RESUMO
BACKGROUND AND OBJECTIVES: Few studies have evaluated the effect of the topical application of sodium alendronate (ALN) on the treatment of intrabuccal bone defects, especially those caused by periodontitis. This 6-month randomized placebo controlled clinical trial aimed at evaluating the effect of non-surgical periodontal treatment associated with the use of 1% ALN, through clinical evaluations and cone-beam computed tomography (CBCT). MATERIAL AND METHODS: Twenty individuals with chronic periodontitis underwent periodontal examination at the baseline as well as 3 and 6 months after periodontal treatment, registering clinical attachment level (CAL), periodontal probing depth (PPD), and bleeding on probing (BOP) as the clinical outcomes. After manual scaling and root planing, 40 bilateral sites with interproximal vertical bone defects were randomly treated with either 1% ALN gel or a placebo. Bone defects were evaluated through CBCT at the baseline and 6 months post-treatment. The clinical and CBCT parameters were compared using the Wilcoxon and Friedman tests (p<0.05). RESULTS: Although ALN produced a greater CAL gain when compared to the placebo at 6 months post-treatment (p=0.021), both treatments produced similar effects on the PPD, BOP, and bone height. Significant differences in bone fill were observed only in patients of the ALN group (4.5 to 3.8 mm; p=0.003) at 6 months post-treatment. CONCLUSIONS: Topical application of 1% ALN might be a beneficial adjuvant to non-surgical periodontal therapy.
Assuntos
Alendronato/administração & dosagem , Conservadores da Densidade Óssea/administração & dosagem , Doenças Ósseas Infecciosas/tratamento farmacológico , Periodontite Crônica/tratamento farmacológico , Sódio/administração & dosagem , Adulto , Doenças Ósseas Infecciosas/diagnóstico por imagem , Regeneração Óssea/efeitos dos fármacos , Periodontite Crônica/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Índice de Placa Dentária , Raspagem Dentária/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Placebos , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do TratamentoRESUMO
Abstract Background and objectives Few studies have evaluated the effect of the topical application of sodium alendronate (ALN) on the treatment of intrabuccal bone defects, especially those caused by periodontitis. This 6-month randomized placebo controlled clinical trial aimed at evaluating the effect of non-surgical periodontal treatment associated with the use of 1% ALN, through clinical evaluations and cone-beam computed tomography (CBCT). Material and Methods Twenty individuals with chronic periodontitis underwent periodontal examination at the baseline as well as 3 and 6 months after periodontal treatment, registering clinical attachment level (CAL), periodontal probing depth (PPD), and bleeding on probing (BOP) as the clinical outcomes. After manual scaling and root planing, 40 bilateral sites with interproximal vertical bone defects were randomly treated with either 1% ALN gel or a placebo. Bone defects were evaluated through CBCT at the baseline and 6 months post-treatment. The clinical and CBCT parameters were compared using the Wilcoxon and Friedman tests (p<0.05). Results Although ALN produced a greater CAL gain when compared to the placebo at 6 months post-treatment (p=0.021), both treatments produced similar effects on the PPD, BOP, and bone height. Significant differences in bone fill were observed only in patients of the ALN group (4.5 to 3.8 mm; p=0.003) at 6 months post-treatment. Conclusions Topical application of 1% ALN might be a beneficial adjuvant to non-surgical periodontal therapy.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Sódio/administração & dosagem , Doenças Ósseas Infecciosas/tratamento farmacológico , Alendronato/administração & dosagem , Conservadores da Densidade Óssea/administração & dosagem , Periodontite Crônica/tratamento farmacológico , Placebos , Fatores de Tempo , Doenças Ósseas Infecciosas/diagnóstico por imagem , Regeneração Óssea/efeitos dos fármacos , Índice de Placa Dentária , Reprodutibilidade dos Testes , Seguimentos , Raspagem Dentária/métodos , Resultado do Tratamento , Estatísticas não Paramétricas , Tomografia Computadorizada de Feixe Cônico , Periodontite Crônica/diagnóstico por imagemRESUMO
The authors retrospectively analyzed the files of 11 patients with osteochondral sequelae of meningococcemia, which were referred to this service between 1988 and 1996. The purpose of this study was to radiographically evaluate bone and physeal injuries observed in these patients, deformities caused by them and correlate these findings with the current literature. During radiographic evaluation of patients with sequelae of meningococcemia, two distinct parameters should be observed: bone injury and physeal plate injury patterns. The most frequent bone injury pattern was lytic lesion and the most common physeal plate injury pattern was peripheral asymmetric physis destruction. The most frequent deformities were lower limb length discrepancy, angular deformities and digital amputations. Based upon the findings of the present research, a descriptive radiographic classification was proposed.
Assuntos
Bacteriemia/complicações , Doenças Ósseas Infecciosas/diagnóstico por imagem , Doenças Ósseas Infecciosas/etiologia , Infecções Meningocócicas/complicações , Osteonecrose/diagnóstico por imagem , Osteonecrose/etiologia , Bacteriemia/diagnóstico , Doenças Ósseas Infecciosas/microbiologia , Criança , Pré-Escolar , Epífises/diagnóstico por imagem , Epífises/lesões , Epífises/patologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Infecções Meningocócicas/diagnóstico , Osteonecrose/microbiologia , Radiografia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
Bone scintigraphy is a very sensitive method for the detection of osteoblastic activity of the skeleton. The technique consists of imaging the uptake of bone-seeking radiopharmaceuticals, particularly technetium-99m labeled diphosphonates, in the mineral component of bone, which consists of hydroxyapatite crystals and calcium phosphate, as well as in the organic matrix such as collagen fibers. Plain radiographs, computed tomography, and magnetic resonance imaging are classified as structural imaging modalities, whereas bone scintigraphy is a functional method. In many cases, radionuclide imaging techniques are the only means by which early physiologic changes that are a direct result of biochemical alteration may be assessed, before significant bone mineral changes can be detected by other means. Since many oral diseases may cause metabolic changes in the oromaxillofacial complex, it would be of great value to use bone scintigraphy to evaluate more completely some conditions involving the bones in the region to formulate more appropriate treatment plans. Based upon the current literature, the authors discuss the possible applications of bone scintigraphy as a diagnostic and treatment planning adjunct for oral diseases. Bone scintigraphy has proven particularly useful in the study of malignant lesions and in the evaluation of vascularized bone grafts used for maxillofacial reconstructions.