Histopathological Features of Dental Pulp in Teeth with Different Levels of Chronic Periodontitis Severity

Purpose. To evaluate the histopathological condition of the pulp in teeth with different levels of chronic periodontitis in humans. Methods. Twenty-five single-root nondecayed teeth were divided into three groups as follows: group 1, clinical attachment level (CAL) 3 to 4 mm and alveolar bone loss (BL) from 4 to 6 mm without reaching the tooth apex; group 2, CAL ≥ 5 mm and BL > 6 mm without reaching the tooth apex; group 3, CAL ≥ 5 mm and BL > 6 mm up to the tooth apex. Histological analyses were accomplished after laboratorial processing. Results. The mean of CAL was 3.2 ± 0.7 mm in group 1, 7.6 ± 2.0 mm in group 2, and 12.1 ± 2.8 mm in group 3, while for BL it was 4.8 ± 0.9 mm, 7.6 ± 2.2 mm, and 11.9 ± 2.1 mm, respectively. Histopathological data in the pulpal chambers were similar among the three groups showing normal aspects, and, the radicular pulps showed variable levels of reactive dentin, fibrosis, dystrophic mineralizations, atrophy, and mononuclear inflammatory infiltrate. Conclusions. Gradual progression of the chronic periodontitis led to changes in the histopathological aspects of the radicular pulp with progressive involvement

Bone-Implant Contact around Crestal and Subcrestal Dental Implants Submitted to Immediate and Conventional Loading

The present study aims to evaluate the influence of apicocoronal position and immediate and conventional loading in the percentage of bone-implant contact (BIC). Thus, 36 implants were inserted in the edentulous mandible from six dogs. Three implants were installed in each hemimandible, in different positions in relation to the ridge: Bone Level (at crestal bone level), Minus 1 (one millimeter apical to crestal bone), and Minus 2 (two millimeters apical to crestal bone). In addition, each hemimandible was submitted to a loading protocol: immediate (prosthesis installed 24 hours after implantation) or conventional (prosthesis installed 120 days after implantation). Ninety days after, animals were killed, and implant and adjacent tissues were prepared for histometric analysis. BIC values from immediate loaded implants were 58.7%, 57.7%, and 51.1%, respectively, while conventional loaded implants were 61.8%, 53.8%, and 68.4%. Differences statistically significant were not observed among groups (P=0.10, ANOVA test). These findings suggest that different apicocoronal positioning and loading protocols evaluated did not interfere in the percentage of bone-implant contact, suggesting that these procedures did not jeopardize osseointegration

Influência do estado diabético na doença periodontal induzida em ratos: análise metabólica, genética e radiográfica

