Artigos - Diagnóstico e Cirurgia - ICT

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Parents with periodontitis drive the early acquisition of dysbiotic microbiomes in their offspring
(2023-07-01) Reis, Aurélio Amorim; Monteiro, Mabelle Freitas; Bonilha, Gabriela Martin; Saraiva, Luciana; Araújo, Cassia [UNESP]; Santamaria, Mauro Pedrine [UNESP]; Casati, Marcio Zaffalon; Kumar, Purnima; Casarin, Renato Corrêa Viana; Universidade Estadual de Campinas (UNICAMP); Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); University of Michigan
Aim: To evaluate the microbial colonization in different dentition phases on individuals from 0 to 18 years of age belonging to families with a history of periodontitis compared to descendants of periodontally healthy parents. Materials and Methods: The offspring of subjects with periodontitis (‘Perio’ group) and the offspring of periodontally healthy subjects (‘Healthy’ group), matched for gender and age, were included in this cross-sectional study and divided according to the dentition phase: pre-dentate, primary, mixed and permanent. The patients were clinically assessed, and their saliva was collected. DNA was extracted, and V1–V3 and V4–V5 regions of the 16S rRNA gene were sequenced. Results: Fifty children of parents with periodontitis and 50 from healthy parents were included in the study and divided according to the dentition phase: pre-dentate (n = 5/group), primary dentition (n = 15/group), mixed dentition (n = 15/group) and permanent dentition (n = 15/group) in each group. The microbiome composition was different between dentitions for both groups. Children of the Perio group presented a microbial diversity different from that of the Healthy group in mixed and permanent dentitions. The more intense shift in the community occurred between primary and mixed dentition in the Perio group, while the transition between mixed and permanent dentition was the period with greater changes in the microbiome for the Healthy group. Furthermore, a pathogen-rich environment—higher prevalence and abundance of periodontitis-associated species such as Prevotella spp., Selenomonas spp., Leptotrichia spp., Filifactor alocis, Prevotella intermedia, Treponema denticola and Tannerella forsythia— was observed in the Perio group. Conclusions: The parents' periodontal status significantly affects the microbiome composition of their offspring from an early age. The mixed dentition was the phase associated with establishing a dysbiotic and pathogen-rich microbiome in descendants of parents with periodontitis.
Cone-beam computed tomography texture analysis can help differentiate odontogenic and non-odontogenic maxillary sinusitis
(2023-01-01) Costa, Andre Luiz Ferreira; Fardim, Karolina Aparecida Castilho [UNESP]; Ribeiro, Isabela Teixeira [UNESP]; Jardini, Maria Aparecida Neves [UNESP]; Braz-Silva, Paulo Henrique; Orhan, Kaan; de Castro Lopes, Sérgio Lúcio Pereira [UNESP]; Cruzeiro do Sul University; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP); Ankara University
Purpose: This study aimed to assess texture analysis (TA) of cone-beam computed tomography (CBCT) images as a quantitative tool for the differential diagnosis of odontogenic and non-odontogenic maxillary sinusitis (OS and NOS, respectively). Materials and Methods: CBCT images of 40 patients diagnosed with OS (N=20) and NOS (N=20) were evaluated. The gray level co-occurrence (GLCM) matrix parameters, and gray level run length matrix texture (GLRLM) parameters were extracted using manually placed regions of interest on lesion images. Seven texture parameters were calculated using GLCM and 4 parameters using GLRLM. The Mann-Whitney test was used for comparisons between the groups, and the Levene test was performed to confirm the homogeneity of variance (α=5%). Results: The results showed statistically significant differences (P<0.05) between the OS and NOS patients regarding 3 TA parameters. NOS patients presented higher values for contrast, while OS patients presented higher values for correlation and inverse difference moment. Greater textural homogeneity was observed in the OS patients than in the NOS patients, with statistically significant differences in standard deviations between the groups for correlation, sum of squares, sum of entropy, and entropy. Conclusion: TA enabled quantitative differentiation between OS and NOS on CBCT images by using the parameters of contrast, correlation, and inverse difference moment.
