Patrícia Oehlmeyer Nassar

Selective cyclooxygenase-2 inhibition prevents bone resorption

The aim of the present work was to evaluate the effect of a selective cyclooxygenase-2 (COX-2) inhibitor (meloxicam) on the alveolar bone loss progression in experimentally induced periodontitis. Forty (40) Wistar rats were separated into 8 experimental groups (n = 5). Cotton ligatures were placed at the gingival margin level of the lower right first molars of some rats. Four groups were treated for 5 or 15 days with an oral dose of 15 mg/kg of body weight/day of the selective COX-2 inhibitor. The other groups were used as positive control (sham) or negative control in each experimental period. Standardized digital radiographs were taken after sacrifice at 5 and 15 days to measure the amount of bone loss at the mesial root surface of the first molar tooth in each rat. The treatment with meloxicam did not induce weight alteration or other visible systemic manifestations. One way analysis of variance (ANOVA) indicated that groups treated with meloxicam, after 5 days, had significantly less alveolar bone loss (p < 0.05) when compared with control groups. On the other hand, no significant differences in bone loss were observed after 15 days of treatment with meloxicam. These data provide evidence that systemic therapy with meloxicam can modify the progression of experimentally induced periodontitis in rats during the initial experimental period.

Periodontal evaluation of different toothbrushing techniques in patients with fixed orthodontic appliances

INTRODUCTION Plaque control is the major consensus during orthodontic treatment to prevent the occurrence of cavities and periodontal inflammation. The mechanic resource of greater effectiveness and frequent use in this control is the oral hygiene. The tooth brushing techniques most used in orthodontic patients are: Ramfjords method, Modified Stillman technique and Bass method. OBJECTIVE Since control studies evaluating the effectiveness of usual tooth brushing techniques do not show clear advantage, the objective of this study was to evaluate the effectiveness of three brushing methods, through periodontal clinical parameters of patients with fixed orthodontic appliances. METHODS Thirty patients were selected, with ages between 14 and 22 years old, with fixed orthodontic appliances. After basic periodontal treatment the following factors were evaluated: 1--Plaque index and 2--Gingival index and each patient was randomly included in one of the three selected groups according to the brushing technique: Group 1--Scrubbing technique; Group 2--Modified Stillman technique and Group 3--Bass technique. Patients were evaluated for 9 months. RESULTS The results showed a significant reduction of clinical parameters by the end of this period, however there was a very significant reduction of Gingival index on group 3 (13.6%) when compared to the other groups. CONCLUSION Thus, it can be suggested that the Bass technique can be effective on the reduction of periodontal clinical parameters of Plaque index and Gingival index in patients with fixed orthodontic appliances.

Effectiveness of periodontal treatment on the improvement of inflammatory markers in children

AIM It is known that atherosclerosis begins in childhood, a behaviour towards oral health care and metabolic control, since an early age, is essential for patients with cardiovascular disease. The aim of this research was to evaluate the effectiveness of periodontal treatment full-mouth scaling and root planning (FMSRP), applied to children without systemic diseases, correlating with periodontal clinical and blood parameters (lipid profile and inflammatory markers). MATERIALS AND METHODS The 29 patients were divided into two groups, group 1 (14) - scaling and rot planning (SRP), group 2 (15) - FMSRP and the follow-up was conducted among 180 days. RESULTS The results showed a significant improvement in clinical periodontal parameters (p<0.05) in both groups. In the analyzed blood parameters there was a greater evidence, with a significant improvement (p<0.05), in total cholesterol (TC), triglycerides (TGs), fibrinogen (FGN), and interleukin-6 (IL-6) CONCLUSIONS: Thus, we suggest that both periodontal treatments were effective in children without any systemic diseases.

Lipid profile of people with diabetes mellitus type 2 and periodontal disease.

The objective of this study was to evaluate improvement of lipids and periodontal disease in patients with type 2 Diabetes mellitus, by means of the relationship between blood levels of total cholesterol and its fractions, triglycerides and clinical periodontal parameters. Twenty patients, in age-range 18-70 years, were selected and divided into 2 groups: (1) conventional periodontal scaling and root planing+controlled mechanic; (2) conventional periodontal scaling and root planing+controlled mechanical+maintenance therapy. The analyses were performed on day 0, 180 and 720 days, including plaque index, gingival index, probing depth and clinical attachment level, and evaluation of total cholesterol and its fractions, and triglycerides. The 2 groups presented significant reduction in clinical periodontal parameters, however, probing depth did not diminish significantly only in Group 1. There was significant improvement in all blood parameters in both groups. It was concluded that after 720 days of the experiment, there were significant improvements in clinical and blood parameters, in general. The group that received maintenance therapy also showed a more expressive improvement in clinical periodontal parameters, in general, suggesting that this therapy is important and necessary in patients with type 2 Diabetes mellitus and periodontal disease.

