New tendencies in non-surgical periodontal therapy

The aim of this review was to update the evidence of new approaches to non-surgical therapy (NSPT) in the treatment of periodontitis. Preclinical and clinical studies addressing the benefits of adjunctive antimicrobial photodynamic therapy, probiotics, prebiotics/synbiotics, statins, pro-resolving mediators, omega-6 and -3, ozone, and epigenetic therapy were scrutinized and discussed. Currently, the outcomes of these nine new approaches, when compared with subgingival debridement alone, did not demonstrate a significant added clinical benefit. However, some of these new alternative interventions may have the potential to improve the outcomes of NSPT alone. Future evidence based on randomized controlled clinical trials would help clinicians and patients in the selection of different adjunctive therapies

Effects of platelet-rich fibrin produced by three centrifugation protocols on bone neoformation in defects created in rat calvaria.

This study evaluated the potential of Leukocyte-platelet-rich fibrin (L-PRF; fixed angle centrifugation protocol), Advanced-platelet-rich fibrin (A-PRF; low-speed fixed angle centrifugation protocol), and Horizontal-platelet-rich fibrin (H-PRF; horizontal centrifugation protocol) in bone neoformation in critical size defects (CSDs) in rat calvaria. Thirty-two rats were divided into groups: Control (C), L-PRF, A-PRF, and H-PRF. 5 mm diameter CSDs were created in the animals' calvaria. Defects from group Control (C) were filled with blood clots, while defects from groups L-PRF, A-PRF, and H-PRF were filled with respective platelet-rich fibrin (PRF) membranes. L-PRF, A-PRF, and H-PRF were prepared from animal blood collection and specific centrifugation protocols. At 14 and 30 days, calcein (CA) and alizarin (AL) injections were performed, respectively. Animals were euthanized at 35 days. Microtomographic, laser confocal microscopy, and histomorphometric analyzes were performed. Data were statistically analyzed (ANOVA, Tukey, p < .05). L-PRF, A-PRF, and H-PRF groups showed higher values of bone volume (BV), newly formed bone area (NFBA), and precipitation of CA and AL than the C group (p < .05). The H-PRF group showed higher values of BV, number of trabeculae (Tb. N), NFBA, and higher precipitation of AL than the A-PRF and L-PRF groups (p < .05). Therefore, it can be concluded that: i) L-PRF, A-PRF, and H-PRF potentiate bone neoformation in CSDs in rat calvaria; ii) H-PRF demonstrated more biological potential for bone healing

Processo de cicatrização óssea em defeitos cirúrgicos de tamanho crítico tratados com partículas do novo vidro bioativo associadas ou não à barreira de sulfato de cálcio: estudo histológico e histométrico em calvárias de rato

Este estudo avaliou, histologicamente e histometricamente, a influência das partículas esféricas do novo vidro bioativo (NVB), associadas ou não à barreira de sulfato de cálcio (SC), na cicatrização óssea de defeitos de tamanho crítico (DTC) cirurgicamente criados em calvárias de rato. Um DTC de 5 mm de diâmetro foi realizado na calvária de 60 ratos, divididos em três grupos: C (controle) - defeito preenchido apenas com coágulo sangüíneo; NVB - apenas NVB; e NVB/SC - NVB coberto por barreira de SC. Cada grupo foi sudividido para eutanásia em 4 ou 12 semanas pós-operatórias (n=10). As quantidades de osso neoformado e de remanescentes dos materiais implantados foram calculadas como porcentagens da área total do defeito original e os dados foram analisados estatisticamente (Kruskal-Wallis, teste da soma dos postos de Wilcoxon, p<0,05). Nenhum defeito regenerou completamente com tecido ósseo. A espessura da área do defeito foi similar à da calvária original nos Grupos NVB e NVB/SC. O Grupo C apresentou um tecido conjuntivo fino na área central do defeito. Partículas de NVB foram observadas nos Grupos NVB e NVB/SC em ambos os períodos de análise. Após 4 semanas, o Grupo C apresentou neoformação óssea significativamente maior do que o Grupo NVB/SC. Não foram encontradas diferenças estatísticas entre o Grupo NVB e o Grupo C ou o Grupo NVB/SC. Após 12 semanas, o Grupo C apresentou formação óssea significativamente maior do que os Grupos NVB e NVB/SC. A área de NVB remanescente foi significantemente maior no Grupo NVB/SC do que no Grupo NVB em 12 semanas. As partículas de NVB, associadas ou não à barreira de SC, mantiveram o volume e o contorno das áreas tratadas em DTC. A presença de partículas remanescentes de NVB pode ter contribuído para a menor quantidade de osso neoformado observada nos Grupos NVB e NVB/SC em 12 semanas pós-operatórias.This study analyzed histologically and histometrically the influence of new spherical bioactive glass (NBG) particles with or without a calcium sulfate (CS) barrier on bone healing in surgically created critical-size defects (CSD) in rat calvaria. A 5 mm diameter CSD was made in each calvarium of 60 rats. They were divided into three groups: C (control): defect filled with blood clot only; NBG: NBG only; and NBG/CS: NBG covered by a CS barrier. These groups were divided into subgroups and euthanized at 4 or 12 weeks (n=10). Amounts of new bone and remnants of implanted materials were calculated as percentages of the total area of the original defect. Data were statistically analyzed (Kruskal-Wallis, exact Wilcoxon rank sum tests, p<0.05). No defect completely regenerated with bone. The thickness throughout the defects in Groups NBG and NBG/CS was similar to the original calvarium, while Group C had a thin connective tissue in the center of the defect. NBG particles were observed in Groups NBG and NBG/CS at both periods of analysis. At 4 weeks, Group C had significantly more bone formation than Group NBG/CS. No significant differences were found between Group NBG and either Group C or Group NBG/CS. At 12 weeks, Group C had significantly more bone formation than Group NBG or NBG/CS. The area of remaining NBG was significantly greater for Group NBG/CS than for NBG at 12 weeks. NBG particles, used with or without a CS barrier, maintained the volume and contour of the area grafted in CSD. The presence of remaining NBG particles might have accounted for the smaller amount of newly formed bone observed in Groups NBG and NBG/CS at 12 weeks post-operative.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Processo de cicatrização óssea em defeitos cirúrgicos de tamanho crítico tratados com partículas de vidro bioativo associadas ou não à barreira de sulfato de cálcio: estudo histológico e histométrico em calvárias de rato

