O efeito das proteinas derivadas da matriz do esmalte e da regeneração ossea guiada no tratamento de defeitos periimplantares : estudo histometrico em cães

Orientador: Enilson Antonio Sallum, Antonio Wilson SallumTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O objetivo deste estudo foi avaliar, histometricamente, a utilização das proteínas derivadas da matriz do esmalte (PME), associadas ou não à técnica de regeneração óssea guiada (ROG), no tratamento de deiscências ósseas peri-implantares. Foram utilizados seis cães, os quais tiveram os pré molares (p2, p3, p4) e molar (m1) mandibulares extraídos bilateralmente. Após três meses da extração, foram criadas quatro deiscências ósseas vestibulares bilaterais e instalados quatro implantes. As deiscências foram designadas aleatoriamente aos seguintes grupos: PME, ROG, associação PME + ROG e grupo controle. Após dois meses, nos mesmos animais, mais quatro deiscências foram criadas e mais quatro implantes instalados, sendo tratadas da mesma maneira. Três meses depois da primeira intervenção, os animais foram sacrificados e o material processado. As porcentagens médias obtidas para o parâmetro contato ossolimplante, nos grupos PME, ROG, associação PME + ROG e grupo controle, no período de um mês de pós-operatório foram 15,03:t 23,76; 12,87 :t 9,35; 8,52 :t 6,89; 3,88 :t 5,70, respectivamente (p>0,05). No período de três meses: 18,07:t 13,52; 24,42:t 19,88; 36,11 :t 17,53; 16,96:t 17,77, respectivamente (p>0,05). Para o parâmetro área de novo osso na região das roscas, no período de um mês de pós-operatório, observou-se: 41,82 :t 22,03; 42,89 :t 18,08; 34,43 :t 15,75; 34,07 :t 22,08, respectivamente (p>0,05). No período de três meses: 55,55 :t 11,81; 53,89 :t 16,35; 62,15 :t 18,47; 36,95 :t 25,10, respectivamente, sendo as diferenças entre o grupo controle e o grupo da associação PME + ROG estatisticamente significantes (p0,05). The three-month evaluation showed a mean of 18.07 _ 13.52; 24.42 _ 19.88; 36.11 _ 17.53; 16.96 _ 17.77, respectivelly (p>0,05). The mean new bone area in the implant threads in the first month was as follows: 41.82 _ 22.03; 42.89 _ 18,08; 34.43 _ 15.75; 34.07 _ 22.08, respectivelly (p>0,05). At three months, the mean values were: 55.55 _ 11.81; 53.89 _ 16.35; 62.15 _ 18.47; 36.95 _ 25.10, respectivelly. The differences between the control group and EMP + GBR group were statistically significant (p<0,05). Within the limits of the present study, the association of EMP and GBR provided a greater implant thread bone fill when compared to the control group at the three-month evaluationDoutoradoPeriodontiaDoutor em Clínica Odontológic

Regeneração tecidual guiada com membranas reabsorviveis em retrações gengivais : estudo histometrico em cães

