Association of preterm low-birth-weight infants and maternal periodontitis during pregnancy An interventional study

Context: The impact of periodontal disease during pregnancy and its effect on adverse pregnancy outcomes is seen in the literature. When it comes to the link of disease related to periodontium to that of adverse pregnancy outcomes, a need can arise if a significant cause-effect relationship does exist or not between them. Aim: The study was aimed to determine the association of periodontal health status in pregnant women with the occurrence of preterm low birth weight (LBW) infants in Vadodara, Gujarat. Settings and Design: An interventional study with 100 patients was conducted, of which 67 participants were included in the control group and 33 participants were included in the intervention group. A total of 12 participants dropped out from the study and 88 were analyzed for the outcome. Subjects and Methods: The Community periodontal Index of Treatment needs index was taken for all enrolled participants and then were divided into interventional group and control group. Participants in the interventional group underwent scaling and root planning. Data related to the time of delivery and weight of the baby was taken from the hospital records. Statistical Analysis: A comparison of baseline characteristics was made using unpaired t-test. Chi-square test was used for the analysis of intergroup comparison. The odds ratio and the relative risk calculation were also done. P ? 0.05 was considered for statistical significance. Results: The odds ratio for both preterm and LBW were 3.86 times and 2.96, respectively. The Chi-square statistical test analysis was statistically significant for both preterm and LBW infants on the intergroup comparison. Conclusion: Periodontal disease can be considered as one of the risk factors for preterm LBW babies as not only the presence of disease condition causes an increase in inflammatory mediator but also the elimination of the disease condition reduces the adverse pregnancy outcomes.

Evaluation Of Effect Of Melatonin On Hematological Parameters In Patients Of Periodontitis

Introduction:Considering the immunity enhancing property of melatonin, a study on the evaluation of the effect of melatonin on the hematological parameters in patients suffering from Periodontitis.Methods:This study was con-ducted in the Department of Periodontics, Rural Dental College, Loni. Patients of chronic Periodontitis, of age be-tween 18 to 65 years of either gender ready to give informed consent to participate in the study were included. Postop-erative patients, patients having night duties, drivers and those using heavy machinery, pregnant women, lactating mothers, patients with any clinically significant systemic disease and patients on any other drugs were excluded from the study. Patients were divided into two Groups. Group B received scaling and root planning (SRP) and melatonin 3 mg per day were compared to Group A which received SRP only. The Total Leukocyte count, Differential Leukocyte count and Erythrocyte sedimentation rate of each patient was studied at a baseline, 1st(30 days) visit, 2nd(60 days) visit and 3rd(90 days) visit. Results:Both the groups consisted of 80 subjects each. Group A consisted of 71.25% male and 28.75% female patients. There were 56.25% male and 43.75% female patients in Group B. With respect to visit 3, the TLC was statistically lower in Group B. The neutrophil count of Group B was significantly lower during visit 3 as compared to Group A. The lymphocyte count of Group B was significantly lower than that of Group A dur-ing the visit 1, and also significantly higher during visit 3 on comparison with Group A. There was no statistically sig-nificant difference in the groups with respect to eosinophil and basophil count. The Monocyte count of Group B was statistically lower when compared to that of Group A. There was no statistically significant difference between ESR of Group A & Group B.Conclusions: It can be concluded that melatonin has a positive effect on TLC and differential count of patients of periodontitis, conferring a new facet to the management of periodontitis and an attempt to impede the disease progression.

