Abstract The topical glucocorticoid budesonide has been prescribed before and after sinus lift surgery as adjuvant drug treatment for maxillary sinus membrane inflammation. However, there is no study on the effects of budesonide on the regenerative process of bone grafting biomaterials. We investigated the effect of the association of budesonide with some biomaterials on the growth and differentiation capacity of pre-osteoblastic cells (MC3T3-E1 subclone 4). Xenogeneic (Bio-Oss and Bio-Gen) and synthetic hydroxyapatites (Osteogen, Bonesynth, and HAP-91) were tested in conditioned medium (1% w/v). The conditioned medium was then supplemented with budesonide (0.5% v/v). Cell viability was assessed using the MTT assay (48, 96, and 144 h), and mineralized nodules were quantified after 14 days of culture using the Alizarin Red Staining. Alkaline phosphatase activity was assessed through the release of thymolphthalein at day seven. All biomaterials showed little or no cytotoxicity. The Bio-Gen allowed significantly less growth than the control group regardless of the experimental time. Regarding differentiation potential of MC3T3-E1, the HAP-91-conditioned medium showed remarkable osteoinductive properties. In osteodifferentiation, the addition of budesonide favored the formation of mineral nodules when cells were cultured in medium conditioned with synthetic materials, whereas it weakened the mineralization potential of cells cultured in xenogeneic medium. Regardless of whether budesonide was added or not, Osteogen and Bio-Oss showed higher alkaline phosphatase activity than the other groups. Budesonide may improve bone formation when associated with synthetic biomaterials. Conversely, the presence of this glucocorticoid weakens the mineralization potential of pre-osteoblastic cells cultured with xenogeneic hydroxyapatites.

RESUMO A substituição dos dentes ausentes, por próteses implanto retidas, é uma forma previsível de reabilitação na população como um todo. Devido à similaridade da doença periodontal com a periimplantite, infere-se a hipótese de que pacientes com histórico de doença periodontal seriam mais suceptíveis a periimplantite. Este conceito vem sendo discutido e suportado por novas evidencias científicas.O objetivo desta revisão é avaliar se pacientes historicamente periodontalmente comprometidos apresentam relação com maior perda óssea peri-implantar. A literatura pertinente conclui que a reabilitação por meio de implantes em pacientes com histórico de doença periodontal é previsível e com índice de sucesso semelhantes pacientes sem histórico de periodontite.

ABSTRACT The replacement of missing teeth by implant retained prostheses is a predictable form of rehabilitation in the population as a whole. Due to thesimilarity between periodontal disease and peri-implantitis, the hypothesis is inferred that patients with a history of periodontal disease would be more susceptible to peri-implantitis. This concept has been discussed and supported by new scientific evidence. The purpose of this review was to evaluate whether there is any relationship between periodontitis and greater peri-implant bone loss in periodontally compromised patients. The pertinent literature has concluded that rehabilitation by means of implants in patients with a history of periodontal disease was predictable and has shown success rates similar to those obtained in patients with no history of periodontitis.

O objetivo do presente estudo foi revisar a literatura pertinente sobre a utilização do 2-octil cianoacrilato (Dermabond®, Ethicon US, USA) como adesivo tecidual na Odontologia, assim como relatar seu uso na estabilização e fixação de um enxerto gengival livre indicado para aumento da mucosa ceratinizada inserida na região dos incisivos inferiores. A análise da literatura revelou ampla aplicabilidade deste adesivo tecidual na área médica relacionada aos ferimentos maxilofaciais. Na Odontologia existem relatos clínicos e estudos controlados em humanos e em modelos animais, descrevendo resultados positivos, inclusive por meio da análise histológica, sobre a utilização de diferentes adesivos teciduais, à base do cianocrilato. Estes estudos relataram que o uso dos adesivos teciduais, reduz o tempo operatório, elimina visitas pós-operatórias, não apresenta o desconforto da remoção de suturas, além de não interferir no processo de reparo clínico. Resultados favoráveis como os descritos na literatura, foram obtidos no presente relato de caso com a utilização do Dermabond®.