Orientadores: Enilson Antonio Sallum, Antonio Wilson SallumDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: o objetivo deste trabalho foi avaliar, histometricamente, o processo de cura de defeitos periodontais tipo retrações gengivais, criados cirurgicamente nos caninos superiores de cães, após serem tratados pela técnica de regeneração tecidual guiada utilizando-se de membranas reabsorvíveis de ácido poliláctico (Guidor@). Após a criação cirúrgica, os defeitos ficaram sujeitos a acúmulo de placa por três meses. Terminado este período, os defeitos bilaterais semelhantes foram aleatoriamente designados a receber os seguintes tratamentos: regeneração tecidual guiada (Grupo teste) e retalho reposicionado coronariamente (Grupo controle). Após três meses de cicatrização, foram obtidas as .peças para a análise histológica. Foram avaliados os seguintes parâmetros histométricos: cobertura radicular, extensão do epitélio sulcular e juncional, adaptação conjuntiva, novo cemento, novo osso e extensão do defeito. A porcentagem de recobrimento radicular. observada nos grupos teste e controle foi, 90.6% e 91.9%, respectivamente. As médias obtidas no grupo teste e controle, respectivamente, foram: novo cemento, 3,8 ::!:: 1,5mm e 2,4 ::!:: 0,3mm; extensão do epitélio sulcular e juncional, 1,9 ::!:: 0,8mm e 3,0 ::!:: 0,9mm; a.daptação conjuntiva, 0,1 ::!:: O,lmm e 0,8 ::!:: 0,5mm; novo osso, 1,1 ::!:: 0,5mm e 1,4 ::!:: 0,2mm. Não foram encontradas diferenças estatisticamente significantes entre os grupos, em nenhum dos parâmetros avaliados. Considerando os limites deste estudo, pode-se concluir que ambos os procedimentos resultaram numa resposta favorável quanto ao recobrimento radicular e proporcionaram regeneração periodontal na parte apical do defeito, sem diferenças estatisticamente significantes entre os tratamentosAbstract: The goal of this investigation was to evaluate histologically and histometrically the healing process of gingival recessions treated by guided tissue regeneration with polylactic acid membranes (GTR-group) and to compared it to that obtained with coronally positioned flaps (CPF-group). Five mongrel dogs were used in the experiment. Gingival recessions were surgically created on the bucal aspect of the upper cuspids after removing the soft and hard tissue using hand instruments. The created defects, measuring 5x7 mm, were exposed to plaque accumulation for a period of 3 months. After this period, the contralateral defects were randomly assigned to the GTR-group or the CPF-group. After 3 months ofhealing, the dogs were sacrificed and the blocks containing the experimental specimens were processed for histological analysis. The histometric parameters evaluated were: length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone and defect coverage. The extension of the sulcular andjunctional epithelium was 1.9:t 0.8 mm for the GTR-group and 3.0:t 0.9 mm for the CPF-group (P=0.16). The new connective tissue ,!djacent to the root without cementum formation was 0.1 :t 0.1 and 0.8 :t 0.5 mm in the GTR-group and CPF-group, respectively (p=0.05). The new cementum formation observed was 3.8 :t 1.5mm and 2.4 :t 0.3 mm in the GTR-group and CPF-group, respectively (P=0.16). Bone formation was 1.1 :t 0.5 mm in the GTR-group and 1.4:t 0.2 mm in the CPF-group (P=0.53). Histologically, the defect coverage observed with the two techniques was similar, 90.6% and 91.9% for the GTR-group and the CPF-group, respectively. No statistical differences in any ofthe parameters evaluated could be detected. Within the limits of this study it can be concluded that both procedures resulted in a favorable healing response with no significant difference between the treatmentsMestradoPeriodontiaMestre em Clínica Odontológic

Efeito de uma única sessão de controle de placa supragengival nos parâmetros clínicos e bioquímicos da periodontite crônica

Supragingival plaque control is a requisite for the success of any periodontal procedure. However, little is know about the effect of this procedure alone on periodontitis. The aim of this study was to determine the effect of supragingival plaque control on clinical and biochemical parameters of chronic periodontitis. Twenty-five subjects exhibiting at least 4 pockets >; 5mm, non-smokers and with no relevant systemic diseases, were selected for the study. The clinical and biochemical assessments were done before and 21 days after removal of plaque retentive factors, extraction of affected teeth and instruction in oral hygiene. The statistical analysis was done with the Student paired t-test (pO objetivo deste estudo foi avaliar o efeito do controle de placa supragengival sobre os parâmetros clínicos e bioquímicos da periodontite crônica. Foram selecionados 25 pacientes apresentando pelo menos 4 sítios com profundidade de sondagem >; 5 mm, não fumantes e sem alterações sistêmicas relevantes. A avaliação clínica e bioquímica foi feita antes e 21 dias após a remoção dos fatores retentivos de placa, exodontia dos dentes condenados e instrução de higiene bucal. A análise estatística foi feita através do teste t de Student pareado (

