furca/patologia , Humanos , Modelos Lineares , Mandíbula , Pessoa de Meia-Idade , Dente Molar , Índice Periodontal , Prognóstico , Radiografia , Aplainamento Radicular/instrumentação , Terapia por UltrassomRESUMO
BACKGROUND AND OBJECTIVE: Recent studies have pointed to potentially periodontal risk indicators, however no information is available on the impact of changes in thyroid hormone levels on the progression of periodontitis and on the quality of alveolar bone. Thus, the aim of the present study was to evaluate histologically, in rats, the influence of thyroid hormones on the rate of periodontal bone loss resulting from ligature placement and on the quality of tooth-supporting alveolar bone. MATERIAL AND METHODS: Thirty-six male Wistar rats were randomly assigned to the following groups: healthy (control, n = 12), hypothyroidism (n = 12) and hyperthyroidism (n = 12). Once alterations were confirmed by total serum levels of triiodothyronine and thyroxine, ligatures were randomly placed around one of the first mandibular molars. Thirty days later, the animals were killed and specimens routinely processed for serial decalcified sections. The parameters assessed were periodontitis-related bone loss, quality of tooth-supporting alveolar bone and the number of cells positive for tartrate-resistant acid phosphatase (TRAP), a marker of bone resorption. RESULTS: At the ligated sites, intergroup analysis revealed that hypothyroidism significantly increased the bone loss resulting from ligature-induced periodontitis (p = 0.02) and the number of TRAP-positive cells on the linear surface of bone crest (p = 0.01). In addition, no significant differences were detected regarding the quality of the bone (p = 0.24) or the number of TRAP-positive cells in the area of the interradicular bone for ligated teeth among the groups (p = 0.17). CONCLUSION: It may be concluded that decreased serum levels of thyroid hormones may enhance periodontitis-related bone loss, as a function of an increased number of resorbing cells, whereas the tooth-supporting alveolar bone seems to be less sensitive to alterations in hormone levels.
Assuntos
Perda do Osso Alveolar/etiologia , Processo Alveolar/patologia , Periodontite/complicações , Hormônios Tireóideos/fisiologia , Fosfatase Ácida/análise , Perda do Osso Alveolar/patologia , Animais , Biomarcadores/análise , Densidade Óssea/fisiologia , Progressão da Doença , Defeitos da Furca/etiologia , Defeitos da Furca/patologia , Gengivite/etiologia , Gengivite/patologia , Hipertireoidismo/complicações , Hipotireoidismo/complicações , Isoenzimas/análise , Masculino , Periodontite/patologia , Distribuição Aleatória , Ratos , Ratos Wistar , Fosfatase Ácida Resistente a Tartarato , Tiroxina/sangue , Tri-Iodotironina/sangueRESUMO
BACKGROUND: Although some studies have reported a negative influence of caffeine on bone metabolism, there is no information about its effect on the progression of periodontitis. The aim of this study was to evaluate the effect of high doses of caffeine on ligature-induced periodontitis in rats. METHODS: Twenty-two Wistar rats were assigned to one of the following groups: non-caffeine group (n = 12) = animals without caffeine ingestion; caffeine group (n = 10) = animals ingesting 10 mg/100 g body weight/day of caffeine via drinking water for 56 days. Two weeks after the beginning of caffeine intake, one of the mandibular molar was randomly assigned to receive a ligature, whereas the contralateral molar was left unligated. Forty-two days later, the animals were sacrificed, and the specimens were processed to obtain decalcified sections. The area of periodontal ligament and/or bone loss in the furcation region of the first molars was histometrically determined. RESULTS: Caffeine intake did not have a direct effect on the alveolar bone loss in unligated teeth. But on the ligated tooth, a greater area of bone loss was observed in the animals that ingested caffeine compared to those that did not (P <0.05). CONCLUSION: The present study demonstrated that daily intake of high doses of caffeine may enhance ligature-induced periodontitis progression.
