Evaluation of characteristics of periodontal probes

Aim: This study aimed to evaluate the millimeter distances and active tip diameters of different periodontal probes. Methods: Two types of periodontal probes were analyzed (North Carolina (15-UNC) and PCP-12). Two manufacturers were selected for each probe type. Digital images of the probes were obtained and the distances were measured using a software program. The diameter of the active tip was measured using a digital caliper. Both variables were measured by two trained and calibrated examiners. The data were analyzed using the Bland-Altman method and two-way ANOVA with Tukey's post-hoc test. Statistical significance was set at p<0.05. Results: A comparison of measurements between the 15UNC and PCP-12 probes showed a significant difference in all millimeter markings. The 15-UNC probe showed differences between the 3 and 12 mm markings. The PCP-12 probe only showed differences between the marks at the 12 mm mark. The 15-UNC probe had a similar active tip diameter between the two manufacturers. The PCP-12 probe showed a significant difference between the two manufacturers. Both types of probes had similar active tip diameters when compared by the two manufacturers. Conclusion: There was no standardization in relation to millimeter marks and tip diameters of the two types of periodontal probes produced by the two different manufacturers. The probe types exhibited little variability

Avances científico-técnicos en la clasificación de las enfermedades periodontales y su enfoque social

El desarrollo de la ciencia y la técnica impone una revi sión de conceptos que deben ajustarse a las evidencias que surgen de los avances de la propia ciencia. Dentro de las ciencias particulares puede hacerse alusión al campo de la Estomatología, cuyo desarrollo ha generado subes pecialidades como la Periodoncia. Durante muchos años se han propuesto y diseñado sistemas de clasificación de las enfermedades periodontales que han permitido incrementar la calidad de la atención a los pacientes. Es deber de todo profesional de la salud brindar la mejor atención posible y hacerla dispo nible y accesible para toda la sociedad. En el presen te trabajo se pretende analizar, desde un enfoque ciencia-tecnología y sociedad, la evolución de las clasificaciones de la enfermedad periodontal desde una perspectiva adecuada a la realidad social en que se desarrolla tanto el profesional como el paciente, con el fin de lograr un impacto positivo que resulte en el incremento de la calidad de vida de la población. Se realizó una revisión bibliográfica que se caracterizó por la selección de estudios y la estrategia de búsqueda. Fueron utilizadas como palabras clave las siguientes: ciencia, tecnología, sociedad, periodoncia, clasificación. Las fuentes de información consultadas fueron Google Scholar; PubMed; Cochcrane; MediSur. Se seleccionaron 20 artículos. Se concluyó que en periodoncia resulta necesario actualizar los conocimientos teniendo en cuenta los avances científico-técnicos y utilizarlos desde la perspectiva de la profesionalidad y la ética, siempre en beneficio de la sociedad.

The development of science and technology imposes a revision of concepts that must be adjusted to the evidence that arises from the advances of science itself. Within the particular sciences, reference can be made to the field of Stomatology, whose development has generated subspecialties such as Periodontics. For many years, classification systems for periodontal diseases have been proposed and designed, which have made it possible to increase the quality of care for patients. It is the duty of every health professional to provide the best possible care and make it available and accessible to all of society. The aim of this research is to analyze, from a science-technology and society approach, the evolution of the classifications of periodontal disease from an appropriate perspective to the social reality in which both the professional and the patient develop, in order to achieve a positive impact that results in the population's quality of life increase. A bibliographic review was carried out that was characterized by the selection of studies and the search strategy. The keywords: science, technology, society, periodontics, classification were used. The information sources consulted were Google Scholar; PubMed; Cochcrane; MediSur. 20 articles were selected. It was concluded that in periodontics it is necessary to update knowledge taking into account scientific-technical advances and use them from the professionalism and ethics perspective, always for the society benefit.

Consistency of recommendations of clinical practice guidelines in periodontology: a systematic review

Abstract The aim of this systematic review was to evaluate the methodological quality and the consistency of recommendations of clinical practice guidelines (CPGs) in Periodontology. An electronic search was conducted in two databases, MEDLINE and EMBASE, eight CPGs databases, and home pages of scientific societies in Periodontology up to April 2022. Three reviewers independently assessed methodological quality using the AGREE II instrument. In addition, we evaluated the consistency of the recommendations. Eleven CPGs were included, and the topics developed focused on prevention, diagnosis, risk factors, surgical and non-surgical periodontal treatment, antimicrobial therapy, root coverage, and maintenance. We found that the AGREE domains 2 (Stakeholder involvement) and 5 (Applicability) obtained the lowest scores. Domains 1 (Scope and purpose), 3 (Rigor of development) and 4 (Clarity of presentation) obtained the highest scores among the evaluated CPGs. The clinical recommendations for treatment of periodontal diseases were mostly consistent. Overall, the quality of CPGs used in periodontics was high. There was consistency of recommendations in specific fields. These findings may help researchers to promote CPGs focused on different fields of periodontics that have not yet been developed. Furthermore, the clinician will be able to make better clinical decisions.

Láserterapia en tratamientos odontológicos mediante una revisión bibliográfica / Laser therapy in dental treatment by means of a literature review

Introducción: De acuerdo con el avance científico y tecnológico de la sociedad, se van implementando nuevas y mejoradas técnicas en la práctica dental, que están destinadas a ofrecer tratamientos efectivos, más rápidos, conservadores y que reduzcan los niveles de miedo y ansiedad en los pacientes. Objetivo: Interpretar los beneficios de emplear laserterapia en el campo odontológico, mediante una revisión bibliográfica. Métodos: Estudio del nivel exploratorio, auxiliado por la hermenéutica para interpretar la revisión bibliográfica ejecutada. Correspondió al tipo observacional, transversal, descriptivo y retrospectivo. Las búsquedas se efectuaron en las bases de datos: Lilacs, Pubmed, Sciencedirect y se buscaron estudios clínicos aleatorizados. Resultados: Se encontraron 252 artículos, de los cuales fueron seleccionados 7 de acuerdo con los criterios de inclusión y exclusión. Se percibieron resultados favorables sobre el láser en las especialidades de cirugía, endodoncia, periodoncia y patología oral, en comparación con las terapias consideradas como gold standard, lo que demuestra que el uso del láser es mejor o igual de efectivo que los tratamientos convencionales, ya que reduce el nivel de tiempo en las intervenciones, en tratamientos quirúrgicos evita el sangrado y el uso de sutura en algunos casos, además de que bien aceptado para pacientes porque también evita la presencia de dolor al aplicarlo. Conclusiones: Usando láser para intervenciones odontológicas se puede obtener una mejoría o al menos el mismo resultado que aplicando técnicas convencionales, lo que comprueba que es viable su uso(AU)

