Fenótipo Periodontal: uma Visão Clínica e Atual / Periodontal Phenotype: a Clinical and Current View

Um dos elementos essenciais para alcançar a estética do sorriso é o fenótipo e o contorno gengival que, com suas arquiteturas, in- fluenciam no tamanho das coroas dentais. O termo "fenótipo periodontal" foi padronizado no Workshop Mundial para a Classificação das Doenças e Condições Periodontais e Peri-Implantares de 2017, porém esse tema já havia sido abordado outras vezes, com outras nomenclaturas. A avaliação dos diferentes fenótipos periodontais é fundamental, pois nos dão informações relacionadas às características dos tecidos periodontais e às formas dentárias, além de tornar o tratamento mais previsível, podendo evitar problemas como: trau- ma, inflamação e outras complicações clínicas e cirúrgicas. O objetivo desta revisão de literatura é fazer uma pesquisa a respeito do tema fenótipo periodontal por meio dos artigos mais relevantes entre o período de 2017 a 2021, evidenciando sua classificação, prevalência e formas de diagnóstico. Existem várias formas de diagnosticar o fenótipo periodontal, sendo a transparência do sulco gengival por meio da sonda milimetrada a preconizada pelo Workshop Mundial. Podemos observar uma prevalência do fenótipo fino pelo gênero feminino, e o fenótipo espesso pelo gênero masculino. Ainda faltam mais evidências científicas para o correto relacionamento do fenótipo periodontal com outros fatores como idade, tabagismo, hábitos de higiene, alimentação e má oclusão.

One of the essential elements to achieving smile esthetics is the phenotype and gingival contour, which with their architecture influence the size of dental crowns. The term "periodontal phenotype" was standardized in the 2017 World Workshop on the Classification of Periodontal and Peri- Implant Diseases and Conditions. However, much has been said about the topic, with other nomenclatures. Evaluating different periodontal phenotypes is essential, as they provide us with information related to the characteristics of periodontal tissues and dental forms. In addition to making the treatment more predictable, it can avoid problems such as trauma, inflammation, and other clinical and surgical complications. The purpose of this literature review is to research the topic, periodontal phenotype, through the most relevant articles between the period 2017 to 2021, showing its classification, prevalence, and forms of diagnosis. There are several ways to diagnose the periodontal phenotype, and the one recommended by the World Workshop is the transparency of the gingival sulcus using the millimeter probe. We can observe a prevalence of the thin phenotype for the female gender, whereas the thick phenotype is prevalent for the male gender. There is still a lack of scientific evidence for the correct relationship of the periodontal phenotype with other factors such as age, smoking, hygiene habits, diet and, malocclusion

Modification Of Gums By Periodate Oxidation: A Natural Cross-Linker

Scientists throughout the world are in search of novel modified biopolymer to fabricate smart drug delivery systems based on hydrogel formulations using several cross-linkers like glutaraldehyde, glyoxal, epichlorhydrin, adipic acid dihydrazide, carbodiimide, genipin, etc. Agents that are fused into the polymeric structure like isocyanates, glutaraldehyde, polyepoxides, etc., and are extremely toxic in nature. In addition, these are susceptible to percolate out into the body on biodegradation of polymeric structure. As an alternative to these toxic cross-linking agents, the periodate-Schiff base staining technique is widely being used for cross-linking in biology and biochemistry. The mechanism of this cross-linking technique is based on the reaction in-between the Schiff reagent and the aldehydes produced via the periodate oxidation. During the past few decades, several researchers have already been studied on the natural gums and also, developed their dialdehyde derivatives via the periodate oxidation technique. These periodate oxidized gums are being used to cross-link gelatin, other proteins and chitosan to develop various smart systems for drug delivery, tissue engineering, wound dressing, edible films, etc. The current review presents a comprehensive discussion of the available reported literature on the periodate oxidation of various gums and their use as natural cross-linker.

