Association of Khat chewing, smoking, age and sex with periodontal status among Yemeni adults / Associação da mastigação de Khat, tabagismo, idade e gênero com a condição periodontal entre adultos iemenitas

Objective: Periodontal diseases are very common dental disease. Many risk factors may play significant role in the periodontal disease initiation and progression. This study was performed to evaluate the effects of khat chewing, smoking, age and gender on periodontal status among Yemeni adults. Material and Methods: This cross-sectional study was performed on 1231 patients attending the outpatient dental polyclinics of University of Science and Technology during the academic years 2017/2018. All completed sheets were collected throughout the year by the supervisors. Data cleaning, descriptive statistics, and inferential statistics were then performed. Results: Khat chewers were more frequent than non-chewers counterparts (60.7% vs. 39.3%). The prevalence of smoking was 25.5% (297 patients). Study results indicated that periodontitis is more associated with female gender and participants aged more than 35 years old. Results also showed that female and age older participants aged more than 35 years were significantly associated with gingival recession. Mean number of the teeth with gingival recession in male patients were higher than in females. Male gender and patients aged more than 35 years old were significantly associated with furcation involvement. Conclusion: The present study has shown females gender and age older than 35 seem to be risk factors of periodontal diseases. Males has more teeth affected by gingival recession and more furcation involvement (AU)

Objetivo: As doenças periodontais são patologias dentárias com alta prevalência. Diversos fatores de risco podem desempenhar papel significativo no início e progressão das doenças periodontais. Este estudo foi realizado para avaliar os efeitos da mastigação de khat, tabagismo, idade e gênero na condição periodontal de adultos iemenitas. Material e Métodos: Este estudo transversal foi realizado em 1231 pacientes atendidos nas policlínicas odontológicas ambulatoriais da Universidade de Ciência e Tecnologia durante os anos acadêmicos de 2017/2018 através de um questionário para coleta de dados préestabelecido. Todas os questionários preenchidos foram coletados ao longo do ano pelos supervisores. A apuração dos dados, estatística descritiva e estatística inferencial foram realizadas. Resultados: os mastigadores de Khat foram mais frequentes do que as não-mastigadores (60,7% vs. 39,3%). A prevalência de tabagismo foi de 25,5% (297 pacientes). Os resultados do estudo indicaram que a periodontite está mais associada ao gênero feminino e aos participantes com mais de 35 anos de idade. Os resultados também mostraram que participantes do gênero feminino e acima de 35 anos foram significativamente associadas à recessão gengival. O número médio de dentes com recessão gengival em pacientes do gênero masculino foi maior que no feminino. O gênero masculino e os pacientes com mais de 35 anos de idade foram significativamente associados ao envolvimento da furca. Conclusão: O presente estudo mostrou que o gênero feminino e a idade acima de 35 anos parecem ser fatores de risco para doenças periodontais. Pacientes do gênero masculino têm mais dentes afetados pela recessão gengival e mais envolvimento de furca.(AU)

Prevalence of Gingival Recession in Dental Students from the Federal University of Juiz de Fora - Brazil / Prevalencia de Recesión Gingival en Estudiantes de Odontología de la Universidad Federal de Juiz de Fora - Brasil

ABSTRACT: Gingival recessions are characterized by partial denudation of the root surface due to apical displacement of the gingival margin from the amelocemental junction and may be localized or generalized. The aim of this study was evaluate the prevalence of gingival recession and dentine hypersensitivity of dental students of Federal University of Juiz de Fora, Brazil. Were examined 80 students with on average age of 22.9, randomly selected to assess the prevalence, level of gingival recession and the presence of dentinal hypersensitivity. Fifty students had at least one gingival recession and dentine hypersensitivity was observed in 28 students. Buccal surface was the most prevalent (86.6 %), with measures mostly between 1 and 2 mm (92 %) and classified as Class I Miller (96.25 %). The pre-molars were the group most frequently affected teeth (37.35 %). Gingival recession with small measures is a very common condition in young patients.

RESUMEN: Las recesiones gingivales se caracterizan por una denudación parcial de la superficie radicular debido al desplazamiento apical del margen gingival, desde la unión amelocemental y puede ser localizada o generalizada. El objetivo de este estudio fue evaluar la prevalencia de la recesión gingival y la hipersensibilidad dentinaria en estudiantes de Odontología de la Universidad Federal de Juiz de Fora, Brasil. Se examinaron 80 estudiantes con una edad promedio de 22,9, seleccionados al azar para evaluar la prevalencia, el nivel de recesión gingival y la presencia de hipersensibilidad dentinal. En cincuenta estudiantes se observó al menos una recesión gingival y se reportó hipersensibilidad a la dentina en 28 estudiantes. La superficie oral fue la más prevalente (86,6 %), con medidas principalmente entre 1 y 2 mm (92 %) y clasificada como Clase I Miller (96,25 %). Los premolares fueron el grupo de dientes afectados con mayor frecuencia (37,35 %). La recesión gingival con medidas pequeñas es una condición muy común en pacientes jóvenes.

