Recesión gingival. Diagnóstico y tratamiento / Gingival recession. Diagnosis and treatment

Introducción: La recesión gingival localizada es un problema de salud bucodental fundamental porque su progresión conduce a la pérdida dentaria. Discusión: El criterio de actuación será controlar periodontalmente al paciente para asegurar un adecuado control de placa de las zonas más susceptibles a presentar la recesión (AU)

Introduction: The localized gingival recession is a fundamental problem of oral health because its progression leads to the dental loss. Discussion: The criterion of acting will be to control periodontally the patient to ensure an adequate plaque’s control of the areas that are more likely to develop the recession (AU)

Effect of periodontal treatment on glycemic control of diabetic patients: a systematic review and meta-analysis.

OBJECTIVE: There is growing evidence that periodontitis may affect general health. This study was assigned to explore the robustness of observations that periodontal therapy leads to the improvement of glycemic control in diabetic patients. RESEARCH DESIGN AND METHODS: A literature search (until March 2009) was carried out using two databases (MEDLINE and the Cochrane Library) with language restriction to English. Selection of publications was based on 1) original investigations, 2) controlled periodontal intervention studies where the diabetic control group received no periodontal treatment, and 3) study duration of > or =3 months. RESULTS: Screening of the initial 639 identified studies and reference checking resulted in five suitable articles. A total of 371 patients were included in this analysis with periodontitis as predictor and the actual absolute change in A1C (DeltaA1C) as the outcome. The duration of follow-up was 3-9 months. All studies described a research population of type 2 diabetic patients in whom glycemic control improved after periodontal therapy compared with the control group (range DeltaA1C: Delta-1.17 up to Delta-0.05%). The studies in a meta-analysis demonstrated a weighted mean difference of DeltaA1C before and after therapy of -0.40% (95% CI -0.77 to -0.04%, P = 0.03) favoring periodontal intervention in type 2 diabetic patients. Nevertheless, this improvement in %A1C must be interpreted with care due to limited robustness as evidenced by heterogeneity among studies (59.5%, P = 0.04). CONCLUSIONS: The present meta-analysis suggests that periodontal treatment leads to an improvement of glycemic control in type 2 diabetic patients for at least 3 months.

Safety of the ArF193 excimer laser for the removal of dental plaque and calculi: an in vitro histological study.

OBJECTIVE: To assay the safety of the ArF excimer laser in the integrity of human pulp elements. BACKGROUND DATA: The use of lasers in dentistry remains controversial, in spite of their increasing application in medical practice. The main reason for this discrepancy is the frequent report of damage to surrounding tissues and the dental pulp, due to the energy transfer, from the site of laser impact. The progress made on laser technology during the last 10 years, could overcome this obstacle and allow the use of lasers in dentistry. METHODS AND RESULTS: The present study reports the use of the ArF 193 excimer laser, under conditions of strict control of frequency and fluency, for the ablation of dental carries, plaque, and calculi, by the use of a new, articulated arm. We have tested 10 teeth, extracted for prosthetic reasons, immediately after extraction. Our in vitro results show that the ArF193 excimer laser does not produce any harm to the dental pulp (at least at the photo- or electronic microscopy level), whereas in a matter of seconds, it can be effective in removing all dental deposits. In addition, the use of the flexible articulated arm, makes this treatment comfortable and easier for both the dentist and patient. CONCLUSION: Under a strict control of laser technology, and the use of the new articulated arm presented, the use of the ArF excimer laser in dentistry is safe and comfortable.

Effect of mechanical treatment on healing after third molar extraction.

The aim of this study was to determine the effect of subgingival scaling and root planing on healing of the distal surface of second molars following extraction of third molars. Twenty-eight patients with contralateral erupted third molars and pocket depths greater than or equal to 3 mm on the distal surface of the second molars participated in this study. Measurements of supragingival bacterial plaque, bleeding on probing, pocket depth, and relative attachment level were performed at baseline and 2 months after treatment. Extraction of contralateral third molars was carried out simultaneously. The experimental site received thorough scaling and root planing of the distal surface of the second molar, while the control site received extraction alone. Experimental sites showed significant improvement in all clinical parameters assessed compared to the control sites. In conclusion, periodontal lesions on the distal of second molars can be significantly improved following scaling and root planing after extraction of third molars.

