Resumen Los cementos bioactivos a base de silicato tricálcico se introdujeron en el mercado para uso en odontología, con una variedad de aplicaciones clínicas. Estos cementos pueden estar en contacto con tejidos como la pulpa dental o el periodonto, en caso de extrusión no intencionada. Por lo tanto, es importante conocer la genotoxicidad y la citoxicidad de estos materiales. El objetivo de este estudio fue evaluar la citotoxicidad y genotoxicidad de los selladores bioactivos Bio-C® Sealer y MTA Repair HP® en fibroblastos humanos. Se prepararon discos de selladores bioactivos Bio-C® Sealer y MTA Repair HP® y se colocaron durante 24h en condiciones de esterilidad. Los discos se colocaron en medio de cultivo a 2,5mg/mL dentro de un mezclador de rodillos SRT6D (Stuart, Reino Unido) a 60rpm durante 24h. Los eluidos obtenidos se incubaron durante 24h con fibroblastos de la línea celular ATCC previamente activados y cultivados al 80% de confluencia. La citotoxicidad se evaluó mediante ensayos Alamar Blue® y LIVE/DEAD; así como el análisis de los ensayos Tunnel y Mitotracker para evaluar la genotoxicidad, utilizando el microscopio confocal láser de barrido. En el ensayo Alamar Blue®, el Sellador Bio-C® presentó una proliferación celular del 87%, mientras que el sellador MTA Repair HP® fue del 72%. Se encontró una diferencia estadísticamente significativa entre el sellador MTA Repair HP® con respecto al control negativo (p=<0.001). En cuanto a las pruebas de genotoxicidad, en el ensayo Tunel, ambos materiales tiñen el núcleo de las células fibroblásticas expuestas a los eluidos, mientras que el ensayo Mitotracker, el sellador MTA Repair HP®, mostró una mayor función mitocondrial que el Bio-C® Sealer. Los selladores a base de silicato de calcio, Bio-C® Sealer y MTA Repair HP® no son citotóxicos y tienen una baja genotoxicidad.

Abstract Bioactive cements based on tricalcium silicate have been introducedto the market for use in dentistry, with a variety of clinical applications. These cements are in contact with vital tissues such as dental pulp or periodontium in cases of unintentional extrusion; thus, it is important to know the genotoxicity and cytoxicity of these materials. The objective of this study was to evaluate the cytotoxicity and genotoxicity of bioactive sealers, Bio-C® Sealer and MTA Repair HP®, in human fibroblasts. Discs of bioactive sealers Bio-C® Sealer, and MTA Repair HP®, were prepared and set for 24h under sterile conditions. The discs were placed in culture medium at 2.5mg/mL inside a SRT6D roller mixer (Stuart, UK) at 60rpm for 24h. The eluates obtained were incubated for 24h with previously activated and cultured ATCC cell line fibroblasts at 80% confluence. The cytotoxicity was evaluated by Alamar Blue® and LIVE/ DEAD assays, as well as the analysis of the Tunel and Mitotracker assays to evaluate genotoxicity using the confocal laser-scanning microscope. In the Alamar Blue® assay, the Bio-C® Sealer presented a cell proliferation of 87%, while the MTA Repair HP® Sealer was 72%. A statistically significant difference was found between the MTA Repair HP® Sealant and the negative control (p=<0.001). Regarding the genotoxicity tests, in the Tunel assay, both materials stain the nucleus of the fibroblast cells exposed to the eluates, while in the Mitotracker assay, the MTA Repair HP® Sealer showed greater mitochondrial function than the Bio-C® Sealer. Calcium silicate-based sealers, Bio-C® Sealer and MTA Repair HP®, are not cytotoxic and have low genotoxicity.

RESUMO A dor associada ao tratamento ortodontico, que é tanto frequente quanto desafiadora, surge principalmente após procedimentos como a colocação de separadores elásticos interproximais e a instalação de arcos ortodonticos. Esta dor frequentemente resulta da inflamação do periodonto, levando ao desconforto. A gestão farmacológica eficaz é essencial para melhorar o conforto do paciente ao longo do tratamento ortodontico. Os anti-inflamatórios não esteroides (AINEs) e o paracetamol são comumente empregados devido à sua eficácia e perfis de segurança comprovados. Esses medicamentos ajudam a reduzir tanto a inflamação quanto a dor, melhorando assim a tolerância do paciente aos procedimentos ortodonticos. Ao selecionar um analgésico, é importante considerar fatores como a intensidade da dor, condições médicas pré-existentes e potenciais interações medicamentosas. O uso cuidadoso e supervisionado desses medicamentos ajuda a minimizar os riscos e otimizar o conforto do paciente durante o tratamento ortodontico.

