Effects of probiotics in rats with experimental metabolic syndrome and periodontitis: An investigation of the intestine-adipose tissue axis.

BACKGROUND: This study evaluated the systemic (intestine and adipose tissue) and local (periodontal tissues) impact of probiotic therapy in rats with metabolic syndrome (MS) associated or not with periodontitis (PE). METHODS: Forty-eight rats received a high-fat diet for induction of MS for 16 weeks. They were subdivided into groups with (+) and without (-) PE, receiving (*) or not (**) receiving probiotics (PROB): MS (-**), MSP (-*), MSPE (+**), and MSPEP (+*). PROB administration (Bifidobacterium animalis subsp. lactis HN019) started on the 8th week of the study and PE was induced on the 14th week by placing ligature on the animals' lower first molars. Euthanasia occurred in the 16th week. Biomolecular, immunoenzymatic assays, and histomorphometric analyses were performed. The data obtained were statistically analyzed (ANOVA, Tukey, p < 0.05). RESULTS: The MSPEP group exhibited reduced alveolar bone loss when compared with the MSPE group, as well as lower levels of hepatic steatosis and proteinuria (p < 0.05). In the intestinal environment, the MSPE group exhibited significantly lower villus height and crypt depth, as well as a greater increase in Bacillota when compared with the MSPEP group (p < 0.05). The MSPEP group showed lower adipokine gene expression (LEPR, NAMPT, and FABP4) in adipose tissue than the MSPE group (p < 0.05). CONCLUSION: The probiotic B. lactis HN019 reduced the severity of experimental periodontitis and modulated the expression of lipogenic genes and intestinal morphological and microbiological parameters in rats with MS.

Evaluation of Bone Response to a Nano HA Implant Surface on Sinus Lifting Procedures: Study in Rabbits.

The aim of this study was to evaluate the bone response to two different implant surfaces on sinus lift procedures in rabbits. Bilateral sinus lifting with inorganic bovine bone associated with collagen membrane and immediate implantation were performed in 16 rabbits. Custom mini-implants were randomly installed in the prepared sites: one side received a double acid-etched (DAE) surface and the other a nano-hydroxyapatite (NHA) surface. The animals were euthanized 30 and 60 days after surgery, and biopsies were collected for microtomographic and histomorphometric analysis. After 30 days, no intra- and inter-group statistical differences were observed in microtomographic analysis, while at 60 days, bone analysis showed statistically significant differences between groups (p < 0.05) for all the evaluated parameters. Histomorphometric analysis showed, after 30 days, mean % of Bone-to-Implant Contact (BIC) for DAE and NHA of 31.70 ± 10.42% vs. 40.60 ± 10.22% (p > 0.05), respectively; for % of Bone Area Fraction Occupancy (BAFO), mean values were 45.43 ± 3.597% for DAE and 57.04 ± 5.537% for NHA (p < 0.05). After 60 days, mean %BIC and %BAFO for DAE and NHA implants were statistically significant (p < 0.05). The NHA surface showed superior biological features compared to the DAE treatment, promoting higher bone formation around the implants in an experimental model of bone repair in a grafted area.

Root coverage with tunneling technique or modified advanced flap associated with acellular dermal matrix: results from 6 months randomized clinical trial.

OBJECTIVES: This study compared two surgical techniques using acellular dermal matrix (ADM) for the treatment of multiple gingival recessions. MATERIAL AND METHODS: Twenty patients, with bilateral RT1 gingival recessions, were selected. One side received a modified extended coronally advanced flap (MECAF), and the contralateral side a supra-periosteal flap (TUN). The evaluated parameters were probing depth (PD), relative clinical attachment level, gingival index, gingival recession height (GR), width of keratinized tissue, keratinized tissue thickness, and gingival recession area at baseline and 6 months postoperative. Pain was evaluated weekly, using a visual analog scale (VAS) during first month postoperative. RESULTS: Both groups were effective in reducing GR (ΔGR: MECAF 2.28 mm; TUN 1.93 mm), without significant differences. The % of root coverage was numerically superior favoring MECAF (MECAF 61.24%; TUN 56.07%), without significant differences between groups. VAS scale failed to provide differences between groups. CONCLUSIONS: Both treatment were effective in root coverage and might be valuable for the treatment of multiple gingival recessions. The use of vertical releasing incisions and a flap design including the papillae did not hamper root coverage. CLINICAL RELEVANCE: This study compared two techniques for use of ADM in large multiple gingival recessions. Within its limitations, both treatments successfully achieved root coverage and were able to reduce gingival recession. It is expected a partial root coverage when using these techniques in large gingival recessions. The study failed to provide significant differences between groups. The use of modified extended coronally advanced flap may be advisable for the treatment of multiple gingival recessions, specially involving large defects when using ADM, to avoid early matrix exposure.

