Avaliação do alfabetismo em saúde bucal dos responsáveis por crianças e adolescentes atendidos na clínica escola de odontologia Uninassau Recife / Evaluation of literacy in oral health of those responsible for children and adolescents attended at the Uninassau Recife dental school clinic / Evaluación del alfabetismo en la salud bucal de niños y adolescentes en la escuela de odontología clínica Uninassau Recife

Objetivo: Analisar a influência do nível de alfabetismo dos pais e/ou responsáveis na saúde bucal de crianças e adolescentes atendidos na Clínica Escola de Odontologia do Centro Universitário Maurício de Nassau, em Recife. Métodos: Estudo de campo de desenvolvimento transversal e natureza observacional realizado na Clínica Escola de Odontologia do Centro Universitário Maurício de Nassau, no período de janeiro a abril de 2023. A amostra foi composta por 32 pais e/ou responsáveis. Os instrumentos de coleta utilizados foram: ficha específica, Índice de Placa Visível (IPV) modificado e Índice de dentes cariados, perdidos e obturados (CPO-D)/ Índice de dentes cariados, extraídos e obturados (ceo-d), Critério de Classificação Econômica (CCEB) e Rapid Estimate of Adult Literacy in Dentistry ­ Brazil (REALD-B). Resultados: Observou-se uma predominância do acompanhamento materno nas consultas odontológicas de suas crianças/adolescentes. Quanto a procura por atendimento odontológico para seus filhos, a maioria afirmou buscar em caso de prevenção, diferente do resultado para o atendimento próprio, que prevaleceu os casos de tratamento. Ademais, ao associar o resultado obtido pelo CCEB e teste REALD-B, obteve-se que dos 19 participantes classificados como "ruim", ao acertarem entre 0 a 18 palavras, 18 são da Classe "C-D,E", com nível econômico médio-baixo. A inspeção de saúde bucal das crianças/adolescentes foi considerada razoável, com a média de 2 a 3 dentes acometidos, no entanto a faixa etária predominante da amostra variou entre 3 e 10 anos, ratificando o ínicio precoce dos problemas de saúde bucal. Conclusão: Foi observado uma associação entre o nível de alfabetismo em saúde bucal dos pais e/ou responsáveis e as condições clínicas de saúde bucal de suas crianças/adolescentes.

Objective: To analyze the influence of the level of literacy of parents and/or guardians on the oral health of children and adolescents attended at the Clinical School of Dentistry of the Maurício de Nassau University Center, in Recife. Methods: Field study of cross-sectional development and observational nature conducted at the Clinical School of Dentistry of the University Center Maurício de Nassau, in the period from January to April 2023. The sample consisted of 32 parents and/or guardians. The collection instruments used were: specific token, Visible Plate Index (IPV) modified and Index of decayed, lost and filled teeth (CPO-D)/ Index of decayed, extracted and filled teeth (ceo-d), Economic Classification Criterion (CCEB) and Rapid Estimate of Adult Literacy in Dentistry - Brazil (REALD-B). Results: A predominance of maternal follow- up was observed in the dental consultations of their children/adolescents. As for the search for dental care for their children, most said to seek in case of prevention, different from the result for the own care, which prevailed the cases of treatment. Furthermore, by associating the result obtained by the CCEB and the REALD-B test, it was obtained that of the 19 participants classified as "bad", when they hit between 0 to 18 words, 18 are of the Class "C-D,E", with medium-low economic level. Oral health inspection of children/adolescents was considered reasonable, with the average of 2 to 3 affected teeth, however the predominant age range of the sample ranged between 3 and 10 years, ratifying the early onset of oral health problems. Conclusion: An association was observed between the level of oral health literacy of parents and/or guardians and the clinical conditions of oral health of their children/adolescents.