Non-surgical instrumentation associated with povidone-iodine in the treatment of interproximal furcation involvements

OBJECTIVE: The aim of this controlled clinical trial was to evaluate the effect of topically applied povidone-iodine (PVP-I) used as an adjunct to non-surgical treatment of interproximal class II furcation involvements. MATERIAL AND METHODS: Thirty-two patients presenting at least one interproximal class II furcation involvement that bled on probing with probing pocket depth (PPD) >;5 mm were recruited. Patients were randomly chosen to receive either subgingival instrumentation with an ultrasonic device using PVP-I (10%) as the cooling liquid (test group) or identical treatment using distilled water as the cooling liquid (control group). The following clinical outcomes were evaluated: visible plaque index, bleeding on probing (BOP), position of the gingival margin, relative attachment level (RAL), PPD and relative horizontal attachment level (RHAL). BAPNA (N-benzoyl-L-arginine-p-nitroanilide) testing was used to analyze trypsin-like activity in dental biofilm. All parameters were evaluated at baseline and 1, 3 and 6 months after non-surgical subgingival instrumentation. RESULTS: Six months after treatment, both groups had similar means of PPD reduction, RAL and RHAL gain (p>;0.05). These variables were, respectively, 2.20±1.10 mm, 1.27±1.02 mm and 1.33±0.85 mm in the control group and 2.67±1.21 mm, 1.50±1.09 mm and 1.56±0.93 mm in the test group. No difference was observed between groups at none of the posttreatment periods, regarding the number of sites showing clinical attachment gain >;2 mm. However, at 6 months posttreatment, the test group presented fewer sites with PPD >;5 mm than the control group. Also at 6 months the test group had lower BAPNA values than control group. CONCLUSION: The use of PVP-I as an adjunct in the non-surgical treatment of interproximal class II furcation involvements provided limited additional clinical benefits

Exposure of periodontal ligament progenitor cells to lipopolysaccharide from Escherichia coli changes osteoblast differentiation pattern

Periodontal ligament mesenchymal stem cells (PDLMSCs) are an important alternative source of adult stem cells and may be applied for periodontal tissue regeneration, neuroregenerative medicine, and heart valve tissue engineering. However, little is known about the impact of bacterial toxins on the biological properties of PDLSMSCs, including self-renewal, differentiation, and synthesis of extracellular matrix. Objective : This study investigated whether proliferation, expression of pro-inflammatory cytokines, and osteogenic differentiation of CD105-enriched PDL progenitor cell populations (PDL-CD105+ cells) would be affected by exposure to bacterial lipopolysaccharide from Escherichia coli (EcLPS). Material and Methods : Toll-like receptor 4 (TLR4) expression was assessed in PDL-CD105+ cells by the immunostaining technique and confirmed using Western blotting assay. Afterwards, these cells were exposed to EcLPS, and the following assays were carried out: (i) cell viability using MTS; (ii) expression of the interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor alpha (TNF-α) genes; (iii) osteoblast differentiation assessed by mineralization in vitro, and by mRNA levels of run-related transcription factor-2 (RUNX2), alkaline phosphatase (ALP) and osteocalcin (OCN) determined by quantitative PCR. Results : PDL-CD105+ cells were identified as positive for TLR4. EcLPS did not affect cell viability, but induced a significant increase of transcripts for IL-6 and IL-8. Under osteogenic condition, PDL-CD105+ cells exposed to EcLPS presented an increase of mineralized matrix deposition and higher RUNX2 and ALP mRNA levels when compared to the control group. Conclusions : These results provide evidence that CD105-enriched PDL progenitor cells are able to adapt to continuous Escherichia coli endotoxin challenge, leading to an upregulation of osteogenic activities