Treatment of peri-implant soft tissue defects: a narrative review

Abstract Soft tissue defects around dental implants, such as papilla or volume loss, peri-implant recession and alterations of the ridge color and/or texture, lead to esthetic and functional complaints. Treatments of these defects in implants are more demanding than in teeth because peri-implant tissue exhibits different anatomical and histological characteristics. This narrative review discusses the proposed treatments for soft tissue defects around implants in the current literature. Several clinical and pre-clinical studies addressed methods to augment the quantity of the peri-implant keratinized mucosa. Autogenous grafts performed better than soft tissue substitutes in the treatment of soft tissue defects, but there is no clinical consensus on the more appropriate donor area for connective tissue grafts. Treatment for facial volume loss, alterations on the mucosa color or texture and shallow peri-implant recessions are more predictable than deep recessions and sites that present loss of papilla. Correction of peri-implant soft tissue defects may be challenging, especially in areas that exhibit larger defects and interproximal loss. Therefore, the regeneration of soft and hard tissues during implant treatment is important to prevent the occurrence of these alterations.

Periodontal clinical evaluation before and after surgically assisted rapid maxillary expansion

ABSTRACT Introduction: The surgically assisted rapid maxillary expansion is a procedure that reduces the resistance of the sutures correcting the posterior crossbite in adults. Objective: The aim of this study was to evaluate the periodontal status of 17 adults submitted to this procedure. Methods: The clinical attachment level (CAL), gingival recession, attached gingiva and bleeding were evaluated in maxillary first premolars and molars, central and lateral incisors of right and left sides before surgery, 5 days and 6 months after. Means, standard deviation, medians, minimum and maximum values were compared among the evaluations using the Friedman and McNemar tests. Results: There was a statistically significant increase in CAL in the right central incisor, right and left premolars and right and left molars. There was a statistically significant increase in gingival recession in the right and left premolars and molars. The amount of attached gingiva significantly decreased in right premolars and right and left molars. There was increase in bleeding in most of the teeth. Conclusion: Results indicated that the surgically assisted rapid maxillary expansion might cause alterations in periodontal tissue.

RESUMO Introdução: a expansão rápida da maxila assistida cirurgicamente (ERMAC) é um procedimento que reduz a resistência das suturas, corrigindo a mordida cruzada posterior em adultos. Objetivo: o objetivo deste estudo foi avaliar o status periodontal de 17 adultos submetidos a esse procedimento. Métodos: o nível clínico de inserção (NCI), a recessão gengival, gengiva inserida e sangramento foram avaliados nos primeiros pré-molares, molares, incisivos centrais e laterais superiores dos lados direito e esquerdo antes da cirurgia, e depois de 5 dias e 6 meses. Médias, desvios-padrão, medianas, valores mínimos e máximos foram comparados entre as avaliações, usando os testes de Friedman e McNemar. Resultados: houve aumento estatisticamente significativo no NCI no incisivo central direito, pré-molares direito e esquerdo e molares direito e esquerdo. Houve aumento estatisticamente significativo na recessão gengival nos pré-molares e nos molares direito e esquerdo. A quantidade de gengiva inserida diminuiu significativamente nos pré-molares direitos e molares direitos e esquerdos. Houve aumento no sangramento na maioria dos dentes. Conclusão: os resultados indicaram que a ERMAC pode causar alterações no tecido periodontal.

Relación entre frenillos labiales y periodonto en una población peruana / Relationship between labial frenulum and periodontium in a Peruvian population

RESUMEN: Los frenillos aberrantes están incluidos dentro de las deformidades mucogingivales, y estas pueden alterar la función y la estética del periodonto de protección. Este estudio tuvo como objetivo evaluar la inserción de los frenillos labiales y establecer una relación con la pérdida papilar y recesión gingival a nivel de los dientes anterosuperiores y anteroinferiores. Materiales y métodos Estudio transversal que evaluó a 97 pacientes sistémicamente sanos en los cuales se evaluó el tipo de frenillo (TF), la altura del frenillo (AF), el tipo de recesión gingival y la pérdida papilar al nivel de los sectores anteriores maxilar y mandibular. Resultados El TF más prevalente fue el mucoso, con un 54,6% y 93,8% de prevalencia a nivel maxilar y de la mandíbula respectivamente; la AF promedio fue de 8,37mm ± 2,671mm para el frenillo labial maxilar y 8,33mm ± 1,657mm para el frenillo labial mandibular. No se encontraron relaciones entre el TF, la AF con la presencia y severidad de pérdida papilar y recesión gingival al nivel de los incisivos centrales (p>0,05). Conclusión El frenillo más común de la población estudiada fue el frenillo mucoso, no existiendo una relación directa entre su clasificación e inserción con la presencia de una recesión gingival o pérdida papilar.