Long†term results after treatment of periodontitis in patients with Papillon Lefevre syndrome with or without antibiotics a comparative study

Aim: Evaluation of periodontal status in patients with Papillon–Lefèvre syndrome (PLS) observed for ≥5 years, Treatment of patients of PLS with SRP and maintenance for a period of ≥5 years, Comparing the effects of treatment of periodontitis in (PLS) patients with SRP (scaling and root planning) as a monotherapy with antibiotics as an adjunct. Materials and methods: All subject showing signs and symptoms of PLS, were selected for this study comprising of both the sexes, visiting outpatient Department of Periodontology, Govt. Dental College and Hospital Srinagar. Eight patients (aged 5-12 years) from five families (three pairs of siblings) were included. Subjects were randomly distributed into two groups 4 patients each. Control group- Group A given SRP + Placebo and Treatment group- Group B given SRP + 250 mg of amoxicillin TDS and 125 clavulanate for 14 days and metronidazole 250 mg BD for 14 days . Results: In this study by comprehensive maintenance therapy in both the groups we delay the loss of dentition of the patients of PLS. The use of antibiotics had proven to show a statistically significant difference in retaining the teeth of PLS. Patients compared to the control. Conclusion: PLS patients, periodontitis may be arrested by combined mechanical and antibiotic periodontal treatment; extraction of severely diseased teeth; oral hygiene instructions; intensive maintenance therapy; and microbiological monitoring and treatment of the infection with Aggregatibacter actinomycetemcomitans.

Clinical and microbiologic follow-up evaluations after non-surgical periodontal treatment with Nd: YAG laser and scaling and root planning / 华西口腔医学杂志

<p><b>OBJECTIVE</b>Our research aimed to detect the efficacy of non-surgical periodontal treatment with Nd: YAG laser and scaling and root planning (SRP) for chronic periodontitis.</p><p><b>METHODS</b>We recruited chronic periodontitis patients who have more than four teeth with clinical pocket depth of 4-8 mm. These teeth were distributed in four different zones within the oral cavity. Moreover, the teeth were single root teeth and not adjacent to each other. The subordinated teeth were randomized into four groups, as follows: no treatment (C group), simple SRP (SRP group), Nd: YAG laser after SRP treatment (SRP+L group), and SRP after Nd: YAG laser treatment (L+SRP group). The four experimental observation points were as follows: before treatment (baseline) and 1 week, 1 month, and 3 months after treatment. We measured clinical indicators and collected subgingival deposits in the four time points to analyze changes of red complex in periodontitis.</p><p><b>RESULTS</b>The clinical indicators were better in all treatment groups than in the control group. Comparison among treatment groups indicated that the value of bleeding on probing, periodontal probing depth, and clinical attachment loss showed no difference. However, the value of plaque index in SRP+L and L+SRP presented a significant reduction at 3 months after treatment. The percentages of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola in all treatment groups decreased after clinical treatment, and differences were observed among the treatment groups at different time points.</p><p><b>CONCLUSIONS</b>Non-surgical periodontal treatment with SRP and Nd: YAG laser is not more effective than SRP monotherapy. The sequence of laser treatment and SRP has no significant effect on the treatment. However, SRP with Nd: YAG laser was beneficial for plaque control. Non-surgical periodontal treatment with Nd: YAG laser may be used as an alternative to reduce and control the proliferation of microorganisms in persistent periodontitis, but it still needs further verification.</p>

Studay on the analgesic effects of ketorolac tromethamine for periodontal operation / 实用口腔医学杂志

64 patients with severe chronic periodontitis were divided into 2 groups(n =32)randomly.Intramuscular injection of ketorolac tromethamine(KT group)and local block injection of lidocaine(L group)were respectively applied for periodontal subgingival scaling and root planning.The analgesic effect was assessed using VAS,the adverse drug reactions were recorded during and after operation.During op-eration the VAS between the 2 groups was not statistically different(P >0.05).6 and 1 2 h after operation the VAS of KT group was lower than that of L group(P 0. 05).