Estudo comparativo in vitro da rugosidade radicular após instrumentação com ultrassom e pontas sônicas diamantadas

OBJECTIVE: The purpose of this study was to evaluate the root surface roughness after instrumentation with hand curette and diamond-coated sonic and universal ultrasonic tips. MATERIALS AND METHODS: Forty root surfaces of human teeth were randomly assigned to four treatment groups: control group (without instrumentation), curette instrumentation, ultrasonic instrumentation with universal tip and sonic instrumentation with diamond-coated tip. Each sample was instrumented with fifteen strokes. Before and after instrumentation, surface roughness was measured. In addition, the root surface topography was examined after treatment under the scanning electron microscope. RESULTS: Significant statistical differences (p ;0.05). CONCLUSION: The diamond-coated tip with sonic scaler instrumentation and ultrasonic instrumentation produce similar root surface roughness, higher than curette instrumentation.OBJETIVO: O objetivo do presente estudo foi avaliar a rugosidade radicular obtida após instrumentação por aparelho sônico com pontas diamantadas, curetas e ultrassom. MATERIAL E MÉTODOS: Quarenta superfícies radiculares, devidamente polidas e incluídas em resina acrílica, foram dividas em 4 grupos de tratamento: grupo controle (sem instrumentação) e instrumentação com cureta Gracey 5/6, ultrassom ou aparelho sônico com ponta diamantada. Em cada amostra foram realizados 15 movimentos de raspagem. Antes e após esta instrumentação foi utilizado um rugosímetro para a medição da rugosidade radicular. Além disso, a topografia da superfície radicular foi avaliada após o tratamento com microscopia eletrônica de varredura. RESULTADOS: Diferenças estatisticamente significantes (p;0.05). CONCLUSÃO: A instrumentação sônica com pontas diamantadas promove uma rugosidade radicular equivalente à instrumentação com ultrassom, sendo essa rugosidade superior àquela apresentada pela instrumentação manual

Exposure of periodontal ligament progenitor cells to lipopolysaccharide from Escherichia coli changes osteoblast differentiation pattern

Periodontal ligament mesenchymal stem cells (PDLMSCs) are an important alternative source of adult stem cells and may be applied for periodontal tissue regeneration, neuroregenerative medicine, and heart valve tissue engineering. However, little is known about the impact of bacterial toxins on the biological properties of PDLSMSCs, including self-renewal, differentiation, and synthesis of extracellular matrix. This study investigated whether proliferation, expression of pro-inflammatory cytokines, and osteogenic differentiation of CD105-enriched PDL progenitor cell populations (PDL-CD105+ cells) would be affected by exposure to bacterial lipopolysaccharide fromEscherichia coli (EcLPS). Toll-like receptor 4 (TLR4) expression was assessed in PDL-CD105+ cells by the immunostaining technique and confirmed using Western blotting assay. Afterwards, these cells were exposed to EcLPS, and the following assays were carried out: (i) cell viability using MTS; (ii) expression of the interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor alpha (TNF-α) genes; (iii) osteoblast differentiation assessed by mineralization in vitro, and by mRNA levels of run-related transcription factor-2 (RUNX2), alkaline phosphatase (ALP) and osteocalcin (OCN) determined by quantitative PCR.PDL-CD105+ cells were identified as positive for TLR4. EcLPS did not affect cell viability, but induced a significant increase of transcripts for IL-6 and IL-8. Under osteogenic condition, PDL-CD105+ cells exposed to EcLPS presented an increase of mineralized matrix deposition and higher RUNX2 and ALP mRNA levels when compared to the control group. These results provide evidence that CD105-enriched PDL progenitor cells are able to adapt to continuous Escherichia coli endotoxin challenge, leading to an upregulation of osteogenic activities232FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPNão te

Decision making in the treatment of class III furcation: resective therapy? Extraction? Implant?

