ABSTRACT
Abstract Although dental implants and bone regenerative procedures are important approaches for the reestablishment of esthetics and function in young patients with a history of generalized aggressive periodontitis (GAP), no predictable outcomes have been reported, and the host osteo-immunoinflammatory response may play a relevant role in this context. In view of the lack of molecular investigations into the bone tissue condition of young patients with periodontitis, the aim of this study was to evaluate the gene expression of bone-related factors in this population. Bone biopsies were obtained from the posterior mandible in 16 individuals previously diagnosed with GAP and on periodontal support therapy and from 17 periodontally healthy (PH) patients. The gene expression of tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β, receptor activator of the NF-κB ligand (RANKL), osteoprotegerin (OPG), osteocalcin (OC), bone sialoprotein (BSP), and type I collagen (COL-I), important biomarkers of bone turnover, was evaluated by qRT-PCR. Lower TGF-β and OPG mRNA levels were observed in GAP patients compared to PH individuals (p ≤ 0.05). There were no between-group differences in levels of TNF-α, BSP, RANKL, OC, or COL-I mRNA (p>0.05). In young adults, a history of periodontal disease can negatively modulate the gene expression of important bone-related factors in alveolar bone tissue. These molecular outcomes may contribute to the future development of therapeutic approaches to benefit bone healing in young patients with history of periodontitis via modulation of osteo-immuno-inflammatory biomarkers.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Aggressive Periodontitis/genetics , Gene Expression , Aggressive Periodontitis/metabolism , Reference Values , Biomarkers , Osteocalcin/analysis , Osteocalcin/genetics , Single-Blind Method , Cross-Sectional Studies , Transforming Growth Factor beta/analysis , Transforming Growth Factor beta/genetics , Tumor Necrosis Factor-alpha/analysis , Tumor Necrosis Factor-alpha/genetics , Statistics, Nonparametric , Collagen Type I/analysis , Collagen Type I/genetics , RANK Ligand/analysis , RANK Ligand/genetics , Osteoprotegerin/analysis , Osteoprotegerin/genetics , Integrin-Binding Sialoprotein/analysis , Integrin-Binding Sialoprotein/genetics , Alveolar Process/chemistry , Real-Time Polymerase Chain ReactionABSTRACT
Este relato descreveu um caso clínico no qual foi realizado um planejamento multidisciplinar priorizando, além do restabelecimento funcional, uma adequada estética ao paciente. Para que tais metas fossem alcançadas, foi importante a implementação de uma visão multidisciplinar do caso, garantindo um planejamento integrado capaz de reunir todos os requisitos para a otimização de resultados satisfatórios, considerando os padrões de estética periodontal e dental. O presente caso clínico descreveu uma abordagem clínica multidisciplinar para reabilitação anterior envolvendo cirurgia plástica periodontal, para aumento de coroa e confecção de facetas em resina composta pela técnica direta para devolução de estética dental, resultando em sucesso clínico e satisfação da paciente.
This report describes a clinical case in which a multidisciplinary planning was performed, prioritizing, in addition to functional restoration, adequate aesthetics to the patient. In order to achieve these goals, it was important to implement an interdisciplinary view of the case, guaranteeing an integrated planning capable of meeting all the requirements for the optimization of satisfactory results, considering the patterns of periodontal and dental aesthetics. The present case report describes a multidisciplinary clinical approach for previous rehabilitation involving periodontal plastic surgery for crown lengthening and direct composite resin veneers to retrieve dental esthetics achieving clinical success and patient satisfaction.