Gingival overgrowth and drug association: A review.

Drugs used locally or systemically induce several alterations in micro and macroscopic tissues. However, nearly 20 drugs have been reported so far in the literature associated with gingival enlargement. Many systemic diseases have limited therapeutic options and such drugs or their metabolites have an adverse influence on different systems/organs, and one of these is that they initiate or accelerate the overgrowth of gingival tissue. The increase in size may be to the extent that teeth may be partially or completely covered, and the resultant 'gummy smile' may result in aesthetic concern for the patient.In the presence of bacterial inflammation in the gingiva, many of these drugs enhance the production of collagen by fibroblast cells, and simultaneously retard the destruction of collagen and hence increase the bulk of gingival tissue. It is apparent that there is a subpopulation of fibroblasts which is sensitive to these drugs. The exuberant growth of gingival tissue is of great aesthetic concern, which may require mechanical removal of bacterial plaque, calculus, and surgical intervention, and/or substitution of the drug with analogs. A relatively healthy oral environment provided by the dentist will reduce local microflora that will help in eliminating the major focus of infection. Physicians, general practitioners, and dentists need to make a coordinated and concise treatment plan that will be beneficial for the patients. This article will facilitate full information to physicians to involve dentists in the multidisciplinary treatment plan.

Remoção química-mecânica da cárie: revisão de literatura / Chemomechanical caries removal: literature review

O princípio básico da remoção químico-mecânica da cárie consiste na aplicação de agentes químicos específicos que promovam o amolecimento seletivo da dentina degradada durante o processo carioso, seguido de uma leve escavação usando instrumentos manuais especialmrnete adaptados, restando ao final do processo apenas a dentina sadia. O primeiro sistema chegaria ao mercado na década de 80, com o nome de Caridex, contudo, devido a uma série de desvantagens ele sairia de circulação no início da década de 90. O atual sistema, o Carisolv, mostra-se bem mais vantajoso que o sistema anterior, tendo como principais características: ser indolor, dispensando deste modo a anestesia local, ser mais econômico e bem mais simples. O sistema é especialmente indicado para pacientes pediátricos, pacientes com fobia, pacientes sistematicamente comprometidos e para pacientes especiais. O objetivo deste artigo é, através da revisão de literatura, tratar sobre a evolução deste método e suas principais particularidades.