Search

This study aimed at evaluating soft and hard tissue dimensions after immediate implant placement and immediate temporization with or without alveolar preservation at the maxillary anterior region. Twenty-two patients needing maxillary incisor extraction and with the possibility of immediate implant placement were randomly assigned to the following groups: test (n = 11): immediate implant placement + deproteinized bovine bone derived with collagen inserted into the alveolus or control (n = 11): immediate implant placement without biomaterial. All soft tissue measurements were evaluated at baseline, 3 months, and 6 months after implant therapy. Cone beam tomography was performed at baseline and at 6 months after implant placement to evaluate hard tissue dimension. The test group presented higher height of soft tissue at mesiobuccal and distobuccal sites at 3 months and 6 months when compared to the control group (p

The conventional method of ridge expansion uses a mucoperiosteal flap elevation to allow bone corticotomy, which is followed by bone expansion performed with chisels and bone expanders. To facilitate corticotomy and avoid flap elevation, bone expansion can be performed in 2 stages. This case report presents a modified 2-stage bone expansion technique to achieve better implant stabilization and wound closure. This modified approach may be an efficient procedure for minimizing complications.

Feng HS, Bernardo CC, Sonoda LL, Hayashi F, Romito GA, De Lima LAPA, Lotufo RFM, Pannuti CM. Subgingival ultrasonic instrumentation of residual pockets irrigated with essential oils: a randomized controlled trial. J Clin Periodontol 2011; doi: 10.1111/j.1600-051X.2011.01725.x. Abstract Aim: To evaluate the clinical efficacy of subgingival ultrasonic instrumentation irrigated with essential oils (EOs) of residual periodontal pockets. Material and methods: Sixty-four individuals with chronic periodontitis were invited to participate in this randomized, double-blind, parallel, and placebo-controlled clinical trial. All subjects received non-surgical periodontal therapy. After re-evaluation (baseline), residual pockets (pocket depth 5 mm) received test (ultrasonic instrumentation irrigated with EOs) or control therapy (ultrasonic instrumentation irrigated with negative control). Probing pocket depth (PPD), gingival recession (R), clinical attachment level (CAL), bleeding on probing (BOP), and plaque were assessed at baseline and after 4, 12, and 24 weeks. Differences between groups and changes over the course of time were analysed according to a generalized linear model. Results: There was a significant reduction in PPD and BOP, as well as a significant CAL gain in the two groups (p

This randomized clinicai trial investigated the effect of a dentifrice containing triclosan on the reduction of dental plaque and gingivitis in institutionalized individuais with cerebral palsy. Fifty-seven residents were randomly allocated to a test group (n=28, dentifrice with triclosan) and a control group (n=29. conventional dentifrice). A single calibrated investigator performed examinations at baseline and after three months. The amount of dental plaque was assessed, and gingivitis was meas-ured. The caretakers performed brushing with dentifrice. After three months, there was a significant reduction in the plaque index in both groups, but there was no difference between the two groups. There was a significant reduction in gingivitis only in the test group, and the difference between groups was significant after three months. The authors concluded that the dentifrice with triclosan reduced interdental bleeding in the studied population.