Propósito: analizar la influencia del nivel de alfabetización de padres y/o funcionarios en la salud oral de niños y adolescentes atendidos en la Clínica de Odontología del Centro Universitario Maurício de Nassau de Recife. Métodos: estudio de campo sobre el desarrollo transversal y el carácter observacional realizado en la Facultad de Odontología del Centro Universitario de Mauricio Nassau, en el período comprendido entre enero y abril de 2023. La muestra consistió en 32 padres y/o funcionarios. Los instrumentos de recolección utilizados fueron: token específico, Índice de Tarjeta Viewable Modificado (IAB) y Índice de Dientes Muertos, Perdidos y Obturados (CPO-D)/ Índice de Dientes Recubierto, Extraídos y Obtuados (CCEB), Criterio de Clasificación Económica (CCEB) y Rapid Estimate of Adult Literacy in Dentistry - Brazil (REALD-B). Resultados: Se observó un predominio del acompañamiento materno en las consultas dentales de sus niños/adolescentes. En cuanto a la búsqueda de atención dental para sus hijos, la mayoría declaró que lo buscarían en caso de prevención, diferente del resultado de su propia atención, que prevalecía en los casos de tratamiento. Además, al asociar el resultado obtenido por la CCEB y la prueba REALD-B, se encontró que de los 19 participantes clasificados como "malos", al alcanzar entre 0 y 18 palabras, 18 pertenecen a la clase "C-D,E", con un nivel económico medio- bajo. La inspección de salud oral de los niños/adolescentes se consideró razonable, con un promedio de 2 a 3 pacientes afectados, pero el grupo de edad predominante de la muestra varió de 3 a 10 años, ratificando el inicio temprano de los problemas de salud oral. Conclusión: Se observó una asociación entre el nivel literario en la salud oral de los padres y/o responsables y las condiciones clínicas de salud oral de sus hijos/adolescentes. PALABRAS CLAVE: Alfabetización en Salud; Salud Bucal; Educación en Salud.

Capacidad vital lenta: diferencias entre la capacidad vital espiratoria y la capacidad vital inspiratoria

Resumen Introducción: La capacidad vital (VC) se puede determinar mediante la capacidad vital espiratoria (EVC) o la capacidad vital ins piratoria (IVC). Obtener el mayor volumen de VC es fundamental para la correcta interpretación de las pruebas de función pulmonar. Objetivos: Determinar las diferencias entre EVC y IVC (EVC-IVC) según el patrón ventilatorio; Caracterizar las relaciones FEV1/EVC y FEV1/IVC en la detección de obstrucción de las vías aéreas; Estudiar los efectos de realizar EVC o IVC en la detección de air trapping o de hiperinflación pulmonar. Materiales y Métodos: Estudio transversal. La muestra incluyó 388 individuos que se dividieron en 3 grupos: sanos, obstrucción de las vías aéreas y restricción pulmonar. Para detectar la obstrucción de las vías aéreas, se estudiaron las relaciones FEV1/EVC y FEV1/IVC. La presencia de air trapping o hiperinflación pulmonar se determinó mediante análisis del volumen pulmonar. As diferencias entre EVC e IVC (EVC-IVC) de acuerdo con el padrón ventilatorio fueron agrupados por clases. Resultados: En el grupo normal, 34.8% tuvo una diferencia EVC-IVC ≥ 200 ml, en el grupo de obstrucción de las vías respirato rias 28.4% y en la restricción pulmonar 22.4%, respectivamente. La relación FEV1/EVC detectó obstrucción de las vías aéreas en el 44.8% de los individuos y la relación FEV1/IVC en el 39.4%. En sujetos con obstrucción de las vías respiratorias, la maniobra de EVC determinó el air trapping en el 21.6% de los sujetos y la hiperinflación pulmonar en el 9.5%. En la maniobra de IVC, los porcentajes fueron 18.2% y 10.8%, respectivamente. Conclusiones: El EVC y el IVC no deben considerarse maniobras intercambiables, debido a las diferencias de volumen obtenidas por cada uno de ellos. Los resultados que provienen de su uso influyeron en la interpretación de la función pulmonar.

Slow Vital Capacity: Differences Between the Expiratory Vital Capacity and the Inspiratory Vital Capacity

