Arthur Belém Novaes Júnior

Relationship between periodontitis and rheumatoid arthritis and the effect of non-surgical periodontal treatment

This study analyzed the association of periodontal disease (PD) and rheumatoid arthritis (RA). Seventy-five 35-60-year-old patients were assigned to 5 groups according to the presence (+) or not (-) of PD and RA and the treatment received (TR+) or not (TR-) for PD. Group 3 uses total prosthesis (TP). Clinical and laboratory evaluations were performed at baseline, 3 and 6 months of follow-up by probing pocket depth, bleeding on probing and plaque index for PD, HAQ, DAS28, SF-36 and laboratory: AAG, ESR, CRP for RA. Statistically significant differences for PD after 3 (p=0.0055) and after 6 months (p=0.0066) were obtained in Group 1 (RA+PD+TR+) and 2(RA+PD+TR-); significant reduction in the % of BOP after 6 months (p=0.0128) and significant reduction in the % of Pl after 3 (p=0.0128) and 6 months (p=0.0002) in Group 1. Statistically significant differences between Groups 1 and 3 (RA+TP) for DAS28 at baseline and after 3 months were observed, but not after 6 months. No other parameters for RA were significantly affected. The relationship between RA and PD disease activities is not clear, but the importance of periodontal treatment in the control of inflammation to avoid tooth extraction is evident.

Control of gingival inflammation in a teenager population using ultrasonic prophylaxis

Gingival inflammation is clinically characterized by gingival redness, swelling and increased tendency of bleeding of the soft tissue. Bacterial biofilm is the etiological agent. If, at this stage, the bacterial biofilm is removed and appropriate control methods are applied, remission of gingival inflammation occurs. This study evaluated the effectiveness of a single session of ultrasonic prophylaxis for the reduction of gingivitis in an adolescent population using the Plaque Index (PI) and Gingival Index (GI). The study sample consisted of 15 male adolescent students selected at a dentists office of a public high school. Prior to treatment (baseline), plaque index (PI) and bleeding on probing (BOP) were recorded. The patients then received oral hygiene instructions and ultrasonic prophylaxis. Follow-up exams were made 15 and 30 days after the ultrasonic prophylaxis, again recording PI and BOP. The data were analyzed by the Students t-test for dependent samples. Correlation analysis between presence of biofilm and bleeding on probing was also made using the Pearson correlation test. There was a statistically significant decrease in the plaque index and bleeding on probing between baseline and examinations at both 15 days and 30 days (p<0.05). However, the difference between the means at 15 and 30 days was statistically similar. The correlation analysis showed correlation between both parameters (p<0.05). The results indicate that a single session of ultrasonic prophylaxis associated to oral hygiene instructions is efficient to reverse gingivitis in adolescents.

Expression of osteoblastic phenotype in periodontal ligament fibroblasts cultured in three-dimensional collagen gel

Objective : To investigate the influence of a three-dimensional cell culture model on the expression of osteoblastic phenotype in human periodontal ligament fibroblast (hPDLF) cultures. Material and Methods : hPDLF were seeded on bi-dimensional (2D) and three-dimensional (3D) collagen type I (experimental groups) and and on a plastic coverslip (control) for up to 14 days. Cell viability and alkaline phosphatase (ALP) activity were performed. Also, cell morphology and immunolabeling for alkaline phosphatase (ALP) and osteopontin (OPN) were assessed by epifluorescence and confocal microscopy. The expression of osteogenic markers, including alkaline phosphatase, osteopontin, osteocalcin (OC), collagen I (COL I) and runt-related transcription factor 2 (RUNX2), were analyzed using real-time polymerase chain reaction (RT-PCR). Mineralized bone-like nodule formation was visualized by microscopy and calcium content was assessed quantitatively by alizarin red assay. Results : Experimental cultures produced an increase in cell proliferation. Immunolabeling for OPN and ALP in hPDLF were increased and ALP activity was inhibited by three-dimensional conditions. OPN and RUNX2 gene expression was significantly higher on 3D culture when compared with control surface. Moreover, ALP and COL I gene expression were significantly higher in three-dimensional collagen than in 2D cultures at 7 days. However, at 14 days, 3D cultures exhibited ALP and COL I gene expression significantly lower than the control, and the COL I gene expression was also significantly lower in 3D than in 2D cultures. Significant calcium mineralization was detected and quantified by alizarin red assay, and calcified nodule formation was not affected by tridimensionality. Conclusion : This study suggests that the 3D cultures are able to support hPDLF proliferation and favor the differentiation and mineralized matrix formation, which may be a potential periodontal regenerative therapy.

