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Made available in DSpace on 2022-04-28T17:30:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-12-28 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Introduction: Gingival recession (GR) is a relevant clinical condition due to its high prevalence worldwide, which leads to aesthetic demands and dentin hypersensitivity. Collagen matrices have been associated with different designs of coronally advanced flaps (CAFs) to treat GR defects. However, the literature lacks long-term follow-up of this treatment option. The aim of this study is to present the long-term follow-up (up to 7 years) of two GR defects (associated or not with noncarious cervical lesion) treated with a CAF and a collagen matrix (CM). Case presentation Case 1 underwent a CAF associated with a CM to treat a single GR defect. After 7 years, Case 1 presented with 3 mm of recession reduction, which corresponds with the 85.7% of root coverage. Case 2 presented two GR defects associated with noncarious cervical lesions (NCCLs). The NCCLs were partially restored with resin composite and then underwent a modified CAF for multiple defects and a CM. After 5 years of follow-up, Case 2 presented with 1.5 and 2.5 mm of recession reduction, which corresponds with the average 83.3% defect coverage. Conclusion These two cases may show that CMs can provide long-term stable outcomes in the treatment of GR defects. Fed Univ Pernambuco UFPE, Dept Prosthesis & Surg Orofacial, Recife, PE, Brazil Sao Paulo State Univ, Inst Sci & Technol, Div Periodont, UNESP, Av Engn Francisco Jose Longo 777, BR-12245000 Sao Jose Dos Campos, SP, Brazil Private Educ Inst, Sao Paulo, Brazil Sao Paulo State Univ, Inst Sci & Technol, Div Periodont, UNESP, Av Engn Francisco Jose Longo 777, BR-12245000 Sao Jose Dos Campos, SP, Brazil CAPES: 001 CNPq: 304269/2019-0

The fast spread of COVID-19 around the world has generated significant impacts on the way societies lives, one of which is the scarcity of personal protective equipment (PPE) for workers in the front lines of combat against the virus. Sanitary insecurity has led populations and health professionals to a rampant search for protective equipment and other devices necessary for life maintenance, both for patients and professionals, revealing health system limitations during large-scale crisis, as the COVID-19 pandemic. On this paper, we aimed to present the initiatives of professionals and companies related to 3D printing to share programs and resources whose purpose is supplying workers in the front line, who have been important allies in combating the effects caused by coronavirus. A search was performed in four electronic databases: SCOPUS, BVS, EMBASE and MEDLINE via PUBMED. After analyzing the inclusion and exclusion criteria, a table of results was prepared with the main characteristics of the products manufactured and made available, as well as the institutions involved. It was concluded, therefore, that the applications of 3D printing in the initiatives had great contributions to public health and the additive industry during the pandemic period of COVID-19.

A cross-sectional study was carried out to analyze tooth loss resulting from caries in relation to the number of times the extracted tooth had been restored, the type of caries diagnosed (primary or secondary), and socioeconomic indicators of patients from the city of Recife, Brazil. Ten public health centres and ten centres associated with health insurance companies were randomly selected. The size of the sample was calculated using a standard error of 2.5%. A confidence interval of 95% and a 50% prevalence of reasons for extractions were used for calculating the sample. The minimum size of the sample for meeting these requirements was 381 patients. Patients were randomly selected from the list of adults registered at each centre. A total of 410 patients were invited to take part in the study. The response rate was 100%, but 6 patients were excluded due to incompleteness of data in the questionnaire applied. An assessment was made to obtain the number of decayed, missing or filled teeth (DMFT index) and the reasons for extraction. The results showed a highly significant (p < 0.001) relationship between the number of times the tooth indicated for extraction had been restored and the reason for extraction being caries. Furthermore, the majority of teeth extracted due to caries had been restored two or more times. A highly statistically significant association was also observed between one indicator of use of dental services (F/DMFT) and extraction due to caries (p < 0.001). The findings questioned the belief that tooth loss can be prevented in the general population by merely providing restorative treatment. Um estudo transversal foi conduzido com o objetivo de analisar a perda dentária, pela razão cárie, em relação ao número de vezes que o dente extraído foi restaurado, tipo de cárie diagnosticada (primária ou secundária) e indicadores socioeconômicos de pacientes na cidade de Recife, Brasil. Dez centros do Sistema Público de Saúde e dez pertencentes a empresas de convênios foram sorteados. O tamanho da amostra foi calculado utilizando-se um erro padrão de 2.5%. O intervalo de confiança de 95% e uma prevalência de razões de extração na ordem de 50% foram usados para o cálculo da amostra. Uma amostra mínima requerida de 381 pacientes foi calculada, sendo examinados um total de 410 pacientes sorteados da lista de atendimento dos postos. 100% dos pacientes concordaram em participar da pesquisa, contudo, seis pacientes foram excluídos do estudo por apresentarem dados incompletos no questionário aplicado. Os pacientes foram examinados para a obtenção do CPOD e da razão das extrações. Cárie foi a principal razão para exodontia (p < 0,001). Analisando-se a relação entre o número de vezes que o dente foi restaurado e a razão da exodontia, observou-se um valor altamente significativo (p < 0,001), indicando que a maioria dos dentes extraídos pela razão cárie foram restaurados duas ou mais vezes. Foi observada uma relação altamente significativa estatisticamente entre um indicador de uso de serviços (O/CPOD) e exodontia devido a cárie (p < 0,001). Os achados demonstraram que é errônea a crença de que a perda dentária pode ser prevenida na população simplesmente pela restauração do dente.

