Oral manifestations of systemic fungal infections: 25-year experience in an endemic region

Some mycoses are endemic. They develop through hematogenous spread, causing a generalized infection, usually with secondary mucosal involvement.The aim of this observational and retrospective study was to report the prevalence and characteristics of oral lesions in patients diagnosed with systemic fungal infections (SFI) over a 25-year period in southern Brazil. Demographic (age, sex, ethnicity, occupation) and clinical (anatomical location, symptoms,histopathological diagnosis and management) data from the medical records of patients with SFI were collected from 1995 to 2019. 34 cases of SFI were found, of which 31 (91.18%) were diagnosed as paracoccidioidomycosis (PCM) and 3 (8.82%) as histoplasmosis. Men were much more affected (n = 31; 91.18%), with an average age of 46.9 years. Most patients (n = 18; 58.06%) were Caucasian; 48% (n = 15) were farm/rural workers and the most affected region was the jugal mucosa (n = 13; 25.49%) followed by the alveolar ridge (n = 12; 23.52%). All patients with histoplasmosis were immunocompetent men (mean age: 52.67 years), and the palate was the most affected. All patients underwent incisional biopsy and were referred to an infectologist. The dentist has an essential role in the recognition of SFI, whose oral manifestations may be the first sign. SFI should be included in differential diagnosis in patients from endemic areas. In addition, the inevitable human mobility and globalization make knowledge of these mycosesnecessary worldwide, especially since advanced cases in immunocompromised patients can be fatal.

Pam2CSK4 (TLR2 agonist) induces periodontal destruction in mice

Abstract Lipoproteins are important bacterial immunostimulating molecules capable of inducing receptor activator of nuclear factor-κB (RANKL) and osteoclast formation in vitro and in vivo . Although these molecules are present in periodontopathogenic bacteria, their role in periodontitis is not known. In this study, we used Pam2CSK4 (PAM2), a synthetic molecule that mimics bacterial lipoprotein, to investigate the effects of lipoproteins on periodontitis in mice. C57BL/6 male mice were randomly divided into three experimental groups: 1) Negative control group: animals received vehicle injection; 2) Positive control group: animals received injection of Escherichia coli lipopolysaccharide (LPS); 3) PAM2 group: animals received PAM2 injection. All the injections were performed bilaterally every other day into the palatal mucosa between first and second molars. After twenty-four days, the animals were euthanized to assess alveolar bone volume (micro-CT), cellular and extracellular composition in the gingiva (stereometric analysis), and osteoclast numbers (TRAP staining). Treatment with either PAM2 or LPS induced gingival inflammation, as demonstrated by increased infiltration of inflammatory cells and enhanced angiogenesis, associated with a smaller number of fibroblasts and decreased extracellular matrix. Importantly, treatment not only with LPS but also with PAM2 resulted in a larger number of TRAP+ multinucleated osteoclasts and significant loss of alveolar bone. Collectively, our data demonstrate that PAM2 can induce gingival inflammation and bone loss in mice, broadening the avenues of investigation into the role of lipoproteins in the pathogenesis of periodontal disease.

Prevalence of horizontal alveolar changes in edentulous patients: a retrospective tomographic study

Abstract Horizontal bone loss after tooth extraction is a common finding that demands bone reconstruction in various cases. The aim of this study was to assess the horizontal alveolar status in partially and completely edentulous patients using cone-beam computed tomography (CBCT). In total, 1516 CBCT scans of 1404 adult patients were analyzed. Assessment of the images was performed in accordance with the previously published horizontal alveolar change (HAC) classification, which categorizes horizontal bone defects into four classes: HAC 1, HAC 2, HAC 3 and HAC 4 (from the least severe to the most severe condition). Analysis of 1048 scans from partially edentulous patients presented a distribution of 63.55%, 22.14%, 13.36% and 0.95% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Analysis of 468 scans from completely edentulous patient images presented a distribution of 19.87%, 28.63%, 41.67% and 9.83% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Based on these results, as in HAC 4, no cancellous bone was found between the cortical buccal and lingual/palatal bone plates, it seems reasonable to state that the absence of cancellous bone is higher in completely edentulous patients than in partially edentulous patients. Therefore, the absence of cancellous bone seems to be higher in completely edentulous than in partially edentulous patients.

