Background This double‐blind, randomized, controlled clinical trial assessed the efficacy of multiple sessions of antimicrobial photodynamic therapy (aPDT) as an adjunct to surgical periodontal treatment (ST) in patients with severe chronic periodontitis (SCP). Methods Sixteen patients with SCP were treated with aPDT+ST (test group, TG) or ST only (control group, CG), in a split‐mouth design. aPDT was applied at 0, 2, 7, and 14 postoperative days only in TG. All patients were followed up for 90 days after surgery. The following clinical and microbiological parameters were assessed: clinical attachment level (CAL), probing depth (PD), gingival recession (GR), bleeding on probing (BOP), plaque index (PI), and count of 40 subgingival microbial species (checkerboard DNA‐DNA hybridization). Data were collected at baseline (preintervention), at 60 days (30 days after the end of non‐surgical therapy), and at 150 days (90 days after surgery). Results A significant reduction in PD was observed at 150 days for the TG, when compared with the CG (P ˂ 0.05). CAL gain was significantly higher in the TG at 60 and 150 days (P ˂ 0.05). Changes in the subgingival microbiota were similar between the groups (P ˃ 0.05), but the TG revealed a larger number of bacteria associated with periodontal disease at the end of the experiment compared with the CG (P < 0.05). Conclusion Multiple sessions of aPDT as an adjunct to surgical periodontal treatment significantly improved clinical parameters at 90 postoperative days.

The present study evaluated polymorphisms in RANK, RANKL and OPG-encoding genes to assess whether they are associated with mucositis and peri-implantitis in a population from the Brazilian Amazon region. One hundred and fourteen patients with dental implants were included in the study. After clinical and radiographic examination, the sample was categorized into 4 groups, according to the peri-implant status: Healthy (n=71), Mucositis (n=30), Peri-implantitis (n=13) and Diseased (Mucositis + Peri-implantitis, n=43). Genomic DNA was extracted from buccal cells from saliva, and the genetic polymorphism in osteoprotegerin (OPG), Kappa nuclear factor activator receptor (RANKL) and nuclear kappa factor activator receptor (RANK) were genotyped by the real time PCR. Univariate and multivariate statistical analyses were performed to compare clinical variables among groups and to evaluate genotypes and alleles distributions and the established alpha was 5%. Age, peri-implant biotype, diabetes and presence of peri-implant biofilm were associated with mucositis (p<0.05) and peri-implantitis (p<0.05). Smoking, alcoholism, and periodontal biofilms were also associated with the presence of peri-implantitis (p<0.05). Univariate and multivariate analysis did not demonstrate an association of peri-implantitis or mucositis with any genetic polymorphism in RANK (rs3826620), RANKL (rs9594738) and OPG (rs2073618) (p>0.05). The studied genetic polymorphism in RANK, RANKL and OPG were not associated with mucositis and peri-implantitis in a Brazilian population from the Amazon region.

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Agradeço aos meus pais, Plinio e Heloisa, por me amarem tanto. Vocês são o alicerce da minha vida. Aos meus irmãos, Marcelo e Aline, por me ensinarem a dividir. Aos meus avós, Henrique e Lourdes, por se orgulharem de mim incondicionalmente. Ao meu companheiro, João Octávio, que me apoia e me incentiva em todas as loucuras da vida. Aos primeiros mestres que tive, Profa Suzie, Prof Brentegani e Marcelo Azenha, por me mostrarem que a formação profissional vai muito além da técnica. Aos amigos de Odontologia, Juliana Arid, Jardel e Fabiane Lopes, mesmo que os caminhos destoassem, sempre pude contar com a amizade de vocês. À Clínica Bem Sorrir, por confiarem no meu trabalho e por torcerem diariamente pelo meu sucesso. Aos irmãos e irmã que a Periodontia me deu Uislen, Bárbara Masalskas, Sérgio Lago, Gabriel Bastos, Umberto, Kleber e Gabriel David. Aprendi e continuo aprendendo todos os dias ao lado de vocês. Aos funcionários, Daniela Steter, Dani Lima e Bel, obrigada por quererem sempre o nosso bem e por fazerem da nossa vida o menos burocrática possível. Aos professores da Pós-Graduação em Periodontia da FORP, obrigada pelas trocas diárias de conhecimento e experiência profissional. Por último, mas não menos importante, ao meu orientador, Prof Arthur Belém Novaes Jr. É imensurável a gratidão que tenho pelo incentivo, pelo apoio e pela confiança que o senhor sempre depositou em mim, independente do resultado. Obrigada! Resumo Resumo REIS, M. B. L. O uso do enxerto de matriz dérmica acelular no recobrimento de retrações gengivais unitárias associadas a lesões cervicais não cariosas. Estudo clínico controlado. 2018. Nº de 48f. Dissertação

Background : Post-extraction sockets associated to periodontal disease may be immediately implanted, only by following tooth extraction and socket debridement when associated to an adequate pre and post-operatory antibiotic therapy. As an alternative to antimicrobial resistance and as a new and promising approach in the treatment of both periodontal and peri-implant disease, the Antimicrobial photodynamic therapy (aPDT) has been suggested. Aim/Hypothesis : The aim of this study was to evaluate the effect of the aPDT in the osseointegration of immediate implant placement in a more impaired healing situation such as ligature-induced periodontitis. Materials and Methods : Firstly, eight dogs had periodontitis induced for 8 weeks. Following periodontal disease induction, the animals had their first to fourth mandibular pre-molars extracted from both sides of the mandible. One side was decontaminated solely with alveoli debridement thoroughly curettage and rinsing with sterile saline solution (CG). The other side was submitted to an additional treatment with aPDT (TG). Immediate implants were installed on the second, third and forth alveoli. Seven days later, the sutures were removed, prosthetic connections were adapted, and temporary metallic prostheses were installed. Twelve weeks later the dogs were euthanized. Histomorphometric analyses were performed in a buccolingual section, buccal bone resorption, bone-implant contact, bone density. Results : Statistically significant differences for almost all the intergroup comparisons was observed, favoring the TG. The exception was the bone density parameter, in which the TG (70.57 ± 8.49%) had a numerically better value in relation to the CG (58.37 ± 9.55%). Conclusions and Clinical Implications : In conclusion, the sites treated with aPDT led to osseointegration of the immediate implants placed into a more challenging healing situation, induced periodontitis, and presented healing without evidence of inflammation. On the other hand, where aPDT was not used, evidence of periimplantitis was observed on the immediate implants.

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