Introduction: In accordance with the scientific and technological progress of society, new and improved techniques are being implemented in dental practice that are aimed at offering effective, faster, and more conservative treatments that reduce the levels of fear and anxiety in patients. Objective: To interpret the benefits of using laser therapy in the dental field by means of a review of the literature. Methods: This was an exploratory study, aided by hermeneutics to interpret the literature review. It was observational, cross-sectional, descriptive, and retrospective. The searches were carried out in the following databases: Lilacs, Pubmed, Sciencedirect and randomized clinical studies were searched. Results: 252 articles were found, of which 7 were selected according to the inclusion and exclusion criteria. Favorable results were found on laser in the specialties of surgery, endodontics, periodontics, and oral pathology, in comparison with therapies considered as gold standard. thus, demonstrating that the use of laser is better or equally effective than conventional treatments, since it reduces the level of time in interventions, in surgical treatments it avoids bleeding and the use of suture in some cases, besides being well accepted for patients because it also avoids the presence of pain when applying it. Conclusions: Using laser for dental interventions an improvement can be obtained or at least the same result as applying conventional techniques, which proves that its use is feasible (AU)

Antibiotics prescribing habits of Brazilian general dental practitioners during periodontal treatments / Hábitos de prescrição de antibióticos de dentistas brasileiros durante tratamentos periodontais

Introdução: O tratamento periodontal envolve procedimentos que visam reduzir a carga bacteriana, envolvendo ou não o uso de antibióticos locais ou sistêmicos. Objetivo: O objetivo deste estudo foi avaliar o conhecimento dos cirurgiões-dentistas brasileiros sobre a prescrição de antibióticos durante o tratamento periodontal. Material e método: Foi disponibilizado um questionário online solicitando aplicação sistêmica de prescrição de antibióticos locais ou sistêmicos (frequência e sequência com tratamento periodontal mecânico) e em relação a diferentes doenças periodontais. A utilização de serviços de diagnóstico microbiano e dados demográficos dos voluntários também foram elucidados. Os dados foram analisados estatisticamente (Teste Binomial, p<0,05). Resultado: Trezentos e noventa e três voluntários responderam ao questionário. Vinte e três por cento do sexo masculino e 76,2% do sexo feminino. A idade média foi de 27,7 anos. A minoria (19,2%) dos voluntários relatou indicar antibióticos sistêmicos para tratamento de gengivite ou periodontite estágios I e II (antiga periodontite crônica leve e moderada). A maioria dos profissionais indica para tratar abscesso periodontal, gengivite ou periodontite ulcerativa necrosante, periodontite em imunodeficiências graves, periodontite agressiva antiga e periodontite estágios III e IV (periodontite crônica grave antiga). Raramente (2,5%) a prescrição foi sem a associação com terapia mecânica. Os exames microbiológicos como método auxiliar de diagnóstico raramente (3,1%) são solicitados por falta de informação ou custo. As respostas mais frequentes sobre o número de vezes que os profissionais relataram prescrever antibióticos sistêmicos como parte do tratamento periodontal por trimestre foram "pelo menos uma vez", seguido de "2 vezes". Conclusão: Pode-se concluir que os cirurgiões-dentistas brasileiros possuem conhecimento sobre a correta prescrição de antibióticos na terapia periodontal

Introduction: Periodontal treatment involves procedures aimed to reduce bacterial load, involving or not the use of local or systemic antibiotics. Objective: The purpose of this study was to assess Brazilian dentists' knowledge about antibiotics prescription during periodontal treatment. Material and method: An online questionnaire was available asking for systemic application of local or systemic antibiotics prescription (frequency, and sequence with mechanical periodontal treatment) and in relation to different periodontal diseases. The use of microbial diagnostic services and volunteers' demographic data were also elucidated. Data were statistically analyzed (Binomial Test, p<0.05). Result: Three hundred and ninety-three volunteers answered the questionnaire. Twenty-three percent males and 76.2% females. Average age was 27.7 years. Minority (19.2%) of the volunteers reported to indicate systemic antibiotics to treat gingivitis or periodontitis stages I and II (old slight and moderate chronic periodontitis). Majority of the professionals indicate it to treat periodontal abscess, necrotizing ulcerative gingivitis or periodontitis, periodontitis in severe immunodeficiencies, old aggressive periodontitis, and periodontitis stages III and IV (old severe chronic periodontitis). Rarely (2.5%) the prescription was without the combination with mechanical therapy. Microbiological tests as an auxiliary diagnostic method are rarely (3.1%) requested due to lack of information or cost. Most frequent answers about the number of times professionals reported prescribing systemic antibiotics as part of periodontal treatment per trimester was "at least once", followed by "2 times". Conclusion: It can be concluded that Brazilian dentists have knowledge about the correct prescription of antibiotics in periodontal therapy

Use of Ionized Monocalcium phosphate and enameline derivatives to reduce dentin hypersensitivity after periondontal therapy / Uso de Fostato Monocálcio y derivados en Enamelina para reducir la hipersensibilidad dentaria después de terapia periodontal

Abstract This study aimed to evaluate the effectiveness of using an ionized monocalcium phosphate and enamelin derivatives (IMP+ED) based mouthwash for the treatment of dentin hypersensitivity (DH) after scaling and root planing (SRP). 47 patients who reported DH after SRP treatment were included in this prospective cohort study. The Schiff Cold Air Sensitivity Scale (SCASS) was applied to classify their degree of pain in mild, moderate or intense at two times: after SRP (T0), and after one month of using a IMP+ED-based mouthwash (T1). The McNemar-Bowker test was used to compare the correlated proportions between both times (p<0.05). After the SRP therapy (T0), all the sample members reported pain distributed in the following manner: 12.8% were mild, 27.6% moderate, and 59.6% intense. At one month since treatment and with the use of the IMP+ED-based mouthwash (T1), the distribution of pain levels changed to 83% mild, 12.8% moderate, and 4.3% intense, this change was statistically significant (p<0.001). IMP+ED-based mouthwash produces a positive effect in reducing painful responses caused by exposure of the dentin tubules to the oral environment after SRP therapy.

Resumen El objetivo de este estudio fue evaluar la efectividad de un enjuague bucal a base de fosfato monocálcico ionizado y derivados de enamelina (FCI+DE) para el tratamiento de hipersensibilidad dentinaria (HD) posterior al tratamiento de raspado y alisado radicular (RAR). 47 pacientes que reportaron tener HD posterior al tratamiento de RAR fueron incluidos en este estudio prospectivo de cohorte. Con el fin de clasificar la HD de los pacientes en leve, moderada o intensa se utilizó la Escala de Sensiblidad al Aire Frío de Schiff (ESAFS). Los pacientes fueron evaluados después del tratamiento de RAR (T0) y posterior al uso de un enjuague bucal basado en FCI+DE (T1). Para comparar las proporciones correlacionadas se utilizó la prueba de McNemar-Bowker (p<0.05). La distribución del dolor de los pacientes posterior al tratamiento de RAR (T0) fue la siguiente: 12.8% fueron leves, 27.6% moderado, and 59.6% intenso. Un mes después del uso del enjuague buccal basado en FCI+DE (T1) la distribución en los niveles de dolor cambio a 83% leve, 12.8% moderado, and 4.3% intenso, este cambio fue estadísticamente significativo (p<0.001). El uso del enjuague bucal basado en FCI+DE produce una reducción significativa a la respuesta de dolor causada por la exposición de la dentina al ambiente oral como consecuencia del tratamiento de RAR.