Pam2CSK4 (TLR2 agonist) induces periodontal destruction in mice

Abstract Lipoproteins are important bacterial immunostimulating molecules capable of inducing receptor activator of nuclear factor-κB (RANKL) and osteoclast formation in vitro and in vivo . Although these molecules are present in periodontopathogenic bacteria, their role in periodontitis is not known. In this study, we used Pam2CSK4 (PAM2), a synthetic molecule that mimics bacterial lipoprotein, to investigate the effects of lipoproteins on periodontitis in mice. C57BL/6 male mice were randomly divided into three experimental groups: 1) Negative control group: animals received vehicle injection; 2) Positive control group: animals received injection of Escherichia coli lipopolysaccharide (LPS); 3) PAM2 group: animals received PAM2 injection. All the injections were performed bilaterally every other day into the palatal mucosa between first and second molars. After twenty-four days, the animals were euthanized to assess alveolar bone volume (micro-CT), cellular and extracellular composition in the gingiva (stereometric analysis), and osteoclast numbers (TRAP staining). Treatment with either PAM2 or LPS induced gingival inflammation, as demonstrated by increased infiltration of inflammatory cells and enhanced angiogenesis, associated with a smaller number of fibroblasts and decreased extracellular matrix. Importantly, treatment not only with LPS but also with PAM2 resulted in a larger number of TRAP+ multinucleated osteoclasts and significant loss of alveolar bone. Collectively, our data demonstrate that PAM2 can induce gingival inflammation and bone loss in mice, broadening the avenues of investigation into the role of lipoproteins in the pathogenesis of periodontal disease.

H2S in periodontal immune-inflammatory response and bone loss: a study in rats / Influência do H2S na resposta imunoinflamatória e perda óssea periodontal: um estudo em ratos

ABSTRACT Halitosis is highly prevalent in periodontitis and attributed mainly to the presence of volatile sulfur compounds (VSC), where hydrogen sulfide (H2S) is the chief culprit in the characteristic malodor of periodontitis and thus may play an active role in its pathogenesis. The aim of this study was to evaluate the effect of H2S in the acute, intermediate and chronic immuneinflammatory host response and alveolar bone loss in vivo by using an animal model of induced periodontal disease. Thirtysix rats were divided into 2 groups: test group (n = 18), rats exposed to H2S (NaHS H2S donor molecule) and control group (n = 18), rats treated with saline only (Ctrl). All animals had one of their lower second molars ligated to induce periodontal disease (PD). The sound contralateral molar was used as control (H). Each group was subdivided into 3 (n = 6), according to followup time (3h, 5 days and 14 days). The gingival tissue was used for mRNA expression analysis (IL1, IL6, RANKL, OPG and SOFAT) by realtime PCR and the mandibles were analyzed morphometrically. Data analysis showed that the ligature promoted alveolar bone loss, observed mainly at 14 days, both in the group exposed to H2S and in the Ctrl group. H2S administration did not result in additional bone loss. Gene expression showed a significant increase in IL1, IL6, RANKL and SOFAT only in the CtrlPD group (p<0.05). A significant downregulation in OPG expression was observed over time in the CtrlPD group (p<0.05). In conclusion, H2S had no effect on alveolar bone loss in the absence of a ligature. In the presence of a ligature, however, exposure to H2S had an immunoregulatory effect on the expression of proinflammatory and proresorptive cytokines.

RESUMO A halitose é altamente prevalente na periodontite e é atribuída principalmente à presença de compostos sulforosos voláteis (CSV), sendo o sulfeto de hidrogênio (H2S) o principal gás relacionado ao mau odor e que pode estar envolvido na patogênese da doença periodontal. O objetivo deste estudo foi avaliar o efeito agudo, intermediário e crônico do H2S na resposta imunoinflamatória e na perda óssea alveolar em ratos, com e sem doença periodontal induzida. Trinta e seis ratos foram divididos em 2 grupos: teste (n = 18), ratos expostos ao H2S (NaHS molécula doadora de H2S) e grupo controle (n = 18), ratos tratados apenas com solução salina (Ctrl). Todos os animais tiveram um dos seus segundos molares inferiores submetidos à colocação de uma ligadura para o desenvolvimento da doença periodontal (DP), em comparação com o dente contralateral saudável (H). Cada grupo foi subdividido em 3 (n = 6), de acordo com o tempo de eutanásia (3h, 5 dias e 14 dias). Os tecidos gengivais foram utilizados para a análise da expressão gênica (IL1, IL6, RANKL, OPG e SOFAT) por PCR em tempo real e as mandíbulas foram analisadas morfometricamente. Análise dos dados demonstrou que a ligadura promoveu perda óssea alveolar, observada principalmente aos 14 dias, tanto no grupo exposto ao H2S quanto no grupo Ctrl. A administração de H2S não resultou em perda óssea adicional. A expressão gênica demonstrou aumento significativo de IL1, IL6, RANKL e SOFAT apenas no grupo CtrlPD (p <0,05). Uma significativa regulação negativa na expressão de OPG foi observada ao longo do tempo no grupo CtrlPD (p <0,05). Podese concluir que o H2S não teve efeito adicional na perda óssea alveolar, na ausência de ligadura. Entretanto, na presença de ligadura, a exposição ao H2S teve um efeito imunorregulatório na expressão de citocinas próinflamatórias e próreabsortivas.

