Abstract Titanium dioxide nanotubes (TiO2-nts) were incorporated into a glass ionomer cement (GIC) with improved mechanical properties and antibacterial activity. The aims of the present in vitro study were to define the elemental characterization, aluminum (Al) release rate, and initial working time for GIC reinforced with TiO2-nts, in an experimental caries model. TiO2-nts were incorporated into GIC powder components at 5% by weight, and compared with unblended GIC. Experimental approaches used energy-dispersive spectrometry (EDS), atomic absorption spectrophotometry (AAS), and brightness loss to define surface element properties, Al release rates, and initial working time, respectively. Statistical analysis was performed by 2-way ANOVA, Tukey’s test, generalized linear models, and Student’s t test (a = 0.05). EDS data analysis revealed that TiO2-nts incorporated into GIC had no significant impact on the typical elemental composition of GICs in an in vitro caries model. Regarding the demineralizing solution, GIC with TiO2-nt significantly decreased the Al release rate, compared with the control group (p < 0.0001). Moreover, TiO2-nt incorporated into GIC did not alter the initial working time of the material (p > 0.05). These findings add information to our scientific body of knowledge concerning the potential impact of TiO2-nt on the performance of conventional GICs.

O objetivo do estudo foi avaliar a influência da inalação da fumaça de cigarros (IFC) sobre os períodos iniciais de reparo ósseo alveolar. Quarenta ratos Wistar foram aleatoriamente divididos em teste: animais expostos à IFC, que se iniciou 3 dias antes das extrações mantendo-se até o sacrifício (n=20)e controle (animais que não foram expostos à IFC; n=20). Os animais tiveram seus segundos molares inferiores extraídos bilateralmente (n=5/grupo/período) e foram sacrificados nos dias 3, 7, 10 e 14 dias após a cirurgia. Imagens digitalizadas foram analisadas de acordo com os seguintes parâmetros histométricos: tecido osteóide (OT), área remanescente (RA), tecido mineralizado (MT) e tecido não mineralizado (NMT) em cada alvéolo. Análise intergrupo mostrou que não houve diferença estatisticamente significante aos 3 dias (p>0,05) para todos os parâmetros. Aos 7 dias, a IFC influenciou negativamente (p?0,05) o preenchimento ósseo mostrando diferença estatisticamente significante para os parâmetros tecido não mineralizado e defeito remanescente (MT: 36%, NMT: 53%, RA: 12%; and MT: 39%, NMT: 29%, RA: 32%, para controle e teste, respectivamente). No entanto, não houve diferença estatisticamente significante (p>0,05) aos 10 e 14 dias. Conclui-se que a IFC pode afetar o reparo ósseo alveolar inicial, o que pode ser crítico para a quantidade e qualidade da nova formação óssea em fumantes.

The aim of this study was to evaluate, histometrically, the bone healing of the molar extraction socket just after cigarette smoke inhalation (CSI). Forty male Wistar rats were randomly assigned to a test group (animals exposed to CSI, starting 3 days before teeth extraction and maintained until sacrifice; n=20) and a control group (animals never exposed to CSI; n=20). Second mandibular molars were bilaterally extracted and the animals (n=5/group/period) were sacrificed at 3, 7, 10 and 14 days after surgery. Digital images were analyzed according to the following histometric parameters: osteoid tissue (OT), remaining area (RA), mineralized tissue (MT) and non-mineralized tissue (NMT) in the molar socket. Intergroup analysis showed no significant differences at day 3 (p>0.05) for all parameters. On the 7th day, CSI affected negatively (p<0.05) bone formation with respect to NMT and RA (MT: 36%, NMT: 53%, RA: 12%; and MT: 39%, NMT: 29%, RA: 32%, for the control and test groups, respectively). In contrast, no statistically significant differences (p>0.05) were found at days 10 and 14. It may be concluded that CSI may affect socket healing from the early events involved in the healing process, which may be critical for the amount and quality of new-bone formation in smokers.