ABSTRACT Pain associated with orthodontic treatment, which is both frequent and challenging, primarily arises following procedures such as the placement of interproximal elastic separators and the installation of archwires. This pain is often due to inflammation of the periodontium, leading to discomfort. Effective pharmacological management is essential to enhance patient comfort throughout orthodontic treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are commonly employed due to their proven efficacy and safety profiles. These medications help reduce both inflammation and pain, thereby improving patient tolerance of orthodontic procedures. When selecting an analgesic, it is important to consider factors such as the intensity of pain, pre-existing medical conditions, and potential drug interactions. Careful and supervised use of these medications helps minimize risks and optimizes patient comfort during orthodontic care.

RESUMEN El dolor en tratamientos de ortodoncia, frecuente y desafiante, ocurre especialmente después de procedimientos como la colocación de elásticos separadores interproximales y la instalación de arcos. Esta situación provoca inflamación del periodonto, causando dolor y malestar. Para garantizar una experiencia confortable al paciente durante la ortodoncia, el manejo farmacológico del dolor es crucial. Los antiinflamatorios no esteroides (AINE) y el paracetamol son los más empleados por su eficacia y seguridad. Estos fármacos disminuyen la inflamación y el dolor, facilitando la tolerancia a los procedimientos ortodónticos. La elección del analgésico debe considerar la intensidad del dolor, las condiciones médicas preexistentes y las posibles interacciones medicamentosas. Su uso cuidadoso y supervisado es vital para minimizar riesgos y maximizar la comodidad del paciente durante el tratamiento de ortodoncia.

ABSTRACT: Anchoring is the process that allows new information to be inserted into the framework of pre-existing schemes. Allows to instrumentalize the content in communication. In During the training of specialists, we anchor contents with a situational diagnosis. The purpose of this essay was to anchor contents of mastication and mandibular dynamics in professionals, students in the specialization program in Periodontics, of the Faculty of Dentistry, Universidad de Chile. The program has a rehabilitation unit in reduced periodontium (one credit, 5 sessions). This is taught with situational diagnosis and active methodologies: Reverse classroom and small group discussion. The chewing and mandibular dynamics contents were anchored through these methodologies with videos, to stimulate the identification of patterns; pinned content is identified. Individual and collective reflection was encouraged and students from the 2020 (telematic) and 2022 (in-person) classes were compared. Students were coded from 1 to 14. Characterization of the 2020 cohort: 4 men, 4 women; 5.75 years of average graduation, 2 from U. del Desarrollo, 1 U. de Concepción, 2 U. de Talca, 2 U. de Chile and 1 U. de Los Andes. Cohort characterization 2022: 3 women, 3 men; 6 years of average graduation, 5 U. de Chile and 1 U. de La Frontera. The 2020 cohort identified patterns in the second session, except for students 5 and 7 who did so in the fifth session. During the collective reflection, transformational leadership predominated. Of the 2022 cohort, only student 14, was able to identify patterns in the second session, while all of her classmates did so in the fifth session. During the collective reflection, transactional leadership predominated. In teaching professionals, the same methodologies, applied telematically or in person to anchor new content, were influenced by the leadership styles of the students, which favored or delayed the identification of the patterns.

RESUMEN: El anclaje es el proceso que permite insertar lo nuevo en el entramado de esquemas preexistentes. Posibilita instrumentalizar el contenido en la comunicación. En formación de especialistas, anclamos contenidos con un diagnóstico situacional. El propósito de este ensayo fue, anclar contenidos de masticación y dinámica mandibular en profesionales, estudiantes del programa de especialización en Periodoncia, Facultad de Odontología, Universidad de Chile. El programa posee la unidad de rehabilitación en periodonto reducido (un crédito, 5 sesiones). Esta se imparte con diagnóstico situacional y metodologías activas: aula reversa y discusión de grupo pequeño. Los contenidos masticación y dinámicamandibular se anclaron mediante estas metodologías con videos, para estimular la identificación de patrones; contenido anclado es identificado. Se incentivó la reflexión individual y colectiva y se compararon los estudiantes de las promociones 2020 (telemática) y 2022 (presencial). Los estudiantes fueron codificados del 1 al 14. Caracterización de la cohorte 2020: 4 hombres, 4 mujeres; 5.75 años de egreso promedio, 2 U. Desarrollo, 1 U. de Concepción, 2 U. de Talca, 2 U. de Chile y 1 U de los Andes. Caracterización cohorte 2022: 3 mujeres, 3 hombres; 6 años de egreso promedio, 5 U. de Chile y 1 U. de La Frontera. La cohorte 2020 identificó patrones en la segunda sesión, a excepción de los estudiantes 5 y 7 que lo hicieron en la quinta sesión. Durante la reflexión colectiva, predominaron liderazgos transformacionales. De la cohorte 2022, solo el estudiante 14 identificó patrones en la segunda sesión y todos sus compañeros lo hicieron en la quinta sesión. Durante la reflexión colectiva, predominaron liderazgos transaccionales. En educación de profesionales, iguales metodologías, aplicadas telemáticamente o de manera presencial para anclar nuevos contenidos, se vieron influenciadas por los estilos de liderazgos de los estudiantes, que favorecieron o retardaron la identificación de patrones.

Abstract Objective To analyze the effect of mast cells (MCs) in neurogenic inflammation and the neuroimmune response of trigeminal ganglia (TG) due to pulpitis and detect the regulatory effect of curcumin (Cur) on neuroimmune responses induced by pulpitis. Methodology Immunohistochemistry, toluidine blue staining (TB), and other methods were used to detect the dynamic changes of MCs, as well as tryptase expression changes and protease activated receptor 2 (PAR2) and calcitonin gene-related peptide (CGRP) levels in the neuroimmune response induced by pulpitis. After administering Cur by intraperitoneal injection, the expression levels of Toll-like receptor 4 (TLR4), CGRP, glial fibrillary acidic protein (GFAP), fractalkine (CX3CL1), Tumor necrosis factor (TNF-α), and other factors were examined in the TG of pulpitis-induced rats. Results After pulpitis induction, the expression of CGRP-positive neurons and GFAP-positive soluble guanylate cyclase (SGC) in the TG significantly increased. A large number of MCs underwent degranulation. MCs were scattered between the CGRP-positive nerve fibers. MCs showing a typical degranulated state within the TG significantly increased and tryptase-positive MCs surrounded the TG nerve fibers and neurons. After treatment with Cur, the inflammatory response in the periodontal bone induced by pulpitis decreased and promoted early tissue repair. The expression of TNF-α significantly decreased as did degranulation of MCs. In contrast, the expression of CGRP, TLR4-positive neurons, activated SGCs, and PAR2-positive TG neurons significantly decreased. MCs could participate in the neuroimmune response induced by pulpitis by the tryptase signaling pathway. Conclusion Importantly, Cur inhibited the degranulation of MCs, downregulated the expression of tryptase and PAR2 in the TG, and attenuated the activation response of osteoclasts in the apical periodontium. (MCs (TG (Cur Immunohistochemistry TB, TB , (TB) PAR (PAR2 generelated gene related CGRP (CGRP injection Tolllike Toll like TLR4, TLR4 TLR (TLR4) GFAP, GFAP (GFAP) CX3CL1, CX3CL1 CXCL CX CL (CX3CL1) TNFα, TNFα TNF α (TNF-α) pulpitisinduced rats induction CGRPpositive positive GFAPpositive SGC (SGC tryptasepositive repair contrast TLR4positive TLRpositive SGCs PAR2positive PARpositive pathway Importantly periodontium (TB (PAR (TLR4 (GFAP CX3CL (CX3CL1 (TNF-α (TLR (CX3CL

