Periodontal status among 12-year-old schoolchildren: a population-based cross-sectional study in Quito, Ecuador

Abstract This study aimed to estimate the prevalence and extent of bleeding on probing and calculus in 12-year-old schoolchildren of Quito, Ecuador, and evaluate the associated factors. We conducted an epidemiological survey with a representative sample of 1,100 12-year-old schoolchildren from public schools in the urban area of Quito, Ecuador. We assessed the periodontal health using the Community Periodontal Index (CPI). The prevalence and extent of the periodontal condition was based on the presence of at least one site with bleeding on probing (BOP), and the presence of dental calculus was also evaluated. We used univariate and multiple multilevel Poisson regression analyses to verify the association between the independent variables and the number of sextants with BOP and calculus. The prevalence of BOP and calculus was 92% and 69.9%, respectively. The adjusted mean of the affected sextants was 4.3 and 2.2 for BOP and calculus, respectively. The mother's schooling and malocclusion were associated with the number of sextants with bleeding. The mother's schooling and dental caries experience were associated with calculus. Gingival bleeding and the presence of dental calculus are highly prevalent in 12-year-old schoolchildren from Quito. Gingival bleeding is associated with maternal education and malocclusion, and dental calculus is associated with maternal education and dental caries.

Efficacy of mouthrinses in reducing oral SARS-COV-2 load: a review

Abstract Accumulated evidence has shown that the oral cavity may be an important reservoir for SARS-CoV-2. Some authors have suggested that the use of mouthrinses could reduce SARS-CoV-2 viral load in the saliva. Thus, the aim of this review was to synthesize evidence about the efficacy of mouthrinses in reducing the salivary viral load of SARS-CoV-2. 2. Nine randomized controlled trials (RCTs) have investigated the efficacy of different mouthrinses in reducing salivary SARS-CoV-2 loads. Various active ingredients have been tested in these trials: 0.5%,1% and 2% povidone-iodine, 0.2% and 0.12% chlorhexidine (CHX), 0.075% cetylpyridinium chloride (CPC), 0.075% CPC with Zinc lactate, 1% and 1.5% hydrogen peroxide (HP), 1.5% HP + 0.12% CHX and ß-cyclodextrin and citrox. The studies reported an intra-group reduction in the salivary levels of the virus, when compared with the baseline. However, the majority of these trials failed to demonstrate a significant inter-group difference between active groups and the control group relative to the decrease in salivary SARS-CoV-2 loads. Although promising, these results should be confirmed by larger trials.

Toothpaste-related interests of Google users from different countries

Abstract The Internet is a growing source of knowledge and can provide information about oral health. This ecological study aimed to characterize the interests in toothpaste among Google users from different countries. Our hypothesis was that there would be an increase in Google users' interest in information about toothpaste. This retrospective longitudinal ecological study analyzed the toothpaste-related interest of Google users from 10 countries between January 2004 and December 2020. The monthly variation in relative search volume (RSV) and the main related queries were determined using Google Trends. Autoregressive integrated moving average (ARIMA) forecasting models were built to establish the predictive RSV values for toothpaste for an additional 12 months. Autocorrelation plots and the generalized additive model (GAM) were used to diagnose trends and seasonality in RSV curves. Additionally, the influence of social isolation related to the outbreak of COVID-19 was analyzed. Although not detected by autocorrelation function (ACF) and partial autocorrelation function (PACF) analyses, the heuristic analysis showed an increase in the interest in toothpaste-related information in all countries, with a stable trend observed in the 12-month forecasts, except for the increases in the United Kingdom and South Africa. Also, GAM analyses demonstrated a non-significant monthly or quarterly seasonal influence on data. In addition, social isolation during the COVID-19 pandemic did not influence the online information-seeking behavior of Google Search users linked to this topic. We confirmed the hypothesis that the interest of Google Search users in information about toothpaste increased in all of the 10 assessed countries.