Effect of Photobiomodulation Therapy Associated With Biphasic Phosphate Calcium on Bone Repair: A Histomorphometric Study in Rats
(2022-01-01) De Marco, Andréa Carvalho [UNESP]; Torquato, Letícia Cavassini [UNESP]; Ribeiro, Tatiana Camacho; Nunes, Camilla Moretto; Bernardo, Daniella Vicensotto; Maciel, Clarissa Carvalho Martins [UNESP]; Pereira, Kauê Alberto [UNESP]; Jardini, Maria Aparecida Neves [UNESP]; Santamaria, Mauro Pedrine [UNESP]; Universidade Estadual Paulista (UNESP); Faculdade Santo Antônio
Introduction: This study aimed to investigate the effects of photobiomodulation (PBM) therapy associated with biphasic calcium phosphate on calvaria critical defects in rats. Methods: Forty-eight (90 days old) adult male rats (Rattus norvegicus, Albinus variation, Wistar) received critical defects of 5 mm in diameter, which were made on their skull, and they were randomly assigned into the following groups: C-blood clot, B-biphasic calcium phosphate, L-photobiomodulation therapy, and B + L-biphasic calcium phosphate + photobiomodulation therapy. A low-level a gallium aluminum arsenide (GaAlAs) laser was applied in a single dose during surgery, in a wavelength of 660 nm and total energy density of 45 J/cm2. On 30th and 60th days, the animals from each group were euthanized. Histological and histomorphometric analyses were performed. Results: In 30 days, almost all specimens (C, L, B and B + L) showed bone neoformation areas in regions near the borders of the surgical defect. In 60 days, in many specimens (C, L, B, B + L), it was possible to see a narrow neoformed bone structure along almost the whole extension of the surgical defect, though it was thinner than the original calvary bone. Data were recorded as mean ± standard deviation, and after normality was tested, a suitable statistical test was applied (α = 5%). On day 60, there was a statistically significant difference when comparing the proportion of neoformation area between group L (0.52% ± 0.13) and group B + L (0.20% ± 0.08). Group L showed a difference compared with all the groups when we compared the remaining distance between the edges of neoformed bone (C × L, P = 0.0431; B × L, P = 0.0386; L × B + L, P = 0.0352), demonstrating a great defect closure. Conclusion: Our findings suggest that although biphasic calcium phosphate exerts some osteogenic activity during bone repair, PBM therapy is not able to modulate this process
Multiple gingival recessions associated with non-carious cervical lesions treated by partial restoration and modified coronally advanced flap with either connective tissue graft or xenogeneic acellular dermal matrix: A randomized clinical trial
(2023-01-01) Santamaria, Mauro Pedrine [UNESP]; Rossato, Amanda [UNESP]; Fernanda Ferreira Ferraz, Laís [UNESP]; Maria Viana Miguel, Manuela [UNESP]; Venturoso Simões, Beatriz [UNESP]; Pereira Nunes, Marcelo; Bresciani, Eduardo [UNESP]; de Sanctis, Massimo; Mathias-Santamaria, Ingrid Fernandes [UNESP]; Universidade Estadual Paulista (UNESP); College of Dentistry; São Paulo; Università Vita-Salute San Raffaele; University of Maryland School of Dentistry
Background: This study aimed to compare a connective tissue graft (CTG) to a (porcine) xenogeneic acellular dermal matrix (XDM), both associated with modified coronally advanced flap (MCAF) and partial resin composite restoration to treat multiple combined defects (CDs). Methods: Seventy-eight defects in 38 patients presenting multiple combined defects, that is, gingival recession associated with non-carious cervical lesions, were treated by partial resin composite restoration (apical margin up to 1 mm of the estimated cement-enamel junction) and MCAF along with CTG or XDM. After 6 months, the groups were compared with regard to clinical, patient-centered, and esthetic outcomes. Results: CD coverage was 72.9% for CTG versus 50.7% for XDM (P < 0.001). Recession reduction was 2.3 mm for CTG versus 1.5 mm for XDM (P < 0.001). CTG resulted in a greater increase in keratinized tissue width (CTG: 0.96 mm vs. XDM: 0.3 mm, P = 0.04) and gingival thickness (CTG: 0.9 mm vs. XDM: 0.3 mm, P < 0.001). Both treatments successfully reduced dentin hypersensitivity and increased esthetics satisfaction, with no statistically significant intergroup differences. Moreover, XDM patients experienced a shorter surgery duration (CTG: 57.2 min vs. XDM: 37.4 min, P < 0.001) and less time to no pain (visual analog scale = 0; CTG: 6.5 days vs. XDM: 3.5 days, P = 0.04). Conclusion: CTG resulted in significantly greater root coverage and increased keratinized tissue width compared to XDM for treating multiple partially restored CDs. However, increased root coverage at the CTG sites was accounted for by increased probing depth compared to the XDM sites.
Evaluation of a novel restorative protocol to treat non-carious cervical lesion associated with gingival recession: a 2-year follow-up randomized clinical trial
(2023-04-01) Mathias-Santamaria, Ingrid Fernandes [UNESP]; Santamaria, Mauro Pedrine [UNESP]; Silveira, Camila Augusto [UNESP]; Martinho, Frederico Canato; de Melo, Mary Anne Sampaio; De Marco, Andrea Carvalho [UNESP]; Augusto, Marina Gullo; de Andrade, Guilherme Schmitt; Roulet, Jean-François; Bresciani, Eduardo [UNESP]; Baltimore; Universidade Estadual Paulista (UNESP); University of Kentucky; Western Paraná State University; University of Florida
Objective: To compare 2 different resin composites and 2 adhesive systems used in a new restorative protocol (partial restoration) to treat non-carious cervical lesions associated with gingival recession type 1 (RT1). Material and methods: Eighty combined defects (CDs) were treated with a partial restoration and periodontal plastic surgery for root coverage. The CDs were randomly assigned to one of the following groups: NP + TE (n = 20), nanofilled composite and 2-step total-etch adhesive system; NP + UA (n = 20), nanofilled composite and universal adhesive system; MH + TE (n = 20), microhybrid composite and 2-step total-etch adhesive; MH + UA (n = 20), microhybrid composite and universal adhesive. Restorations were assessed using the United States Public Health Service (USPHS) criteria at 1 week (baseline) and 6, 12, and 24 months. Survival rate, periodontal parameters, dentin hypersensitivity (DH), and aesthetics were also evaluated. Results: After 24 months, only the MH + TE group did not lose any restoration, with no significant differences between groups. For surface roughness parameter, MH presented 83.3% of the restorations scoring Bravo, whereas NP presented 48.5% of the restorations scoring Bravo. All groups presented restorations with marginal discoloration. All periodontal parameters behaved similarly, regardless of the restorative material. All groups presented significant reductions of dentin hypersensitivity and improved aesthetic perceptions (p < 0.05). Conclusion: Both resin composites and adhesives tested can be combined for partial restorations to treat CDs. Clinical relevance: This new restorative-surgical protocol to treat CDs presents satisfactory outcomes. The partial restorations can be successfully executed with both combinations of adhesives and resin composites evaluated in this investigation. TRN: ClinicalTrial.gov: NCT03215615; registration date July 12, 2017.