Foi conduzido no “Centro Espírita Nosso Lar Casas André Luiz" (Guarulhos, São Paulo) um ensaio clínico aleatório, de desenho paralelo, duplo-cego, para investigar o efeito de um dentifrício contendo Triclosan e Flúor na redução de placa bacteriana e gengivite. Cinqüenta e cinco internos da instituição foram aleatoriamente divididos em dois grupos: teste (n=28, Colgate Total) e controle (n=27, dentifrício convencional contendo Flúor). A alocação dos sujeitos aos grupos foi conduzida pela farmácia “Fórmula e Ação", que distribuiu os dentifrícios em tubos de acordo com o grupo experimental. A identidade de cada grupo foi mantida sob sigilo pela farmácia até o final da fase experimental da pesquisa. Os critérios de inclusão foram: presença de pelo menos 20 dentes na cavidade bucal e idade entre 15 e 45 anos. Os critérios de exclusão foram: presença de doença periodontal avançada e histórico de hipersensibilidade ao triclosan. Não se permitiu que os sujeitos da pesquisa utilizassem qualquer outro produto para controle de placa durante o estudo. Os sujeitos da pesquisa foram examinados por Um investigador calibrado, no início da pesquisa, três meses e seis meses após o início. Avaliou-se a quantidade de placa bacteriana pelo Índice de Placa (IP) de Quigley-Hein (1962) modificado por Turesky et al (1970). Após evidenciação da placa, cada dente foi aferido em quatro sítios: MV, V, DV e P ou L, com exceção dos terceiros molares. Aferiu-se a gengivite pelo Índice Sangramento Interdental (ISI). O grupo teste apresentou redução significativa (p

The primary stability of dental implants is fundamental for osseointegration. Therefore, this study aimed to assess the correlation between insertion torque (IT) and resonance frequency analysis (RFA) of implants placed in mandibles and maxillas of different bone densities. Eighty dental implants were placed in maxillas and mandibles, and IT and the implant stability quotient (ISQ) were measured at the time of implant insertion. Bone density was assessed subjectively by the Lekholm and Zarb index. The type I and II densities were grouped together (group A)as were the type III and IV densities (group B). The IT in group A was higher (Student t test, P = .0013) than in group B (46.27 ± 18.51 Ncm, 33.62 ± 14.74 Ncm, respectively). The implants placed in group A showed higher ISQ (Student t test, P = .0004) than those placed in group B (70.09 ± 7.50, 63.66 ± 8.00, respectively). A significant correlation between IT and the ISQ value was observed for group A (Pearson correlation test; r = 0.35; P = .0213) and for group B (r = 0.37; P = .0224). Within the limitations of this study, it was possible to conclude that there is a correlation between IT and RFA of implants placed in mandibles and maxillas of different bone densities.

To evaluate the clinical efficacy of subgingival ultrasonic instrumentation irrigated with essential oils (EOs) of residual periodontal pockets.Sixty-four individuals with chronic periodontitis were invited to participate in this randomized, double-blind, parallel, and placebo-controlled clinical trial. All subjects received non-surgical periodontal therapy. After re-evaluation (baseline), residual pockets (pocket depth ≥5 mm) received test (ultrasonic instrumentation irrigated with EOs) or control therapy (ultrasonic instrumentation irrigated with negative control). Probing pocket depth (PPD), gingival recession (R), clinical attachment level (CAL), bleeding on probing (BOP), and plaque were assessed at baseline and after 4, 12, and 24 weeks. Differences between groups and changes over the course of time were analysed according to a generalized linear model.There was a significant reduction in PPD and BOP, as well as a significant CAL gain in the two groups (p0.001). Nevertheless, there were no differences between the groups at any time of the study. When only initially deep pockets (PPD ≥7 mm) were analysed, a significantly greater CAL gain (p=0.03) and PPD reduction (p=0.01) was observed in the test group.The adjunctive use of EOs may promote significant CAL gain and PPD reduction in deep residual pockets.

