A Case of Doxycycline-induced Melanin in the Gingiva Tissue: Case Report.

BACKGROUND: Gingival pigmentation is a discoloration of the gingiva due to a variety of lesions and conditions associated with several endogenous and exogenous etiologic features. OBJECTIVE: The purpose of this study is to describe a report of gingival pigmentation in a patient who used doxycycline. CASE REPORT: A 21-year-old Caucasian female was under dermatological treatment and antibiotic therapy with doxycycline 100 mg (one time a day) for 90 days. She presented brown pigmentation at the gingival margin on the facial surfaces of the upper and lower anterior incisors and premolars. The patient was evaluated by immunohistochemical (S-100, Melan-A, and HMB-45) and histopathologic analyses, and clinical history. Blood levels of malondialdehyde (MDA), glutathione (GSH), and superoxide dismutase (SOD) were analyzed by UV/Vis spectroscopy. The adrenaline, noradrenaline, and dopamine in blood were analyzed by high-performance liquid chromatography (HPLC); dehidroepiandrosterone (DHEA) in serum by radioimmunoassay; and luteinizing hormone (LH) and 25-Hydroxyvitamin D by chemiluminescence. Hematoxylin-eosin stained sections revealed keratinocytes with pigment compatible with melanin. The Fontana-Masson staining was positive in melanophages and in some basal keratinocytes. S-100, Melan A and HMB-45 were confirmed as positive markers of melanocytic differentiation in gingival tissue. We observed a significant increase in malondialdehyde (p˂0.05) and a decrease in superoxide dismutase levels (p˂0.05). The dopamine value was found to be 15 pg/ml (reference value ≤ 10 pg/ml). CONCLUSION: The use of doxycycline is associated with an increase in oxidative stress and of dopamine with melanin pigments in the gingival tissue. This case report showed a cause-effect relationship between exposure to doxycycline and pigmentation of the marginal gingiva.

Case report: Anterior open bite correction treatment by dental treatment and physical therapy through craniocervical mandibular and occlusal stabilization.

BACKGROUND: The opinion on whether a patient with an anterior open bite should be treated surgically or not is controversial. These patients generally suffer from associated discomfort due to their occlusal instability and musculoskeletal pain. CLINICAL PRESENTATION: A 60-year-old woman visited the clinic with dental mobility of her upper central incisors as her chief complaint. She had a severe anterior open bite, with a history of continuous grinding and multiple dental restorations in poor condition. Additionally, she suffered neck pain with movement restrictions. CONCLUSION: Dentists can evaluate and treat patients with an anterior open bite using this integrative model (physical therapy/dentistry) as a possible alternative as part of the treatment for anterior open bite patients.

Dental tissue-derived stem cell sheet biotechnology for periodontal tissue regeneration: A systematic review.

OBJECTIVE: This study aimed to conduct a systematic review of the use of a cell sheet formed by mesenchymal stem cells derived from dental tissues (ddMSCs) for periodontal tissue regeneration in animal models in comparison with any other type of regenerative treatment. DESIGN: PubMed and Scopus databases were searched for relevant studies up to December 2020. The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. RESULTS: Of the 1542 potentially relevant articles initially identified, 33 fulfilled the eligibility criteria and were considered for this review. Even with a wide variety of selected study methods, the periodontal tissue was always regenerated; this indicates the potential for the use of these cell sheets in the future of periodontics. However, this regeneration process is not always complete. CONCLUSION: Despite the implantation, ddMSCs sheets have a great potential to be used in the regeneration of periodontal tissue. More in vivo studies should be conducted using standardized techniques for cell sheet implantation to obtain more robust evidence of the relevance of using this modality of cell therapy for periodontal tissue regeneration.

Root Coverage with Platelet-Rich Fibrin in Miller's Class I, III, and IV Gingival Retractions.

Coronally advanced flap (CAF) with connective tissue graft (CTG) is considered as the most predictable method to treat Miller's Class I and II gingival recessions (GR). However, due to the patient's postsurgical discomfort, the difficulty of finding a donor with an adequate tissue thickness, the high costs of acellular dermal substitute among others, the platelet concentrates have been found to scaffold alternative to replace CTG as a part of the CAF treatment for GR. Nevertheless, according to the recent literature, the evidence of success in Class III and IV has been limited for CAF and platelet-rich fibrin (PRF). The purpose of this report is to present a case of multiple Miller's Class III and IV GR treated with CAF and PRF where the potential of PRF to increase gingival thickness and clinical attachment level, and improve soft-tissue healing and clinical appearance was corroborated.