La moxifloxacina como coadyuvante en el tratamiento de las periodontitis / Moxifloxacine an adjunct in the treatment of periodontitis

La enfermedad periodontal es causada por complejos bacterianos subgingivales organizados en una biopelícula, que genera beneficios ecológicos y metabólicos a los microorganismos que residen en ella. Por otro lado, la biopelícula también genera ventajas contra los mecanismos de defensa del huésped representados en antimicrobianos naturales o contra los antibióticos sintéticos. Pacientes de Centroamérica y Sudamérica tienen perfiles microbiológicos similares en periodontitis agresivas como crónicas. En ambas entidades, los periodontopatógenos más frecuentes asociados con la enfermedad periodontal en los pacientes latinoamericanos son Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Tannerella forsythia, Eikenella corrodens y bacilos entéricos gramnegativos. Los antibióticos han sido prescritos como apoyo a la terapia mecánica para reducir la carga bacteriana a nivel subgingival. Sin embargo, algunas especies bacterianas han desarrollado resistencia antimicrobiana debido a la prescripción indiscriminada de antibióticos, en especial en Latinoamérica. Las quinolonas representan una nueva alternativa en la terapia periodontal debido a su actividad contra los periodontopatógenos y los bacilos entéricos gramnegativos puesto que tienen una reducida resistencia bacteriana, y tienen alta difusión tisular y buena absorción. Se realizó una revisión de literatura con el propósito de brindar una actualización en el uso de antimicrobianos como terapia coayudante en el tratamiento de la periodontitis, enfocando el potencial terapéutico de la moxifloxacina como nueva alternativa.

Periodontal disease results from infection by specific subgingival bacterial complexes organized in a biofilm. Biofilm protects bacteria and other microbial pathogens from host immune system defenses and from natural and artificial antibiotics. Patients with aggressive and chronic periodontitis from Central and South American countries have similar microbiological profiles. In both entities, the most frequent periodontopathogens associated with periodontal disease in Latin American patients are Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Tannerella forsythia, Eikenella corrodens and gram negative enteric rods. Supplemental antibiotics to the mechanical periodontal treatment are prescribed to reduce periodontopathic bacteria in the subgingival environment. Nonetheless, some bacterial species have developed antibiotic resistance due to their indiscriminate prescription in Latin America. Quinolones represent a new alternative in periodontal therapy, due to their activity against periodontopathogens and gram negative enteric rods, to reduced bacterial resistance, high tissue penetration, and good absorption. The aim of this review is to present an update on the use of antimicrobials as adjunctive therapy in the treatment of periodontitis, focusing on the potential therapeutic use of moxifloxacin.

Assessment of patients discomfort and nursing care with the application of vector system in periodontal treatment / 中国实用护理杂志

Objective The study aimed to compare the vector system with the hand instrument in the pain severity during scaling and root planning.Methods 60 periodontal patients were randomly divided into two groups for supportive periodontal therapy (SPT):the experimental group (using vector system) and the control group (using gracey instruments),with 30 cases in each group.And the painfulness after SPT was evaluated by Visual Analogue Scale (VAS).Results 66％ patients felt mild pain during the supportive periodontal therapy with the application of vector system,while 36％ patients felt mild pain in the control group.24 patients in the experimental group accepted vector system for SPT and 23 patients in the experimental group felt less fear of the treatment.Conclusions Patients will feel less discomfort with the application of the vector system,therefore better compliance will be reached.And the cooperation of the doctors and nurses has great impact on the treatment effect.

Efecto preventivo de los agentes desensibilizantes en pacientes con indicaciones de raspado y alisado radicular / Preventive effect of desensitizing agents on patients with indications of scaling and root planning treatment

La hipersensibilidad dentinaria (HD) posterior al raspado y alisado radicular (RAR) ha sido poco estudiada desde una perspectiva preventiva a pesar de su relevancia clínica. El objetivo de esta investigación fue evaluar el efecto de las cremas desensibilizantes en pacientes con indicaciones de raspado y alisado radicular. Para ello, se realizó un estudio longitudinal cuasi-experimental con una muestra no probabilística de 18 pacientes (hombres y mujeres) entre 20 y 50 años de edad, que requerían tratamiento con RAR en dientes posteriores (premolares y primer molar), quienes fueron asignados al azar en cada uno de los tres grupos a evaluar. Las cremas desensibilizantes utilizadas en esta investigación contienen citrato de potasio, nitrato de potasio, fluoruro de sodio y triclosan estas se indicaron un mes antes de realizar los RAR en todos los grupos. Para medir la presencia de hipersensibilidad dentinaria se aplicaron estímulos táctiles y térmicos a los 8, 15 y 22 días posteriores al tratamiento de RAR y se usó la Escala Visual Análoga Graduada (EVAG) para evaluar el dolor. Como resultado se obtuvo menor presencia de HD en el grupo que utilizó citrato de potasio 5.04% y monofluorfosfato 1.1%, aun cuando en los tres grupos se observó disminución de HD durante los tres periodos de medición. Llegando a la conclusión que es pertinente prescribir cremas desensibilizantes con citrato de potasio 5.04% y monofluorfosfato 1.1% a los pacientes con necesidades clínicas similares a los de este estudio un mes antes de planificar los RAR.

