Adjunctive Use of Plasma Rich in Growth Factors for Improving Alveolar Socket Healing: A Systematic Review

Purpose: The purpose of this study was to determine if the adjunctive use of plasma rich in growth factors in post-extraction sites could be beneficial in terms of hard/soft tissue healing and patient\u2019s comfort. Materials and Methods: An electronic search was performed on MEDLINE, EMBASE, Scopus, and CENTRAL. Only controlled clinical trials or randomized clinical trials that used plasma rich in growth factors in the test group were included. The primary outcomes were: pain assessment, complications and adverse events; secondary outcomes were hard tissue healing, bone remodelling, soft tissue healing. Results: Eight comparative studies (5 RCTs) were included. Four studies had a split-mouth design. 614 teeth were extracted in 338 patients. Only qualitative analysis could be done. Postoperative pain and the incidence of complications like alveolar osteitis was consistently lower in the test group. Hard tissue healing, evaluated by clinical, radiographic, histological and histomorphometric technique showed results significantly better for the test group in almost all studies. Better epithelization, keratinized tissue thickness and healing score were also reported. Conclusion: Plasma rich in growth factors may bring advantages in some relevant clinical and radiographic outcomes following tooth extraction, such as bone density and soft tissue healing. It could also represent a useful tool for reducing adverse events, complications and patients\u2019 discomfort, however still not quantifiable

Anatomical factors associated with gender recognizability: A study on intraoral standardized photographs

AIM: The aim of this research was to evaluate the possibility of identifying the sex of 1 subject through visual assessment of a frontal photograph of dentition, and to investigate if some morphological characteristics are related to sex determination. METHODS: 5 expert dentists, 5 non-expert dentists and 5 laypeople were made to watch 100 intraoral photographs for 5 seconds each and to establish their sex. The responses of the participants and the baseline characteristics of photographed dentitions were analyzed. RESULTS: The proportion of right answers was 56.0% \ub1 8.2% in the group of expert dentists, 65.0% \ub1 6.0% in the group of non-expert dentists and 58.6% \ub1 4.5% in the group of non-expert people. The round shape of maxillary central incisors was related to the female gender (P = .006). The male condition was correlated with poor oral hygiene for 4 observers. Female sex perception was correlated with round morphology of upper central incisors for 3 observers. CONCLUSION: No difference in the ability to determine the sex was registered among groups, suggesting that sex perception is not strongly influenced by the characteristics of dentition

In Vivo and In Vitro Effectiveness of Rotary Nickel-Titanium vs Manual Stainless Steel Instruments for Root Canal Therapy : Systematic Review and Meta-analysis

Introduction: This systematic review evaluated the effectiveness of nickel-titanium (NiTi) rotary files compared to stainless-steel (SST) hand files. Methods: An electronic search was performed on Medline, EMBASE, CENTRAL and Scopus databases up to February 2016. An additional hand searching was performed in 13 journals. The studies were classified according to study type and the outcome variables. Two reviewers independently applied eligibility criteria, extracted data, and three reviewers independently assessed the quality of the evidence of each included study according to The Cochrane Collaboration's procedures. A meta-analysis was performed whenever it was possible. Results: The electronic and hand search strategies yielded 1155 references of studies after removal of duplicates. Four clinical studies (two prospective and two retrospective studies) and 18 in vitro studies (on extracted teeth) were included for the qualitative synthesis after full-text evaluation of the eligible studies. The overall level of methodological quality of the studies included can be considered inadequate. Only one clinical study was judged at low risk of bias, whereas most non-clinical studies had a low risk of bias. Three meta-analyses, based on a very limited number of studies, could be performed. Each meta-analysis contained two studies. Of these, one meta-analysis was based on clinical studies. Conclusions: The results of this systematic review suggested that NiTi rotary instruments were associated with lower canal transportation and apical extrusion when compared to SST hand files, whereas both groups had similar outcomes in terms of success of therapy, amount of residual bacteria, and cleansing ability after treatment. However, due to the limited evidence available, these results should be interpreted with caution. Consequently, more randomized control trials using standardized protocols are needed in order to provide more solid recommendations

Influence of Diabetes on Implant Failure and Peri-Implant Diseases: A Retrospective Study

