Diabetes mellitus is a heterogeneous group of disorders, in which hyperglycemia is a main feature. The objective was to evaluate the involvement of RAGE, inflammatory cytokines, and metalloproteinases in spontaneous periodontitis triggered by diabetes induction. Immunohistochemical procedures for MMP-2, MMP-9, TNF-α, IL-1β, IL-6, RANKL, and RAGE were performed in rats after 1, 3, 6, 9, and 12 months of diabetes induction. Total DNA was extracted from paraffin-embedded tissues and evaluated by Real-TimePCR for 16S total bacterial load and specific periodontopathogens. Our data did not demonstrate differences in microbiological patterns between groups. In diabetic groups, an increase in RAGE-positive cells was detected at 6, 9, and 12 months, while TNF-alpha-stained cells were more prevalent at 6 and 12 months. In experimental groups, IL-β-positive cells were increased after 12 months, IL-6 stained cells were increased at 9 and 12 months, and RANKL-positive cells at 9 months. Diabetes resulted in widespread expression of RAGE, followed by expression of proinflammatory mediators, without major alterations in oral microbial profile. The pervasive expression of cytokines suggests that spontaneous periodontitis development may be independent of microbial stimulation and may be triggered by diabetes-driven imbalance of homeostasis.
Diabetes mellitus comprises a heterogeneous group of disorders with the main feature of hyperglycemia. Chronic hyperglycemia increases the severity of periodontal disease via an exacerbated inflammatory response, activated by advanced glycation end products and their receptor, RAGE. Therefore, anti-inflammatory agents represent potential inhibitors of this pathological interaction. In particular, green tea has been shown to possess anti-inflammatory properties mediated by its polyphenol content. Objectives: This study investigated the mechanisms by which green tea attenuates the spontaneous onset of diabetes-induced periodontitis. Methods: Diabetes was induced in rats via a single intraperitoneal injection of streptozotocin (STZ). Diabetic and control animals were divided into water-treated and green tea-treated subgroups and were analyzed at 15, 30, 60 and 90 days after diabetes induction. Immunohistochemistry was performed to quantitatively evaluate tumor necrosis factor-α (TNF-α), receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), interleukin-10 (IL-10) and runt-related transcription factor 2 (RUNX-2) expression in serial sections of each hemimaxilla. Morphometric measurements of the distance from the cementum-enamel junction (CEJ) of the superior distal root of the first molar to the alveolar bone crest (ABC) were performed to assess bone loss. Results: Diabetes resulted in significant bone loss and alterations in the number of cells that stained positive for inflammatory mediators. In the diabetic rats treated with green tea, we observed a decreased number of cells expressing RANKL and TNF-α compared with that observed in the diabetic rats treated with water. Additionally, green tea increased the numbers of cells that stained positive for OPG, RUNX-2 and IL-10 in the diabetic rats. Conclusion: Green tea intake reduces expression of the pro-inflammatory cytokine TNF-α and the osteoclastogenic mediator RANKL to normal levels while increasing expression of the anti-inflammatory cytokine IL-10, the osteogenesis-related factor RUNX-2 and the anti-osteoclastogenic factor OPG. Therefore, green tea represents a potential therapeutic agent for the treatment of diabetes-related periodontal disease.
