Gingival crevicular fluid response to protocols of non-surgical periodontal therapy: A longitudinal evaluation.

CONTEXT AND AIM: Gingival crevicular fluid (GCF) volume reflects the level of periodontal inflammation. This secondary analysis aimed to evaluate the GCF volume in patients submitted to non-surgical periodontal therapies under a split-mouth design. MATERIALS AND METHODS: GCF volume of 25 participants (47.24 ± 6.47 years) with moderate-to-severe chronic periodontitis was collected at Days 0, 30, 60, 90, 120, 270, and 450. The participants were submitted to three different non-surgical therapies randomly assigned per quadrant [GI: supragingival control (Supra) as only intervention (one quadrant); GII: Supra plus scaling and root planing (SRP) on Day 0 (two quadrants); GIII: Supra on Day 0 and SRP 30 days later (one quadrant)]. During treatment (0-60 days) and maintenance (90-450 days) participants were submitted to supragingival plaque control reinforcements. GCF volumes were analyzed after logarithmic transformation (log10) and linear models were used for intra- and inter-group comparisons, considering the data dependence. RESULTS: Baseline GCF volumes were similar between groups (GI: 0.39 ± 0.22 µl; GII: 0.42 ± 0.26 µl; GIII: 0.41 ± 0.14 µl;P > 0.05). At Day 60, GCF volumes were significantly reduced (GI: 0.20 ± 0.13 µl; GII: 0.18 ± 0.11 µl; GIII: 0.22 ± 0.13 µl; P < 0.001), without inter-groups differences. These results were maintained along maintenance period (P > 0.05). Even in sites bleeding on probing (BOP) + the means of GCF volume did not differ between groups (P > 0.05). CONCLUSIONS: All therapies determined reductions on the GCF volume along time. Supragingival plaque control modulated the subgingival area during the study, reinforcing the importance of this control over the subgingival inflammatory response.

Self-perception of patients after periodontal treatment: A longitudinal study.

AIMS: To investigate the perceptions of subjects regarding nonsurgical periodontal treatment over a period of 1 year. SETTINGS AND DESIGN: This is a secondary analysis of a randomized clinical trial, in a longitudinal observational design. METHODS: Nineteen subjects (47.24 ± 6.47 years) with moderate to severe periodontitis completed a questionnaire at two different times after a nonsurgical periodontal treatment: 30 (T1) and 390 days (T2). The questionnaire with 40 items was divided into three domains: 1-perception of changes in clinical signs of periodontal disease, 2-psychological aspects of the subject regarding their oral health status, and 3-satisfaction with the treatment. STATISTICAL ANALYSIS: Each response on the Likert scale initially showed scores ranging from 1 to 5 points. The results for each question were dichotomized into 1 or 0, respectively, showing if the subject was favorable or unfavorable to treatment. A descriptive data analysis was performed, assessing the agreement of the results in T1 and T2 (Kappa). RESULTS: The results generally showed a favorable perception related to the treatment and continued satisfaction over time. The exceptions were in regards to gingival recession, persistent bleeding and bad breath, and difficulty in performing the mechanical control imposed by the professional. CONCLUSION: It was concluded that the therapy used was satisfactory to the subjects and that a favorable perception was maintained after 1 year of follow-up.

How do peri-implant mucositis and gingivitis respond to supragingival biofilm control - an intra-individual longitudinal cohort study.

PURPOSE: This single-arm study to compare the gingival with peri-implant mucosal inflammatory response to a mechanical supragingival-supramucosal biofilm control program. MATERIALS AND METHODS: Twenty-two participants (55.7 ± 11.2 years) with both gingivitis and periimplant mucositis were examined at days 0, 30 and 390 (full mouth/6 sites per tooth/implant [TTH/IMPL]) for visible plaque (VPI), gingival bleeding (GBI), modified plaque (mPlI) and bleeding indexes (mBI), probing depth (PD) and bleeding on probing (BOP). The biofilm control was carried out weekly in the first month and every 3 months thereafter. An intention-to-treat analysis was performed (drop-out rate = 8) and linear models were used against comparisons in order to look at the clustering of TTH/IMPL by each individual. RESULTS: VPI/mPlI and GBI/mBI reduced from day 0 onwards. Intra-group reductions (P < 0.05) were observed at day 30. PD values (in mm) were higher (P < 0.001) for IMPL than for TTH [mean difference (95% CI) at day 0: -1.10 (-1.58 to -0.63); day 30: -0.88 (-1.28 to -0.48); and day 390: -0.60 (-0.84 to -0.33)], where both groups showed reductions (P < 0.05) throughout the study. BOP was greater (P = 0.00001) for IMPL at baseline [mean difference (95% CI): -0.24 (-0.31 to -0.17)] but reduced (P = 0.00001) and showed similar levels to TTH from day 30 onwards. With regard to sites with the greatest PD, BOP reduced (P < 0.05) in both IMPL and TTH, with greater PD reductions observed for IMPL (P = 0.00001). CONCLUSIONS: The supragingival-supramucosal biofilm control benefited both teeth and implants.