ABSTRACT Introduction: The vital capacity (VC) can be determined by means of the expiratory vital capacity (EVC) or the inspiratory vital capacity (IVC). Obtaining the highest VC volume is essential for the correct interpretation of lung function tests. Objectives: To determine the differences between the EVC and the IVC (EVC-IVC) according to the ventilatory pattern; to characterize the FEV1/EVC and FEV1/IVC ratios when an obstruction of the airways is detected; to study the effects of the EVC or IVC on the detec tion of air trapping or lung hyperinflation. Materials and Methods: Cross-sectional study. The sample included 388 individuals divided in 3 groups: healthy, airway obstruc tion, and restrictive lung disease. In order to detect the airway obstruction, we studied the FEV1/EVC and FEV1/IVC ratios. The presence of air trapping or lung hyperinflation was determined by means of a lung volume test. The differences between the EVC and the IVC (EVC-IVC) according to the ventilatory pattern were grouped into classes. Results: In the normal group, there was an EVC-IVC difference of ≥ 200 ml in 34.8% of the individuals; in the airway obstruction group, 28.4%, and in the restrictive lung disease group, 22.4%. The FEV1/EVC ratio detected airway obstruction in 44.8% of the individuals, and the FEV1/IVC ratio in 39.4%. In patients with airway obstruction, the EVC maneuver determined the presence of air trapping in 21.6% of subjects and lung hyperinflation in 9.5%. The IVC maneuver showed 18.2% and 10.8%, respectively. Conclusions: The EVC and IVC should not be used as interchangeable maneuvers, considering the volume differences obtained with each one of them. Their results influenced the interpretation of lung function.

Health needs of adolescents from the perspective of Primary Health Care professionals. / Necessidades em Saúde dos adolescentes na perspectiva dos profissionais da Atenção Primária à Saúde.

The recognition of health needs is essential to develop public actions and policies. OBJECTIVE: to analyze the recognition and the meeting of the health needs of adolescents, from the perspective of Primary Health Care professionals. METHOD: qualitative, exploratory and descriptive study, which analyzed 15 interviews with Primary Health Care professionals of the III Health District in the municipality of Recife, state of Pernambuco, Brazil, who have worked in Primary Health Care for a year or more. Content analysis was performed using the webQDA software. RESULTS: five empirical categories emerged: Adolescent and adolescence, Individual and social group needs, Political and normative organization, Professional, team and intersectoral actions and Potentials and limits in adolescent care. The concept of adolescence is based on stereotypes and a fragile articulation to social, economic, political and historical contexts. The professionals recognize the demands compatible with the Primary Care programmatic actions as needs, but they do not have enough instruments to deal with the group peculiarities. The absence of goals in the Municipal Health Plan equals adolescents to other social groups and offers them the same menu of needs.

O reconhecimento das necessidades em saúde é essencial na elaboração de ações e políticas públicas. Objetivo: analisar o reconhecimento e a satisfação das necessidades em saúde dos adolescentes, a partir da perspectiva de profissionais da Atenção Primária à Saúde. Método: estudo qualitativo, exploratório e descritivo, analisou 15 entrevistas realizadas com profissionais da Atenção Primária à Saúde que atuam no Distrito Sanitário III em Recife, Pernambuco, Brasil, há um ano ou mais. Foi realizada análise de conteúdo com apoio do software webQDA. Resultados: emergiram cinco categorias empíricas: Adolescente e adolescência, Necessidades individuais e do grupo social, Organização política e normativa, Ações profissionais, em equipe e intersetoriais e Potencialidades e limites no atendimento ao adolescente. A compreensão sobre a adolescência é pautada em estereótipos e de frágil articulação aos contextos sociais, econômicos, políticos e históricos. Os profissionais reconhecem como necessidades as demandas compatíveis com as ações programáticas da Atenção Básica sem terem instrumentos suficientes para lidar com as peculiaridades do grupo. A ausência de metas no Plano Municipal de Saúde iguala os adolescentes a outros grupos sociais e lhes oferece o mesmo cardápio de necessidades.

Necessidades em Saúde dos adolescentes na perspectiva dos profissionais da Atenção Primária à Saúde / Health needs of adolescents from the perspective of Primary Health Care professionals

Resumo O reconhecimento das necessidades em saúde é essencial na elaboração de ações e políticas públicas. Objetivo: analisar o reconhecimento e a satisfação das necessidades em saúde dos adolescentes, a partir da perspectiva de profissionais da Atenção Primária à Saúde. Método: estudo qualitativo, exploratório e descritivo, analisou 15 entrevistas realizadas com profissionais da Atenção Primária à Saúde que atuam no Distrito Sanitário III em Recife, Pernambuco, Brasil, há um ano ou mais. Foi realizada análise de conteúdo com apoio do software webQDA. Resultados: emergiram cinco categorias empíricas: Adolescente e adolescência, Necessidades individuais e do grupo social, Organização política e normativa, Ações profissionais, em equipe e intersetoriais e Potencialidades e limites no atendimento ao adolescente. A compreensão sobre a adolescência é pautada em estereótipos e de frágil articulação aos contextos sociais, econômicos, políticos e históricos. Os profissionais reconhecem como necessidades as demandas compatíveis com as ações programáticas da Atenção Básica sem terem instrumentos suficientes para lidar com as peculiaridades do grupo. A ausência de metas no Plano Municipal de Saúde iguala os adolescentes a outros grupos sociais e lhes oferece o mesmo cardápio de necessidades.

