All that glitters is not gold: X-ray fluorescence analysis of a fixed dental prosthesis from Colecção de Esqueletos Identificados Século XXI, Portugal (CEI/XXI)

Access to better health care anticipates that more medical devices can be found alongside skeletal remains. Those employed in oral rehabilitation, with available brands or batch/series, can prove useful in the identification process. A previous study in the Colecção de Esqueletos Identificados Século XXI described macroscopically the dental prostheses. An unusual case of a dental device with chromatic alterations demonstrated to require a more detailed analysis. The individual, a 53-year-old male, exhibited, at both arches, a fixed tooth-supported rehabilitation, with gold colouring classified initially as a gold-palladium alloy. Simultaneously, a green pigmentation deposit was observable in bone and prosthesis. This investigation aimed to verify the elemental composition of the dental prosthesis alloy. Elemental analysis was performed by X-ray fluorescence in two regions (labial surface of the prosthetic crown and the root surface of the lower right lateral incisor). Both the spectra and the qualitative results found higher levels of copper and aluminium, followed by nickel, iron, zinc, and manganese. No gold or palladium was detected. The most probable assumption is that a copper-aluminium alloy was used, as its elemental concentration corresponds to those measured in similar devices. Dental prostheses of copper-aluminium alloys have been made popular since the 1980s, particularly in the USA, Japan, and Eastern Europe. Apart from the biographical information, it was also known that the individual's place of birth was an Eastern European country, which highlighted the usefulness of this type of information when dealing with missing people cases.info:eu-repo/semantics/publishedVersio

Contribuição para o estudo da regeneração periodontal: a influência de um derivado das proteínas da matriz do esmalte no epitélio gengival - estudo in vivo.

ese de doutoramento em Medicina Dentária (Patologia e Cirurgia - Periodontologia) apresentada à Fac. de Medicina de CoimbraA periodontite e as suas sequelas inflamatórias alteram a estrutura e a integridade do periodonto. No tratamento dos defeitos periodontais, a regeneração os tecidos destruídos é um objectivo fundamental. Recentemente, um derivado das proteínas da matriz do esmalte (EMD), foi apresentado como promotor da regeneração periodontal, baseando-se em processos biomiméticos. Diversos estudos demonstraram que o EMD influencia o metabolismo das células do ligamento periodontal assim como das células epiteliais, osteoblásticas e do folículo dentário. No entanto, os eventos celulares são ainda parcialmente desconhecidos. O trabalho experimental desta dissertação inclui dois estudos, tendo-se optado pelo rato Wistar como modelo experimental. O primeiro teve por objectivo determinar qual dos procedimentos de colocação do fio de sutura no espaço interdentário dos molares resultava no desenvolvimento de uma lesão periodontal passível de ser tratada cirurgicamente. Apesar de aos oito dias ambos os procedimentos terem resultado no desenvolvimento de bolsas periodontais pouco profundas, aos quinze dias verificou-se uma diferenciação entre os procedimentos quanto à evolução das lesões. Como conclusão, pode afirmar-se que o procedimento mais adequado é a colocação de um fio de sutura através do afastamento das faces interproximais, o qual deverá permanecer no sulco gengival durante duas semanas. O segundo estudo teve como objectivo a avaliação da influência de um derivado das proteínas da matriz do esmalte na cicatrização dos tecidos epiteliais da margem gengival de uma bolsa periodontal. A cicatrização de um retalho muco-perióstico ao décimo quinto dia resultou predominantemente na formação de um epitélio juncional longo, o mesmo tendo sido verificado com aplicação de EDTA, de PGA e da sua associação. Deste modo, nestes grupos observou-se uma cicatrização de cariz reparativo e não regenerativo. Pelo contrário, a aplicação de EMD resultou na formação de uma adesão epitelial de pequena extensão e de uma adesão conjuntiva. A análise histológica foi confirmada pelos resultados da quantificação histomorfométrica. Deste estudo conclui-se que o EMD, neste modelo experimental, inibe a proliferação epitelial, numa fase inicial da cicatrização, uma vez que resultou na formação de um epitélio juncional pouco extenso e na formação de uma nova adesão conjuntiva