Histological and Nanomechanical Properties of a New Nanometric Hydroxiapatite Implant Surface. An In Vivo Study in Diabetic Rats.

Implant therapy is a predictable treatment to replace missing teeth. However, the osseointegration process may be negatively influenced by systemic conditions, such as diabetes mellitus (DM). Microtopography and implant surface developments are strategies associated to better bone repair. This study aimed to evaluate, in healthy and diabetic rats, histomorphometric (bone to implant contact = %BIC; and bone area fraction occupancy = %BAFO) and nanomechanical (elastic modulus = EM; and hardness = H) bone parameters, in response to a nanometric hydroxyapatite implant surface. Mini implants (machined = MAC; double acid etched = DAE, and with addition of nano-hydroxyapatite = NANO) were installed in tibias of healthy and diabetic rats. The animals were euthanized at 7 and 30 days. NANO surface presented higher %BIC and %BAFO when compared to MAC and DAE (data evaluated as a function of implant surface). NANO surface presented higher %BIC and %BAFO, with statistically significant differences (data as a function of time and implant surface). NANO surface depicted higher EM and H values, when compared to machined and DAE surfaces (data as a function of time and implant surface). Nano-hydroxyapatite coated implants presented promising biomechanical results and could be an important tool to compensate impaired bone healing reported in diabetics.

Effect of smoking on the DNA methylation pattern of the SOCS1 promoter in epithelial cells from the saliva of patients with chronic periodontitis.

BACKGROUND: The aim of the present study was to evaluate the methylation pattern in the suppressor of cytokine signaling 1 (SOCS1) gene in smokers and non-smokers with chronic periodontitis (CP). METHODS: Methylation-specific polymerase chain reaction (PCR) was performed to determine the methylation status of the SOCS1 promoter in 45 saliva samples from smokers and non-smokers with CP. RESULTS: Cells from the saliva of CP patients who smoked were 7.08 times more likely to have a methylated SOCS1 promoter than cells from the saliva of non-smoking patients. CONCLUSIONS: SOCS1 gene promoter methylation, with its potential effects on the expression of this gene, seems to be a consequence of exposure to tobacco and not to periodontal disease. Further studies are needed to elucidate the relationship between the epigenetic control of immune response gene expression, exposure to environmental factors, and the development, progression, and prognosis of CP.

Sub-antimicrobial doses of doxycycline decreased bone loss related to ligature-induced periodontitis in hypertensive rats.

BACKGROUND/OBJECTIVE: The beneficial effects of sub-antimicrobial dose doxycycline (SDD) associated with nonsurgical periodontal therapy are well documented. Recently, the effects of SDD on metalloproteinases have been investigated in the treatment of hypertension. The aim of this study was to evaluate the effects of SDD on ligature-induced periodontitis in spontaneously hypertensive rats (SHR). METHODS: Fifty-four adult male rats were divided into three groups: SHR-C, SHR-L and SHR-L-DOX (C - Control; L - Ligature). In group SHR-L-DOX, animals were treated with daily 5 mg/kg SDD administration. In L groups, a ligature remained around mandibular first molars for the first 10 days. Each group was divided for euthanasia at 10 or 21 days. Microtomographic and histometric analyses were performed. Osteoclastogenesis was evaluated by tartrate-resistant acid phosphatase (TRAP) assay and gene expression of 84 inflammatory mediators by polymerase chain reaction (PCR) array. RESULTS: Group SHR-L-DOX presented reduced systolic blood pressure when compared with group SHR-L at both 10 and 21 days (p < 0.05). Group SHR-L-DOX showed decreased bone and attachment loss in comparison with group SHR-L at both 10 and 21 days (p < 0.05). SDD treatment reduced the amount of TRAP-positive cells at 10 days (p < 0.05). Group SHR-L-DOX showed a downregulated inflammatory genes profile in comparison with SHR-L at 10 and 21 days. CONCLUSION: SDD therapy exerted systemic modulatory effect on inflammation with reduced periodontal tissue destruction in hypertensive rats.