Evidências sugerem existir correlação positiva entre diabetes mellitus e destruição periodontal. Com intuito de estudar a influência do Diabetes Mellitus sobre a evolução da doença periodontal induzida, o presente estudo apresenta como objetivos, avaliar alterações metabólicas como, peso corporal, níveis séricos de cálcio, fósforo e fosfatase alcalina, alterações macroscópicas e óssea, e a expressão tecidual de mieloperoxidase e das citocinas IL-1β, IL-6, TNF-α, IFN-γ. Foram utilizados ratos machos Wistar divididos em 4 grupos de 24 ratos, sendo: Grupo I controle; Grupo II diabético; Grupo III controle com doença periodontal induzida e Grupo IV diabético com doença periodontal induzida. Após dois dias da confirmação do estado diabético induzido por estreptozotocina, foi realizada a colocação da ligadura. Oito animais de cada grupo foram sacrificados nos períodos experimentais de 3, 7, 15 e 30 dias após colocação da ligadura. Foi utilizado testes bioquímicos para avaliação das enzimas séricas, lupa esteroscópica para análise macroscópica, programa analisador de imagens digital para mensuração da perda óssea, leito de ELISA para determinar a concentração de MPO e Real-time PCR para expressão das citocinas. Os resultados demonstraram que o estado diabético perdurou até o final do experimento nos grupos II e IV, com níveis glicêmicos elevados. Dentre os marcadores bioquímicos, somente a ALP apresentou-se estatisticamente maior nos grupos diabéticos (II e IV). Macroscopicamente, houve diferença somente entre os grupos com e sem doença periodontal, independente da presença do diabetes, com maior alteração tecidual, caracterizada por migração apical da gengiva marginal, perda de contorno marginal e de tecido interdental, nos períodos tardios de periodontite (15 e 30 dias).Evidences suggest the existence of a positive correlation between diabetes mellitus and periodontal collapse. In order to evaluate the influence of Diabetes Mellitus on the progression of periodontal disease induced in rats, the objective of the present study was to verify glycemic, calcium, phosphorus and alkaline phosphatase serum levels, to evaluate tissue and alveolar bone loss, myeloperoxidase (MPO) gingival levels, as IL-1β, IL-6, TNF-α, IFN-γ tissue expression. Wistar male rats were used in this study. They were divided into 4 groups of 24 rats each, as follows: Group I – control; Group II – diabetic; Group III – control with periodontal disease induced; and Group IV – diabetic with periodontal disease induced. After streptozotocin diabetic state was confirmed, a ligature was placed on the mandibular first molar teeth of Groups III and IV rats. Eight animals of each group were killed at the experimental periods of 3, 7, 15 and 30 days after the ligature placement. Was used biochemical tests for evaluation of serum enzymes, magnifying glass to macroscopic analysis, digital image analyzer program for measurement of bone loss, ELISA to determine the concentration of MPO and Real-time PCR for expression of cytokines. Results demonstrated that the diabetic state lasted up to the end of the experiment at groups II and IV. Significant increases in serum alkaline phosphatase were observed at diabetic groups (II and IV). Macroscopically, in the groups where periodontal disease was induced, it was possible to observe more tissue alterations and it was higher in the 30-day experimental period. The MPO levels were significantly higher in induced periodontitis groups (III and IV) (p<0.05). The Group IV showed higher bone loss significantly when compared to the other groups (p < 0.05). The cytokines IL-6 and IFN-γ were elevated in groups III and IV at 30 ° day. The cytokine IL-1β was reduced at group II.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Avaliação clínica e microbiológica de pacientes portadores de Diabetes mellitus do tipo 2

O objetivo deste estudo foi avaliar os efeitos do tratamento periodontal em pacientes diabéticos do tipo 2 sobre alterações de fluxo salivar, xerostomia, Candida spp. na saliva e candidose bucal clínica. Foram selecionados 20 pacientes diabéticos tipo 2 e 17 pacientes não-diabéticos de ambos os gêneros, com idade média entre 37 e 55 anos, portadores de doença periodontal crônica. Após exame clínico para avaliação das condições clínicas periodontais, presença de xerostomia e presença clínica de candidose bucal, amostras de saliva foram coletadas para mensuração do fluxo salivar (mL/min), contagem das colônias de Candida spp. (UFC/mL) e identificação das espécies. Esse procedimento foi realizado antes da terapia periodontal (baseline), que consistiu em raspagem e alisamento radicular, instrução de higiene bucal e motivação do paciente, aos 30 e 90 dias após a mesma. Os resultados demonstraram que os pacientes diabéticos apresentaram maior ocorrência de xerostomia e de candidose bucal, sendo estes colonizados por várias espécies de Candida spp. com predominância de C. albicans, sem no entanto, implicar no desenvolvimento da candidose clinicamente. A terapia periodontal, a motivação do paciente e a instrução de higiene bucal foram importantes para melhorar as condições clínicas periodontais e evitar a formação de reservatórios intrabucais de infecção.In order to investigate the effect of periodontal therapy, in type 2 diabetes mellitus subjects about salivar flow rates, presence of xerostomia, presence of Candida species in the saliva and presence of buccal candidose, twenty type 2 diabetes mellitus subjects and seventeen no-diabetes mellitus subjects, with medium age among 33 to 55 years, presenting generalized chronic periodontal disease were selected. After initial clinical exam to analyze periodontal parameters, xerostomia and buccal candidose presence, saliva samples were assessed to quantify as millimeters of saliva generated per minute (mL/min), account yeasts by colony forming units per mL (CFU/mL) and identificated species. That procedure was accomplished before periodontal therapy (baseline) that it consisted in scaling and root planning, oral hygiene instructions and patient's motivation to the thirty and ninety days after these. Diabetics subjects showed to having hyposalivation in similar levels in no-diabetics groups and in all the analyzed periods, higher prevalence of xerostomia and higher occurrence of buccal candidose. Candida albicans were the prevalent yeast at all periods in both groups, but the presence of yeasts in saliva not implied in the development of buccal candidose. Concluded that the periodontal therapy, the patients' motivation and the buccal hygiene instructions improve periodontal conditions and avoid the formation of microbial reservoirs in mouth.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Periodontal disease in individuals with Down Syndrome: genetic focus