Is the use of Lactobacillus reuteri probiotic efficient as adjunctive therapy in the treatment of periodontitis? A systematic review
(2023-01-01) Tricoly, Tainá da Silva [UNESP]; Ferreira, Camila Lopes [UNESP]; Lima, Victória Clara da Silva [UNESP]; de MARCO, Andrea Carvalho [UNESP]; Caneppele, Taciana Marco Ferraz [UNESP]; Jardini, Maria Aparecida Neves [UNESP]; Universidade Estadual Paulista (UNESP)
Objective: This systematic review had the purpose to validate the probiotic Lactobacillus reuteri as adjuvant therapy in the periodontal treatment of periodontitis, by the analysis of randomized controlled trial, controlled clinical trial, and observational studies. Material and Methods: Search keys related to the subject were defined, and the following databases were used as search strategies: MEDLINE via PubMed, Scopus, Web of Science, Cochrane Central Controlled Trials Registry, and EMBASE. The data selection and study were performed by two independent evaluators: first, they selected the article by title and abstract and subsequently qualified according to the bias risk analysis. A narrative synthesis has been performed based on the data obtained from the best-quality articles. After data extraction, their heterogeneity was analyzed, and a meta-analysis was performed. Results: In general, the results of the meta-analysis were positive for the use of probiotics as an adjuvant treatment. Considering the limitations of the comparisons between the analyzed articles studied, the conclusion was that probiotics may provide supplementary benefits to the treatment of periodontitis, with improvement in bleeding on probing rates and probing depth.
Magnetic resonance imaging texture analysis of the temporomandibular joint for changes in the articular disc in individuals with migraine headache
(2023-01-01) Fardim, Karolina Aparecida Castilho [UNESP]; Ribeiro, Thais Mara Aparecida Monfredini [UNESP]; de ARAÚJO, Elaine Cristina de Carvalho Beda Correa [UNESP]; Ogawa, Celso Massahiro; Costa, Andre Luiz Ferreira; Lopes, Sérgio Lucio Pereira de Castro [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Cruzeiro do Sul (UNICSUL)
Objective: the aim of this study was to analyse the performance of the technique of texture analysis (TA) with magnetic resonance imaging (MRI) scans of temporomandibular joints (TMJs) as a tool for identification of possible changes in individuals with migraine headache (MH) by relating the findings to the presence of internal derangements. Material and Methods: thirty MRI scans of the TMJ were selected for study, of which 15 were from individuals without MH or any other type of headache (control group) and 15 from those diagnosed with migraine. T2-weighted MRI scans of the articular joints taken in closed-mouth position were used for TA. The co-occurrence matrix was used to calculate the texture parameters. Fisher’s exact test was used to compare the groups for gender, disc function and disc position, whereas Mann-Whitney’s test was used for other parameters. The relationship of TA with disc position and function was assessed by using logistic regression adjusted for side and group. Results: the results indicated that the MRI texture analysis of articular discs in individuals with migraine headache has the potential to determine the behaviour of disc derangements, in which high values of contrast, low values of entropy and their correlation can correspond to displacements and tendency for non-reduction of the disc in these individuals. Conclusion: the TA of articular discs in individuals with MH has the potential to determine the behaviour of disc derangements based on high values of contrast and low values of entropy.