OBJECTIVE: The aim of this controlled clinical trial was to evaluate the effect of topically applied povidone-iodine (PVP-I) used as an adjunct to non-surgical treatment of interproximal class II furcation involvements. MATERIAL AND METHODS: Thirty-two patients presenting at least one interproximal class II furcation involvement that bled on probing with probing pocket depth (PPD) >5 mm were recruited. Patients were randomly chosen to receive either subgingival instrumentation with an ultrasonic device using PVP-I (10%) as the cooling liquid (test group) or identical treatment using distilled water as the cooling liquid (control group). The following clinical outcomes were evaluated: visible plaque index, bleeding on probing (BOP), position of the gingival margin, relative attachment level (RAL), PPD and relative horizontal attachment level (RHAL). BAPNA (N-benzoyl-L-arginine-p-nitroanilide) testing was used to analyze trypsin-like activity in dental biofilm. All parameters were evaluated at baseline and 1, 3 and 6 months after non-surgical subgingival instrumentation. RESULTS: Six months after treatment, both groups had similar means of PPD reduction, RAL and RHAL gain (p>0.05). These variables were, respectively, 2.20±1.10 mm, 1.27±1.02 mm and 1.33±0.85 mm in the control group and 2.67±1.21 mm, 1.50±1.09 mm and 1.56±0.93 mm in the test group. No difference was observed between groups at none of the posttreatment periods, regarding the number of sites showing clinical attachment gain >2 mm. However, at 6 months posttreatment, the test group presented fewer sites with PPD >5 mm than the control group. Also at 6 months the test group had lower BAPNA values than control group. CONCLUSION: The use of PVP-I as an adjunct in the non-surgical treatment of interproximal class II furcation involvements provided limited additional clinical benefits.

O objetivo deste estudo foi avaliar os resultados clínicos e centrados no paciente após abordagem cirúrgica minimamente invasiva (CMI) associada à aplicação das proteínas derivadas da matriz do esmalte (PDE) no tratamento de defeitos infra-ósseos. Doze pacientes apresentando um sítio com profundidade de sondagem >5 mm e sangramento à sondagem , associado à evidência radiográfica de defeito infra-ósseo, foram tratados com CMI e aplicação das PDE. Os parâmetros clínicos foram avaliados imediatamente antes do procedimento e após 3 e 6 meses. A percepção de dor e desconforto do paciente durante o período trans-cirúrgico e ao longo da primeira semana de pós-operatório, bem como a satisfação estética 6 meses após o tratamento, foram avaliadas por meio de questionários. Os resultados mostraram que o uso da CMI associada à aplicação de PDE promoveu melhoras estatisticamente significantes nos parâmetros clínicos, mínima dor e desconforto e máxima satisfação estética aos pacientes. Dentro dos limites do estudo, foi demonstrado que a associação de CMI e PDE, no tratamento de defeitos infra-ósseos, é capaz de promover satisfatórios resultados clínicos e centrados no paciente.

This case series evaluated the clinical performance and patient-centered outcomes after a minimally invasive surgical technique (MIST) associated with enamel matrix protein derivative (EMD), for the treatment of intra-bony defects. Twelve patients presenting teeth with probing depth >5 mm and bleeding on probing associated with radiographic evidence of intra-bony defect were treated by MIST associated with EMD. Clinical parameters were measured at baseline, 3 and 6 months. Patient perception during the intraoperative period and during the first postoperative week was evaluated. The use of MIST with EDM promoted significant improvements in clinical parameters, minimal pain/discomfort and maximum esthetics satisfaction. Within of limits of the present study, it could be shown that MIST combined with EMD for the treatment of intra-bony defects promotes satisfactory clinical and patient-centered outcomes.

OBJECTIVES: The aim of this study was to evaluate the influence of the crown shape on the outcomes of root coverage procedures. MATERIAL AND METHODS: Eighty patients with Miller class I gingival recessions in maxillary canines or premolars were selected. The recession areas were treated using the subepithelial connective tissue grafting. The following clinical parameters were analyzed: crown length (CL) and width (CW), recession height and width, probing depth, clinical attachment level, width and thickness of the keratinized tissue and percentage of root coverage achieved. These measurements were recorded at baseline and 6 months after the surgical procedure. The CW/CL ratio was calculated for each tooth and the median obtained (0.83). Patients were then ranked into two groups, according to the shape of the tooth with gingival recession: Group A - square crown shape (CW/CL values above 0.83) and Group B - long and narrow crown shape (CW/CL values below 0.83). RESULTS: No statistically significant differences (p>0.05) were found between groups in any of the clinical parameters at baseline. After 6 months, both groups presented improved clinical outcomes for all parameters analyzed compared to baseline (p>0.05). The mean percentages and standard deviations of root coverage achieved in Group A and Group B was 91.37 (16.75) and 85.49 (23.55), respectively (p>0.05). CONCLUSIONS: Crown shape did not influence the root coverage obtained with the subepithelial connective tissue graft technique.