The presence of dentine hypersensitivity (DH) after scaling and root planning treatment (RPT) has been scarcely studied from a preventive perspective in spite the clinical relevance of the issue. The aim of this research was to evaluate the preventive effect of some desensitizing dentifrices in patients previous to a RPT. In this sense, a cuasi-experimental, longitudinal study was performed. The non probabilistic sample was constituted by 18 patients (women and men) aged between 20 and 50; all of them diagnosed as requiring scaling and root planning treatment for posterior teeth (premolars and first molars). Subjects were randomly assigned to one of the three groups. The desensitizing toothpaste used in the study contained potassium citrate, potassium nitrate, sodium fluoride and triclosan. These paste were prescribed for patients a month before the RPT. Dentine hypersensitivity was evaluated by using tactile and thermal stimuli applied 8, 25 and 22 days after RPT; the Visual Analogue Scale (VSA) was used to assess pain. Results showed lower presence DH in the 5.04% potassium citrate group and 1.1% monofluor fosfate, even when there was a decrease of DH for the three measurement periods. It was concluded that it would be good to prescribe 5.04% potassium citrate group and 1.1% monofluorfosfate desensitizing agents to patients with clinical needs similar to the ones described in this study, a month before the RPT.

Avaliação da descontaminação com ácido cítrico e tetraciclina e da rugosidade, na adesão de coágulo a superfícies radiculares submetidas a diferentes tipos de instrumentação / Evaluation of decontamination with citric acid and tetracycline and roughness on clot adhesion to root surfaces after different types of instrumentation