Effects of long-term cyclosporin therapy on gingiva of rats: analysis by stereological and biochemical estimation

Cyclosporin A (CsA) is used as an immunosuppressive agent and its prominent side effect is the induction of gingival overgrowth, which remains a significant problem. The risk factors appraised include the duration of treatment. However, there are no stereological and biochemical studies exploring the effects of long-term CsA therapy on gingival tissue. The purpose of the present study was to investigate the level of TGF-beta1 in saliva and describe the densities of fibroblasts and collagen fibers in the gingival tissue of rats treated with CsA for long periods. Rats were treated for 60, 120, 180 and 240 days with a daily subcutaneous injection of 10 mg/kg of body weight of CsA. At the end of the experimental periods, saliva was collected for the determination of TGF-beta1 levels. After histological processing, the oral epithelium and the connective tissue area were measured as well as the volume densities of fibroblasts (Vf) and collagen fibers (Vcf). After 60 and 120 days of CsA treatment, there was a significant increase in Vf and Vcf as well as a significant increase in TGF-beta1 levels. After 180 and 240 days, reduction in the gingival overgrowth associated with significant decreases in the level of TGF-beta1, and also decreased Vf and Vcf, were observed. The data presented here suggest that after long-term therapy, a decrease in TGF-beta1 levels occurs, which might contribute to an increase in the proteolytic activity of fibroblasts in the gingiva, favoring the normality of extracellular matrix synthesis.

Lipid profiles and inflammatory markers after periodontal treatment in children with congenital heart disease and at risk for atherosclerosis.

Due to the biological associations between periodontal and cardiovascular diseases, as well as the fact that atherosclerosis begins in childhood, behavior based on oral health care and metabolic control from an early age is essential for patients with cardiovascular disease. The aim of this research was to examine the effect of full-mouth scaling and root planing on the reduction of periodontal disease in children with congenital heart disease. In this study, treatments were related to clinical periodontal parameters and also to blood ones, such as lipid profile and inflammatory markers. The patients were divided into two groups: group 1 (n=17), scaling and root planing; and group 2 (n=16), full-mouth scaling and root planing. The results showed a significant improvement in clinical periodontal parameters (P<0.05) in both groups. Considering lipid parameters, total cholesterol, triglycerides, and very-low-density lipoprotein parameters showed significant improvement (P<0.05). There was also an improvement in C-reactive protein (ultrasensitive) in the group treated with scaling and root planing (P<0.05). Fibrinogen and interleukin-6 parameters improved (P<0.05) in both groups. We suggest that both periodontal treatments were effective in children with congenital heart disease, though neither demonstrated superiority.

Decreased TNF-α gene expression in periodontal ligature in MSG-obese rats: A possible protective effect of hypothalamic obesity against periodontal disease?

The prevalence of obesity is increasing globally. There is evidence that the uncontrolled energetic metabolism in obese patients can accelerate periodontal disease. Therefore, the aim of this study was evaluate the possible relationship between hypothalamic obesity induced by neonatal treatment with MSG and experimental periodontal disease. Newborn male Wistar rats received subcutaneous injections in the cervical region, of 4g/Kg/day of body weight (BW) of MSG (MSG group) or hypertonic saline solution, 1.25/kg/day BW (control group, CTL). At 70 days of life periodontal disease was induced in these animals. After they were sacrificed, radiographic analyses of alveolar bone resorption and Tumor Necrosis Factor α (TNFα) gene expression in gingival tissue were performed. The neonatal treatment with MSG did not affect the concentration of plasma glucose and cholesterol (CHOL). However, plasma insulin, non-esterified fatty acids (NEFA) and triglycerides (TG) leves were higher in MSG compared with CTL group. The alveolar bone resorption was 44% lower in MSG-obese rats compared with CTL rats. In the presence of periodontal ligature, there was an increase in this parameter in all groups. The TNFα gene expression, an inflammatory marker, in periodontal tissue was similar in obese and CTL rats. The presence of ligature increased TNFα gene expression in both groups, but in a lower extension in MSG-obese rats. In conclusion these results suggested that hypothalamic obesity may produce a protective effect against periodontal disease, however further research is needed to understand the mechanisms involved in this process.

Effects of long-term cyclosporin therapy on gingiva of rats--analysis by stereological and biochemical estimation.

Cyclosporin A (CsA) is used as an immunosuppressive agent and its prominent side effect is the induction of gingival overgrowth, which remains a significant problem. The risk factors appraised include the duration of treatment. However, there are no stereological and biochemical studies exploring the effects of long-term CsA therapy on gingival tissue. The purpose of the present study was to investigate the level of TGF-beta1 in saliva and describe the densities of fibroblasts and collagen fibers in the gingival tissue of rats treated with CsA for long periods. Rats were treated for 60, 120, 180 and 240 days with a daily subcutaneous injection of 10 mg/kg of body weight of CsA. At the end of the experimental periods, saliva was collected for the determination of TGF-beta1 levels. After histological processing, the oral epithelium and the connective tissue area were measured as well as the volume densities of fibroblasts (Vf) and collagen fibers (Vcf). After 60 and 120 days of CsA treatment, there was a significant increase in Vf and Vcf as well as a significant increase in TGF-beta1 levels. After 180 and 240 days, reduction in the gingival overgrowth associated with significant decreases in the level of TGF-beta1, and also decreased Vf and Vcf, were observed. The data presented here suggest that after long-term therapy, a decrease in TGF-beta1 levels occurs, which might contribute to an increase in the proteolytic activity of fibroblasts in the gingiva, favoring the normality of extracellular matrix synthesis.

Root Coverage in Miller Classes I and II associated with Subepithelial Connective Tissue Graft: A comparative Clinical Trial of Two Techniques

Introduction: Gingival recession is characterized by apical positioning of the gingival side in relation to the cementoenamel junction. Thus, this study aimed at evaluating the effectiveness of two surgical techniques for root coverage in patients with gingival recession of Miller class I or II. Materials and methods: A total of 13 patients were selected, from the age group of 20 to 50 years, with bilateral gingival recession Miller class I or II, totaling 34 recessions. When the basic periodontal treatment was accomplished, every recession was included in one of both selected groups according to the surgical technique: Control group—Subepithelial connective tissue graft associated with coronally positioned fl ap technique and test group—Subepithelial connective tissue graft associated with the modifi ed envelope technique. Patients were evaluated for 180 days, and the periodontal parameters were analyzed in 0, 90, and 180 days. Results: The results showed that both surgeries were effective since they kept probe depths with periodontal health and clinical attachment gain (p < 0.05) in both groups, up from 90 days. The reduction was kept for 180 days, mainly for the control group that showed a clinical attachment gain that was still statistically signifi cant at 180 days (p < 0.05). Regarding the root coverage, the control group showed a 90.2% of coverage while the test group showed 89.5%. ORIGINAL RESEARCH 1 Department of Periodontology, Unipar Energy Systems Private Limited, Cascavel, Parana, Federal Republic of Brazil Department of Dentistry, West Paraná State University, Cascavel Parana, Federal Republic of Brazil 2,7 Department of Periodontology, Júlio de Mesquita Filho State University, Cascavel, Parana, Federal Republic of Brazil Department of Periodontology, West Paraná State University Cascavel, Parana, Federal Republic of Brazil; Department of Biosciences and Health and Dentistry, West Paraná State University, Cascavel, Parana, Federal Republic of Brazil 3-5 Department of Periodontology, School of Dentistry, West Paraná State University, Cascavel Parana, Federal Republic of Brazil 6 Dentistry Auxiliar, Nurse Technique, Cascavel, Parana, Federal Republic of Brazil Corresponding Author: Carlos A Nassar, Department of Periodontology, Júlio de Mesquita Filho State University, Cascavel Parana, Federal Republic of Brazil; Department of Periodontology West Paraná State University, Cascavel, Parana, Federal Republic of Brazil; Department of Biosciences and Health and Dentistry West Paraná State University, Cascavel, Parana, Federal Republic of Brazil, Phone: +554591013369, e-mail: canassar@yahoo.com 10.5005/jp-journals-10015-1446 Conclusion: Thus, it can be concluded that both techniques, after 180 days, were effective for the health of periodontal tissues; however, a greater emphasis can be observed on the subepithelial connective tissue graft-associated coronally positioned fl ap technique because this technique demonstrated a greater signifi cant gain in the clinical attachment level. Clinical signifi cance: The subepithelial connective tissue graft is used for gaining the clinical attachment level in the root coverage of patients with gingival recession Miller classes I and II.

AVALIAÇÃO MORFOMÉTRICA DA INFLUÊNCIA DA OBESIDADE SOBRE O TECIDO GENGIVAL DE RATOS COM PERIODONTITE EXPERIMENTAL

Objetivo: O objetivo desse trabalho foi avaliar o comportamento do tecido gengival de ratos apos a inducao experimental de obesidade e doenca periodontal. Material e Metodos: Vinte e quatro ratos machos (n=24) foram divididos inicialmente em 2 grupos, que foram submetidos a injecoes intradermicas na regiao cervical de 4g/kg/dia de solucao glutamato monossodico (MSG) (grupo OBS) e 1,25g/kg/dia de solucao salina (grupo CTL), nos primeiros 5 dias de vida. Aos 70 dias foi induzida a doenca periodontal com a colocacao de ligadura nos dentes posteriores dos ratos, apos esse procedimento 4 grupos, com 6 ratos cada, foram originados: grupo controle sem ligadura (CTL); grupo controle com ligadura (LIG); obeso sem ligadura (OBS), obeso com ligadura (OBSLIG). Aos 100 dias os ratos foram sacrificados, e a hemimandibula direita de cada rato foi retirada para a analise morfometrica do tecido gengival. Resultados: A altura do epitelio da crista gengival foi significativamente (p<0,05) maior nos grupos com periodontite induzida (LIG 44,26±0,69; OBSLIG 43,30±1,23). A altura do tecido conjuntivo na regiao media mostrou-se menor nos grupos CTL (237,44±7,38) e OBS (238,17±0,73), sendo estas diferencas estatisticamente significativas (p<0,05) em relacao aos demais grupos. Conclusao: A obesidade induzida pelo glutamato monossodico nao alterou as caracteristicas dos tecidos epitelial e conjuntivo da regiao gengival de ratos. DESCRITORES Doenca Periodontal. Obesidade. Gengiva.