Influência de laminados cerâmicos cimentados sobre dentes naturais sem término cervical na microbiota do fluido gengival crevicular: estudo clínico, prospectivo e longitudinal usando PCR em tempo real / Influence of laminate veneers cemented over natural teeth without finish line on the microbiota of gingival crevicular fluid: clinical, prospective and longitudinal study using real-time PCR

Objetivo: quantificar bactérias colonizadoras do sulco gengival em paralelo à verificação do comportamento clínico periodontal e da adaptação marginal de laminados cerâmicos cimentados sobre dentes sem término cervical. Métodos: 73 laminados cerâmicos em dissilicato de lítio monolítico foram cimentados sobre dentes naturais sem término cervical e com a margem cervical posicionada cerca de 0,5mm no interior do sulco gengival. Para todos os dentes foi feita a coleta do fluido gengival crevicular (FGC) previamente à cimentação da restauração (baseline) e em 7, 180 e 365 dias após a cimentação para quantificação das bactérias S. mitis, P. intermedia e P. gingivalis através de PCR em tempo real. Clinicamente foram avaliados os parâmetros índice de placa visível (IPV), sangramento à sondagem (SS), profundidade de sondagem (PS), perda de inserção clínica (PIC), recessão gengival (RG) e a adaptação marginal da restauração em baseline, 7, 15, 30, 60, 180 e 365 dias. Foram obtidas réplicas da região cervical para análise da adaptação marginal por microscopia eletrônica de varredura (MEV). Resultados: Não houve diferença estatisticamente significante para o IPV, PS, SS em todos os períodos analisados (Anova, p>0,05). Não houve registro de PIC e RG. Houve diferença estatisticamente significante para S. mitis na comparação entre 180 e 365 dias (Dunn, p=0,03). Não foi detectado P. intermedia em nenhum dos sítios e não houve diferença estatisticamente significante para P. gingivalis em todos os tempos do estudo (Friedman, p>0,05). Todas as restaurações receberam o conceito alfa para a adaptação marginal nas análises clínica e microscópica. Conclusões: o sobrecontorno causado pelo laminado cerâmico não contribuiu para o acúmulo de placa na região cervical e para alterações no comportamento clínico periodontal, microbiológico e microscópico em relação aos mesmos dentes antes do tratamento restaurador(AU)

Purpose: quantify colonizing bacteria of the gingival sulcus, in parallel to the verify of the periodontal clinical behavior and the marginal adaptation of natural teeth restored with ceramic veneers without finish line. Methods: 73 ceramic veneers in monolithic lithium disilicate were cemented onto natural teeth without finish line and with the cervical margin positioned about 0.5mm inside the gingival sulcus. Gingival crevicular fluid (GCF) was collected for all teeth prior to cementation of the restoration (baseline) and 7, 180 and 365 days after cementation to quantify the bacteria S. mitis, P. intermedia and P. gingivalis through of real-time PCR. Clinically, visible plaque index (PIV), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), gingival recession (GR) and marginal adaptation were evaluated at baseline, 7, 15, 30, 60, 180 and 365 days. Replicas of the cervical region were obtained for analysis of marginal adaptation by scanning electron microscopy (SEM). Results: There was no statistically significant difference for PIV, PD, BOP in all periods analyzed (Anova, p>0.05). There were no records of CAL and RG. There was a statistically significant difference for S. mitis in the comparison between 180 and 365 days (Dunn, p=0.03). P. intermedia was not detected in any of the analyzed samples. There was no statistically significant difference for P. gingivalis at all study times (Friedman, p>0.05). All restorations had an alpha concept for marginal adaptation in clinical and SEM analysis. Conclusions: the overcontouring caused by ceramic veneers did not contribute to the accumulation of plaque in the cervical region and to changes in the clinical, microbiological and microscopic behavior in relation to the same teeth before the restorative treatment(AU)

Short term sodium alendronate administration improves the peri-implant bone quality in osteoporotic animals

Abstract Sodium alendronate is a bisphosphonate drug that exerts antiresorptive action and is used to treat osteoporosis. Objective The aim of this study was to evaluate the bone repair process at the bone/implant interface of osteoporotic rats treated with sodium alendronate through the analysis of microtomography, real time polymerase chain reactions and immunohistochemistry (RUNX2 protein, bone sialoprotein (BSP), alkaline phosphatase, osteopontin and osteocalcin). Material and Methods A total of 42 rats were used and divided in to the following experimental groups: CTL: control group (rats submitted to fictitious surgery and fed with a balanced diet), OST: osteoporosis group (rats submitted to a bilateral ovariectomy and fed with a low calcium diet) and ALE: alendronate group (rats submitted to a bilateral ovariectomy, fed with a low calcium diet and treated with sodium alendronate). A surface treated implant was installed in both tibial metaphyses of each rat. Euthanasia of the animals was conducted at 14 (immunhostochemistry) and 42 days (immunohistochemistry, micro CT and PCR). Data were subjected to statistical analysis with a 5% significance level. Results Bone volume (BV) and total pore volume were higher for ALE group (P<0.05). Molecular data for RUNX2 and BSP proteins were significantly expressed in the ALE group (P<0.05), in comparison with the other groups. ALP expression was higher in the CTL group (P<0.05). The immunostaining for RUNX2 and osteopontin was positive in the osteoblastic lineage cells of neoformed bone for the CTL and ALE groups in both periods (14 and 42 days). Alkaline phosphatase presented a lower staining area in the OST group compared to the CTL in both periods and the ALE at 42 days. Conclusion There was a decrease of osteocalcin precipitation at 42 days for the ALE and OST groups. Therefore, treatment with short-term sodium alendronate improved bone repair around the implants installed in the tibia of osteoporotic rats.