Utilización de injertos óseos autólogos y biomateriales en pacientes con atrofia alveolar. Matanzas / Use of autologous bone grafts and biomaterials in patients with alveolar atrophy.Matanzas

RESUMEN Introducción: los injertos óseos constituyen una de las técnicas más utilizadas en la cirugía reconstructiva implantológicas, son muy utilizadas para el reemplazo del hueso perdido por traumatismos, procesos patológicos congénitos o adquiridos y atrofia, son los injertos óseos autógenos o autólogos. Objetivo: caracterizar los pacientes con rebordes atróficos que necesitaron ser rehabilitados en implantología oral como alternativa de tratamiento en la consulta de Cirugía Máxilo Facial del Hospital Universitario "Faustino Pérez" y la Clínica "III Congreso del PCC", municipio Matanzas de septiembre del 2014 a julio de 2016. Material y Método: estudio prospectivo longitudinal. El universo fue de 20 pacientes mayores de 18 años de ambos sexos, que presentaron el diagnóstico de edentulismo parcial y atrofia alveolar. Se determinó por el interrogatorio, el examen clínico y los medios diagnósticos los síntomas y signos que caracterizaron esta entidad. Resultados: los traumatismos alveolares fue la causa que predominó en la pérdida dentaria, en el sexo masculino y en las edades de 18 a 37 años. La zona de mayor afectación fue la región anterior del maxilar superior y predominó la perdida de hueso en altura y en anchura y un gran número de injertos conservaron la cresta alveolar. Conclusiones: el uso de biomateriales en el tratamiento de pacientes con atrofia alveolar junto al injerto óseo fue satisfactorio en pacientes que necesitaron una base de sostén sobre la cual se colocaron los implantes dentales osteointegrados (AU).

SUMMARY Introduction: autogenous and autologous bone grafts are the elective material for replacing bones lost by trauma, congenital or acquired pathologic processes and atrophy. Objective: to characterize patients with atrophic rims needing rehabilitation in oral grafting as an alternative treatment in the Maxilla-Facial Surgery consultation of the University Hospital "Faustino Perez" and the Clinic "III Congreso del PCC", municipality of Matanzas, from September 2014 to July 2016. Materials and Methods: longitudinal prospective study. The universe was 20 patients aged 18 years and older, males and females, who presented the diagnosis of partial lack of teeth and alveolar atrophy. The symptoms and signs characterizing this entity were stated by questioning, physical examination and diagnostic means. Results: alveolar traumas were the predominant cause of dental lost in male patients aged 18-37 years. The most affected zone was the anterior region of the upper maxilla; bone lost in height and width predominated, and a great number of grafts conserved the alveolar crest. Conclusions: the use of biomaterials in the treatment of patients with alveolar atrophy together with bone graft was satisfactory in patients who needed a base support on which to put dental grafts (AU).

Losartan improves alveolar bone dynamics in normotensive rats but not in hypertensive rats

Abstract Hypertension is one of the main causes of premature death in the world; also, it is associated with several bone alterations. Preclinical studies have demonstrated delayed alveolar bone healing in hypertensive rats. However, losartan has been favorable for consolidation of bone grafts and reduction in active periodontitis. Therefore, losartan is suggested to be effective in bone formation stages, as well as in the synthesis of matrix proteins and mineralization. Objectives: To evaluate the alveolar bone dynamics in hypertensive rats treated with losartan by laser confocal microscopy and histological analysis. Methodology: Thirty-two rats, 16 spontaneously hypertensive rats (SHR) and 16 Wistar albinus rats, treated or not with losartan (30 mg/kg/day) were used. Calcein fluorochrome at 21 days and alizarin red fluorochrome at 49 days were injected in rats (both 20 mg/kg). The animals were submitted to euthanasia 67 days after treatment, and then the right maxilla was removed for laser confocal microscopy analysis and the left maxilla for histological analysis. Results: This study showed a greater calcium marking in normotensive animals treated with losartan in relation to the other groups. Laser confocal microscopy parameters showed higher values of bone volume formed, mineralized surface, active surface of mineralization and bone formation rate in normotensive animals treated with losartan. However, a smaller mineralized surface was observed in all hypertensive animals. Conclusion: Losartan can improve bone mineralization parameters under normal physiological conditions, but the same anabolic effect does not occur under hypertension.

Macroscopic and microscopic evaluation of flapless alveolar perforations on experimental tooth movement

Abstract Objective: The aim of this study was to evaluate a flapless surgical technique as an alternative to traditional alveolar corticotomy used to accelerate orthodontic tooth movement (OTM). Methods: To induce OTM in Wistar rats, 40 cN of orthodontic force were applied to the maxillary left first molars. Forty rats were distributed into control groups (CG1, CG3, CG7 and CG14) and experimental groups (n= 5), in which alveolar perforations were made using a spear-shaped guide bur (EG1, EG3, EG7, EG14). Euthanasia dates were set at 1, 3, 7 and 14 days, respectively, after tooth movement began. The amount of OTM was measured with a caliper, and osteoclasts present in the periodontal ligament of the mesial root of the moved tooth were counted by means of histological evaluation (tartrate-resistant acid phosphatase staining, TRAP). Results: Although there was no difference in the amount of OTM within subgroups of corresponding experimental periods (p> 0.05), when EG14 and CG14 were compared, a larger number of osteoclasts was counted in the experimental group (p< 0.00). Conclusion: The authors concluded that flapless cortical alveolar perforations led to more intense osteoclastic activity on the fourteenth day; nevertheless, no evidence of accelerated OTM could be noted.