Diabetes is an important modifying factor of periodontitis, but its association with peri-implant diseases has not been fully explored and the existing literature reports controversial results. The aim of this retrospective study was to evaluate the influence of diabetes on peri-implantitis and implant failure. Smoking status, history of periodontal disease, presence of diabetes, diabetes type, therapy and glycaemia levels were collected in a total of 204 subjects treated with 929 implants, with a mean follow-up time of 5.7 \ub1 3.82 years after loading. Odds ratio (OR) for diabetes as a direct cause of peri-implantitis and implant failure were calculated, adjusted for smoking status and history of periodontitis. Nineteen patients were diabetic and most of them presented a good control of the disease at the time of surgery. The overall patient-level prevalence of peri-implantitis was 11.3%. Among diabetic patients, one developed peri-implantitis, whereas one experienced multiple implant failures. The calculated ORs, adjusted for smoking status and periodontitis, were not statistically significant. The results revealed no association between diabetes and peri-implantitis or implant failure coherently with the existing scientific literature. The actual influence of hyperglycemia on implant failure is still uncertain and new studies with larger cohorts of patients are needed

Fifteen-Year Follow-Up of a Case of Surgical Retreatment of a Single Gingival Recession

Purpose. The aim of the present case report was to describe the retreatment of the single gingival recession in aesthetic area, in the presence of scar formation and consequent impairment of aesthetic appearance. Methods. A young patient with one single recession of 4 mm of 2.1 was treated with coronally advanced flap and subepithelial connective tissue graft, through a microsurgical approach that aimed at the removal of the scarred fibrous tissue. The intervention was performed using a surgical microscope as a magnification device. Results. Fifteen years after the surgical treatment, a substantial stable resolution of the gingival recession could be observed. Moreover, a further improvement of the aesthetic appearance could be observed. Conclusions. This case report suggests that periodontal microsurgery could be an effective approach for the retreatment of gingival recessions and, in long-Term evaluation, to reduce the aesthetic problem due to the presence of scar formation. Further studies with a larger sample size are needed to better evaluate its efficacy

Guided tissue regeneration using a barrier membrane in endodontic surgery

Endodontic surgery aims at the resolution of a periapical inflammatory process by surgical access followed by enucleation of the lesion and root-end filling to curb any potentially noxious agent within the physical confines of the affected root. Guided bone regeneration could be associated to endodontic surgery aiming to enhance periradicular tissue regeneration. The objective of this paper was to review the scientific literature about guided bone regeneration in endodontic surgery, evaluating the effects on periapical lesion healing process. The included articles are classified considering the anatomical characteristics of the lesion. Fourteen articles were included in the review after abstract and title selection. Eight articles were on studies on lesions affecting only the periapical region (three about through-and-through lesions) while six were about the treatment of apico-marginal lesions. On the basis of the currently available literature, there is a low scientific evidence of a benefit related. to the use of guided bone regeneration procedure in endodontic surgery

CONVERSAR e Tensionar na Formação (des)continuada, Inventiva/inclusiva: Cartografia de uma Escola Território

A tese inicia com indagações sobre a formação de educadores inclusivos a partir do paradigma de rede. A concepção de homem e de mundo que orienta esta investigação aponta para a complexidade da vida, entendendo o homem e a sociedade como emaranhados em uma rede de produções, intensidades de sentidos e afetações que configuram a existência. Compreendem-se os fenômenos como produção coletiva, produção de subjetividade, onde os padrões assumidos como normais são fruto de um complexo processo de reprodução de sujeitos e reinvenção da vida através da potência de criação. O trabalho configura-se como uma investigação qualitativa móvel, onde nos perguntávamos e perguntamos acerca de como a conversação, na formação de professores se efetiva como uma forma de resistência, de criação à subjetividade capitalística? Como as conversações da formação de professores se efetivavam e inventavam modos de existência inclusivos? Realizamos uma pesquisa-intervenção porque assume o plano da experiência enquanto intervenção. Tateamos, fabricamos dispositivos produtivos para fazer emergir desde o fazer, o saber. Realizamos uma cartografia das ações e criações de profissionais de uma escola pública de Ensino Fundamental de Educação de Jovens e Adultos que trabalha nos três turnos com pessoas oriundas das camadas populares e que tiveram negado o direito de estudar. Realizamos o acompanhamento do percurso formativo de um grupo de professores da escola-território no decorrer do ano de 2014. Todos os relatos e narrativas foram registrados no diário de campo e gravados digitalmente. O material produzido foi analisado a partir das orientações da análise do discurso proposto por Foucault, buscando escapar da frágil interpretação daquilo que estaria por trás dos documentos, pois entendemos que as produções são uma realização histórica, política. As análises dos discursos nos levaram a dois platôs, duas regiões, territórios intensivos: a) A formação descontinuada que dinamiza o processo de organização do trabalho docente e b) A prática inclusiva via produção de redes colaborativas que dinamizam a escolaterritório. Uma formação em tempos de desafios inclusivos demanda ser inventiva. Na experiência junto à escola-território vimos que quando uma formação se rege por análises da implicação, onde não há linearidade dos estudos e reflexões, já que a cada encontro se conversa sobre novas experiências vividas e problemas enfrentados, proliferam redes colaborativas, fundamentais para a superação do individualismo. Uma formação que opera pela resistência produzirá agenciamentos e conexões éticas/estéticas/políticas, possibilitando a produção de outros valores, diferentes dos da sociedade neoliberal, porque fortalece a coletivização da vida, criando redes sociais territoriais. O encontro das modalidades da Educação de Jovens e Adultos e da Educação Especial pela via da formação inventiva/descontinuada/ ética/estética/política se apresenta como um forte caminho e modo de produção de uma educação equitativa, por ser pública e popular