Técnicas de afastamento gengival / Techniques of gingival retraction

O presente estudo é uma revisão de literatura, a qual visa demonstrar aos cirurgiões dentistas diversas técnicas de afastamento gengival, suas vantagens e desvantagens no que diz respeito à longevidade da restauração protética e preservação dos tecidos periodontais circunjacentes.(AU)

The present study is a review of the literature and have the objective that shows to dentists the various techniques of gingival retraction, its advantages and disadvantages, that have respect for the longevity of the prosthetic protection and preservation of the surrounding periodontal tissues.(AU)

Efeitos da combinação do fator de crescimento de fibroblastos básico e fator de transformação de crescimento beta na proliferação, expressão de genes para colágeno tipos I e III, metaloproteases-1 e -2 e TIMPs 1,2 e 3, e na modulação da síntese destes próprios fatores de crescimento pelas células do ligamento periodontal de humanos / The effects of association of basic fibroblast growth factor and transforming growth factor beta on the proliferation, expression of colagen type I e III, matrix metalloproteinases-1 e -2 e TIMPs 1,2 and 3, and on the modulation of the syntheses of these growth factors by humans periodontal ligament cells

O objetivo do presente estudo avaliar o efeito da combinação do fator de crescimento de fibroblastos básico (b-FGF) e fator de transformação de crescimento beta (TGFbeta) na proliferação, expressão de genes para colágeno tipos I e III, metaloproteases -1 e ­2 e TIMPs 1, 2 e 3, e na síntese destes próprios fatores de crescimento pelas células do ligamento periodontal de humanos. Para a realização do estudo, as células em diferentes concentrações, de acordo com cada experimento, foram tratadas com os fatores de crescimento nas concentrações de 1.0ng e 10ng/ml de meio de cultura para o b-FGF e para o TGF-ß, tanto isoladamente quanto associados. A avaliação da proliferação celular foi realizada após os períodos de 24 e 48h na presença dos fatores de crescimento, através da mensuração do nível de MTS reduzido a formazan pelas células viáveis, e a síntese de b-FGF e TGF-ß pelo teste ELISA empregando a técnica "sandwich". A expressão de genes para colágeno tipos I e III, metaloproteases-1 e -2 foi avaliada pela técnica de RT-PCR. O teste ANOVA mostrou haver diferenças estatisticamente significantes para proliferação e síntese de bFGF (p<0.05) entre os tratamentos. O teste de Comparação Múltipla de Bonferroni mostrou que todas as associações aumentaram a proliferação celular e a síntese de bFGF (p<0.001). Isoladmente, só o TGF-ß foi capaz de estimular a proliferação, independente do tempo e da dose (p<0.001), enquanto que, somente o bFGF estimulou a síntese dele próprio de maneira dose-dependente (p<0.05). Em relação à síntese de TGF-ß, apenas a associação das menores doses de cada fator, foi capaz de modular a síntese dele mesmo. O teste de Kolmogorov- Smirnov mostrou haver diferenças estatisticamente significantes quanto à expressão de genes entre o uso isolado dos fatores de crescimento (p<0.1), já que o bFGF aumentou a expressão de MMP-1 e MMP-2 e reduziu para Col I e III, e TIMPs1, 2 e 3, enquanto que, o TGF-ß atuou de maneira inversa. Todas as associações apresentaram efeito semelhante ao uso isolado do TGFß, com exceção da associação de 10ng de bFGF com 1ng de TGF-ß, na qual prevaleceu o efeito do bFGF. Conclui-se que as associações do bFGF e do TGF-ß atuaram de maneira dose-dependente no estímulo a proliferação celular, o aumento na expressão de genes para colágeno e TIMPs, e redução para as metalproteases e, modulação da síntese deles próprios

The aim of this study was to evaluate the effect of association of basic fibroblast growth factor and transforming growth factor beta on the proliferation, expression of colagen type I e III, matrix metalloproteinases-1 e ­2 e TIMPs 1, 2 e 3, and on the modulation of the syntheses oh these growth factors by humans periodontal ligament cells. Different concentrations of cells, according to experiment, were incubated on the presence of 1.0 or 10 ng/ml of DMEM of growth factors, associated or no. The cellular proliferation was evaluated to 24 and 48 hours of incubation by the colorimetric method. The synthese of bFGF and TGF-ß was verificated by ELISA method, using a "sandwich" techinique, and mRNA expression by Real Time - PCR. ANOVA test results indicated significant differences on the proliferation and bFGF synthesis (p<0.05) among the treatments. Bonferroni for pairwise comparition test results showed that all association estimulated the proliferation and bFGF synthesis (p<0.001). Alone, only TGF-ß can stimulate the proliferation to both concentrations and periods (p<0.001), and only bFGF stimulated its own synthesis by dosedependent manner (p<0.05). Only the asssociation of 1ng of each growth factor can stimulate the synthesis of TGF-ß. Kolmogorov-Smirnov test results indicated significant differences on the expression of mRNA among treatment with the isolated growth factors (p<0.1). Basic fibroblast growth factor increased the expression of MMP-1 e MMP-2 and reduced to collagen I e III, e TIMPs1, 2 e 3, as long as TGF-ß behaved the inverse manner. All the associations had similar effect to isolated TGF-ß, except the association of 10ng of bFGF to 1ng of TGF-ß. In conlusion, the associations of bFGF e TGF-ß influenced of dose-dependent manner on the cellular proliferation, on the increasing of the expression to collagen and TIMPs, and on the reduction to metaloproteinases and, the modulation of these own synthesis