Profundidade do sulco gengival em pacientes de faixa etária de 18-25 anos / Depth of gingival sulcus in patients aged between 18 to 25 years

Gingival probing performed in periodontal normal condition brings important results for the definition of health and diseases of the periodontal tissues. The aim was to evaluate the depth probing of the gingival sulcus in permanent dentition of young adults. It was carried out a transversal study with 120 volunteers aged 18 to 25 years and with healthy gum. It was used a manual periodontal probe Williams model. The evaluation was performed on all four sides, with a total of four measurements per tooth. The collected data were first tabulated and submitted to Kruskal-Wallis test with Dunn's post test.The mean and standard deviation of the upper teeth were: incisor (1.1343 ± 0.33665); canine (1.1819 ± 0.369); premolar ratio (1.3677 ± 0.3752); molar(1.8030 ± 0.4116). The mean of the lower teeth was: incisor (1.1260 ± 0.3272); canine (1.2106 ± 0.3390); premolar ratio (1.4580 ± 0.3778); molar (1.9068 ± 0.4497).It concludes that the average depth of the gingival sulcus, between the group of teeth was higher in the lower arch relative to the upper; except for faces: incisive distal, buccal molar and the lingual incisor and canine; in which the result related to the average depth is less than the upper arch. (AU)

A sondagem gengival realizada em condições periodontais normais traz importantes resultados para a definição de saúde e doenças dos tecidos periodontais. O objetivo deste estudo foi avaliar a profundidade clínica do sulco gengival em uma dentição jovem. Um estudo transversal foi realizado com 120 voluntários entre 18 e 25 anos com gengiva saudável. Um modelo de Williams de sonda periodontal manual foi utilizado. A avaliação foi realizada nos quatro lados, com um total de quatro medidas por dente. Os dados coletados foram tabulados e submetidos ao teste de KruskalWallis com pós-teste de Dunn. A média e o desvio padrão dos dentes superiores foram: incisivo (1,1343 ± 0,33665); canino (1,1819 ± 0,369); pré molar (1,3677 ± 0,3752); molar (1,8030 ± 0,4116). A média dos dentes inferiores foi: incisivo (1,1260 ± 0,3272); canino (1,2106 ± 0,3390); pré-molar (1,4580 ± 0,3778); molar (1,9068 ± 0,4497). Concluise que a profundidade média do sulco gengival, entre o grupo de dentes, foi maior no arco inferior em relação ao superior; exceto por faces: incisiva distal, molar vestibular e incisivo lingual e canino; em que o resultado relacionado à profundidade média é menor que o arco superior (AU)

Effect of platelet-rich fibrin extract on the proliferation of gingival fibroblasts / 口腔疾病防治

Objective@#To study the effects of platelet-rich fibrin extract (PRFe) and platelet-derived growth factor (PDGF) released from PRFe on the proliferation of human gingival fibroblasts (HGFs) and to provide an experimental basis for its application in promoting gingival soft tissue increment.@*Methods@#Platelet-rich fibrin (PRF) was transformed into PRFe by tissue culture. The three-dimensional structure of PRF was observed by electron microscopy, and the content of PDGF in PRF was quantitatively determined by ELISA. The ratios of PRFe examined were 2.5% PRFe, 5% PRFe, 7.5% PRFe, 10% PRFe, 12.5% PRFe and 15% PRFe. Gingival fibrosis was detected by the CCK-8 method. After determining the optimal concentration of PRFe, flow cytometry was used to detect the effect of PRFe on the proliferation cycle of human gingival fibroblasts, and the effect of PDGF on the proliferative activity of gingival fibroblasts was observed by neutralizing the release of PDGF.@*Results @# PRF is a three-dimensional reticular structure that contains a large number of growth factors. PDGF release peaked on the 7th day. The proliferative activity of HGFs cultured with different concentrations of PRFe was concentration-dependent, but the effect was optimal at 5% PRFe (P < 0.05). There were no significant differences in the effect of subsequent concentration increases on the proliferation of HGFs (P > 0.05). The flow cytometry results showed that 5% PRFe could significantly stimulate the S-phase division and proliferation of gingival fibroblasts, while the PDGF neutralization test showed that the proliferation of gingival fibroblasts was significantly inhibited by the neutralization of PDGF.@*Conclusion@#Overall 5% PRFe had the best effect on promoting gingival fibroblast proliferation in vitro. PDGF released from PRF plays an important role in promoting the proliferation of gingival fibroblasts.