Conventional versus flap-protected free gingival graft: a multicenter randomized clinical trial

Abstract The purpose of this study was to compare the outcomes of a modified gingival graft technique, in which the released flap is positioned and sutured over the graft, with the conventional free gingival graft (FGG) procedure, when both are used for gingival augmentation. A 12-month, multicenter parallel randomized controlled trial was conducted. Subjects with buccal RT2 gingival recessions and keratinized tissue width (KTW) < 2 mm in at least one mandibular incisor were randomized to control group (n = 20; conventional FGG) or test group (n = 20; modified FGG; flap sutured over FGG using sling sutures). The primary outcome (KTW) was measured at baseline and after 3, 6 and 12 months, as was keratinized tissue thickness (KTT). Postoperative pain (POP) and analgesic intake were also recorded. Both techniques promoted a significant increase in KTW and KTT when compared to baseline (p < 0.05) with no significant differences between groups (KTW change of 6.1±1.5 mm and 5.4±1.6 mm, for control and test, respectively; p=0.16). However, test group patients reported less POP after 7 days and used less analgesic medication than control group patients (p < 0.05). We concluded that the modified FGG was comparable to conventional FGG in augmenting keratinized tissue width and thickness at mandibular incisors, but resulted in less patient morbidity.

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.

Clinically relevant outcomes in dental clinical trials: challenges and proposals

Abstract The impact of clinical trials on patient care depends on the outcomes that they evaluate. In Dentistry, many trials use outcomes that are important to clinicians, but not to the patients. Thus, the aim of the present manuscript is to present an overview of the limitations, challenges, and proposals on the use of clinically relevant outcomes (CRO) in dental trials. Clinically relevant outcomes are variables that directly measure how the patient feels, functions, or survives. Some CROs, such as tooth loss, implant failure, and restorations failure require many years to occur and the number of events is low. The adoption of these variables as primary outcomes results in challenges for the researchers, such as use of large sample sizes and long follow-up periods. Surrogate outcomes, such as biomarkers, radiographic measurements and indexes, are frequently used to replace CROs. However, they present many limitations, since the effect of the treatment on a surrogate does not necessarily reflect a change in the clinical outcome. Some proposals for the adoption of CROs are presented, such as the development of core outcome sets within each dental specialties and the organization of multi-center clinical trials.

Periodontal disease and its impact on general health in Latin America. Section II: Introduction part II

Abstract: The epidemiological data on gingivitis and periodontitis in Latin America are scarce, as the majority of the Latin American studies have analyzed probing depth instead of clinical attachment loss. Reported data have shown high variations in results between different Latin American countries, with the main causes of these differences being the clinical case definition and methodological strategies used. In general, data have revealed that the prevalence of periodontal disease is higher in Latin Americans than in populations in the USA or Europe. Regarding its relations with other diseases and conditions, some Latin American studies have focused on the association between periodontitis and adverse pregnancy outcomes, or poor glycemic control in diabetic patients; however, these studies have reported controversial results. In Chile, reports have indicated that periodontal treatment significantly reduced the preterm birth rate; however, no association between periodontitis and perinatal outcome was found in Brazil. For diabetes mellitus, Brazilian studies have reported controversial findings; however, a Chilean interventional study reported significant reductions in the glycosylated hemoglobin levels after periodontal treatment. Although epidemiological data for Latin America are scarce, the information available at present is useful for establishing national policies on health promotion, prevention, and treatment of periodontal disease. Therefore, dental schools must play a key role in educating professionals who are highly trained in the promotion, prevention, early diagnosis and treatment of periodontal disease, with an approach to risk, and strong biopsychosocial and ethical components. Thus, future Latin American dentists would be able to face the challenge of decreasing the prevalence of periodontal diseases by leading interdisciplinary health teamwork.

Implant-based factor as possible risk for peri-implantitis

Abstract Peri-implantitis is currently a topic of major interest in implantology. Considered one of the main reasons of late implant failure, there is an emerged concern whether implant characteristics could trigger inflammatory lesion and loss of supporting bone. The purpose of this narrative review is to provide an evidence based overview on the influence of implant-based factors in the occurrence of peri-implantitis. A literature review was conducted addressing the following topics: implant surface topography; implant location; occlusal overload; time in function; prosthesis-associated factors (rehabilitation extension, excess of cement and implant-abutment connection); and metal particle release. Although existing data suggests that some implant-based factors may increase the risk of peri-implantitis, the evidence is still limited to consider them a true risk factor for peri-implantitis. In conclusion, further evidences are required to a better understanding of the influence of implant-based factors in the occurrence of peri-implantitis. Large population-based studies including concomitant analyses of implant- and patient-based factors are required to provide strong evidence of a possible association with peri-implantitis in a higher probability. The identification of these factors is essential for the establishment of strategies to prevent peri-implantitis.

