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1.
PLoS One ; 14(6): e0214260, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31216288

RESUMO

Orthodontic relapse after orthodontic treatment is a major clinical issue in the dental field. However, the biological mechanism of orthodontic relapse is still unclear. This study aimed to establish a mouse model of orthodontic retention to examine how retention affects the rate and the amount of orthodontic relapse. We also sought to examine the role of osteoclastogenesis in relapse using an antibody to block the activity of M-CSF, an essential factor of osteoclast formation. Mice were treated with a nickel-titanium closed-coil spring that was fixed between the upper incisors and the upper-left first molar to move the first molar in a mesial direction over 12 days. Mice were randomly divided into three groups: group 1, no retention (G1); group 2, retention for 2 weeks (G2); and group 3, retention for 4 weeks (G3). In G2 and G3, a light-cured resin was placed in the space between the first and second molars as a model of retention. Orthodontic relapse was assessed by measuring changes in the dimensions of the gap created between the first and second molars. To assess the activity and role of osteoclasts, mice in G3 were injected with anti-c-Fms antibody or PBS, and assessed for changes in relapse distance and rate. Overall, we found that a longer retention period was associated with a slower rate of relapse and a shorter overall amount of relapse. In addition, inhibiting osteoclast formation using the anti-c-Fms antibody also reduced orthodontic relapse. These results suggest that M-CSF and/or its receptor could be potential therapeutic targets in the prevention and treatment of orthodontic relapse.


Assuntos
Anticorpos Monoclonais/administração & dosagem , Fator Estimulador de Colônias de Macrófagos/antagonistas & inibidores , Osteogênese/efeitos dos fármacos , Mobilidade Dentária/tratamento farmacológico , Animais , Anticorpos Monoclonais/farmacologia , Células Cultivadas , Modelos Animais de Doenças , Fator Estimulador de Colônias de Macrófagos/metabolismo , Masculino , Camundongos , Osteoclastos/citologia , Osteoclastos/efeitos dos fármacos , Ligação Proteica/efeitos dos fármacos , Receptor de Fator Estimulador de Colônias de Macrófagos/metabolismo , Mobilidade Dentária/metabolismo , Resultado do Tratamento
2.
Pak J Pharm Sci ; 32(6): 2673-2677, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31969301

RESUMO

Simvastatin is an anti-hyperlipidemic drug which reduces the cholesterol synthesis and also has anti-inflammatory, immunomodulatory and anti-microbial action against the bacteria. This develops the interest of periodontologist to use it in combination with conventional treatment to treat periodontal diseases. The objective of the study was to develop the gel and mouthwash of simvastatin and use it locally to treat gingivitis and periodontitis as an adjunct to scaling and root planning. The patients were randomly allocated into three groups that were standard treatment group, gel treatment group and mouthwash treatment group. Results indicated that simvastatin gel and mouthwash in 1% preparation showed favorable results by significantly reducing periodontal parameters and inflammatory biomarkers (p<0.001) as compared to standard treatment. Thus, we strongly suggest the use of simvastatin by local drug delivery system as an adjunct treatment of scaling and root planning.


Assuntos
Raspagem Dentária/métodos , Doenças Periodontais/terapia , Aplainamento Radicular/métodos , Sinvastatina/uso terapêutico , Adulto , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/uso terapêutico , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Terapia Combinada , Feminino , Géis , Gengivite/terapia , Humanos , Masculino , Antissépticos Bucais , Perda da Inserção Periodontal/tratamento farmacológico , Bolsa Periodontal/tratamento farmacológico , Periodontite/terapia , Sinvastatina/administração & dosagem , Mobilidade Dentária/tratamento farmacológico
3.
J Mol Histol ; 48(2): 73-81, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27981392

RESUMO

This study evaluated the effects of metformin on orthodontic tooth movement in a rat model of type 2 diabetes mellitus. Rats were fed a high-fat diet for 4 weeks to induce fat accumulation and insulin resistance, and then injected with a low dose of streptozotocin (35 mg/kg) intraperitoneally to induce type 2 diabetes. An orthodontic appliance was placed in normoglycemic, type 2 diabetes, and type 2 diabetes with metformin-administrated rats. After 14 days, type 2 diabetes rats exhibited greater orthodontic tooth movement and had a higher number of tartrate-resistant acid phosphatase-positive osteoclasts, stronger cathepsin K expression, and weaker alkaline phosphatase immunostaining than normoglycemic rats. Metformin administration resulted in normalization of osteoclast numbers, cathepsin K immunostaining, and of tooth movement as well as partly recovery of alkaline phosphatase expression in diabetic rats. Metformin also reduced sclerostin expression and improved the immunolocalization of dentin matrix protein 1 in osteocytes of type 2 diabetes rats. These results suggest that metformin administration reversed the adverse effects of diabetes on orthodontic tooth movement.