The presence of furcation lesions is associated with bone resorption and lack of insertion in the inter-radicular space, and is a condition that considerably increases the risk of dental loss, particularly in the absence of adequate treatment. In this context, the object of some of the therapies is to keep teeth with furcation lesions that are important to dental planning, to re-establish an anatomy that enables the patient to remove dental biofilm from the compromised area. However, the long term maintenance and treatment of molars with Class III furcation lesions continues to be a challenge to dentists during periodontal therapy, since the anatomy of the inter-radicular region makes it difficult for both professionals and patients to gain access to perform adequate and efficient control of dental biofilm. The impossibility of obtaining appropriate decontamination of the area involved during the root scraping process, including by means of surgical access, demands thatdentists have adequate knowledge to determine the correct therapeutic approach during the treatment of teeth with advance inter-radicularbone loss. The aim of the present study was to discuss the treatments available for Class III furcation lesions and relate clinical procedures that could be performed for the treatment of this type of defect

Protective effect of topical Cordia verbenacea in a rat periodontitis model: immune-inflammatory, antibacterial and morphometric assays

BACKGROUND: This study evaluated the effects of C. verbenacea essential oil topically administered in a rat periodontitis model. METHODS: Periodontitis was induced on rats in one of the mandibular first molars assigned to receive a ligature. Animals were randomly divided into two groups: a) non-treatment group (NT) (n = 18): animals received 1mL of vehicle; b) C. verbenacea group (C.v.) (n = 18): animals received 5mg/Kg of essential oils isolated from C. verbenacea. The therapies were administered topically 3 times daily for 11 days. Then, the specimens were processed for morphometric analysis of bone loss. The ligatures were used for microbiological assessment of the presence of Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Porphyromonas gingivalis using PCR. The gingival tissue was collected to Elisa assay of interleukin (IL)-1α and IL-10 levels. RESULTS: Bone loss was inhibited by C. verbenacea when compared to the NT group (p < 0.05). A decrease in the levels of IL-1α and increase in the IL-10 amounts was observed in the C.v. group as compared to NT group (p < 0.05). A lower frequency of P. gingivalis was found in C.v. group (p < 0.05). CONCLUSION: C. verbenacea essential oil topically administered diminished alveolar bone resorption, promoting a positive local imbalance in the pro/anti-inflammatory system and reducing the frequency of detection of P. gingivalis

Association of rs142548867 (EEFSEC) and periodontitis Grade C in a young Brazilian population

Periodontitis Stage III-IV, Grade C (PerioC) is a severe form of Periodontitis. The individual genetic background has been shown to be an important etiopathogenic factor for the development of this disease in young, systemically healthy, and non-smokers patients. Recently, after exome sequencing of families with a history of the disease, PerioC was associated with three single nucleotide variations (SNVs) – rs142548867 (EEFSEC), rs574301770 (ZNF136), and rs72821893 (KRT25) – which were classified as deleterious or possibly harmful by prediction algorithms. Objective: Seeking to validate these findings in a cohort evaluation, this study aims to characterize the allele and genotypic frequency of the SNVs rs142548867, rs574301770, and rs72821893 in the Brazilian population with PerioC and who were periodontally healthy (PH). Methodology: Thus, epithelial oral cells from 200 PerioC and 196 PH patients were harvested at three distinct centers at the Brazilian Southern region, their DNA were extracted, and the SNVs rs142548867, rs574301770, rs72821893 were genotyped using 5′-nuclease allelic discrimination assay. Differences in allele and genotype frequencies were analyzed using Fisher’s Exact Test. Only the SNV rs142548867 (C &gt; T) was associated with PerioC. Results: The CT genotype was detected more frequently in patients with PerioC when compared with PH subjects (6% and 0.5% respectively), being significantly associated with PerioC (odds ratio 11.76, p=0.02). Conclusion: rs142548867 represents a potential risk for the occurrence of this disease in the Brazilian population