Treatment of multiple recessions with collagen matrix versus connective tissue: a randomized clinical trial

Abstract The objective of this study was to determine whether collagen matrix (CM) is an alternative to connective tissue graft technique (CTG) in the treatment of multiple gingival recessions (GR). The indication of CM for the treatment of multiple GR is not yet clear. More studies are needed to better understand this treatment modality, as an alternative to CTG. In this single-blind, split-mouth randomized clinical trial, fifteen patients with multiple Miller class I upper GR were selected and randomly assigned to control group (CTG) or test group (CM). Root coverage (RC) and patient-centered outcomes were evaluated at baseline and after 3, 6, and 12 months. A total of 82 GRs were treated. There was no significant difference regarding GR depth (GRD, primary outcome) between CTG (0.5 ± 0.9 mm) and CM groups (0.6 ± 1.0 mm) (p = 0.225). Percentage of RC was 82.14% in CTG and 77.7% in CM. Both groups demonstrated a gain in keratinized tissue width at 12 months (p < 0.05). Dentine hypersensitivity was effectively reduced in both groups. Postoperative pain was significantly higher in the CTG (p = 0.001). Esthetic satisfaction was high for both groups, with no significant difference (p > 0.05) between groups. After 12 months, both surgical treatments were able to promote RC, and GRD was similar in both CTG and CM groups.

Comparison of full-mouth scaling and quadrant-wise scaling in the treatment of adult chronic periodontitis

Abstract In the search for the ideal treatment of periodontal disease various non-surgical techniques should be considered. The objective of this study was to evaluate the efficacy of full-mouth scaling (FMS) by clinical and microbiological parameters. 670 individuals were evaluated with 230 subjects meeting the selection criteria and were divided into two groups; 115 subjects treated with FMS and 115 treated with weekly sessions of scaling and root planning (SRP). The patient population had a mean age of 51.67 years, with moderate chronic periodontitis. Subjects were evaluated prior to treatment (T1) and 90 days after execution of therapy (T2), with regards to: probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and microbial detection for the presence of Porphyromonas gingivalis (P.g.) and Prevotella intermedia (P.i.) by culture method and confirmed by biochemical tests. Subjects treated in the FMS group also rinsed with 0.12% chlorhexidine mouthwash for seven days following treatment. The results were analyzed using statistical Student's t-test and chi-square test. No statistically significant differences were observed for PD and CAL between T1 and T2 in both groups. For GI and PI significant difference was observed between the groups. For the evaluated microbial parameters was observed reduction of P.g. and P.i., but only for P.g. with a significant reduction in both groups. The full mouth scaling technique with the methodology used in this study provided improved clinical conditions and reduction of P.g. in subjects with moderate periodontitis, optimizing the time spent in the therapeutic execution.

Resumo Na busca do tratamento ideal da doença periodontal varias são técnicas não-cirúrgicas que podem ser consideradas. O objetivo deste estudo foi avaliar a eficácia da técnica de desinfecção total de boca (FMD, na sigla em Inglês) por parâmetros clínicos e microbiológicos. Foram avaliados 670 indivíduos com 230 indivíduos atendendo aos critérios de seleção e divididos em dois grupos; 115 indivíduos tratados com FMD e 115 tratados com sessões semanais de raspagem e alisamento corono radicular (SRP, na sigla em Inglês). A população avaliada tinha idade média de 51,67 anos, com periodontite crônica moderada. Os sujeitos foram avaliados antes do tratamento (T1) e 90 dias após a execução da terapia (T2), quanto à profundidade de sondagem (PS), nível de inserção clínica (NIC), índice de placa (IP), índice gengival (IG) e detecção microbiana da presença de Porphyromonas gingivalis (P.g.) e Prevotella intermedia (P.i.) por método de cultura e confirmada por testes bioquímicos. Os indivíduos tratados no grupo FMD também realizaram bochechos com clorexidina 0,12% durante sete dias após o tratamento. Os resultados foram analisados ​​utilizando o teste estatístico t de Student e o teste de qui-quadrado. Não foram observadas diferenças estatisticamente significativas para PS e NIC entre T1 e T2 em ambos os grupos. Para IG e IP observou-se diferença significativa entre os grupos. Para os parâmetros microbianos avaliados foi observada redução de P.g. e P.i., mas apenas para P.g. com uma redução significativa em ambos os grupos. A técnica FMD com a metodologia utilizada neste estudo proporcionou condições clínicas melhoradas e redução da P.g. Em indivíduos com periodontite moderada, otimizando o tempo gasto na execução terapêutica.

