Effectiveness of lip repositioning surgeries in the treatment of excessive gingival display: A systematic review and meta-analysis.

To synthesize the available evidence regarding lip repositioning surgery (LRS) and quantify the short- and long-term reduction in excessive gingival display (EGD) with the procedure. Additionally, evaluate the effect of myotomy on the results. Seven electronic databases were searched up to May 2020 by two independent reviewers. Studies evaluating the exclusive use of LRS to treat EGD were included. After risk of bias assessment, the data were quantitatively evaluated with random-effects meta-analysis. The initial database search yielded 368 studies, of which 16 were selected for full-text review. Finally, eight studies were included. The random effects model exhibited an EGD reduction of 2.87 mm (95% CI: 1.91-3.82) after 3 months of LRS. These results decreased after 6 months (2.71 mm; 95% CI: 1.95-3.47) and 12 months (2.10 mm; 95% CI: 1.48-2.72). Meta-analysis comparing the performance of myotomy showed greater EGD reduction at 6 months than without myotomy (P < 0.02). LRS is an effective approach for treating EGD, and it has satisfactory results up to 6 months. After this period, the effectiveness appears to progressively decrease over time indicating substantial relapse at 12 months. Myotomy seems a suitable alternative to increase the stability of LRS. Lip repositioning surgery is an effective procedure to improve smile esthetics in the short-term (up to 6 months). After this period, the efficacy of LRS seems to decrease progressively, and an approximately 25% relapse may be expected after 12 months. Clinicians should combine the procedure with other approaches, such as plastic periodontal surgeries, restorative procedures, or botulin toxin injections for more predictable and stable outcomes.

Conhecimento dos profissionais da estratégia de saúde da família sobre diabetes e doença periodontal / The knowledge of family health program professionals on diabetes and periodontal disease

Este estudo tratou de uma abordagem de cunho quantitativo, que teve como objetivo avaliar parte do conhecimento dos profi s- sionais médicos, cirurgiões-dentistas e enfermeiros atuantes no programa de estratégia de saúde da família das cidades de Patos, Santa Luzia e São Mamede, no estado da Paraíba, sobre a relação bidirecional entre as duas doenças. Para a coleta dos dados, utilizou-se um formulário contendo questões relativas a dados sociodemográficos, diabetes e doença periodontal. Um total de 138 profissionais foi convidado a participar da pesquisa, sendo que 110 preencheram o termo de consentimento livre e esclarecido. Dos profissionais envolvidos neste estudo, 92,7% (n=101) informaram possuir conhecimento sobre doença periodontal; um total de 62,6% (n=67) da amostra afi rmou que o tratamento periodontal auxilia no controle glicêmico em pacientes diabéticos. Entre os participantes, 98,2% (n=108) afirmaram questionar fatores relacionados a diabetes durante a anamnese. A realização de um trabalho conjunto e multidisciplinar entre diferentes classes profissionais da saúde irá proporcionar uma melhor identificação e tratamento de pacientes com diabetes, predispostos ao desenvolvimento de doença periodontal.

This study consisted of a quantitative nature approach, which aimed to assess part of the knowledge of the medical professionals, dental surgeons and nurses who work in family health strategy program from the cities of Patos, Santa Luzia and São Mamede in the state of Paraiba, on the bidirectional relationship between the two diseases. For the data collection a questionnaire containing questions regarding socio- demographic data, diabetes and periodontal diease was applied to participants. A total of 138 professionals were invited to participate, with 110 filling in the informed consent form. From the professionals involved in this study, 92.7% (n=101) reported having knowledge about periodontal disease, a total of 62.6% (n=67) of the sample reported that periodontal treatment helps in glycemic control in diabetic patients. Among the participants, 98. 2% (n=108) reported questioning factors related to diabetes during anamnesis. The conducting of a collaborative and multidisciplinary work among different health professionals classes will provide better identification and treatment of diabetic patients predisposed to the development of periodontal disease.

Evaluation of the Biological Behavior of Mucograft® in Human Gingival Fibroblasts: An In Vitro Study

Mucograft(r) is a resorbing porcine matrix composed of type I and type III collagen, used for soft tissue augmentation in guided tissue bony regeneration procedures. This in vitro study aimed to evaluate the biological behavior of Mucograft(r) in human gingival fibroblasts, as well as the ability of the matrix to induce production of extracellular matrix. Six resorbing Mucograft(r) matrices (MCG) were cut into 3 x 2 mm rectangles and 5 x 5 mm squares and were placed in 96- and 24-well plates, respectively. The control group (CTRL) consisted of cells plated on polystyrene without the MCG. After one, two, three and seven days, cell proliferation and viability were assessed using the Trypan exclusion method and MTT test, respectively. Type III collagen (COL 3A1) and vimentin (VIM) expression were also evaluated at 10 and 14 days, using Western blotting. Statistical analysis, using ANOVA with post hoc Bonferroni test, revealed that human gingival fibroblasts from MCG showed similar results (p>0.05) for proliferation and viability as the cells cultured on CTRL. After 14 days, a significant decrease in COL 3A1 expression (p<0.05) was observed when cultured with the MCG. VIM expression showed no significant difference at any time period (p>0.05). Although no increase in extracellular matrix secretion was observed in this in vitro study, Mucograft(r) presented cellular compatibility, being an option for a scaffold whenever it is required.