Diagnosis and treatment of extraction sockets in preparation for implant placement: report of three cases

This article addresses diagnostic parameters that should be assessed in the treatment of extraction sockets with dental implant placement by presenting three case reports that emphasize the relevance of the amount of remaining bone walls. Diagnosis was based on the analysis of clinical and radiographic parameters (e.g.: bone defect morphology, remaining bone volume, presence of infections on the receptor site). Case 1 presents a 5-wall defect in the maxillary right central incisor region with severe root resorption, which was treated with immediate implant placement. Cases 2 and 3 present, respectively, two- and three-wall bone defects that did not have indication for immediate implants. These cases were first submitted to a guided bone regeneration (GBR) procedure with bone graft biomaterial and membrane barriers, and the implants were installed in a second surgical procedure. The analysis of the preoperative periodontal condition of the adjacent teeth and bone defect morphology is extremely important because these factors determine the choice between immediate implant or GBR treatment followed by implant installation in a subsequent intervention.

Immune Cells Depletion During Wound Healing as a Long-Term Effect of Undernutrition

La desnutricion postnatal esta asociada a un conjunto de secuelas agudas y cronicas, y su recuperacion es aun asunto controvertido. En Brasil, a pesar de estar disminuyendo la desnutricion, algunos estudios han demostrado que alrededor del 31% de los ninos presentan malnutricion moderada o severa. El objetivo del presente estudio fue inducir una desnutricion precoz en ratas y observar los efectos inmediatos (desnutricion) y permanentes (depues de la recuperacion) sobre las celulas de defensa involucradas en la cicatrizacion. La desnutricion fue provocada separando las crias de sus madres, por 10 horas diarias, durante el periodo de lactancia (21 dias de nacidos). Como contoles fueron usadas ratas de la misma edad no sometidas a restricion lactea. Los estados de desnutricion y de recuperacion fueron evaluados por el peso corporal. Las heridas fueron realizadas en la piel rasurada del dorso de los animales desnutridos, recuperados y controles, bajo anestesia con tribromoetanol. Los animales fueron sacrificados 1, 3, 7 y 14 dias despues de la cirugia y los tejidos de la region cicatricial fueron procesados histologicamente y examinados al microscopio optico. Los resultados mostraron que: 1) el numero de neutrofilos, linfocitos y macrofagos en la area de cicatrizacion, fue menor en los animales desnutridos y en recuperacion que en los controles; 2) enlos animales recuperados hubo una deficiencia basal en el numero de linfocitos y macrofagos, lo que no ocurrio en los animales con desnutricion aguda. Estos resultados permitieron concluir que los animales sometidos a desnutricion postnatal mostraron una recuperacion completa en el peso fisico despues del periodo de recuperacion nutricional, pero que la region de cicatrizacion mostro menor densidad de celulas de defensa, sugiriendo secuelas permanentes de la desnutricion postnatal

Auxiliary chemical therapies in the treatment of aggressive periodontitis: current aspects

Aggressive periodontitis, a distinct clinical entity of periodontal disease, is characterized by a pronounced episodic and rapid destruction of periodontal tissues and may result in rapid and early loss of teeth. Some studies have shown that conventional mechanical debridement together with oral hygiene is often not sufficient to disease control. Recent studies of this condition have shown beneficial effects of auxiliary therapies or adjuncts such as the administration of systemic and locally antimicrobials. Among the local adjuncts, the literature presents antiseptics, antibiotics and photodynamic therapy. Antibiotics and anti-inflammatory represent systemic adjuncts. Regardless of the results presented by each of them, the difficulty of establishing a single protocol for all cases is recognized depending on the individual response shown by each patient. The aim of the present study was to review the current results about chemical adjuncts administration associated with conventional treatment in cases of aggressive periodontitis and suggest clinical protocols.