Pasta dental con fluoruro de amina en la prevención de caries dental: revisión de la literatura / Amine fluoride dentifrice in dental caries prevention: a literature review

Objetivos: Las pastas dentales con fluoruro de amina han sido propuestas como una alternativa superior a otras con distintos fluoruros debido a su estructura molecular. Por tanto, el objetivo de esta revisión fue describir el mecanismo de acción de las pastas dentales que contienen fluoruro de amina, así como su papel dentro de los procesos de remineralización y la evaluación de su eficacia clínica en la prevención de la caries dental. Material y métodos: Dos investigadores realizaron búsquedas de forma independiente en las bases de dados electrónicas MEDLINE y EMBASE, sin restricción de fecha. Fueron incluidos solo estudios in vitro, in situ o ensayos clínicos controlados. Después de la lectura de los textos, fue realizada la extracción de datos. La evaluación del riesgo de sesgo de los ensayos clínicos fue realizada por los mismos investigadores. Resultados: Estudios in vitro e in situ mostraron que el AmF redujo la desmineralización y promovió la remineralización. En algunos estudios, AmF promovió mayor remineralización que los otros tratamientos. Cuatro ensayos clínicos que fueron incluidos en esta revisión sugieren que existe cierta evidencia de la superioridad de las pastas dentales con fluoruro de amina con relación a la reducción en el incremento de caries, comparados con otros grupos control. Conclusión: Existe evidencia de que las pastas dentales que contienen fluoruro de amina actúan en el proceso de la caries dental disminuyendo la desmineralización, promoviendo la remineralización y reduciendo la formación de lesiones cavitadas. (AU)

Objective: Amine fluoride dentifrices have proposed as a superior alternative to other fluorides because of its molecular structure. Thus, the aim of this review was to describe the mechanism of action of tooth pastes containing amino fluorides, its effect in the remineralisation process and the evaluation of its clinical efficacy in the prevention of dental caries. Material and methods: A research in MEDLINE and EMBASE was conducted independently by two researchers with no date restriction. In vitro, in situ or randomized controlled trials were included. After text reading data extraction was conducted. Risk of bias assessment was performed for the randomized trials. Results: In vitro and in situ studies observed that AmF reduced demineralization and increased remineralization. In some studies, AmF promoted greater remineralization tan the other treatments.Four randomized trials included in this review suggest that there is some evidence of superiority of the amine fluoride dentifrices in the reduction of caries increment, when compared to control groups. Conclusion: There is evidence that suggest that toothpastes containing amino fluoride have an impact on the process of dental caries, reducing demineralization, promoting remineralisation and reducing the formation of carious lesions. (AU)

Dentifrício com fluoreto de amina na prevenção de cárie dentária: uma revisão da literatura / Amine fluoride dentifrice in dental caries prevention: a literature review

