Association of rs142548867 (EEFSEC) and periodontitis Grade C in a young Brazilian population

Abstract Periodontitis Stage III-IV, Grade C (PerioC) is a severe form of Periodontitis. The individual genetic background has been shown to be an important etiopathogenic factor for the development of this disease in young, systemically healthy, and non-smokers patients. Recently, after exome sequencing of families with a history of the disease, PerioC was associated with three single nucleotide variations (SNVs) - rs142548867 (EEFSEC), rs574301770 (ZNF136), and rs72821893 (KRT25) - which were classified as deleterious or possibly harmful by prediction algorithms. Objective Seeking to validate these findings in a cohort evaluation, this study aims to characterize the allele and genotypic frequency of the SNVs rs142548867, rs574301770, and rs72821893 in the Brazilian population with PerioC and who were periodontally healthy (PH). Methodology Thus, epithelial oral cells from 200 PerioC and 196 PH patients were harvested at three distinct centers at the Brazilian Southern region, their DNA were extracted, and the SNVs rs142548867, rs574301770, rs72821893 were genotyped using 5′-nuclease allelic discrimination assay. Differences in allele and genotype frequencies were analyzed using Fisher's Exact Test. Only the SNV rs142548867 (C > T) was associated with PerioC. Results The CT genotype was detected more frequently in patients with PerioC when compared with PH subjects (6% and 0.5% respectively), being significantly associated with PerioC (odds ratio 11.76, p=0.02). Conclusion rs142548867 represents a potential risk for the occurrence of this disease in the Brazilian population.

Influence of rs6667202 SNP on Interleukin-10 levels in the gingival fluid of patients with periodontitis grade C

Grade C periodontitis in youngers is characterized by a severe form of periodontitis, and IL10 rs6667202 single nucleotide polymorphism (SNP) has been described as an important feature in this disease etiology. Aim: This study aimed to evaluate, in vivo, the functionality of IL10 rs6667202 SNP on IL-10 gingival fluid levels. Methods: Thirty patients with Perio4C were selected, 15 with the IL10 AA genotype (rs6667202) and 15 with AC/CC genotypes. The gingival fluid was collected from two sites with probing depth ≥ 7 mm and bleeding on probing, and two healthy sites. The IL-10 concentration was determined by Luminex/MAGpix platform. Results: In deep pockets, the IL10 AA genotype presented a lower concentration of IL-10 when compared with AC or CC genotypes (p<0.05). In shallow pockets, no difference between groups was seen (p>0.05). Conclusion: IL10 rs6667202 SNP decreases the production of IL-10 in crevicular fluid, potentially affecting this disease progression

Rethinking the decision-making process to treat gingival recession associated with non-carious cervical lesions

Abstract The presence of a tooth-surface defect, such as a non-carious cervical lesion (NCCL), associated with sites of gingival recession (GR) defects creates a combined soft tissue/tooth defect (CD) that requires a different treatment plan. This study aimed to critically review the literature regarding the available treatment protocols for CDs and suggest a new decision-making process. NCCLs were classified as Class A-: the cementoenamel junction (CEJ) was visible and the root surface discrepancy was < 0.5 mm (no step); Class A+: CEJ was visible and the root surface discrepancy was > 0.5 mm (with a step); Class B-: unidentifiable CEJ without a step; Class B+: unidentifiable CEJ with a step. NCCLs affecting both root and crown surfaces (Class B) lead to CEJ destruction and consequently eliminate an important landmark used before and after root coverage procedures. The depth of the root surface discrepancy is vital owing to its possible impact on soft tissue adaptation after healing, which, in turn, may influence the treatment options, namely the use of graft and/or composites to compensate for the discrepancy. Clinically, a step with horizontal depth greater than 0.5 mm should be recognized as the minimum threshold value to define this condition. Extremely deep defects tend to assume a V-shaped topography. Therefore, extremely deep V-shaped defects were classified into subclasses A+V, a V-shaped defect, and B+V, a V-shaped defect with loss of CEJ, for management considerations. The treatment options, supported by the literature, and a decision-making process to deal with each condition are presented.

Periodontal regeneration: is it still a goal in clinical periodontology?