Resumo A Mucograft(r) é uma matriz reabsorvível, de origem suína, composta de colágenos do tipo I e III, utilizada para aumento de tecido mole em regeneração óssea guiada. Este estudo in vitro teve como objetivo avaliar o comportamento biológico da Mucograft(r), em fibroblastos gengivais humanos, bem como a indução da síntese de matriz extracelular. Seis matrizes reabsorvíveis de Mucograft(r) (MCG) foram cortadas em retângulos e quadrados medindo 3 x 2 mm e 5 x 5 mm e alocadas em placas de 96 e 24 poços, respectivamente. O grupo controle (CTRL) consistiu no plaqueamento celular em poliestireno, sem MCG. Após um, dois, três e sete dias, a proliferação e a viabilidade celular foram avaliadas utilizando o corante vital azul de Trypan e o teste MTT, respectivamente. Além disso, a expressão de colágeno tipo III (COL 3A1) e vimentina (VIM) foi avaliada após 10 e 14 dias, por meio de Western-blotting. Após análise estatística (Anova e pós teste de Bonferroni), pode-se observar que os fibroblastos gengivais humanos, cultivados sobre MCG, apresentaram proliferação e viabilidade semelhantes em comparação às células que foram cultivadas apenas no poliestireno (CTRL). Após 14 dias, notou-se uma diminuição significativa da expressão de COL 3A1 (p<0,05) quando as células foram cultivadas sobre a MCG. A expressão da VIM não mostrou diferença significativa em nenhum dos períodos estudados (p>0,05). No presente estudo in vitro pode-se concluir que apesar de não ter sido observado aumento da síntese de matriz extracelular, a Mucograft(r) apresentou compatibilidade celular, sendo uma opção de biomaterial em casos que o arcabouço é necessário.

Responsabilidade civil: análise estatística da sua inter-relação com profissionais atuantes na Periodontia / Civil liability: statistical analysis of interrelationship with your professional active in Periodontics

Objetivo: analisar o nível de conhecimento de 200 cirurgiões- -dentistas atuantes na área de Periodontia, sobre sua responsabilidade civil. Material e métodos: uma amostra estabelecida por conveniência, composta por 200 cirurgiões-dentistas atuantes na área de Periodontia, de todas as regiões do Brasil. Esses profissionais responderam um questionário autoaplicável, constituído por 25 perguntas objetivas, com o intuito de obter algumas informações sobre o conhecimento destes a respeito de responsabilidade civil. Foram excluídos os profissionais que não estavam atuando na Odontologia, embora possuíssem titulação. Resultados: a pesquisa buscou analisar de forma estatística o conhecimento dos profissionais quanto à sua responsabilidade civil, análise esta feita com base nos dados obtidos em pesquisa de campo, por meio de levantamento de questionários. Os resultados mostraram, na maioria dos assuntos, que mais da metade dos profissionais respondeu de forma incorreta, demonstrando a necessidade de conhecerem mais o assunto. A pesquisa também mostrou que o número de profissionais que conhecem e possuem seguro de responsabilidade civil é significativamente superior no grupo que já concluiu curso de pós-graduação. Conclusão: os resultados demonstraram a necessidade de um melhor conhecimento por parte dos profissionais com prática em Periodontia, referente ao assunto responsabilidade civil, fato reconhecido por 89% dos profissionais pesquisados ao responderem positivamente quando questionados se sentem necessidade de um programa de atualização sobre responsabilidade civil. A necessidade de conhecimento do assunto pode prevenir eventuais problemas judiciais, pois o profissional, sabendo o que pode ocorrer, tomará os cuidados necessários.

Objective: this study aimed to analyze the level of knowledge of two hundred dentists working in the area of periodontics, about their civil liability. Materials and methods: a sample established for convenience, consisting of two hundred dentists working in the area of periodontics, from all regions of Brazil. These professionals answered a self-administered questionnaire, consisting of twenty-five objective questions, in order to obtain some information about the knowledge of these regarding civil liability. Were excluded the professionals who were not working in dentistry, although possessed titration. Results: the research sought to analyze statistical form the knowledge of professionals as to its civil liability, this analysis is made on the basis of the data obtained in field research, through survey questionnaires. The results showed, in most subjects, more than half of the professionals answered incorrectly, demonstrating the need for professionals more aware of the issue. The survey also showed that the number of professionals who know and have civil liability insurance is significantly higher in the group that has already completed graduate course. Conclusion: the results showed the need for a better knowledge on the part of professionals with practice in periodontics, referring to the civil liability issue, a fact recognized by 89% of professionals surveyed to respond positively when asked if they feel the need of an upgrade program on civil liability. The need for knowledge of the subject can prevent any legal problems, because the professional, knowing what may occur, it shall take the necessary care.