Analgesia and sedation for intratracheal intubation in the neonatal period: an integrative literature review
(2023-03-01) Naujorks, Silvia; Knob, Gabriele H. [UNESP]; Dotto, Patrícia P. [UNESP]; Henn, Roseli; Zamberlan, Cláudia; Saúde Materno-Infantil; Universidade Estadual Paulista (UNESP); Pediatria e Saúde da Criança; Mestrado em Saúde Materno-Infantil
Objective: to assess evidence available in the literature about the use of sedation and analgesia for intratracheal intubation of newborns. Data sources: by means of an integrative literature review, the authors looked for evidence related to the theme from the last ten years, indexed in the Pubmed, Medline, Lilacs, Scielo, and Scopus databases, by combining the descriptors: newborn, intratracheal intubation, and analgesia. Articles in Portuguese, English, and Spanish that met the research purpose were included. Data summary: After applying the eligibility criteria, ten articles on the topic were obtained, predominantly narrative reviews, retrospective studies, observational studies, and only one non-randomized clinical trial, which characterizes the literature related to the topic as having a low level of scientific evidence. There is still no consensus in the literature on which medications and indications are for use in non-elective intubations, despite the ethical recommendation. Discussion: pain and its deleterious effects should not be neglected. Neonatal Intensive Care Units should have their own protocols regarding sedation and analgesia for intubation considering the individual characteristics of each patient. There is an ethical recommendation regarding the use of sedation and analgesia for intubation since it is a known painful procedure.
Xenogeneic Acellular Dermal Matrix for the Treatment of Multiple Gingival Recessions Associated with Partially Restored Noncarious Cervical Lesions
(Quintessence Publishing Co Inc, 2022-11-01) Rossato, Amanda [UNESP]; Mathias-Santamaria, Ingrid Fernandes [UNESP]; Ferreira Ferraz, Lais Fernanda [UNESP]; Gomez Bautista, Cristhian Reynaldo [UNESP]; Viana Miguel, Manuela Maria [UNESP]; Santamaria, Mauro Pedrine [UNESP]; Universidade Estadual Paulista (UNESP); Univ Maryland; Univ Kentucky
This study evaluated the use of a xenogeneic acellular dermal matrix (XADM) combined with a modified coronally advanced flap (MCAF) and partial resin composite filling (anatomic crown plus 1 mm of the root surface) to treat multiple Type 1 gingival recessions associated with B+ noncarious cervical lesions (NCCLs). The study included 24 recessions in 10 patients. Bleeding on probing, probing depth, combined defect height, relative gingival recession, clinical attachment level, esthetics, and dentin hypersensitivity were recorded. After 6 months, the treatment provided statistically significant outcomes: It reduced the combined defect height by 2.02 +/- 0.65 mm, increased clinical attachment level by 1.96 +/- 0.83 mm, and increased keratinized tissue thickness by 0.46 +/- 0.47 mm, and shallow probing depths were seen. Significant dentin hypersensitivity reduction and esthetic improvements were observed. Therefore, XADM associated with MCAF and partial restoration might be a promising alternative to autogenous grafts used to treat multiple gingival recessions associated with B+ NCCLs.
Texture analysis in cone-beam computed tomographic images of medication-related osteonecrosis of the jaw
(Korean Acad Oral & Maxillofacial Radiology, 2023-02-11) Queiroz, Polyane Mazucatto [UNESP]; Fardim, Karolina Castilho [UNESP]; Costa, Andre Luiz Ferreira; Matheus, Ricardo Alves; Lopes, Sergio Lucio Pereira Castro [UNESP]; Inga Univ Ctr; Universidade Estadual Paulista (UNESP); Cruzeiro Univ; Universidade Estadual de Londrina (UEL)
Purpose: The aim of this study was to evaluate changes in the trabecular bone through texture analysis and compare the texture analysis characteristics of different areas in patients with medication-related osteonecrosis of the jaw (MRONJ).Materials and Methods: Cone-beam computed tomographic images of 16 patients diagnosed with MRONJ were used. In sagittal images, 3 regions were chosen: active osteonecrosis (AO); intermediate tissue (IT), which presented a zone of apparently healthy tissue adjacent to the AO area; and healthy bone tissue (HT) (control area). Texture analysis was performed evaluating 7 parameters: secondary angular momentum, contrast, correlation, sum of squares, inverse moment of difference, sum of entropies, and entropy. Data were analyzed using the Kruskal-Wallis test with a significance level of 5%.Results: Comparing the areas of AO, IT, and HT, significant differences (P<0.05) were observed. The IT and AO area images showed higher values for parameters such as contrast, entropy, and secondary angular momentum than the HT area, indicating greater disorder in these tissues.Conclusion: Through texture analysis, changes in the bone pattern could be observed in areas of osteonecrosis. The texture analysis demonstrated that areas visually identified and classified as IT still had necrotic tissue, thereby increasing the accuracy of delimiting the real extension of MRONJ. (Imaging Sci Dent 20220202)
Biomechanical, operative and biological aspects of the cervical margin relocation: a case report
(2022-06-01) Prado, Taiana Paola [UNESP]; Chun, Eliseo Pablo; Augusto, Marina Gullo; Bernardon, Paula; Grassi, Elisa Donaria Aboucauch [UNESP]; Saavedra, Guilherme De Siqueira Ferreira Anzaloni [UNESP]; Mathias-Santamaria, Ingrid Fernandes; Santamaria, Mauro Pedrine [UNESP]; De Andrade, Guilherme Schmitt; Universidade Estadual Paulista (UNESP); Private Practice; School of Dentistry; Universidade Estadual do Oeste do Paraná; Division of Operative Dentistry
The clinical success of tooth-colored indirect restorations has been confirmed in several studies. However, inlays and onlays restorations in Class II cavities with deep gingival margins can still be considered a clinical challenge. With the purpose of facilitating the execution of the operative procedures in intrasulcular margins and reducing the risk of restorative failures, the technique of cervical margin relocation has been explored as a noninvasive alternative to surgical crown lengthening. This work aims at discussing through a case report the biomechanical, operative and biological aspects in the treatment of teeth with deep gingival margins. Therefore, given the therapy applied in the clinical case presented, it is concluded that the cervical margin relocation with composite resin is advantageous since it eliminates the need for surgery, allowing the implementation of indirect restorations in fewer clinical sessions, not causing damage to periodontal tissues once it provided good finishing and polishing with the establishment of a correct emergence profile, allowing flawless maintenance of gingival health after one year.