Abstract The recognition of health needs is essential to develop public actions and policies. Objective: to analyze the recognition and the meeting of the health needs of adolescents, from the perspective of Primary Health Care professionals. Method: qualitative, exploratory and descriptive study, which analyzed 15 interviews with Primary Health Care professionals of the III Health District in the municipality of Recife, state of Pernambuco, Brazil, who have worked in Primary Health Care for a year or more. Content analysis was performed using the webQDA software. Results: five empirical categories emerged: Adolescent and adolescence, Individual and social group needs, Political and normative organization, Professional, team and intersectoral actions and Potentials and limits in adolescent care. The concept of adolescence is based on stereotypes and a fragile articulation to social, economic, political and historical contexts. The professionals recognize the demands compatible with the Primary Care programmatic actions as needs, but they do not have enough instruments to deal with the group peculiarities. The absence of goals in the Municipal Health Plan equals adolescents to other social groups and offers them the same menu of needs.

Comprehensive Treatment for Pregnant and/or Parenting Women with Substance Use Disorders and Their Children: A Cross-Cultural Comparison.

Background: Substance use during pregnancy and early parenting years is a well-known global public health problem, but the literature comparing treatment programs for this subpopulation across countries is limited. This article both describes three women-centered treatment programs in the United States, Brazil, and Argentina and examines similarities and differences among the programs in terms of patient characteristics. Such an analysis can better inform clinicians in the assessment and treatment of women who use substances and improve the universal understanding about them. Methods: A secondary data analysis of patient characteristics (e.g., pregnant at treatment admission) and patient history (e.g., substance dependence diagnosis, family history of substance use, co-occurring mental health issues) of reproductive age women (N=356) from substance use treatment programs in the United States, Brazil, and Argentina. Results: The Horizons program admitted the highest percentage of pregnant women (60%), Lua Nova (36%), and Casa Santa Clara (17%). Horizons patients (82%) were more likely to have a substance dependence diagnosis than Lua Nova (15%) or Casa Santa Clara patients (13%). Horizons patients (78%) were more likely to have a family history of substance use than Lua Nova (15%) or Casa Santa Clara (57%) patients. Horizons was also more likely than Lua Nova or Casa Santa Clara to have patients who had entered mental health treatment (70% vs. 19% vs. 9%, respectively). Conclusion: Substance use problems that continue during pregnancy and parenting are common within different cultures and societies. These analyses identified similarities and differences in patient characteristics, history, and treatment programs. Cross-cultural comparisons of treatment approaches provide opportunities for clinicians to explore new ways of caring for this population.

Anything but Conventional Chromatography Approaches in Bioseparation.

While packed bed chromatography, known as conventional chromatography, has been serving the biopharmaceutical industry for decades as the bioseparation method of choice, alternative approaches are likely to take an increasing leading role in the next few years. The high number of new biological drugs under development, and the need to make biopharmaceuticals widely accessible, has been driving the academia and industry in the quest of anything but conventional chromatography approaches. In this perspective paper, these alternative approaches are discussed in view of current and future challenges in the downstream processing field.

The Effect of Laser-Lok Abutments on Fiber Orientation and Buccal Bone Remodeling: A Histomorphometric Study.

The purpose of this study was to evaluate the effect that microgrooved abutments may have on peri-implant tissues. After the flapless extractions of the mandibular premolars of eight dogs, four Laser-Lok implants were placed in each mandibular quadrant, and half of them received laser-microgrooved abutments. A xenograft (MinerOss X, BioHorizons) was used in the gaps. The dogs were euthanized 12 weeks after treatment, and the histomorphometric analysis was performed. Unlike the machined abutments, the microgrooved abutments influenced the orientation of connective tissue fibers, which appeared perpendicularly and adhered to the implant-abutment surfaces, preventing the apical migration of the junctional epithelium. Laser-microgrooved abutments showed superior results.

Role of Structure and Composition on the Performances of P-Type Tin Oxide Thin-Film Transistors Processed at Low-Temperatures.