Tratamento de áreas proximais relacionadas com prótese / The treatment of the proximal areas related to prothesis

O tratamento para as áreas proximais relacionadas com prótese foi analisado e discutido neste trabalho. Baseados na literatura, os autores mostram que dependendo da situaçäo, podemos tratar apenas removendo os fatores locais que se tornam nichos bacterianos ou realizando procedimentos cirúrgicos para eliminaçäo completa da bolsa periodontal ou cratera interproximal, remodelamento ósseo e o procedimento do R.A.I.(Restorative Alveolar Interface)

[The Perioplaner/Periopolisher. The loss of substance on the root surface and the initial clinical experiences]. / Perioplaner/Periopolisher. Substanzverlust auf der Wurzeloberfläche und erste klinische Erfahrungen.

A new system for the removal of supragingival and subgingival plaque and calculus was studied. The system involves two motor driven handpieces. One handpiece works with curettes and hoes (Perioplaner) and the other works with diamond-layered instruments (Periopolisher). In the first part of this study the loss of root substance was measured as a consequence of treatment by these motor-driven instruments. These results were compared with those using classical hand curettes and rotating diamonds (Perio-Set). In the literature there is still debate over whether it is necessary to remove not only plaque and calculus but also cementum which may contain endotoxin or may even be infected. Whatever opinion one may have, it must be known how much root substance is lost by using a particular scaling instrument. This study has shown that the use of the Perioplaner and Periopolisher results in about the same loss of root substance as the use of hand instruments. In the second part of this study, first clinical experiences with these instruments are reported.

In vitro effectiveness of a newly-designed ultrasonic scaler tip for furcation areas.

This study was undertaken to perform an in vitro comparison of the accessibility and effectiveness of a newly-designed furcation tip for an ultrasonic system with conventional curets and ultrasonic scalers. The new furcation tip was spiral in shape with a spherical end. The study was conducted on three groups of 40 teeth, each comprising 20 maxillary and 20 mandibular molars. The furcation of each tooth was colored by black felt-tipped marker, after which the teeth were fixed into artificial jaw models. Each group was then instrumented by either the newly-designed furcation tip, a straight type ultrasonic scaler tip, or a Gracey curet. The teeth were photographed by a stereomicroscope from the dome surface of furcation, and the percentage of remaining colored area was calculated for each tooth. Replica models were also made and examined with scanning electron microscopy (SEM). The mean percentage of the remaining colored areas for each instrument was, for the maxillary molars and mandibular molars respectively, 15.1% and 16.7% with the newly-designed tip; 50.3% and 44.1% with the straight type ultrasonic scaler; and 61.1% and 39.5% with the Gracey curets. The newly-designed tip thus showed high levels of effectiveness and accessibility for furcation debridement. Although the SEM photographs showed that each instrument had affected the furcation surfaces in various degrees, the teeth instrumented by the newly-designed tip maintained relatively smoother surfaces. It was concluded that the newly-designed furcation tip was more effective than the straight type ultrasonic scaler or the Gracey curet in the debridement of furcation in vitro.

[Exposed cementum and root surfacing]. / Cément exposé et surfaçage radiculaire.

Plaque exposed cementum presents structure alterations and becomes cytotoxic. The purpose of this review is to synthetize the actual datas about these cementum modifications and treatment by root planing. It appears that root planing does not eliminate all the subgingival calculus. Endotoxins are rather easily removed but roots are not completely detoxified. Treatment of the exposed cementum could evaluate to a less severe root planing and completed by a detoxification with chemical agents.

INCIDENCIADE DE PLACA MICROBIANA EN NIÑOSEN EDAD PRE-ESCOLAR EN RELACION CON EL GRADO DE LIMPIEZA

Introducción, Generalidades, La placa Bacteriana(Dental), Revelador de placa bacteriana, Casuistica(Presentación de casos clínicos), Resultados, Conclusiones, Recomendaciones, Bibliografia