Assuntos
Perda do Osso Alveolar/fisiopatologia , Cafeína/administração & dosagem , Estimulantes do Sistema Nervoso Central/administração & dosagem , Periodontite/fisiopatologia , Perda do Osso Alveolar/etiologia , Perda do Osso Alveolar/patologia , Processo Alveolar/efeitos dos fármacos , Processo Alveolar/patologia , Processo Alveolar/fisiopatologia , Animais , Cafeína/farmacologia , Estimulantes do Sistema Nervoso Central/farmacologia , Progressão da Doença , Defeitos da Furca/etiologia , Defeitos da Furca/patologia , Defeitos da Furca/fisiopatologia , Ligadura/instrumentação , Masculino , Ligamento Periodontal/efeitos dos fármacos , Ligamento Periodontal/patologia , Ligamento Periodontal/fisiopatologia , Periodontite/etiologia , Periodontite/patologia , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
AIM: To assess orthodontic intrusion effects on periodontal tissues in dogs' pre-molars with class III furcations treated with open flap debridement (OFD) or with guided tissue regeneration (GTR) associated to bone autograft (BA). MATERIAL AND METHODS: Class III furcations were created in the pre-molars of seven mongrel dogs. After 75 days, teeth were randomly treated with OFD or GTR/BA. After 1 month, metallic crowns were assembled on pre-molars and connected apically to mini-implants by nickel-titanium springs. Teeth were randomly assigned to orthodontic intrusion (OFD+I and GTR/BA+I) groups or no movement (OFD and GTR/BA) groups. Dogs were sacrificed after 3 months of movement and 1 month retention. RESULTS: All class III furcations were closed or reduced to class II or I in the intrusion groups, while 50% of the lesions in non-moved teeth remained unchanged. Intruded teeth presented higher probing depth and lower gingival marginal level than non-moved teeth (p<0.01). Clinical attachment gain was reduced in the intrusion groups by the end of retention (p<0.05). OFD+I presented smaller soft tissue area and larger bone tissue area than other groups (p<0.05). CONCLUSION: Orthodontic intrusion with anchorage via mini-implants improved the healing of class III furcation defects after OFD in dogs. GTR/BA impaired those results.
Assuntos
Dente Pré-Molar/cirurgia , Transplante Ósseo/métodos , Defeitos da Furca/cirurgia , Regeneração Tecidual Guiada Periodontal/métodos , Retalhos Cirúrgicos , Técnicas de Movimentação Dentária/métodos , Processo Alveolar/patologia , Processo Alveolar/fisiopatologia , Animais , Dente Pré-Molar/fisiopatologia , Desbridamento , Cemento Dentário/patologia , Cemento Dentário/fisiopatologia , Cães , Defeitos da Furca/patologia , Defeitos da Furca/fisiopatologia , Retração Gengival/fisiopatologia , Retração Gengival/cirurgia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Aparelhos Ortodônticos , Contenções Ortodônticas , Fios Ortodônticos , Perda da Inserção Periodontal/fisiopatologia , Perda da Inserção Periodontal/cirurgia , Ligamento Periodontal/patologia , Ligamento Periodontal/fisiopatologia , Bolsa Periodontal/fisiopatologia , Bolsa Periodontal/cirurgia , Distribuição Aleatória , Estresse Mecânico , Fatores de Tempo , Técnicas de Movimentação Dentária/instrumentação , Transplante Autólogo , Resultado do TratamentoRESUMO
OBJECTIVE: The aim of the present randomized, double-blind study was to evaluate the clinical response of proximal furcations treated with enamel matrix derivative proteins (EMD). MATERIAL AND METHODS: Fifteen patients, each with a pair of contralateral class-II proximal furcation involvements, presenting probing depths (PDs) >/=5 mm and bleeding on probing (BOP) were selected. The patients were randomly assigned to: control group (n=15) - open flap debridement (OFD)+24% ethylenediaminetetraacetic acid (EDTA) conditioning; test group (n=15) - OFD+24% EDTA conditioning+EMD application. Plaque index (PI), BOP, PD, gingival margin position (GMP), relative vertical and horizontal clinical attachment level (RVCAL and RHCAL), vertical and horizontal bone level (VBL and HBL) and furcation closure were evaluated immediately before and 2, 4 and 6 months after the surgeries. RESULTS: At 6 months, the RVCAL gains of the control and test group were 0.39 +/- 1.00 and 0.54 +/- 0.95 mm, while the RHCAL gains were 1.21 +/- 2.28 and 1.36 +/- 1.26 mm (p>0.05). The VBL and HBL gains of the control group were 1.04 +/- 1.12 and 1.00 +/- 1.79 mm, and 0.82 +/- 1.82 and 1.17 +/- 1.38 mm for the test group (p>0.05). In addition, a statistical difference was observed in the number of the remaining class-II furcations between the test and control groups (p<0.05) in this period. CONCLUSION: It may be concluded that the use of EMD in proximal furcations did not promote a superior reduction in PD or a gain in clinical and osseous attachment levels, but resulted in a higher rate of class-II to class-I furcation conversion.