Fundamental concepts of etiology, inheritance and clinical characteristics of Down syndrome are used in this review as a basis for submission of studies that focus on periodontal disease in individuals with Down syndrome, since almost 100% of them develop the disease in adult life. It is believed that in association with environmental and cultural factors related to hygiene and disabilities of coordination, the immunological characteristics that are found altered in individuals with Down syndrome, such as deficient neutrophil chemotaxis and reduced number of mature T lymphocytes, may contribute to the greater prevalence and severity of periodontal involvement in patients with Down syndrome. Moreover, the pattern of periodontal destruction observed in individuals with Down syndrome is consistent with aggressive periodontitis, with a predominance of periodontopathogens such as Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythensis during childhood and adolescence of Down’s syndrome patients. It is possible to note a relationship between the development of molecular techniques and the evolution of knowledge about Down syndrome, for example: identification of the trisomy syndrome by observing only part of chromosome 21 (distal long arm); identification of genes in this trisomic region and the pattern of superexpression (or not) of these genes. Moreover, in this review future perspectives are presented with regard to better understanding Down syndrome in the genetic context, which will reflect in more individualized and effective clinical treatments that will provide these patients with a better quality of life

Prevenção da retração gengival por tratamento ortodôntico e efetiva higiene bucal: relato de vinte anos de observação

Introduction: The crowding of lower permanent incisors is an often occurrence during the mixed dentition, a condition that may lead to the formation of an inadequate width of attached gingiva and / or retraction of the gingival border. Besides crowding, rotations, buccal or lingual inclinations, and the presence of adhesions and large muscle insertions may cause dental biofilm retention which, combined with a thin gingival biotype, are considered risk factors for the onset of gingival recession in this area. Thus, it is important to use measures that can avoid the formation of gingival recession to prevent the occurrence of mucogingival problems that in most cases lead to the necessity of surgical procedures that can be traumatic for patients. Proposition: To present a clinical case involving the prevention of gingival retraction through orthodontic treatment and oral hygiene. Materials and Methods: After the person responsible for the minor signed an informed consent, the patient underwent periodontal and orthodontic clinical examination with the purpose of evaluating the mucogingival condition and the dental position in order to plan the proper orthodontic treatment. Case report: The patient was a 7-year old girl with lower incisors crowding, rotations, and excessive buccal and lingual inclinations. Additionally, she also presented extremely thin keratinized gingiva, strongly suggesting that her tooth development alone would not keep the gingival thickness; there was also the possibility of gingival retraction due to the orthodontic movement and poor hygiene. The recommended orthodontic treatment, along with an oral hygiene orientation and maintenance program, was kept during the four years of orthodontic treatment. Its success was observed after 16 years of maintenance. Conclusion: The orthodontic treatment together with periodontal maintenance provided satisfactory results, which were followed-up during twenty years of observation.Introdução: O apinhamento dos incisivos permanentes inferiores ocorre com frequência durante a fase da dentição mista, situação que pode levar à formação de uma faixa de gengiva inserida inadequada e/ou retração da margem gengival. Além do apinhamento, as giroversões, inclinações vestibulares ou linguais, a presença de bridas e inserções musculares altas são fatores de retenção do biofilme dentário que, aliados a um biótipo gengival delgado, são considerados de risco para o aparecimento das retrações gengivais nessa região. Dessa forma, medidas que possam evitar a formação da retração gengival são importantes para prevenir o aparecimento de problemas mucogengivais que, na maioria dos casos, levam à necessidade de intervenções cirúrgicas que podem ser traumáticas para os pacientes. Proposição: Apresentar um caso clínico sobre prevenção da retração gengival por tratamento ortodôntico e higiene bucal. Materiais e métodos: Após consentimento livre e esclarecido do responsável pelo menor, o paciente foi submetido a exame clínico periodontal e ortodôntico com finalidade de avaliação mucogengival e da posição dentária para planejamento ortodôntico adequado. Caso clínico: Paciente, gênero feminino, com 7 anos de idade, apresentava os incisivos inferiores com apinhamento, giroversões e excessivas inclinações vestibulares e linguais. Adicionalmente, também apresentava gengiva queratinizada extremamente delgada, com forte sugestão de que o desenvolvimento da dentição por si só não manteria a espessura gengival, tendo ainda a possibilidade de risco de retração gengival com a movimentação ortodôntica e higiene precária. O tratamento ortodôntico preconizado, juntamente com um programa de orientação e manutenção de higienização bucal, foi mantido durante os quatro anos de tratamento ortodôntico. Seu sucesso foi observado após 16 anos de manutenção. Conclusão: O tratamento ortodôntico, em associação com a manutenção periodontal, proporcionou resultados satisfatórios, os quais foram mantidos ao longo de vinte anos de observação