Comportamento dos tecidos peri-implantares pós- reabilitação unitária em região estética comparando pilares protéticos pré-fabricados versus personalizados / Behavior of peri-implant tissues after unitary rehabilitation in the aesthetic region comparing prefabricated versus customized prosthetic abutments

A estética e estabilidade dos tecidos moles e ósseo ao redor do implante é um componente crítico para o sucesso do implante em longo prazo e pode ser influenciado por fatores como os tipos de conexões protéticas. OBJETIVO: Comparar o comportamento do tecido peri-implantar em reabilitação com coroas implantossuportadas cimentadas na região estética usando um pilar protético pré-fabricado em titânio (GT) e um pilar protético personalizado em zircônia (GZ). METODOLOGIA: Neste estudo longitudinal do tipo ensaio clínico controlado, cego e não randomizado, 30 coroas cimentadas sobre implantes dentários unitários em região estética anterior foram alocados sequencialmente: 15 reabilitados sobre um sistema de implante com pilar protético pré-fabricado em titânio (GT) e 15 sobre um sistema de implantes com pilar protético personalizado em zircônia (GZ). O comportamento do tecido peri-implantar foi avaliado em T0 (início do condicionamento tecidual), T1 (fim do condicionamento tecidual), T2 (7 dias após cimentação final), T3 (6 meses após cimentação final). Índice de Placa Visível (IPV), Índice de Sangramento Gengival (ISG), Sangramento a sondagem (SS), Profundidade de Sondagem (PS), Relação Altura/Largura da papila interdental (AP/LP), Faixa de Mucosa Ceratinizada (MC), Espessura gengival (EG), Fenótipo periodontal (FP), Recessão Gengival (RG), distância radiográfica da crista óssea para o ponto de contato e Pink Esthetic Score (PES) foram avaliados. A análise dos dados foi realizada utilizando os seguintes testes estatísticos: Friedman, Mann-Whitney e Qui- quadrado/Exato de Fisher, com nível de significância de 5%. RESULTADOS: Não houve diferenças estatísticas significativas entre os grupos para nenhum dos parâmetros clínicos periodontais nos tempos avaliados (p>0,05). Entretanto, a análise intragrupo mostrou uma redução estatística no IPV e ISG entre T1 e T2 apenas para o GZ (p<0,05). Houve diminuição significativa entre os tempos T0 e T3 para o parâmetro de EG (1,67 mm - 1,47 mm no GT; 1,70 mm -1,47mm no GZ) e aumento da razão AP/LP (0,56 ­ 0,80 no GT; 0,70-0,83 no GZ) em ambos os grupos (p<;0.001). O PES também aumentou significativamente para ambos os grupos (9 ­ 12 no GT; 7 ­ 12 no GZ) de T0 para T1, mantendo-se elevado nos demais tempos analisados. CONLUSÃO: Os resultados mostraram que os pilares protéticos utilizados não impactaram em diferenças nas variáveis clínicas e estética relacionadas ao comportamento dos tecidos periimplantares ao longo do tempo. Sendo assim, a decisão pela seleção dos componentes para a reabilitação em região estética poderia se basear em aspectos como o custo, fluxo e tempo de trabalho (AU).

The esthetics and stability of the soft tissue and bone around the implant is a critical component to the long-term success of the implant and can be influenced by factors such as the type of prosthetic connections. OBJECTIVE: To compare the behavior of the periimplant tissue of single implant-supported crowns in the anterior aesthetic area using prefabricated titanium prosthetic abutments (GT) and customized zirconia prosthetic abutments (GZ). METHODOLOGY: In this controlled, blinded, non- randomized clinical trial, 30 single cemented crown over anterior implants were sequentially allocated: 15 implants rehabilitated on implant system with a prefabricated titanium prosthetic abutment (GT) and 15 on implant system with customized zirconia prosthetic abutment (GZ). The behavior of the peri- implant tissue was evaluated at T0 (beginning of tissue conditioning), T1 (end of tissue conditioning), T2 (7 days after final cementation), T3 (6 months after final cementation). Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), Bleeding on Probing (BoP), Probing Depth (PD), Interdental Papilla Height/Width Ratio (PH/PW), Keratinized Mucosa Width (KM), Gingival Thickness (PT), Periodontal Phenotype (PF), Gingival Recession (GR), radiographic distance from the bone crest to the contact point and Pink Esthetic Score (PES) were registered. The results were analyzed with the following statistical tests: Friedman, Mann-Whitney and Chi- square/Fisher; Exact test with a significance level of 5%. RESULTS: No statistically significant differences were observed between groups for any of the clinical parameters in any, (p>0.05). However, intragroup analysis showed a statistical reduction in VPI between T1 and T2 only for GZ (p< 0.05). There was a significant decrease between T0 and T3 for GT (1.67 mm - 1.47 mm in GT, and 1.70 mm -1.47 mm in GZ) and increase in the ratio PH/PW (0.56 - 0.80 in GT and 0.70- 0.83 in GZ) in both groups (p<0.0001). PES also increased significantly for both groups (9 ­ 12 in GT and 7 ­ 12 in GZ) from T0 to T1 and remained high in the other periods. CONCLUSION: The results showed that the prosthetic abutments used did not impact differences in clinical and aesthetic variables related to the behavior of peri-implant tissues during the study. Therefore, the decision to select components an aesthetic area should be based on aspects such as cost, workflow and timing (AU).

The absence of proximal contact point on periodontal parameters of teeth moved into extraction sites

Abstract The aim of study was to evaluate periodontal conditions of upper canines and second premolars with and without proximal contact of individuals undergoing orthodontic treatment associated to extractions of the upper first premolars. The study selected upper canines and premolars of individuals undergoing orthodontic treatment without extractions (30 hemiarches - control group), or with extraction of the upper first premolars and whose canines and second premolars had interproximal contact (16 hemiarches - group 1) or diastema (17 hemiarches - group 2). Clinical (plaque index, probing depth, gingival bleeding index, height of the gingival margin, clinical attachment loss and gingival clefts) and radiographic (crest height, bone height and bone-crest discrepancy) parameters of the distal surfaces of canines and mesial surfaces of premolars were evaluated. Group 1 had worse results when compared to the control group for the levels of plaque in canines and premolars and for probing depth in canines (distal and mean) and in premolars (lingual and mean), as well as increasing tendency of clinical attachment loss (lingual and mean) in premolars. Plaque level in canines in group 1 was also significantly higher than in group 2. There was no difference between group 2 and the control group. The lack of proximal contact between canines and second premolars did not significantly affect their periodontal characteristics.

Resumo A extração de dentes para obtenção de espaço nos arcos dentários é uma estratégia rotineiramente utilizada em Ortodontia, porém a movimentação de dentes para os locais de extrações pode estar associada à falhas na estabilidade dos dentes e abertura do ponto de contato, gerando prejuízo aos tecidos periodontais. Objetivo: Avaliar a condição periodontal de caninos e segundos pré-molares superiores com e sem ponto de contato entre si de indivíduos submetidos ao tratamento ortodôntico associado à extração dos primeiros pré-molares superiores. Foram selecionados caninos, primeiros e segundos pré-molares superiores de indivíduos submetidos ao tratamento ortodôntico sem extração (30 hemiarcos - grupo controle) ou com extração dos primeiros pré-molares superiores cujos caninos e os segundos pré-molares apresentavam contato interproximal (16 hemiarcos - grupo 1) ou diastema (17 hemiarcos - grupo 2). Nas superfícies distal dos caninos e mesial dos pré-molares foram avaliados parâmetros clínicos e radiográficos para determinar o efeito da movimentação dos dentes para o local de extração e da ausência de ponto de contato interproximal nos tecidos periodontais. Os grupos não apresentaram diferença significativa para a idade e o tempo de pós-tratamento. O grupo 1 apresentou valores mais desfavoráveis em relação ao grupo controle para o índice de placa em caninos e pré-molares e para a profundidade de sondagem em caninos (distal e média) e em pré-molares (lingual e média), além de uma tendência de maior perda de inserção clínica (lingual e média) nos pré-molares. O índice de placa nos caninos do grupo 1 também foi significativamente maior do que no grupo 2. Os grupos 2 e controle não apresentaram diferença significativa. A ausência de ponto de contato entre os caninos e os segundos pré-molares superiores não afetou significativamente a situação periodontal desses dentes.

Prevalencia de la enfermedad periodontal en el embarazo / Prevalence of periodontal disease in pregnancy

RESUMEN Introducción: los cambios hormonales que experimentan las mujeres gestantes acentúa la respuesta gingival y causa un cuadro clínico diferente, se considera un factor modificador en la enfermedad periodontal. Objetivo: valorar la prevalencia de la enfermedad periodontal en gestantes atendidas en la Clínica Estomatológica José Martí en el período de septiembre 2018 a enero 2020. Métodos: se realizó un estudio observacional, descriptivo y transversal en 83 pacientes gestantes, en el período comprendido de septiembre del 2018 a enero 2020. La información de interés se obtuvo de las historias clínicas individuales de servicios básicos de estomatología y de periodoncia. Todos los pacientes dieron su consentimiento informado y los resultados se obtuvieron con la utilización del análisis estadístico que incluyó el porcentaje y la razón. Resultados: predominaron pacientes enfermas con un 82 % sobre las sanas con 18 %. La gingivitis fue la enfermedad más frecuente en el 35 % de las gestantes estudiadas. Las formas menos graves de la enfermedad se presentaron con mayor frecuencia en el grupo de 27 a 36 años para el 43,7 %, y las periodontitis fueron más frecuentes en las gestantes de 37 a 45 años para un 33,3 %. El nivel de conocimientos fue regular para un 37,3 % seguido del bueno para un 36,2 %. Conclusiones: la frecuencia de la enfermedad periodontal fue alta con predominio de la forma leve de esta.

ABSTRACT Introduction: the hormonal changes experienced by pregnant women accentuate the gingival response and cause a different clinical picture, being considered a modifying factor in periodontal disease. Objective: to assess the prevalence of periodontal disease in pregnant women attended at Jose Marti Dentistry Clinic in the period from September 2018 to January 2020. Methods: an observational, descriptive and cross-sectional study was conducted in 83 pregnant women, in the period from September 2018 to January 2020. The information of interest was collected from individual medical records of basic dentistry and Periodontics services. All patients provided an informed consent and the results were processed using statistical analysis including percentage and ratio. Results: sick patients predominated with 82 % over healthy patients with 18 %. Gingivitis was the most frequent disease in the 35 % of pregnant women studied. Less severe forms of the disease were more frequent in the age group 27 to 36 years for 43,7 %, and periodontitis was more frequent in pregnant women aged 37 to 45 years for 33,3 %. The level of knowledge was fair for 37,3 % followed by good for 36,2 %. Conclusions: the frequency of periodontal disease was high with a predominance of mild periodontal disease.

Necesidad de tratamiento periodontal en diabéticos fumadores y no fumadores y su relación con criterios clínicos

El objetivo de este trabajo fue determinar la asociación correlacional que pudiera presentarse entre necesidad de tratamiento periodontal con los siguientes criterios clínicos: tiempo de evolución de la diabetes, hábito de fumar, conocimiento de la influencia de la diabetes, presencia de cálculo visible, movilidad dentaria, sangrado al sondaje en diabéticos fumadores y no fumadores que concurren al Programa Nacional de Diabetes del Ministerio de Salud Pública y Bienestar Social durante los meses de abril a setiembre del 2014. Participaron del estudio 242 sujetos seleccionados al azar y que cumplieron con los criterios de inclusión. Se realizó un análisis estadístico descriptivo-correlacional estableciéndose como límite de significancia un valor de p<0,05. En cuanto a los resultados se encontró un nivel de correlación significativa (p< 0,05) en conocimiento de la influencia de la diabetes; y muy significativa (p < 0,01) en índice comunitario de hábito de fumar, presencia de cálculo visible, movilidad dentaria y en el sangrado al sondaje. En conclusión, se encontró asociación entre los siguientes criterios clínicos considerados en esta investigación: el hábito de fumar, conocimiento de la influencia de la diabetes, presencia de cálculo visible, movilidad dentaria, sangrado al sondaje en diabéticos fumadores y no fumadores.

The objectiveof this study was to determine the correlation between the need for periodontal treatment and the following clinical criteria considered: time of evolution of diabetes, smoking, knowledge of the influence of diabetes, presence of visible calculus, tooth mobility, bleeding on probing in diabetic smokers and non-smokers attending the National Diabetes Program of the Ministry of Public Health and Social Welfare during the months of April to September, 2014. A total of 242 randomly selected subjects who met the inclusion criteria participated in the study. A descriptive-correlational statistical analysis was performed, establishing a p-value <0.05 as the limit of significance. Regarding the results, a significant level of correlation was found (p<0.05) in knowledge of the influence of diabetes and highly significant (p<0.01) in community smoking index, presence of visible calculus, tooth mobility and bleeding on probing. In conclusion, an association was found between the following clinical criteria considered in this research: smoking, knowledge of the influence of diabetes, presence of visible calculus, tooth mobility, bleeding on probing in diabetic smokers and non-smokers.

Evaluation of pain perception on periodontal probing in patients with dental plaque induced gingivitis and chronic periodontitis - a cross sectional study, part I / Evaluación de la percepción del dolor al sondaje periodontal en pacientes con gingivitis inducida por placa dental y periodontitis crónica: un estudio transversal, parte I

Background: Probing of periodontal pockets is an essential part in the diagnosis of periodontal disease. Fifteen to seventy seven percent of untreated periodontal patients experience pain during probing. Hence the aim of this study is to evaluate the pain perceived by patients with gingivitis and periodontitis during periodontal probing. The goals of this study were to compare the patients' pain perception when using a conventional UNC15 probe and a manual pressure sensitive periodontal probe, and to relate the clinical features of gingivitis and periodontitis to the discomfort associated with periodontal probing. Material and Methods: A total of 475 subjects were recruited into the study. The subjects were initially divided into two groups ­ Group ­ A (Gingivitis group - 275 patients) and Group ­ B (Chronic Periodontitis group -200 patients) according to the AAP 1999 Classification. These two groups were further subdivided into two groups each (Gingivitis ­ Conventional Probe ­ GCP, Gingivitis ­ Manual Pressure Sensitive Probe ­ GMPS, Periodontitis - Conventional Probe ­ PCP, Periodontitis ­ Manual Pressure Sensitive Probe ­ PMPS) using a computer generated program of random numbers. Results: A significant difference was noted in pain perception when pressure sensitive probe was used compared to conventional UNC-15 probe. Reduced Bleeding on Probing and Pain scores were noted in Chronic periodontitis subjects with use of pressure sensitive probe, which was statistically significant (p<0.001). Conclusion: Dentistry has changed its focus towards painless dentistry. In this context, the present study presents data towards use of manual pressure sensitive probes, which offers an advantage of low cost when compared to more advanced computerized systems with reduced pain during periodontal examination. It could result in a positive attitude of the patients towards continuous supportive periodontal therapy thereby monitoring periodontal health.

