Steroidal and non-steroidal cyclooxygenase-2 inhibitor anti-inflammatory drugs as pre-emptive medication in patients undergoing periodontal surgery

The aim of the present study was to compare the pre-emptive use of a cyclooxygenase-2 (COX-2) inhibitor with a well established steroidal anti-inflammatory drug for pain and edema relief following periodontal surgery for crown lengthening. Thirty patients requiring periodontal surgery were randomly assigned to receive one of the following medications: selective COX-2 inhibitor or steroidal anti-inflammatory drug, 60 min before the surgical procedure. To examine patient anxiety, a Corah's dental anxiety scale was applied before surgery. Using a visual analog scale, the extent of pain/discomfort during the trans-operative period and immediately after the surgery was measured. Additionally, intensity of pain/discomfort and edema were examined 4, 8, 12 and 24 h postoperatively. With regard to anxiety, no statistical differences between the groups were observed (p>0.05). With respect to the extent of pain/discomfort during the trans-operative, immediate and late postoperative period, data demonstrated no significant differences (p>0.05) between the COX-2 inhibitor and steroidal groups. With regard to edema, intragroup analysis did not reveal any statistically significant difference (p>0.05) during the 24 h following surgery in either group. In conclusion, both anti-inflammatory drugs presented a similar potential for pain and edema relief following periodontal surgery.

O objetivo do presente estudo foi comparar a utilização pré-emptiva de medicamento inibidor da COX-2 (cicloxigenase-2) com uma droga antinflamatória esteroidal amplamente utilizada, para o controle da dor e edema após cirurgia periodontal para aumento de coroa. Trinta pacientes que necessitavam de cirurgia periodontal foram aleatoriamente designados a receber uma das seguintes medicações: inibidor seletivo da COX-2 ou a droga antinflamatória esteroidal, 60 min antes do procedimento cirúrgico. Para avaliar a ansiedade do paciente, a escala de ansiedade ao tratamento dental de Corah foi aplicada antes da cirurgia. Com a utilização de escala analógica visual a extensão de dor/desconforto durante o período trans-cirúrgico e imediatamente após a cirurgia foi mensurada. Adicionalmente, a intensidade de dor/desconforto e edema foram avaliados no periodo pós-operatório tardio 4, 8, 12 e 24 h após o procedimento cirúrgico. Com relação à ansiedade, não foi observada diferença estatística entre os grupos (p>0,05). Com relação à extensão de dor/desconforto durante os períodos trans-cirúrgico e pós operatório imediato e tardio, os dados não demonstraram diferenças entre o grupo que recebeu o inibidor seletivo da COX-2 e o aintinflamatório esteroidal (p>0,05). A avaliação do edema, intragrupo, não revelou diferença estatística durante as primeiras 24 h em nenhum dos grupos estudados (p>0,05). Em conclusão, ambas as drogas antiinflamatórias utilizadas apresentaram um potencial similar no controle da dor e edema após cirurgia periodontal.

Influence of crown shape on root coverage therapy

OBJECTIVES: The aim of this study was to evaluate the influence of the crown shape on the outcomes of root coverage procedures. MATERIAL AND METHODS: Eighty patients with Miller class I gingival recessions in maxillary canines or premolars were selected. The recession areas were treated using the subepithelial connective tissue grafting. The following clinical parameters were analyzed: crown length (CL) and width (CW), recession height and width, probing depth, clinical attachment level, width and thickness of the keratinized tissue and percentage of root coverage achieved. These measurements were recorded at baseline and 6 months after the surgical procedure. The CW/CL ratio was calculated for each tooth and the median obtained (0.83). Patients were then ranked into two groups, according to the shape of the tooth with gingival recession: Group A - square crown shape (CW/CL values above 0.83) and Group B - long and narrow crown shape (CW/CL values below 0.83). RESULTS: No statistically significant differences (p>0.05) were found between groups in any of the clinical parameters at baseline. After 6 months, both groups presented improved clinical outcomes for all parameters analyzed compared to baseline (p>0.05). The mean percentages and standard deviations of root coverage achieved in Group A and Group B was 91.37 (16.75) and 85.49 (23.55), respectively (p>0.05). CONCLUSIONS: Crown shape did not influence the root coverage obtained with the subepithelial connective tissue graft technique.