Resumo Objetivo: o objetivo do presente estudo foi avaliar a técnica cirúrgica sem retalho como alternativa à tradicional corticotomia alveolar utilizada para acelerar o movimento dentário experimental. Métodos: para induzir a movimentação dentária experimental em ratos Wistar, foram aplicados 40 cN de força ortodôntica aos primeiros molares superiores esquerdos. Quarenta ratos foram distribuídos nos grupos (n = 5) controles (GC1, GC3, GC7 e GC14) e experimentais (GE1, GE3, GE7, GE14), nos quais foram realizadas perfurações alveolares com uma ponta lança. As datas de eutanásia foram estabelecidas em 1, 3, 7 e 14 dias, respectivamente, após o início do movimento dentário. A quantidade de deslocamento dentário foi medida com um paquímetro e os osteoclastos presentes no ligamento periodontal da raiz mesial do dente movimentado foram contados por meio de avaliação histológica (coloração por fosfatase ácida resistente ao tartarato, TRAP). Resultados: embora não tenha havido diferença na quantidade de deslocamento dentário dentro dos subgrupos dos períodos experimentais correspondentes (p> 0,05), quando GC14 e GE14 foram comparados, um número maior de osteoclastos foi contado no grupo experimental (p< 0,00). Conclusão: os autores concluíram que as perfurações alveolares corticais sem retalho levaram a uma atividade osteoclástica mais intensa no décimo quarto dia; entretanto, nenhuma evidência de movimento dentário acelerado pôde ser notada.

Effects on alveolar bone of diabetes mellitus induced by streptozotocin in rats: histopathologic and immunohistochemical study / Efectos de la diabetes mellitus inducida por streptozotocina en el hueso alveolar de ratas: estudio histopatológico e inmunohistoquímico

SUMMARY: The purpose of this study was to investigate effects of diabetes mellitus (DM) on the alveolar bone with histopathological and immunohistochemical methods. Wistar rats were divided into two groups, control and diabetes group. Control group was fed standard rat chow and drinking water for 8 weeks. Single dose (Streptozotocin) STZ (55 mg/kg), was dissolved in sodium citrate buffer and introduced intraperitoneal injection. Diabetes group and control group were compared in terms of glucose values. The blood glucose concentration in diabetic rats was significantly high (p <0.05). In diabetes group; periodontal membrane and the dilation of blood vessels, hemorrhage has also been a significant increase in inflammatory cells. In the diabetes group, osteonectin showed positive expression in periodontal membrane and showed negative expression in osteocytes of alveolar bone. Osteopontin expression in fibroblast cells and periodontal membrane collagen fibrils was positive, alveolar cells, osteocytes and bone matrix bone was found positive. Diabetes results showed that there formed periodontitis; due to the increase in inflammation inhibiting bone formation delaying the development of early bone cells.

RESUMEN: El objetivo de este estudio fue investigar los efectos de la diabetes mellitus (DM) sobre el hueso alveolar con métodos histopatológicos e inmunohistoquímicos. Las ratas Wistar se dividieron en dos grupos, grupo control y grupo de diabetes. El grupo control fue alimentado con comida estándar y agua potable durante 8 semanas. La dosis única Streptozotocina (STZ) (55 mg/ kg), se disolvió en tampón de citrato de sodio y se introdujo mediante inyección intraperitoneal. El grupo diabetes y el grupo control se compararon en términos de valores de glucosa. La concentración de glucosa en sangre en ratas diabéticas fue significativamente alta (p <0,05). En el grupo diabetes hubo un aumento significativo de la membrana periodontal y dilatación de los vasos sanguíneos y hemorragia, con un aumento significativo de células inflamatorias. En el grupo diabetes, la osteonectina mostró una expresión positiva en la membrana periodontal además se observó expresión negativa en los osteocitos del hueso alveolar. La expresión de osteopontina en fibroblastos y fibrillas de colágeno en membrana periodontal fue positiva, las células alveolares, osteocitos y hueso de la matriz ósea dio positivo. Los resultados de la diabetes mostraron que existía periodontitis, debido al aumento de la inflamación que inhibió la formación ósea retardando el desarrollo de células óseas tempranas.

Maxillary sinus floor pneumatization and alveolar ridge resorption after tooth loss: a cross-sectional study

Abstract This is a cross-sectional study that aimed to estimate maxillary sinus floor (MSF) pneumatization in single missing tooth of posterior maxilla, by using cone-beam computed tomography (CBCT). CBCT images were analyzed bilaterally and divided into 2 groups: edentulous site (EdS) - edentulous single region of upper second premolar, first or second molars; Tooth site (TS) - contralateral region homologous to the EdS region, with tooth present. Variables evaluated were: sinus height (SH), estimated sinus pneumatization (eSP: ∆ EdS - TS), healed ridge height (HR) and presence of localized sinus pneumatization (LSP) in molars teeth at TS. HR were categorized according to therapeutic option for posterior maxilla. 183 CBCT scans were included and it was observed that EdS presented a higher SH than the TS (p < 0.001) showing an eSP of 0.9 ± 2.93 mm. First molars presented the highest SH for both sides, although significant differences were detected when compared to second molars. First molars were mostly affected by LSP at TS (36 out of 43). Individuals with LSP at TS presented lower HR than the ones without LSP (p < 0.05). 54% of the cases presenting LSP obtained HR < 5 mm, which indicates sinus lift surgery. The present study showed that tooth loss in posterior maxilla favors sinus pneumatization and the identification of LSP at molar roots seems to indicate a greater necessity for sinus lift surgeries.

