ABSTRACT
ABSTRACT: Prosthodontics, in general, aims to rehabilitate the masticatory function of the patient, as well as the stomatognathic system, maintaining his or her individual facial characteristics. The immediate removable complete denture is placed immediately after extraction of the natural teeth and allows adaptation of the patient from the dentate state to the denture, until the definitive denture is placed. When an immediate complete denture is fabricated, esthetics plays a fundamental role and thus the assembly of artificial teeth can be performed maintaining the same position, alignment and arrangement of the remaining anterior teeth, providing a natural and esthetic appearance to the denture, thus the transition from the dentate to the edentulous state is less noticeable. This paper reports the case of a patient who needed oral rehabilitation with an immediate upper complete denture and presented favorable smile esthetics of the anterior teeth, which allowed the preservation of alignment, position and arrangement of natural teeth during the assembly of artificial teeth, maintaining and preserving the esthetic individuality and facial harmonization, meeting the patient's desire and expectations.
RESUMEN: La prostodoncia, en general, tiene como objetivo rehabilitar la función masticatoria del paciente, así como el sistema estomatognático, manteniendo sus características faciales individuales. La dentadura postiza completa removible se coloca inmediatamente después de la extracción de los dientes naturales y permite la adaptación del paciente del estado dentado a la dentadura, hasta que se coloque la dentadura definitiva. Cuando se fabrica una dentadura postiza completa inmediata, la estética juega un papel fundamental y, por lo tanto, el ensamblaje de dientes artificiales se puede realizar manteniendo la misma posición, alineación y disposición de los dientes anteriores restantes, proporcionando un aspecto natural y estético a la dentadura, por lo tanto, la transición desde el estado dentado hasta el estado desdentado es menos notable. Este artículo informa el caso de una paciente que necesitó rehabilitación oral con una dentadura postiza completa superior inmediata y presentó una estética de sonrisa favorable de los dientes anteriores, lo que permitió preservar la alineación, la posición y la disposición de los dientes naturales durante el ensamblaje de los dientes artificiales, manteniendo y preservando la individualidad estética y la armonización facial, satisfaciendo los deseos y expectativas del paciente.
Subject(s)
Humans , Female , Middle Aged , Denture, Complete, Immediate , Denture, Complete, Upper , Radiography, Dental/methods , Esthetics, DentalABSTRACT
Abstract Although periodontitis is one of the commonest infectious inflammatory diseases in humans, the mechanisms involved with its immunopathology remain ill understood. Numerous molecules may induce inflammation and lead to bone resorption, secondary to activation of monocytes into osteoclasts. TACE (TNF-α converting enzyme) and DC-STAMP (dendritic cell-specific transmembrane protein) appear to play a role on bone resorption since TACE induces the release of sRANKL (soluble receptor activator of nuclear factor kappa-β ligand) whereas DC-STAMP is a key factor in osteoclast induction. The present study evaluated the levels of TACE and DC-STAMP in patients with and without periodontitis. Twenty individuals were selected: 10 periodontally healthy participants undergoing gingivectomy for esthetic reasons and 10 diagnosed with periodontitis. Protein levels of such molecules in gingival tissue were established using Western blotting. Protein levels of both TACE and DC-STAMP were higher in the periodontitis group than in the control group (p<0.05; Student t-test). In conclusion, TACE and DC-STAMP protein levels are elevated in patients with periodontitis, favoring progression of bone resorption.
Resumo Apesar de a periodontite ser uma das doenças infecto inflamatórias humanas mais comuns, os mecanismos que conduzem à imunopatologia não estão bem definidos. Inúmeras moléculas induzem atividade inflamatória que levam à perda óssea. Para que haja a reabsorção óssea, células monocíticas são ativadas e se transformam em osteoclastos. As moléculas TACE (Enzima conversora de TNF-α) e DC-STAMP (Proteína transmembrana específica de célula dendrítica) parecem atuar no processo de reabsorção óssea uma vez que a TACE induz a liberação de sRANKL (ativador do receptor do fator nuclear kappa-β ligante solúvel), enquanto a DC-STAMP é um fator chave na indução dos osteoclastos. Diante disso, o presente estudo avaliou a expressão gênica das moléculas TACE e DC-STAMP em pacientes com e sem periodontite uma vez que o papel destas moléculas no curso do desenvolvimento da periodontite ainda é pouco explorado. Foram selecionados 20 indivíduos, sendo 10 com saúde periodontal e com indicação para remoção de tecido gengival por motivos estéticos e 10 pacientes com periodontite. As análises da expressão das moléculas no tecido gengival foram realizadas por meio de western blotting. Os níveis proteicos tanto de TACE quanto de DC-STAMP, foram maiores nos tecidos do grupo com periodontite em comparação aos do grupo controle (p<0.05; Student' t-test). Portanto, os dados demonstram que a expressão protéica das moléculas TACE e DC-STAMP estão elevados em pacientes com periodontite, favorecendo a progressão da reabsorção óssea nesta patologia.
Subject(s)
Humans , Periodontitis , Bone Resorption , Adaptor Proteins, Signal Transducing/metabolism , ADAM17 Protein/metabolism , Membrane Proteins/metabolism , Osteoclasts , Cell DifferentiationABSTRACT
Abstract The possible role of B-cell growth and differentiation-related cytokines on the pathogenesis of diabetes-related periodontitis has not been addressed so far. The aim of this study was to evaluate the effects of diabetes mellitus (DM) on the gene expression of proliferation-inducing ligand (APRIL) and B-lymphocyte stimulator (BLyS), two major cytokines associated to survival, differentiation and maturation of B cells in biopsies from gingival tissue with periodontitis. Gingival biopsies were obtained from subjects with periodontitis (n = 17), with periodontitis and DM (n = 19) as well as from periodontally and systemically healthy controls (n = 10). Gene expressions for APRIL, BLyS, RANKL, OPG, TRAP and DC-STAMP were evaluated using qPCR. The expressions APRIL, BLyS, RANKL, OPG, TRAP and DC-STAMP were all higher in both periodontitis groups when compared to the control group (p < 0.05). Furthermore, the expressions of BLyS, TRAP and RANKL were significantly higher in the subjects with periodontitis and DM when compared to those with periodontitis alone (p < 0.05). The mRNA levels of BLyS correlated positively with RANKL in the subjects with periodontitis and DM (p < 0.05). BLyS is overexpressed in periodontitis tissues of subjects with type 2 DM, suggesting a possible role of this cytokine on the pathogenesis DM-related periodontitis.