Assuntos
Proteínas do Esmalte Dentário/uso terapêutico , Defeitos da Furca/tratamento farmacológico , Defeitos da Furca/cirurgia , Análise de Variância , Quelantes/uso terapêutico , Método Duplo-Cego , Ácido Edético/uso terapêutico , Feminino , Defeitos da Furca/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
BACKGROUND: The purpose of this study was to evaluate acellular dermal matrix (ADM) as a membrane for guided tissue regeneration (GTR) in the treatment of mandibular Class II furcation lesions and to compare it to a bioabsorbable membrane. METHODS: Class II furcation lesions were created surgically and chronified in six mongrel dogs on the buccal surfaces of mandibular third and fourth premolars, bilaterally. After 1 month, GTR was performed. Each side was assigned randomly to the control group (CGr: bioabsorbable membrane made of polyglycolic acid: trimethylene carbonate) or the test group (TGr: ADM as a membrane). Clinical measurements of the width and thickness of the keratinized tissue (WKT and TKT, respectively) were made before GTR. The dogs were sacrificed 12 weeks following GTR, and histomorphometric analysis was performed. Area measurements were taken of new tissue, epithelium, connective tissue, and new bone; bone height and new cementum were measured. RESULTS: The formation of new bone, cementum, and periodontal ligament were similar in both groups. There were no statistically significant differences between the groups for any histomorphometric measurement. The TGr had a statistically significant increase in WKT and TKT after 3 months. The mean TKT gain was 1.03 mm for the TGr and 0.26 mm for the CGr (P <0.05). CONCLUSION: The ADM demonstrated histomorphometric results similar to the bioabsorbable membrane and resulted in a greater increase in the thickness of the keratinized tissue.
Assuntos
Implantes Absorvíveis , Materiais Biocompatíveis/uso terapêutico , Colágeno/uso terapêutico , Defeitos da Furca/terapia , Regeneração Tecidual Guiada Periodontal/métodos , Membranas Artificiais , Animais , Materiais Biocompatíveis/química , Dioxanos/uso terapêutico , Cães , Defeitos da Furca/patologia , Gengiva/efeitos dos fármacos , Gengiva/patologia , Gengiva/cirurgia , Mandíbula , Ácido Poliglicólico/uso terapêutico , Pele ArtificialRESUMO
BACKGROUND: The aim of this clinical trial was to compare the outcome of non-surgical treatment of interproximal and non-interproximal Class II furcation involvements. METHODS: Thirty-eight patients presenting at least one Class II furcation involvement that bled on probing with a probing depth (PD) > or = 5 mm were recruited. Furcation involvements were grouped as either buccal and lingual furcation involvements (BLFI) or interproximal furcation involvements (IFI). The following clinical outcomes were evaluated: visible plaque index, bleeding on probing (BOP), position of the gingival margin, relative attachment level (RAL), PD, and relative horizontal attachment level (RHAL). N-benzoyl-l-arginine-p-nitroanilide (BAPNA) testing was used to analyze trypsin-like activity in dental biofilm. All parameters were evaluated at baseline and 1, 3, and 6 months after non-surgical subgingival instrumentation. RESULTS: Six months after treatment, both groups had similar means of RAL and RHAL gain (P >0.05). These variables were 1.22 and 1.07 mm in the IFI group and 1.38 and 1.20 mm in the BLFI group, respectively. The PD reduction was significantly greater in the BLFI group than in the IFI group (2.59 and 2.11 mm, respectively; P <0.05). The BLFI group presented fewer sites with PD > or = 5 mm than the IFI group at all post-treatment periods. At 6 months, the BAPNA test showed that only the BLFI group had values significantly different from baseline. This means that the BLFI group had significantly lower BAPNA values compared to the IFI group at 6 months. CONCLUSION: Buccal and lingual Class II furcation involvements respond better to non-surgical therapy compared to interproximal Class II furcation involvements.