Antecedentes: El sondaje de los sacos periodontales es una parte esencial en el diagnóstico de la enfermedad periodontal. Del quince al setenta y siete por ciento de los pacientes periodontales no tratados experimentan dolor durante el sondaje. De ahí que el objetivo de este estudio fué evaluar el dolor percibido por pacientes con gingivitis y periodontitis durante el sondaje periodontal. Los objetivos de este estudio fueron comparar la percepción del dolor de los pacientes al usar una sonda UNC15 convencional y una sonda periodontal sensible a la presión manual, y relacionar las características clínicas de la gingivitis y la periodontitis con la incomodidad asociada con el sondaje periodontal. Material y Métodos: Un total de 475 sujetos fueron reclutados en el estudio. Los sujetos se dividieron inicialmente en dos grupos - Grupo - A (grupo de Gingivitis - 275 pacientes) y Grupo - B (grupo de Periodontitis Crónica - 200 pacientes) de acuerdo con la Clasificación AAP 1999. Estos dos grupos se subdividieron en dos grupos cada uno (Gingivitis - Sonda convencional - GCP, Gingivitis - Sonda manual sensible a la presión - GMPS, Periodontitis - Sonda convencional - PCP, Periodontitis - Sonda manual sensible a la presión - PMPS) usando un programa generado por computadora de datos aleatorios. números. Resultados: Se notó una diferencia significativa en la percepción del dolor cuando se usó una sonda sensible a la presión en comparación con la sonda UNC-15 convencional (p<0,001). Conclusion: La odontología ha cambiado su enfoque hacia una odontología sin dolor. En este contexto, el presente estudio presenta datos hacia el uso de sondas manuales sensibles a la presión, que ofrece una ventaja de bajo costo en comparación con sistemas computarizados más avanzados con reducción del dolor durante el examen periodontal. Podría resultar en una actitud positiva de los pacientes hacia la terapia periodontal de apoyo continuo, monitoreando así la salud periodontal.

Magnificación en Periodoncia

RESUMEN: Esta revisión sobre magnificación en periodoncia presenta la evidencia disponible sobre el tema. Dentro de este trabajo se incluyen: principios y prestaciones de la magnificación, ventajas y desventajas de los diferentes sistemas, características de los instrumentos de microcirugía, ergonomía, trastornos músculo esqueletales, resultados clínicos, cicatrización, percepción de los pacientes y habilidades clínicas necesarias. El objetivo del trabajo fue comprender el funcionamiento de la magnificación, comparar la microcirugía (cirugía con magnificación) vs macro cirugía (cirugía sin magnificación) en función de la ergonomía, la cicatrización y los resultados clínicos. Comparar las ventajas y desventajas de las lupas vs microscopio y conocer las habilidades necesarias para su utilización. Se realizó una búsqueda bibliográfica manual, las bases consultadas fueron: PubMed, Biblioteca Cochrane, EMBASE, Scopus, Science Direct, SciELO. La búsqueda fue sin límites temporales o de idiomas. Se incluyeron investigaciones, revisiones bibliográficas y metaanálisis, también se realizó rastreo de citas. Se recabaron un total de 251 artículos de los cuales se seleccionaron 43 para la revisión. Los artículos fueron revisados por los autores y aceptados por consenso para su discusión. En conclusión trabajar con magnificación aporta ventajas en todos los aspectos estudiados en esta revisión y en la percepción de los pacientes. Si se comparan las lupas con el microscopio, éste ultimo es mejor en cuanto a ergonomía, iluminación, posibilidades de documentación y mayor aumento. Incorporar la magnificación requiere entrenamiento, esta revisión expone los fundamentos por los cuales dicho esfuerzo se traduce en beneficios mayores.

ABSTRACT: This review on magnification in periodontics presents the available evidence on the subject, comprising principles and benefits of magnification, advantages and disadvantages of different systems, characteristics of the instruments in microsurgery, ergonomics, musculoskeletal disorders, clinical results, healing, perception of patients and necessary clinical skills. Objective: to understand the operation of magnification, to compare microsurgery (surgery with magnification) vs macro surgery (surgery without magnification) based on ergonomics, healing, and clinical results. Compare the advantages and disadvantages of loupes vs microscope and know the skills necessary to use them. Material and Method: a manual bibliographic search was carried out, the databases consulted were: PubMed, Cochrane Library, EMBASE, Scopus, Science Direct, SciELO. The search was without time or language limits. Research, literature reviews, and meta-analysis were included, and citation tracking was also done. Results: a total of 251 articles were collected, of which 43 were selected for the review. The articles were reviewed by the authors and accepted by consensus for discussion. Conclusion: working with magnification provides advantages in all the aspects studied in this review and in the perception of the patients. If the magnifying glasses are compared with the microscope, the latter is better in terms of ergonomics, lighting, documentation possibilities and higher magnification. Incorporating magnification requires training, this review expound the justification for which such effort translates into greater benefits.

Evolución de defectos óseos periodontales tratados con plasma rico en plaquetas / Evolution of periodontal defects bone treated with platelets rich-plasm

RESUMEN Introducción: los factores bioactivos y entre ellos, los concentrados plaquetarios, son empleados como terapia para la reparación y cicatrización de los tejidos periodontales por su potencial regenerativo. Objetivo: evaluar la evolución de defectos óseos periodontales tratados con plasma rico en plaquetas, en pacientes con periodontitis, en Santiago de Cuba, en el período 2017-2019. Método: se realizó un estudio longitudinal prospectivo en Santiago de Cuba, desde diciembre del 2017 hasta diciembre del 2019, en pacientes de ambos sexos, entre 30 y 59 años de edad, con diagnóstico de periodontitis que requerían tratamiento quirúrgico, seleccionándose una muestra de 45 pacientes que presentaban al menos un sitio con defectos intraóseos periodontales, de 4 o más milímetros de profundidad, que cumplían con el diagnóstico y los criterios para utilizar Plasma Rico en Plaquetas. Se utilizaron variables clínicas, radiográficas y de respuesta, expresadas en frecuencias absolutas/relativas y media aritmética, con desviación estándar y validación con la prueba t. Resultados: el 93,3 % de los casos lograron signos clínicos de normalidad del tejido blando intervenido a los 7 días. El sangrado al sondaje, a los seis meses de evolución, solo persistió en el 4,4 % de los casos. La comparación de medias de movilidad dentaria, profundidad al sondaje y pérdida de inserción clínica antes y después del tratamiento, disminuyeron significativamente. Conclusiones: la evolución de los parámetros periodontales evaluados en los defectos óseos, tras la aplicación de plasma rico en plaquetas, como parte del tratamiento quirúrgico en las periodontitis, fue satisfactoria en casi la totalidad de los casos, con mejoría clínica.