BackgroundDental erosion is caused by frequent exposure to acids without the involvement of microorganism. This study analyzed the effect of biguanides (polyhexamethylene biguanide – PHMB and chlorhexidine – CHX) on dentin erosion due to their possible influence on the enzymatic degradation of the demineralized organic matrix.MethodSixty bovine dentin specimens were prepared. On both sides of their surface, nail varnish was applied to maintain the reference surfaces for the determination of dentin loss. Samples were cyclically de- and remineralized for 6 days. Demineralization was performed with a 0.87 M citric acid solution (6×5 min daily). Thereafter, samples were treated with distilled water (negative control), 0.12% CHX (positive control), 0.07% PHMB, Sanifill Perio Premium™ (0.07% PHMB plus 0.05% NaF), or F solution (0.05% NaF) for 1 min and then subjected to enzymatic challenge for 10 min using a bacterial collagenase (Clostridium hystoliticum, 100 μg/ml). Dentin loss was assessed using profilometry (μm) daily. Data were analyzed using 2-way repeated measures-ANOVA and Bonferroni’s test (p < 0.05).ResultsDentin loss progressed significantly for all groups during the 6 days. After the 3rd day, Sanifill Premium™, CHX, and PHMB significantly reduced dentin erosion compared to control. On the 6th day, the lowest mean (±SD) dentin loss was observed for Sanifill Perio Premium™ (94.4 ± 3.9 μm). PHMB and CHX led to intermediate dentin loss (129.9 ± 41.2 and 135.3 ± 33.5 μm, respectively) that was significantly lower than those found for negative control (168.2 ± 6.2 μm). F (157.4 ± 6.1 μm) did not significantly differ from negative control.ConclusionsSanifill Perio Premium™ mouthwash has a good potential to reduce dentin loss, which might be associated with the presence of PHMB.
A utilização de implantes dentários tem sido cada vez mais uma escolha por parte dos pacientes. Na busca pela reabilitação unitária ou de todos os elementos dentários, os implantes osseointegrados possuem inúmeros benefícios para o restabelecimento da função, estética, fonética e conforto ao paciente. O objetivo dessa revisão de literatura é abordar a importância dos cuidados pré-operatórios que o Implantodontista deve realizar previamente a instalação dos implantes. Para isso, foi realizada uma busca de estudos nas bases de dados Scielo, Lilacs, PubMed e Science Direct. com os descritores “dental implants and installation”, “dental implants and complementary exams” com “and” e “or” como ferramentas integrativas de busca. Observa-se diversos estudos abordandos o comprometimento da taxa de sobrevivência e de sucesso de implantes dentários em pacientes com alguma alteração sistêmica. Quando presente essas alterações, o risco de falhas e complicações são maiores, porém a partir de um adequado exame físico e auxiliados por exames complemetares, é possível mimetizar riscos ao paciente e promover mais sobrevida ao implante. Deve se ressaltar que o tratamento com implantes dentais é um procedimento controlado, seguro e confiável, inclusive na reabilitação dos pacientes idosos. Portanto, cabe ao Implantodontodontista possuir conhecimento para saber avaliar integralmente adequadamente o paciente que será submetido a cirurgia de instalação de implantes.
O aumento da população idosa nos consultórios odontológicos e o incremento da procura por tratamentos reabilitadores, faz com que os profissionais se especializem ainda mais para atender as necessidades desses pacientes. Os quais, na maioria das vezes possuem atrofia óssea, sendo que na parte posterior da mandíbula, a complexidade é maior, devido à aproximação do nervo alveolar e da possibilidade de fratura mandibular. Esta revisão de literatura tem como objetivo descrever as técnicas encontradas na literatura para a reabilitação das mandíbulas atróficas. Para isso, foi realizada uma busca de estudos nas bases de dados Scielo, Lilacs, PubMed e Science Direct. com os descritores “dental implants and jaw”, “dental implants and edentulous jaw”, “Rehabilitation”, “Graft” “Prostheses and Implants” com “and” e “or” como ferramentas integrativas/seletivas de busca. No estudo foi encontrado técnicas como a utilização de implantes curtos, próteses protocolo Branemark, reconstrução do rebordo com enxertos ósseos, lateralização do feixe vasculho-nervoso do alveolar inferior e distração osteogênica. Na comparação dos estudos, foi verificado que a utilização dos implantes curtos possui uma ligeira vantagem custo-benefício, por causar uma menor morbidade ao paciente e um menor custo do tratamento. Todavia, foi verificado que todas as técnicas possuem uma porcentagem bastante significativa de sucesso, sendo opções tratamento viáveis para pacientes com atrofia mandibular. Portanto, o profissional deve escolher o procedimento que se sente mais seguro, com base do seu conhecimento teórico e habilidade clínica, para proporcionar ao paciente uma melhor resolução para o tratamento.
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