Multiple sessions of antimicrobial photodynamic therapy associated with surgical periodontal treatment in patients with chronic periodontitis.

BACKGROUND: This double-blind, randomized, controlled clinical trial assessed the efficacy of multiple sessions of antimicrobial photodynamic therapy (aPDT) as an adjunct to surgical periodontal treatment (ST) in patients with severe chronic periodontitis (SCP). METHODS: Sixteen patients with SCP were treated with aPDT+ST (test group, TG) or ST only (control group, CG), in a split-mouth design. aPDT was applied at 0, 2, 7, and 14 postoperative days only in TG. All patients were followed up for 90 days after surgery. The following clinical and microbiological parameters were assessed: clinical attachment level (CAL), probing depth (PD), gingival recession (GR), bleeding on probing (BOP), plaque index (PI), and count of 40 subgingival microbial species (checkerboard DNA-DNA hybridization). Data were collected at baseline (preintervention), at 60 days (30 days after the end of non-surgical therapy), and at 150 days (90 days after surgery). RESULTS: A significant reduction in PD was observed at 150 days for the TG, when compared with the CG (P Ë‚ 0.05). CAL gain was significantly higher in the TG at 60 and 150 days (P Ë‚ 0.05). Changes in the subgingival microbiota were similar between the groups (P Ëƒ 0.05), but the TG revealed a larger number of bacteria associated with periodontal disease at the end of the experiment compared with the CG (P < 0.05). CONCLUSION: Multiple sessions of aPDT as an adjunct to surgical periodontal treatment significantly improved clinical parameters at 90 postoperative days.

Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: A randomized clinical trial.

AIM: This randomized placebo-controlled clinical trial evaluated the effect of Bifidobacterium animalis subsp. lactis (B. lactis) HN019-containing probiotic lozenges as adjuvant to scaling and root planing (SRP) in patients with generalized chronic periodontitis. MATERIALS AND METHODS: Forty-one chronic periodontitis patients were recruited and monitored clinically, immunologically, and microbiologically at baseline (before SRP) and 30 and 90 days after SRP. All patients were randomly assigned to a Test (SRP + Probiotic, n = 20) or Control (SRP + Placebo, n = 21) group. The probiotic lozenges were used twice a day for 30 days. The data were statistically analysed. RESULTS: The Test group presented a decrease in probing pocket depth and a clinical attachment gain significantly higher than those of the Control group at 90 days. The Test group also demonstrated significantly fewer periodontal pathogens of red and orange complexes, as well as lower proinflammatory cytokine levels when compared to the Control group. Only the Test group showed an increase in the number of B. lactis HN019 DNA copies on subgingival biofilm at 30 and 90 days. CONCLUSION: The use of B. lactis HN019 as an adjunct to SRP promotes additional clinical, microbiological, and immunological benefits in the treatment of chronic periodontitis (NCT03408548).

Effect of surgical periodontal treatment associated to antimicrobial photodynamic therapy on chronic periodontitis: A randomized controlled clinical trial.

AIM: This randomized controlled clinical trial evaluated the effects of an adjunctive single application of antimicrobial photodynamic therapy (aPDT) in Surgical Periodontal Treatment (ST) in patients with severe chronic periodontitis (SCP). MATERIAL AND METHODS: In a split-mouth design, 20 patients with SCP were treated with aPDT+ST (Test Group, TG) or ST only (Control Group, CG). aPDT was applied in a single episode, using a diode laser and a phenothiazine photosensitizer. All patients were monitored until 90 days after surgical therapy. Levels of 40 subgingival species were measured by checkerboard DNA-DNA hybridization at baseline, 60 and 150 days. Clinical and microbiological parameters were evaluated. RESULTS: In deep periodontal pockets depth (PPD ≥5 mm), Test Group presented a significantly higher decrease in PPD than Control Group at 90 days after surgical therapy (p < .05). Test Group also demonstrated significantly less periodontal pathogens of red complex (Treponema denticola) (p < .05). CONCLUSION: A single episode of aPDT used in adjunct to open flap debridement of the root surface in the surgical treatment of SCP: i) significantly improved clinical periodontal parameters; ii) eliminates periodontal pathogens of the red complex more effectively (NCT02734784).