Dehiscences and fenestrations: methodological care necessary to avoid errors in diagnosis and measurement

ABSTRACT The low prevalence of gingival recessions observed in orthodontic clinical practice may be assigned to the fact that in studies in which dehiscences and bone fenestrations are described as frequent, they were diagnosed based on: 1) dry skull studies; 2) areas with periosteal reflection together with flap; and 3) imaging techniques with low sensitivity to detect these defects, which have a delicate structure and function. In areas of pseudo-dehiscences and fenestrations, the periosteum and the alveolar cortical bone are very thin; also, they either have been removed during preparation of the dry specimens in the areas for analysis, or, alternatively, have not been investigated using an ideal imaging method.

RESUMO A ausência de prevalência elevada das recessões gengivais relacionadas à prática clínica ortodôntica se explica, provavelmente, porque, nos trabalhos em que as deiscências e fenestrações ósseas são descritas como frequentes, essas foram diagnosticadas a partir de: 1) estudos em crânios secos; 2) áreas com rebatimento periosteal junto com o retalho; e 3) uso de métodos imagiológicos que falham em sensibilidade para captá-las, pela sua delicadeza estrutural e funcional. Nessas áreas de pseudodeiscências e fenestrações, existe periósteo e cortical óssea alveolar muito fina, que foram eliminados nos procedimentos de preparação dos espécimes secos, nas áreas para a análise ou, então, não se aplicou um método imagiológico ideal.

Root length and alveolar bone level of impacted canines and adjacent teeth after orthodontic traction: a long-term evaluation

Abstract Objective The aim of this retrospective study was to evaluate the long-term effects of orthodontic traction on root length and alveolar bone level in impacted canines and adjacent teeth. Material and Methods Sample consisted of 16 patients (nine males and seven females), mean initial age 11 years and 8 months presenting with unilaterally maxillary impacted canines, palatally displaced, treated with the same surgical and orthodontic approach. Teeth from the impacted-canine side were assigned as Group I (GI), and contralateral teeth as control, Group II (GII). The mean age of patients at the end of orthodontic treatment was 14 years and 2 months and the mean post-treatment time was 5 years and 11 months. Both contralateral erupted maxillary canines and adjacent teeth served as control. Root length and alveolar bone level (buccal and palatal) were evaluated on cone-beam computed tomography (CBCT) images. The comparison of root length and alveolar bone level changes between groups were assessed by applying paired t-test, at a significance level of 5% (p<0.05). Results There were no statistically significant differences in root length and buccal and palatal bone levels of canines and adjacent teeth among groups. Conclusions Impacted canine treatment by closed-eruption technique associated with canine crown perforation, has a minimal effect on root length and buccal and palatal alveolar bone level in both canine and adjacent teeth, demonstrating that this treatment protocol has a good long-term prognosis.

Regeneración tisular guiada en defecto óseo de 3 paredes: enfermedad periodontal y oclusión / Guided tissue regeneration and in a three-walled osseous defect: periodontal disease and occlusion

Relacionar la importancia del éxito en regeneración tisular guiada y el correcto diagnóstico del problema, en este caso enfermedad periodontaly un contacto prematuro en ORC producto de una obturación de amalgama incorrecta. Caso clínico: tratamiento de un defecto infraóseo de3 paredes mediante la utilización de hueso de origen bovino particulado junto con proteínas derivadas de la matriz del esmalte. Tanto los parámetros clínicoscomo los radiográficos fueron evaluados al inicio, en el postquirúrgico inmediato y a los 12 meses. Conclusión: se observó un alto grado de regeneración pasados los 12 meses del tratamiento. Parecería no ser siempre necesaria la utilización de membrana colágena. Las proteínas derivadas de la matrizdel esmalte serían un sustituto de la membrana en algunos casos. Resulta fundamental el chequeo de la situación oclusal en piezas periodontalmente comprometidas...

Alveolar bone loss induced by chronic ethanol consumption from adolescence to adulthood in Wistar rats.

Though there are literature indicating the bone loss due to alcohol consumption, studies on the association between ethanol consumption and periodontal breakdown in animals are either scarce or have provided conflicting results. Here, we investigated the effects of chronic alcohol exposure from adolescence to adulthood on the alveolar bone in rats. Wistar rats were exposed to ethanol (6.5 g/kg/day) in a solution of 22.5% (w/v) or distilled water (control) by gavage from 35 days of age (adolescent) until 90 days (adulthood). Evaluation of the bone loss was performed using scanning electronic microscopy, in which the distances between the cement-enamel junction and the alveolar bone crest from the palatal side of the first molar mandibular were measured. The measurements obtained were tabulated and analyzed using Student’s t-test. Alcohol-treated group revealed greater bone loss in comparison to the control group. These findings indicate that heavy chronic alcohol exposure from adolescent to adulthood can induce alveolar bone loss in rats associated to absence of periodontitis.