ABSTRACT: Aberrant frenums are included within the mucogingival deformities, which can alter the function and aesthetic periodontal protection. This study aimed to evaluate the adherence of labial frenulum and establish a relationship with papillary loss and gingival recession of the anterior teeth in maxilla and in the jaw. Materials and methods A cross-sectional study was conducted on 97 systemically healthy patients in whom the type of frenulum (TF), the height of the frenulum (AF), the type of gingival recession, and papillary loss was evaluated in the upper maxillary and mandibular sectors. Results The most prevalent frenum was the mucosal. The prevalence of TF was 54.6% and 93.8% of maxilla and mandible, respectively. The mean AF was 8.37mm ± 2.671mm for the labial frenulum in maxillary, and 8.33mm ± 1.657mm for frenulum. No relationship was found between the TF, AF with the presence and severity of papillary loss and gingival recession (P>.05). Conclusion The most common frenulum of the study population was the mucosal frenulum. There was no direct relationship between the classification and adherence of the frenulum with the presence of gingival recession or papillary loss.

Retalho reposicionado coronalmente com a finalidade de recobrimento radicular / Coronally advanced flap with the purpose of root coverage

Introdução: a recessão gengival é caracterizada pelo desnudamento parcial da superfície radicular decorrente da migração apical da gengiva marginal e pela degradação do mecanismo de inserção gengival sobre o elemento dentário. Objetivo: descrever um caso clínico de retalho reposicionado coronalmente com a finalidade de recobrimento radicular em paciente que apresentava recessão gengival Classe I de Miller nos elementos dentários 23 e 24. Materiais e Métodos: O presente estudo contou com a participação de um paciente que queixava-se de hipersensibilidade dentinária, quando aplicado o estímulo térmico, e de insatisfação estética devido à exposição radicular visível ao sorrir e durante o ato de conversação. Foi traçado um plano de tratamento para o recobrimento radicular através de cirurgia de retalho reposicionado de forma coronal, seguido de encaminhamento para a realização de tratamento ortodôntico, já que o paciente possuía oclusão traumática na região acometida pela recessão gengival, decorrente da presença de contato prematuro. Resultados e Discussão: com a técnica empregada, foi possível restabelecer a normalidade estética, prevenir o acúmulo de biofilme dental, devido à maior facilidade de higienização da região cervical, permitindo também a redução da hipersensibilidade dentinária, anteriormente relatada pelo paciente. Conclusão: a técnica cirúrgica de retalho coronal, utilizada para a resolução deste caso, mostrou-se uma eficiente forma de tratamento, pois apresentou resultados satisfatórios levando-se em consideração a previsibilidade de recobrimento da superfície radicular para esta técnica, que é de 70 a 99% da área exposta, devolvendo assim, função ao elemento tratado. (AU)

Introduction: the gingival recession is characterized by the partial denudation of the root surface resulting from the apical migration of the marginal gingiva and by the degradation of the gingival insertion mechanism on the dental element. Objective: we present a clinical report of a coronally advanced flap with the purpose of root coverage in a patient who presented gingival recession Miller Class I in the elements 23 and 24. Material and Method: the patient complained of dental hipersensibility when a thermal stimulus was applied and also a aesthetics dissatisfaction due to a visible root exposure to smile and during the act of conservation. A treatment plan was traced for the root coverage by a coronally repositioned flat, followed by a orthodontic treatment due to premature contact. Results: with the technique employed, it was possible to restore aesthetic normality, to prevent the accumulation of dental biofilm due to an ease of cleaning the cervical region, also allowing the reduction of dental hipersensibility, previously reported by the patient. Conclusion: it's possible to claim that the surgical technique of coronal flap used to the resolution of this case is an efficient form of treatment taking into account the root surface coverage for this technique, which is of 70 to 99% of the exposure area, returning to the treated element its function. (AU)

The influence of primary occlusal trauma on the development of gingival recession / La influencia del trauma oclusal primario en el desarrollo de la recesión gingival

This study aimed to histometrically evaluate the presence of gingival recession in the mesial surface of the teeth of rats experimentally subjected to primary occlusal trauma. This evaluation verified the distance from the cement-enamel junction (CEJ) to the free marginal gingiva (FMG) and to the height of the alveolar bone crest (CEJ-crest bone distance). There were 10 animals, randomly divided into 2 groups: occlusal trauma (OT) (n = 5) - creation of an occlusal interference by fixing an orthodontic wire segment on the mandibular first molar occlusal face, which was randomly chosen, and a Control Group (CG) (n = 5) - five animals with no exposure to the OT variable were euthanised after 14 days to obtain the initial parameters. The inter-group evaluation showed there was no significant difference between OT × CG when the CEJ-FGM distance (P = 0.192) was evaluated after 14 days, but there was a significant difference between the two groups as regards the CEJ-alveolar crest bone distance (P = 0.0142). Thus, it can be concluded that the OT induction model, after 14 days of experiment, promoted bone resorption. This was observed by the increase in the CEJ-alveolar crest bone distance. It also did not promote gingival recession, which was evaluated by the CEJ-FGM distance.