Objetivos: Dentifrícios com fluoreto de amina têm sido propostos como uma alternativa superior a outros fluoretos devido à sua estrutura molecular. Assim, o objetivo dessa revisão foi descrever o mecanismo de ação dos dentifrícios contendo fluoreto de amina, assim como seu papel dentro dos processos de remineralização e a avaliação da sua eficácia clinica na prevenção da cárie dentária. Material e métodos: Dois investigadores pesquisaram de forma independente as bases de dados eletrônicas MEDLINE e EMBASE, sem restrição de data. Foram incluídos apenas estudos in vitro, in situ ou ensaios clínicos controlados. Após a leitura dos textos, foi feita a extração de dados. A avaliação do risco de viés dos ensaios clínicos foi realizada pelos mesmos investigadores. Resultados: Estudos in vitro e in situ mostraram que AmF reduziu a desmineralização e promoveu remineralização, sendo que em alguns estudos a remineralização foi maior no grupo que utilizou AmF. Quatro ensaios clínicos incluídos nessa revisão sugerem que existe alguma evidência de superioridade de dentifrícios com fluoreto de amina em relação a redução de incremento de cárie, comparados com os grupos controle. Conclusão: Existe evidência que dentifrícios contendo fluoreto de amina agem no processo de cárie dentária diminuindo a desmineralização, promovendo a remineralização e reduzindo a formação de lesões cavitadas (AU)

Objective: Amine fluoride dentifrices have been proposed as asuperior alternative to other fluorides because of its molecular structure. Thus, the aim of this review was to describe the mechanism of action of toothpastes containing amino fluorides, its effect in the remineralisation process and the evaluation of its clinical efficacy in the prevention of dental caries. Material and methods: A research in MEDLINE and EMBASE was conducted independently by two researchers with no date restriction. In vitro, in situ or randomized controlled trials were included. After text reading data extraction was conducted. Risk of bias assessment was performed for the randomized trials. Results: In vitro and in situ studies observed that AmF reduced demineralization and increased remineralization. In some studies, AmF promoted greater remineralization than the other treatments. Four randomized trials included in this review suggest that there is some evidence of superiority of the amine fluoride dentifrices in the reduction of caries increment, when compared to control groups. Conclusion: There is evidence that suggest that toothpastes containing amino fluoride have an impact on the process of dental caries, reducing demineralization, promoting remineralisation and reducing the formation of carious lesions.(AU)

Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study

Abstract The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76-19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76-30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55-20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.

Condição bucal de hepatopatas pré- transplantados e transplantados hepáticos: revisão da literatura / Oral Health Status of liver transplant candidates and post–liver transplant patients: a literature review

O transplante de fígado é o tratamento preconizado para a doença hepática terminal. Infecções são complicações frequentes e estão associadas à alta morbidade e mortalidade de pacientes pré e pós-transplantados. Assim, a prevenção de processos infecciosos é fundamental para reduzir a progressão da cirrose e diminuir o risco de complicações após o transplante. Portanto, o objetivo desta revisão de literatura é verificar quais são as condições bucais de candidatos ao transplante de fígado e de pós-transplantados, bem como verificar se a doença hepática está associada com pior condição bucal. Os artigos incluídos demonstraram higiene bucal ruim, alta prevalência de doença periodontal e de doença cárie. Alguns estudos observaram maior perda óssea e maior perda de inserção clínica em pré e pós-transplantados do que em pacientes sadios. A literatura é controversa em relação à associação entre condição hepática e doença cárie. Não há evidência suficiente para suportar a hipótese de que a doença hepática seja um fator de risco para doenças bucais

Liver transplantation is the indicated treatment for endstage hepatic disease. Infections are frequent complications in patients waiting for liver transplant and post-transplant patients, and have been associated with high morbidity and mortality.Thus, prevention of infections is important in the reduction of the progression of hepatic disease and in the reduction of complications in the transplanted patient. The aim of the review is to describe the oral conditions of liver transplant candidates and transplanted patients, and to verify if hepatic disease is associated with poor oral conditions. The included articles demonstrated poor oral hygiene, high prevalence of periodontal disease and caries disease. Some of the studies observed greater bone loss and clinical attachment loss in liver transplant candidates and transplanted patients, when compared to healthy controls. The literature is controversial regarding association between liver disease and dental caries. We concluded that there is not enough evidence to support the hypothesis that liver disease increases the risk for oral diseases

Supragingival biofilm control and systemic inflammation in patients with type 2 diabetes mellitus