Assuntos
Diabetes Mellitus Experimental/complicações , Mobilidade Dentária/tratamento farmacológico , Fosfatase Alcalina/metabolismo , Animais , Catepsina K , Complicações do Diabetes/tratamento farmacológico , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Proteínas da Matriz Extracelular/análise , Hipoglicemiantes , Metformina , Osteoclastos/patologia , Osteócitos/química , Fosfoproteínas/análise , Ratos , Mobilidade Dentária/etiologia
4.
Drug Deliv ; 23(7): 2228-2234, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25259423

RESUMO

AIM: The aim of the novel study was to check the efficacy of a locally applied 2%w/w nanoemulgel (NEG) of Ketoprofen (KP) in preventing the periodontitis, and was also checked NEG without KP to ensure the effect of eugenol in NEG as an oil phase. DESIGN: For experimentally induced periodontitis, sterile silk ligatures (3/0) were placed around the crevices of the first left lower molar teeth of the male Wistar rats. During 8 weeks, all rats were fed with 10%w/v sucrose solution. The experimental assessment was carried out at 11 d after treatment of experimental periodontal disease (EPD) rats by various clinical parameters like gingival index (GI), tooth mobility (TM), alveolar bone loss (ABL), histological analysis, detection of TNF-α, and IL-1ß in gingival tissue by ELISA and the roughness were measured by atomic force microscopy (AFM) in tapping modes. RESULTS: After treatment, comparison studies with EPD were performed. NEG loaded with KP prevents significantly (p < 0.05) various parameters (GI, TM, and ABL), which were responsible for periodontitis. The histopathology of the periodontium showed that Group 3 (NEG loaded with KP) had a more significant reduction in inflammatory cell infiltration, alveolar bones resorption, and cementum (p < 0.05). In the topographical images, significant reduction in roughness of NEG loaded with KP was observed in comparison with EPD without treatment. CONCLUSION: The study revealed the great synergistic potential of the combined NEG of an anti-inflammatory drug KP along with eugenol as the oil phase, which have potential antibacterial, analgesic, and anesthetic properties to combat periodontal disease.


Assuntos
Emulsões/farmacologia , Eugenol/química , Géis/farmacologia , Cetoprofeno/farmacologia , Nanopartículas/administração & dosagem , Óleos/química , Periodontite/tratamento farmacológico , Perda do Osso Alveolar/tratamento farmacológico , Perda do Osso Alveolar/metabolismo , Animais , Antibacterianos/farmacologia , Anti-Inflamatórios/farmacologia , Cemento Dentário/efeitos dos fármacos , Cemento Dentário/metabolismo , Emulsões/metabolismo , Gengiva/efeitos dos fármacos , Gengiva/metabolismo , Inflamação/tratamento farmacológico , Interleucina-1beta/metabolismo , Ligadura/efeitos adversos , Masculino , Periodontite/metabolismo , Ratos , Ratos Wistar , Mobilidade Dentária/tratamento farmacológico , Mobilidade Dentária/metabolismo , Fator de Necrose Tumoral alfa/metabolismo
5.
Dental Press J Orthod ; 20(5): 58-65, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26560822

RESUMO

INTRODUCTION: Orthodontic anchorage is one of the most challenging aspects of Orthodontics. Preventing undesired movement of teeth could result in safer and less complicated orthodontic treatment. Recently, several reviews have been published about the effects of different molecules on bone physiology and the clinical side effects in Orthodontics. However, the effects of local application of these substances on the rate of orthodontic tooth movement have not been assessed. OBJECTIVES: The aim of this research was to analyze the scientific evidence published in the literature about the effects of different molecules on orthodontic anchorage. METHODS: The literature was systematically reviewed using PubMed/Medline, Scopus and Cochrane databases from 2000 up to July 31st, 2014. Articles were independently selected by two different researchers based on previously established inclusion and exclusion criteria, with a concordance Kappa index of 0.86. The methodological quality of the reviewed papers was performed. RESULTS: Search strategy identified 270 articles. Twenty-five of them were selected after application of inclusion/exclusion criteria, and only 11 qualified for final analysis. Molecules involved in orthodontic anchorage were divided into three main groups: osteoprotegerin (OPG), bisphosphonates (BPs) and other molecules (OMs). CONCLUSIONS: Different drugs are able to alter the bone remodeling cycle, influencing osteoclast function and, therefore, tooth movement. Thus, they could be used in order to provide maximal anchorage while preventing undesired movements. OPG was found the most effective molecule in blocking the action of osteoclasts, thereby reducing undesired movements.