The effects of binge-pattern alcohol consumption on orthodontic tooth movement

OBJECTIVE: This study aimed to assess tissue changes during orthodontic movement after binge-pattern ethanol 20% exposure. METHODS: Male Wistar rats (n = 54) were divided into two groups. The control group (CG) received 0.9% saline solution, while the experimental group (EG) received 20% ethanol in 0.9% saline solution (3 g/kg/day). On the 30th day, a force of 25 cN was applied with a nickel-titanium closed coil spring to move the maxillary right first molar mesially. The groups were further divided into three subgroups (2, 14 and 28 days). Tartrate-resistant acid phosphatase and picrosirius were used to assess bone resorption and neoformation, respectively. Data were compared by two-way ANOVA, Tukey's HSD, Games-Howell and chi-square test. Significance level was set at 5%. RESULTS: There was a decrease in the number of osteoclasts in EG at day 28. The percentage of collagen showed no interaction between group and time. CONCLUSION: Binge-pattern 20% ethanol promoted less bone resorption at the end of tooth movement, thereby suggesting delay in tooth movement. .

OBJETIVO: objetivou-se avaliar as alterações teciduais decorrentes da administração de etanol a 20% no padrão binge, durante o movimento ortodôntico. MÉTODOS: foram utilizados ratos Wistar machos (n = 54), divididos em dois grupos, sendo Grupo Controle (GC), com administração de soro fisiológico a 0,9%; e Grupo e Experimental (GE), com administração de etanol a 20% em soro fisiológico a 0,9%, no volume de 3g/kg/dia. Após o 30º dia de administração, foi aplicada força de 25cN com mola fechada de níquel-titânio para mover o primeiro molar superior direito para mesial. Os grupos foram subdivididos nos subgrupos 2, 14 e 28 dias, correspondendo ao número de dias de movimentação dentária. Utilizou-se as colorações de fosfatase ácida-tartarato resistente e picrosírius para avaliar reabsorção óssea e neoformação óssea, respectivamente. Os dados foram comparados por ANOVA a dois critérios, Tukey HSD e Games-Howell, ao nível de significância de 5%. RESULTADOS: verificou-se diminuição no número de osteoclastos no GE II no 28º dia. A percentagem de colágeno não demonstrou alteração na interação grupo x tempo. CONCLUSÕES: o etanol no padrão binge a 20% promoveu menor reabsorção óssea no final da movimentação dentária, sugerindo atraso na movimentação dentária. .

Immunolocalization of FGF-2 and VEGF in rat periodontal ligament during experimental tooth movement

OBJECTIVE: This article aimed at identifying the expression of fibroblast growth factor-2 (FGF-2) and vascular endothelial growth factor (VEGF) in the tension and pressure areas of rat periodontal ligament, in different periods of experimental orthodontic tooth movement. METHODS: An orthodontic force of 0.5 N was applied to the upper right first molar of 18 male Wistar rats for periods of 3 (group I), 7 (group II) and 14 days (group III). The counter-side first molar was used as a control. The animals were euthanized at the aforementioned time periods, and their maxillary bone was removed and fixed. After demineralization, the specimens were histologically processed and embedded in paraffin. FGF-2 and VEGF expressions were studied through immunohistochemistry and morphological analysis. RESULTS: The experimental side showed a higher expression of both FGF-2 and VEGF in all groups, when compared with the control side (P < 0.05). Statistically significant differences were also found between the tension and pressure areas in the experimental side. CONCLUSION: Both FGF-2 and VEGF are expressed in rat periodontal tissue. Additionally, these growth factors are upregulated when orthodontic forces are applied, thereby suggesting that they play an important role in changes that occur in periodontal tissue during orthodontic movement. .

OBJETIVO: o objetivo desse estudo foi identificar a expressão do fator de crescimento de fibroblastos 2 (FGF-2) e do fator de crescimento vascular endotelial (VEGF) nos lados de tensão e pressão do ligamento periodontal de ratos, durante movimento ortodôntico experimental, em diferentes períodos de tempo. MÉTODOS: uma força ortodôntica de 0,5N foi aplicada no primeiro molar superior direito de 18 ratos Wistar machos, por períodos de 3 (grupo I), 7 (grupo II) e 14 dias (grupo III). O primeiro molar do lado oposto foi utilizado como controle. Os animais foram sacrificados nos períodos de tempo mencionados, sendo a arcada superior removida e fixada. Após a desmineralização, os espécimes foram processados histologicamente e embebidos em parafina. A expressão do FGF-2 e do VEGF foram estudadas por meio de análise imuno-histoquímica. RESULTADOS: o ligamento periodontal dos dentes submetidos à movimentação ortodôntica mostraram maior expressão tanto de FGF-2 quanto de VEGF, em todos os grupos experimentais, quando comparados com os dentes do lado controle (p < 0,05). Diferenças estatisticamente significativas entre os lados de tensão e pressão também foram encontradas nos dentes submetidos à movimentação ortodôntica. CONCLUSÕES: tanto o FGF-2 quanto o VEGF são expressos no tecido periodontal de ratos, e esses fatores de crescimento são aumentados quando forças ortodônticas são aplicadas, sugerindo que esses desempenham um papel importante na reorganização do periodonto durante o movimento ortodôntico. .