The aim of the present study was to review the literature regarding the utilization of 2-octyl cyanoacrylate's (Dermabond®, Ethicon US, USA) as a tissue adhesive in dentistry; also, to report its use in the stabilization and fixation of a free gingival graft, indicated to increase the width of the keratinized attached mucosa at the lower incisive region. Literature analysis revealed numerous indications for this tissue adhesive in the medical field related to maxillofacial injuries. In dentistry, clinical reports, as well as controlled clinical studies conducted in humans and in animal models, using histological analysis described positive results for the use of different cyanoacrylate-based tissue adhesives. These studies reported that the use of tissue adhesives reduced the surgical procedure time period, eliminated postoperative visits as well as the discomfort of suture removal and, in addition, did not interfere with the clinical repair process. Favorable results, like the ones described in the literature, were obtained in the present case report using Dermabond®.

Focal reactive overgrowths are among the most common oral mucosal lesions. The gingiva is a significant site affected by these lesions, when triggered by chronic inflammation in response to microorganisms in dental plaque. Myofibroblasts are differentiated fibroblasts that actively participate in diseases characterized by tissue fibrosis. The objective of this study was to evaluate the presence of stromal myofibroblasts in the main focal reactive overgrowths of the gingiva: focal fibrous hyperplasia (FFH), peripheral ossifying fibroma (POF), pyogenic granuloma (PG), and peripheral giant cell granuloma (PGCG). A total of 10 FFHs, 10 POFs, 10 PGs, and 10 PGCGs from archival specimens were evaluated. Samples of gingival mucosa were used as negative controls for stromal myofibroblasts. Oral squamous cell carcinoma samples, in which stromal myofibroblasts have been previously detected, were used as positive controls. Myofibroblasts were identified by immunohistochemical detection of alpha smooth muscle actin (α-sma). Myofibroblast immunostaining was qualitatively classified as negative, scanty, or dense. Differences in the presence of myofibroblasts among FFH, POF, PG, and PGCG were analyzed using the Kruskal-Wallis test. Stromal myofibroblasts were not detected in FFH, POF, PG, or PGCG. Consequently, no differences were observed in the presence of myofibroblasts among FFH, POF, PG, or PGCG (p > 0.05). In conclusion, stromal myofibroblasts were not detected in the focal reactive overgrowths of the gingiva that were evaluated, suggesting that these cells do not play a significant role in their pathogenesis.

OBJECTIVES:The aim of this study was to compare the pattern of secretion and the expression of mucin glycoprotein-2 (MG2) and lactoferrin in individuals with or without periodontitis. MATERIAL AND METHODS: Five individuals with aggressive periodontitis (APG), 5 with generalized chronic periodontitis (CPG) and 5 without periodontitis (CG) were enrolled after informed consent. Non-stimulated and stimulated submandibular and sublingual saliva was collected and samples analyzed by Western blot probed with specific antibodies. RESULTS: Stimulated and non-stimulated salivary flow rates did not differ among groups. Western blot analysis revealed that stimulation led to: an increase in MG2 expression in all groups, and to lactoferrin expression in APG and CPG. In non-stimulated saliva, CG exhibited the highest expression of both glycoproteins. In stimulated saliva, CG exhibited the highest expression of MG2, whereas APG the highest of lactoferrin. CONCLUSIONS: The pattern of secretion of MG2 and lactoferrin in health and disease is complex. Although the present study analyzed samples from a limited number of participants, the reduced expression of MG2 and lactoferrin in APG and CPG under non-stimulated condition, the predominant circumstance of salivary secretion during the day, suggests that these salivary constituents may play a role in the etiopathogenesis of these diseases.