Tratamento da pigmentação melânica gengival ­ revisão sistemática da literatura / Treatment of gingival melanin pigmentation - systematic literature review

A pigmentação oral é uma descoloração que atinge principalmente a gengiva e a mucosa oral, associada a fatores etiológicos endógenos e exógenos. A melanina é um dos pigmentos responsáveis por essa coloração sendo produzida pelos melanossomos presentes nos melanócitos, que estão localizados ao nível da camada basal e suprabasal do epitélio. A pigmentação melânica gengival configura-se como um problema estético. Este trabalho teve por objetivo fazer uma revisão sistematizada da literatura abordando ensaios clínicos que apresentassem técnicas de remoção da pigmentação melânica gengival. Para a seleção dos artigos utilizados foi realizada uma busca online nas bases bibliográficas PubMed (www.ncbi.nlm.nih.gov/pubmed) e Scopus (https://www.scopus.com) compreendendo o período de janeiro de 2006 a abril de 2016, utilizando os descritores: "gingival", "melanin", "pigmentation", "hyperpigmentation" e "depigmentation", em combinação. Realizou-se um refinamento na pesquisa bibliográfica utilizando como critérios de inclusão: publicações na língua inglesa de estudos clínicos de intervenção em humanos. Foram selecionados inicialmente 188 artigos e após a leitura dos títulos e resumos 15 estudos foram considerados válidos para essa revisão. A técnica da desepitelização para remoção da pigmentação melânica gengival com o uso de broca e lâmina de bisturi é considerada padrão ouro, sendo uma alternativa economicamente viável e de fácil execução. Porém, o uso do laser vem sendo indicado como opção ao tratamento. Foram encontrados relatos de recidivas das pigmentações em todas as técnicas apresentadas, com maiores relatos de repigmentações nas técnicas que promovem a remoção do epitélio (AU)

The oral pigmentation is a discoloration that primarily affects the gums and oral mucosa is associated with endogenous and exogenous etiological factors. Melanin is a pigment responsible for this coloring being produced by the present melanosomes in melanocytes, which are located at the level of the basal and suprabasal layer of the epithelium. The gingival melanin pigmentation appears as an aesthetic problem. This study aimed to make a systematic review of the literature regarding clinical trials to submit removal techniques of gingival melanin pigmentation. For the selection of articles used a search online bibliographic databases was conducted in PubMed (www.ncbi.nlm.nih.gov/pubmed) and Scopus (https://www.scopus.com) covering the period from January 2006 to April 2016, using the key words: "gingival" "melanin", "pigmentation", "hyperpigmentation" and "depigmentation" in combination. This was a refinement in the literature search using the following inclusion criteria: clinical intervention studies in humans published in English. They were initially selected 188 articles and after reading the titles and abstracts 15 studies were considered valid for this review. The scalpel technique for removal gingival melanin pigmentation using drill and scalpel blade is considered the gold standard, with an economically viable and easy to perform. However, the use of laser has been recommended as an option for treatment. The recurrence of pigmentations was observed on all the techniques presented with greater repigmentações reports on techniques that promote surgical stripping (AU)

Granuloma telangiectásico en cavidad oral / Telangiecticum granuloma in oral cavity

El granuloma telangiectásico se considera como una lesión benigna no neoplásica de la mucosa gingival de tipo reactivo asociado a trauma. Durante varios años tuvo diferentes nombres dentro de los que destacan granuloma piógeno del embarazo o gravídico, hemangioma capilar lobular y épulis. Histológicamente se caracteriza por una proliferación vascular, infiltrado inflamatorio crónico y tejido de granulación. El objetivo del presente caso es describir las características clínicas e histológicas de un granuloma telangiectásico en cavidad oral y su plan de tratamiento. Llega a consulta paciente femenina de 50 años de edad, refiere presentar sangrado gingival en repetidas ocasiones en zona posterior de la arcada dentaria superior, durante el cepillado o con el consumo de algunos alimentos. Clínicamente se observa prótesis provisional desadaptada en órganos dentarios 11 al 15. Al retirar la prótesis es notorio un aumento de volumen en la encía interdental, con aspecto eritematoso, que sangra con facilidad. El reporte de anatomía patológica mostró una lesión con engrosamiento del epitelio escamoso, formación de nuevos vasos sanguíneos e infiltrado inflamatorio crónico. Diagnosticado como granuloma telangiectásico. La lesión fue eliminada quirúrgicamente por alargamiento coronal con reducción ósea. Ocho días después de la cirugía se evidencia proceso de cicatrización sin ninguna complicación. La lesión presentó recidiva transcurrido seis meses. Ello nos lleva a destacar la importancia del control de factores locales, como la presencia de prótesis desadaptadas y el acúmulo de placa bacteriana luego de la eliminación quirúrgica de este tipo de lesiones(AU)