O tratamento periodontal engloba o processo de raspagem e alisamento radicular, podendo ser realizado por diferentes meios que além de remover o cálculo dental, produzem diferentes características na superfície radicular como ranhuras e concavidades e também a formação de smear layer. O uso de agentes químicos é proposto na literatura para remover essa smear layer, e descontaminar a superfície radicular, aumentando assim as chances de formação de nova inserção conjuntiva. O objetivo do Estudo 1 foi avaliar, por meio de microscopia eletrônica de varredura, a influência de diferentes concentrações, modos e tempos de aplicação de ácido cítrico na biomodificação de superfícies radiculares submetidas à raspagem e alisamento radicular. Neste estudo, 270 amostras foram divididas em 6 grupos (45 amostras/grupo): soro fisiológico (controle), ácido cítrico (0.5%, 1%, 2%, 15% e 25%), com tempos de 1, 2 ou 3 minutos para cada grupo, nos modos de aplicação: a) aplicação passiva (bolinha de algodão); b) fricção suave (pincel); c) fricção vigorosa (bolinha de algodão), com renovação da solução a cada 30 segundos. As amostras foram submetidas à desidratação em concentrações crescentes de álcool etílico e HMDS, sendo em seguidas metalizadas e levadas para observação em microscopia eletrônica de varredura. Um examinador treinado, calibrado (kappa=0,93) e cego avaliou as fotomicrografias obtidas. A análise estatística foi realizada utilizando-se os testes de Kruskal- Wallis e Dunn. No estudo 2, investigou-se a influência da biomodificação radicular associada a diferentes meios de instrumentação na adesão de coágulo e elementos sanguíneos. Cento e cinquenta dentes afetados periodontalmente foram divididos em 5 grupos: Grupo I, instrumentação com curetas; Grupo II, instrumentação com curetas removendo cálculo superficial; Grupo III, remoção do cálculo superficial com ultrassom; Grupo IV, remoção do cálculo superficial com instrumento ultrassônico seguido pela instrumentação com curetas Grupo V, superfície com cálculo. Estes cinco grupos foram divididos em três subgrupos (10 amostras cada) de acordo com o condicionamento químico: a) sem condicionamento químico; b) condicionamento químico com ácido cítrico; c) condicionamento químico com cloridrato de tetraciclina. Em seguida, uma gota de sangue humano da circulação periférica foi aplicada à superfície radicular das amostras. Foi aguardado o período para coagulação e as amostras foram então preparadas para microscopia eletrônica de varredura. As fotomicrografias obtidas foram avaliadas por um examinador treinado, calibrado (kappa=0,87) e cego e os escores obtidos submetidos à análise estatística (Kruskal-Wallis e Dunn). No estudo 3 , investigou-se a influência dos diferentes meios de instrumentação e da biomodificação na rugosidade e morfologia radicular. Neste estudo foram utilizados cento e cinquenta dentes comprometidos periodontalmente. Os dentes foram divididos em cinco grupos: Grupo I, instrumentação com curetas; Grupo II, instrumentação com curetas removendo cálculo superficial; Grupo III, remoção do cálculo superficial com ultrassom; Grupo IV, remoção do cálculo superficial com instrumento ultrassônico seguido pela instrumentação com curetas Grupo V, superfície com cálculo. Estes cinco grupos foram divididos em três subgrupos (10 amostras cada) de acordo com o condicionamento químico: a) sem condicionamento químico; b) condicionamento químico com ácido cítrico; c) condicionamento químico com cloridrato de tetraciclina. As amostras obtidas foram avaliadas por meio de rugosímetro, obtendo-se valores de rugosidade para os parâmetros (Ra, Rt, Ry e Rz) e por meio de microscopia eletrônica de varredura para avaliação da morfologia. Os resultados mostraram que: o ácido cítrico a 25% aplicado por pincel, por 1 ou 3 minutos foi mais eficiente na obtenção da biomodificação radicular; o condicionamento químico favoreceu a formação de rede de fibrina e adesão de componentes sanguíneos após raspagem e alisamento radicular, apesar de não haver diferenças entre os meios de instrumentação avaliados; os grupos instrumentados por raspagem vigorosa apresentaram menores valores de rugosidades que os grupos que tiveram o cálculo apenas destacado. A avaliação da morfologia mostrou um aspecto mais rugoso da superfície radicular foi observado no grupo controle e nos grupos que tiveram o cálculo apenas destacado. Presença de smear layer e hiperdesmineralização, com aspecto de maior lisura de superfície foi observadas nos grupos após raspagem, com e sem condicionamento químico da superfície

Periodontal treatment encompasses the scaling and root planning process and can therefore be carried out by various means. In addition to removing dental calculus, the root instrumentation produces different characteristics in the radicular surface as the formation of concavities and smear layer. The use of chemical agents is proposed in the literature to remove the smear layer, and detoxify the radicular surface, thereby increasing the chances of forming new connective attachment. The aim of the Study 1 was to assess, through scanning electron microscopy, the influence of different concentrations, application methods and application times of citric acid in the root conditioning after scaling and root planning. Two hundred seventy (270) samples were equally divided into six groups (n=45) for treatment with saline solution (control) and five different concentrations of citric acid (0.5, 1, 2, 15, and 25 percent). Three acid application methods were used (passive, brushing, and burnishing) as well as three application periods (1, 2, and 3 minutes). A previously trained, calibrated (kappa score = 0.93), and blind examiner subsequently scored scanning electron micrographs (SEMs) of the samples. Statistical analyses were performed by using Kruskal-Wallis and Dunn’s post-hoc tests. In Study 2, was investigated the influence of root conditioning associated with different modes of instrumentation in the adhesion of clot and blood elements. One hundred and fifty periodontally affected teeth were divided into five groups: Group I, instrumentation with curettes; Group II, instrumentation with curettes removing the superficial calculus; Group III, ultrasonic scaler with removal of the superficial calculus; Group IV, ultrasonic scaler for removal of the superficial calculus and after that, instrumentation with curettes; Group V, calculus surface. These five groups were further divided into three subgroups (10 samples each) according to the root conditioning method used: a) no root conditioning; b) root conditioning with citric acid; c) root conditioning with tetracycline hydrochloride. After that, teeth were evaluated according to roughness parameters (Ra, Rt, Ry, Rz) and surface morphology. The results showed that exposure of collagen fibers were obtained with application of citric acid at 25 percent by brushing for one or three minutes; chemical root conditioning favored the fibrin network formation and adhesion of blood components after scaling and root planning, although there are no differences between the Instrumentation means; the groups instrumented by vigorous scaling and root planning have smaller roughness values than the groups that had only the superficial dental calculus removed. Morphology evaluation showed a rough aspect of radicular surface, observed in the control group and the groups that had only the superficial dental calculus removed. Presence of smear layer and chemical demineralization, with respect to greater surface smoothness were observed in the groups after scaling, with and without chemical conditioning of the surface