Comparison between connective tissue graft and xenogeneic acellular dermal matrix to treat single gingival recession: A data reanalysis of randomized clinical trials
(2022-01-01) Miguel, Manuela Maria Viana [UNESP]; Ferraz, Laís Fernanda Ferreira [UNESP]; Rossato, Amanda [UNESP]; Cintra, Tuana Mendonça Faria [UNESP]; Mathias-Santamaria, Ingrid Fernandes; Santamaria, Mauro Pedrine [UNESP]; Universidade Estadual Paulista (UNESP); University of Maryland School of Dentistry; College of Dentistry
Objectives: There are few studies comparing xenogeneic acellular dermal matrixes (XDMs) with connective tissue graft (CTG) to treat single gingival recession (GR). The present study involved a reanalysis of previous studies and comparison of CTG or XDM to treat single RT1/GR. Materials and methods: Fifty patients from three previous randomized clinical trials treated either by CTG (n = 25) or XDM (n = 25) were evaluated after 6-month. Clinical, patient-centered, and esthetic parameters were assessed. Pearson's correlation and regression analyses were also performed. Results: Greater recession reduction (RecRed), percentage of root coverage (%RC), and complete root coverage (CRC) were observed in the CTG group (p ≤ 0.02). Gingival thickness (GT) and keratinized tissue width (KTW) gains were higher in the CTG group. The CTG group showed better esthetic at 6-month. Logistic analyses reported that GT([OR] = 1.6473) and papilla height (PH) (OR = 8.20) are predictors of CRC. GT*XDM interaction was a negative predictor of CRC (OR = 7.105−5). GT at baseline acted as a predictor of RecRed in both groups (p = 0.03). The XDM graft impacted RecRed and %RC negatively. Baseline PH was a predictor of %RC for both grafts. Conclusion: CTG was superior for treating RT1/GR, providing better root coverage outcomes and tissue gains over time. GT, PH, and graft type were classified as predictors of CRC. Clinical significance: CTG presented better outcomes to treat single RT1 gingival recession when compared to the XDM.
Collagen matrix biofunctionalized with injectable platelet-rich fibrin for the treatment of single gingival recession: A case report
(Wiley-Blackwell, 2022-08-30) Santamaria, Mauro Pedrine [UNESP]; Rossato, Amanda [UNESP]; Ferraz, Lais Fernanda Ferreira [UNESP]; Bonafe, Ana Carolina [UNESP]; Miguel, Manuela Maria Viana [UNESP]; Nunes, Marcelo Pereira; Universidade Estadual Paulista (UNESP); Univ Kentucky; Proimperio Inst
Introduction Collagen matrices have been used as connective tissue graft (CTG) substitutes. However, they do not have the same efficacy compared to CTG. Adding biological agents may increase collagen matrices' efficacy. The present case reports the use of a biofunctionalized volume-stable collagen matrix (VCMX) with injectable platelet-rich fibrin (iPRF) associated with the coronally advanced flap (CAF) to treat single gingival recession (GR) defect. Case Presentation A Recession Type 1 (RT1 A-) defect at maxillary left canine in a male patient was treated using a VCMX biofunctionalized with iPRF associated with CAF. No swelling or edema was observed during the first 14 days after surgery. Complete root coverage was observed (RecRed of 4.0 mm) after 6 months. Gingival thickness (GT) increased (1.0 mm) by the end of the follow-up. Conclusion The present case report shows that CAF associated with VCMX+iPRF presents good clinical outcomes for single GR defect. Key points Why is this case new information? This case is the first one to our knowledge to describe the biofunctionalization of VCMX with iPRF to treat single gingival recession. What are the keys to successful management of this case? Proper material handling. Proper iPRF protocol execution. What are the primary limitations to success in this case? Need of venipuncture. Correct preparation of VCMX+iPRF. Patient compliance.
