Inter-relação entre consumo de cigarros e a periodontia

A instalação e progressão da doença periodontal envolve um conjunto de eventos imunopatológicos e inflamatórios com a participação dos fatores modificadores locais, sistémicos, ambientais e genéticos. O consumo de cigarros está atualmente estabelecido como um fator de risco da doença periodontal ( Kerdvongbundit & Wikesjo, 2002) e como um potente modificador na progressão e severidade desta (SALLUM et al., 1993; HABER, 1994; NOCITI JR. et al., 2000). Além disso, vários trabalhos têm demonstrado que o tabagismo apresenta um impacto negativo sobre a resposta à terapia periodontal cirúrgica e não-cirúrgica, incluindo raspagem e alisamento radicular, cirurgias periodontais e procedimentos regenerativos (Cortellini et al., 1996; Kaldahl et al.,1996; Martins et al.,2004). A existência de uma série de toxinas no tabaco ainda não identificadas faz com que o mecanismo preciso pelo qual o fumo interfere nos tecidos periodontais não seja completamente compreendido. Isto mostra o quanto ainda precisa-se conhecer sobre os verdadeiros efeitos deste consumo e o quanto necessita-se analisar sua influência negativa em procedimentos periodontais. Aliado ao motivo anteriormente citado, tem o fato do consumo de cigarros em nossa sociedade estar cada vez maior, aumentando a rotina destes pacientes nos serviços odontológicos. Há assim, a necessidade de que os profissionais conheçam mais o comportamento dos tecidos periodontais dos pacientes fumantes frente tanto aos periodontopatógenos como às terapias periodontais. Torna-se importante analisarmos o consumo do tabaco como um verdadeiro fator de risco para a doença periodontal, interferindo na microbiota, na resposta imuno-inflamatória, nos tecidos periodontais e no processo de reparo do hospedeiro.The development and progression of periodontal diseases involves many inflammatory and immunopathologic factors. In the past few years, epidemiological studies have caused professionals to change their concepts and increase attention toward risk factors. Smoking appears to be one of the most significant risk factors, not only affecting the prevalence, but also changing the progression of periodontal diseases. Experimental evidence has demonstrated that cigarette smoking may negatively influence the healing outcome following various periodontal therapeutic procedures. Smokers showed a significantly less favorable response compared to that observed for non-smokers after surgical and non-surgical treatments. ln addition , smoking has become more popular and the number of smokers in dental society has increased significantly. Therefore, further studies are needed to investigate the effects of smoking on periodontal therapies. lt is important to analyze the smoking as a true risk factor of periodontitis that effects on microbiology, on the inflammatory response and on the response to periodontal therapy

Platelet-rich plasma plus bioactive glass in the treatment of intra-bony defects: a study in dogs

OBJECTIVE: This study was designed to evaluate, histomorphometrically, the association of platelet-rich plasma (PRP) and bioactive glass (BG) in the treatment of periodontal intrabony defects. MATERIAL AND METHODS: Nine mongrel dogs were included in the study. Three-wall intrabony defects were surgically created at the mesial and distal aspect of first mandibular molar and exposed to plaque accumulation for 1 month. The defects were randomly assigned to the groups: control, BG, PRP, PRP+BG. Dogs were sacrificed 90 days after the surgeries. The histometric parameters evaluated were: length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone, defect extension and area of new bone filling the defect. RESULTS: A superior area of new bone was observed in PRP+BG and BG (13.80±2.32 mm² and 15.63±2.64 mm², respectively) when compared to the other groups (8.19±1.46 mm² and 8.81±1.47 mm² for control and PRP, respectively). No statistically significant differences were observed in the remaining parameters. CONCLUSIONS: Within the limits of this study, it may be concluded that PRP failed to provide statistically significant improvements in the histometric parameters

Platelet-rich plasma in the treatment of Class II furcation defects: a histometrical study in dogs

OBJECTIVE: This study was designed to evaluate the potential adjunctive benefits of platelet-rich plasma (PRP) when used with guided-tissue regeneration (GTR) and bioactive glass (BG) in the treatment of Class II furcation lesions. MATERIAL AND METHODS: Bilateral Class II furcation lesions were surgically created and allowed to become chronic in the mandibular third premolars of 9 dogs. The defects were randomly assigned to: A) GTR+BG and B) GTR+BG+PRP. Similar defects were created in the maxillary third premolars and received the same treatments after 45 days. Dogs were sacrificed 90 days after the first treatment. The histometric parameters evaluated were: connective tissue adaptation, new cementum, new bone, mineralized bone area, non-mineralized bone area, and residual BG particle area. RESULTS: Data analysis showed a superior length of new cementum and a greater mineralized bone area for group B in both periods (p<0.05). The non-mineralized bone area was greater in the control group (p<0.05) in both periods. CONCLUSION: Within the limits of this study, it can be concluded that the use of PRP in the treatment of Class II furcation defects may enhance the amount of new cementum and provide a more mineralized bone in a shorter period of time