O propósito deste estudo foi avaliar, histologicamente, a cicatrização óssea em defeitos de tamanho crítico (DTC), na calvária de ratos, tratados com: a) partículas de vidro bioativo (VB) (Biogran®); b) partículas de VB/barreira de sulfato de cálcio (SC) (Calcigen™). Um DTC de 5 mm de diâmetro foi realizado na calvária de 48 ratos, divididos em 3 grupos: a) C (Controle): defeito preenchido com coágulo sangüíneo; b) VB: defeito preenchido com VB; c) VB/SC: defeito preenchido com VB, com barreira de SC. Cada grupo foi subdividido para eutanásia em 4 ou 12 semanas pós-operatórias (n=8). Foram realizadas análises histológica e histométrica. A quantidade de osso neoformado foi calculada como uma porcentagem da área total do defeito. Esses valores foram transformados em arcoseno para a análise estatística (ANOVA, Tukey, p<0,05). Nenhum defeito regenerou completamente com tecido ósseo. Partículas de VB foram observadas nos Grupos VB e VB/SC em ambos os períodos de análise. A espessura da área do defeito foi similar à da calvária original nos Grupos VB e VB/SC, enquanto o Grupo C apresentou um tecido conjuntivo fino na área central do defeito em ambos os tempos de observação. Após 4 semanas, os Grupos C (22,04%±5,42) e VB/SC (19,17%±11,61) apresentaram significativamente mais neoformação óssea que o Grupo VB (9,21%±3,81). Não foram encontradas diferenças estatísticas entre os Grupos C e VB/SC. Após 12 semanas, o Grupo VB/SC (30,40%±14,28) apresentou mais formação óssea que os Grupos C (26,88%±11,83) e VB (21,02%±9,76). Contudo, as diferenças não foram significativas. Comparando-se os resultados de 4 e 12 semanas, observou-se um aumento significativo na neoformação óssea nos Grupos VB e VB/SC, mas não no Grupo C. As partículas de VB podem ser usadas, associadas ou não à barreira de SC, para tratar DTC, visando impedir o colapso da área cirúrgica.The purpose of this study was to histologically analyze the influence of the following materials on bone healing in surgically created critical-size-defects (CSD) in rat calvaria: a) Bioactive glass (BG) particles (Biogran®); b) BG/calcium sulfate (CS) barrier (Calcigen™). A 5 mm diameter CSD was made in each calvarium of 48 rats. They were divided into 3 groups: a) C (control): defect filled by blood clot only; b) BG: defect filled with bioactive glass; c) BG/CS: defect filled with BG covered by a CS barrier. Groups were divided into subgroups and euthanized at either 4 or 12 weeks (n=8). Histometric, using image analysis software, and histologic analyses were performed. Amount of new bone was calculated as percentage of total area of original defect. Percentage data were transformed into arccosine for statistical analysis (ANOVA, Tukey, p<0.05). No defect completely regenerated with bone. BG particles were observed in Groups BG and BG/CS at both periods of analysis. Thickness throughout entire healing area in Groups BG and BG/CS was similar to that of original calvarium, while Group C presented a thin connective tissue in the central area of the defect at both periods of analysis. At 4 weeks, Groups C (22.04%±5.42) and BG/CS (19.17%±11.61) presented significantly more bone formation than Group BG (9.21%±3.81). No significant differences were found between Groups C and BG/CS. At 12 weeks, Group BG/CS (30.40%±14.28) presented more bone formation than Groups C (26.88%±11.83) and BG (21.02%±9.76). However, the differences were not significant among the 3 groups. When comparing 4 and 12 weeks, there was a significant increase in new bone formation within groups BG and BG/CS, but not C. BG particles used with or without a CS barrier can be used to treat CSD in order to avoid collapse of the area