OBJETIVO: O objetivo do presente estudo foi avaliar a rugosidade radicular obtida após instrumentação por aparelho sônico com pontas diamantadas, curetas e ultrassom. MATERIAL E MÉTODOS: Quarenta superfícies radiculares, devidamente polidas e incluídas em resina acrílica, foram dividas em 4 grupos de tratamento: grupo controle (sem instrumentação) e instrumentação com cureta Gracey 5/6, ultrassom ou aparelho sônico com ponta diamantada. Em cada amostra foram realizados 15 movimentos de raspagem. Antes e após esta instrumentação foi utilizado um rugosímetro para a medição da rugosidade radicular. Além disso, a topografia da superfície radicular foi avaliada após o tratamento com microscopia eletrônica de varredura. RESULTADOS: Diferenças estatisticamente significantes (p<0.05) foram observadas ao se comparar o grupo controle (0.48±0.07mm) aos grupos tratados (cureta - 1.246±0.279mm, ultrassom - 1.468±0.177mm e aparelho sônico com ponta diamantada - 1.576±0.20mm). As maiores rugosidades foram produzidas pela ponta sônica diamantada e ponta universal de ultrassom (p>0.05). CONCLUSÃO: A instrumentação sônica com pontas diamantadas promove uma rugosidade radicular equivalente à instrumentação com ultrassom, sendo essa rugosidade superior àquela apresentada pela instrumentação manual.

OBJECTIVE: The purpose of this study was to evaluate the root surface roughness after instrumentation with hand curette and diamond-coated sonic and universal ultrasonic tips. MATERIALS AND METHODS: Forty root surfaces of human teeth were randomly assigned to four treatment groups: control group (without instrumentation), curette instrumentation, ultrasonic instrumentation with universal tip and sonic instrumentation with diamond-coated tip. Each sample was instrumented with fifteen strokes. Before and after instrumentation, surface roughness was measured. In addition, the root surface topography was examined after treatment under the scanning electron microscope. RESULTS: Significant statistical differences (p <0.05) were observed when comparing the control group (0.48±0.07mm) to the treated groups (hand - 1.246±0.279mm, ultrasonic - 1.468±0.177mm and sonic instrumentation - 1.576±0.20mm). The highest roughness was produced by diamond-coated sonic tip and by ultrasonic universal tip (p >0.05). CONCLUSION: The diamond-coated tip with sonic scaler instrumentation and ultrasonic instrumentation produce similar root surface roughness, higher than curette instrumentation.

Agentes antiinflamatórios têm sido descritos como reguladores do reparo ósseo. O objetivo deste estudo foi investigar o efeito de um inibidor seletivo da cicloxigenase-2 (meloxicam) no reparo ósseo em defeitos de calvárias de ratos. Trinta e seis ratos machos Wistar foram incluídos no estudo. Após anestesia, incisão linear e rebatimento de retalho de espessura total, um defeito de 4 mm de diâmetro foi criado na calvária dos animais com broca trefina. Os mesmos foram aleatoriamente distribuídos em um dos 4 grupos de tratamento (9 animais por grupo), recebendo injeções subcutâneas diárias de: A: soro fisiológico por 15 dias; B: soro fisiológico por 45 dias; C: 3 mg/kg de meloxicam por 15 dias; D: 3 mg/kg de meloxicam por 45 dias. Os animais foram sacrificados e os espécimes rotineiramente processados. Medidas do preenchimento ósseo foram histometricamente realizadas e analisadas estatisticamente. Comparações intergrupos demonstraram que os grupos com meloxicam apresentaram uma redução significativa no reparo ósseo quando comparados com os respectivos grupos-controle (grupo A, 44,5 ± 5,75%, contra grupo C, 57,5 ± 7,25%, p < 0,05; grupo B, 40,25 ± 13,75%, contra grupo D, 52,25 ± 17,25%). Dentro dos limites do presente estudo, pode ser concluído que os inibidores seletivos da cicloxigenase-2 podem reduzir o reparo ósseo em defeitos em calvárias de ratos após sua administração contínua.

Anti-inflammatory agents have been reported to regulate bone healing. The aim of this study was to investigate the effect of a selective cyclooxygenase-2 inhibitor (meloxicam) on bone healing in calvarial defects in rats. Thirty-six adult male Wistar rats were included. After anesthesia, a linear incision was made through the skin of the scalp, a full-thickness flap was reflected and a 4 mm round defect was made with a trephine drill. The animals were randomly assigned to one of the following 4 treatment groups (9 animals each), including daily subcutaneous injections: A: saline solution for 15 days; B: saline solution for 45 days; C: 3 mg/kg of meloxicam for 15 days and D: 3 mg/kg of meloxicam for 45 days. The animals were sacrificed and the specimens, routinely processed. The bone filling was histometrically measured and statistical analysis, performed. Intergroup comparisons demonstrated that the meloxicam groups presented a significant reduction in bone healing when compared to their respective controls (group A, 44.5 ± 5.75%, against group C, 57.5 ± 7.25%, p < 0.05; group B, 40.25 ± 13.75%, against group D, 52.25 ± 17.25%). Within the limits of the present study, it can be concluded that selective cyclooxygenase-2 inhibitors may reduce bone healing in calvarial defects in rats after continuous administration.

O objetivo deste estudo foi avaliar o efeito do controle de placa supragengival sobre os parâmetros clínicos e bioquímicos da periodontite crônica. Foram selecionados 25 pacientes apresentando pelo menos 4 sítios com profundidade de sondagem > 5 mm, não fumantes e sem alterações sistêmicas relevantes. A avaliação clínica e bioquímica foi feita antes e 21 dias após a remoção dos fatores retentivos de placa, exodontia dos dentes condenados e instrução de higiene bucal. A análise estatística foi feita através do teste t de Student pareado (p<0,05) e demonstrou redução da porcentagem de sítios com sangramento à sondagem de 42,72 ± 15,83 para 35,87 ± 13,30 (p=0,002). Redução na profundidade de sondagem foi observada nos dentes anteriores (média inicial/final: 2,88 mm/2,78 mm; p=0,01) e faces interproximais (média inicial/final: 3,80 mm/3,65 mm; p=0,001). Houve aumento de 66,81% para 68,65% (p=0,03) no número de sítios com profundidade de sondagem de 1 a 3 mm e redução de 26,21% para 24,17% (p=0,04) nos de 4 a 6 mm. O valor do BAPNA apresentou redução de 51,44 ± 20,78 para 38,64 ± 12,34 (p=0,04). Baseado nesses achados pôde-se concluir que o controle de placa supragengival tem efeitos benéficos, principalmente relacionados à redução da inflamação gengival e da atividade de enzima tipo tripsina no biofilme subgengival (BAPNA).

Supragingival plaque control is a requisite for the success of any periodontal procedure. However, little is know about the effect of this procedure alone on periodontitis. The aim of this study was to determine the effect of supragingival plaque control on clinical and biochemical parameters of chronic periodontitis. Twenty-five subjects exhibiting at least 4 pockets > 5mm, non-smokers and with no relevant systemic diseases, were selected for the study. The clinical and biochemical assessments were done before and 21 days after removal of plaque retentive factors, extraction of affected teeth and instruction in oral hygiene. The statistical analysis was done with the Student paired t-test (p<0,05) and demonstrated a reduction on the percentage of sites with bleeding on probing from 42.72 ± 15.83 to 35.87 ± 13.30 (p=0.002). Reduction in probing depth was detected on anterior teeth (initial/final mean: 2.88 mm/2.78 mm; p=0.01) and interproximal sites (initial/final mean: 3.80 mm/3.65 mm; p=0.001). There was an increase from 66.81% to 68.65% in the number of sites with probing depth of 1 to 3mm and a decrease from 26.21% to 24.17% in those with probing depth of 4 to 6mm. The BAPNA results showed a decrease from 51.44 ± 20.78 to 38.64 ± 12.34 (p=0.04). This study demonstrated that supragingival plaque control provides a reduction in gingival inflammation and alterations in the subgingival microflora detected by the BAPNA test.