Supragingival treatment as an aid to reduce subgingival needs: a 450-day investigation.

This study investigated the clinical effects of using a supragingival biofilm control regimen (SUPRA) as a step prior to scaling and root planing (SRP). A split-mouth clinical trial was performed in which 25 subjects with periodontitis (47.2 ± 6.5 years) underwent treatment (days 0­60) and monitoring (days 90­450) phases. At Day 0 (baseline) treatments were randomly assigned per quadrant: SUPRA, SRP and S30SRP (SUPRA 30 days before SRP). The full-mouth visible plaque index (VPI), gingival bleeding index (GBI), periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) were examined on days 0, 30, 60, 90, 120, 270, and 450. Baseline data were similar among all groups. From days 0 to 60, the groups showed similar significant decreases in VPI and GBI. Reductions in PPD for the SRP (3.39 ± 0.17 to2.42 ± 0.16 mm) and S30SRP (3.31 ± 0.11 to 2.40 ± 0.07 mm) groups were greater (p < 0.05) than those for the SUPRA group. This pattern was also observed for BOP. Attachment gain was similar and greater for the SRP (3.34 ± 0.28 to 2.58 ± 0.26 mm) and S30SRP (3.25 ± 0.21 to 2.54 ± 0.19 mm) groups compared to the SUPRA group. Results were maintained from day 90 forward. Overall, the S30SRP treatment reduced the subgingival treatment needs in 48.16%. Performance of a SUPRA step before SRP decreased subgingival treatment needs and maintained the periodontal stability over time.

Profilaxia antibiótica de infecção pós-operatória nos períodos pré e pós-operatórios em cirurgia de terceiros molares / Antibiotic prophylaxis of postoperative infection on pre and postoperative periods in third molars surgery

O uso rotineiro de profilaxia antibiótica em cirurgia para exodontia de terceiros molares é controverso. O objetivo deste trabalho foi analisar a conduta farmacológica de cirurgiões-dentistas que realizam este tipo de extração dentária em relação à profilaxia de infecções pós-operatórias, comparando os dados à conduta dos professores das disciplinas de Cirurgia Bucomaxilofacialdo curso de Odontologia da Universidade Luterana do Brasil, Canoas/RS. Para tanto, foi aplicado um questionário a 60 profissionais com o intuito de verificar os critérios de indicação de profilaxia antibiótica parainfecções pós-operatórias, posologia farmacológica e associação com controle químico do biofilme bacteriano,relacionando essas variáveis ao curso de origem e tempo de formado do profissional. Conclui-se que a maioria dos entrevistados indica profilaxia para infecções pós-operatórias, entretanto não segue um protocolo definido sustentado em evidências científicas

Lesão endo-periodontal: plausibilidade biológica para o tratamento endodôntico prévio ao periodontal / Endo-periodontal lesions: biological plausibility to the previous endodontics treatment

Para haver sucesso na resolução de uma lesão endo-periodontal é fundamental que, previamente ao estabelecimento do diagnóstico e do plano de tratamento, o cirurgião-dentistaconheça a anatomia dos tecidos envolvidos, as vias de comunicação entre eles e os eventos etiopatogênicos associados aos mesmos. O presente trabalho foi motivado pela controvérsia em relação à seqüência de tratamento das lesões endo-periodontais verdadeiras, objetivando uma discussão particular em relação à plausibilidade biológica para o tratamento endodôntico prévio ao periodontal. Pode-se observar que, contando com poucos estudos, a literatura apontapara possíveis benefícios do tratamento endodôntico prévio ao periodontal, o que permitiria acicatrização, em momentos distintos, dos problemas comunicantes, mas de origens diferentes.Portanto, pode-se concluir que o tratamento endodôntico, prévio ao periodontal, realizado com qualidade, e o acompanhamento da resposta cicatricial deste, constituem-se em questões im-portantes para a abordagem destas lesões. Após a avaliação da cicatrização, o tratamento periodontal poderia ser realizado, melhorando, desta forma, o prognóstico das lesões endo-periodontais verdadeiras.

The success of the endo-periodontal lesions treatment is dependent on an adequate diagnosis and treatment plan also associated with a previous knowledge regarding the involved tissues anatomy and the ethoopatogenesis pathways associated with the lesions.The present literature review was motivated by the controversies related to the treatmentof the endo-periodontal lesions, particularly related to the biologic plausibility for the endodontic treatment previous to the periodontal. It could be observed that, eventhougthin few numbers, the literature points to the benefit of the previous endodontic treatment,leading to the periapical healing and avoiding the elimination of potentially healing, i.e demineralized bone matrix, due to the periodontal instrumentation. In this sense, it is possible to conclude that an adequate initial endodontic treatment and the longitudinal evaluation of the healing process, before the periodontal instrumentation, may determine abetter prognosis to the endodontic-periodontic lesions.