ABSTRACT Introduction: bioactive factors, including platelet concentrates, are used as therapy for the repair and healing of periodontal tissues due to their regenerative potential. Objective: to evaluate the evolution of periodontal bone defects treated with platelet-rich plasma, in patients with periodontitis, in Santiago de Cuba, during the period 2017-2019. Methods: a prospective longitudinal study was conducted in Santiago de Cuba, from December 2017 to December 2019, in patients of both sexes, between 30 and 59 years old, with a diagnosis of periodontitis requiring surgical treatment, choosing a sample of 45 patients presenting at least one site with periodontal intra-osseous defects, 4 or more millimeters deep, who met the diagnosis and criteria for using Platelet-Rich Plasma. Clinical, radiographic and response variables were used, expressed in absolute/relative frequencies and arithmetic mean, with standard deviation and t-test validation. Results: the 93,3 % of the cases achieved clinical signs of normality of the operated soft tissue at 7 days. Bleeding on probing at six months of evolution persisted in only 4,4 % of the cases. The comparison of mean tooth mobility, probing depth and clinical insertion loss before and after treatment decreased significantly. Conclusions: the evolution of periodontal parameters evaluated in bone defects after the application of platelet-rich plasma as part of the surgical treatment of periodontitis was satisfactory in almost the totality of the patients, with clinical improvement.

Prevention of oral cancer through the implementation of a teledentistry platform for the elderly / Prevención del cáncer oral mediante la implementación de una plataforma de teleodontología para adultos mayores

Objective: To contribute to early diagnosis of lesions in older patients, including potentially malignant lesions or those suspected of oral cancer by support of a web-based teledentistry platform. Material and Methods:This report contains information from 27 patients with oral lesions out of a total of 135 who received mobile dental care. Specialists who participated in the study involved professionals from the disciplines of periodontics, temporomandibular disorders, oral implantology, oral radiology, oral pathology and geriatrics. Referral consultations were carried out synchronously or asynchronously. Clinical information sent to oral pathology specialists involved a medical history and a traditional description of the lesion which considered size, color, limits, symptomatology, type of surface, consistency, location, and evolution. This information was complemented with a three-dimensional representation of the lesion, simulating an extra/intra oral clinical examination including a marker tool that allows to perform the anatomical-referencing of oral lesions. Results:27 consultations from 26 patients were evaluated for oral pathology lesions. 12 lesions were diagnosed as reactive, 5 were infectious lesions, 4 of vascular etiology, 3 pigmented lesions (amalgam tattoo and smoking-related melanosis) and 3 potentially malignant lesions. The most frequent location was the tongue with 8 cases, followed by the gingiva and jugal mucosa, each with 5 cases. Four lesions required biopsy and histopathological report. Conclusion: A teledentistry platform including digital representations of oral lesions using different digital markers, also associated with a mobile system to provide dental care, constitutes an excellent tool to treat patients that present oral lesions with potential cancer risk.

Objetivo: Contribuir al diagnóstico precoz de lesiones en pacientes mayores, incluyendo lesiones potencialmente malignas o con sospecha de cáncer oral mediante el apoyo de una plataforma de teleodontología basada en la web.Material y Métodos: Este informe contiene información de 27 pacientes con lesiones orales de un total de 135 que recibieron atención odontológica móvil. Los especialistas que participaron en el estudio incluyeron profesionales de las disciplinas de periodoncia, trastornos temporomandibulares, implantología oral, radiología oral, patología oral y geriatría. Las interconsultas se realizaron de forma sincrónica o asincrónica. La información clínica enviada a los especialistas en patología oral involucró una historia clínica y una descripción tradicional de la lesión que consideró tamaño, color, límites, sintomatología, tipo de superficie, consistencia, localización y evolución. Esta información se complementó con una representación tridimensional de la lesión, simu-lando un examen clínico extra/intraoral incluyendo una herramienta marcadora que permite realizar la referenciación anatómica de las lesiones orales. Resultados: Se evaluaron 27 consultas de 26 pacientes por lesiones de patología bucal. Se diagnosticaron 12 lesiones como reactivas, 5 lesiones infecciosas, 4 de etiología vascular, 3 lesiones pigmentadas (tatuaje de amalgama y melanosis por tabaquismo) y 3 lesiones potencialmente malignas. La localización más frecuente fue lengua con 8 casos, seguida de encía y mucosa yugal con 5 casos cada una. Cuatro lesiones requirieron biopsia e informe histopatológico. Conclusión: Una plataforma de teleodontología que incluye representaciones digitales de lesiones orales utilizando diferentes marcadores digitales, también asociada a un sistema móvil para brindar atención odontológica, constituye una excelente herramienta para tratar pacientes que presentan lesiones orales con riesgo potencial de cáncer.

Tratamiento de sonrisa gingival con planificación digital. Reporte de caso / Treatment of gummy smile with digital planning. Case report

La sonrisa gingival (SG) es una condición clínica de etiología multifactorial, caracterizada por la sobreexposición de la encía maxilar, mayor de 3 mm, mientras el paciente sonríe. Es considerada una de las alteraciones más comunes en la población con una prevalencia de 10,5-29%, 7% en hombres y 14% en mujeres, en el grupo etário de 20-30 años. La literatura científica reporta diversos tratamientos quirúrgicos invasivos y mínimamente invasivos que pueden ser acompañados con planificación digital. El objetivo de este reporte de caso fue describir el tratamiento de SG por erupción pasiva alterada tipo I, subcategoría A e hipermovilidad de músculo elevador del labio superior, en paciente femenino corregido con procedimientos quirúrgicos y métodos conservadores como la toxina botulínica planificado digitalmente. El uso de planificación digital en la reducción de SG acompañada de técnicas conservadoras como toxina botulínica permiten realizar procedimientos con postoperatorios favorables, disminución en errores de la técnica con resultados predecibles, seguros, rápidos y consistentes de acuerdo a las expectativas del paciente

Gummy smile (GS) is a clinical condition of multifactorial etiology, characterized by overexposure of the maxillary gingiva greater than 3mm while the patient smiles. It is considered one of the most common alterations among the population with a prevalence between 10,5-29%, 7% in men and 14% in women, in the age group of 20-30 years-old. The scientific literature reports several invasive and minimally invasive surgical treatments that can be accompanied with digital planning. The aim of this case report was to describe the treatment of GS due to altered passive eruption type I subcategory A and levator labii superioris muscle hypermobility in a female patient corrected with surgical procedures and conservative methods such as digital planned botulinum toxin. The use of digital planning in GS reduction accompanied by conservative techniques such as botulinum toxin allows performing procedures with favorable postoperative results, less technical errors with predictable, safe, fast and consistent results according to patient's expectations.

