Regenerative endodontic treatment of teeth with incomplete root formation: a review

Endodontic treatment of teeth with open apex requires a non-conventional approach and the goals new therapies are to allow root’s complete development differently from what happens with traditional apexification technique. Objective: This study aimed to review the literature on the most recent regenerative endodontic procedures. Literature review: Regenerative endodontics goal is to obtain pulp vitality. Some case reports on donor-obtained dental stem cells show promising results. Other types of laboratory-based dental stem cell therapies are under development. Conclusion: Dentin-pulp complex shows regenerative capacity, but the literature lacks evidence to validate the regenerative therapies in endodontic practic

Reconstruction of atrophic maxilla with the use of allogenic bone graft and platelet concentrate – clinical case report

Introduction: The use of allogenic bone has the advantage of not producing donor area in the patient, which can decrease the morbidity. However, there is an important vascularization demand for this type of graft, which can be increased with the use of platelet concentrate. Objective: To report a case of atrophic maxilla reconstruction with particle allogenic bone associated with Platelet Rich Fibrin (PRF). Case report: A female patient, who presented a maxilla with a reduced alveolar ridge and pneumatization of the maxillary sinuses, underwent surgery to lift the maxillary sinuses and reconstruct thealveolar ridge, with macro and micro particulate allogenic bone associated with fluid/injectable PRF (i-PRF), and total covering of the graft with PRF membranes, for better accommodation and graft protection. The graft was osseointegrated and able to receive the implants. Conclusion: The technique was effective, presenting several advantages in relation to reconstruction with autologous bone, such as shorter surgical time, amount of material for the graft, and less surgical trauma.Introduction: The use of allogenic bone has the advantage of not producing donor area in the patient, which can decrease the morbidity. However, there is an important vascularization demand for this type of graft, which can be increased with the use of platelet concentrate. Objective: To report a case of atrophic maxilla reconstruction with particle allogenic bone associated with Platelet Rich Fibrin (PRF). Case report: A female patient, who presented a maxilla with a reduced alveolar ridge and pneumatization of the maxillary sinuses, underwent surgery to lift the maxillary sinuses and reconstruct thealveolar ridge, with macro and micro particulate allogenic bone associated with fluid/injectable PRF (i-PRF), and total covering of the graft with PRF membranes, for better accommodation and graft protection. The graft was osseointegrated and able to receive the implants. Conclusion: The technique was effective, presenting several advantages in relation to reconstruction with autologous bone, such as shorter surgical time, amount of material for the graft, and less surgical trauma

Injection of platelet aggregates in facial rejuvenation: a systematic review

Introduction: This systematic review was conducted to assess whether the use of a platelet aggregate injection with or without associated facial rejuvenation techniques favors facial rejuvenation in adult patients. Methods: Randomized clinical trials that compared the use of techniques for facial rejuvenation alone with the same techniques coupled with the injection of platelet aggregates were searched. The search was performed in indexed databases and in the gray literature. The Cochrane Collaboration bias risk tool was applied to assess the quality of the studies. Results: In total, 7137 articles were identified. Only four studies remained in the qualitative synthesis, and the others were considered as having undefined bias risk in the key domains. Conclusion: There are few studies in the literature that compare the use of platelet aggregates in facial rejuvenation and those that are available have a risk of "undefined" or "high" bias. There is a need for more well-designed clinical studies comparing the use of platelet aggregate injection with or without associated facial rejuvenation techniques

Implantes dentários em região estética e qualidade de vida relacionada à saúde bucal / Dental implants in esthetic zone and quality of life related to oral health