Telangiectatic granuloma is a non-neoplastic benign lesion of the gingival mucosa, reactive type, associated with trauma. For several years, it had different names among which we can mention the pyogenic granuloma gravidarum occurring during pregnancy, the lobular capillary hemangioma and the epulis. Histologically, it is characterized by a vascular proliferation, chronic inflammatory infiltrate and granulation tissue. The aim of this case is to describe the clinical and histological characteristics of the telangiectatic granuloma of the oral cavity and its treatment plan. A 50-year-old female patient comes to the consultation reporting repeated gingival bleeding on the posterior area of the upper dental arch when brushing or consuming some food. Clinically, unadjusted provisional prosthesis was observed in the dental organs from 11 to 15. After removing the prosthesis, an increase in the volume of the interdental gum of erythematous type which bleeds easily was obvious. The pathologic report showed a lesion with swelling of the flaky epithelium, formation of new blood vessels and chronic inflammatory infiltrate. The diagnosis was telangiectatic granuloma. The lesion was surgically removed by crown lengthening with osseous reduction. Eight days after surgery, a healing process without complications was seen. 6 months later, the lesion relapsed. This fact leads us to outline the importance of the control of local factors, such as the presence of unadjusted prosthesis and the accumulation of dental plaque after the surgical removal of this type of lesions(AU)

Effect of chewing gums on gastrointestinal function of rectal cancer patients undergoing surgical operations / 现代临床护理

Objective To explore the effect of chewing gums on gastrointestinal function of rectal cancer patients undergoing surgical operations.Methods One hundred rectal cancer patients were randomized equally into the control group and test group:the former received routine nursing care and the latter began to chew the chewing 2-3 gums for 4-5 times a day 2-4 hours after operation until anal passage of gas or defecation.The two groups were compared in terms of first time for anal passage of gas,first time for defecation and postoperative abdominal distension.Results The time for anal passage of gas in the test group was(62.52±19.99)h, significantly shorter than that of(70.68±19.34)h in the control group(t=2.184,P<0.05).The defecation time in the test group was (84.20±14.25 ) h,also significantly shorter than that of the control group(t=-2.204,P<0.05).The incidence of abdominal distension in the test group was significantly lower than that in the control group(8.00%vs.26.00%;χ2=5.741,P<0.05).Conclusion Chewing the gums,as an adjunctive therapy,is effective for the recovery of gastrointestinal function after operations on rectal cancer.

Factores de riesgo de hipersensibilidad dentinaria en pacientes adultos con prótesis dental / Risk factors of dentin hypersensitivity in adult patients with dental prosthesis

Se realizó un estudio de casos y controles para determinar algunos factores de riesgo asociados a la hipersensibilidad dentinaria en pacientes con prótesis dental que asistieron a la Clínica de Rehabilitación Bucomaxilofacial de Santiago de Cuba, desde mayo del 2009 hasta diciembre del 2010. Fueron conformados 2 grupos: uno de 60 integrantes (casos) y otro de 120 (control), con edades de 20 a 61 años. Se aplicó la prueba de Ji al cuadrado, con 95 % de confiabilidad, y se determinó la asociación básica entre las variables mediante el cálculo de la oportunidad relativa, cuyos resultados predominantes estuvieron en la retracción gingival (3,62), la erosión (3,20) y el cepillado incorrecto (2,56); las 2 primeras variables constituyeron, además, los principales factores de riesgo en la población estudiada (con riesgos atribuibles de 2,62 y 2,20 %, respectivamente). Asimismo, fue valorada la necesidad de instruir a los pacientes en los elementos que propician el inicio de esta afección bucal y el modo de eliminarlos.