Efeito da raspagem com laser de Er, Cr: YSGG nas superfícies radiculares: estudos in vitro / Effect of Er, Cr: YSGG irradiation on root surfaces: an in vitro study

Foram utilizados 60 dentes humanos nessa pesquisa. No primeiro experimento, 15 dentes extraídos por doença periodontal foram selecionados para avaliar a influência da irradiação com laser de Er,Cr: YSGG sobre a morfologia e adesão de células sanguíneas sobre as superfícies radiculares. As 60 amostras provenientes desses dentes foram divididos em 3 grupos de acordo com o tipo de tratamento aplicado: Grupo 1- RAR; Grupo 2- Irradiação com laser de Er,Cr: YSGG; Grupo 3- RAR e irradiação com o laser de Er,Cr: YSGG. 10 amostras de cada grupo foram avaliados quanto a adesão de elementos sanguíneos, e as outras 10 amostras foram avaliados quanto a morfologia da superfície radicular por MEV. Os testes de Kruskall-Wallis e Mann-Whitney foram utilizados para avaliar os resultados. Em relação à adesão de elementos sanguíneos, este estudo não demonstrou diferenças estatísticas entre os grupos (p=0.359), a análise morfológica demonstrou que as superfícies radiculares irradiadas com o laser de Er-Cr:YSGG foram mais rugosas que as do grupo controle (G2-G1: p=0.0003 e G3-G1: p=0.0003). No segundo experimento, 20 dentes foram utilizados para avaliar a influência do ângulo de irradiação do laser de Er,Cr:YSGG sobre a rugosidade e o desgaste das superfícies radiculares. Cada face proximal foi dividida em 3 áreas, sendo que a área superior foi tratada com raspagem e alisamento radicular, a área média não foi submetida a nenhum tipo de tratamento e a área inferior foi irradiada com o laser de Er,Cr:YSGG. Os dentes foram divididos em 4 grupos ,com 5 dentes cada, a depender da angulação da aplicação da irradiação do laser de Er,Cr:YSGG na área ( 30º, 45º, 60º, 90º). A rugosidade das áreas foram avaliadas através de um rugosímetro e posteriormente os dentes foram submetidos a processamento histológico convencional e as lâminas obtidas foram analisadas em microscópio óptico onde foi avaliado o desgaste no tecido dentário. Os testes de ANOVA e de Tukey foram utilizados para analisar os resultados. Todas as regiões que foram irradiadas com o laser apresentaram-se mais rugosas que as amostras que foram raspadas e alisadas com instrumentos manuais (p≤0.05). As amostras irradiadas com laser com ângulo de trabalho de 90º apresentaram-se mais rugosas que as amostras irradiadas com laser na angulação de 30º e com 45º (p≤0.05), e as amostras irradiadas com laser na angulação de 60º apresentaram-se mais rugosas que as amostras irradiadas com o laser na angulação de 30º (p≤0.05). O grupo que foi irradiado com laser de Er,Cr:YSGG com ângulo de trabalho de 30º apresentou o menor desgaste em relação a todos os outros tratamentos (p<0.01). A raspagem manual provocou desgastes semelhante aos grupos irradiados com laser de Er,Cr:YSGG com ângulos de trabalho de 45º, 60º e de 90º(p≥0.05). No terceiro experimento, 20 dentes extraídos por doença periodontal foram utilizados para avaliar a influência do ângulo de irradiação com o laser de Er;Cr:YSGG sobre a morfologia e adesão de elementos sanguíneos nas superfícies radiculares irradiadas. Os 80 espécimes provenientes dos dentes foram divididos em 4 grupos de acordo com o ângulo de irradiação utilizado ( 30º,45º,60º,90º). 10 amostras de cada grupo foram avaliadas quanto a adesão de elementos sanguíneos, e as outras 10 amostras foram avaliadas quanto a morfologia da superfície radicular por MEV. Os testes de KruskallWallis e Mann-Whitney foram utilizados para avaliar os resultados. As superfícies radiculares irradiadas com o laser de Er,Cr:YSGG com ângulo de 45º e 60º apresentaram maior adesão de elementos sanguíneos que o grupo onde o laser de Er,Cr:YSGG foi irradiado com ângulo de 30º e 90º (G2-G1: p=0.0007 ; G3-G1: p=0.0025; G2-G4: p=0.0041 e G3-G4: p=0.0025). As amostras irradiadas com ângulo de 30º apresentaram-se menos rugosas e afetadas pela irradiação com laser de Er,Cr:YSGG, que os grupos que foram irradiados com ângulo de 45º, 60º e 90º. (G2-G1:p=0.008; G3-G1: p=0.02; G4-G1: p=0.008). Concluiu-se que a irradiação com laser de Er,Cr:YSGG promoveu uma maior rugosidade nas superfícies radiculares em relação ao tratamento de raspagem e alisamento radicular, porém esse fato não interferiu negativamente na adesão de elementos sanguíneos. Irradiações com ângulos iguais ou menores que 30º promovem uma intervenção mais conservadora a superfície radicular