Impact of Periodontal Attachment Loss on the Outcome of Endodontic Microsurgery: A Systematic Review and Meta-Analysis

Background and Objectives: Endodontic microsurgery (EMS) aims to eradicate the sources of infection once the apical root resection removes most of the infected anatomical structures and repairs potential procedural errors in the apical region. An endodontic-periodontal lesion yields a pathological communication between the pulp and the periodontium. The purpose of this systematic review and meta-analysis is to evaluate the impact of periodontal attachment loss on the outcome of teeth submitted to EMS. Materials and Methods: PRISMA guidelines were followed. An electronic search was performed in EBSCOhost, Embase and PubMed databases with the following search key: (“endodontic microsurgery” AND “outcome”). No filters were used concerning the year of publication or language. Only randomized clinical trials, prospective and retrospective clinical studies in humans, with a minimum one-year follow-up, defined clinical and radiographic outcome criteria and estimable success rate for endodontic-periodontal lesion were included. Statistical analysis was performed using OpenMeta[Analyst] software. Results: Of a total of 113 articles, 34 were selected for full-text reading after duplicates deletion and title and abstract analysis. Thirteen and six studies were included in the systematic review and meta-analysis, respectively. A total of 2775 pooled teeth were submitted to EMS, of which 492 teeth and 4 roots had periodontal involvement. According to the qualitative analysis, success rates of the endodontic-periodontal group ranged from 67.6% to 88.2%. Meta-analysis revealed that the absence of periodontal attachment loss was predictive of a higher likelihood of success with an odds ratio of 3.14. Conclusions: Periodontal attachment loss presents a risk factor for EMS outcome. Although endodontic-periodontal lesions were associated with lower success rates considering a 1 to 10 years follow-up period, long-term successful prognosis following EMS has been reported, therefore presenting a fully valid and viable therapeutic option for the management of this type of lesions

Implantoplasty Improves Clinical Parameters over a 2-Year Follow-Up: A Case Series

Background and Objectives: Peri-implantitis treatment is still undefined. Regenerative treatment is expensive and technically demanding due to the need to handle biomaterials, membranes and different methodologies of decontamination. Resective treatment and implantoplasty might be a viable solution. This case series presents a 24 month retrospective observational study of 10 peri-implantitis patients treated with implantoplasty. Materials and Methods: In the present case series, 10 peri-implantitis patients (20 implants) were treated with a resective approach and implantoplasty. Previous to implantoplasty, all patients underwent non-surgical treatment. This surgery consisted in a full-thickness flap and implant surface exposure. The exposed non-osseointegrated implant body was submitted to implantoplasty. The flap was apically repositioned and sutured. Patients were accompanied for 24 months. Results: The mean initial probing depth (PD) (PD = 5.37 ± 0.86 mm), bleeding on probing (BoP = 0.12 ± 0.06%) and suppuration (Sup = 0.01 ± 0.01%) decreased significantly at the 12 month evaluation (PD = 2.90 ± 0.39 mm; BoP = 0.01 ± 0.01% and Sup = 0.00 ± 0.00%). Between the 12 and 24 month evaluations, there were no significant clinical changes (PD = 2.85 ± 0.45 mm; BoP = 0.01 ± 0.01% and Sup = 0.00 ± 0.00%). Mucosal recession (MR) had a significant increase between the baseline and the first 12 months (0.69 ± 0.99 mm vs. 1.96 ± 1.33 mm), but there were no significant changes between the 12th and 24th month (1.94 ± 1.48 mm). The success rate was 100% without implant fracture or loss. Conclusions: Resective surgery and implantoplasty might be a valid option in some specific peri-implantitis cases. Properly designed clinical trials are needed to confirm this possibility