O objetivo do presente estudo foi avaliar, por meio de questionário Oral Health Impact Profile em versão abreviada (OHIP-14), o impacto das reabilitações com implantes dentários em região anterior, em adultos atendidos em um curso de especialização em Implantodontia. Participaram 35 pacientes, de ambos os gêneros, atendidos no segundo semestre de 2017 e contatados entre julho e setembro de 2019. Por telefone, os pacientes foram agendados para uma entrevista presencial, realizada por três pesquisadores treinados que aplicaram o OHIP-14. Os dados foram analisados descritivamente e para o cálculo do OHIP-14 foi considerado o método da adição; para variáveis qualitativas foi aplicado teste de Qui-quadrado e quantitativas foi feito teste de correlação de Spearman. Adotou-se nível de significância de 5%. Um total de 58 procedimentos implanto/protéticos foi realizado. Predominaram as mulheres (57,1%) e a reabilitação de incisivos laterais superiores (34,5%). O valor do coeficiente Alfa de Cronbach foi alto (0,854), indicando consistência interna do instrumento. Não foram observadas diferenças estatisticamente significativas para associação entre gênero e idade, dimensões e OHIP-14 total (p > 0,05). A média geral e o desvio-padrão do OHIP-14 total foi 8,46 (± 8,76). Pela estratificação por gênero, apenas a dificuldade de alimentação apresentou diferença (p = 0,048), com homens relatando piores impactos. A reabilitação implanto/protética em indivíduos com perda dentária em região estética tem impacto na qualidade de vida relacionada à saúde bucal e deve ser melhor pesquisada, com vistas a melhor compreender os efeitos psicológicos do tratamento nos pacientes

Treatment of Miller Class I Gingival Recession with Using Nonpedicle Adipose Tissue after Bichectomy Surgical Technique: A Case Report

Gingival recession is an oral health problem that affects a large part of the population. Several treatments are suggested in the current literature; among them is the use of buccal fat pad grafting. The objective of this case report is to describe the treatment of a Miller Class I gingival recession using a nonpedicled buccal fat pad graft immediately after performing the surgery for buccal fat pad removal (bichectomy technique). First, bilateral surgical removal of the buccal fat pad was performed with the main objective of eliminating oral mucosa biting. The recipient site was prepared to receive a portion of the fat pad that was cut and macerated in a size that was sufficient to cover the recession. The patient was followed up at 15, 30, 60, and 365 days postsurgery, and the results showed an elimination of the oral mucosa biting and complete coverage of the gingival recession. It was concluded that the nonpedicled buccal fat pad graft is another option for the treatment of Miller Class I recessions

Reconstruction of atrophic maxilla with the use of allogenic bone graft and platelet concentrate – clinical case report

Introduction: The use of allogenic bone has the advantage of not producing donor area in the patient, which can decrease the morbidity. However, there is an important vascularization demand for this type of graft, which can be increased with the use of platelet concentrate. Objective: To report a case of atrophic maxilla reconstruction with particle allogenic bone associated with Platelet Rich Fibrin (PRF). Case report: A female patient, who presented a maxilla with a reduced alveolar ridge and pneumatization of the maxillary sinuses, underwent surgery to lift the maxillary sinuses and reconstruct thealveolar ridge, with macro and micro particulate allogenic bone associated with fluid/injectable PRF (i-PRF), and total covering of the graft with PRF membranes, for better accommodation and graft protection. The graft was osseointegrated and able to receive the implants. Conclusion: The technique was effective, presenting several advantages in relation to reconstruction with autologous bone, such as shorter surgical time, amount of material for the graft, and less surgical trauma.Introduction: The use of allogenic bone has the advantage of not producing donor area in the patient, which can decrease the morbidity. However, there is an important vascularization demand for this type of graft, which can be increased with the use of platelet concentrate. Objective: To report a case of atrophic maxilla reconstruction with particle allogenic bone associated with Platelet Rich Fibrin (PRF). Case report: A female patient, who presented a maxilla with a reduced alveolar ridge and pneumatization of the maxillary sinuses, underwent surgery to lift the maxillary sinuses and reconstruct thealveolar ridge, with macro and micro particulate allogenic bone associated with fluid/injectable PRF (i-PRF), and total covering of the graft with PRF membranes, for better accommodation and graft protection. The graft was osseointegrated and able to receive the implants. Conclusion: The technique was effective, presenting several advantages in relation to reconstruction with autologous bone, such as shorter surgical time, amount of material for the graft, and less surgical trauma

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author