Abstract In the last decades, Periodontal Regeneration has been one of the most discussed topics in Periodontics, attracting the attention of researchers and clinicians. This can be justified by the evident and continuous progress observed in the field, characterized by a better understanding of the biological mechanisms involved, significant improvement of operative and technical principles, and the emergence of a wide range of biomaterials available for this purpose. Together, these aspects put the theme much in evidence in the search for functional and esthetic therapeutic solutions for periodontal tissue destruction. Despite the evident evolution, periodontal regeneration may be challenging and require the clinician to carefully evaluate each case before making a therapeutic decision. With a critical reassessment of the clinical and preclinical literature, the present study aimed to discuss the topic to answer whether Periodontal Regeneration is still a goal in clinical periodontology. The main aspects involved in the probability of success or failure of regenerative approaches were considered. A greater focus was given to intrabony and furcation defects, clinical conditions with greater therapeutic predictability. Aspects such as more appropriate materials/approaches, long-term benefits and their justification for a higher initial cost were discussed for each condition. In general, deep intrabony defects associated with residual pockets and buccal/lingual class II furcation lesions have predictable and clinically relevant results. Careful selection of the case (based on patient and defect characteristics) and excellent maintenance are essential conditions to ensure initial and long-term success.

Transcriptome profile of highly osteoblastic/cementoblastic periodontal ligament cell clones

Abstract Heterogeneous cell populations of osteo/cementoblastic (O/C) or fibroblastic phenotypes constitute the periodontal dental ligament (PDL). A better understanding of these PDL cell subpopulations is essential to propose regenerative approaches based on a sound biological rationale. Objective Our study aimed to clarify the differential transcriptome profile of PDL cells poised to differentiate into the O/C cell lineage. Methodology To characterize periodontal-derived cells with distinct differentiation capacities, single-cell-derived clones were isolated from adult human PDL progenitor cells and their potential to differentiate into osteo/cementoblastic (O/C) phenotype (C-O clones) or fibroblastic phenotype (C-F clones) was assessed in vitro. The transcriptome profile of the clonal cell lines in standard medium cultivation was evaluated using next-generation sequencing technology (RNA-seq). Over 230 differentially expressed genes (DEG) were identified, in which C-O clones showed a higher number of upregulated genes (193) and 42 downregulated genes. Results The upregulated genes were associated with the Cadherin and Wnt signaling pathways as well as annotated biological processes, including "anatomical structure development" and "cell adhesion." Both transcriptome and RT-qPCR showed up-regulation of WNT2, WNT16, and WIF1 in C-O clones. Conclusions This comprehensive transcriptomic assessment of human PDL progenitor cells revealed that expression of transcripts related to the biological process "anatomical structure development," Cadherin signaling, and Wnt signaling can identify PDL cells with a higher potential to commit to the O/C phenotype. A better understanding of these pathways and their function in O/C differentiation will help to improve protocols for periodontal regenerative therapies.

Periodontal disease and associated factors in the adult and elderly population from Jundiaí City, Brazil

Aim: This study assessed the prevalence of periodontal disease in the adult and elderly populations from Jundiaí City, and its association with individual social inequalities in a conceptual framework approach. Methods: The survey was conducted with a sample of 342 adults and 145 elderly, and periodontal disease was assessed based on the Community Periodontal Index (CPI) and Clinical Attachment Loss (CAL). A questionnaire addressing socio-demographic and behavioral variables, smoking and diabetes was included. Bivariate and multivariate analyses, using binary regression analyses, were carried out in a hierarchical approach with conceptual framework to reveal association among periodontal disease and social-demographic, smoking and diabetes variables. Results: One adult and fifty-six elderly who had lost all teeth were excluded from the sample. Mild periodontal disease (CAL ≤3 mm) was the condition more prevalent in the adult (74%) and elderly populations (60.6%). Adjusted analysis revealed that low educational level (OR 2.65, 95% CI 1.19-5.88), irregular use of tooth floss (OR 1.9, 95% CI 1.06-3.40), and smoking (OR 2.14, 95% CI 1.04-4.42) were independently associated with moderate/severe periodontal disease (CAL and Probing Depth ≥4 mm) in the adult group. For the elderly group, low educational levels (OR 0.16, 95% CI 0.04-0.58), use of public dental service (OR 5.32, 95% CI 1.23-23.03), and diabetes condition (OR 3.78, 95% CI 1.20-11.91) were significantly associated with periodontal disease. Conclusion: In conclusion, the data showed that education level, smoking habits, diabetes, use of dental floss and type of dental service are factors associated to moderate/severe periodontal disease among Brazilians from Jundiaí City