El objetivo de este estudio fue evaluar histométricamente en ratas la presencia de recesión gingival en la superficie mesial de los dientes sometidos experimentalmente a trauma oclusal primario a partir de la evaluación de la distancia desde la unión esmalte cemento (CEJ) a la encía marginal libre y la altura de la cresta ósea restante (distancia de la CEJ-cresta ósea) Con este fin, 10 animales fueron divididos al azar en 2 grupos: trauma oclusal (TO) (n = 5) - creación de una interferencia oclusal mediante la fijación de un segmento de alambre de ortodoncia en la superficie oclusal del primer molar elegido al azar; y un grupo control (CO) (n = 5) -5 animales sin la introducción de la variable TO fueron sometidos a eutanasia después de 14 días para obtener los parámetros iniciales. La evaluación intergrupo no mostró diferencias significativas entre los grupos TO × CO al evaluar después de 14 días la distancia de la CEJ-encía marginal libre (p = 0,192) pero mostró una diferencia significativa entre los grupos TO × CO en cuanto a distancia de la CEJ-cresta ósea alveolar (p = 0,0142). Por lo tanto, se concluye que el modelo de inducción del TO después de 14 días del experimento promueve reabsorción ósea siendo observado por el aumento en la distancia de la CEJ-cresta ósea alveolar y no promueve la recesión gingival evaluada a partir de la distancia de la CEJ-encía marginal.

Checklist dos possíveis fatores que afetam a recessão gengival vestibular em implantes imediatos / Factors that can affect the labial gingival recession at immediate dental implants: a checklist proposal

O objetivo desse artigo foi realizar uma revisão da literatura sobre os fatores que interferem nas alterações da margem vestibular de tecido mole em sítios unitários onde foram instalados implantes imediatos. Foi realizado um levantamento utilizando a base de dados PubMed, de 2006 a 2016. Vários fatores parecem interferir na modificação do nível de tecido mole marginal vestibular após a instalação de implantes imediatos. Embora nenhum fator, isoladamente, pareça ser determinante no resultado estético final, a necessidade de uma parede óssea intacta, um bom posicionamento tridimensional do implante e um biotipo espesso parece contribuir para prevenção e/ou menor recessão da margem gengival.

The purpose of this article was conduct a literature review on the factors that can interfere with changes in the labial margin of single-tooth soft tissue sites receiving immediate dental implants. For this, an electronic search was performed at the PubMed site from 2006 to 2016. Several factors seem to interfere with the labial soft tissue margins after immedia te implants. Although no single factor alone appears to be determining for the aesthetic result, the need for an intact bone wall, a good three-dimensional implant position, and a thick biotype appears to contribute for prevention and/or minor recession at the gingival margins.

Gingival recession: its causes and types, and the importance of orthodontic treatment

abstract Gingival recession has direct causes and predisposing factors. Orthodontic treatment is able to prevent recession and even contribute to its treatment, with or without periodontal approach, depending on the type and severity of gingival tissue damage. There is no evidence on the fact that orthodontic treatment alone might induce gingival recession, although it might lead the affected teeth (usually mandibular incisors or maxillary canines) to be involved in situations that act as predisposing factors, allowing direct causes to act and, therefore, trigger recession, especially when the buccal bone plate is very thin or presents with dehiscence. Several aspects regarding the relationship between orthodontic treatment and gingival recession have been addressed, and so has the importance of the periosteum to the mechanism of gingival recession formation. Clinical as well as experimental trials on the subject would help to clarify this matter, of which understanding is not very deep in the related literature.

Resumo As recessões gengivais têm causas diretas e fatores predisponentes. O tratamento ortodôntico pode prevenir as recessões e, até, contribuir para o seu tratamento, com ou sem uma abordagem por parte do periodontista, dependendo do tipo e da severidade do comprometimento dos tecidos gengivais. Não há evidências de que o tratamento ortodôntico possa induzir, de forma primária, as recessões gengivais, muito embora possa levar os dentes envolvidos (comumente, os incisivos inferiores e os caninos superiores) a situações que ajam como fatores predisponentes para que as causas diretas possam atuar e produzir recessões - em especial, quando deixa-se uma tábua óssea vestibular muito fina ou, até, com deiscência. Vários aspectos da relação entre o tratamento ortodôntico e as recessões gengivais já foram abordados, assim como a importância do periósteo no mecanismo de formação delas. Trabalhos clínicos e experimentais sobre o assunto ajudariam a esclarecer o assunto, que ainda se apresenta muito pouco aprofundado na literatura pertinente.

