Consenso do simpósio promovido pela Associação Gaúcha de Odontopediatria sobre riscos e benefícios de dentifrícios fluoretados na primeira infância

This Consensus reports the conclusions from the Symposium promoted by the Associação Gaúcha de Odontopediatria (AGOPED) conducted in September 2012 with the title Fluoride Dentifrices in Primary Childhood: Risks and Benefits. The conclusions of the Symposium were as follows: based on the best available scientific evidence about strategies to control dental caries, it is recommended that a fluoride dentifrice of at least 1100 ppm of fluoride be used two times a day as an adjuvant for tooth cleaning by all children; during the phase in which children are not able to self-care, the use of fluoride dentifrice is a parents’ responsibility warranting greater safety about dental fluorosis; it is also recommended that only a small amount of dentifrice (pea size) should be used for children under 2 years of age.A Associação Gaúcha de Odontopediatria (AGOPED), entidade que tem por finalidade, entre outras, promover o intercâmbio cultural, técnico e científico com entidades congêneres, pondo em prática medidas concretas para atingir seus objetivos, realizou nos dias 09 e 10 de setembro últimos, um Simpósio intitulado “Dentifrícios Fluoretados na 1a Infância: Riscos e Benefícios”. O objetivo deste Simpósio foi discutir com base na melhor evidência científica disponível os riscos e benfícios da utilização dos dentifrícios fluoretados na primeira infância. As principais conclusões do simpósio foram: 1. Com base na melhor evidência científica disponível sobre estratégias para o controle de cárie dentária, se recomenda que um creme dental fluoretado de no mínimo 1100 ppm de flúor seja utilizado 2x/dia como coadjuvante da limpeza dos dentes de todas as crianças; 2. Enquanto a criança não tiver condições de se autocuidar, o uso de dentifrício fluoretado é de responsabildade dos pais ou cuidadores, garantindo assim maior segurança quanto à fluorose dentária; 3. Também se recomenda que seja usada apenas uma lambuzadela ("grão de arroz cru") de dentifrício fluoretado quando da limpeza dos dentes de crianças menores de 2 anos de idade

Outcome measurements following palatal soft tissue graft harvesting : a review

Free gingival graft (FGG) and connective tissue graft (CTG) are two of the most commonly techniques performed in periodontal and peri-implant plastic surgery. Although several outcome measurements have been proposed for evaluation of palatal wound healin

Avaliação funcional da reabilitação oral com prótese parcial removível após cinco anos

Most removable partial denture (RPD) wearers are satisfied with their prostheses, but the factors that influence satisfaction and acceptance are still not determined. OBJECTIVE: This study explored technical, biological, and satisfaction variables for the functioning of RPDs after five years, and compared the evaluation by the patient and by the clinician. MATERIAL AND METHODS: Fifty adults (39 females, 11 males) were re-examined after five years of RPD service. Data were collected through clinical examination and a structured questionnaire to record the conditions of supporting soft tissues, prosthesis acceptance and technical characteristics, mastication, esthetics, comfort, hygiene, and need for professional intervention. Data were analyzed by descriptive statistics and Spearman correlation. RESULTS: More than 50% of patients classified their RPDs as excellent regarding retention, mastication, esthetics, comfort, and hygiene. In the professional evaluation, retention and stability were considered excellent in more than 66% of cases, and hygiene of teeth and prostheses was considered good in 52% and 46%, respectively. The metallic framework and acrylic base were considered adapted in 92% of cases. Prosthesis acceptance was associated with retention, mastication, esthetics, hygiene, and comfort evaluated by the patient, and with retention, stability, and condition of the framework evaluated by the clinician. Retention and mastication/comfort evaluated by the patient had moderate positive correlation with retention and stability measured by the clinician. There was no association of hygiene evaluation by the patient and by the clinician. CONCLUSIONS: After five years, the oral rehabilitation with RPDs was satisfactory for most cases. There was correspondence between retention/retention and mastication-comfort/stability variables evaluated by the patient and by the clinician. Oral and prosthesis hygiene were not related.A maioria dos usuários de PPR mostra-se satisfeita com suas próteses, porém os fatores que influenciam a satisfação e aceitação não estão determinados. OBJETIVO: Este estudo explorou variáveis técnicas, biológicas e de satisfação no funcionamento de próteses parciais removíveis (PPRs) após cinco anos de uso, comparando a avaliação do paciente e do cirurgião-dentista. MATERIAIS E MÉTODOS: Cinqüenta adultos (39 mulheres, 11 homens) foram reexaminados após cinco anos da instalação de PPR. Através de exame clínico e questionário estruturado, foram coletados os dados relativos às condições dos tecidos de suporte, aceitação e características técnicas da PPR, mastigação, estética, conforto, higiene e necessidade de intervenção profissional. Os dados foram analisados por estatística descritiva e por correlação de Spearman. RESULTADOS: Mais de 50% dos pacientes classificaram suas próteses como excelente quanto à retenção, mastigação, estética, conforto e higiene. Na avaliação do profissional, retenção e estabilidade foram consideradas excelentes em mais de 66% dos pacientes, e a higiene dos dentes e da prótese foi considerada boa em 52% e 46% dos casos, respectivamente. As armações metálicas e bases acrílicas foram consideradas adaptadas em 92% dos casos. Aceitação da prótese foi associada com retenção, mastigação, estética, higiene e conforto avaliados pelo paciente, e com retenção, estabilidade e condição da armação metálica avaliadas pelo profissional. Retenção e mastigação/conforto, avaliados pelo paciente, mostraram correlação positiva moderada com retenção e estabilidade medidas pelo profissional. Não houve associação entre avaliação de higiene pelo paciente e pelo profissional. CONCLUSÕES: Após cinco anos, a reabilitação oral com PPR estava satisfatória na maioria dos casos. Houve correspondência entre as variáveis retenção/retenção e mastigação-conforto/estabilidade. Higiene oral e da prótese não mostraram associação