Recessões gengivais associadas a lesões cervicais não cariosas: uma revisão sobre o tratamento multidisciplinar / Gingival recessions associated with non-carious cervical lesions: a review on the multidisciplinary treatment

Frequentemente, as recessões gengivais (RG) estão associadas a lesões cervicais não cariosas (LCNC), defi nidas como a perda de estrutura dentária ao longo da margem gengival do dente, com a distinta característica de presença de tecido duro mineralizado em contraste com o tecido carioso. A partir de um ponto de vista topográfi co, a LCNC pode envolver apenas a coroa do dente (esmalte e/ou dentina coronal) ou somente a superfície radicular (cemento e/ou dentina radicular), ou pode localizar-se tanto na coroa como na raiz exposta. As principais indicações para o tratamento da LCNC são: 1) estética; 2) hipersensibilidade dentinária; 3) desenvolvimento de cáries; 4) acúmulo de biofi lme. Os procedimentos envolvem o tratamento restaurador e/ou cirúrgico, a depender do tipo de LCNC. Quando a LCNC atinge apenas a coroa do dente, o tratamento restaurador é mais indicado, enquanto uma lesão confi nada à raiz pode ser tratada preferencialmente com cirurgia plástica periodontal. Porém, a realidade clínica é geralmente complexa, o que torna o tratamento combinado mais favorável para certos casos. Portanto, o objetivo desse artigo foi realizar uma revisão da literatura concernente ao tratamento de recessões gengivais associadas a lesões cervicais não cariosas.

Often, gingival recessions (GR) are associated with non-carious cervical lesions (NCCL), defi ned as the loss of tooth structure along the gingival margin of the tooth, with the distinctive feature of the presence of mineralized hard tissue, in contrast to the carious tissue. From a topographical point of view, NCCL may involve only the tooth crown (enamel and/or coronal dentin) or only the root surface (cementum and/or radicular dentin) or can be located both in the crown and exposed root. The main indications for the treatment of NCCL are: 1) aesthetic; 2) dentine hypersensitivity; 3) development of caries; 4) biofi lm formation. The procedures involve restorative treatment and/or surgery depending on the type of NCCL. When NCCL is located exclusively at the tooth crown, the restorative treatment is best suited while a lesion located at the root surface should be treated preferably with periodontal plastic surgery. However, clinical reality is often complex, which makes the combination treatment more favorable for some cases. Therefore, the aim of this article is to review the literature concerning the treatment of gingival recession associated with non-carious cervical lesions.

Mesenchymal stem cells in periodontics: new perspectives / Células mesenquimais indiferenciadas em periodontia: novas perspectivas

ABSTRACT Tissue engineering is a contemporary field of science, which aims to create conditions based on principles of cell and molecular biology, bioengineering and biomaterials to regenerate tissues. Mesenchymal stem cells present high proliferation rates and are able to differentiate into multilineages under certain conditions, suggesting that they have great potential to act in regeneration field. Tooth derived stem cells are a suitable alternative source of mesenchymal cells once they are easily accessible and have poor morbidity to the donor. Studies showed that they have been isolated and characterized from diverse tissues such as dental pulp, exfoliated deciduous teeth, periodontal ligament, gingiva, dental follicle and apical papilla. However studies show that there is heterogeneity among these populations and there is no standard method to select the most appropriate tooth derived stem cells for regenerative procedures. The aim of this review is to present the current perspective of the multiple types of tooth-derived stem cells and to discuss the basis for their use in periodontal tissue engineering.

RESUMO A engenharia de tecidos é um campo contemporâneo da ciência, que visa criar condições baseadas em princípios de biologia celular e molecular, bioengenharia e biomateriais para regenerar tecidos. As células tronco mesenquimais apresentam altas taxas de proliferação e são capazes de se diferenciar, sob certas condições, em multi-linhagens, sugerindo que elas têm grande potencial para atuar no campo da regeneração. As células tronco derivadas de tecidos dentais são uma fonte alternativa adequada de células mesenquimais uma vez que são de fácil acesso e têm baixa morbidade para o doador. Estudos demonstraram que elas já foram isoladas e caracterizadas a partir de diversos tecidos tais como polpa dentária, dentes decíduos esfoliados, ligamento periodontal, gengiva, folículo dental e papila apical. Entretanto, os estudos demonstram que há heterogeneidade entre essas populações e não existe um método padrão para selecionar as células-tronco dentais mais apropriadas para procedimentos regenerativos. O objetivo desta revisão é apresentar o conhecimento atual dos vários tipos de células-tronco derivadas de dentes e discutir as novas perspectivas para seu uso na engenharia de tecidos periodontais.