Single implant placement in the maxillary aesthetic area with or without connective tissue grafting: A 1-year follow-up randomised clinical trial
(Quintessence Publishing Co Inc, 2022-03-01) Lazzari, Thiago Rodrigues [UNESP]; Jardini, Maria Aparecida Neves[UNESP]; Santos, Nidia Castro dos [UNESP]; Neves, Felipe Lucas da Silva [UNESP]; Lima, Victoria Clara da Silva[UNESP]; Melo Filho, Antonio Braulino de [UNESP]; Santamaria, Mauro Pedrine [UNESP]; Universidade Estadual Paulista (UNESP); Univ Guarulhos
Purpose: To evaluate the influence of connective tissue graft on the soft tissue thickness and aesthetics around single implants placed in the aesthetic zone of the maxilla. Materials and methods: Forty-two patients with indications for single implant placement in the aesthetic zone were randomly allocated into two groups: the implant group (implant insertion) and the implant + connective tissue graft group (implant insertion and placement of a 1.50-mm-thick connective tissue graft). Clinical evaluations were performed at baseline, 4 months after surgery (prior to prosthetic reconstruction) and 1 year after crown placement to assess tissue thickness at the crestal aspect and the buccal aspect, buccal defects, keratinised tissue width and proximal bone resorption. Aesthetics were assessed using the pink aesthetic score index, and postoperative discomfort and pain tests were also performed. Results: Only the implant + connective tissue graft group presented a significant increase in tissue thickness at the buccal aspect, with 2.36 +/- 0.94 mm at baseline, 3.35 +/- 1.00 mm after 4 months and 3.23 +/- 0.77 mm after 1 year (P < 0.05), whereas no change was observed in the implant group. The difference between the two groups was significant after 4 months and 1 year (P < 0.05). The implant + connective tissue graft group also showed a greater reduction in buccal defects after 1 year compared to the implant group (Delta -0.50 +/- 0.70 mm and Delta -1.80 +/- 1.30 mm, respectively; P < 0.05). After 1 year, a significant intergroup difference in proximal bone resorption was observed, with the implant + connective tissue graft group showing less bone resorption compared to the implant group (0.75 +/- 0.20 mm and 0.92 +/- 0.30 mm, respectively; P < 0.05). Conclusions: Placement of a connective tissue graft simultaneous to single implant insertion in the anterior maxillary region can increase the thickness of the peri-implant mucosa and reduce proximal bone resorption.
The authors thank all the authors who responded to their requests and provided useful information that made it possible to complete this systematic review and meta-analysis.
(2022-01-01) Lazzari, Thiago Rodrigues [UNESP]; Jardini, Maria Aparecida Neves [UNESP]; dos Santos, Nidia Castro; da Silva Neves, Felipe Lucas [UNESP]; da Silva Lima, Victória Clara [UNESP]; de Melo Filho, Antonio Braulino [UNESP]; Santamaria, Mauro Pedrine [UNESP]; Universidade Estadual Paulista (UNESP); Dental Research Division
Purpose: To evaluate the inﬂuence of connective tissue graft on the soft tissue thickness and aesthetics around single implants placed in the aesthetic zone of the maxilla. Materials and methods: Forty-two patients with indications for single implant placement in the aesthetic zone were randomly allocated into two groups: the implant group (implant insertion) and the implant + connective tissue graft group (implant insertion and placement of a 1.50-mm-thick connective tissue graft). Clinical evaluations were performed at baseline, 4 months after surgery (prior to prosthetic reconstruction) and 1 year after crown placement to assess tissue thickness at the crestal aspect and the buccal aspect, buccal defects, keratinised tissue width and proximal bone resorption. Aesthetics were assessed using the pink aesthetic score index, and postoperative discomfort and pain tests were also performed. Results: Only the implant + connective tissue graft group presented a signiﬁcant increase in tissue thickness at the buccal aspect, with 2.36 ± 0.94 mm at baseline, 3.35 ± 1.00 mm after 4 months and 3.23 ± 0.77 mm after 1 year (P < 0.05), whereas no change was observed in the implant group. The difference between the two groups was signiﬁcant after 4 months and 1 year (P < 0.05). The implant + connective tissue graft group also showed a greater reduction in buccal defects after 1 year compared to the implant group (Δ −0.50 ± 0.70 mm and Δ −1.80 ± 1.30 mm, respectively; P < 0.05). After 1 year, a signiﬁcant intergroup difference in proximal bone resorption was observed, with the implant + connective tissue graft group showing less bone resorption compared to the implant group (0.75 ± 0.20 mm and 0.92 ± 0.30 mm, respectively; P < 0.05). Conclusions: Placement of a connective tissue graft simultaneous to single implant insertion in the anterior maxillary region can increase the thickness of the peri-implant mucosa and reduce proximal bone resorption.