Bioactive Glass Particles in Two-Dimensional and Three-Dimensional Osteogenic Cell Cultures.

This study aimed to investigate the influence of a three-dimensional cell culture model and bioactive glass (BG) particles on the expression of osteoblastic phenotypes in rat calvaria osteogenic cells culture. Cells were seeded on two-dimensional (2D) and three-dimensional (3D) collagen with BG particles for up to 14 days. Cell viability and alkaline phosphatase (ALP) activity was performed. Cell morphology and immunolabeling of noncollagenous bone matrix proteins were assessed by epifluorescence and confocal microscopy. The expressions of osteogenic markers were analyzed using RT-PCR. Mineralized bone-like nodule formation was visualized by microscopy and calcium content was assessed quantitatively by alizarin red assay. Experimental cultures produced a growing cell viability rate up to 14 days. Although ALP activity at 7 days was higher on BG cultures, cells on 3D and 3D+BG had an activity decrease of ALP at 14 days. Three-dimensional conditions favored the immunolabeling for OPN and BSP and the expression of ALP and COL I mRNAs. BG particles influenced positively the OC and OPN mRNAs expression and calcified nodule formation in vitro. The results indicated that the 3D cultures and BG particles contribute to the expression of osteoblastic phenotype and to differentiated and mineralized matrix formation.

Impact of Different Implant Surfaces Topographies on Peri-Implant Tissues: An Update of Current Available Data on Dental Implants Retrieved from Human Jaws.

The high success range obtained with the implant-supported restorations has improved its applicability on routine of the daily clinical practice. This elevated percentage of success is related to the previous pre-clinical data obtained from animal and in vitro studies that evaluated the impact of implant surface topographies on bone tissue. However, the histological evaluation of human bone tissue is scarce. Therefore, the aim of this review is to depict an actual panorama of the data available on boneto- implant contact (BIC) of retrieved implants from human jaws. Some aspects of implant surface topography as well as systemic conditions as osteoporosis and smoking habit were demonstrated to have a strong impact, suggesting that the data obtained from human bone tissue is still valuable for the better understanding of the osseointegration process. This article also highlighted that most data in humans are difficult to interpret, due to the lack of detailed information about the surfaces found in retrieved implants. Without the definition of the surface characteristics, it is difficult to link exactly the surface patterns to specific clinical observations, and all observations remain de facto incomplete. As a conclusion, data from implants retrieved from human jaws are very important for our understanding, however the studies remain scarce and data is fragmented. This important approach should be improved, completed and developed in the future.

Benefits of Bifidobacterium animalis subsp. lactis Probiotic in Experimental Periodontitis.

BACKGROUND: This study evaluates effects of topical administration of probiotic bacteria of the genus Bifidobacterium on experimental periodontitis (EP) in rats. METHODS: Thirty-two rats were divided into groups C (control; without EP), EP (EP only), C-HN019 (control+probiotic), and EP-HN019 (EP+probiotic). On day 0 of the experiment, animals of groups EP and EP-HN019 received cotton ligatures around mandibular first molars (MFMs). In groups C-HN019 and EP-HN019, 1 mL of suspensions containing Bifidobacterium animalis subsp. lactis (B. lactis) HN019 was topically administered in the subgingival region of MFMs on days 0, 3, and 7. In groups C and EP, topical administrations were performed using a sham suspension (without probiotic). All animals were euthanized at day 14. Gingival tissue, hemimandibles, and oral biofilm were collected. Data were statistically analyzed (P <0.05). RESULTS: Group EP presented greater bone porosity, trabecular separation, and connective tissue attachment loss (CTAL) as well as reduced bone volume than all other groups (P <0.05). In group EP-HN019, there were greater proportions of Actinomyces and Streptococcus-like species and lower proportions of Veillonella parvula, Capnocytophaga sputigena, Eikenella corrodens, and Prevotella intermedia-like species than group EP. Group EP-HN019 presented greater expressions of osteoprotegerin and ß-defensins than group EP (P <0.05). Group EP presented greater levels of interleukin-1ß and receptor activator of nuclear factor-kappa B ligand than group EP-HN019 (P <0.05). CONCLUSION: Topical use of B. lactis HN019 promotes a protective effect against alveolar bone loss and CTALs attributable to EP in rats, modifying immunoinflammatory and microbiologic parameters.