Nova abordagem no tratamento de recessões gengivais associadas à lesão cervical não cariosa / New approach in the treatment of gingival recessions associated with non-carious cervical lesion ­ case report

A recessão gengival está frequentemente associada à lesão cervical não cariosa (LCNC), originando uma lesão combinada que tem um prognóstico de tratamento diferente de quando as duas lesões se apresentam sozinhas. Tratamentos propostos possuem limitações, e o protocolo clínico ideal para o manejo dessas lesões ainda não foi estabelecido. Assim, o objetivo do presente relato de caso foi apresentar uma nova técnica cirúrgico-restauradora para o tratamento de recessões gengivais associadas à LCNC. Para tal, uma restauração parcial em resina composta foi realizada somente na parte coronal da lesão cervical. Em uma segunda sessão, o procedimento cirúrgico para recobrimento radicular com enxerto de tecido conjuntivo foi realizado. Seis meses após o procedimento, a paciente estava satisfeita com o resultado final alcançado, demonstrando que esse protocolo pode ser uma alternativa de tratamento aos protocolos existentes para o tratamento de recessões gengivais associadas à LCNC.

Gingival recession is often associated with non-carious cervical lesion (NCCL), resulting in a combined lesion which has a different treatment prognosis when the two lesions appear alone. Proposed treatments have limitations and the ideal clinical protocol for the management of these lesions has not been established. Thus, the aim of this case report is to present a new surgical-restorative technique for the treatment of gingival recessions associated with NCCL. For this, a composite resin partial restoration was performed only in the coronal part of the cervical lesion. In a second session, the surgical procedure for root coverage with connective tissue graft was performed. Six months after the procedure, the patient was satisfied with the final result achieved, demonstrating that this protocol may be an alternative to the existing protocols for the treatment of gingival recessions associated with NCCL.

Doença peri-implantar: Abordagens contemporâneas / Peri-implant disease: contemporary approaches

O uso de implantes dentários é considerado uma revolução na Odontologia moderna. Entretanto, um dos grandes desafios encontrados na Implantodontia é o processo de reabsorção óssea ao redor dos implantes, após sua colocação ou durante o uso. Esta revisão teve por objetivo discutir alguns avanços nas pesquisas científicas que utilizam parâmetros clínicos para classificação da doença peri-implantar. Diversos estudos na literatura demonstram que essas ferramentas podem promover uma melhor compreensão, tanto do cirurgião-dentista quanto dos pacientes que necessitam da utilização desses.

The use of dental implants is considered a revolution in modern dentistry. However, the great challenges found at implantodontology is the process of bone resorption around implants after placement or during use. This review aims to discuss some advances in scientific research that use clinical parameters to classify peri-implant disease. Several studies in the literature demonstrate these tools can promote a better understanding for both dental surgeons and patients in need of this.

Cemento dental: aspectos atuais de interesse para o clínico / Dental cementum: current aspects to the clinicians

Embora tenha havido avanço no entendimento da homeostase do cemento dental, o papel deste tecido e sua biologia permanecem não completamente elucidados. Este estudo buscou fornecer informações sobre os conhecimentos mais recente relacionados à biologia do cemento dental, com o objetivo de discutir o papel exercido por este tecido em condições não fisiológicas nos tecidos periodontais. Devido aos avanços na exploração do tecido ósseo, que compartilha diversas características similares, a pesquisa abrangente sobre o cemento dental tem sido encorajada, a fim de esclarecer a função completa deste tecido na homeostase periodontal e regeneração. Desta forma, no presente trabalho, sempre que possível será feito um paralelo entre osso alveolar e cemento dental. O desenvolvimento de metodologias e técnicas celulares e moleculares avançadas possibilitou um melhor entendimento do comportamento do cemento em situações diversas, como quando em situações patológicas, como a doença periodontal, e até mesmo frente à regeneração tecidual. Ademais, estudos clínicos e em modelo animal demonstraram resultados em relação à formação de cemento em abordagens regenerativas. No entanto, sugere-se que estudos posteriores possam contribuir para um melhor conhecimento sobre o cemento e o perfil celular dos cementoblastos e cementócitos, bem como suas interações para fornecer novos insights para o desenvolvimento de terapias eficientes e mais previsíveis para regeneração dos tecidos periodontais. Apesar dos avanços dos estudos clínicos e laboratoriais, pôde-se concluir que inúmeras questões referentes à biologia do cemento permanecem não esclarecidas.

