Periodontal status of individuals with Down syndrome: sociodemographic, behavioural and family perception influence.

BACKGROUND: The aim of the present study was to assess the periodontal condition of individuals with Down syndrome and the association with sociodemographic and behavioural characteristics and family perception of oral health. METHODS: This cross-sectional observational study was performed at a referral centre for dental assistance to disabled persons in Araçatuba, Brazil. Parents of the individuals were interviewed, and the visible plaque index, bleeding on probing, probing pocket depth and clinical attachment level were recorded by one periodontist in six sites per tooth of all teeth. The individual was the unit of analysis. The significance level was set at 5%. RESULTS: Sixty-four subjects (23.8 ± 8.3 years old) were included. Eighteen (28.1%) were diagnosed with gingivitis and 46 (71.9%) with periodontitis. In the multiple logistic regression final model, age and self-reported oral hygiene practices were associated with the occurrence of periodontitis. The chance of having periodontitis was 4.7 times higher among individuals older than 20 years and approximately 4 times higher in patients whose oral hygiene was performed by themselves and their parents, compared with those who performed oral hygiene alone. Sex, follow-up time in the centre, education, degree of participants' dependence, flossing and family history of periodontal disease were not associated with the occurrence of periodontitis. Higher levels of plaque and bleeding were observed for participants with parents reporting bad gingival health (76.2% and 46.9%) and deficient oral hygiene (79.5% and 47.3%). The perception of parents regarding gingival bleeding was correlated with higher bleeding detected clinically (P = 0.01; 50.1%). CONCLUSIONS: The prevalence of periodontitis in individuals with Down syndrome is high and increases with age, even in the face of the parents' perception about their children's oral condition.

Effects of Lactobacillus reuteri as an adjunct to the treatment of periodontitis in smokers: randomised clinical trial.

The aim of this randomised clinical trial was to evaluate the effect of Lactobacillus reuteri in chewable tablets as an adjunct to non-surgical periodontal treatment of chronic periodontitis in smoking patients. 34 patient smokers were selected and randomly divided into two groups. The SRP group (n=17) received scaling and root planing (SRP) in one session and a placebo; the PRO group (n=17) received SRP in one session and 2 probiotic tablets 2× per day, for 21 days. Bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), gingival recession (GR), and pockets with PD≥5 mm and bleeding were measured at baseline and 90 days. After 90 days of treatment, the PD and pockets with PD≥5 mm and bleeding were significantly lower in both groups compared to baseline (P<0.05). In the PRO group, the BOP had significantly reduced at 90 days when compared with the baseline (P<0.05). There was statistically significant reduction in PD between baseline and 90 days in the PRO group in deep pockets (P<0.05). There was no statistically significant difference between the groups in the reduction in PD (P=0.95) or gain in CAL (P=0.97) in moderate and deep pockets. The adjuvant use of L. reuteri in the treatment of chronic periodontitis was effective in controlling gingival inflammation because reduced bleeding on probing which means reduced gingival inflammation and was effective in reducing deep pocket in manner clinically relevant.

Effect of low-level laser therapy as an adjuvant in the treatment of periodontitis induced in rats subjected to 5-fluorouracil chemotherapy.

BACKGROUND AND OBJECTIVE: This study aimed to assess the effect of multiple sessions of a low-level laser therapy (LLLT) adjuvant to scaling and root planing (SRP) on the treatment of experimental periodontitis (EP) in rats treated with 5-fluorouracil (5-FU). MATERIAL AND METHODS: A total of 120 rats were divided into five groups: no treatment (NT); treatment with 5-FU (60 and 40 mg/kg) and no local periodontal treatment (5FU); treatment with 5-FU and SRP (5FU-SRP); treatment with 5-FU, SRP and one LLLT session (660 nm; 0.035 W; 4.2 J; 120 s) (5FU-SRP-1LLLT); and treatment with 5-FU, SRP and four LLLT sessions (0, 24, 48 and 72 h) (5FU-SRP-4LLLT). EP was induced in the mandibular molars through ligature placement. The alveolar bone loss (ABL) area in the furcation region was analysed histometrically. TRAP, proliferating cell nuclear antigen, RANKL, osteoprotegerin and activated caspase-3 patterns were analysed by immunolabeling. Prostaglandin E2 was quantified using an ELISA, and tumour necrosis factor α and interleukin-6 were assessed using the multiplex method. The prevalence rates of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella nigrescens, Prevotella intermedia and Fusobacterium nucleatum were assessed using the PCR method. The data were subjected to statistical analysis (α = 5%). RESULTS: 5FU, 5FU-SRP and 5FU-SRP-1LLLT treatment groups showed higher ABL compared with the NT group (p < 0.05), whereas the 5FU-SRP-4LLLT group showed lower ABL compared with the 5FU group on day 7 and decreased RANKL immunolabeling (p < 0.05). CONCLUSION: Treatment with 5-FU worsened EP, and multiple LLLT sessions adjuvant to SRP seemed to improve periodontitis in rats subjected to 5-FU chemotherapy.