Etiologia e tratamento cirúrgico das recessões gengivais / Etiology and surgical treatment of gingival recessions

A migração apical da margem gengival com exposição da superfície radicular é denominada recessão gengival, possui alta prevalência na população e aumenta em quantidade e severidade com o passar dos anos. O tratamento desta alteração pode ser necessário, já que o paciente pode apresentar lesões cervicais cariosas ou não cariosas, hipersensibilidade dentinária cervical, controle inadequado de biofilme, perda de inserção periodontal progressiva e queixas estéticas. Existem diversas possibilidades de técnicas cirúrgicas para o tratamento da recessão gengival, e a combinação que mostra resultados mais favoráveis é a realização de um retalho posicionado coronalmente e um enxerto de tecido conjuntivo subepitelial. O objetivo deste artigo foi realizar uma revisão da literatura e apresentar um caso clínico acerca da etiologia, prognóstico e tratamento cirúrgico da recessão gengival.

Gingival recession is defi ned by the apical migration of the gingival margin exposing the root surface. This alteration presents a high prevalence in the population and increases in number and severity along the years. The treatment of this condition may be necessary since the patient may present carious or non-carious cervical lesions, cervical dentinal hypersensitivity, inadequate plaque control, progressive periodontal attachment loss and aesthetic complaints. There are several surgical techniques to treat gingival recessions and the procedure that shows more favorable results is the combination of a coronally positioned flap and a subepithelial connective tissue graft. The aim of this article is to review the literature and present a clinical case about the etiology, prognosis, and surgical treatment of gingival recession.

Combined effect of end-rounded versus tapered bristles and a dentifrice on plaque removal and gingival abrasion

Abstract Two previous clinical studies evaluated the effect of end-rounded versus tapered bristles of soft manual brushes on the removal of plaque and gingival abrasion. However, the combined effect of an abrasive dentifrice on these outcomes has yet to be understood. The purpose of the present study was to compare the incidence of gingival abrasion and the degree of plaque removal obtained after the use of toothbrushes with tapered or end-rounded bristles in the presence or absence of an abrasive dentifrice. The study involved a randomized, single-blind, crossover model (n = 39) with a split-mouth design. Subjects were instructed to refrain from performing oral hygiene procedures for 72 hours. Quadrants were randomized and subjects brushed with both types of toothbrushes using a dentifrice (relative dentin abrasion = ± 160). Plaque and gingival abrasion were assessed before and after brushing. After 7 days, the experiment was repeated without the dentifrice. The average reduction in plaque scores and the average increase in the number of abrasion sites were assessed by repeated-measures ANOVA and Bonferroni's post-hoc tests. End-rounded bristles removed significantly more plaque than tapered bristles, regardless of the use of a dentifrice. The dentifrice did not improve plaque removal. In the marginal area (cervical free gingiva), no difference in the incidence of gingival abrasion was detected between toothbrush types when used with a dentifrice (p ≥ 0.05). However, the dentifrice increased the incidence of abrasion (p < 0.001), irrespective of the toothbrush type tested. End-rounded bristles therefore removed plaque more effectively without causing a higher incidence of gingival abrasion when compared with tapered bristles. An abrasive dentifrice can increase the incidence of abrasion, and should be used with caution by individuals who are at risk of developing gingival recession.

Association between post-orthodontic treatment gingival margin alterations and symphysis dimensions

Sabe-se que o tratamento ortodôntico está associado com odesenvolvimento de recessão gengival. Vários fatores podemestar envolvidos na cadeia causal deste desfecho, incluindoaspectos anatômicos e comportamentais. Dentre os aspectosanatômicos, as dimensões da sínfise mandibular poderia terum papel predisponente. O presente estudo avaliou a relaçãoentre as dimensões da sínfise mandibular prévias ao tratamentoortodôntico e o desenvolvimento de recessões gengivais nosincisivos e caninos inferiores. Prontuários de 189 adolescentestratados ortodonticamente foram avaliados, incluindo radiografias,modelos e fotografias intra-orais. Dimensões dasínfise foram determinadas em cefalogramas. Alterações damargem gengival foram observadas em fotografias e modelos.Associações entre alterações da margem gengival e dimensõesda sínfise foram testadas por qui-quadrado (α=0.05). A ocorrênciade recessão gengival aumentou após tratamentoortodôntico. Não foi observada associação entre as medidasmédias de sínfise e a ocorrência de recessões gengivais. Podeseconcluir que as dimensões da sínfise pré-tratamentoortodôntico não podem ser usadas como preditores de recessãogengival pós-tratamento ortodôntico...