Assuntos
Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Difosfonatos/farmacologia , Difosfonatos/uso terapêutico , Procedimentos de Ancoragem Ortodôntica/métodos , Osteoprotegerina/farmacologia , Osteoprotegerina/uso terapêutico , Mobilidade Dentária/tratamento farmacológico , Mobilidade Dentária/prevenção & controle , Acetilcisteína/farmacologia , Acetilcisteína/uso terapêutico , Animais , Remodelação Óssea/efeitos dos fármacos , Celecoxib/farmacologia , Celecoxib/uso terapêutico , Ácido Clodrônico/farmacologia , Ácido Clodrônico/uso terapêutico , Diclofenaco/farmacologia , Diclofenaco/uso terapêutico , Humanos , Imidazóis/farmacologia , Imidazóis/uso terapêutico , Interferon gama/farmacologia , Interferon gama/uso terapêutico , Isoxazóis/farmacologia , Isoxazóis/uso terapêutico , Lactonas/farmacologia , Lactonas/uso terapêutico , Camundongos , Osteoclastos/efeitos dos fármacos , Pamidronato , Ratos , Resveratrol , Estilbenos/farmacologia , Estilbenos/uso terapêutico , Sulfonas/farmacologia , Sulfonas/uso terapêutico , Técnicas de Movimentação Dentária , Ácido Zoledrônico
6.
Dermatology ; 224(3): 215-20, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22538799

RESUMO

Morphea is a cutaneous disorder characterized by an excessive collagen deposition. While in almost all cases the sclerosing process exclusively affects the skin, there are anecdotal cases in which associated mucosal involvement has been described. We here report the case of a woman developing a whitish indurated plaque over the left upper vestibular mucosa and hard palate leading to dental mobility and exposure of the roots of several teeth. Cone beam computed tomography of the left maxilla showed bone resorption involving the upper cuspid to the second molar region with widened periodontal ligament spaces, while light microscopy studies demonstrated epithelial atrophy and fibrosis of the dermis extending into the submucosa with hyalinization of subepithelial collagen. Our observation expands the spectrum of clinical presentations of morphea and provides the first example of isolated oral morphea. Its recognition is important to avoid significant local complications.


Assuntos
Esclerodermia Localizada/diagnóstico , Doenças Dentárias/diagnóstico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Mucosa Bucal/diagnóstico por imagem , Mucosa Bucal/efeitos dos fármacos , Mucosa Bucal/patologia , Radiografia , Esclerodermia Localizada/diagnóstico por imagem , Esclerodermia Localizada/tratamento farmacológico , Doenças Dentárias/diagnóstico por imagem , Doenças Dentárias/tratamento farmacológico , Mobilidade Dentária/diagnóstico , Mobilidade Dentária/diagnóstico por imagem , Mobilidade Dentária/tratamento farmacológico , Triancinolona/uso terapêutico , Adulto Jovem
7.
Spec Care Dentist ; 32(2): 61-5, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22416988

RESUMO

Individuals with Down syndrome (DS) are susceptible to severe periodontal disease, due to immune alterations related to functional defects of polymorphonuclear leukocytes and monocytes. The adjunctive use of locally delivered antimicrobials has been proven to be beneficial, especially in areas where mechanical therapy might fail. This article describes the management of a patient with DS who had aggressive periodontitis. The treatment used a local drug delivery system with tetracycline fibers as an adjunct to scaling and root planing.


Assuntos
Periodontite Agressiva/tratamento farmacológico , Antibacterianos/administração & dosagem , Síndrome de Down/complicações , Sistemas de Liberação de Medicamentos , Tetraciclina/administração & dosagem , Adulto , Periodontite Agressiva/terapia , Perda do Osso Alveolar/tratamento farmacológico , Perda do Osso Alveolar/terapia , Colágeno , Terapia Combinada , Índice de Placa Dentária , Raspagem Dentária/métodos , Portadores de Fármacos , Feminino , Seguimentos , Defeitos da Furca/tratamento farmacológico , Defeitos da Furca/terapia , Humanos , Perda da Inserção Periodontal/tratamento farmacológico , Perda da Inserção Periodontal/terapia , Índice Periodontal , Bolsa Periodontal/tratamento farmacológico , Bolsa Periodontal/terapia , Aplainamento Radicular/métodos , Mobilidade Dentária/tratamento farmacológico , Mobilidade Dentária/terapia
8.
Calcif Tissue Int ; 90(4): 330-42, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22382900