Although some progress has been made to understand dental cementum homeostasis, its role and biology remains not completely elucidated. This study aimed to provide information on the recent knowledge related to the dental cementum biology, in order to discuss the role of this tissue in physiological and non-physiological conditions in the periodontal tissues. Due to advances in the exploration of bone tissue, which shares several similar features, comprehensive research on dental cementum has been encouraged in order to clarify the complete function of this tissue in periodontal homeostasis and regenerative approach. Novel methodologies and advanced cellular and molecular techniques provided better understanding of cementum in different circumstances, as pathological situations such as periodontal disease and even tissue regeneration. In addition, clinical and animal model designs show positive outcomes to cementum formation in regenerative approaches, however, it is suggested that further studies may contribute to better understand cementum tissue and cementoblasts and cementocytes profile, as well as their interactions, providing new insights to develop efficient and more predictable therapies for periodontal tissue regeneration. Despite advances in clinical and laboratory studies, it can be concluded that many questions regarding the cementum biology remain unclear.

Periodontia e Ortodontia: o paciente ortodôntico e o controle do biofilme / Periodontics and Orthodontics: the orthodontic patient and biofilm control

Está bem estabelecido que a presença de uma microflora patogênica no biofilme é o fator etiológico primário no desenvolvimento das doenças periodontais. Assim, o principal objetivo durante a terapia periodontal é o rompimento e remoção do biofilme, juntamente com a restauração do relacionamento homeostase entre a resposta imune do hospedeiro e a comunidade polimicrobiana do biofilme. Fatores como as características de uma superfície podem influenciar a quantidade e a qualidade do biofilme a ser removido da superfície dental, como é possível observar em pacientes ortodônticos. O tratamento ortodôntico com componentes fixos é utilizado amplamente na resolução de diversas más-oclusões. Durante a terapia ortodôntica, os ortodontistas são frequentemente confrontados com gengivite generalizada em seus pacientes, entre outras alterações periodontais. Não há um consenso na literatura sobre a transitoriedade dessas reações no periodonto. Assim, o objetivo desta revisão da literatura foi discutir diferentes perspectivas relacionadas às áreas de Periodontia e Ortodontia no controle do biofilme em pacientes ortodônticos.

It is well established that the presence of a pathogenic microflora in biofilm is the primary etiological factor in the development of periodontal diseases. Thus, the main objective in periodontal therapy is the disruption and removal of biofilm along with the restoration of homeostasis relationship between the host immune response and polymicrobial biofilm community. Factors such as the characteristics of a surface can influence the quantity and quality of the biofilm to be removed from the tooth surface, as can be seen in orthodontic patients. Orthodontic treatment with fixed components is widely used in solving various malocclusions. During orthodontic treatment, orthodontists are often faced with generalized gingivitis in their patients, among other periodontal changes. There is no consensus in the literature about the transience of these reactions in periodontal tissues. The objective of this literature review was to discuss differents perspectives related areas of Periodontics and Orthodontics about the biofilm control in orthodontics patients.