Force distribution is more important than its intensity!

A common question about root resorption is raised in orthodontic practice: What is more important, the intensity of force or its distribution along the root, periodontal and alveolar structures? Diffuse distribution of forces applied to periodontal tissues during tooth movement tends not to promote neither extensive areas of cell matrix hyalinization nor significant death of cementoblasts that lead to root resorption. However, focal distribution or concentration of forces within a restricted area - as it occurs in tipping movements, even with forces of lower intensity - tend to induce extensive areas of hyalinization and focal death of cementoblasts, which is commonly associated with root resorption. In tipping movements, the apical regions tend to concentrate more forces in addition to wounding the cementoblasts due to the smaller dimension of their root structure as well as their cone shape. For this reason, there is an increase in root resorption. In the cervical region, on the other hand, the large area resulting from a large diameter and bone crown deflection tends to reduce the effects of forces, even when they are more concentrated, thus rarely inducing death of cementoblasts and root resorption.

Um questionamento comum sobre as reabsorções radiculares na prática ortodôntica: "O que é mais importante? A intensidade das forças aplicadas ou sua distribuição ao longo das estruturas radiculares, periodontais e alveolares?" A distribuição difusa das forças aplicadas sobre os tecidos periodontais durante o movimento dentário de corpo tende a não promover extensas áreas de hialinização da matriz extracelular, nem morte significativa de cementoblastos que levariam à reabsorção radicular. Porém, a distribuição focal ou concentração de forças - como nas inclinações, mesmo nas de menor intensidade - em uma área restrita tende a induzir áreas extensas de hialinização e morte focal de cementoblastos, associando-se mais comumente à reabsorção radicular. Nos movimentos de inclinação, as áreas apicais, por sua menor dimensão da estrutura radicular e sua forma cônica, tendem a concentrar mais ainda as forças e lesar cementoblastos, aumentando a frequência das reabsorções radiculares. Na região cervical, a maior área decorrente do maior diâmetro e a deflexão óssea da crista óssea tendem a reduzir os efeitos das forças, mesmo quando mais concentradas, muito raramente induzindo a morte de cementoblastos e reabsorções radiculares.

Dental and skeletal components of Class II open bite treatment with a modified Thurow appliance

INTRODUCTION: Due to the lack of studies that distinguish between dentoalveolar and basal changes caused by the Thurow appliance, this clinical study, carried out by the School of Dentistry - State University of São Paulo/Araraquara, aimed at assessing the dental and skeletal changes induced by modified Thurow appliance. METHODS: The sample included an experimental group comprising 13 subjects aged between 7 and 10 years old, with Class II malocclusion and anterior open bite, and a control group comprising 22 subjects similar in age, sex and mandibular plane angle. Maxillary/mandibular, horizontal/vertical, dental/skeletal movements (ANS, PNS, U1, U6, Co, Go, Pog, L1, L6) were assessed, based on 14 landmarks, 8 angles (S-N-ANS, SNA, PPA, S-N-Pog, SNB, MPA, PP/MPA, ANB) and 3 linear measures (N-Me, ANS-Me, S-Go). RESULTS: Treatment caused significantly greater angle decrease between the palatal and the mandibular plane of the experimental group, primarily due to an increase in the palatal plane angle. ANB, SNA and S-N-ANS angles significantly decreased more in patients from the experimental group. PNS was superiorly remodeled. Lower face height (ANS-Me) decreased in the experimental group and increased in the control group. CONCLUSIONS: The modified Thurow appliance controlled vertical and horizontal displacements of the maxilla, rotated the maxilla and improved open bite malocclusion, decreasing lower facial height. .