Antimicrobial photodynamic therapy as an alternative to systemic antibiotics: results from a double-blind, randomized, placebo-controlled, clinical study on type 2 diabetics.

AIM: This double-blind, placebo-controlled clinical study compared multiple applications of the antimicrobial photodynamic therapy (aPDT) treatment protocol, to systemic doxycycline as adjuvant to scaling and root planing (SRP) on type 2 diabetic patients on clinical, systemic and immune-inflammatory outcomes. MATERIALS AND METHODS: Thirty patients with Hba1c >7% were allocated in two groups, SRP + Doxy (n = 15) using systemic doxycycline 100 mg/day (14 days) and SRP + aPDT (n = 15) with multiple applications (0, 3, 7 and 14 days). Primary outcome was glycated haemoglobin levels (HbA1c). Clinical parameters: plaque score (PS), bleeding on probe, probing depth, suppuration, gingival recession, and clinical attachment level, percentage of pockets with desired clinical endpoint were measured at baseline and 3 months after therapy. Cytokine profile was assessed at 0, 1 and 3 month to measure IL1-ß, TNF-α and TGF-ß on gingival crevicular fluid. RESULTS: No significant difference was detected on HbA1c, between treatments. The SRP + aPDT group showed advantage on reducing moderate pockets in single-rooted teeth at 3 months. SRP + aPDT presented better results at 3 months on IL1-ß levels. There were no significant differences between TNF-α and TGF-ß. CONCLUSIONS: Both treatments improved clinical and systemic outcomes (Hba1c). SRP + aPDT performed better in moderate probing pocket depth on single-rooted teeth, reduced favourably inflammation in short term, and may be an alternative to systemic antibiotics. (Clinicaltrials.org ID NCT01595594).

Comparative study of two surgical techniques for root coverage of large recessions in heavy smokers.

Reduced root coverage due to diminished periodontal vascularity can be expected in heavy smokers. The aim of this study was to evaluate the root coverage obtained for large gingival recessions in heavy smokers using two different surgical techniques. Twenty heavy smokers were selected. Each patient had large, bilateral Miller class I or II gingival recessions (Control Group (CG): 3.30 ± 1.29; Test Group (TG): 3.45 ± 0.80) on nonmolar teeth. Clinical measurements of probing pocket depth (PPD), clinical attachment level (CAL), recession height (RH), keratinized mucosa height (KMH), and keratinized mucosa thickness (KMT) were determined at baseline and after 12 months. One side received a coronally positioned flap (CPF), while the contralateral side received the extended flap technique (EFT), both procedures carried out in conjunction with a subepithelial connective tissue graft (SCTG). Saliva samples to measure cotinine levels were taken at baseline and after 12 months as an indicator of the level of exposure to nicotine. Intergroup and intragroup analysis showed no statistical differences for the evaluated clinical parameters. Patients maintained the same exposure to smoke during the evaluation period. Both techniques resulted in low root coverage (CPF: 48.60%; EFT: 54.28%), but both techniques were effective in decreasing the gingival recessions (P ≤ 0.01). The variables smoke exposure, root coverage, and the thickness and height of keratinized tissue were subjected to linear regression. Regardless of the surgical technique used, heavy smoking strongly limits root coverage, especially for large recessions.

The influence of the periodontal biotype on peri-implant tissues around immediate implants with and without xenografts. Clinical and micro-computerized tomographic study in small Beagle dogs.

OBJECTIVE: Soft tissues and buccal bone plate remodeling after immediate implantation in sockets with thin buccal bone, using the flapless approach with or without bone graft into the buccal gap, was compared between sites with thin and normal gingiva. MATERIAL AND METHODS: Eight dogs had the gingiva of one side of the mandible thinned, the mandibular premolars were extracted without flaps, and 4 implants were installed in each side, positioned 1.5 mm from the buccal bone. The sites were randomly assigned into: TG (test group) = thin gingiva; TG + GM (TG with grafting material); CG (control group) = normal gingiva; and CG + GM (CG with grafting material). Buccal bone thickness (BBT), thickness of keratinized tissue (TKT), alveolar thickness (AT), gingival recession (GR), and probing depth (PD) were clinically evaluated. Within 12 weeks the dogs were sacrificed and the samples were analyzed by micro-computerized tomography. RESULTS: A thin BBT was observed in all the dogs. The presurgical procedures reduced TKT in the test group, with minimal changes of the AT. There were no statistically significant differences among the groups for the clinical parameters and the tomographic analysis showed similar linear and tri-dimensional bone reduction in all the groups. CONCLUSION: The thickness of the buccal bone was a fundamental factor in buccal bone plate resorption, even with flapless implantation. The decrease in gingival thickness or the addition of a biomaterial in the gap did not influence the results.