This work reports on the role of structure and composition on the determination of the performances of p-type SnOx TFTs with a bottom gate configuration deposited by rf magnetron sputtering at room temperature, followed by a post-annealed step up to 200 °C at different oxygen partial pressures (Opp) between 0% and 20% but where the p-type conduction was only observed between in a narrow window, from 2.8% to 3.8%. The role of structure and composition were evaluated by XRD and Mössbauer spectroscopic studies that allows to identify the best phases/compositions and thicknesses (around 12 nm) to be used to produce p-type TFTs with saturation mobility of 4.6 cm² V-1 s-1 and on-off ratio above 7 × 104, operating at the enhancement mode with a saturation voltage of -10 V. Moreover, a brief overview is also presented concerning the present state of the existing developments in processing SnOx TFTs with different methods and using different device configurations.

Influence of the quality of life and locus of control of mothers of disabled children on the oral health of their children.

AIM: To investigate whether quality of life of mothers is related to oral health of disabled children. METHOD: This is an analytical cross-sectional study, based on interviews with 49 mothers and oral clinical examination (DMFT and OHI-S) in children with disabilities from 2 to 6 years old, assisted by the Rehabilitation Center of Piracicaba, SP. Mothers answered WHOQOL BREF quality of life instrument and Multidimensional Health Locus of Control Scale. Data analysis was performed with descriptive statistics, Chi-square test, Fisher's exact test, and multiple logistic regression. RESULT: Most children of the sample were aged from 37 to 48 months (40.81%) and presented neuropsychomotor development delay. Mothers reported (55.1%) that their interference in the health/illness of their children was a fortuitous process. The social relationships domain of WHOQOL BREF presented significant association (p = 0.0404) with DMFT index. CONCLUSION: We observed that quality of life of mothers can interfere in oral health of children, regarding social relationships.

A cirurgia de redução de volume pulmonar e a função respiratória / Lung volume reduction surgery and lung function

A cirurgia de redução de volume pulmonar (CRVP) é um tratamento paliativo utilizado em doentes com enfisema grave que visa melhorar a função pulmonar e a qualidade de vida, através da remoção do tecido fibrosado resultante do enfisema. Esta intervenção promove uma expansão adequada dos pulmões na caixa torácica, melhorando o recoil elástico e a relação ventilação/perfusão devido à diminuição da hiperinsuflação pulmonar. Foi objetivo do presente artigo de revisão caracterizar os efeitos da CRVP no enfisema no respeitante à melhoria da função pulmonar. Foram considerados artigos publicados em periódicos indexados nas bases de dados MEDLINE, SciELO, Latindex e DOAJ. Foram incluídos 25 documentos que abrangem artigos originais e artigos de revisão de literatura. A CRVP promove uma melhoria dos parâmetros avaliados por espirometria e pletismografia corporal total, devido ao aumento do recoil elástico promovido pela redução dos volumes pulmonares não mobilizáveis (redução da hiperinsuflação pulmonar), pelo reposicionamento dos músculos respiratórios e pela diminuição da resistência das vias aéreas. Contudo, diversas investigações demonstraram que os efeitos na função pulmonar são temporários e reversíveis. Fatores como a elevada taxa de morbilidade e mortalidade e o custo elevado relativamente à durabilidade dos benefícios que este procedimento acarreta estão na base das opiniões controversas relativas à CRVP. A CRVP não modifica o curso natural da doença, sendo por isso necessário avaliar a vertente económica deste procedimento bem como a sua relação custo-benefício, isto porque este tratamento se tem demonstrado dispendioso face à durabilidade dos benefícios.

Lung volume reduction surgery (LVRS) is a palliative treatment used in patients with severe emphysema that aims to improve lung function and quality of life by removing the fibrous tissue resulting from emphysema. This intervention promotes an adequate expansion of the lungs in the chest cavity, thus improving the elastic recoil and ventilation/perfusion ratio due to decrease of lung hyperinflation. The aim of this review article is to characterize, the effects of LVRS in emphysema in relation to the improvement in lung function. We considered articles published in journals indexed in MEDLINE , SciELO , Latindex and DOAJ. We included 25 documents covering original articles and literature review articles. LVRS promotes the improvement of the spirometry and whole body plethymography parameters, caused by the increase of elastic recoil through the reduction of not mobilized lung volumes (lung hyperinflation reduction), the repositioning of the respiratory muscles and the decrease of airways resistance. However, several investigations have shown that the effects on lung function are temporary and reversible. Factors such as the high morbidity and mortality rates and the high cost in relation to the durability of the benefits of the procedure lead to controversial opinions about LVRS. LVRS does not modify the natural course of the disease, so it is necessary to evaluate the economic aspect of this procedure and its cost-effectiveness, because this treatment is considered expensive comparatively to the durability of benefits.