O objetivo desse estudo foi avaliar o efeito clínico da instrumentação ultra-sônica subgengival irrigada com óleos essenciais na redução de bolsas periodontais em sítios 5mm após a reavaliação. Para tanto foi conduzido um ensaio clínico aleatório, duplo-cego, paralelo e controlado com placebo. Foram convidados para participar deste estudo 64 indivíduos com periodontite crônica. Os pacientes foram aleatoriamente alocados para grupo teste (irrigação com óleos essenciais contendo Timol 0,064%, Eucaliptol 0,092% Salicilato de Metila 0,06%, Mentol 0,042% e Álcool 21,6%) ou controle (irrigação com placebo, solução alcoolica 21%). Foram avaliados os parâmetros clínicos profundidade clínica de sondagem (PCS), nível clínico de inserção (NCI), retração da margem gengival (R), sangramento à sondagem (SS) e índice de placa (IP) no início e 4, 12 e 24 semanas após. O indivíduo foi considerado a unidade estatística. As diferenças entre os grupos e as alterações ao longo do tempo foram analisadas de acordo com um modelo linear generalizado (análise de variância de medidas repetidas). Houve redução significativa de PCS (1,59mm teste e 1,16mm controle) e SS (44,4% teste e 52,62% controle) e ganho em NCI (1,15mm teste e 0,91mm controle) nos dois grupos (p7mm observou-se redução significativa na PCS no grupo teste (1,60mm, p = 0,004) e controle (1,10mm, p = 0,0008) e ganho de NCI significativo no grupo teste apenas (teste: 1,59mm, p 7mm, quando comparado com o grupo controle. The aim of this study was to evaluate the clinical effect of ultrasonic instrumentation irrigated with essential oils in the reduction of sites with a probing depth of 5 mm or more. For this purpose, a randomized, double-blind, parallel-arm and placebocontrolled clinical trial was conducted. Sixty-four individuals with chronic periodontitis were invited to participate in this study. The patients were randomly allocated to the test group (irrigation with essential oils containing 0.064% Thymol, 0.092% Eucalyptol, 0.06% Methyl Salicylate, 0.042% Menthol and 21.6% Alcohol) or control (irrigation with placebo, 21% alcoholic solution). Probing pocket depth (PD), clinical attachment level (CAL), gingival recession (R), bleeding on probing (BOP) and plaque index (PI) were assessed. The individual was considered the statistical unit. The differences between the groups and the alterations over the course of time were analyzed according to a generalized linear model (repeated measures analysis of variance). There was a significant reduction in PD (1.59mm test and 1.16mm control) and BOP (44.4% test and 52.62% control) and CAL gain (1.15mm test and 0.91mm control) in both groups (p7mm at baseline were analyzed, a significant reduction in PD was observed in test (1.60mm, p = 0.004) and control groups (1.10mm, p = 0.0008), as well as a significant gain in CAL in test group only (test: 1.59mm, p 7mm, when compared to test group.

The objective of this independent, double-blind, seven-day clinical study was to assess the efficacy of a commercially available mouthrinse containing 0.05% cetylpyridinium chloride (CPC) in preventing dental plaque build-up relative to that of a control mouthrinse without 0.05% CPC.Adult male and female subjects from the São Paulo, Brazil area reported to the clinical facility, having refrained from any oral hygiene procedures for 12 hours, and from eating, drinking, and smoking for four hours, for an assessment of the oral soft and hard tissues and a baseline dental plaque evaluation. Subjects qualifying for participation received a complete dental prophylaxis. Qualifying subjects were randomly assigned into one of the two treatment groups and were provided with their assigned mouthrinse, an adult soft-bristled toothbrush, and a commercially available fluoride toothpaste for home use. Over the seven-day period of home use, during which there were no restrictions regarding diet or smoking habits, subjects were instructed to brush their teeth for one minute twice daily (morning and evening) with the toothbrush and toothpaste supplied, to rinse their mouths with water after brushing, and then to rinse with 15 ml of their assigned mouthrinse for one minute before expectorating. The use of other oral hygiene products or procedures, such as floss or interdental stimulators, was not permitted during the study. After seven days of product use, subjects returned to the clinical facility having followed the same restrictions with respect to oral hygiene procedures, eating and drinking, as prior to the baseline examination, and the oral soft and hard tissue assessments and dental plaque evaluations were repeated.Forty-three subjects complied with the protocol and completed the study. Results demonstrated that after seven days of product use, mean plaque levels were statistically significantly lower (p0.05) than the pre-prophylaxis levels for both treatment groups. The mean plaque level for the CPC mouthrinse group was 46.1% of the pre-prophylaxis plaque level, whereas the mean plaque level for the control mouthrinse group was 75.5% of the pre-prophylaxis plaque level. The results demonstrate a statistically significant reduction in plaque build-up for the CPC mouthrinse group (29.3%) as compared to the control group.The overall results from this double-blind clinical study support the conclusion that, after seven days of product use, a mouthrinse containing 0.05% CPC provides significantly greater efficacy in preventing dental plaque build-up than a control mouthrinse without 0.05% CPC. As measurements were made 12 hours after final product use, the results also demonstrate that the CPC rinse provides 12-hour protection against dental plaque build-up.