OBJETIVO: Relatar um caso de dilaceração cementária, uma condição periodontal rara caracterizada pela separação total ou parcial do cemento dental, abordando principalmente aspectos relativos ao seu diagnóstico e tratamento. DESCRIÇÃO DO CASO: Um homem de 50 anos procurou assistência odontológica queixando-se de dor localizada no segundo molar inferior que apresentava profundidade de sondagem de 4 mm com presença de um corpo estranho no sulco gengival da face distal. O exame radiográfico demonstrou um fragmento radiopaco destacado da raiz. O fragmento foi removido sem cirurgia periodontal. O exame histopatológico demonstrou tratar-se de um fragmento de cemento com presença de lamelas cementárias, cementócitos e fibras do ligamento periodontal, confirmando o diagnóstico de dilaceração cementária. CONCLUSÃO: Após dois anos, o tratamento periodontal não cirúrgico demonstrou aspectos clínicos e radiográficos satisfatórios. Portanto, a terapia periodontal não cirúrgica pode ser uma modalidade de tratamento adequada e previsível para a dilaceração cementária.

PURPOSE: To report a case of cemental tear, a rare periodontal condition characterized by total or partial separation of the dental cementum, mainly addressing issues related to its diagnosis and treatment. CASE DESCRIPTION: A 50 years-old man sought dental assistance complaining of pain located in the mandibular left second premolar that showed a 4 mm probing depth with the presence of a foreign body in the distal gingival sulcus. Radiographic examination demonstrated a slight radiopaque fragment detached from the root. The fragment was removed without a periodontal flap. Histopathological examination was performed and evidenced the presence of a cementum fragment with cementum lamellae, cementocytes, and adhered periodontal ligament fibers, confirming the diagnosis of cemental tear. CONCLUSION: After a follow-up of 2 years, the nonsurgical periodontal therapy showed satisfactory clinical and radiographic outcome. Therefore, this approach should be a suitable and predictable treatment modality for the cemental tear.

Este trabalho teve como objetivo avaliar a capacidade alergênica provocada pelos bráquetes ortodônticos, comparando a sensibilidade cutânea provocada pelos metais presentes nos bráquetes metálicos convencionais com a provocada por bráquetes com baixa concentração de níquel ("nickel-free"). A amostra foi selecionada dos 400 pacientes em tratamento da clínica de Ortodontia da Pontifícia Universidade Católica de Minas Gerais (Belo Horizonte, MG, Brasil), no período compreendido entre o início de 2002 e o final de 2003. A amostra consistiu de 58 pacientes (30 homens e 28 mulheres), com idades variando de 11 a 30 anos, os quais eram portadores de aparelho ortodôntico fixo Morelli® em ambos os arcos. Estes pacientes foram diagnosticados quanto à sensibilidade ao níquel, por meio da aplicação do "patch test" com sulfato de níquel a 5%. Em uma segunda fase, trinta dias após o "patch test", comparou-se a sensibilidade cutânea provocada pelos metais presentes nos bráquetes convencionais e nos "Nickel Free", por meio de um teste de sensibilidade cutânea utilizando-se dois tipos de corpos-de-provas, em formato de disco, com a mesma composição destes bráquetes. A área de eleição para realização deste teste foi a parte interna do antebraço, sendo aplicados vinte corpos-de-prova de cada experimento (referente a uma boca completa de bráquetes). Dos 58 pacientes avaliados, 16 deles foram sensíveis ao "patch test" com sulfato de níquel a 5%. Dentre estes 16 pacientes, 12 deles desenvolveram reação alérgica ao Experimento 1 (corpo-de-prova com níquel), enquanto que no Experimento 2 (corpo-de-prova "Niquel Free") apenas 5 pacientes apresentaram sensibilidade a esta amostra. O teste de McNemar revelou que os corpos-de-prova "nickel-free" provocaram menor reação alérgica quando comparados aos convencionais (p = 0.016).