Self-assembled nanofiber coatings for controlling cell responses.

Nanofibers are thought to enhance cell adhesion, growth, and function. We demonstrate that the choice of building blocks in self-assembling nanofiber systems can be used to control cell behavior. The use of 2 D-coated, self-assembled nanofibers in controlling lens epithelial cells, fibroblasts, and mesenchymal stem cells was investigated, focusing on gene and protein expression related to the fibrotic response. To this end, three nanofibers with different characteristics (morphology, topography, and wettability) were compared with two standard materials frequently used in culturing cells, TCPS, and a collagen type I coating. Cell metabolic activity, cell morphology, and gene and protein expression were analyzed. The most hydrophilic nanofiber with more compact network consisting of small fibers proved to provide a beneficial 2 D environment for cell proliferation and matrix formation while decreasing the fibrotic/stress behavior in all cell lines when compared with TCPS and the collagen type I coating. This nanofiber demonstrates the potential to be used as a biomimetic coating to study the development of fibrosis through epithelial-to-mesenchymal transition. This study also shows that nanofiber structures do not enhance cell function by definition, because the physico-chemical characteristics of the nanofibers influence cell behavior as well and actually can be used to regulate cell behavior toward suboptimal performance. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2252-2265, 2017.

The effect of a flapless alveolar ridge preservation procedure with or without a xenograft on buccal bone crest remodeling compared by histomorphometric and microcomputed tomographic analysis.

OBJECTIVES: This study evaluated buccal bone crest remodeling, socket composition after healing, and dimensional ridge preservation after flapless tooth extraction procedures with or without a xenograft comparing histomorphometric and microcomputed tomographic (micro-CT) data. MATERIAL AND METHODS: The mandibular premolars of eight dogs were extracted without flaps. One socket on each side received a grafting material (test group), and the other remained only with a blood clot (control group). Twelve weeks after treatment, buccal bone crest, alveolar ridge dimensions, and composition were analyzed by histomorphometry and micro-CT. RESULTS: Two- and three-dimensional evaluations showed better results for the grafted group when compared to the non-grafted group. CONCLUSION: The flapless alveolar ridge preservation procedure with deproteinized bovine bone material enhanced buccal bone crest, alveolar ridge dimensions and bone formation when compared to sockets with the blood clot only, as observed by histomorphometric and micro-CT analysis.

Editorial: ECAB focus issue: Engineered catalysts, robust, cost-effective and integrated bioprocesses and high-throughput screening.

How can technology and industrial biotechnology contribute to a more bio-based economy? At the 3rd European Congress of Applied Biotechnology (ECAB3) in Nice in 2015, relevant topics and technologies and their contribution to sustainability were presented and discussed. In this issue of Biotechnology Journal, five special articles are selected from this conference, highlighting processes and technologies envisaging the development of engineered catalysts, robust bioprocesses, as well as high-throughput screening methods for process development.

Investigation of Friction-induced Damage to the Pig Cornea.

Mechanical friction causes damage to the cornea. A friction measurement device with minimal intervention with the pig cornea tear film revealed a low friction coefficient of 0.011 in glycerine solution. Glycerine molecules presumably bind to water, mucins, and epithelial cells and therewith improve both squeeze film and boundary lubrication. Using confocal microscopy, we determined that glycerine solution reduced damage to epithelial cells by 50% compared with the phosphate buffer saline.

A modified surgical flap for root coverage in association with grafting materials.