To identify the primary reasons for tooth extraction in a Brazilian adult population.Interviews and oral examinations were conducted with 466 subjects aged from 18-76 years in the city of Maceió, Brazil. Frequency distributions, means and medians were calculated and the chi-square test was used to determine the level of significance. A logistic regression model was used to evaluate the variables associated with reasons for tooth extraction.Of the 466 extractions, 295 (63.3%) were due to dental caries, 61 (13.1%) due to periodontal disease, 56 (12.0%) for orthodontic reasons, 32 (6.9%) at the patient's request, 15 (3.2%) for pre-prosthetic reasons, four (0.9%) due to pericoronitis, two (0.4%) due to trauma and one (0.2%) for other reasons. Tooth extraction due to caries and other causes (excluding periodontal disease) shows a significant association with family income, toothache, type of health centre (public or private), educational level (P0.001) and marital status (P = 0.002). The logistic regression model has shown that patients undergoing treatment at a public health centre, those suffering from toothache or with an incomplete secondary education were more likely to lose their teeth due to caries, with educational level as the strongest indicator. For tooth extraction due to periodontal disease and other causes (excluding dental caries) the variables age, family income, type of health centre, tooth types (anterior or posterior), educational level (P0.001) and toothache (P = 0.006) were statistically significant, and age was the only associated variable in the logistic regression model.Dental caries was the main cause of tooth extraction in the study group, following tooth extraction due to periodontal disease.

Objetivo: O objetivo do estudo foi comparar o uso da matriz MucograftÒ (MC) ao enxerto de tecido conjuntivo subepitelial (ETCS), ambos associados a técnica de avanço coronal do retalho modificado (ACRM), no tratamento de recessões gengivais (RGs) RT1 múltiplas em área estética, avaliando a não-inferioridade do grupo teste (ACR+MC) em relação ao grupo controle (ACR+ETCS), em até 6 meses de acompanhamento. Materiais e métodos: Os pacientes incluídos no tratamento deveriam apresentar 6 RGs adjacentes em área estética. O resultado da alocação aleatória e de perdas na amostra acarretaram em 20 pacientes no grupo teste e 16 pacientes no grupo controle. Os parâmetros clínicos avaliados, e analisados por meio dos testes de Mann-Whitney e Friedman, foram: redução da altura da recessão gengival (AR), profundidade de sondagem (PS), nível de inserção clínica (NIC), largura da RG (LR), altura da mucosa ceratinizada (AMC) e espessura da mucosa ceratinizada (EMC). Estes desfechos também foram avaliados de acordo com o fenótipo gengival. Para os desfechos centrados no paciente (PROMS), foi utilizada a escala visual analógica (VAS) e o questionário OHIP-14 para análise do impacto na qualidade de vida dos pacientes. O questionário para estética do sorriso (RES) avaliou a percepção estética do profissional. Os períodos de avaliação foram: inicial (bsl), 3 e 6 meses. A avaliação de não-inferioridade foi realizada, por meio do intervalo de confiança, para verificação da relevância clínica na comparação entre os grupos, de acordo com a margem de nãoinferioridade pré-estabelecida (0,75). Resultados: O grupo controle apresentou melhores resultados para a redução da AR (p0,05). Os resultados dos PROMS mostraram que grupo teste apresentou menor morbidade pós-operatória (p0,05). Nos períodos de 3 e 6 meses não houve diferença estatística entre os grupos para a percepção estética do paciente e do profissional (p>0,05). Conclusão: O presente estudo clínico randomizado controlado demonstrou que a MC pode ser considerada uma alternativa viável ao ETCS no RR de RG múltiplas em áreas estéticas extensas. São necessários estudos futuros, com a utilização da MC no RR em defeitos múltiplos extensos, comparando fenótipos gengivais e com maior tempo de acompanhamento Objective: The aim of the study was to compare the use of Mucograft matrix (MC) to subepithelial connective tissue graft (ETCS), both associated with