RESUMO

Relapse after orthodontic tooth movement is a significant problem in orthodontics. The purpose of this study was to examine the efficacy of the osteoclast inhibitor osteoprotegerin-Fc (OPG-Fc) for inhibiting postorthodontic relapse. Rat maxillary molars were moved mesially and allowed to relapse for 24 days. Low-dose (1 mg/kg) or high-dose (5 mg/kg) OPG-Fc or saline was injected adjacent to the molars during relapse. Tooth movement, micro-CT, histologic bone quality, and serum OPG and TRAP-5b were measured. OPG-Fc injections significantly diminished postorthodontic relapse from 63% (0.78/1.20 mm) of total movement in vehicle control rats to 31% (0.31/1.00 mm) in low-dose and 24% (0.28/1.16 mm) in high-dose OPG-Fc groups 24 days after appliance removal. Normalization of bone and periodontal tissues occurred as early as 8 and 16 days in the high- and low-dose OPG-Fc-treated groups, respectively, while the vehicle-treated group showed only partial tissue recovery 24 days following tooth movement. After 24 days of relapse, there was complete recovery to pre-tooth-movement values for bone volume fraction (BVF) and tissue mineral density (TMD) in both the low- and high-dose OPG-Fc groups, while BVF recovered only partially and TMD did not recover in the vehicle control group. Greatly elevated serum OPG levels and reduced serum TRAP-5b levels in OPG-Fc-treated animals indicated systemic exposure to locally injected drug. The profound decrease in postorthodontic relapse by local OPG-Fc administration indicates that osteoclasts are critical to bone maturation following tooth movement and points to the potential pharmacologic use of OPG-Fc or other RANKL inhibitors for orthodontic retention.


Assuntos
Osteoprotegerina/uso terapêutico , Proteínas Recombinantes/uso terapêutico , Mobilidade Dentária/tratamento farmacológico , Dente/efeitos dos fármacos , Animais , Masculino , Osteoprotegerina/administração & dosagem , Ratos , Ratos Sprague-Dawley , Proteínas Recombinantes/administração & dosagem , Recidiva , Dente/fisiologia , Técnicas de Movimentação Dentária
9.
J Periodontol ; 83(9): 1172-82, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22220769

RESUMO

BACKGROUND: Bisphosphonates (BPs) and low-dose doxycycline (LDD) have been shown to inhibit bone resorption and to improve the levels of proinflammatory mediators and destructive enzymes in gingival tissues, respectively. The purpose of this study is to evaluate the effect of mono and combined BP clodronate and LDD therapies in reducing gingival levels of matrix metalloproteinase-9 (MMP-9), interleukin-1ß (IL-1ß), and alveolar bone loss in rats with diabetes. METHODS: Fifty adult Wistar rats were divided into five study groups as follows: 1) group 1 = diabetes control; 2) group 2 = diabetes + periodontitis; 3) group 3 = diabetes + periodontitis + LDD; 4) group 4 = diabetes + periodontitis + clodronate; and 5) group 5 = diabetes + periodontitis + LDD + clodronate. LDD and clodronate were given as a single agent or as combination therapy during the 7 days of the post-experimental periodontitis period. On day 7, the rats were sacrificed, the mobility of the tooth was recorded, and block biopsies were removed. The gingival tissues were analyzed histologically and immunohistochemically for expression of MMP-9 and IL-1ß. Alveolar bone loss was evaluated morphometrically under a light microscope. Data analysis was performed statistically by Kruskal-Wallis and post hoc Tukey and Spearman correlation tests. RESULTS: Alveolar bone loss was significantly greater in groups 2 through 5 than group 1 (P <0.05) but was not significantly different among groups 2 through 5 (P >0.05). Animals with periodontitis (group 2) expressed significantly higher levels of MMP-9 and IL-1ß compared with those without periodontitis (group 1) (P <0.05). MMP-9 expression was significantly lower in group 3 than groups 1, 2, and 5 (P <0.05). IL-1ß expression was significantly lower in the groups 1, 3, 4, and 5 than 2 (P <0.01) but was not significantly different among groups 1, 3, 4, and 5. Positive correlations were found between alveolar bone loss and density of inflammation (ρ = 0.319, P = 0.021) and between MMP-9 and IL-1ß (ρ = 0.418, P = 0.002), respectively. CONCLUSION: Our findings suggest that ligature-induced periodontitis in animals with diabetes results in significantly higher levels of MMP-9 and IL-1ß expression in gingiva. The use of mono and combined clodronate and LDD administrations may significantly reduce levels of MMP-9 and IL-1ß expression. However, drug administration did not affect alveolar bone levels during the study period.


Assuntos
Perda do Osso Alveolar/tratamento farmacológico , Antibacterianos/administração & dosagem , Conservadores da Densidade Óssea/uso terapêutico , Ácido Clodrônico/uso terapêutico , Diabetes Mellitus Experimental/complicações , Doxiciclina/administração & dosagem , Gengiva/química , Interleucina-1beta/análise , Metaloproteinase 9 da Matriz/análise , Perda do Osso Alveolar/patologia , Processo Alveolar/efeitos dos fármacos , Processo Alveolar/patologia , Animais , Biópsia , Conservadores da Densidade Óssea/administração & dosagem , Ácido Clodrônico/administração & dosagem , Quimioterapia Combinada , Gengiva/enzimologia , Gengiva/imunologia , Interleucina-1beta/efeitos dos fármacos , Linfócitos/patologia , Masculino , Metaloproteinase 9 da Matriz/efeitos dos fármacos , Periodontite/tratamento farmacológico , Periodontite/patologia , Ratos , Ratos Wistar , Estreptozocina , Mobilidade Dentária/tratamento farmacológico
10.
Gen Dent ; 59(3): 180-7; quiz 188-9, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21903541

RESUMO

The use of systemic antimicrobials such as doxycycline, metronidazole, and azithromycin in conjunction with debridement has achieved results superior to those produced by debridement alone. The purpose of the present study was to determine if previous results could be improved upon by administering repeated doses of azithromycin during the hygiene phase. One hundred patients with moderate to advanced periodontitis were treated with scaling and root planing plus three courses of azithromycin during the hygiene phase. All patients then were re-evaluated and periodontal surgery and/or extractions involving 96 teeth were performed in 32 patients. All patients then entered a maintenance program that lasted up to 192 weeks, with four-month recalls. Clinical parameters were recorded at baseline, at re-evaluation (week 6 after baseline), and at 96 and 192 weeks into maintenance. The results indicated that probing depths, bleeding upon probing, and suppuration were reduced significantly at re-evaluation. In addition, 14 teeth that displayed a Class III mobility at baseline improved to either Class I or Class II . There was no relapse during the maintenance phase. Multivariate analysis after 192 weeks indicated no change in the number of sites that bled upon probing, or had pockets that were 5.0-6.0 mm or ≥ 7 mm. Ninety-five percent of the sites that initially bled upon probing did not do so four years post-treatment. The results indicate that three courses of azithromicin in conjunction with root instrumentation during the hygiene phase led to long-lasting beneficial effects on all clinical parameters for at least 192 weeks.


Assuntos
Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Periodontite Crônica/terapia , Raspagem Dentária , Aplainamento Radicular , Adulto , Idoso , Perda do Osso Alveolar/tratamento farmacológico , Perda do Osso Alveolar/terapia , Periodontite Crônica/tratamento farmacológico , Periodontite Crônica/cirurgia , Terapia Combinada , Feminino , Seguimentos , Defeitos da Furca/tratamento farmacológico , Defeitos da Furca/terapia , Hemorragia Gengival/tratamento farmacológico , Hemorragia Gengival/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Bolsa Periodontal/tratamento farmacológico , Bolsa Periodontal/terapia , Radiografia Interproximal , Fumar , Supuração , Retalhos Cirúrgicos , Extração Dentária , Mobilidade Dentária/tratamento farmacológico , Mobilidade Dentária/terapia
11.
Aust Dent J ; 55(2): 193-9, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20604763

RESUMO

Azithromycin, first synthesized in 1980, is a macrolide antibiotic related to erythromycin. It is widely used by the medical profession as a broad-spectrum antibiotic in the treatment of pneumonia, urinary tract infections and tonsillitis. In addition to its antibiotic properties, azithromycin has immune-modulating effects and is used for this reason in the management of cystic fibrosis and chronic obstructive pulmonary diseases. The drug is taken up by neutrophils, macrophages and fibroblasts, and is slowly released by these cells. Three diverse case reports are presented in which a single course of azithromycin (consisting of one 500 mg tablet being taken a day for three days) was prescribed before any periodontal intervention occurred. Azithromycin was the principal mode of treatment of severe chronic and aggressive periodontitis in Cases 1 and 2. Azithromycin, together with monthly subgingival debridement, was the treatment in Case 3 (severe chronic periodontitis in a poorly controlled diabetic complicated by gingival overgrowth related to medication with a calcium channel blocker). Favourable resolution of inflammation, reduction in pocket depths and evidence of bone regeneration were evident, even when no periodontal treatment had occurred. In Case 3, resolution of gingival overgrowth occurred over eight months. The potential implications for periodontal management, understanding of the pathogenesis of periodontal diseases and periodontal research are briefly discussed.


Assuntos
Periodontite Agressiva/tratamento farmacológico , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Regeneração Óssea/efeitos dos fármacos , Periodontite Crônica/tratamento farmacológico , Adulto , Idoso , Perda do Osso Alveolar/tratamento farmacológico , Terapia Combinada , Diabetes Mellitus Tipo 2/complicações , Feminino , Seguimentos , Defeitos da Furca/tratamento farmacológico , Crescimento Excessivo da Gengiva/tratamento farmacológico , Gengivite/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Bolsa Periodontal/tratamento farmacológico , Curetagem Subgengival , Mobilidade Dentária/tratamento farmacológico
12.
J Periodontol ; 79(1): 104-13, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18166099

RESUMO

BACKGROUND: Non-steroidal anti-inflammatory agents inhibit the production of cyclooxygenase (COX) products and can attenuate bone loss. In this double-masked, placebo-controlled, randomized clinical trial, the efficacy of celecoxib (COX-2 inhibitor) was evaluated in conjunction with scaling and root planing (SRP) in subjects with chronic periodontitis (CP). METHODS: A total of 131 subjects were randomized to receive SRP and either celecoxib (200 mg) or placebo every day for 6 months. Clinical outcomes were assessed every 3 months for 12 months as mean changes from baseline. Primary efficacy parameters included clinical attachment level (CAL) and probing depth (PD). Secondary outcomes included percentages of tooth sites with CAL loss or gain > or =2 mm, changes in bleeding on probing (BOP), plaque index, and mobility. Prior to analysis, tooth sites were grouped based on baseline PD as shallow (1 to 3 mm), moderate (4 to 6 mm), or deep (> or =7 mm). RESULTS: Mean PD reduction and CAL gain were greater in the celecoxib group, primarily in moderate and deep sites, throughout the study (PD: 3.84 mm versus 2.06 mm, P <0.001; CAL: 3.74 mm versus 1.43 mm, P <0.0001 for deep sites at 12 months). The celecoxib group also exhibited a greater percentage of sites with > or =2 mm CAL gain and fewer sites with > or =2 mm CAL loss. Both groups showed improved plaque control and BOP scores. Demographic, social, and behavioral factors did not affect treatment outcomes. CONCLUSIONS: Celecoxib can be an effective adjunctive treatment to SRP to reduce progressive attachment loss in subjects with CP. Its beneficiary effect persisted even at 6 months postadministration. However, given the increased cardiovascular risks associated with the use of this drug, close patient supervision and strict adherence to dosage and administration guidelines established by the Unites States Food and Drug Administration are of paramount importance.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Inibidores de Ciclo-Oxigenase/uso terapêutico , Periodontite/tratamento farmacológico , Pirazóis/uso terapêutico , Sulfonamidas/uso terapêutico , Adolescente , Adulto , Idoso , Celecoxib , Doença Crônica , Terapia Combinada , Índice de Placa Dentária , Raspagem Dentária , Método Duplo-Cego , Feminino , Seguimentos , Hemorragia Gengival/tratamento farmacológico , Hemorragia Gengival/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/tratamento farmacológico , Perda da Inserção Periodontal/terapia , Bolsa Periodontal/tratamento farmacológico , Bolsa Periodontal/terapia , Periodontite/terapia , Placebos , Aplainamento Radicular , Mobilidade Dentária/tratamento farmacológico , Mobilidade Dentária/terapia , Resultado do Tratamento
13.
Oral Dis ; 12(5): 500-5, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16910922

RESUMO

BACKGROUND: Herpes zoster (HZ) infection of the trigeminal nerve is associated with complications such as postherpetic neuralgia, facial scarring, loss of hearing ability and conjunctivitis. Until 2005, postherpetic alveolar necrosis and spontaneous tooth exfoliation have been described in 20 cases unrelated to HIV infection. OBJECTIVE: The aim of this study was to describe HIV infection in patients (two women, two men, average age 30 years) who suffered from HZ attacks to their trigeminal nerves. MAIN OUTCOME MEASURES: None of the patients had received antiherpetic medications or antiretroviral therapy. HIV infection was only diagnosed after the development of HZ. Facial scarring with depigmentation and hyperesthesia (postherpetic neuralgia) was diagnosed in all four patients. Oral findings consisted of spontaneous loss of both maxillary or mandibular teeth. Osteonecrosis of varying extent was also found. Treatment consisted of extractions of teeth and administration of antibiotics and analgesics. Healing of alveolar wounds was unremarkable. CONCLUSION: Complications affecting the alveolar bone and teeth seem to be rare in HIV-infected patients.


Assuntos
Infecções por HIV/complicações , Herpes Zoster/complicações , Perda de Dente/virologia , Doenças do Nervo Trigêmeo/virologia , Adulto , Cicatriz/etiologia , Cicatriz/virologia , Dermatoses Faciais/patologia , Dermatoses Faciais/virologia , Neuralgia Facial/virologia , Fácies , Feminino , Herpes Zoster/tratamento farmacológico , Humanos , Masculino , Dermatopatias Virais/patologia , Dermatopatias Virais/virologia , Perda de Dente/tratamento farmacológico , Mobilidade Dentária/tratamento farmacológico , Mobilidade Dentária/virologia , Doenças do Nervo Trigêmeo/complicações
14.
Ned Tijdschr Tandheelkd ; 113(5): 202-5, 2006 May.
Artigo em Holandês | MEDLINE | ID: mdl-16729566

RESUMO

A 53-year-old woman, known with a schizophrenic disorder and a history of drug addiction, was referred because of progressive hematomas of the lower extremities and fatigue. Her medical history included hyperplastic gums, tooth hypermobility and anaemia. Scurvy was diagnosed as a result of an insufficient diet due to drug addiction and a paranoid psychosis. After suppletion of vitamin C and starting highly nutritious food a rapid amelioration of the scurvy related complaints was observed. While dreaded and often fatal in earlier eras, in the 21st century scurvy is easily treatable if this diagnosis is recognised.


