Association between genetic polymorphisms in rank, rankl and opg and peri-implant diseases in patients from the Amazon Region

Abstract The present study evaluated polymorphisms in RANK, RANKL and OPG-encoding genes to assess whether they are associated with mucositis and peri-implantitis in a population from the Brazilian Amazon region. One hundred and fourteen patients with dental implants were included in the study. After clinical and radiographic examination, the sample was categorized into 4 groups, according to the peri-implant status: Healthy (n=71), Mucositis (n=30), Peri-implantitis (n=13) and Diseased (Mucositis + Peri-implantitis, n=43). Genomic DNA was extracted from buccal cells from saliva, and the genetic polymorphism in osteoprotegerin (OPG), Kappa nuclear factor activator receptor (RANKL) and nuclear kappa factor activator receptor (RANK) were genotyped by the real time PCR. Univariate and multivariate statistical analyses were performed to compare clinical variables among groups and to evaluate genotypes and alleles distributions and the established alpha was 5%. Age, peri-implant biotype, diabetes and presence of peri-implant biofilm were associated with mucositis (p<0.05) and peri-implantitis (p<0.05). Smoking, alcoholism, and periodontal biofilms were also associated with the presence of peri-implantitis (p<0.05). Univariate and multivariate analysis did not demonstrate an association of peri-implantitis or mucositis with any genetic polymorphism in RANK (rs3826620), RANKL (rs9594738) and OPG (rs2073618) (p>0.05). The studied genetic polymorphism in RANK, RANKL and OPG were not associated with mucositis and peri-implantitis in a Brazilian population from the Amazon region.

Resumo O presente estudo avaliou a associação da predisposição clínica e dos fatores genéticos com a presença de doenças peri-implantares. Cento e quatorze pacientes com implantes dentais instalados na Clínica de Especialização do Amazonas, Brazil, foram incluidos no estudo. Após exame clínico e radiográfico, a amostra foi categorizada em 4 grupos, de acordo com o Status peri-implantar: saúde (n=71), mucosite (n=30), peri-implantite (n=13) e doentes (mucosite + peri-implantite). DNA genômico foi extraído de células orais da saliva, e o polimorfismo genético em osteoprotegerina (OPG), ligante do receptor ativador do fator Kappa nuclear (RANKL) e receptor ativador do fator Kappa nuclear (RANK) foram genotipados por PCR em tempo real. O estudo se propôs a avaliar se os polimorfismos em RANK, RANKL e OPG estão envolvidos na patogênese da mucosite e da peri-implantite, e avaliar também a presença de fatores de risco moduladores da resposta em uma população brasileira. Idade, biotipo peri-implantar, diabetes e presença de biofilme peri-implantar foram associados a mucosite (p<0.05) e peri-implantite (p<0.05). Tabagismo, alcoolismo e biofilme periodontal também foram associados com a presença de peri-implantite (p<0.05). Análise univariada e multivariada não demonstraram associação de peri-implantite ou mucosite com os polimorfismos genéticos em RANK (rs3826620), RANKL (rs9594738) e OPG (rs2073618) (p>0.05). Os polimorfismos genéticos estudados não foram associados com mucosite e peri-implantite em uma população brasileira da região Amazônica.

Identification of root canals in maxillary molars using cone beam computed tomography / Identificação de canais radiculares nos molares superiores utilizando tomografia computadorizada

Introduction: Knowledge on variations in the root canal system is essential for a successful endodontic treatment. Objective: To present a case of identification of root canals in the maxillary left first molar,including the fourth root canal in the mesiobuccal root, using cone beam computed tomography (CBCT). Conclusion: The CBCT system proved to be relevant in providing important information on the root canal system for the planning of endodontic treatment in cases of persistent infection or access difficulties.

Cone beam tomography evaluation of lingual cortical mandibular defect diagnosed as Stafne bone cavity / Cone beam tomography evaluation of lingual cortical mandibular defect diagnosed as Stafne bone cavity

Mandibular lingual bone depressions are considered to be developmental anomalies known as Stafne bone cavity. The purpose of the present report is to describe the characteristics of classic Stafne bone cavity in molar region evaluated by cone beam computed tomography (CBCT). A male patient, 27 years old, was submitted to CBCT to evaluation the relation between the right lower third molar roots and mandibular canal and the unilateral cystic image found in the panoramic radiographic below the mandibular canal in the right molar area. It was used a gray scale of 12 bits and voxel of 0.2 mm. The CBCT showed fine images of the Stafne bone cavity. In the present case, periodic clinical and radiological controls were the therapeutic option. In atypical cases or in doubtful diagnosis, surgical intervention and anatomopathological examination may be indicated. Although the diagnosis of a Stafne bone cavity can often be established with plain radiographs, confirmatory tests are sometimes required. In these situations, the diagnosis can be confirmed with CBCT.

Análise da anatomia externa no primeiro molar superior por meio da tomografia computadorizada cone beam / Analysis of external anatomy of maxillary firstmolar evaluated by cone beam computed tomography

Introdução: O sucesso no tratamento endodôntico é conseguido após uma limpeza completa seguida de obturação em toda a extensão dos canais radiculares. Dessa forma, estar familiarizado com as variações anatômicas é muito importante para a completa limpeza dos canais radiculares. Objetivo: Avaliou-se a anatomia externa nos molares superiores, bem como a capacidade da tomografia computadorizada cone beam no diagnóstico dessas variações. Material e métodos: Analisaramse 50 molares superiores de 37 pacientes submetidos à tomografia computadorizada cone beam. Resultados: Foram encontrados 49 dentes com três raízes e apenas um dente com quatro raízes (duas vestibulares e duas palatinas). Conclusão: A freqüência da presença de duas raízes palatinas, apesar de baixa, deve ser considerada. A tomografia computadorizada cone beam mostrou-se eficaz no diagnóstico da morfologia externa dos canais radiculares e muito útil na endodontia.

Introduction: The success in endodontic treatment is obtained after thorough cleaning followed by filling the whole length of root canals. Thus, knowledge on variations in the systems of root canals is very important for cleanness of the root canals. Objective: Evaluate the frequency of two palatal roots in the maxillary first molar as well as the capacity of cone beam computed tomography in diagnosed of this variation. Material and methods: Fifty maxillary first molars were evaluated in 37 patients using cone beam computed tomography. Results: It was found only one tooth (2%) with two palatal roots with 4 roots and 5 canals. Conclusion: The frequency of two palatal roots is low, however it must be considered. Cone beam computed tomography showed effective in diagnosed of morphology of root canals and very useful in Endodontics.

Clínica integrada da UNIVILLE / Integrated clinics at UNIVILLE: a holistic view

A prática pedagógica das clínicas integradas docurso de odontologia da Universidade da Região deJoinville/SC tem demonstrado uma visão ampliadano conceito de promoção de saúde. Unindo teoria eprática das disciplinas em uma única atividade clínica,promove um aprendizado mais humanista, com possibilidadesde crescimento para alunos e professores.A triagem realizada pelos próprios alunos, embasadosem uma lista crescente de complexidades, exercita odiagnóstico e o planejamento das demandas para oatendimento. O processo de avaliação procura priorizara visão qualitativa enquanto abandona o conceitode “produção mínima” na produção de tarefascomo meta final e referencia o ser humano e sua integralidade