Oral conditions and body weight in children from a public school in Manaus, AM, Brazil

Abstract Introduction Some studies have pointed to links between the prevalence of caries and periodontal disease, and the occurrence of overweight or obesity; but, few studies have been conducted in children. Objective To assess the relationship between periodontal disease, tooth decay and body weight in children from a public school in Manaus, AM, Brazil. Material and method The study included one hundred and sixty-nine children. Records were obtained of decayed, missing and filled (DMFT) permanent teeth, and of decayed, extracted, or filled (DEF) deciduous teeth, as well as the record of the community periodontal index (CPI). The classification of body weight category was obtained in percentile using the z-Score table. Result Higher averages of weight and body mass index (BMI) were seen in the overweight and obesity groups (p<0.05). All groups were similar regarding the DMFT /DEF and CPI codes from 0 to 4 (p>0.05). All groups showed higher averages of CPI 0 in comparison with other CPI codes from 1 to 4 (p<0.05), and most of the children showed sites with probing depth <3.5 mm and without bleeding on probing. Conclusion There was no relationship between body weight and the occurrence of dental caries and periodontal disease in the studied population. Obesity and overweight showed no negative influence on the increase in the prevalence of these diseases

Fatigue and Fluoride Corrosion on Streptococcus mutans Adherence to Titanium-Based Implant/Component Surfaces

Purpose: The influence of fatigue and the fluoride ion corrosion process on Streptococcus mutans adherence to commercially pure Titanium (Cp Ti) implant/component set surfaces were studied.Materials and Methods: Thirty Nobel implants and 30 Neodent implants were used. Each commercial brand was divided into three groups. Group A: control, Group B: sets submitted to fatigue (105 cycles, 15 Hz, 150 N), and Group C: sets submitted to fluoride (1500 ppm, pH 5.5) and fatigue, simulating a mean use of 5 years in the oral medium. Afterward, the sets were contaminated with standard strains of S. mutans (NTCC 1023) and analyzed by scanning electronic microscopy (SEM) and colony-forming unit counts (CFU/mL).Results: By SEM, bacterial adherence was verified only in group C in both brands. By CFU/mL counts, S. mutans was statistically higher in both brands in group C than in groups A and B (p < 0.05, ANOVA).Conclusion: The process of corrosion by fluoride ions on Cp Ti implant/component sets allowed greater S. mutans adherence than in the absence of corrosion and with the fatigue process in isolation.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES