Aim to evaluate the clinical efficacy of an acetaminophen analgesic by comparing its prescription in fixed versus on-demand schedules after periodontal surgery. The hypothesis of the study was that the fixed regimen would be more effective than the on-demand regimen for postoperative analgesics following periodontal surgery. Methods An open randomized clinical trial was conducted. The 68 patients who needed total flap surgery to restore supracrestal tissue attachment or surgical treatment of periodontitis were randomized”. Visual Analogue Scale was used to assess pain. The fixed group (n = 34) received 500 mg of acetaminophen every 4 hours for 2 days. The on-demand group (n = 34) was instructed to use the acetaminophen “as needed,” at intervals of no less than 4 hours between doses. Ibuprofen was the rescue medication for both groups. Pain scores and medication use were recorded 2, 6, 12, 24 and 48 hours after the surgical procedure. The study was registered at the Brazilian Registry of Clinical Trials under RBR-7wv259. Results The two groups did not differ in relation to the frequency or the intensity of pain in a 48-hour period (n=20 in the fixed group, and n=22 in the on-demand group), or even in the intention-to-treat (n=34 in each group). Individuals who experienced moderate to severe pain used rescue medication more frequently in both groups. No adverse events were reported. Conclusion Both regimens were effective in controlling postoperative pain after periodontal surgery.

Abstract In recent years, different chlorhexidine formulations have been tested, including an alcohol-free alternative, but the effect of this solution on early biofilm formation is not clear. A crossover, randomized, double-blind clinical trial was conducted to evaluate the effect of two chlorhexidine solutions against supra- and subgingival biofilm formation (NCT#02656251). Thirty-five participants were randomized and asked to rinse twice daily with 15 ml of an alcohol-containing 0.12% chlorhexidine solution, an alcohol-free 0.12% chlorhexidine solution, or placebo. The study was conducted in three experimental periods of 4 days each, with a 10-day washout between the periods. All the experimental periods followed the same protocol, except that the solutions were switched. Biofilm distribution was evaluated every 24 hours by the Plaque-Free Zone Index, during 96 hours. Adverse events were self-reported and sensory evaluation was performed using a hedonic scale. Compared to the placebo, the chlorhexidine solutions resulted in a significantly higher number of surfaces free of plaque over 96 hours (p < 0.01), and were able to prevent subgingival biofilm formation (p < 0.01). The alcohol-free chlorhexidine solution was associated with a lower incidence of adverse events, compared with alcohol-containing chlorhexidine (p < 0.05); it also received better sensory evaluation and acceptance by trial participants, compared with the alcohol-containing chlorhexidine (p = 0.007), and had a similar inhibitory effect on the formation of supra- and subgingival biofilms.

O objetivo deste estudo foi comparar procedimentos de medida da altura óssea histológica e morfométrica. O método mais freqüente de mensuração da altura óssea em estudos em animais são as medidas microscópicas. No entanto, tem limitada capacidade de identificar os níveis ósseos associados com os tecidos saudáveis e doença periodontal. Foram colocadas ligaduras no segundo molar superior esquerdo de 10 ratos machos Wistar com 60 dias de vida durante um período de 30 dias. Hemimaxilas direitas e esquerdas de 5 ratos foram processadas para a análise histológica (H), cortadas no sentido vestíbulo-lingual e coradas com HE. Hemimaxilas dos outros 5 ratos tiveram toda a matéria orgânica removida para análise morfométrica (M). Medidas histométricas da junção cemento-esmalte (JCE) à crista óssea alveolar foram realizadas. Fotografias padronizadas foram utilizadas na análise morfométrica. O teste t foi utilizado para amostras dependentes e independentes (alfa = 0,05%). As distâncias entre a JCE e a crista óssea na face palatina foram de 0,95 ± 0,25 e 1,07 ± 0,30 mm para H e M, respectivamente. As medidas vestibulares foram 0,92 ± 0,16 e 1,08 ± 0,35 mm para H e M. Os valores obtidos usando H e M para áreas sem ligadura foram 0,44 ± 0,15 e 0,47 ± 0,11 mm por lingual e 0,23 ± 0,08 e 0,41 ± 0,10 mm por vestibular, respectivamente. Não houve diferenças estatisticamente significativas entre os dois métodos na detecção da altura óssea associada à colocação de ligaduras em ratos.