Objetivo: O objetivo do presente estudo foi avaliar in vitro a precisão dos contatos oclusais obtidos em pacientes dentados por meio do articulador virtual. Materiais e Métodos: Trinta e seis modelos foram obtidos de pacientes dentados e montados em articulador semi ajustavel (ASA) A7 Plus (Bio-art). O registo intermaxilar foi realizado utilizando silicone occlufast Rock (Zhermack). Após a montagem em articulador, os contatos oclusais foram demarcados nos modelos de gesso com carbono de 20 ?m de espessura (AccuFilm), os quais foram utilizados como valores de referência. Com o intuito de obter modelos virtuais, os modelos de gesso foram então digitalizados por meio de um scanner laboratorial (Dental Wings 7, Straumann). Realizou-se a calibração do articulador virtual de acordo com as recomendações do fabricante e os contatos oclusais nos modelos digitais foram obtidos automaticamente por meio do respectivo software. A análise quantitativa dos contatos oclusais foi realizada independentemente por dois examinadores, de forma que cada examinador repetiu a contagem duas vezes com um intervalo de 48h entre as medições. A concordância intra e inter examinadores, assim como a correlação entre os contatos oclusais obtidos em modelos virtuais e modelos de gesso foram avaliados estatisticamente por meio do coeficiente Kappa com nível de significância ? = 5%. A concordância intra-examinador foi de 0.93 a 0.98 (p < 0,001), enquanto que a concordância entre os examinadores variou entre 0.61 a 0.67 (p < 0,001) para ambos modelos virtuais e de gesso. Os contatos obtidos em modelos virtuais e modelos de gesso convencionais apresentaram uma concordância entre 0.52 a 0.55 (p < 0,001). Conclusão: Dentre as limitações apresentadas pelo presente estudo, foi possível concluir que o articulador virtual apresentou uma precisão moderada para a determinação dos contatos oclusais em pacientes dentados. Objective: The objective of the study was to evaluate in vitro the accuracy of occlusal contacts obtained in patients through the virtual articulator. Materials and Methods: Thirty-six models were obtained from patients and mounted on a semi-adjustable articulator (ASA) A7 Plus (Bio-art). The intermaxillary registration was performed using silicone occlufast rock (Zhermack). After mounting in the articulator, the occlusal contacts were delimited in the 20 ?m thick carbon film (AccuFilm), which were used as reference values. In order to obtain virtual models, the gypsum models were scanned with a laboratory scanner (Dental Wings 7, Straumann). The virtual articulator calibration was performed according to the manufacturer\'s recommendations and the occlusal contacts in the digital models were obtained automatically through the corresponding software. Results: The quantitative analysis of the occlusal contacts was performed independently by two examiners, so that each examiner repeated the count twice with a 48h interval between measurements. The intra and inter-examiner agreement, as well as the correlation between the occlusal contacts obtained in virtual models and gypsum models were statistically evaluated using the Kappa coefficient with significance level ?=5%. The intra-examiner agreement was 0.93 to 0.98 (p