Effect of systemic antibiotic and probiotic therapies as adjuvant treatments of subgingival instrumentation for periodontitis: a randomized controlled clinical study
(2022-01-01) Ramos, Tatiane Caroline de Souza [UNESP]; Boas, Mariéllen Longo Vilas [UNESP]; Nunes, Camilla Magnoni Moretto [UNESP]; Ferreira, Camila Lopes [UNESP]; Pannuti, Cláudio Mendes; Santamaria, Mauro Pedrine [UNESP]; Jardini, Maria Aparecida Neves [UNESP]; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP)
OBJECTIVE: This study assessed the efficacy of two adjunct therapies (antibiotic and probiotic) for periodontal treatment based on clinical and immunological parameters in patients with Stage II and III Grade B periodontitis. METHODOLOGY: 45 patients were randomly allocated into three groups: control group (CG); antibiotic group (GAtb), in which 500 mg amoxicillin + 400 mg metronidazole were used; and probiotic group (GProb), for which Lactobacillus reuteri was used. Patients received medications after undergoing periodontal debridement. Clinical and immunological parameters were assessed at baseline, 30 days, and 90 days. RESULTS: All therapies reduced bleeding on probing (BoP) in the evaluated periods, and the GAtb had a greater reduction at 90 days (p=0.03). The GProb group showed better results for plaque index (PI) and gingival recession (GR) compared to the GAtb at 90 days (p=0.0014; p=0.006). The area of inflammation (PISA Index) significantly decreased in all therapies in the evaluated periods. Therapies had no significant differences regarding moderate pockets. The GAtb had a greater reduction in probing depth (PD) for deep pockets (p=0.03) at 90 days and in the number of deep pocket sites at 30 days (p=0.04). The occurrence of adverse effects was commonly reported in the GAtb as a percentage per patient. The GAtb had a significant reduction in the concentration of interleukins IL-1β and IL-8 and an increase in IL-10 and TNF-α. The CG had a reduction in IL-6 and IL-1 β, whereas in the GProb there was no difference. CONCLUSION: After three months, none of the adjuvant therapies provided any additional benefit for subgingival instrumentation.
The Effect of Photobiomodulation Therapy in Different Doses on Bone Repair of Critical Size Defects in Rats: A Histomorphometric Study
(2021-01-01) de Marco, Andrea Carvalho [UNESP]; Torquato, Letícia Cavassini [UNESP]; Gonçalves, Paulo Roberto; Ribeiro, Tatiana Camacho; Nunes, Camilla Moretto [UNESP]; Bernardo, Daniella Vicensotto; Gomes, Mônica Fernandes [UNESP]; Jardini, Maria Aparecida Neves [UNESP]; Santamaria, Mauro Pedrine [UNESP]; Universidade Estadual Paulista (UNESP); Sao Jose dos Campos
Introduction: Photobiomodulation therapy (PBM) appears to induce osteogenesis and stimulate fracture repair; because of its capacity, it is considered a promising treatment, but the characteristics of response to different radiation doses must be investigated through in vivo studies to establish their safety and effectiveness. Thus, this paper aims to analyze the effects of the PBM at different doses on the repair of critical bone defects through histological and histomorphometric analyses. Methods: Sixty 90-day-old adult rats (Rattus norvegicus, albinus, Wistar) weighing approximately 300 g were used. Critical bone defects of 5 mm in diameter were performed in their calvaria. The animals were randomly separated into 5 groups: C-Blood clot, L15-PBM 15J/cm2, L30-PBM 30 J/cm2, L45-PBM 45 J/cm2, L60-PBM 60 J/cm2. Each group was subdivided according to observation periods of 30 and 60 days with 6 rats in each subgroup. Low-level gallium aluminum arsenide (GaAlAs) lasers were used at a 660 nm wavelength, 30 mW and 0.04 cm2 in area. The PBM was applied over 5 points; 4 points of application were distributed on the edges while one point of application was located in the center of the bone defect. PBM occurred right after the procedure. In 30 and 60 days, the animals were euthanized by anesthesia overdose and the analyses were performed. The data were analyzed statistically by the ANOVA, together with the Tukey test, whose significance level was 5%. Results: As regards the treatment factor, the highest percentage of bone neoformation was achieved by group L45-60. The group with the highest closure, despite not having a statistically significant difference with the other doses, was 45 J with only 0.49 mm between edges. Conclusion: Thus, the present study allowed concluding that the highest percentage of bone neoformation area was achieved at 45 J/cm2 in 60 days; that is, it was significantly effective in comparison with other doses.
Comparison of two types of xenogeneic matrices to treat single gingival recessions: A randomized clinical trial
(2021-01-01) Santamaria, Mauro Pedrine [UNESP]; Rossato, Amanda [UNESP]; Miguel, Manuela Maria Viana [UNESP]; Fonseca, Manuela Bafini [UNESP]; Bautista, Cristhian Reynaldo Gomez [UNESP]; de Marco, Andrea Carvalho [UNESP]; Mathias-Santamaria, Ingrid Fernandes [UNESP]; Ferreira Ferraz, Laís Fernanda [UNESP]; Universidade Estadual Paulista (UNESP); University of Kentucky; University of Maryland School of Dentistry
Background: Xenogeneic matrices (XMs) have been increasingly used for root coverage procedures. This study compared the use of two types of XM (collagen matrix [CM] and xenogeneic acellular dermal matrix [XDM]) associated with the coronally advanced flap technique (CAF) to treat single gingival recessions. Methods: Seventy-five patients presenting single RT1 gingival recession were treated by CAF (control group, n = 25), CAF+CM (test group 1, n = 25), or CAF+XDM (test group 2, n = 25) and completed 6-month follow-up. Clinical, patient-centered, and esthetic assessments were performed and intra- and intergroup differences were analyzed. Results: At 6 months, the mean recession reduction for CAF, CAF+CM, and CAF+XDM was 2.4 ± 0.8 mm, 2.4 ± 0.9 mm and 2.1 ± 0.8 mm, respectively (P > 0.05). The corresponding mean percentage of root coverage was 78.9% ± 26.2% for CAF, 78.0% ± 28.5% for CAF+CM, and 65.6% ± 26.9% for CAF+XDM (P > 0.05). Dentin hypersensitivity and esthetic conditions showed significantly improvements in all groups. Test groups presented significant gains in gingival thickness (GT; CAF+CM: 0.4 ± 0.3 mm; CAF+XDM: 0.4 ± 0.2 mm) compared to the control group (CAF: 0.0 ± 0.1 mm; P < 0.05). Conclusion: The CAF, CAF+CM, and CAF+XDM treatments each provided similar results in the treatment of single gingival recessions. The addition of either CM or XDM to CAF increases the GT.