A case-control study was conducted to determine some risk factors associated with the dentin hypersensitivity in patients with dental prosthesis that attended the Oral Maxillofacial Rehabilitation Clinic of Santiago de Cuba from May 2009 to December 2010. Patients were divided into 2 groups: one of 60 patients (cases) and another of 120 (control) with ages ranging from 20 to 61 years. Chi square test was applied with 95% confidence, and basic association was determined between variables by calculating the odds ratio, whose predominant results were recession of the gums (3.62), erosion (3.20) and incorrect brushing (2.56); the first 2 variables also constituted the main risk factors in the study population (attributable risks of 2.62 and 2.20% respectively). Also, the need to instruct patients in the elements that favor the onset of this oral condition and the way to remove them was evaluated.

Effects of sleep deprivation on depressive behaviors and hippocampus bcl-xl in rats treated with chronic stresses / 中华行为医学与脑科学杂志

Objective To explore the changes of Bcl-xl levels and activities in hippocampus resulting from sleep deprivation, and then to reveal the mechanism for rapid antidepressant aroused by sleep deprivation.Methods 40 SD rats were randomly divided into normal control group, chrinic stress group, sleep deprivation group and tank contral group.10 rats in each group.The depression animal model was established by chronic mild unpredictable stress(CUMS) methods.Sleep deprivation was preformed by the modified multiple platform method ( MMPM ).The animal model and the effect of antidepressant were evaluated by the open field test.The expression levels of Bcl-xl were separately observed by immunohistochemical technology in hippocampus CA1 ,CA3 and DG.Results 1.Compared with the normal control rats, ambulation ( 35.30 ± 18.77,81.30 ± 18.41, P ＜ 0.01 ) and rearing (20.50 ±4.84,27.70 ± 8.19, P＜0.05 ) increased ,and the stopping time in the center decreased (4.60 ± 1.35,2.20 ± 1.55, P ＜ 0.01 ) in the CUMS depressant animal model.2.The Bcl-xl average values of optical density (OD) in hippocampus CA1 ,CA3 ,DG of the model group was lower than that of the normal control group significantly (0.1356 ±0.0224,0.1389 ±0.0250,0.1457 ±0.0162;0.1725 ±0.0327,0.1734 ±0.0261,0.1768 ±0.0271; P＜0.01 ) ,and that of the sleep deprivation group was higher than that of the model group (0.1621 ± 0.0128,0.1603 ± 0.0137,0.1625 ± 0.0192 ;0.1356 ± 0.0224,0.1389 ± 0.0250,0.1457 ± 0.0162; P ＜ 0.05 ).Conclusion Rats showed depressive behaviors after 21 days stresses,while 72 hours sleep deprivation could reverse this effect.The up regulation of the expression and phosphorylation of Bcl-xl by sleep deprivation may participate in the antidepressant-like effect of sleep deprivation.

Immunology and art: Using antibody-based techniques to identify proteins and gums in artworks.

Our diverse world cultural heritage encompasses a vast range of objects, from fi ne art to monumental cultural heritage sites, which represent not only artistic developments but also power, politics and commerce. They are combinations of materials and cultural infl uences that vary over time and according to style, taste, region and artist or workshop. The careful study of how an artwork is made is critical to its preservation: correct identifi cation of materials can guide conservators in treatments but also can direct curators and conservators in display and storage strategies. This identifi cation can also help reveal working practices of the artist, studio or guild: for example, the use of egg tempera, egg mixed with oil or only oil as a binding media in paintings marks a distinct alteration in working practice in Italy in the mid to late 15th century (Dunkerton 1996; Higgitt and White 2005). Furthermore, the identifi cation can also give insight into the trade customs of a town or region and, in some cases, may facilitate authenticating, dating, and determining the regional provenance of an object. For example there are pigments that were only used over certain time periods or became commonly used only later in the 19th century: thus their presence, in conjunction with other supporting evidence, can aid in determining the likely date of origin for an artwork. Scientifi c examination is critical in providing this knowledge and is an essential component in modern technical studies of artworks and cultural heritage. Throughout history a great variety of natural products have been used in art and one of the most common applications of organic materials has been as binding media, adhesives and varnishes1. Mixed with pigments they form the basis for paints (binding media), as adhesives they allow solid joints in furniture, and as varnishes they supply protective coatings for paintings, wood, and other decorative surfaces. Animal and plant materials used in art as binding media and adhesives include oils, waxes, resins, gums, mucilages and proteins. Eggs, milk, and animal glues (made from bones, skin, or fi sh bladders) composed primarily of the proteins ovalbumin, casein, and collagen — can not only be found in artworks but are also used to conserve art. Plant gums such as gum tragacanth2, cherry gum, and gum arabic, known as polysaccharides, have been used mainly as binding media for water soluble paint. Analysing the binding media and adhesives on artworks presents unique challenges. The natural materials, which can be used individually or in combination, are actually complex chemical mixtures whose composition can alter over time due to human intervention (e.g. conservation treatments), environmental conditions (heat, light, humidity, biodeterioration), and chemical interactions between the components of the mixture.In addition, the organic material can be encased in a complex solid matrix, such as pigments, and its concentration in that matrix tends to be very low. Furthermore, the original organic binder or adhesive may itself be a mixture (multiple protein sources or oil and protein mixture, for example) or may have become so via the migration of materials, for example between layers of paint during conservation treatment with adhesives or the application of coatings. And fi nally, that a sample of the artwork is required in order to identify proteins and gums dictates that the analytical techniques be.

