Guilherme de Oliveira Macedo

Salivary Interleukin-6, Matrix Metalloproteinase-8, and Osteoprotegerin in Patients With Periodontitis and Diabetes

BACKGROUNDnDiabetes and periodontitis produce a protein discharge that can be reflected in saliva. This study evaluates the salivary concentrations of interleukin (IL)-6, matrix metalloproteinase (MMP)-8, and osteoprotegerin (OPG) in patients with periodontitis with type 2 diabetes.nnnMETHODSnWhole saliva samples were obtained from 90 subjects who were divided into four groups: healthy (control; n = 22), untreated periodontitis (UPD; n = 24), diabetes mellitus (DM; n = 20), and UPD + DM (n = 24) groups. Clinical and metabolic data were recorded. Salivary IL-6, MMP-8, and OPG concentrations were determined by a standard enzyme-linked immunosorbent assay.nnnRESULTSnThe UPD and UPD + DM groups exhibited higher salivary IL-6 than the control and DM groups (P <0.01). The salivary MMP-8 concentrations in all diseased groups (UPD, DM, and UPD + DM) were higher than in the control group (P <0.01). The salivary OPG concentrations in the DM group were higher than in the UPD and control groups (P <0.05). In the UPD + DM group, salivary IL-6 was correlated with glycated hemoglobin (HbA1c) levels (r = 0.60; P <0.05). The regression analysis indicated that the number of remaining teeth, clinical attachment level, and IL-6 might have influenced the HbA1c levels in patients with diabetes.nnnCONCLUSIONSnSalivary IL-6 concentrations were elevated in patients with periodontitis with or without diabetes. Salivary MMP-8 and OPG concentrations were elevated regardless of periodontal inflammation in patients with diabetes. Therefore, periodontitis and diabetes are conditions that may interfere with protein expression and should be considered when using saliva for diagnoses.

Additional effects of aPDT on nonsurgical periodontal treatment with doxycycline in type II diabetes: a randomized, controlled clinical trial

The association of doxycycline and periodontal treatment in non-controlled diabetes mellitus (DM) has shown positive results on clinical and metabolic parameters. Antimicrobial photodynamic therapy (aPDT) is a local and painless antimicrobial treatment that can be applied in periodontal treatment without systemic risks. The aim of this study was to evaluate the potential improvement of aPDT on clinical and metabolic effects in patients with type 2 diabetes mellitus in conjunction with nonsurgical periodontal treatment plus doxycycline. Thirty patients with type 2 diabetes and diagnosis of chronic periodontitis were treated with scaling and root planning (SRP; Nu2009=u200915) or SRP plus phenothiazine chloride photosensitizer-induced aPDT (SRP + aPDT, Nu2009=u200915). Patients of both groups took doxycycline (100xa0mg/day) for 2xa0weeks and plaque index, bleeding on probe (BOP), probing pocket depth (PPD), suppuration, clinical attachment level (CAL), and glycated hemoglobin levels (HbA1c) were measured at baseline and 3xa0months after therapy. An improvement in clinical parameters such as PPD, CAL, S, and BOP between groups was observed but without statistical significance (pu2009>u20090.05). Intragroup analysis showed a significant reduction of HbA1c (8.5u2009±u20090.9 to 7.5u2009±u20090.1, pu2009<u20090.01) in the SRP + aPDT group. The differences of HbA1c between baseline and 3xa0months were greater for the SRP + aPDT (11.4xa0%) than SRP (10xa0%) (0.87u2009±u20090.9 and 0.4u2009±u20090.84 respectively; pu2009<u20090.05). A single application of the aPDT as an adjunct to periodontal treatment did not show additional benefits in the clinical parameters but resulted in a slight greater decrease in HbA1c.

Histologic evaluation of the buccal and lingual bone plates in anterior dog teeth: possible influence on implant dentistry.