Enamel matrix derivative effects on palatal mucosa wound healing: Randomized clinical trial
(2021-01-01) Miguel, Manuela Maria Viana [UNESP]; Mathias-Santamaria, Ingrid Fernandes [UNESP]; Rossato, Amanda [UNESP]; Ferraz, Laís Fernanda Ferreira [UNESP]; Rangel, Thiago Perez; Casarin, Renato Corrêa Viana; Tatakis, Dimitris N.; Santamaria, Mauro Pedrine [UNESP]; Universidade Estadual Paulista (UNESP); University of Maryland School of Dentistry; Piracicaba Dental School; The Ohio State University (OSU); University of Kentucky
Background: This study was conducted to evaluate the clinical, immunologic, and patient-centered outcomes of enamel matrix protein derivative (EMD) on excisional wounds in palatal mucosa. Materials: Forty-four patients in need of ridge preservation were randomly allocated into two groups: control group (n = 22): open palatal wound after free gingival graft (FGG) harvest and EMD group (n = 22): open palatal wound after FGG harvest that received 0.3 ml of EMD. Clinical and patient-centered parameters were analyzed for 3 months post-treatment. Wound fluid levels of inflammatory markers were assessed 3 and 7 days postoperatively. Results: No significant inter-group difference was observed in remaining wound area and re-epithelialization. EMD and control groups achieved wound closure and re-epithelialization 30 days postoperatively (p <.001), without inter-group differences. Similarly, number of analgesics and Oral Health Impact Profile scores did not present significant inter-group differences (p >.05). EMD appeared to selectively modulate wound fluid levels of monocyte chemoattractant protein-1, macrophage inflammatory protein-1α, matrix metallopeptidase 9, and tissue inhibitor of metalloproteinases-2. Conclusion: Within the limits of the present study, it can be concluded that EMD application to excisional palatal wounds using the investigated protocol does not provide clinical healing benefits, despite an apparent modulation of selected inflammatory markers.
Single gingival recession associated with non-carious cervical lesion treated by partial restoration and coronally advanced flap with or without xenogenous collagen matrix: A randomized clinical trial evaluating the coverage procedures and restorative protocol
(2021-01-01) Mathias-Santamaria, Ingrid Fernandes [UNESP]; Silveira, Camila Augusto [UNESP]; Rossato, Amanda [UNESP]; Sampaio de Melo, Mary Anne; Bresciani, Eduardo [UNESP]; Santamaria, Mauro Pedrine [UNESP]; Universidade Estadual Paulista (UNESP); University of Maryland School of Dentistry; University of Kentucky
Background: Evaluate the use of collagen matrix (CM) as adjunctive to coronally advanced flap (CAF versus CAF + CM) to treat gingival recession (GR) associated with non-carious cervical lesion–combined defects (CDs). Methods: Sixty-two patients presenting 62 CDs (RT1 GR and non-carious cervical lesion (NCCLs) were randomly allocated to either CAF group (n = 31): partial restoration of the NCCL and CAF; or to CAF + CM group (n = 31): partial restoration of the NCCL and CAF associated with CM. Clinical, esthetic, patient-centered outcomes, and restorative parameters were assessed. Results: After 12 months, CD coverage were 55.2% for CAF and 54.4% for CAF + CM (P = 0.8). Recession reduction were 1.9 ± 0.8 mm for CAF and 2.0 ± 0.7 mm for CAF + CM (P = 0.6). CAF+CM resulted in higher increase in keratinized tissue (KT) width (CAF: 0.3 ± 0.7 mm; CAF + CM: 0.9 ± 0.8 mm; P = 0.004) and KT thickness gain (CAF: 0.1 ± 0.3 mm; CAF + CM: 0.7 ± 0.2 mm; P = 0.001). Both treatments presented low postoperative pain and resulted in esthetics improvements. In addition, no restoration was lost, 27.4% showed a reduction of the superficial polishing, and 8% showed marginal staining, but still clinically acceptable. Conclusion: Partial resin composite restoration (with the apical limit up to 1 mm of the estimated CEJ) and CAF alone or combined with CM are suitable for treating CDs. The use of CM provided additional benefits in terms of KT width and thickness gain. (NCT03341598).

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