ABSTRACT:The aim of the present parallel, double-blind investigation was to evaluate the effect of using systemic metronidazole alone or associated to scaling and root planing on adult chronic periodontal disease, monitored at baseline, 30, 60 and 90 days. Twelve subjects were divided into three groups: the first group (Group I -22 sites) was submitted to scaling and root planing (SRP) alone; the second group (Group II -30 sites) received SRP and 250 mg of metronidazole (3 times a day for 10 days), and the third group (Group III -31 sites) was treated with metronidazole alone. The clinical parameters evaluated were probing depth (PD), clinical attachment level (CAL), plaque index (PlI), gingival index (GI) and bleeding upon probing (BP). Microbiological (BANA test) and enzymatic (Pocket Watch) tests were also performed. All three proposed treatments produced significant improvements in clinical conditions of subjects, from baseline, 30, 60 and 90-day period, except for clinical attachment level. The results obtained by microbiological and enzymatic tests did not show statistical differences among the groups for the 90-day period (r = 0.7924 and r = 0.7757, respectively). In relation to clinical parameters, statistical differences among groups were observed only for the gingival index (p = 0.0261) between Groups I and II, and probing depth (p = 0.0124) between Group I and the others. We conclude that the use of systemic metronidazole did not produce additional effects on the microbiological conditions of these patients with chronic periodontal disease. DESCRIPTORS: Periodontal diseases; Metronidazole; Aspartate aminotransferase. RESUMO:O objetivo do presente estudo paralelo, duplo-cego foi o de avaliar os efeitos do uso do metronidazol sistêmico, associado ou não à raspagem e ao alisamento radicular, sobre a doença periodontal crônica do adulto, observados inicialmente, aos 30, 60 e 90 dias. Foram selecionados 12 pacientes, distribuídos em 3 grupos: o primeiro grupo (Grupo I -22 sítios) foi submetido a raspagem e alisamento radicular (RAR) somente; o segundo grupo (Grupo II -30 sítios) recebeu RAR e 250 mg de metronidazol (3 X/dia, durante 10 dias); o terceiro grupo (Grupo III -31 sítios) foi tratado somente com metronidazol. Os parâmetros clínicos avaliados foram profundidade de sondagem (PS), nível de inserção clínica (NI), índices de placa (IPl) e gengival (IG) e sangramento à sondagem (SS). Os pacientes foram submetidos, ainda, à análise microbiológica (BANA) e enzimática ("Pocket Watch"). Os três tratamentos propostos melhoraram significativamente as condições clínicas dos pacientes no início, e nos períodos de 30, 60 e 90 dias, exceto para o nível de inserção clínica. As análises microbiológica e enzimática não apresentaram diferença estatística entre os três grupos para o período de 90 dias (r = 0,7924 e r = 0,7757, respectivamente). Já nos parâmetros clínicos, encontrou-se diferença estatística somente para o índice gengival (p = 0,0261) entre os Grupos I e II e, para a profundidade de sondagem, (p = 0,01...
RESUMENEl objetivo del presente caso clínico fue corregir el defecto vertical de un reborde edentulo en el sector antero superior a través de una Matriz Dérmica Acelular (Alloderm®). El plan de tratamiento contemplo la rehabilitación a través de una Prótesis Parcial Fija. Una vez corregida la altura del reborde se confeccionaron encerados diagnósticos y provisionales para efectuar presión selectiva a los tejidos gingivales y de esta forma estimular a la formación papilar. Paralelamente se modifico el ancho mesio distal de los pónticos a fin de manejar adecuadamente el espacio edéntulo y evitar la formación de espacios por debajo del póntico que perjudicaran la estética, fonética y función del paciente. Palabras clave: PÉRDIDA DE HUESO ALVEOLAR / ENCÍA / TRASPLANTE HOMÓLOGO.Vertical ridge correction and papilla creation using ovate pontics. A clinical report ABSTRACT The objective of the present clinical case was to correct the vertical defect of an edentulous ridge in the anterior-superior area by using an Acellular Dermic Matrix (AlloDerm®). The treatment was planned to make a Fixed Partial Prosthesis. Affter correcting the ridge height, diagnostic wax-up and provisionals were made, to exert selective pressure in the gingival tissues to stimulate the creation of papilla. At the same time, the pontic mesio-distal width were modified to manage correctly the edentulous space and avoid the formation of spaces under the pontic which would affect esthetics, fonetics and function of the patient.
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