Adjunctive effect of antimicrobial photodynamic therapy to nonsurgical periodontal treatment in smokers: a randomized clinical trial.

The aim of this study was to investigate the adjunctive effect of antimicrobial photodynamic therapy (aPDT) to scaling and root planing (SRP) in smokers with chronic periodontitis. Twenty subjects had two contralateral teeth randomly assigned to receive SRP (SRP group) or SRP + a single episode of aPDT (SRP + aPDT group), with a diode laser and a phenothiazine photosensitizer. Plaque index, bleeding on probing, probing depth (PD), clinical attachment level (CAL), and gingival recession were recorded, and gingival crevicular fluid was collected for assay of IL-1ß and matrix metalloproteinase (MMP)-8 levels. There was a significant PD reduction (SRP 1.81 ± 0.52 mm/SRP + aPDT 1.58 ± 1.28 mm; p < 0.001) and a significant CAL gain (SRP 1.60 ± 0.92 mm/SRP + aPDT 1.41 ± 1.58 mm; p < 0.001) for both groups. Significant differences were not observed in between-group comparisons. IL-1ß level in gingival crevicular fluid was higher in SRP group after 1 week (SRP 24.65 ± 18.85 pg/µL/SRP + aPDT 34.07 ± 24.81 pg/µL; p = 0.048), and MMP-8 level was higher in SRP group after 12 weeks (SRP 303.31 ± 331.62 pg/µL/SRP + aPDT 534.23 ± 647.37 pg/µL; p = 0.024). There were no statistically significant differences in intragroup comparisons. The adjunctive effect of aPDT did not warrant improvements on clinical parameters in smokers. However, it resulted in a suppression of IL-1ß and MMP-8 when compared with SRP alone.

Antimicrobial photodynamic therapy associated to nonsurgical periodontal treatment in smokers: microbiological results.

BACKGROUND: Studies suggest that smokers present more or greater numbers of potential periodontal pathogens than non-smokers. The aim of this study was to investigate the microbiologic effects of adjunctive aPDT on nonsurgical periodontal treatment in smokers with chronic periodontitis (CP). METHODS: Twenty smokers with CP had two contralateral teeth randomly assigned in a split-mouth design to receive SRP (CG) or SRP + a single episode of aPDT (TG), with a diode laser and a phenothiazine photosensitizer. Levels of 40 subgingival species were measured using checkerboard DNA-DNA hybridization at baseline and 1, 4 and 12 weeks after periodontal treatment. RESULTS: All 40 bacterial species evaluated were detected in different levels at baseline, with no statistic significant differences between groups. After periodontal treatment, the levels of some bacterial species decreased, while some other species presented an increase. Despite this variation, the statistical analysis was not able to identify significant differences neither at intragroup nor at intergroup comparisons. CONCLUSION: Periodontal treatment with SRP or SRP + aPDT was not able to reduce levels of 40 subgingival species in smokers with CP. These outcomes indicate that smoking impairs periodontal healing after nonsurgical treatment even associated with aPDT.

A modified surgical technique for root coverage with an allograft: a 12-month randomized clinical trial.

BACKGROUND: The aim of this randomized controlled clinical study is to investigate whether a modified surgical technique could provide better results for root coverage and greater amounts of keratinized tissue (KT) with the acellular dermal matrix graft (ADMG). METHODS: Fifteen bilateral Miller Class I or II gingival recessions (GRs) were selected. The recessions were treated and assigned randomly to the test group (TG), and the contralateral recessions were assigned to the control group (CG). The ADMG was used in both groups with differences in the graft positioning between them. The following clinical parameters were measured before the surgeries and after 12 months: 1) probing depth; 2) relative clinical attachment level; 3) GR; 4) thickness of KT (TKT); and 5) KT width. A new parameter, the GR area (GRA), was measured in standardized photographs using a special device and software. RESULTS: There was no significant difference between groups in KT width and TKT parameters at the 12-month postoperative period. However, there was a significant difference between the gains in GR (ΔGR) and GRA (ΔGRA), favoring the TG after 12 months. The TG presented ΔGR = 3.04 ± 0.29 mm and ΔGRA= 38,919 ± 9,238 pixel square values (pix(2)), and the CG presented ΔGR= 2.61 ± 0.41 mm and ΔGRA= 22,245 ± 9,334 pix(2) (P <0.05 and <0.001, respectively). CONCLUSIONS: Both techniques were successful. The TG treatment was more effective in reducing GR and GRA. The flap and graft position may be of importance in root coverage procedures outcome.