Effect of the probiotic Saccharomyces cerevisiae on ligature-induced periodontitis in rats.

BACKGROUND AND OBJECTIVE: This study assessed the effects of the local use of Saccharomyces cerevisiae as monotherapy and as an adjuvant to the mechanical treatment of ligature-induced periodontitis in rats. MATERIAL AND METHODS: Periodontitis was induced in 72 rats via the installation of a ligature around the mandibular first molar. After 7 d, the ligature was removed and the rats were placed in one of the following groups: no treatment (C; n = 18); scaling and root planing (SRP; n = 18); local irrigation with probiotics (PRO; n = 18); and SRP followed by local irrigation with probiotics (SRP/PRO; n = 18). Six rats from each group were killed at 7, 15 and 30 d. The histological characteristics, alveolar bone loss (ABL) and immunolabeling of tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1ß), interleukin-10 (IL-10) and TRAP on the furcation area of the first molar were assessed. RESULTS: The PRO group showed features of acceleration of the tissue-repair process during the entire experiment. On day 15, there was less ABL in the SRP/PRO group compared with the C group. There were fewer TRAP-positive cells in the SRP and SRP/PRO groups at 30 d. There was less immunostaining for TNF-α in the PRO and SRP/PRO groups and less immunostaining for IL-1ß in the PRO group. However, there was more immunostaining for IL-10 in the PRO group on day 15. CONCLUSION: Local use of the probiotic did not result in any adverse effects on periodontal tissues. When used as monotherapy or as an adjuvant, the probiotic was effective at controlling periodontitis in rats.

Effect of the concentration of phenothiazine photosensitizers in antimicrobial photodynamic therapy on bone loss and the immune inflammatory response of induced periodontitis in rats.

BACKGROUND AND OBJECTIVE: Antimicrobial therapy can suppress periodontal pathogens and increase the effectiveness of conventional mechanical treatment. The aim of this study was to assess bone loss and the immune inflammatory response of rats under the influence of two photosensitizing agents (MB and TBO) at two different concentrations in antimicrobial photodynamic therapy (aPDT), used as an adjuvant therapy in the treatment of periodontitis. MATERIAL AND METHODS: Periodontitis was induced in the mandibular first molars of 162 rats. The animals were divided into nine groups: G1 - scaling and root planing (SRP); G2 - SRP plus 100 µg/mL of methylene blue (MB); G3 - SRP plus 10 mg/mL of MB; G4 - SRP plus 100 µg/mL of toluidine blue (TBO); G5 - SRP plus 10 mg/mL of TBO; G6 - SRP plus 100 µg/mL of MB and laser; G7 - SRP plus 10 mg/mL of MB and laser; G8 - SRP plus 100 µg/mL of TBO and laser; and G9 - SRP plus 10 mg/mL of TBO and laser. Six animals from each group were euthanized 7, 15, or 30 d after treatment. Bone loss (BL) in the furcation region was evaluated using histomorphometric and immunohistochemical analyses to detect the receptor activator of nuclear factor-Κappa B ligand (RANKL), osteoprotegerin (OPG) and tartrate-resistant acid phosphatase (TRAP). RESULTS: There was significantly less BL in animals treated with aPDT using low concentrations of MB and TBO at 7, 15 and 30 d. Immunohistochemical analysis revealed decreased RANKL and increased OPG in the aPDT groups and decreased TRAP-positive cells in G6 and G8. CONCLUSIONS: aPDT, using low concentrations of MB and TBO, was the most effective adjuvant therapy to SRP, acting indirectly as a downregulator of the molecular mechanisms that control bone resorption in periodontitis.

Nonsurgical periodontal therapy combined with laser and photodynamic therapies for periodontal disease in immunosuppressed rats.