Physical Activity Reduces the Prevalence of Periodontal Disease: Systematic Review and Meta-Analysis

Background: Regular physical activity boosts several physical capacities and reduces many inflammatory markers of several diseases. In this sense, periodontal disease is a multifactorial inflammatory disease of tooth supporting tissues that has been claimed to trigger processes of systemic alterations. The aim of this systematic review and meta-analysis was to assess the effects of physical activity on periodontal disease.Methods: Observational studies published until August 2018 were searched in online databases (PubMed, Scopus, Web of Science, The Cochrane Library, LILACS, OpenGrey, and Google Scholar) after developing a PECO statement that focused on the comparison between adults that followed a routine of exercises or presented a sedentary lifestyle and its effects on periodontal disease. Searching and data extraction were conducted by following PRISMA guidelines. Registration protocol: CRD42016049661. Quality assessment and risk of bias were analyzed by following Fowkes and Fulton protocol.Results: A total of 512 references were retrieved, while only seven were considered eligible. Two meta-analysis involving the prevalence of periodontal disease and unadjusted/adjusted Odds ratio were performed. One of studies did not find association between clinical periodontal parameters and physical activity. Six articles suggested an association between periodontal disease and regular practice of physical activity since a reduction of periodontal prevalence was observed. Moderate level of evidence was demonstrated on GRADE analysis.Conclusion: Physical activity was associated as a potential tool for reduction of periodontal disease prevalence. The frequency of physical activity is directly related to a low occurrence of periodontitis. However, it is important that further investigations evaluate the effects of other exercise variables, such as volume and intensity, on the periodontal disease prevalence

Comparison of different methods involved in the planning of clinical crown lengthening surgery

There is little material in the literature that compares biological width measurements in periapical and bite-wings radiographs with clinical measurements. The purpose of this study was to compare measurements of biological width taken by three different methods which are frequently used for planning periodontal surgery - periapical radiograph, bite-wing radiograph and transperiodontal probing - with the trans-surgical measurements. Thirty-four sites from twenty-one subjects were analyzed. The intra-class correlation coefficients between measurements obtained trans-surgically (gold standard) and those obtained by transperiodontal probing, periapical radiography and bite-wing radiography were determined. Average measurements were compared using the Wilcoxon test at a significance level of 0.05. Also, the frequency distribution of differences between test measurements and the gold standard was calculated. The results showed that transperiodontal probing (mean 2.05 mm) was the most accurate measurement, as compared to the gold standard (mean 1.97 mm), with no statistically significant difference observed. On the other hand, periapical and bite-wing radiographic mean values (1.56 mm and 1.72 mm, respectively) were smaller than the gold standard, with statistically significant differences (p < 0.05). It was concluded that transperiodontal probing was the most accurate measurement, as compared to the gold standard, followed by that obtained with the bite-wing radiograph. The clinical relevance of these results could be that planning for crown lengthening surgery should, preferably, include transperiodontal probing

Prevalência de perda de inserção periodontal em adolescentes de 12 a 16 anos em uma escola pública de Porto Alegre

The aim of this study was to verify prevalence of loss of attachment in 12-16 years old adolescents of a public school in Porto Alegre. The prevalence of loss of attachment was determined by means of periodontal probing a mesial, distal, buccal and lingual surfaces of incisors and first permanent molars. A trainer examiner performed the examination with Williams periodontal probe, odontoscope are standard illumination. The level of attachmet was defined as thc distance in millimeters from the cementum-enamel junction to the most apically probable portion, close to thc bottom of the sulcus/pocket. For cach site, two measurements were performed, the distance from the gingival margin to the cementure enamel junction, and the distance from the gingival margin to the bottom of the sulcus pocket. The level of attachment for a site was calculated subtracting the first and the second or, in case of gingival recession, adding both. Loss of attachment was considered when this measure exceeded 2 mm in buccal-lingual surfaces and 3 mm in proximal surfaces. 3048 sites were examined, showing a prevalence of 4.82% of loss of attachment. From these, 36.77% bled on probing and 61.22% did not. The buccal surface was the one with the highest prevalence of loss of attachment.O objetivo do estudo foi verificar a prevalência de perda de inserção (PI) em adolescentes de 12 a 16 anos de idade de uma escola pública de Porto Alegre. A prevalência de PI foi constatada através de sondagem periodontal nos ângulos mésio-vestibulares, disto-vestibulares, e no centro das faces vestibulares e linguais/palatinas dos incisivos e primeiros molares permanentes. O exame foi realizado somente por um examinador treinado, dispondo de sonda periodontal tipo Willians, espelho bucal e iluminação padrão. O nível de inserção periodontal foi defìnido como a distância em milímetros do limite amelo-cementário à porção mais apical sondável, próxima ao fundo do sulco/bolsa. Para cada sítio duas medidas foram feitas, a distância da margem gengival ao limite amelo-cementário, e a distância da margem gengival ao fundo do sulco/bolsa. O nível de inserção para um dado sítio foi, então, calculado subtraindo-se o primeiro do segundo ou, no caso de recessão gengival, somando-se os dois. Considerou-se PI quando esta mensuração excedeu 2 mm em faces livres e 3 mm em faces proximais. Foram examinados 3.048 sítios, sendo encontrada uma prevalência de 4,82% e 61.22% com ausência. A face vestibular mostrou-se como o sítio com a maior prevalência de PI