Additional effects of aPDT on nonsurgical periodontal treatment with doxycycline in type II diabetes: a randomized, controlled clinical trial.

The association of doxycycline and periodontal treatment in non-controlled diabetes mellitus (DM) has shown positive results on clinical and metabolic parameters. Antimicrobial photodynamic therapy (aPDT) is a local and painless antimicrobial treatment that can be applied in periodontal treatment without systemic risks. The aim of this study was to evaluate the potential improvement of aPDT on clinical and metabolic effects in patients with type 2 diabetes mellitus in conjunction with nonsurgical periodontal treatment plus doxycycline. Thirty patients with type 2 diabetes and diagnosis of chronic periodontitis were treated with scaling and root planning (SRP; N = 15) or SRP plus phenothiazine chloride photosensitizer-induced aPDT (SRP + aPDT, N = 15). Patients of both groups took doxycycline (100 mg/day) for 2 weeks and plaque index, bleeding on probe (BOP), probing pocket depth (PPD), suppuration, clinical attachment level (CAL), and glycated hemoglobin levels (HbA1c) were measured at baseline and 3 months after therapy. An improvement in clinical parameters such as PPD, CAL, S, and BOP between groups was observed but without statistical significance (p > 0.05). Intragroup analysis showed a significant reduction of HbA1c (8.5 ± 0.9 to 7.5 ± 0.1, p < 0.01) in the SRP + aPDT group. The differences of HbA1c between baseline and 3 months were greater for the SRP + aPDT (11.4 %) than SRP (10 %) (0.87 ± 0.9 and 0.4 ± 0.84 respectively; p < 0.05). A single application of the aPDT as an adjunct to periodontal treatment did not show additional benefits in the clinical parameters but resulted in a slight greater decrease in HbA1c.

Absorção do osso bovino inorgânico utilizado em levantamento do seio maxilar. Caso clínico com avaliações microtomográfica e histomorfométrica após 12 e 20 meses / Resorption of inorganic bovine bone used for maxillary sinus floor augmentation: a case report with micro-CT and histomorphometric evaluations after 12 and 20 months

A reabsorção óssea na região posterior da maxila edêntula pode limitar a colocação de implantes com comprimentos adequados. O objetivo desse estudo foi apresentar um caso clínico de cirurgia de levantamento de seio maxilar bilateral com instalação tardia (após 12 e 20 meses de regeneração óssea guiada – ROG) de implantes cone-morse em área posterior de maxila, utilizando como biomaterial o osso bovino inorgânico (Bio-Oss) associado à membrana de colágeno (Bio-Gide). Após 12 e 20 meses da ROG a área foi reaberta e, previamente à instalação dos implantes, uma biopsia óssea foi realizada para análises microtomográfica e histológica. A técnica de ROG proporcionou ganho de volume ósseo, adequando a região para a colocação dos implantes. A análise microtomográfica da biopsia óssea mostrou 27% de osso neoformado e 39% de biomaterial residual após 12 meses, 52% de volume ósseo e 16% de biomaterial residual após 20 meses. Na avaliação histomorfométrica, foram observadas maior área de biomaterial aos 12 meses (13,74% e 4,34% aos 12 e 20 meses, respectivamente) e maior área de osso neoformado aos 20 meses (15,69% e 30,70% aos 12 e 20 meses, respectivamente). Concluiu-se que no período de 12 a 20 meses houve progressiva substituição de partículas do biomaterial por novo osso, e que o Bio-Oss pode ser utilizado com sucesso nesta situação clínica, sendo uma alternativa ao uso de enxertos ósseos autógenos com a vantagem de evitar maior morbidade ao paciente.