Orthodontic Treatment in Adult Patients with Periodontal Commitment: Case Report / Tratamento Ortodôntico em Pacientes Adultos com Comprometimento Periodontal: Relato de Caso

Abstract There is an increasing demand for orthodontic treatment by adult patients in dental offices. Orthodontic treatment in adults has particular characteristics, because, in addition to not showing active growth, there are situations that demand interrelation with other areas of dentistry, such as, Periodontics, Dental Prosthesis, Restorative Dentistry and Implantology. The objective of this work was to describe a clinical case of an adult patient with periodontal involvement, establishing the main considerations to be taken in the orthodontic treatment of adult patients with periodontal involvement. The results obtained in the clinical case showed that it is possible to treat patients with periodontal involvement as long as some precautions are taken, such as strict hygiene control, in association with the specialty of periodontics, a reduced sequence of wires, in order to shorten treatment time, using low intensity forces, to minimize damage to periodontal tissues. The orthodontic treatment performed, gave the patient the desired smile functionality and aesthetics, prioritizing a strict hygiene control, the use of light forces, simplification in orthodontic movement, as well as the use of fixed and permanent restraints in areas of reduced periodontium. (AU)

Resumo É crescente a procura de tratamento ortodôntico por pacientes adultos nos consultórios odontológicos. O tratamento ortodôntico em adultos, apresenta características particulares, pois, além de não apresentar crescimento ativo, ocorrem situações que demandam a inter-relação com outras áreas da odontologia como a, Periodontia, Prótese dentária, Dentística Restauradora e Implantodontia. O objetivo desse trabalho foi descrever um caso clínico de paciente adulta comprometida periodontalmente, estabelecendo as principais considerações a serem tomadas no tratamento ortodôntico de pacientes adultos com comprometimento periodontal. Os resultados obtidos no caso clínico, demonstraram, que é possível tratar os pacientes com comprometimento periodontal desde que sejam tomados alguns cuidados, como controle restrito de higienização, em associação com a especialidade da periodontia, uma sequência reduzida de fios, com o intuito de abreviar o tempo de tratamento, utilizando forças de baixa intensidade, para minimizar danos aos tecidos periodontais. O tratamento ortodôntico realizado, devolveu a paciente a funcionalidade e a estética do sorriso almejada, priorizando um controle rígido de higienização, o uso de forças leves, a simplificação na movimentação ortodôntica, bem como o uso de contenções fixas e permanentes em áreas de periodonto reduzido. (AU)

Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study

ABSTRACT Objective: The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth. Methods: This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05). Results: In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions. Conclusions: In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.

RESUMO Objetivo: O presente estudo teve como objetivo investigar a relação entre a inclinação dentária e as dimensões ósseas e gengivais em dentes anteriores superiores. Métodos: Esse estudo transversal incluiu imagens de tomografia computadorizada de feixe cônico (TCFC) de 160 dentes anteriores superiores divididos em três grupos (incisivo central, incisivo lateral e canino). Todos os pacientes tinham 18 anos ou mais, não tinham tratamento ortodôntico prévio nem história clínica que pudesse afetar as dimensões ósseas ou gengivais. A inclinação dentária, a espessura do osso e da gengiva e as distâncias da junção cemento-esmalte à crista óssea alveolar e à margem gengival foram medidas na face vestibular. As correlações foram analisadas por meio dos testes de Pearson e de correlação parcial (p≤0,05). Resultados: Nos incisivos centrais, a inclinação dentária foi positiva e significativamente relacionada à espessura do osso apical (R = 0,34, p= 0,001). Nos caninos, a inclinação dentária foi negativa e significativamente relacionada à espessura do osso cervical (R = - 0,34, p= 0,01) e positivamente associada à espessura do osso apical (R = 0,36, p= 0,01) e à distância entre a margem gengival e a junção cemento-esmalte (R = 0,31, p= 0,03). Nos incisivos laterais, a inclinação do dente não foi associada às dimensões do osso ou da gengiva. Conclusões: Nos incisivos centrais, quanto maior a inclinação vestibular do dente, maior a espessura do osso apical. Nos caninos, quanto maior a inclinação vestibular do dente, menor a espessura do osso cervical, maior a espessura do osso apical e maior a margem gengival. As dimensões ósseas e gengivais devem ser avaliadas ao se planejar o tratamento ortodôntico envolvendo a movimentação vestibular dos incisivos centrais e caninos.

Levantamento metodológico de revisões sistemáticas de estudos de intervenção em periodontia utilizando AMSTAR 2 e ROBIS / Methodological survey of systematic reviews of intervention studies in periodontology using AMSTAR 2 and ROBIS

Este estudo teve o objetivo de avaliar a qualidade metodológica e risco de viés das revisões sistemáticas e metanálises de estudos de intervenção (randomizados e não randomizados) na área de Periodontia. Buscas foram realizadas nas bases de dados: MedLine (PubMed), Embase (Elsevier), Web of Science, Scopus, Cochrane Library e LILACS para artigos de revisão sistemática, com ou sem metanálise, indexados no ano 2019 a 2020. Adicionalmente, foram realizadas buscas na literatura cinzenta, nas referências dos artigos selecionados e nos principais periódicos de área. As avaliações da qualidade metodológica e risco de viés foram realizadas através das ferramentas AMSTAR 2 e ROBIS, respectivamente. Os dados foram importados para o software IBM SPSS Statistics for Windows versão 25. Análises descritivas de frequência relativa e absoluta foram realizadas nas variáveis categóricas. Análises descritivas de média, desvio padrão e mínima/máxima foram realizadas nas variáveis contínuas. Cento e vinte e sete revisões sistemáticas cumpriram os critérios de elegibilidade e foram avaliadas. Na avaliação geral pelo ROBIS, 113 (90,6%) das revisões apresentaram alto risco de viés, 11 (7,1%) baixo risco de viés e 3 (2,4%) risco de viés indefinido. Segundo o AMSTAR 2, a qualidade metodológica foi alta em 13 revisões (10,2%), moderada em 1 (0,8%), baixa em 31 (24,4%) e criticamente baixa em 82 (64,6%). No geral, a qualidade das revisões sistemáticas de estudos de intervenção na área de Periodontia foi considerada baixa. Sugere-se que os pesquisadores que pretendam realizar revisões sistemáticas utilizem ao menos um dos dois instrumentos no processo de desenvolvimento do protocolo da revisão. Este simples processo, se respeitado e seguido em conjunto o PRISMA, tem o potencial de resultar na criação de protocolos mais completos e, consequentemente, em revisões de melhor qualidade.