60 human teeth were used in that research. In the first experiment, 15 extracted teeth for periodontal disease were selected to evaluated the effect of Er,Cr:YSGG irradiation on root surfaces for adhesion of blood components and morphology. 60 root surface specimens were obtained by selecting four from each tooth. Samples were divided into three groups of 20 each, according to treatments. Group 1 (G1) was treated by scaling and root planing (SRP), Group 2 (G2) was irradiated by Er,Cr:YSGG laser and Group 3 (G3) was treated by SRP and Er,Cr:YSGG laser irradiation. Blood was placed on each of 10 specimens from each of the three groups, to evaluate adhesion of blood components to the root surfaces. A morphological analysis was made of the root surfaces of the other 10 specimens from each group by scanning electron microscope (SEM). Statistical processing was done with the Kruskal-Wallis and Mann-Whitney tests. No statistical differences for adhesion of blood components to root surfaces were found between the groups (p = 0.359). However, morphological analysis disclosed that all root surfaces irradiated by Er,Cr:YSGG laser (100%) were rougher than surfaces that were not irradiated (G1-G2: p = 0.0003 and G1-G3: p = 0.0003). In the second experiment, 20 teeth were used to evaluated the effect of the working tip angulations on root roughness and substance removal using Er,Cr:YSGG radiation. The distal and mesial surfaces of each tooth was divided in 3 areas. The upper area was treated with scaling and root planing. The medium area was not submitted to any treatment and the lower area was irradiated with Er,Cr:YSGG laser. The teeh were divided in 4 groups, with 5 teeth each depending the working tip angulations using Er,Cr:YSGG at the lower area (30º, 45º, 60º, 90º).The roughness surfaces were evaluated by a profilometer, and the root substance removal were evaluated by histometry. Statistical processing was done with the ANOVA and Tukey tests. The area irradiated with the Er,cr:YSGG were more rougher than those that were scaling with manual curettes(p≤0.05). The areas irradiated with working tip angulation of 90º were rougher than the areas irradiated with working tip angulations of 30º and 45º (p≤0.05), and the areas irradiated with working tip angulation of 60º were rougher than the areas irradiated with working tip angulations of 30º (p≤0.05). The group that was irradiated with Er,Cr:YSGG with working tip angulation of 30º presented the lower root substance removal in relation to all other groups (p<0.01). The scaling and root planing promotes comparable root substance removal to the groups irradiated with working tip angulation of 45º, 60º and 90º(p≥0.05). In the third experiment, 20 extracted teeth for periodontal disease were selected to evaluated the effect of the working tip angulations using Er,Cr:YSGG laser on root surfaces for adhesion of blood components and morphology. 80 root surface specimens were obtained by selecting four from each tooth. Samples were divided into 4 groups of 20 each, according to the working tip angulations of Er,Cr:YSGG (30º,45º,60º,90º). Blood was placed on each of 10 specimens from each of the three groups, to evaluate adhesion of blood components to the root surfaces. A morphological analysis was made of the root surfaces of the other 10 specimens from each group by scanning electron microscope (SEM). Statistical processing was done with the Kruskal-Wallis and Mann-Whitney tests. The samples irradiated with working tip angulations of 45º and 60º presented better adhesion of blood components than the samples irradiated with working tip angulations (G2-G1: p=0.0007 ; G3-G1: p=0.0025; G2-G4: p=0.0041 e G3-G4: p=0.0025). The samples irradiated with working tip angulation were smoother than the others groups (G2-G1:p=0.008; G3-G1: p=0.02; G4-G1: p=0.008). Er,Cr:YSGG laser irradiation produced rougher root surfaces than treatment by SRP, however it did not interfere with adhesion of blood components to the root surfaces. Irradiation with working tip angulation of 30º promotes a more conservative intervention on root surfaces