The aim of this study was to evaluate the allergenic potential of orthodontic brackets, comparing the cutaneous sensitivity provoked by metals present in conventional metallic brackets to that provoked by brackets with a low concentration of nickel, known as "nickel-free". A sample was selected from 400 patients undergoing treatment in the orthodontic clinic of the Pontifical Catholic University of Minas Gerais (Belo Horizonte, MG, Brazil), in the period from the beginning of 2002 to the end of 2003. A cutaneous sensitivity patch test containing 5% nickel sulphate was used in 58 patients (30 males and 28 females), aged between 11 and 30, which were using fixed appliances with Morelli® brackets in both arches. In a second phase, 30 days later, a comparative test of cutaneous sensitivity was applied to the whole sample with two types of test specimens, in the form of a disc. Two alloys were tested: discs composed of the alloy used in the construction of conventional brackets and discs composed of a nickel-free alloy. The internal part of the forearm was chosen for testing, and 20 test specimens of each experiment (corresponding to the twenty brackets of a complete fixed appliance) were applied. Of the 58 patients evaluated, 16 patients were sensitive to the patch test with 5% nickel sulphate. Out of these 16 patients, 12 developed an allergic reaction to experiment 1 (test specimen with nickel), while in experiment 2, only 5 patients showed sensitivity to that sample. The McNemar test revealed that the nickel-free test specimens provoked less allergic reaction when compared with the conventional alloy (p = 0.016).

O objetivo deste estudo foi avaliar a possibilidade da doença periodontal comprometer a qualidade de vida de indivíduos portadores de diabetes mellitus. Foram examinados e entrevistados 159 diabéticos dentados, cadastrados no Hospital Municipal de Itaúna, Minas Gerais, Brasil. Os parâmetros clínicos periodontais registrados foram: sangramento gengival à sondagem, profundidade de sondagem e nível clínico de inserção. A influência da doença periodontal na qualidade de vida foi avaliada utilizando-se o formulário OHIP-14. Em relação à condição periodontal, 15,7% apresentaram periodonto saudável, 35,2% gengivite e 49,1% periodontite, sendo 27,7% na forma leve a moderada e 21,4% na avançada. Associação entre diagnóstico da doença periodontal e qualidade de vida foi significativa nos indivíduos com periodontite (p < 0,001). A presença de sangramento gengival à sondagem, profundidade de sondagem e nível clínico de inserção > 4mm associaram-se com impactos negativos intensificados na qualidade de vida (respectivamente, p = 0,013, p < 0,001 e p = 0,012). Diabéticos com periodontites leve a moderada e avançada apresentaram maiores impactos negativos na qualidade de vida que diabéticos periodontalmente saudáveis ou com gengivite.

The aim of this study was to evaluate the potential impact of periodontal disease on quality of life in diabetics. A total of 159 dentate diabetic individuals registered at the Municipal Hospital in Itaúna, Minas Gerais, Brazil, were examined and interviewed. The clinical periodontal parameters recorded were: gingival bleeding, probing depth, and clinical attachment level. The OHIP-14 form was used to evaluate the impact of periodontal disease on quality of life. In relation to periodontal status, 15.7% of individuals were healthy, 35.2% presented gingivitis, and 49.1% periodontitis (27.7% in the mild-to-moderate and 21.4% in the advanced stages). Association between diagnosis of periodontal disease and impact on quality of life was significant in individuals with periodontitis (p < 0.001). Gingival bleeding, probing depth, and clinical attachment level > 4mm were associated with intensely negative impact on quality of life (p = 0.013, p < 0.001, and p = 0.012 respectively). Diabetics with mild-to-moderate and advanced periodontitis had more negative impact on quality of life than those who were periodontally healthy or with gingivitis.