BACKGROUND: Periodontal disease is often associated with systemic diseases and is characterized by destruction of the tissues supporting the teeth. Patients using immunosuppressive drugs such as tacrolimus are among those who suffer from tissue destruction. OBJECTIVE: We sought to evaluate the effects of laser and photodynamic therapies (PDT; nonsurgical) as an adjunct to scaling and rootplaning (SRP) in the treatment of corona-induced periodontitis in rats immunosuppressed with tacrolimus (Prograf). MATERIALS AND METHODS: The animals were divided into 5 groups. Each groups had 6 rats. Group I, the control group, received only saline solution throughout the study period of 42 days and did not receive periodontal treatment; group II received saline solution and SRP; group III received tacrolimus (1 mg/kg per day) and was treated with SRP; group IV animals were treated identically to group III and then administered laser treatment; and in group V, the animals were treated identically to group III and then administered PDT. RESULTS: Statistical analysis indicated decreased bone loss with the progression of time (P = .035). There was no difference between the bone loss associated with the types of treatment administered to groups I, II, and III (P > .9) or groups IV and V (P > .6). The analysis also indicated that immunosuppression was not a bone loss-determining factor. CONCLUSION: Laser and PDT therapies were effective as an adjunctive treatment to SRP in reducing bone loss caused by experimental periodontitis induced in animals being treated systemically with tacrolimus.

Bone healing in critical-size defects treated with platelet-rich plasma activated by two different methods. A histologic and histometric study in rat calvaria.

BACKGROUND AND OBJECTIVE: The purpose of this study was to analyze histologically the influence of platelet-rich plasma (PRP) coagulated with two different activators on bone healing in surgically created critical-size defects (CSD) in rat calvaria. MATERIAL AND METHODS: Forty-eight rats were divided into three groups: C, PRP-C and PRP-T. An 8 mm diameter CSD was created in the calvarium of each animal. In group C, the defect was filled by a blood clot only. In groups PRP-C and PRP-T, the defect was filled with PRP activated with either calcium chloride or thromboplastin solution, respectively. Each group was divided into two subgroups (n = 8 per subgroup) and killed at either 4 or 12 weeks postoperatively. Histologic and histometric analyses were performed. The amount of new bone formed was calculated as a percentage of the total area of the original defect. Percentage data were transformed into arccosine for statistical analysis (analysis of variance, Tukey's post hoc test, p < 0.05). RESULTS: No defect completely regenerated with bone. Group PRP-C had a statistically greater amount of bone formation than groups C and PRP-T at both time points of analysis. No statistically significant differences were observed between groups C and PRP-T. CONCLUSION: It can be concluded that the type of activator used to initiate PRP clot formation influences its biological effect on bone healing in CSD in rat calvaria.

Bone healing in critical-size defects treated with platelet-rich plasma: a histologic and histometric study in rat calvaria.

BACKGROUND AND OBJECTIVE: The purpose of this study was to analyze histologically the influence of autologous platelet-rich plasma on bone healing in surgically created critical-size defects in rat calvaria. MATERIAL AND METHODS: Thirty-two rats were divided into two groups: the control group (group C) and the platelet-rich plasma group. An 8-mm-diameter critical-size defect was created in the calvarium of each animal. In group C the defect was filled by a blood clot only. In the platelet-rich plasma group, 0.35 mL of platelet-rich plasma was placed in the defect and covered by 0.35 mL of platelet-poor plasma. Both groups were divided into subgroups (n = 8) and killed at either 4 or 12 wk postoperatively. Histometric (using image-analysis software) and histologic analyses were performed. The amount of new bone formed was calculated as a percentage of the total area of the original defect. Percentage data were transformed into arccosine for statistical analysis (analysis of variance, Tukey, p < 0.05). RESULTS: No defect completely regenerated with bone. The platelet-rich plasma group had a statistically greater amount of bone formation than group C at both 4 wk (17.68% vs. 7.20%, respectively) and 12 wk (24.69% vs. 11.65%, respectively) postoperatively. CONCLUSION: Within the limits of this study, it can be concluded that platelet-rich plasma placed in the defects and covered by platelet-poor plasma significantly enhanced bone healing in critical-size defects in rat calvaria.

[Loss of interproximal periodontal tissue. A clinical solution with construction of a removable acrylic resin appliance]. / Perda de tecidos periodontais na área interproximal, solução clínica através da confecção de aparelho removível de resina acrílica.

One of the problems of difficult solution in clinic are the tissue lost from periodontic surgery procedures. The purpose of this survey is to help find the solution of this problem, and we show a case where the patient has great interdental tissue lost after surgery and was solucionated with an acrylic resin appliance. The clinic results prove the efficiency of the appliance, diminishing or having the hole esthetic and phonetic problem solucionated, besides the low-cost of its confection and also allows the patient to have a good plaque control.