Assuntos
Esquizofrenia/complicações , Escorbuto/etiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Mobilidade Dentária/etiologia , Anemia/complicações , Antioxidantes/uso terapêutico , Ácido Ascórbico/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Escorbuto/tratamento farmacológico , Mobilidade Dentária/tratamento farmacológico , Resultado do Tratamento
15.
Med Oral Patol Oral Cir Bucal ; 10(2): 132-41, 2005.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-15735546

RESUMO

AIMS: Currently, an important number of women use HRT to control their hormonal problems during menopause. A large percentage of these have problems at periodontal level. The present study aims at examining the effects that menopause, due to a decline in the synthesis of hormones, mainly of estrogens, can cause on the oral dental health of such women; in particular on the characteristics of the gingiva and periodontium, checking whether characteristics such as gingival recession, pain, tooth mobility and periodontal pocket formation might permit physicians to evaluate the degree of bone loss in menopausal woman. PATIENTS: Menopausal women aged 40 to 58 years of age undergoing hormone replacement therapy that had gingival periodontal disturbances. The total population of the study comprised 210 patients, divided into two groups. One group received HRT administered in patches and the other group did not receive this therapy. METHOD: Gynecologic and odonto-stomatologic protocols were established for data collection. In order to assess the efficacy of the treatment a descriptive statistical study for sociodemographic variables, analysis of variance, McNemar's test and the Stuart-Maxwell test were performed. RESULTS: The mean age of the patients studied was 49.6 years. HRT acts as a protective factor in dental pain and improves tooth mobility and depth of the probing of periodontal pockets. With respect to the variable gingival recession, no significant results were found either for the group not receiving HRT or for the group being treated with patches. CONCLUSIONS: The response to the HR therapy in periodontal disease is probably due to the existence of estrogen receptors localized in the gingiva and in the periodontal ligament.


Assuntos
Estrogênios/uso terapêutico , Terapia de Reposição Hormonal , Menopausa/fisiologia , Doenças Periodontais/tratamento farmacológico , Adulto , Perda do Osso Alveolar/fisiopatologia , Distribuição de Qui-Quadrado , Feminino , Humanos , Pessoa de Meia-Idade , Bolsa Periodontal/tratamento farmacológico , Receptores de Estrogênio/fisiologia , Mobilidade Dentária/tratamento farmacológico
16.
J Am Dent Assoc ; 133(3): 311-20, 2002 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11934186

RESUMO

BACKGROUND: In a previous study involving patients seen at the dental clinic of the Detroit Receiving Hospital, the authors found that 87 percent of teeth initially recommended for surgery or extraction were spared those treatments by a combination of debridement and short-term usage of antimicrobial agents. The objective of the present study was to determine how long the surgery-sparing benefits of less invasive treatment would persist. METHODS: Ninety of these patients were scheduled for maintenance therapy at three-month intervals over a five-year period. They were evaluated periodically for surgical needs by a clinician who was not aware of the nonsurgical periodontal treatment the patient had received. RESULTS: The initial treatment benefits were sustained, as the number of teeth needing periodontal surgery or extraction was 0.06 teeth per patient after 1.1 year, 0.22 after 2.3 years, 0.51 after 3.6 years and 0.86 after 5.1 years. CONCLUSIONS: A noninvasive treatment regimen for an anaerobic infection in teeth seriously compromised by periodontal disease resulted in a reduced need for surgery or tooth extraction for at least five years after completion of the initial treatment.


Assuntos
Doenças Periodontais/terapia , Fatores Etários , Perda do Osso Alveolar/tratamento farmacológico , Perda do Osso Alveolar/terapia , Antibacterianos/uso terapêutico , Bactérias Anaeróbias , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/cirurgia , Infecções Bacterianas/terapia , Raspagem Dentária , Método Duplo-Cego , Doxiciclina/uso terapêutico , Seguimentos , Defeitos da Furca/tratamento farmacológico , Defeitos da Furca/terapia , Humanos , Modelos Lineares , Metronidazol/uso terapêutico , Perda da Inserção Periodontal/tratamento farmacológico , Perda da Inserção Periodontal/terapia , Doenças Periodontais/tratamento farmacológico , Doenças Periodontais/microbiologia , Doenças Periodontais/cirurgia , Bolsa Periodontal/tratamento farmacológico , Bolsa Periodontal/terapia , Placebos , Recidiva , Aplainamento Radicular , Fumar , Extração Dentária , Mobilidade Dentária/tratamento farmacológico , Mobilidade Dentária/terapia
17.
J Int Med Res ; 29(4): 355-65, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11675910

RESUMO

Etidronate 200 mg daily was administered to four female patients with periodontitis and resultant alveolar pyorrhoea for periods of 2 weeks, followed by off-periods of 10 weeks or more, for 2-3 years. The macroscopic appearance of gingival mobility of the teeth, depth of periodontal pockets, and X-ray findings of alveolar bones improved markedly during this time. The effects were first observed after 6-12 months of treatment. These findings indicate that bisphosphonates may be effective in the treatment of periodontitis and resultant alveolar pyorrhoea. The effect may be mediated by the inhibitory action on bone resorption and the anti-inflammatory action of etidronate. Concomitant conventional dental management is also required.