Orthodontic therapy is known to be associated with the developmentof gingival recession. Several factors may be involved in thecausal chain of this outcome, including anatomical and behavioralaspects. Among the anatomical aspects, the dimensions ofthe mandibular symphysis could play a predisposing role. Thisstudy evaluated the relationship between the mandibular symphysisdimensions prior to orthodontic therapy and the developmentof gingival recessions on the lower incisors and cuspids. Recordsfrom 189 orthodontically treated adolescents were evaluated,including radiographs, casts and intra-oral photographs. Symphysisdimensions were assessed by cephalograms. Gingival marginalterations were determined in photographs and cast models.Association between gingival margin alterations and symphysisdimensions was tested by chi-square (α=0.05). Occurrenceof gingival recession increased after orthodontic therapy. No associationwas observed on average of symphysis dimensions and theoccurrence of gingival recessions. It may be concluded that pretreatmentsymphysis dimensions may not be used as predictors ofgingival recession after orthodontic therapy...

Restauração de lesões cervicais nao cariosas utilizando resinas compostas que mimetizam os tecidos gengivais / Restoration of non-carious cervical lesions using composites that mimic the gingival tissues

A recessão gengival é a migração apical da margem gengival em relação à junção cemento-esmalte (JCE), que torna o sorriso menos atraente. Várias técnicas de cirurgia periodontal são indicadas como tratamento, no entanto, pacientes que rejeitam a opção de cirurgia podem ter a solução por meio do recobrimento radicular com resinas compostas que mimetizam os tecidos gengivais

Gingival recession is the apical migration of the gingival margin in relation to the cement-enamel junction (CEJ), which makes the smile less attractive. Various periodontal surgery techniques are indicated as treatment, however, patients who rejected the option of surgery, may have the solution through roots filling with composite resins that mimic the gingival tissues

Oral piercing and its complications in two Serbian youths a case report and review of the literature / El piercing oral y sus complicaciones en dos jóvenes de Serbia reporte de caso y revisión de la literatura

OBJECTIVE: Historically, wearing adornments on pierced body parts has been associated with many cultures as manifestations of religious or cultural identities. Currently, its use has a broad acceptance among young people. In the oral cavity, the most common sites for piercings are the tongue and lower lip. RESULTS: Pain, swelling and infection are the most serious consequences associated with this procedure. Several complications may be associated with this practice with the most frequently observed being halitosis, periodontitis, tooth fracture, glossitis, and the formation of abscesses. Other adverse outcomes include mucosal or gingival trauma, increased salivary flow, and interference with speech, mastication and swallowing. CONCLUSION: This article presents case reports on lip and tongue piercings and literature review highlights of this procedure. Special attention is given to complications and dental implications associated with such a practice.

OBJETIVO: Históricamente, el llevar adornos en partes del cuerpo perforadas ha sido asociado en muchas culturas como manifestaciones de identidades religiosas o culturales. Actualmente, su uso tiene amplia aceptación entre los jóvenes. En la cavidad oral, los sitios más comunes para el piercing son la lengua y el labio inferior. RESULTADOS: Dolor, inflamación e infección son las consecuencias más serias asociadas con este procedimiento. Varias complicaciones pueden asociarse con esta práctica, siendo la halitosis, la periodontitis, la fractura de dientes, la glositis, y la formación de abscesos, las más frecuentemente observadas. Otros resultados adversos incluyen traumas de la mucosa y la encía, aumento del flujo salival, e interferencia con la articulación del habla, la masticación, y la deglución. CONCLUSIÓN: Este artículo presenta reportes de caso de piercing del labio y la lengua, y resalta aspectos de este procedimiento como parte de una revisión de la literatura. Se presta especial atención a las complicaciones y las implicaciones dentales asociadas con tal práctica.

Condición periodontal de las prótesis fijas singulares realizadas en la Clínica Odontológica Integral del Adulto de la Universidad Mayor de Temuco / Periodiontal condition of fixed single prostheses made at Integral Adult Dental Clinic of the Universidad Mayor in Temuco

El objetivo de esta investigación fue determinar la condición periodontal en prótesis fijas singulares (PFS) realizadas en la clínica odontológica Integral del Adulto I y II de la Universidad Mayor de Temuco entre los años 2007 y 2009. Se evaluaron 73 PFS mediante un examen clínico, realizadas en 41 pacientes. Se analizaron las variables: edad, sexo, pieza dentaria, año de atención, año académico en que se realizaron las PFS, material de las prótesis fijas; los parámetros periodontales evaluados en este estudio fueron edema y eritema, sangramiento y recesión gingival. La frecuencia de edema y eritema fue de 81 por ciento, el sangramiento lo encontramos en un 77 por ciento y la recesión gingival en un 27 por ciento. Las mujeres presentaron mayores problemas de los tejidos periodontales con un 85 por ciento de edema y eritema y un 81 por ciento de sangramiento. Las PFS realizadas en el 4to año académico presentaron un 55 por ciento de recesión gingival y las realizadas en el 5to año mostraron un 17 por ciento. En relación al año de atención en el que se realizaron las rehabilitaciones, las PFS realizadas en el año 2007 presentaron un 100 por ciento de inflamación, mientras que en los otros años (2008 y 2009) las PFS presentaron menos daño a nivel gingival. Las piezas más afectadas según la ubicación en la boca, fueron las posteriores con un 84 por ciento de edema y eritema. Respecto al material, las PFS que presentaron más problemas de edema y eritema fueron las de metal cerámica con un 82 por ciento. Del total de los 41 pacientes observados, la mayoría estaban satisfechos con su rehabilitación. Finalmente se puede concluir que no existió evidencia estadísticamente significativa para concluir que existe una asociación entre las variables edad, sexo, año de atención y las variables edema y eritema, sangramiento y recesión gingival. En cambio, si se encontró evidencia estadísticamente significativa entre el cuarto y quinto año académico/ durante el tiempo/...