A proposta desse estudo de 24 meses foi identificar os preditores da cessação de tabagismo em um estudo de coorte em fumantes com periodontite crônica, atendidos em um programa antitabágico multidisciplinar. Dos 286 participantes triados, 116 foram incluídos no estudo e receberam tratamento periodontal não cirúrgico e terapia de cessação de tabagismo, que consistia em palestras, terapia cognitiva comportamental e farmacoterapia de acordo com as necessidades individuais. Durante o início do tratamento periodontal, os dentistas motivavam os participantes do estudo para parar de fumar, usando técnicas de entrevista motivacional. Além disso, aconselhamento e apoio a cessação do tabagismo também foram fornecidos pelos dentistas, durante as sessões de manutenção periodontal aos 3, 6, 12 e 24 meses de estudo. Tabagismo foi avaliado através de um questionário estruturado, e era validado pelas medidas de Monóxido de Carbono (CO) expirado. O teste de Fagerström para a Dependência do Cigarro foi utilizado para aferir a dependência. Dos 61 indivíduos que permaneceram até o final do estudo, 31, 21 e 18 declararam que não eram fumantes após 3, 12 e 24 meses, respectivamente. Foram utilizados teste de associação, teste de comparação de média e regressão logística univariada para identificar os preditores de cessação de tabagismo. Cessação de tabagismo após 24 meses esteve associada com gênero masculino (odds ratio [OR] = 3,77, intervalo de confiança [IC] 95% = 1,16-12,30), nível de CO no início do estudo < 10ppm (OR = 5,81, IC 95% 1,76 - 19,23), não conviver ou trabalhar com fumante (OR = 7,38, IC 95% 1,76 - 30,98) e uma média menor no teste de Fagerström (OR = 5,36, IC 95% 1,55 - 20,43). Pode ser concluído que cessação de tabagismo foi associada com variáveis demográficas, histórico de tabagismo e dependência do cigarro. The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis attending a multidisciplinary smoking cessation program. Among the 286 screened subjects, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and it was validated by exhaled carbon monoxide (CO) measurements. Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Tests for association tests, tests for comparison of means and univariate logistic regression analysis were used to identify predictors of smoking cessation. Among the 61 individuals that remained up to the 24-months examination, 31, 21 and 18 declared that were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with male gender (odds ratio [OR] = 3.77, confidence interval [CI] 95% = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, CI 95% 1.76 - 19.23), not living or working with another smoker (OR = 7.38, CI 95% 1.76 - 30.98) and lower mean Fagerström test score (OR = 5.63, CI 95% 1.55 - 20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.

O tabagismo é o mais importante fator de risco de diversas doenças crônicas, incluindo a periodontite. Atualmente existe uma mobilização mundial contra o uso do tabaco. Embora cirurgiões-dentistas apresentem potencial para ajudar seus pacientes fumantes a abandonar o vicio, o papel do dentista na cessação do tabagismo ainda não está totalmente esclarecido. O objetivo deste estudo prospectivo de 12 meses foi verificar o efeito de um programa antitabágico multidisciplinar na cessação de tabagismo em fumantes com doença periodontal. Duzentos e um (201) sujeitos foram triados, e 93 foram incluídos e receberam tratamento periodontal não-cirúrgico. Simultaneamente, os indivíduos receberam terapia antitabágica, que consistiu em quatro palestras consecutivas ministradas por um médico e uma dentista, terapia cognitiva comportamental realizada por uma psicóloga, e terapia de reposição de nicotina e medicação, de acordo com necessidades individuais. Durante o tratamento periodontal, os dentistas motivaram ativamente os participantes a pararem de fumar, usando técnicas de entrevista motivacional. Aconselhamento e suporte adicionais foram fornecidos durante as visitas de manutenção após 3, 6 e 12 meses do término do tratamento periodontal. A condição de tabagista foi avaliada por meio de um questionário estruturado, e foi validada pela mensuração de monóxido de carbono expirado (CO). Também foi aplicado o Questionário de Tolerância de Fagerström para verificar a dependência à nicotina. Dentre os 52 indivíduos que permaneceram até o exame de 12 meses, 22(42,31%), 17(32,69%) e 17(32,69%) não estavam fumando após 3, 6 e 12 meses, respectivamente. A cessação de tabagismo foi associada aos níveis iniciais de CO (p = 0,03), nível de dependência nicotínica de acordo com o questionário de Fageström (p=0,01) e escore médio do questionário de Fagerström (p