The purpose of this study was to compare histologic and morphometric procedures of bone height measurement. Microscopic measurements are the most frequent methods in periodontal studies with animals, but have limited capacity to identify bone levels associated with both healthy tissues and periodontal disease. Ligatures were placed in the maxillary left second molars of 10 male 60-day-old Wistar rats for 30 days. Left and right maxillary sides of 5 rats were processed for histologic analysis (H), sectioned buccolingually, and stained with HE. The maxillae of the other 5 rats were defleshed and used for morphometric analysis (M). Histometric measurements from the cementoenamel junction to the bone crest were performed. Standardized photographs were used for morphometric analysis. The t test was used for dependent or independent samples (alpha = 0.05%). Distances from cementoenamel junction to bone crest were 0.95 ± 0.25 and 1.07 ± 0.30 mm for H and M, respectively. Buccal measurements were 0.92 ± 0.16 and 1.08 ± 0.35 mm for H and M. The values obtained using H and M for areas without ligatures were 0.44 ± 0.15 and 0.47 ± 0.11 mm for lingual measurements and 0.23 ± 0.08 and 0.41 ± 0.10 mm for buccal measurements. No significant differences were found between the two methods in the detection of bone height associated with the placement of ligatures in rats.

O modelo rato é extensamente usado na pesquisa periodontal, e a qualidade dos cortes histológicos é essencial. A proposta deste estudo foi avaliar as características histológicas dos tecidos periodontais nas maxilas de ratos Wistar, após diferentes períodos de fixação e descalcificação pelo ácido nítrico ou pelo ácido fórmico (Solução de Anna Morse). Quinze ratos foram usados. A fixação foi realizada nos períodos de 24, 48 e 72 horas. As maxilas foram divididas e parte foi descalcificada em ácido nítrico durante 7 dias e parte com solução de Anna Morse por 35 dias. Dois examinadores treinados e cegos executaram a avaliação. Quarenta e oito horas de fixação e descalcificação com solução de Anna Morse mostraram características mais evidentes da interface epitélio-conjuntivo, assim como das estruturas periodontais. As médias, por vestibular, entre a junção cemento-esmalte e a crista óssea nos diferentes tempos experimentais variaram entre 176,5 (± 60,45) e 210,94 (± 39,33) "pixels", e, na face palatina, entre 199,69 (± 38,33) e 298,55 (± 70,81) "pixels", sem nenhuma diferença estatisticamente significativa (ANOVA, p > 0,05). No mesmo período de fixação, a descalcificação com ácido nítrico ou solução de Anna Morse não mostrou diferenças estatisticamente significantes. Pode-se concluir que, para a análise histológica qualitativa, a fixação deve ser preferivelmente em 48 horas e a desmineralização por solução de Anna Morse. Para a análise histo-morfométrica, a solução descalcificadora não interferiu nos resultados.

The rat model is widely used in periodontal research and the quality of histological sections is essential. The purpose of this study was to evaluate the histological characteristics of periodontal tissues in Wistar rat maxillae, with different times of fixation and decalcified by nitric acid or formic acid (Anna Morse Solution). Fifteen rats were used. Fixation was performed for 24, 48 and 72 hours. The maxillae were hemi-sectioned and each part was decalcified either in nitric acid for 7 days or in Anna Morse solution for 35 days. Two trained and blinded examiners performed the evaluation. Fourty eight hours of fixation and decalcification with Anna Morse solution showed more clear characteristics of the epithelium-connective tissue interface and of the periodontal structures. Mean measurements between the cementum-enamel junction and the bone crest varied in the different experimental times from 176.5 (± 60.45) to 210.94 (± 39.33) pixels on the buccal aspect, and from 199.69 (± 38.33) to 298.55 (± 70.81) pixels on the palatal aspect, with no statistically significant differences (ANOVA, p > 0.05). In the same fixation period, decalcification with nitric acid or Anna Morse solution did not display any statistically significant differences. It may be concluded that for a qualitative histological analysis, fixation should preferably be for 48 hours and the demineralization should be made by Anna Morse solution. For a histomorphometric analysis, the decalcification solution does not interfere in the results.