Idiopathic Gingival Fibromatosis With Aggressive Periodontitis – A Rare Case Report

Idiopathic gingival fibromatosis is a rare benign oral condition characterized by a slowly progressive, non-hemorrhagic, fibrous enlargement of maxillary and mandibular attached and non-attached gingivae. A 14 year old female patient suffered from unusual gingival enlargement, more on the left side along with generalized aggressive periodontitis. The enlarged gingiva covered more than two-thirds of the clinical crowns. Marked inflammatory hyperplasia of epithelium and connective tissue of the gingiva was observed histopathologically. Perioscan test was performed, the results of which were negative. The diagnosis of Idiopathic gingival fibromatosis with aggressive periodontitis was made. Conventional periodontal therapy was performed followed by excision of the enlargement using gingivectomy procedure.

Gingival Fibromatosis with Chronic Periodontitis – A Rare Case Report

Gingival fibromatosis is frequently an isolated condition of little consequence apart from a cosmetic problem and occasional associations with uncommon syndromes. This case report of a 38 year old female patient describes the gingival enlargement associated with chronic periodontitis. The enlargement extended beyond the middle thirds of the clinical crowns of the teeth. It was associated with generalized mobility, pocket formation and bone loss. The patient also complained of bleeding gums and difficulty in speech and mastication. This is the first case report of gingival fibromatosis associated with chronic periodontitis.

Efeito terapêutico da fibra goma-guar parcialmente hidrolisada na constipação intestinal funcional em pacientes hospitalizados / Effect of partially hidrolized guar-gum in the treatment of functional constipation among hospitalized patients

Avaliação do impacto da fibra goma-guar parcialmente hidrolisada na constipação intestinal funcional em pacientes hospitalizados. Ensaio clínico com 64 adultos, randomizados para duas dietas: grupo 1 dieta laxante (± 30 g de fibras) e grupo 2 mesma dieta + 10 g de fibra goma-guar parcialmente hidrolisada, durante 15 dias. A dieta laxante ou acrescida da referida fibra reduziu em 78 por cento a constipação intestinal funcional, assim como sua adição não provocou efeito adicional na freqüência evacuatória, consistência fecal, uso de laxativos, embora tenha reduzido a sintomatologia gastrointestinal. Fibras devem ser utilizadas no tratamento da constipação intestinal funcional; entretanto, a suplementação com fibra goma-guar parcialmente hidrolisada precisa ser melhor investigada.

The effect of hydrolyzed partially guar-gum was evaluated in the treatment of functional constipation among hospitalized patients. Following a randomized blind controlled-trial 64 adults were allocated to two groups: one received daily high-fiber diet (@ 30 g) and the other similar diet plus 10 g of hydrolyzed partially guar-gum, during 15 days. Dietary fiber reduced functional constipation by 78.0 percent. Hydrolyzed partially guar-gum did not show any additional effect in defecation frequency, fecal consistence, need of laxative drug use, although a reduction in bowel complaints. Dietary fiber may be used in the treatment of functional constipation. However the therapeutic role of hydrolyzed partially guar-gum should be further investigated.