PURPOSE: To clinically evaluate in humans the effectiveness of a modified flap for root coverage associated with connective tissue graft or acellular dermal matrix graft after a postoperative period of 12 months. MATERIALS AND METHODS: Thirty bilateral gingival recessions were selected and randomly assigned into experimental groups. All of them were treated with a modified surgical flap, with the releasing incisions placed on the mesial and distal line angles of the adjacent teeth, distant from the main defect, providing a broader flap. One site was treated with the autograft and the contralateral site, with the allograft. Probing depth, clinical attachment level, gingival recession, and keratinized tissue width were measured at baseline and after 12 months. RESULTS: Both procedures significantly improved the clinical parameters evaluated, without statistically significant differences between them. While the autograft group had a mean gingival recession reduction from 3.15 to 0.67 mm, in the allograft group, it was from 3.47 to 0.93 mm. CONCLUSION: The extended flap technique can improve the root coverage results using the subepithelial connective tissue graft or the acellular dermal matrix. CLINICAL SIGNIFICANCE: Graft survival plays a decisive role in mucogingival therapy results and the selection of the appropriate surgical technique is important to achieve it. This 12-month randomized study showed that an extended flap is able to improve the results of root coverage of localized gingival recessions not only when using the acellular dermal matrix as shown in a previous study, but also when using the subepithelial connective tissue. On this basis, this surgical technique can be suggested as the procedure of choice for treating this type of defect.

Bone Formation in a Local Defect around Dental Implants Coated with Extracellular Matrix Components.

PURPOSE: The coating of implant surfaces with components of the extracellular matrix offers an approach to influence peri-implant bone healing. In this study, bone healing around coated implants is analyzed in a peri-implant defect model. MATERIALS AND METHODS: Eight months after extraction of the premolar teeth, six dogs received 48 implants (eight per animal) in the mandible. Implant surfaces were sandblasted and acid-etched, and some were additionally coated with collagen type II and chondroitin sulfate (collagen/CS). On each side of the mandible, implants either had no peri-implant defect (control side) or a vertical defect of 5 mm in depth and 0.5, 1.0, or 2.0 mm in width. Implants healed submerged for 8 weeks. Fluorochrome staining, histology, and histomorphometry were used to analyze implant osseointegration. RESULTS: Fluorochrome labels showed an increased mineralization around collagen/CS-coated surfaces at 4 weeks (p = .031). Histomorphometry generally showed lower vertical and horizontal bone apposition with increasing gap size for both surface types. In gapless sites and 0.5-mm gaps, collagen/CS coated implants showed increased bone volume in areas directly adjacent to the implant, in comparison with uncoated implants (p < .05). CONCLUSION: The width of the peri-implant gap influences peri-implant bone formation. Complete filling of all gaps by newly formed bone could not be observed around either surface. In proximity to the surface, implant surface coating by collagen/CS positively influenced bone formation.

Distância interimplantar: um fator a ser observado na reabilitação oral implantossuportada. Revisão crítica e apresentação de um caso clínico com três anos de acompanhamento / The interimplant distance: a topic to be observed at implant-supported oral rehabilitation. A critical review with presentation of a clinical case with 3 years of follow-up

Este trabalho revisou o conceito de distância interimplantar e as estruturas que circundam os implantes contíguos, determinando o sucesso do implante em longo prazo e possibilitando a obtenção de uma restauração protética com um aspecto natural. Entre os fatores que contribuem para este processo, pode-se encontrar na literatura odontológica a espessura inicial do tecido mole, a distância entre implantes, a distância entre o ponto de contato interproximal e a crista óssea alveolar, a profundidade de colocação do implante, o tipo de conexão implante/pilar, o macrodesenho da área cervical do implante e, possivelmente, o tratamento de superfície. Atualmente, está sendo avaliada a interrupção do suprimento sanguíneo proporcionado pela fresagem durante o preparo do sítio para a colocação do implante como um fator que pode proporcionar a reabsorção da crista óssea ao redor de implantes contíguos. As evidências em animais apontam para o uso de implantes com conexão interna cônica e distância interimplantar de 3 mm na redução da perda óssea. Entretanto, mais estudos clínicos controlados são necessários para confirmar estes achados.

This paper reviews the concept of interimplant distance and the surrounding structures that determine long-term implant success and allow for a natural-looking prosthetic restoration. Among the factors that contribute to this process, one can find at the dental literature the initial soft tissue thickness, the interimplant distance, the distance from the interproximal contact point to the alveolar bone crest, the implant depth, the implant/abutment connection type, the macrodesign at the implant cervical area, and possibly the implant surface treatment. Nowadays, the lack of blood nutrition after osteotomy at the implant site for further implant placement has been evaluated as a possible factor on crestal bone resorption at adjacent implants. Evidence from animal models point to the use of implants with internal conical connections and for a 3 mm interimplant distance to reduce bone loss. However, more controlled clinical studies are needed to confirm these findings.