the modified coronally advanced flap technique (ACRM), in the treatment of multiple RT1 gingival recessions (RGs) in aesthetic area, evaluating the non-inferiority of the test group (ACR+MC) in relation to the control group (ACR+ETCS), in 6 months of follow-up. Materials and methods: Patients included in the treatment should have 6 adjacent GRs in the esthetic area. The result of random allocation and sample losses resulted in 20 patients in the test group and 16 patients in the control group. The clinical parameters evaluated, and analyzed by Mann-Whitney and Friedman tests, were: reduction the gingival recession height (AR), probing depth (PS), clinical attachment level (NIC), gingival recession width (LR), keratinized mucosa height (AMC) and keratinized mucosa thickness (EMC). These outcomes were also evaluated according to gingival phenotype. For patient-centered outcomes (PROMS), the visual analogue scale (VAS) and the OHIP-14 questionnaire were used to analyze the impact on patients\' quality of life. The Root coverage esthetic score questionnaire (RES) assessed the professional\'s aesthetic perception. The evaluation periods were: initial (bsl), 3 and 6 months. The assessment of non-inferiority was performed using the confidence interval to verify the clinical relevance in the comparison between groups, according to the pre-established non-inferiority margin (0.75). Results: The control group showed better results for the reduction of AR (p0.05). Results from PROMS showed that the test group had lower postoperative morbidity (p0.05). In the periods of 3 and 6 months, there was no statistical difference between the groups for the aesthetic perception of the patient and the professional (p>0.05). Conclusion: The present randomized controlled clinical study demonstrated that CM can be considered a viable alternative to ETCS in the RR of multiple GR in extensive esthetic areas. Future studies are needed, with the use of CM in RR in multiple extensive defects, comparing gingival phenotypes and with longer follow-up time.

A literatura recente apresenta inúmeros estudos sobre associação entre as doenças peri-implantares (DPi) e níveis de marcadores inflamatórios no fluido do sulco peri-implantar, em biópsias de tecido gengival e sangue. Surpreendentemente, poucos são os estudos de marcadores salivares relacionados à presença e progressão das DPi, uma vez que a saliva representa um meio não invasivo, de fácil coleta e baixo custo. Neste contexto, esta tese apresenta dois estudos distintos: (1) Estudo observacional longitudinal sobre a condição clínica peri-implantar associada aos níveis dos marcadores salivares IL-1, IL-10, RANK, OPG, MMP-2, TGF e TNF- em indivíduos com diagnóstico de mucosite peri-implantar (MP) na ausência e presença de terapia regular de manutenção periodontal e peri-implantar (TMPP); e (2) Revisão sistemática com a seguinte questão focal: Os níveis de biomarcadores salivares podem ajudar a distinguir implantes saudáveis de implantes com doença peri-implantar ? A metodologia do estudo longitudinal envolveu 80 indivíduos diagnosticados com MP, que foram divididos em dois grupos: um que realizou terapia de manutenção periodontal e peri-implantar, chamado de GTP (n=39), e um outro sem manutenção (GNTP, n=41). Cada participante submeteu-se a um exame clínico periodontal e peri-implantar completo [registro do nível clínico de inserção (NCI); profundidade de sondagem periodontal (PS) e peri-implantar (PSi); sangramento à sondagem periodontal (SS) e peri-implantar (SSi); supuração (Si); índice de placa periodontal (IP) e peri-implantar (IPi)], exame radiográfico, para avaliação dos níveis ósseos peri-implantares e coleta de amostras de saliva em dois tempos: exame inicial (T1) e decorridos 5 anos (T2). As amostras salivares foram congeladas e posteriormente avaliadas através do teste de ELISA. Observou-se uma maior incidência de peri-implantite (PI) no grupo GNTP (43,9%) do que no grupo GTP (18%) (p = 0.000). Todos os indivíduos (n = 12) que apresentaram resolução da MP em T2 estavam no GTP. Houve um aumento no número de indivíduos com periodontite no GNTP quando comparado T1 (22,0%) e T2 (41.5%) (p = 0.001). Os resultados imunológicos revelaram um aumento na concentração salivar do TNF- no GNTP comparado ao GTP. Os demais marcadores salivares avaliados não mostraram alteração estatisticamente significativa entre os dois grupos. Concluiu-se que a ausência de consultas regulares para manutenção periodontal/peri-implantar foi associada com pior condição clínica periodontal e peri-implantar, maior incidência de PI e um aumento significativo nos níveis de TNF-, sugerindo ser este um marcador salivar promissor para a progressão das DPi. Adicionalmente, a revisão sistemática demonstrou que não há evidências sólidas para concluir que os biomarcadores salivares poderiam ajudar a distinguir entre implantes saudáveis de implantes com PI. Além disso, sugere-se que os resultados devem ser interpretados com cautela devido a inclusão de muitos estudos na revisão sistemática com um alto risco de viés. Peri-implant disease and levels of salivary biomarkers IL-1, IL-10, RANK, OPG, MMP-2, TGF and TNF-: a 5 years follow-up and systematic review Recent literature presents numerous studies on the association between peri-implant diseases (DPi) and levels of inflammatory biomarkers in peri-implant sulcus fluid, in gingival tissue and blood biopsies. Surprisingly, rare are studies on salivary markers related to the presence and progression of DPi, since saliva is abundant, its collection is an easy, low cost and, non-invasive method. In this sense, this thesis presents two distinct studies. The first (longitudinal) study that aimed to evaluate the peri-implant clinical condition and levels of the salivary markers IL 1, IL-10, RANK, OPG, MMP-2, TGF, and TNF- in individuals in the presence and absence of periodontal/ peri-implant maintenance (TMPP). The second study, a systematic review, focused in answer the following question: Could biomarker levels in the saliva help to distinguish between healthy implants and implants with peri-implant disease? The longitudinal study methodology involved 80 individuals diagnosed with mucositis (MP), who were divided into two groups: a group that underwent periodontal and peri-implant maintenance therapy, called GTP (n = 39), and a second group without regular maintenance, called GNTP (n = 41). Each participant underwent a complete periodontal and peri-implant clinical examination [recording of the clinical level of insertion (NCI), periodontal probing depth (PS) and peri-implant probing depth (PSI), periodontal bleeding (SS) and peri-implant bleeding (SSi), suppuration (SU); periodontal plaque (IP) and peri-implant plaque (IPi) indexes], radiographic examination for evaluation of peri-implant bone levels and collection of saliva samples at two times: initial examination (T1) and after 5 years (T2). The salivary samples were frozen and then evaluated by ELISA's method for the following markers: IL 1, IL-10, RANK, OPG, MMP- 2, TGF and TNF-. Results: A higher incidence of peri-implantitis (PI) was noted in the GNTP group (43.9%) than in the GTP group (18%) (p = 0.000). All the individuals (n = 12) who presented resolution of MP in T2 were from the GTP group. There was an increase in the number of individuals with periodontitis in GNTP when comparing T1 (22.0%) to T2 (41.5%) (p = 0.001). The result of the study revealed an increase in the salivary concentration of TNF- in GNTP compared to GTP. The other salivary markers evaluated did not show statistically significant alteration between the two groups. Conclusion: The absence of regular consultations for periodontal / peri-implant maintenance was associated with worse periodontal and peri-implant clinical condition, higher incidence of PI, and a significant increase in TNF- levels: suggesting this promising salivary marker for the prognosis and diagnosis of DPi.Additionally, the systematic review has shown that there is no solid evidence to conclude that salivary biomarkers could help distinguish between healthy implant implants with PI. Besides that, it is suggested that the results should be interpreted with caution due to the inclusion of many studies, in the systematic review, with a high risk of bias.