Diagnóstico, etiologia e tratamento das doenças peri-implantares / Diagnosis, etiology, and treatment of peri-implant diseases

Sendo a mucosite e a peri-implantite as lesões mais recorrentes ao redor de implantes, e cada vez mais frequentes no consultório odontológico, faz-se necessária uma compreensão abrangente sobre seus principais fatores etiológicos, métodos de prevenção e modalidades de tratamento para uma correta conduta clínica. A presente revisão da literatura visa, de forma clara e sintetizada, identificar e ressaltar as principais causas de mucosite e peri-implantite descritas na literatura, orientar o cirurgião-dentista na obtenção do diagnóstico, informar o leitor sobre as principais modalidades de tratamento e destacar a importância da terapia de suporte para a manutenção da saúde peri-implantar. A busca eletrônica nas bases de dados Scopus, PubMed e Web of Science foi orientada pelos seguintes tópicos: definição de mucosite e peri-implantite, prevalência, obtenção do diagnóstico, fatores de risco, modalidades de tratamento e terapia de suporte. Os resultados da busca indicaram: 1) a mucosite peri-implantar pode ocorrer em 80% dos indivíduos, e a peri-implantite em até 56%; 2) não há uma única ferramenta para o diagnóstico das doenças peri-implantares, mas sim uma associação destas; 3) a etiologia da peri-implantite parece ser multifatorial, e alguns indivíduos parecem ser mais propensos ao seu desenvolvimento do que outros; 4) a mucosite pode se resolver apenas com a remoção e desinfecção não cirúrgica dos fatores locais, enquanto que na peri-implantite a terapia cirúrgica é adotada quando os sítios afetados não respondem à terapia básica; e 5) a terapia de suporte é imprescindível na determinação do sucesso a longo prazo no tratamento das doenças peri-implantares.

As the mucositis and peri-implantitis are the most recurrent lesions around implants and these increasingly frequent in the dental office, a comprehensive understanding of its main etiological factors, prevention methods and treatment modalities is necessary for proper clinic conduct. This literature review aims, in a clearly and synthesized form, identify and highlight the main causes of mucositis and peri-implantitis described in the literature, guide the dentist in getting the diagnosis, inform the reader about the main types of treatment and highlight the importance of supportive therapy for maintenance of the peri-implant health. The electronic search in Scopus databases, PubMed and Web of Science was guided by the following topics: definition of mucositis and peri-implantitis, prevalence, diagnosis, risk factors, treatment modalities and supportive therapy. The search results indicated that: 1) peri-implant mucositis can occur in 80% of individuals, peri-implantitis up to 56%; 2) there isn't a unique tool for the diagnosis of peri-implant disease, but a association of tools; 3) etiology of peri-implantitis appears to be multifactorial, and some individuals appear to be more prone to their development than others; 4) mucositis can be solved only with the non-surgical removal and disinfection of factors, while in peri-implantitis surgical therapy is used where the affected sites do not respond to primary therapy; and 5) supportive therapy is essential in determining the long-term success in the treatment of peri-implant diseases.

Osteogenic potential of periodontal ligament stem cells are unaffected after exposure to lipopolysaccharides

Abstract Periodontitis develops as a result of a continuous interaction between host cells and subgingival pathogenic bacteria. The periodontium has a limited capacity for regeneration, probably due to changes in periodontal ligament stem cells (PDLSCs) phenotype. The aim of this study was to evaluate the effects of lipopolysaccharides from Porphyromonas gingivalis (PgLPS) on mesenchymal phenotype and osteoblast/cementoblast (O/C) potential of PDLSCs. PDLSCs were assessed for Toll-like receptor 2 (TLR2) expression by immunostaining technique. After, cells were exposed to PgLPS, and the following assays were carried out: (i) cell metabolic activity using MTS; (ii) gene expression for IL-1β, TNF-α and OCT-4 by real-time polymerase chain reaction (RT-qPCR); (iii) flow cytometry for STRO-1 and CD105, and (iv) osteogenic differentiation. PDLSCs were positive for TLR2. PgLPS promoted cell proliferation, produced IL-1β and TNF-α, and did not affect the expression of stem cell markers, STRO-1, CD105 and OCT-4. Under osteogenic condition, PDLSCs exposed to PgLPS showed a similar potential to differentiate toward osteoblast/cementoblast phenotype compared to control group as revealed by mineralized matrix deposition and levels of transcripts for RUNX2, ALP and OCN. These results provide evidence that PgLPS induces pro-inflammatory cytokines, but does not change the mesenchymal phenotype and osteoblast/cementoblast differentiation potential of PDLSCs.