Assuntos
Raspagem Dentária/instrumentação , Defeitos da Furca/patologia , Defeitos da Furca/terapia , Terapia por Ultrassom/instrumentação , Análise de Variância , Benzoilarginina Nitroanilida , Placa Dentária/enzimologia , Placa Dentária/microbiologia , Índice de Placa Dentária , Humanos , Índice Periodontal , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
BACKGROUND AND OBJECTIVE: The aim of the present study was to evaluate comparatively the effect of two different approaches for root decontamination on new cementum formation following guided tissue regeneration (GTR). MATERIAL AND METHODS: Nine mongrel dogs were used to obtain bilateral chronic class III furcation defects by placing cotton ligatures around both third mandibular premolars. The teeth were randomly assigned to receive one of the following treatments: scaling and root planing, by means of hand and rotatory instruments, in order to remove soft and hard deposits as well as all root cementum (group A); or removal of only soft microbial deposits, by polishing the root surface with rubber cups and polishing paste, aiming for maximum root cementum preservation (group B). Both groups were treated with GTR, with the use of resorbable polyglycolic-lactic acid membranes (RESOLUT XT). RESULTS: Four months later, data analysis showed that a superior length (mm) (3.59 +/- 1.67 and 6.20 +/- 2.26 for groups A and B, respectively; p = 0.004) and a thicker layer (microm) (18.89 +/- 9.47 and 52.29 +/- 22.48 for groups A and B, respectively; p = 0.001) of new cementum was achieved by keeping the root cementum in place during root decontamination (group B). Regardless of the treatment modality, the new cementum was predominantly of a reparative, cellular extrinsic and intrinsic fiber type. CONCLUSION: Within the limits of the present study, it may be concluded that root cementum preservation may affect the new cementum formation following GTR in class III furcation defects, and the treatment modality did not influence the type of newly formed cementum.
Assuntos
Descontaminação/métodos , Cemento Dentário/fisiologia , Polimento Dentário , Defeitos da Furca/terapia , Regeneração Tecidual Guiada Periodontal/métodos , Animais , Biofilmes , Cemento Dentário/citologia , Cemento Dentário/microbiologia , Raspagem Dentária , Cães , Defeitos da Furca/microbiologia , Defeitos da Furca/patologia , Ligadura , Masculino , Distribuição Aleatória , Aplainamento Radicular , Raiz Dentária/citologia , Raiz Dentária/microbiologiaRESUMO
PURPOSE: The effect of orthodontic movement on the periodontal tissues of maxillary second pre-molars, after regenerative treatment for class II furcations, was evaluated in four mongrel dogs. MATERIAL AND METHODS: Class II furcation lesions were created. After 75 days they were treated with bovine bone mineral matrix and guided tissue regeneration with absorbable membrane. After 2 months of daily plaque control, each of the dog's furcation pre-molars was randomly assigned to a test or control group. Orthodontic appliances were placed on both sides of the maxilla using third pre-molars and canines as anchorages. In the test group, bodily orthodontic movement of the second pre-molars was performed in the mesial direction for 3 months while control pre-molars remained unmoved. The dogs were sacrificed for histometric and histologic analyses. RESULTS: There were no statistically significant differences between the two groups in total bone and biomaterial areas or linear extension of periodontal regeneration on the radicular surfaces. In the test group, however, there was a tendency to a greater quantity of bone and a lesser quantity of biomaterial. CONCLUSION: The orthodontic movement was not pre-judicial to the results obtained with the regenerative periodontal treatment.