Evaluation of the Biological Behavior of Mucograft® in Human Gingival Fibroblasts: An In Vitro Study.

Mucograft(r) is a resorbing porcine matrix composed of type I and type III collagen, used for soft tissue augmentation in guided tissue bony regeneration procedures. This in vitro study aimed to evaluate the biological behavior of Mucograft(r) in human gingival fibroblasts, as well as the ability of the matrix to induce production of extracellular matrix. Six resorbing Mucograft(r) matrices (MCG) were cut into 3 x 2 mm rectangles and 5 x 5 mm squares and were placed in 96- and 24-well plates, respectively. The control group (CTRL) consisted of cells plated on polystyrene without the MCG. After one, two, three and seven days, cell proliferation and viability were assessed using the Trypan exclusion method and MTT test, respectively. Type III collagen (COL 3A1) and vimentin (VIM) expression were also evaluated at 10 and 14 days, using Western blotting. Statistical analysis, using ANOVA with post hoc Bonferroni test, revealed that human gingival fibroblasts from MCG showed similar results (p>0.05) for proliferation and viability as the cells cultured on CTRL. After 14 days, a significant decrease in COL 3A1 expression (p<0.05) was observed when cultured with the MCG. VIM expression showed no significant difference at any time period (p>0.05). Although no increase in extracellular matrix secretion was observed in this in vitro study, Mucograft(r) presented cellular compatibility, being an option for a scaffold whenever it is required.

Evaluation of hygienic douching on the vaginal microflora of female sex workers.

To determine the frequency of abnormal vaginal flora and bacterial vaginosis (BV) in female sex workers (FSW) and the association between douching and vaginal microflora imbalance, a cross-sectional study enrolled 94 users and 61 non-users of vaginal douching. The social-demographic and sexual profile of these women was obtained and their abnormal vaginal flora, BV, vaginal candidiasis, trichomoniasis and cytolitic vaginosis on blinded samples were identified by Gram stain. A stepwise multivariate regression determined the risk of development of vaginal microflora imbalance. Prevalence of abnormal flora, BV, candidiasis, trichomoniasis and cytolytic vaginosis in the entire FSW was 75.5%, 51.0%, 5.1%, 0.64% and 1.9%, respectively. There were no significant differences in these findings between users and non-users of vaginal douching. Regression analysis did not identify any increased risk for altered vaginal flora or BV in vaginal douche users. In conclusion, vaginal douching did not increase the rate of these alterations in FSW.

As doenças periodontais e o Diabetes Mellitus / Periodontal diseases and Diabetes Mellitus

O conhecimento das manifestações sistêmicas e das reações celulares nos pacientes diabéticos traduz e confirma sua posição de grande importância no complexo inter-relacionamento das especialidades médicas. Fica cada vez mais claro que o diabetes agrava e modifica as doenças periodontais e vice-versa. Assim, mostra-se imprescindível um estudo cientifico conjunto dessas manifestações para uma motivação consciente dos profissionais no tratamento de pacientes diabéticos.

The cognizance of the systemic manifestations and cellular reactions over the diabetic patients translates and confirms its position of great importance in the complex inter-relationship of the medical specialties. It is clearer each day that diabetes aggravates and modifies periodontal diseases and vice versa. Therefore, it shows to be necessary a combined scientific study of such diseases for a conscious motivation of the professionals in the treatment of diabetic patients.

Chronic periodontitis and pre-term labour in Brazilian pregnant women: an association to be analysed.

AIM: To investigate the association between chronic periodontitis (CP) and pre-maturity in a group of Brazilian pregnant women from the State of São Paulo. MATERIALS AND METHODS: One hundred and twenty-four women were investigated consecutively in a cross-sectional study, between December 2003 and May 2005. Sixty-eight women had pre-term labour (PTL) and 56 had term labour. A periodontal examination was carried out to identify the presence of CP. Statistical analysis used the Fisher's exact test or chi(2) for the discrete variables and the Mann-Whitney test for the non-parametric variables. Odds ratio (OR) was calculated with a 95% confidence interval (CI), to evaluate the relation between CP and pre-maturity. RESULTS: Periodontal indicators, such as clinical attachment loss (p<0.0001) and bleeding on probing (p=0.012), were observed more in the PTL group. The presence of CP increased the risk for PTL (OR: 4.7, 95% CI: 1.9-11.9), pre-term birth (PTB; OR: 4.9, 95% CI: 1.9-12.8) and low birth weight (<2500 g; OR: 4.2, 95% CI: 1.3-13.3). The pregnant women with PTL presented low levels of schooling (p=0.029) and the lowest number of pre-natal appointments (p=0.0001) when compared with those with term labour. CONCLUSION: CP is strongly associated with PTL, PTB and low birth weight in a group of Brazilian pregnant women. These data point to the necessity of regularly investigating CP during pregnancy.