Transmissão intrafamiliar de patógenos periodontais / Intrafamilial transmission of periodontal pathogens: a literature review

Objetivo: revisar quais seriam os diferentes fatores envolvidos na transmissão de periodontopatógenos entre membros de uma mesma família e quais as suas consequências. Material e métodos: uma revisão da literatura foi realizada na base de dados PubMed, utilizando os termos "vertical transmission", "periodontal pathogens", "oral colonization", e "periodontitis". Resultados: após a leitura do título e resumo, 30 artigos foram incluídos nesta revisão. A transmissão de patógenos periodontais entre indivíduos de uma mesma família está relacionada à passagem via salivar e ao compartilhamento alimentar e de higiene, aos cuidados dos filhos pelos pais ou cuidadores, e ao contato íntimo entre cônjuges. Estudos que avaliaram a transmissão do Aggregatibacter actinomycetemcomitans entre indivíduos de uma mesma família mostraram a ocorrência da transmissão vertical, embora também ocorra transmissão horizontal. Entretanto, resultados semelhantes não puderam ser observados para o Porphyromonas gingivalis. Enquanto alguns relatos indicam a ocorrência de transmissão horizontal desta bactéria, diversos outros estudos indicam características bacterianas que reduzem sua ocorrência. Conclusão: a colonização oral por microrganismos patogênicos está relacionada à transmissão vertical e horizontal de patógenos, embora a persistência dos microrganismos pareça estar relacionada a fatores individuais do hospedeiro e características dos patógenos. Além disso, atividades preventivas e terapêuticas devem ser realizadas de forma a alterar o processo de transmissão, colonização e o maior risco do desenvolvimento de problemas periodontais.

Objective: to review the different factors involved in the transmission of periodontopathogens between members of the same family and their consequences. Material and methods: an electronic literature review was conducted at the PubMed using the keywords "vertical transmission", "periodontal pathogens", "oral colonization", and "periodontitis". Results: after reading of title and abstract, 30 articles were included. The transmission of periodontal pathogens among individuals of the same family is related to the passage through salivary and food and hygiene sharing, the care of the children by parents or caregivers, and the intimate contact between individuals. Studies evaluating the transmission of Aggregatibacter actinomycetemcomitans among individuals from the same family showed the occurrence of vertical transmission and horizontal transmission. However, similar results could not be observed for Porphyromonas gingivalis. While some reports indicate the occurrence of horizontal transmission, several other studies indicate bacterial characteristics that reduce its occurrence. Conclusion: oral colonization by pathogenic microorganisms is related to its vertical and horizontal transmission, although the persistence of the microorganisms seems to be related to individual host factors and pathogen characteristics. In addition, preventive and therapeutic activities must be performed in a way that will alter the transmission, colonization and the greater risk of developing periodontal problems.

Derivado da matriz do esmalte e substituto ósseo sintético para bifurcações mandibulares / Enamel matrix protein derivative plus synthetic bone substitute for mandibular class II furcation defects

Lesões de furca representam um desafio para o tratamento periodontal básico, bem como para a abordagem regenerativa. Neste contexto, existem diferentes técnicas regenerativas disponíveis. Dentre as que têm sido amplamente utilizadas, estão: regeneração tecidual guiada, utilização de derivados da matriz do esmalte, substitutos ósseos e técnicas combinadas. Para buscar resultados mais satisfatórios, o uso da terapia regenerativa combinada parece ser promissor. Portanto, o objetivo foi relatar o tratamento de defeitos de furca mandibular de classe II com proteína derivada da matriz do esmalte (EMD), combinada com um substituto ósseo sintético (beta tricálcio fosfato/hidroxiapatita – βTCP/HA).

Exposure of periodontal ligament progenitor cells to lipopolysaccharide from Escherichia coli changes osteoblast differentiation pattern