The objective of this study was to evaluate the effect of strict supragingival biofilm control on serum inflammatory markers and on periodontal clinical parameters in type 2 diabetes mellitus (T2DM) patients with chronic severe periodontitis. Twenty-four individuals with T2DM and periodontitis were randomly allocated to two treatment groups. The supragingival therapy group (ST, n = 12) received supragingival scaling, whereas the intensive therapy group (IT, n = 12) underwent supra- and subgingival scaling, as well as root planing. Patients from both groups received professional oral hygiene instructions every month. Data regarding visible plaque index (VPI), gingival bleeding index (GBI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL), serum levels of interleukin (IL)-6, IL-17A, IL-8, tumor necrosis factor α (TNF-α), monocyte chemoattractant protein (MCP)-1 enzyme-linked immunosorbent assay (ELISA), and glycated hemoglobin (HbA1c) levels were obtained at baseline and at 6 months post-therapy. Both therapies resulted in the improvement of almost all clinical periodontal parameters (p < 0.05). There were no differences in TNF-α, IL-8, IL-17A and HbA1c levels in either group (p >0.05), between the two periods. However, MCP-1 levels were significantly reduced in both the ST (p = 0.034) and the IT (p = 0.016) groups, whereas the serum IL-6 levels were significantly reduced only in the IT group (p = 0.001). Strict control of supragingival biofilm has a limited effect on systemic inflammatory markers, and a moderate effect on periodontal clinical parameters.

Acurácia da tomografia computadorizada de feixe cônico na detecção de defeitos ósseos periodontais e perda óssea alveolar / Accuracy of cone-beam computed tomography in detecting periodontal bone defects and alveolar bone loss

As tomografias computadorizadas de feixe cônico (TCFC) vêm ganhando espaço no cenário odontológico devido ao elevado nível de nitidez e detalhamento das imagens, bem como pela redução na dose de radiação, comparativamente às tomografias computadorizadas convencionais. Para analisar o uso da TCFC especificamente na área de Periodontia, o objetivo deste trabalho foi realizar uma revisão da literatura sobre o desempenho da TCFC no diagnóstico de defeitos ósseos periodontais e perda óssea alveolar para avaliar avaliar o risco-benefício real deste exame de imagem visando à futura utilização na prática clínica do periodontista. Para isso, foi realizada uma busca na base de dados MEDLINE/ PubMed, em Março de 2014 utilizando algumas palavras-chave. Quatorze artigos preencheram os critérios de inclusão e exclusão, sendo observado que a maioria foi conduzida em cadáveres humanos. A superioridade da TCFC em relação à radiografias periapicais para detecção de perda óssea alveolar ainda parece ser controversa. Entretanto, a TCFC apresenta acurácia superior a das radiografias periapicais quando são analisados defeitos ósseos e lesões de furca. Além disso, a TCFC parece apresentar boa relação risco-benefício, pois a dose de radiação pode ser equivalente a um exame periapical de boca toda. Portanto, por possibilitar avaliação tridimensional de defeitos ósseos, apresentar elevada acurácia e boa relação risco-benefício, a utilização da TCFC pode ser considerada uma opção na prática clínica do periodontista.

Cone beam computed tomography (CBCT) has been considered an advance in dentistry imaging due to its high quality images and lower radiation exposure, compared to the conventional CT. To analyze specifically the use of CBCT in Periodontics, the aim of this study was to make a literature review about the CBCT performance in detecting periodontal bone defects and alveolar bone loss, in order to evaluate the real risk-benefit of CBCT, possibly enabling periodontists to use this technique in the future. A search in MEDLINE/ PubMed was performed in March 2014 using some key-words. Fourteen articles met the inclusion and exclusion criteria, being observed that the majority was conducted with human cadavers. In relation to periapical radiographs, CBCT superiority in detecting alveolar bone loss seems to be controversial. However, accuracy of CBCT is higher than periapical radiographs taking into consideration the analysis of bone defects and furcation involvement. Besides, CBCT seems to present great risk-benefit relation, because radiation dose can be equivalent to a full-mouth periapical exam. Therefore, due to the possibility of tridimensional analysis of bone defects, its high accuracy and good risk-benefit relation, the use of CBCT by the periodontist may be considered an option in the periodontal practice.