O objetivo do presente estudo foi avaliar histometricamente a influência da nicotina sobre a regeneração óssea de defeitos criados cirurgicamente em rebordos alveolares edêntulos de cães. Defeitos ósseos foram criados cirurgicamente em um dos lados da mandíbula de dezesseis cães e foram deixados para que curassem espontanea-mente. Os animais foram aleatoriamente designados para um dos seguintes grupos: Grupo 1 - controle (n = 8) e Grupo 2 - administração subcutânea de nicotina (2 mg/kg) duas vezes ao dia durante 4 meses (n = 8). Os animais foram sacrificados, e secções semi-seriadas descalcificadas, obtidas. Os parâmetros histométricos avaliados foram altura, largura, área e densidade do tecido ósseo neoformado. A análise intergrupos (Mann-Whitney "rank sum test") demonstrou que a administração de nicotina não influenciou altura, largura e área de tecido ósseo neoformado (p > 0,05). Entretanto, a administração de nicotina influenciou significativamente a densidade do tecido ósseo neoformado (p < 0,001). Dentro dos limites do presente estudo, pode-se concluir que a nicotina pode afetar, mas não impedir a regeneração de defeitos ósseos criados cirurgicamente em mandíbulas edêntulas de cães.

The objective of this study was to investigate the histometric impact of nicotine on bone regeneration of surgically created alveolar ridge defects in dogs. Sixteen mongrel dogs were used. One defect was surgically created unilaterally in the mandible, and left to heal spontaneously. The animals were randomly assigned to one of the following groups: Group 1 - control (n = 8) and Group 2 - subcutaneous nicotine administration (2 mg/kg) twice a day (n = 8). After 4 months, the animals were sacrificed and the specimens routinely processed for semi-serial decalcified sections. Bone height (BH), bone width (BW), bone density (BD), and bone area (BA) of the newly-formed bone were evaluated. Intergroup analysis (Mann-Whitney rank sum test) showed that regardless of the presence of nicotine, no significant differences were observed regarding bone width (BW), bone area (BA) and bone height (BH) (p > 0.05). On the other hand, it was demonstrated that nicotine administration significantly influenced the proportion of mineralized tissue within the limits of the newly-formed bone (BD) (p < 0.001). Within the limits of the present study, it can be concluded that nicotine might affect but not prevent bone healing in defects left to heal spontaneously.

O objetivo deste trabalho foi avaliar a influência da administração de ciclosporina A (CsA)/nifedipina e sua interrupção na densidade óssea em uma região lateral à superfície de implantes de titânio inseridos em coelhos. Dois implantes de titânio comercialmente puros foram inseridos bilateralmente em vinte e oito coelhos. Os animais foram aleatoriamente divididos em um dos seguintes grupos experimentais, recebendo injeções diárias subcutâneas por 14 dias: Grupos A e C: veículo (dimetil sulfóxido); Grupos B e D: CsA (10 mg/kg) e nifedipina (50 mg/kg). Os animais pertencentes aos Grupos A/B e C/D foram sacrificados 14 e 42 dias após a colocação dos implantes, respectivamente. Após o sacrifício, as tíbias foram removidas para a obtenção de secções não-descalcificadas. A densidade óssea foi obtida em uma zona de 500 mm lateral à superfície do implante através de análise histométrica. A análise intergrupo não revelou diferenças para os grupos teste e controle em 14 e 42 dias (p > 0,05). Dentro dos limites deste estudo podemos concluir que a associação CsA/nifedipina, administrada em um curto prazo, não apresenta uma influência negativa na densidade do osso preexistente ao redor de implantes de titânio inseridos em coelhos.

The aim of this study was to evaluate the influence of the administration and withdrawal of cyclosporin A/nifedipine on the bone density in a lateral area adjacent to implants placed in rabbits. Two screw-type titanium implants were placed bilaterally in twenty-eight New Zealand rabbits. The animals were assigned to one of the following groups and received daily subcutaneous injections for 14 days: Groups A and C: vehicle (dimethyl sulfoxide); Groups B and D: CsA (10 mg/kg) plus nifedipine (50 mg/kg). The animals in Groups A and B were sacrificed 14 days postoperatively and, in Groups C and D, 42 days postoperatively. After sacrifice, the tibiae were removed and undecalcified sections were obtained. Bone density was obtained in a 500 mm-wide zone lateral to the implant surface. Intergroup analysis showed no significant difference (p > 0.05) in the degree of bone density between control and test groups either on day 14 or on day 42. Thus, it appears that a short-term immunosuppressive therapy may not present a negative influence on the density of the pre-existing bone around titanium implants placed in rabbits.