The aim of this study was to determine the periodontal condition in fixed single prostheses made at Integral Adult Dental Clinic I and II of the Universidad Mayor in Temuco, between the years 2007 and 2009. Seventy-three fixed single prostheses were evaluated by clinical examination, made in 41 patients. Variables were analyzed: age, sex, tooth, year of care, year in which the fixed single prostheses were made, fixed single prostheses material; periodontal parameters evaluated in this study were edema and erythema, bleeding and gingival recession. Edema and erythema's frequency were 81 percent, bleeding in 77 percent and gingival recession in 27 percent. Women presented major problems in periodontal tissues with 85 percent of edema and erythema and 81 percent of bleeding. Fixed single prostheses made in 4th year showed 55 percent of gingival recession and the ones that were made in 5th year showed 17 percent. In relation to the year of care in which the rehabilitations were made, the fixed single prostheses made in 2007 showed 100 percent of inflammation, while in the other years (2008 and 2009) the fixed single prostheses showed less damage at gingival level. The most affected teeth according to the location in the mouth were the back ones with 84 percent of edema and erythema. Regarding material, the fixed single prostheses that showed more edema and erythema problems were the metal-ceramics with 82 percent. Of the total of the 41 patients observed, the majority was satisfied with their rehabilitation. Finally we can conclude that there was no statistically significant evidence to conclude that there is an association between the variables age, sex, year of care and the variables edema and erythema, bleeding and gingival recession. In contrast, if found statistically significant evidence between the 4th and 5th year/ during the time/ years in which the fixed single prostheses and the gingival recession were made.

Complicações decorrentes da utilização do piercing bucal: avaliação e conduta clínica / Complications due use of oral piercing: clinical evaluation and management

Objetivo: apresentar três casos clínicos de pacientes portadores de piercing bucal, nos quais foram motivados a remover os adornos e, quando não admitiram a remoção, foram orientados preventivamente para evitar maiores complicações. Descrição do caso: a conduta do Cirurgião-dentista frente ao paciente portador do piercing na cavidade bucal foi descrita. O estudo ainda enalteceu a importância da intervenção do Cirurgião-dentista no esclarecimento dos possíveis prejuízos à saúde ocasionados pelo piercing bucal. Conclusão: o Cirurgião-dentista e particularmente o periodontista desempenham papel relevante na orientação evitando a instalação do piercing bucal, ou na recomendação de cuidados quando o paciente não aceita a remoção do adorno.

Aim: present 3 clinical cases of patients with oral piercing, who was guided to remove the ornaments, and when the patient did not admit the piercing removal, the patient was preventively warned to avoid more complications. Case description: the dentist management on the patient with oral piercing was described. This study also enhances the importance of the dentist intervention in the explanation of possible health injury occasioned by oral piercing. Conclusion: the dentist and particularly the periodontist play relevant role in guiding avoiding the installation of oral piercing, or the recommendation of care when the patient does not accept the removal of adornment.

Injerto de tejido conjuntivo sub-epitelial para el tratamiento de recesiones gingivales: reporte de caso clínico / Graft sub-epithelial tissue for the treatment of gingival recession: case report

El tratamiento de recesiones gingivales atrae un gran interés no solo para los odontólogos sino de pacientes, los cuales muestran gran preocupación, principalmente al factor estético asociado a esta condición. Diversas técnicas han sido propuestas para la obtención del recubrimiento radicular, entre ellas, el injerto de tejido conjuntivo sub - epitelial, el cual se convirtió en una de las formas mas difundidas entre los periodoncistas. El grado de recubrimiento es muy relativo, variando principalmente de acuerdo con las características clínicas y el grado de experiencia y destreza manual del cirujano. Entre las ventajas asociadas a esta técnica resaltamos la previsivilidad de la técnica y la estética obtenida

The treatment of gingival recessions has been attracted interest from both the dental practice as well as patients concerned mainly with the aesthetic factor associated with this condition. A variety of techniques have been offered to obtain root recovering. One of them, the subepithelial grafting of connective tissue became one of the tools most prevalent among the periodontists. The quantity of recovery is relative, depending mainly of the clinical aspects and the experience and manual dexterity of the surgeon. Among the advantages related to this technique, the predictably of the technique and the aesthetic reached are emphasized