BACKGROUNDnRecent studies in animals have shown pronounced resorption of buccal bone plate after immediate implantation. The sectioning of experimental material for histologic evaluation of the bone plates could provide valuable information about the possible effect of bone exposure in periodontal and implant surgeries.nnnMETHODSnTwenty-four incisors were collected from dogs. After decalcification, the blocks were immersed in paraffin and bucco-lingual histologic sections were examined under light microscope. Some sections were reserved for immunohistochemical analysis.nnnRESULTSnThe bone density, the width of the bone plates, and the percentage of vessels presented in the periodontal ligament and periosteum were analyzed in the buccal and lingual bone plates, which were divided corono-apically into thirds. The buccal bone plates showed statistically higher bone density compared to the lingual bone plates in the coronal thirds. The width of both bone plates increased from the coronal to the apical third, but all the buccal thirds were significantly thinner compared to the lingual thirds. No statistically significant differences were found between the bone plates for the percentage of area occupied by the blood vessels in the periodontal ligament or periosteum.nnnCONCLUSIONnIt is reasonable to conclude that the higher bone density, represented by the lower number of marrow spaces, in association with the thinner aspect of the buccal bone plates made them more fragile to absorb compared to the lingual bone plates, especially during mucoperiosteal procedures.

The Bone Formation Capabilities of the Anorganic Bone Matrix-Synthetic Cell-Binding Peptide 15 Grafts in an Animal Periodontal Model: A Histologic and Histomorphometric Study in Dogs

BACKGROUNDnThe aim of this study is to verify the regenerative potential of particulate anorganic bone matrix-synthetic peptide-15 (ABM-P-15) in class III furcation defects associated or not with expanded polytetrafluoroethylene membranes.nnnMETHODSnClass III furcation defects were produced in the mandibular premolars (P2, P3, and P4) of six dogs and filled with impression material. The membranes and the bone grafts were inserted into P3 and P4, which were randomized to form the test and control groups, respectively; P2 was the negative control group. The animals were sacrificed 3 months post-treatment.nnnRESULTSnHistologically, the complete closure of class III furcation defects was not observed in any of the groups. Partial periodontal regeneration with similar morphologic characteristics among the groups was observed, however, through the formation of new cementum, periodontal ligament, and bone above the notch. Histologic analysis showed granules from the bone graft surrounded by immature bone matrix and encircled by newly formed tissue in the test group. The new bone formation area found in the negative control group was 2.28 + or - 2.49 mm(2) and in the test group it was 6.52 + or - 5.69 mm(2), which showed statistically significant differences for these groups considering this parameter (Friedman test P <0.05). There was no statistically significant difference among the negative control, control, and test groups for the other parameters.nnnCONCLUSIONSnThe regenerative potential of ABM-P-15 was demonstrated through new bone formation circumscribing and above the graft particles. The new bone also was accompanied by the formation of new cementum and periodontal ligament fibers.

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

PURPOSEnTo 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.nnnMATERIALS AND METHODSnThirty 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.nnnRESULTSnBoth 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 0.67u2009mm, in the allograft group, it was from 3.47 to 0.93u2009mm.nnnCONCLUSIONnThe extended flap technique can improve the root coverage results using the subepithelial connective tissue graft or the acellular dermal matrix.nnnCLINICAL SIGNIFICANCEnGraft 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.

Differences in collagen distribution of healthy and regenerated periodontium. Histomorphometric study in dogs.

Previous studies have shown that there is a relationship between periodontal disease and the distribution of collagen fibers. This study evaluated the distribution of collagen types I and III in regenerated bone and periodontal ligament, comparing them to the tissues near the regenerated area and to the healthy periodontium. In the third (P3) and fourth (P4) mandibular premolars of 5 healthy mongrel dogs, bilaterally, buccal class 2 furcation lesions were surgically created and chronified for 3 weeks. After that, full flaps were elevated and expanded polytetrafluoroethylene (e-PTFE) membranes were adapted, sutured and recovered by the flaps. Two weeks after surgery, two membranes on the same side were removed and the other membranes were removed four weeks after surgery. The dogs were euthanized at 12 weeks following placement of the e-PTFE membranes. P3 and P4 teeth as well as the second premolars (healthy control teeth) and their periodontal tissues were removed and histologically processed for Collagen Quantification (COLQ). The amount of type III collagen was higher in native bone compared to the regenerated area. For periodontal ligament, COLQ for type I collagen showed statistically significant differences (Tukeyss Multiple Comparison, p⟨0.05) between the regenerated groups and the control group. These differences were not found for type III COLQ. There are significant differences in collagen distribution among the regenerated, native and control tissues. Membrane removal 2 or 4 weeks postoperatively did not influence the collagen composition.