Use of the Probiotic <i>Bifidobacterium animalis</i> subsp. <i>lactis</i> HN019 in Oral Diseases

The oral cavity is one of the environments on the human body with the highest concentrations of microorganisms that coexist harmoniously and maintain homeostasis related to oral health. Several local factors can shift the microbiome to a pathogenic state of dysbiosis. Existing treatments for infections caused by changes in the oral cavity aim to control biofilm dysbiosis and restore microbial balance. Studies have used probiotics as treatments for oral diseases, due to their ability to reduce the pathogenicity of the microbiota and immunoinflammatory changes. This review investigates the role of the probiotic Bifidobacterium animalis subsp. lactis (B. lactis) HN019 in oral health, and its mechanism of action in pre-clinical and clinical studies. This probiotic strain is a lactic acid bacterium that is safe for human consumption. It mediates bacterial co-aggregation with pathogens and modulates the immune response. Studies using B. lactis HN019 in periodontitis and peri-implant mucositis have shown it to be a potential adjuvant treatment with beneficial microbiological and immunological effects. Studies evaluating its oral effects and mechanism of action show that this probiotic strain has the potential to be used in several dental applications because of its benefit to the host

A standartized research protocol for platelet-rich plasma (PRP) preparation in rats

Introduction: The urgent need for studies using standardized protocols to evaluate the real biological effects of PRP has been emphasized by several authors. Objective: The purpose of this study was to standardize a methodology for autologous Platelet-Rich Plasma (PRP) preparation in rats. Material and methods: Twentyfour, 5 to 6-month-old, male rats, weighing 450 to 500 g were used. After general anesthesia, 3.15 ml of blood was collected from each animal, via cannulation of the jugular vein. A standardized technique of double centrifugation was used to prepare PRP. PRP samples and peripheral blood platelets were then manually counted using a Neubauer chamber. Student’s t-test was used to compare the differences between the number of platelets in peripheral blood and PRP samples (p < 0.05). In addition, PRP and peripheral blood smears were stained to see platelets’ morphology. Results: All surgical procedures were well tolerated by the animals and they were healthy during the entire experimental period. PRP samples showed higher significantly platelet concentrations than peripheral blood samples (2,677,583 and 683,680 respectively). Conclusion: Within the limits of this study, it can be concluded that the method used produced autologous PRP with appropriated platelet quantity and quality, in rats

Effect of systemic administration of Bifidobacterium animalis subsp. lactis HN019 on apical periodontitis

Abstract This study aimed to evaluate the effect of Bifidobacterium animalis subsp. lactis (B. lactis) HN019 in drinking water on the development of apical periodontitis (AP) in rats. In total 60 animals were divided into a control group (sound teeth); Group I - regular water without AP; Group II - probiotic water without AP; Group III - regular water with AP; Group IV - probiotic water with AP. AP was induced after 3 days in the control groups and after 7, 21, and 42 days in groups III and IV. The animals were euthanized, and the mandibles were subjected to histotechnical processing. Samples were stained with hematoxylin & eosin (H&E) to identify root canal features, apical and periapical regions. Additionally, histoenzymology was performed to detect osteoclasts, immunohistochemistry was used to identify osteoclastogenesis markers, and the Brown & Brenn technique was applied for microbiological analysis. The data were analyzed using GraphPad Prism 8.0.1 with a significance level of 5%. Although no statistical differences were observed, the groups administered with probiotics showed better conditions in terms of histological aspects seen microscopically. Furthermore, there were no differences in the number of osteoclasts (p > 0.05). The RANKL marker was not found in the probiotic group at 42 days, unlike in group III