This study aimed to assess the methodological quality and risk of bias of systematic reviews and meta-analyses of intervention studies (randomized and nonrandomized studies) in periodontics. The following databases were searched: MedLine (PubMed), Embase (Elsevier), Web of Science, Scopus, Cochrane Library, and LILACS for systematic review articles, with or without meta-analysis, indexed between 2019 to 2020. Additionally, we searched on grey literature, and a manually searched the references of selected articles and main journals in the area. AMSTAR 2 and ROBIS tools were used to assess the methodological quality and risk of bias, respectively. Data were imported into the IBM SPSS Statistics for Windows version 25 software. Categorical variables were descriptively analyzed by relative and absolute frequency. Continuous variables were analyzed by mean, standard deviation, and minimum/maximum. One-hundred twenty-seven systematic reviews were included and were evaluated. In the overall ROBIS assessment, 113 (90.6%) were at high risk of bias, 11 (7.1%) were at low risk of bias, and 3 (2.4%) had unclear risk of bias. According to AMSTAR 2, 13 reviews (10.2%) had high methodological quality, 1 (0.8%) moderate, 31 (24.4%) low and 82 (64.6%) critically low. Overall, the quality of systematic reviews of intervention studies in the field of periodontics was low. Systematic review authors could use at least one between both tools before creating the study protocol. This simple process, if followed together with PRISMA, has the potential aid authors in the creation of more complete protocols and, consequently, better quality reviews.

Influence of proximal contact point on alveolar bone crest in teeth moved to extraction sites: pilot study / Influência do ponto de contato proximal na crista óssea alveolar em dentes movidos pala locais de extrações dentárias: um estudo piloto

Introduction: The opening of the contact point can happen after orthodontic closure of the site of dental extraction and opened interproximal contacts are considered potential factors for periodontal diseases. Objective: To evaluate the condition of the alveolar bone crest of the interdental site between canines and upper premolars with or without contact points in individuals submitted to orthodontics associated with the extraction of the first premolars. Material and Methods: This cross-sectional observational study selected upper canines and premolars of individuals undergoing orthodontic treatment without extractions (12 hemiarches ­ control group), or with extraction of the upper first premolars and whose canines and second premolars had interproximal contact (11 hemiarches ­ group 1) or diastema (15 hemiarches ­ group 2). The height and the presence of lamina dura in the interproximal bone crest of the distal surfaces of canines and mesial surfaces of premolars were evaluated. Results: Groups 1 and 2 demonstrated the higher and smallest prevailing of the presence of lamina dura, respectively. The control group presented the bone crest positioned more crownly in relation to the others groups. Experimental groups did not present significant differences to the height of bone crest. Conclusion: The orthodontic allocation of teeth to extraction sites was associated with the significant reduction of the height of the marginal bone crest, regardless of the presence or absence of contact point between the teeth. The lack of contact point resulted in a minor prevalence of the continuity of the lamina dura of the alveolar bone crest in these regions.

Introdução: A abertura do ponto de contato pode ocorrer após o fechamento ortodôntico do sítio de extração dentária e os contatos interproximais abertos são considerados fatores potenciais para as doenças periodontais. Objetivo: Avaliar a condição da crista óssea alveolar do espaço interdentário entre caninos e pré-molares superiores com ou sem pontos de contato em indivíduos submetidos a tratamento ortodôntico associado à exodontia dos primeiros pré-molares. Material e Métodos: Este estudo transversal observacional selecionou caninos e pré-molares superiores de indivíduos submetidos a tratamento ortodôntico sem extrações (12 hemiarcos ­ grupo controle), ou com exodontia dos primeiros pré-molares superiores e cujos caninos e segundos pré-molares tiveram contato interproximal (11 hemiarcos ­ grupo 1) ou diastemas (15 hemiarcos ­ grupo 2). Foram avaliadas a altura e a presença da lâmina dura na crista óssea interproximal das superfícies distais dos caninos e mesiais dos pré-molares. Resultados: Os grupos 1 e 2 demonstraram a maior e a menor prevalência da presença de lâmina dura, respectivamente. O grupo controle apresentou a crista óssea posicionada mais coronalmente em relação aos demais grupos. Entre os grupos experimentais, não houve diferença significativa para a altura da crista óssea. Conclusão: Neste estudo preliminar, a movimentação ortodôntica dos dentes para os locais de exodontia foi associada à redução significativa da altura da crista óssea marginal, independentemente da presença ou ausência de ponto de contato entre os dentes. A falta de ponto de contato resultou em menor prevalência de continuidade da lâmina dura da crista óssea alveolar nessas regiões.

Effects of removable periodontal splint combined with minocycline on periodontal indexes and tooth aesthetics in patients with severe periodontal disease / 中国基层医药

Objective:To investigate the effects of removable periodontal splint combined with minocycline on periodontal indexes and tooth aesthetics in patients with severe periodontal disease.Methods:A total of 102 patients with severe periodontal disease treated in the School and Hospital of Stomatology, China Medical University from November 2018 to April 2020 were included in this study. They were randomly allocated into study and control groups ( n = 51/group). The control group was subject to repair with removable periodontal splint based on routine interventions. The study group was subject to medication with minocycline in addition to the treatments used in the control group. Clinical efficacy, periodontal status (sulcus bleeding index, plaque index, periodontal pocket depth) and gingival crevicular fluid inflammatory factors (transforming growth factor β, monocyte chemoattractant protein-1, interleukin-6, matrix metalloproteinase-8) and bone metabolism indexes [osteocalcin, N-terminal procollagen of type I (PINP), N-terminal propeptide of type I procollagen (PINP), C-terminal telopeptide of type I collagen (CTX) levels], comfort and aesthetics scores, and patient satisfaction were compared between the two groups. Results:Total response rate was significantly higher in the study group than in the control group [94.12% (48/51) vs. 80.39% (41/51), χ2 = 4.32, P < 0.05]. At 1 and 3 months after treatment, sulcus bleeding index (1.32 ± 0.41, 1.11 ± 0.36), plaque index (1.51 ± 0.44, 1.32 ± 0.51), periodontal pocket depth [(3.29 ± 0.70) mm, (2.51 ± 0.63) mm] were significantly lower in the study group than in the control group [1.65 ± 0.39, 1.45 ± 0.38, 1.92 ± 0.42, 1.88 ± 0.49, (5.05 ± 0.79) mm, (3.82 ± 0.86) mm, t = 4.16, 4.63, 4.81, 5.65, 11.90, 8.77, all P < 0.001]. At 1 and 3 months after treatment, the level of transforming growth factor β in the gingival crevicular fluid was significantly higher, and the level of matrix metalloproteinase-8 in the gingival crevicular fluid was significantly lower, in the study group compared with the control group (both P < 0.001). At 1 and 3 months after treatment, the level of osteocalcin in the gingival crevicular fluid was significantly higher, and the level of C-terminal telopeptide of type I collagen in the gingival crevicular fluid was significantly lower, in the study group compared with the control group ( t = -9.97, -10.71, -5.77, -7.40, 7.24, 16.11, all P < 0.001). At 1 and 3 months after treatment, the scores of comfort and aesthetics in the study group were significantly higher than those in the control group ( t = 7.49, 8.26, 7.84, 9.10, all P < 0.001). Patient satisfaction in the study group was significantly higher than that in the control group (94.12% vs. 80.39%, χ2 = 4.32, P < 0.05). Conclusion:Repair with a removable periodontal splint combined with minocycline can increase the therapeutic effects through reducing periodontal inflammation and regulating bone metabolism, thereby improving the periodontal condition, and improving tooth comfort and aesthetics and patient satisfaction in patients with severe periodontal disease.