Effect of absorbent tetracycline-loaded membrane used in the reduction of periodontal pockets: an in vivo study

This clinical study evaluated the influence of scaling and root planning (SRP), with and without the use of tetracycline-loaded bovine absorbent membrane, in the reduction of periodontal pockets according to 3 parameters: probing pocket depth (PPD), bleeding on probing (BOP) and plaque index (PI). Twenty-four patients were selected totalizing 144 random teeth divided in 2 groups (n=72 teeth) - control (SRP) and experimental (SRP with tetracycline-loaded absorbent membrane). PPD, BOP and PI were determined before and 28 days after the treatment. In all patients, the PPD values at the end of the treatment were always lower than the baseline values. There was a reduction of the PI for both treatments, but it was more evident on the experimental group. In conclusion, the use of tetracycline-loaded absorbent membrane could result in a better prognosis compared to scaling and root planning after only 28 days of evaluation.

Este estudo clínico avaliou a influência da raspagem e alisamento radicular, com e sem a utilização de membrana absorvível de liberação de tetraciclina na redução de bolsa periodontal utilizando 3 parâmetros: sondagem da profundidade de bolsa, sangramento à sondagem e índice de placa. Vinte e quatro pacientes foram selecionados totalizando 144 dentes aleatoriamente divididos em 2 grupos (n=72 dentes) - controle (raspagem e alisamento radicular) e experimental (raspagem e alisamento radicular e utilização de membrana absorvível de liberação de tetraciclina). Antes da execução do tratamento foram determimados profundidade de bolsa, sangramento à sondagem e índice de placa. Os pacientes foram avaliados usando os mesmos parâmetros após 28 dias. Os valores da sondagem da profundidade de bolsa foram sempre menores no final do tratamento quando comparado ao início. Houve redução no índice de placa para as 2 formas de tratamento, apesar de ter sido mais evidente no grupo experimental. Concluiu-se que o uso da membrana absorvível de liberação de tetraciclina pode resultar em melhor prognóstico quando comparado apenas com a raspagem e alisamento radicular, após 28 dias de análise.