Magnification devices for endodontic therapy

BACKGROUND: After the introduction of microsurgical principles in endodontics involving new techniques for root canal treatment, there has been a drive to enhance the visualisation of the surgical field. It is important to know if the technical advantages for the operator brought in by magnification devices such as surgical microscopes, endoscopes and magnifying loupes, are also associated with advantages for the patient in terms of improvement of clinical and radiographic outcomes. This version updates the review published in 2009.OBJECTIVES: To evaluate and compare the effects of endodontic treatment performed with the aid of magnification devices versus endodontic treatment without magnification devices. We also aimed to compare the different magnification devices used in endodontics with one another.SEARCH METHODS: The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 13 October 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 9), MEDLINE via OVID (1946 to 13 October 2015) and EMBASE via OVID (1980 to 13 October 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.SELECTION CRITERIA: We considered all randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing endodontic therapy performed with versus without one or more magnification devices, as well as randomised and quasi-randomised trials comparing two or more magnification devices used as an adjunct to endodontic therapy.DATA COLLECTION AND ANALYSIS: We conducted screening of search results independently and in duplicate. We obtained full papers for potentially relevant trials. The Cochrane Collaboration statistical guidelines were to be followed for data synthesis.MAIN RESULTS: No trials met the inclusion criteria for this review.AUTHORS' CONCLUSIONS: No article was identified in the current literature that satisfied the criteria for inclusion. It is unknown if and how the type of magnification device affects the treatment outcome, considering the high number of factors that may have a significant impact on the success of endodontic surgical procedure. This should be investigated by further long-term, well-designed RCTs that conform to the CONSORT statement (www.consort-statement.org/)

Healing of Postextraction Sockets Preserved With Autologous Platelet Concentrates : A Systematic Review and Meta-Analysis

Purpose The true benefit of autologous platelet concentrates (APCs) for enhancing the healing of postextraction sites is still a matter of debate, and in recent years several clinical trials have addressed this issue. The purpose of this study was to determine the effectiveness of an APC adjunct in the preservation of fresh extraction sockets. Materials and Methods An electronic search was performed on Medline, Embase, Scopus, and the Cochrane Central Register of Controlled Trials. Only controlled clinical trials or randomized clinical trials were included. Selected articles underwent risk-of-bias assessment. The outcomes were complications and adverse events, discomfort and quality of life, bone healing and remodeling assessed by histologic and radiographic techniques, and soft tissue healing. Results Thirty-three comparative studies were included. Nine articles had a parallel design and 24 had a split-mouth design. Twenty studies were considered to have a low risk of bias and 13 were considered to have a high risk. Overall, 1,193 teeth were extracted from 911 patients. Meta-analysis showed that soft tissue healing, probing depth at 3 months, and bone density at 1, 3, and 6 months were statistically better for the APC group. Qualitative analysis suggested that APCs might be associated with a decrease in swelling and trismus. However, no relevant difference among groups was found for probing depth at 1 month, incidence of alveolar osteitis, acute inflammation or infection, percentage of new bone, and indirect measurement of bone metabolism. Conclusion APCs should be used in postextraction sites to improve clinical and radiographic outcomes such as bone density and soft tissue healing and postoperative symptoms. The actual benefit of APCs on decreasing pain in extraction sockets is still not quantifiable