The distinct ability of the gingival and periodontal ligament fibroblasts to secrete MIP-1alpha, SDF-1, and IL-6 emphasizes that these cells may differently contribute to the balance of cytokines in the LPS-challenged periodontium.
The gingival recession was assessed in 380 adult individuals aged more than 20 years and comprised both subjects being treated and looking for treatment at Bauru Dental School. Clinical evaluation was conducted by a single examiner in all teeth and involved analysis of four dental aspects (mesial, buccal, distal and lingual). The gingival recession was regarded as present whenever more than 1mm of root surface was exposed, and its vertical width was measured in millimeters from the cementoenamel junction to the gingival margin. The recessions were further scored following the criteria suggested by Miller in 1985. Gingival recession was observed in at least one dental surface in about 89% of the individuals analyzed. The prevalence, extension and severity of this clinical aspect increased with age. Class I recessions were the most frequent, yet there was a gradual increase of Class III and IV recessions as older subjects were evaluated. The mandibular teeth displayed more surfaces with gingival recession than the maxillary teeth and the mandibular incisors were the most affected teeth. Such high prevalence of gingival recession in adult patients demonstrates that dental professionals should provide attention to the clinical relevance of such alterations, as well as to the diagnosis of the etiologic factors.
This systematic review confirmed that implant therapy can be successfully used in patients with a diagnosis of periodontitis who underwent proper therapy and regular periodontal maintenance. Residual pockets, non-attendance to the periodontal maintenance program, and smoking were considered to be negative factors for the long-term implant outcomes.
The aim of this systematic literature review was to evaluate which type of periodontal preventive and therapeutic approaches presents superior outcomes in patients with Down syndrome (DS). Studies reporting different methods of periodontal care from DS patients were considered eligible. Included clinical studies should indicate at least two periodontal parameters in different periods of assessment. Screening of the articles, data extraction and quality assessment were conducted independently and in duplicate. Electronic search according to the PICO search, with both Key-words and MESH terms were conducted in MEDLINE, EMBASE and CENTRAL databases until March 2016. Manual search was conducted in four journals, namely Journal of Periodontology, Journal of Clinical Periodontology, Journal of Periodontal Research and Special Care in Dentistry and their electronic databases were searched. Electronic and manual search resulted in 763 papers, and of them 744 were excluded after title/abstract assessment. The full text of 19 potentially eligible publications was screened and 9 studies met inclusion criteria. The results demonstrated the importance to introduce youngest DS patients in preventive programs, as well as participation of parents, caregivers or institutional attendants in supervising/performing oral hygiene. In studies with higher frequency of attendance, all age groups presented superior preventive and therapeutic results, irrespective of the therapeutic approach used (surgical/nonsurgical/periodontal care program). The important factors for reducing periodontal parameters were the frequency of the appointments and association with chlorhexidine/plaque disclosing agents as adjuvant treatment. This systematic review demonstrated that early introduction in periodontal care, participation of parents/caregivers/institutional attendants, frequency of attendance and association with chemical adjuvants (independently of the periodontal treatment adopted) seems to improve periodontal outcomes in preventive and periodontal treatment of DS patients. Registration number (Prospero): CRD42016038433.
Gingival recessions are caused by many etiologic factors, which usually act in combination. Thus, all factors causing recession should be analyzed so that planning and treatment of this clinical condition may be established, for achievement of optimal outcomes.
Low-intensity laser therapy aims at pain suppression, edema reduction and acceleration of wound healing. The main goal of this study was to clinically evaluate the effects of Aluminum Gallium Arsenate laser - 670nm in wound healing after gingivoplasty in 11 patients. Surgery was performed in anterior superior and/or inferior regions. The right side of the patient (test group) received a laser energy density of 4J/cm², in a 48-hour interval, during one week, totalizing four sessions. The irradiation was punctual in a contact mode in three points. The left side did not receive irradiation (control group). Clinical evaluation was performed by five specialists in periodontology through photography of the treated areas at post-surgical periods of 7, 15, 21,30,60 days. The observers pointed the best healed side. The Sign test was used for statistical analysis with a confidence level of 5% (P<0.05). The examiners found a better pattern of healing sometimes in the test and sometimes in the control group until 21 days after surgery. After this period there was no apparent difference between them. There was no statistical difference between the sides (p>0.05). These results have shown that low-intensity laser therapy did not accelerate oral mucosa healing after gingivoplasty.
Dental roots that have been exposed to the oral cavity and periodontal pocket
environment present superficial changes, which can prevent connective tissue
reattachment. Demineralizing agents have been used as an adjunct to the periodontal
treatment aiming at restoring the biocompatibility of roots.ObjectiveThis study compared four commonly used demineralizing agents for their capacity of
removing smear layer and opening dentin tubules. MethodsFifty fragments of human dental roots previously exposed to periodontal disease
were scaled and randomly divided into the following groups of treatment: 1) CA:
demineralization with citric acid for 3 min; 2) TC-HCl: demineralization with
tetracycline-HCl for 3 min; 3) EDTA: demineralization with EDTA for 3 min; 4) PA:
demineralization with 37% phosphoric acid for 3 min; 5)Control: rubbing of saline
solution for 3 min. Scanning electron microscopy was used to check for the
presence of residual smear layer and for measuring the number and area of exposed
dentin tubules. ResultsSmear layer was present in 100% of the specimens from the groups PA and control;
in 80% from EDTA group; in 33.3% from TC-HCl group and 0% from CA group. The mean
numbers of exposed dentin tubules in a standardized area were: TC-HCl=43.8±25.2;
CA=39.3±37; PA=12.1±16.3; EDTA=4.4±7.5 and Control=2.3±5.7. The comparison showed
significant differences between the following pairs of groups: TC-HCl and Control;
TC-HCl and EDTA; CA and Control; and CA and EDTA. The mean percentages of area
occupied by exposed dentin tubules were: CA=0.12±0.17%; TC-HCl=0.08±0.06%;
PA=0.03±0.05%; EDTA=0.01±0.01% and Control=0±0%. The CA group differed
significantly from the others except for the TC-HCl group. ConclusionThere was a decreasing ability for smear layer removal and dentin tubule widening
as follows: AC>TC-HCl>PA>EDTA. This information can be of value as an
extra parameter for choosing one of them for root conditioning.
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