O objetivo deste estudo foi avaliar a possibilidade da doença periodontal comprometer a qualidade de vida de indivíduos portadores de diabetes mellitus. Foram examinados e entrevistados 159 diabéticos dentados, cadastrados no Hospital Municipal de Itaúna, Minas Gerais, Brasil. Os parâmetros clínicos periodontais registrados foram: sangramento gengival à sondagem, profundidade de sondagem e nível clínico de inserção. A influência da doença periodontal na qualidade de vida foi avaliada utilizando-se o formulário OHIP-14. Em relação à condição periodontal, 15,7% apresentaram periodonto saudável, 35,2% gengivite e 49,1% periodontite, sendo 27,7% na forma leve a moderada e 21,4% na avançada. Associação entre diagnóstico da doença periodontal e qualidade de vida foi significativa nos indivíduos com periodontite (p < 0,001). A presença de sangramento gengival à sondagem, profundidade de sondagem e nível clínico de inserção > 4mm associaram-se com impactos negativos intensificados na qualidade de vida (respectivamente, p = 0,013, p < 0,001 e p = 0,012). Diabéticos com periodontites leve a moderada e avançada apresentaram maiores impactos negativos na qualidade de vida que diabéticos periodontalmente saudáveis ou com gengivite.

The aim of this study was to evaluate the potential impact of periodontal disease on quality of life in diabetics. A total of 159 dentate diabetic individuals registered at the Municipal Hospital in Itaúna, Minas Gerais, Brazil, were examined and interviewed. The clinical periodontal parameters recorded were: gingival bleeding, probing depth, and clinical attachment level. The OHIP-14 form was used to evaluate the impact of periodontal disease on quality of life. In relation to periodontal status, 15.7% of individuals were healthy, 35.2% presented gingivitis, and 49.1% periodontitis (27.7% in the mild-to-moderate and 21.4% in the advanced stages). Association between diagnosis of periodontal disease and impact on quality of life was significant in individuals with periodontitis (p < 0.001). Gingival bleeding, probing depth, and clinical attachment level > 4mm were associated with intensely negative impact on quality of life (p = 0.013, p < 0.001, and p = 0.012 respectively). Diabetics with mild-to-moderate and advanced periodontitis had more negative impact on quality of life than those who were periodontally healthy or with gingivitis.

OBJETIVO: o presente trabalho avaliou a condição periodontal de pacientes com idades entre 10 e 18 anos. METODOLOGIA: todos os pacientes eram portadores das seguintes más oclusões: sobressaliência maior que 6mm, sobremordida maior que 6mm, sobressaliência e sobremordida associadas maiores que 6mm ou mordida cruzada posterior unilateral ou bilateral. Os parâmetros clínicos periodontais (índice de placa, sangramento gengival, mucosa ceratinizada inserida, recessão periodontal, profundidade de sondagem e perda de inserção) foram mensurados em dentes-índices (16, 11, 26, 36, 42 e 46). Os resultados foram analisados pelo teste estatístico de Kruskall Wallis (p<0,05). RESULTADOS: observou-se que a condição periodontal dos dentes índices, nos quatro grupos de más oclusões avaliadas, apresentou-se nos limites de normalidade. Entretanto, observou-se uma maior tendência ao acúmulo de placa nos pacientes portadores de sobressaliência e sobremordida associadas, bem como nos portadores de mordida cruzada posterior que, também, apresentaram aumento na profundidade de sondagem, no entanto, sem significância estatística. CONCLUSÃO: a gravidade da má oclusão não esteve relacionada de maneira significante à presença de doença periodontal.

AIM: to evaluate the periodontal status of 41 patients with ages between 10 and 18 years. METHODS: all the patients presented one of the following severe malocclusion: overjet greater than 6mm, overbite greater than 6mm, posterior unilateral or bilateral cross-bite or overjet and overbite greater than 6mm. The periodontal indexes of plaque and bleeding and the parameters of probing depth, amount of keratinized mucosa, periodontal recession and attachment level were measured in index teeth (16, 26, 36, 46, 11 and 42). The data collected was evaluated by the Kruskall Wallis statistical test (p< 0.05). RESULTS: periodontal of the teeth in the four groups of malocclusion was within the normal limits. However, the group with posterior cross-bite as well as the group with severe overjet and overbite associated, demonstrated tendency to have a greater plaque index when compared to normal parameters. The group, with posterior cross-bite malocclusion, also showed a tendency to have deeper probing depth, but without statistic significance. CONCLUSIONS: the severity of malocclusion was not significantly related with the presence of periodontal disease.