INTRODUÇÃO: devido ao número reduzido de estudos que distinguem entre as mudanças dentoalveolares e ósseas produzidas pelo aparelho de Thurow, esse estudo clínico, conduzido pelo departamento de Ortodontia da Faculdade de Odontologia de Araraquara, foi proposto para avaliar as mudanças dentárias e esqueléticas induzidas pelo aparelho de Thurow modificado. MÉTODOS: a amostra incluiu um grupo experimental de 13 indivíduos, entre 7 e 10 anos de idade, com má oclusão Classe II e mordida aberta anterior, e um grupo controle de 22 indivíduos, com idades, plano mandibular e má oclusão similares. Com base em 14 pontos cefalométricos, 8 ângulos (S-N-ANS, SNA, PPA, S-N-Pog, SNB, MPA, PP/MPA, ANB) e 3 medidas lineares (N-Me, ANS-Me, S-Go), foram avaliados movimentos maxilares e mandibulares horizontais e verticais dentários e esqueléticos (ANS, PNS, U1, U6, Co, Go, Pog, L1, L6). RESULTADOS: o tratamento produziu diminuição significativamente maior no ângulo entre o plano palatino e o plano mandibular do grupo controle, devido ao aumento do ângulo do plano palatino. Os ângulos A-N-B, S-N-A e S-N-ANS diminuíram significativamente mais no grupo tratado. A PNS sofreu remodelação superior. A altura facial inferior (ANS-Me) diminuiu no grupo tratado, ao passo que aumentou no grupo controle. CONCLUSÕES: o aparelho controlou deslocamento vertical e horizontal da maxila, rotacionou a maxila para melhorar a mordida aberta e diminuiu a altura facial inferior. .

Microscopic evaluation of induced tooth movement after subluxation trauma: an experimental study in rats

OBJECTIVE: The objective of this study was to assess the histological alterations that occurred in the periodontal area of rat molars submitted to induced tooth movement (ITM) right after an intentional trauma (subluxation). METHODS: Forty adult male Wistar rats (Rattus norvegicus albinus) were selected. The animals were divided into eight groups (n = 5), according to the combination of variables: Group 1 - control (neither trauma nor ITM); Group 2 - ITM; Groups 3, 4, 5 and 6 - dentoalveolar trauma groups corresponding, respectively, to 1, 3, 8 and 10 days after trauma; Groups 7 and 8 - the animals' molars were subjected to a 900 cN impact and, one and three days after the trauma event, tooth movement was induced. The rats' maxillary first molars were mesially moved during seven days with a closed coil (50 cN). After the experimental period of each group, the animals were sacrificed by anesthetic overdose and the right maxillas were removed and processed for histological analysis under light microscopy. RESULTS: In the animals of group 3, 4, 5 and 6, the histological alterations were not very significant. Consequently, the effect of induced tooth movement right after a subluxation event (groups 7 and 8) was very similar to those described for Group 2. CONCLUSION: There was no difference in the quality of periodontal repair when ITM was applied to teeth that had suffered a subluxation trauma. .

OBJETIVO: avaliar as alterações histológicas ocorridas na área periodontal de molares de ratos submetidos à movimentação dentária induzida (MDI), logo após um trauma intencional (subluxação). MÉTODOS: quarenta ratos Wistar machos adultos (Rattus norvegicus albinus) foram selecionados. Os animais foram divididos em oito grupos (n = 5), de acordo com a combinação das variáveis: Grupo 1 - controle (sem trauma e sem MDI); Grupo 2 - MDI; Grupos 3, 4, 5 e 6 - grupos de trauma dentoalveolar correspondendo, respectivamente, para 1, 3, 8 e 10 dias após o trauma; Grupos 7 e 8 - os molares murinos foram submetidos a um impacto de 900cN e, de um e três dias após o evento trauma, o movimento do dente foi induzido. Os primeiros molares superiores dos animais foram movidos mesialmente durante sete dias, com uma mola fechada (50cN). Após período experimental de cada grupo, os animais foram sacrificados por overdose anestésica e as maxilas direitas foram removidas e processadas para análise histológica qualitativa. RESULTADOS: nos animais dos grupos 3, 4, 5 e 6, as alterações histológicas não foram muito significativas. Consequentemente, o efeito do movimento dentário induzido logo após um evento de subluxação (grupos 7 e 8) foi muito semelhante ao descrito para o grupo 2. CONCLUSÃO: não houve diferença na qualidade do reparo periodontal quando a MDI foi aplicada aos dentes que sofreram um trauma de subluxação. .

Tratamiento de un defecto vertical profundo en un pilar protético mediante la técnica de regeneración tisular guiada: evaluación clínica y radiográfica con reentrada a los 12 meses (AU) / Treatment of a deep vertical intrabony defect in a prosthetic abutment by means of guided tissue regeneration: clinical and radiographic evaluation with re-entry procedure 12 months later

Objetivo: evaluar clínica y radiográficamente el tratamiento de un defecto vertical profundo en un pilar protético mediante la técnica de regeneración tisular guiada (RTG). Caso clínico: se presenta el tratamiento de un defecto vertical profundo mediante una técnica combinada de injerto bovino y membrana de colágeno. Los parámetros clínicos y radiográficos fueron evaluados al incicio y 12 meses después, momento en el cual se realizó una reentrada quirúrgica para evaluar la regeneración obtenida. Conclusión: los resultados clínicos mostraron una mejoría en los parámetros evaluados y radiográficamente, un año después, se observó un alto grado de regeneración. La utilización de esta técnica (RTG) en pilares dentarios estratégicos permite mejorar el pronóstico periodontal de la pieza dentaria y posteriormente, incluirlos en la futura rehabilitación protética. Más allá de las limitaciones de este estudio, los resultados sugieren que la terapia regenerativa combinada es eficaz para el tratamiento de pilares periodontalmente comprometidos.