Assuntos
Ácido Etidrônico/uso terapêutico , Doenças Periodontais/tratamento farmacológico , Doenças Periodontais/etiologia , Periodontite/complicações , Periodontite/tratamento farmacológico , Reabsorção Óssea/tratamento farmacológico , Reabsorção Óssea/patologia , Ácido Etidrônico/administração & dosagem , Feminino , Humanos , Inflamação/tratamento farmacológico , Inflamação/patologia , Pessoa de Meia-Idade , Doenças Periodontais/patologia , Periodontite/patologia , Mobilidade Dentária/tratamento farmacológico , Mobilidade Dentária/etiologia , Mobilidade Dentária/patologia
18.
J Periodontol ; 65(9): 840-7, 1994 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-7990020

RESUMO

The purpose of this study was to assess the clinical and microbiological effects of a newly developed root conditioning gel system containing tetracycline or a mixture of tetracycline and citric acid on non-surgical periodontal therapy. Sixty-four (64) single-rooted teeth with a probing depth of 4 to 6 mm were randomly subjected to one of the following four treatments; 1) root planing alone (RP group); 2) tetracycline-containing gel alone (TCG group); 3) root planing plus tetracycline-containing gel (RP + TCG group); or 4) root planing plus a mixture of tetracycline and citric acid-containing gel (RP + TC-CAG group). Probing depth, attachment level, and tooth mobility were measured and the presence of dental plaque and gingival inflammation was recorded at baseline and after 2, 4, 8, and 12 weeks. Subgingival plaque samples from each site were collected at the same visits and examined with phase contrast microscopy for proportions of motile rods and spirochetes. Plaque index, gingival sulcus bleeding index (SBI), probing depth, and attachment level decreased significantly in all groups compared to the baseline values (P < 0.05). A significant decrease in probing pocket depth was noted after 12 weeks in RP + TC-CAG group compared to the other groups (P < 0.05). Significantly more gain in attachment was detected in the RP + TC-CAG group compared to the TCG group (P < 0.05). Tooth mobility scores also decreased later in the study. A significant decrease in the proportion of motile rods was found primarily in the RP + TC-CAG group.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Citratos/uso terapêutico , Doenças Periodontais/tratamento farmacológico , Tetraciclina/uso terapêutico , Adulto , Bactérias/classificação , Bactérias/isolamento & purificação , Citratos/administração & dosagem , Ácido Cítrico , Contagem de Colônia Microbiana , Terapia Combinada , Placa Dentária/microbiologia , Índice de Placa Dentária , Combinação de Medicamentos , Feminino , Géis , Hemorragia Gengival/tratamento farmacológico , Hemorragia Gengival/terapia , Gengivite/tratamento farmacológico , Gengivite/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/terapia , Índice Periodontal , Bolsa Periodontal/tratamento farmacológico , Bolsa Periodontal/terapia , Aplainamento Radicular , Spirochaetales/isolamento & purificação , Tetraciclina/administração & dosagem , Mobilidade Dentária/tratamento farmacológico , Mobilidade Dentária/terapia
19.
Fogorv Sz ; 86(10): 327-31, 1993 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-8299810

RESUMO

The authors describe a case of a 4 years old boy. In connection with this case they discuss the latest classification of histiocytosis accepted by the Histiocytosis Society, and the stomatological aspects of the disease (severe gingivitis, necrosis of the gingivae, ulceration, and high degree of tooth mobility). The new classes of the disease: Langerhans cell's histiocytosis, Non-Langerhans cell's histiocytosis, malignant histiocytosis.


Assuntos
Histiocitose de Células de Langerhans/complicações , Antineoplásicos/uso terapêutico , Pré-Escolar , Gengivite/tratamento farmacológico , Gengivite/etiologia , Gengivite Ulcerativa Necrosante/tratamento farmacológico , Gengivite Ulcerativa Necrosante/etiologia , Histiocitose de Células de Langerhans/classificação , Histiocitose de Células de Langerhans/diagnóstico por imagem , Histiocitose de Células de Langerhans/tratamento farmacológico , Humanos , Masculino , Radiografia Panorâmica , Mobilidade Dentária/tratamento farmacológico , Mobilidade Dentária/etiologia
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