Periodontal ligament mesenchymal stem cells (PDLMSCs) are an important alternative source of adult stem cells and may be applied for periodontal tissue regeneration, neuroregenerative medicine, and heart valve tissue engineering. However, little is known about the impact of bacterial toxins on the biological properties of PDLSMSCs, including self-renewal, differentiation, and synthesis of extracellular matrix. Objective : This study investigated whether proliferation, expression of pro-inflammatory cytokines, and osteogenic differentiation of CD105-enriched PDL progenitor cell populations (PDL-CD105+ cells) would be affected by exposure to bacterial lipopolysaccharide from Escherichia coli (EcLPS). Material and Methods : Toll-like receptor 4 (TLR4) expression was assessed in PDL-CD105+ cells by the immunostaining technique and confirmed using Western blotting assay. Afterwards, these cells were exposed to EcLPS, and the following assays were carried out: (i) cell viability using MTS; (ii) expression of the interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor alpha (TNF-α) genes; (iii) osteoblast differentiation assessed by mineralization in vitro, and by mRNA levels of run-related transcription factor-2 (RUNX2), alkaline phosphatase (ALP) and osteocalcin (OCN) determined by quantitative PCR. Results : PDL-CD105+ cells were identified as positive for TLR4. EcLPS did not affect cell viability, but induced a significant increase of transcripts for IL-6 and IL-8. Under osteogenic condition, PDL-CD105+ cells exposed to EcLPS presented an increase of mineralized matrix deposition and higher RUNX2 and ALP mRNA levels when compared to the control group. Conclusions : These results provide evidence that CD105-enriched PDL progenitor cells are able to adapt to continuous Escherichia coli endotoxin challenge, leading to an upregulation of osteogenic activities. .

Considerações clínicas para tratamento ortodôntico em paciente periodontal / Clinical considerations for orthodontic treatment in patients with periodontal disease: a review

A reabilitação oral do paciente muitas vezes necessita de uma inter-relação entre várias especialidades para permitir a melhora nas condições da saúde bucal. Hoje, a procura cada vez maior de pacientes adultos para tratamento ortodôntico torna a Periodontia e a Ortodontia duas áreas com relação muito estreita no intuito de oferecer melhores resultados no tratamento odontológico do paciente. Sendo assim, o intuito desse trabalho foi realizar uma revisão da literatura sobre algumas questões relacionadas à inter-relação entre a Periodontia e a Ortodontia, principalmente no que diz respeito a: a) movimentação ortodôntica em pacientes com periodonto reduzido; b) movimentação ortodôntica e recessão gengival; c) microbiologia associada combandas ortodônticas; d) aumento gengival relacionado à movimentação ortodôntica.

Oral rehabilitation of the patient often requires an inter-relationship between many specialties to allow an improvement in oral health conditions. Today, the growing demand of adult patients for orthodontic treatment become the Periodontics and Orthodontics two areas very closely, in order to better results in the patient’s dental treatment. Therefore, the aim of this study was a literature review on some issues related to the interrelationship between Periodontics and Orthodontics, especially with regard to (a) tooth movement in patients with reduced periodontium, (b) orthodontic movement and gingival recession, (c) microbiology associated with orthodontic bands and (d) gingival enlargement related to orthodontic movement.

Engenharia tecidual em periodontia / Tissue engineering in Periodontics

Nas últimas décadas, muitos procedimentos foram realizados com o objetivo de regenerar o periodonto, como a regeneração tecidual guiada, a utilização de enxertos ósseos e os derivados da matriz do esmalte. No entanto, estudos têm demonstrado que estas terapias apresentam baixa previsibilidade de regenerar o periodonto. A fim de aumentar o potencial e previsibilidade de regeneração, a engenharia tecidual tem sido proposta como uma alternativa para promover as condições necessárias para regenerar os tecidos periodontais. Neste contexto, este trabalho teve como objetivo revisar a literatura acerca dos estudos de engenharia tecidual em Periodontia. A engenharia tecidual se baseia em princípios de biologia celular e engenharia de biomateriais, envolvendo basicamente três elementos-chave: células, moléculas de sinalização e arcabouços. O conjunto de células obtidas a partir do ligamento periodontal, assim como células isoladas com fenótipo de células mesenquimais indiferenciadas (células-tronco), tem sido investigado quanto ao potencial em promover a regeneração. Os efeitos das moléculas sinalizadoras sobre estas células e sobre o processo regenerativo também têm sido avaliados. Além disso, diversos arcabouços têm sido estudados com o objetivo de mimetizar a matriz extracelular, carrear células e liberar tais moléculas sinalizadoras na forma de proteínas recombinantes, a fim de propiciar um microambiente mais favorável à regeneração. Abordagens de engenharia tecidual envolvendo a interação destes três elementos têm demonstrado melhores resultados do que o uso isolado de um deles. Com base nestas abordagens, espera-se o desenvolvimento de técnicas que estimulem a regeneração periodontal, levando a resultados satisfatórios mais previsíveis.