Aspectos microbiológicos, histopatológicos e clínicos da cárie radicular / Microbiology, histopathology and clinical aspects of human root caries

O avanço científico da Odontologia e um maior acesso ao tratamento odontológico fizeram com que o número de pacientes com idade avançada, ainda portadores de dentições naturais, aumentasse. Assim, aumentou também a quantidade de superfícies radiculares expostas, seja por processos fisiológicos, patológicos ou terapêuticos, tornando estas superfícies mais susceptíveis e vulneráveis ao processo de cárie. Este estudo teve como objetivo revisar as características microbiológicas, histopatológicas e clínicas das lesões de cárie radicular. Os estudos revisados apontaram que, dentre os fatores etiológicos dessa patologia, destaca-se a ação do Streptococcus mutans. Contudo, o microrganismo não é o único responsável pelo aparecimento das lesões. A falta de higiene oral, assim como a presença de dieta rica em carboidratos fermentáveis contribui para o desenvolvimento e progressão das cáries de raiz. O tratamento destas lesões é realizado de acordo com a severidade destas, variando desde aplicação de flúor em cáries incipientes, até em restaurações estéticas nos casos mais avançados. Novos estudos, clínicos e laboratoriais, são necessários para se avaliar a longevidade dos tratamentos propostos, principalmente o restaurador.

This study reviewed the microbiological, histopathological and clinical aspects of root caries. Dental caries is one of the most significant health problems facing older adults. More than half of the elderly who are dentate are affected with either coronal or root caries, and caries is the primary cause of tooth loss in this population. However, age per se is not considered to be the main reason for caries development on root surfaces. The same main factors as for coronal caries, ie, cariogenic microorganisms, diet and saliva seem to play important roles in root caries development. Due to different anatomy, histology, and chemical composition of the tissues, there may be a higher risk of caries development on root surfaces than on coronal surfaces. In treatment of root surface caries, a causative treatment strategy should be determined. Prevention should focus on oral hygiene, fluoride exposure, and restriction of intake frequency of foods containing sugars or other easily fermentable carbohydrates. When a more invasive treatment is necessary, caries are removed and the cavities are restored with glass ionomer cement or with flowable composites, where aesthetics procedures become indispensable. New materials and techniques are emerging to help with geriatric preventive and restorative needs.

Uso de piercing na língua como fator etiológico incomum de recessões gengivais / Tongue piercing as an unusual etiologic factor for gingival recessions

O uso de adornos em partes não convencionais do corpo incluindo a cavidade oral, é conhecido como body art. Essa antiga prática indígena retornou aos padrões da moda tanto no Brasil quanto em todo o mundo e, apesar de apresentar um contexto social e comportamental, o uso do piercing pode ser perigoso. Inúmeros problemas podem ocorrer devido ao uso nas regiões intra e peribucal, entre elas: fratura e desgaste dentários, trincas de esmalte, dor, dificuldade na fala, mastigação e deglutição, hipersalivação, infecção e recessão gengival. E ainda, complicações mais graves como hemorragia, aspiração do piercing com obstrução de vias aéreas e bacteremia seguida de morte já foram relatadas na literatura. O presente artigo descreve um caso de recessões múltiplas na face lingual de dentes inferiores causadas pelo uso prolongado de piercing na língua. O paciente havia removido o metal dois meses antes do exame periodontal, o que dificultou a obtenção do diagnóstico final, que foi definido após exame intrabucal acurado e análise comportamental detalhada. Como essa prática tem se tornado cada vez mais comum, os cirurgiões-dentistas devem estar alertas sobre o uso de piercing na região bucal e peribucal, conhecer os riscos e aconselhar seus pacientes sobre cuidados, manutenção e possíveis lesões decorrentes do uso dessas bijuterias. Além disso, o uso de piercing deve sempre ser levado em consideração como fator etiológico de lesões dentárias e de tecidos moles da boca como a recessão gengival.

The wearing of jewelry in unconventional parts of the body including oral cavity is known as body art. This practice is a fashion nowadays all over the world. Despite all the social and behavioral reasons for the use of a piercing, it can be harmful. In general the complications of using an intraoral piercing are tooth fracture, chipping tooth, pain, speech, mastication and deglution difficulties, hypersalivation, infection, gingival recession. Moreover, emergency situations such as hemorrhage, collapse, jewelry aspiration and airway obstruction may occur. This paper describes an unusual case of multiple mandibular lingual recessions caused by a prolonged use of a tongue piercing. Since the patient had removed the piercing two months before, the final diagnosis was obtained by an accurate intraoral exam and detailed behavioral history. As this practice is becoming more popular, dentists should be aware of this problem and know how to advise the patients about risks, care and maintenance of such appliances. Furthermore, the use of oral piercing must be remembered as an etiological factor and differential diagnosis for recessions and tooth fracture.