Tratamento de recessão gengival com enxerto de tecido conjuntivo subepitelial / Treatment of gingival recession with subepithelial connective tissue graft – a case report

O recobrimento radicular com enxerto de tecido conjuntivo subepitelial (ETCS) vem se apresentando como uma das melhores alternativas para o tratamento de exposições radiculares. O objetivo desse trabalho foi ilustrar, através de um caso clínico, como o ETCS pode melhorar a estética e a hipersensibilidade dentinária de uma recessão classe III de Miller. Paciente do sexo masculino, com 38 anos de idade, procurou atendimento odontológico apresentando recessão gengival classe III de Miller na unidade 1.3, associada a uma lesão cervical não cariosa devido a um trauma de escovação. O tratamento incluiu a restauração da unidade com resina composta e o recobrimento radicular com ETCS. O paciente foi acompanhado periodicamente durante dez semanas. Concluiu-se que, mesmo havendo dificuldades que limitam a obtenção do completo recobrimento da raiz, é possível obter um resultado clínico satisfatório, tanto do ponto de vista periodontal quanto estético, utilizando o ETCS.

The use of subepithelial connective tissue graft (SCTG) has been considered one of the best options for the treatment of toothroot exposures. This paper aims to ilustrate, throughout a case report, how SCTG can improve esthetics and dentin hypersensitivity of a Miller class III recession type-defect. We report the case of a 38-year-old male patient presenting a Miller class III recession-type defect on tooth no. 1.3 associated with a non-carious cervical lesion caused by traumatic toothbrushing. Treatment included filling of the abrasion with composite resin and root-coverage with SCTG. The patient was followed-up for 10 weeks after the surgery. It is possible to conclude that, even when difficulties narrow the chances of a complete root coverage, it is possible to achieve a satisfactory esthetical and periodontal result with the SCTG.

Modulação da proliferação, apoptose e autofagia de linfocitos T por RAGE / Modulation of proliferation, apoptosis and autophagy of T lymphocytes by RAGE

RAGE (Receptor for advanced glycation endproducts) é um receptor de padrões moleculares (PRR) reconhecido principalmente por seu envolvimento na patogênese de complicações secundárias do Diabetes Mellitus. Sua ativação está relacionada à modulação da resposta imune-inflamatória, promovendo ativação, migração e maturação de leucócitos; e induzindo a liberação de citocinas inflamatórias. A sinalização via RAGE também está relacionada à regulação dos processos de sobrevivência, apoptose e autofagia celular. Pouco se sabe sobre o papel de RAGE na regulação desses processos em células da resposta imune adaptativa e, especificamente, em linfócitos T. Nosso objetivo foi avaliar a influência da ativação de RAGE na biologia de células T. Para isso, observamos seus efeitos na modulação da proliferação, apoptose e autofagia, e a contribuição da ativação de NF-κB na indução desses processos. Células de linhagem de linfócitos T (JM/Jurkat) foram estimuladas com os ligantes de RAGE BSA-AGE (100 e 200 µg/mL) e S100b (10 µg/mL). A estimulação também foi realizada mediante a pré-ativação do receptor de células T (TCR). Experimentos de ganho de função foram realizados por meio da transfecção transitória das células com um vetor plasmidial de RAGE. A proliferação celular foi determinada por ensaio de exclusão com azul de Trypan. A apoptose foi avaliada através da detecção da fragmentação do DNA pelo método TUNEL e da expressão de p53, Bax e Bcl-2 por Western blot. Ainda por Western blot, observamos a expressão de proteínas características do processo de autofagia, p62 e LC3; e de p50, subunidade do fator de transcrição NF-κB. O estímulo com BSAAGE e S100b não alterou a proliferação e a viabilidade, mas, em células transfectadas, esse estímulo tendeu a aumentar a proliferação e a viabilidade, sobretudo após a pré-ativação das células. O BSA-AGE e o S100b produziram efeitos distintos sobre a apoptose a depender da pré-ativação e do período experimental avaliado. O estímulo com os agonistas de RAGE atenuaram a inibição de LC3 e p53 induzida pela camptotecina. Efeito de "resgate" semelhante foi verificado na expressão de p50. O estímulo de RAGE parece favorecer a proliferação e a autofagia de linfócitos T. Os seus efeitos sobre a apoptose variam de acordo com o tipo, concentração e período de exposição ao ligante utilizado

RAGE (Receptor for advanced glycation endproducts) is a pattern recognition receptor (PRR) that is especially recognized for its involvement in the pathogenesis of secondary complications of Diabetes Mellitus. Its activation is related to the modulation of immune-inflammatory responses, by promoting activation, maturation and migration of leukocytes, as well as the induction of inflammatory cytokines. RAGE signaling is also related to the regulation of cellular processes like survival, apoptosis and autophagy. Little is known about the role of RAGE in the regulation of these processes in cells of the adaptive immune response, specifically in T lymphocytes. Our main purpose was to evaluate the influence of RAGE activation in T cell biology. We observed the role of this receptor in the modulation of proliferation, apoptosis and autophagy, and the contribution of NF-kB in the induction of these processes. A human cell line of T lymphocytes (JM/ Jurkat) were stimulated with the RAGE ligands: BSA-AGE (100 and 200 µg/mL) and S100B (10 µg/mL). The stimulation was also performed after pre-activation of the T cell receptor (TCR). Gain of function experiments were performed by transient transfection of cells with a plasmid vector to increase RAGE expression. Cell proliferation was determined by Trypan blue dye exclusion assay. Apoptosis was assessed by the detection of DNA fragmentation by the TUNEL method, and p53, Bax and Bcl-2 expression by Western blotting. Also by Western blotting, we observed the effect of RAGE on the expression of autophagy-related proteins, p62 and LC3, and on the expression of p50, subunit of the transcription factor, NF-κB. The stimulation with BSA- AGE and S100b did not alter the proliferation and viability, but, in transfected cells, this stimulation tended to increase proliferation and viability, especially after the cell pre-activation. BSA-AGE and S100b had distinct effects on apoptosis depending on the cell pre-activation and trial period evaluated. The stimulation with agonists of RAGE attenuated the inhibition of LC3 and p53 induced by camptothecin. Similar effect was observed in the expression of p50. The stimulation of RAGE seems to favor the proliferation and autophagy of T lymphocytes. Its effects on apoptosis may vary according to the type, concentration and period of exposure to the ligand used

Instrumentation of dental implants: a literature review

Introduction and Objective: The aim of this study was to review the literature on the systems used to decontaminate the implant's surface. Different instruments have been proposed, but there is no agreement in the literature about which methods would be more efficient with no damage to the implant surface. It was reported the use of plastic, carbon fiber, stainless-steel and titanium curettes and also the use of other systems such as ultrasonic points with different tips, rubber cups and air abrasion. Literature review: In most of the studies, the injury caused on the titanium surface at the time of instrumentation was examined. In others, the cell adhesion on the titanium dental implants following instrumentation of the implant surface was observed. Moreover, to enhance cleaning around implants, ultrasonic systems were recently tested. Conclusion: Metal instruments can lead to major damage to implant surface, therefore, they are not indicated for decontamination of dental implants surfaces. Furthermore, non-metallic instruments, such as plastic curettes, rubber cups, air abrasion and some ultrasonic systems seem to be better choices to remove calculus and plaque of the sub- and supra-gingival peri-implant area. It is noteworthy that more studies evaluating the effects of these systems are required to establish best practices to be used in the treatment of patients with dental implants.