ABSTRACT Objective: To assess the temperature variation of gutta-percha removal with stainless steel and two NiTi instruments using infrared thermography and thermocouples. Material and Methods: 45 single-rooted teeth were divided into three groups (n = 15) according to the following gutta-percha removal instruments: Largo Peeso (L), Protaper Retreatment (PR), and Reciproc (R). Thermal analysis was conducted using a FLIR T650sc infrared thermography camera and three thermocouples. For infrared thermography assessment, the infrared camera was programmed to acquire thermograms every 15 seconds before the gutta-percha removal started until temperature normalization. Root temperature was assessed in the thermograms using FLIR tools software v6.4 with the straight-line tool along the long axis of the tooth and in the cervical, middle, and apical thirds of each tooth. The temperature from the thermocouples was recorded and registered for each root third. Inferential statistical analysis Kruskal-Wallis and post hoc Tukey tests were used. Results: For the infrared thermography camera, the highest median temperature value was found 15 seconds after guttapercha removal for the L technique (20.3°C), which presented the highest temperatures at all studied times. For thermocouples, the highest temperature was found in the middle third during gutta-percha removal with L (20.7°C). PR and R presented similar patterns of root temperature. Conclusion: Stainless-steel L temperature reaches values above 10°C; however, the exposure time was too short to cause injuries to the periodontium. Objective gutta percha Methods 4 singlerooted single rooted n L, , (L) PR, (PR) R. . (R) Tsc T sc assessment 1 normalization v64 v v6 v6. straightline straight line cervical KruskalWallis Kruskal Wallis used Results 20.3°C, 203C C 20.3°C 20 3 (20.3°C) times 20.7°C. 207C 20.7°C 7 (20.7°C) Conclusion Stainlesssteel Stainless 10°C 10C 10 however periodontium (L (PR (R 2 (20.3°C (20.7°C

Resumo Objetivo Avaliar a qualidade radiográfica de tratamentos endodônticos e suas respectivas restaurações coronárias, correlacionando-os ao status periapical. Material e método A qualidade da obturação de quatrocentos e dezesseis dentes foi criteriosamente avaliada em três parâmetros radiográficos: i) limite apical, ii) homogeneidade e iii) conicidade, sendo E0, E1 e E2. E0 e E1 corresponderam a acentuado e suave desvio da normalidade, respectivamente; enquanto E2 correspondeu ao padrão-ouro. Em função da combinação dos escores atribuídos, a obturação foi classificada em perfeita (PF), com três escores E2; satisfatória (ST), com dois escores E2; ou deficiente (DF), com um ou nenhum escore E2. Além disso, o status periapical foi considerado como periodonto sadio; espessamento do ligamento periodontal e presença de periodontite apical. Restaurações coronárias foram classificadas quanto à presença e tipo de restauração. As associações entre as variáveis foram analisadas através do teste de Correlação de Spearman (p<0.05). Resultado Duzentos e vinte e um dentes apresentaram obturação DF (53.1%). O limite apical foi o parâmetro com maior número de E0, perfazendo 38,94% dos escores atribuídos. Individualmente, os parâmetros observados não apresentaram associação estatisticamente significativa com o status periapical (p>0.05); entretanto, o mesmo associou-se significativamente com a qualidade geral da obturação (p=0.021). Conclusão As obturações apresentaram baixo padrão de qualidade, sendo o parâmetro mais crítico, influenciando o status periapical de toda a amostra. correlacionandoos correlacionando radiográficos i ii iii conicidade E normalidade respectivamente padrãoouro. padrãoouro ouro. ouro padrão-ouro atribuídos PF, PF , (PF) ST, ST (ST) DF, (DF) disso sadio restauração p<0.05. p005 p p<0.05 . 0 05 (p<0.05) 53.1%. 531 53.1% 53 1 (53.1%) 3894 38 94 38,94 Individualmente p>0.05 (p>0.05) entretanto associouse associou se p=0.021. p0021 p=0.021 021 (p=0.021) crítico amostra (PF (ST (DF p00 p<0.0 (p<0.05 53.1 5 (53.1% 389 3 9 38,9 p>0.0 (p>0.05 p002 p=0.02 02 (p=0.021 p0 p<0. (p<0.0 53. (53.1 38, p>0. (p>0.0 p=0.0 (p=0.02 p<0 (p<0. (53. p>0 (p>0. p=0. (p=0.0 p< (p<0 (53 p> (p>0 p=0 (p=0. (p< (5 (p> p= (p=0 (p ( (p=

Abstract Objective To evaluate the radiographic quality of endodontic treatments and their respective coronal restorations, correlating it with periapical status. Material and method The root filling quality of four hundred and sixteen teeth was carefully evaluated regarding three radiographic parameters: i) apical extension, ii) homogeneity and iii) taper, being E0, E1 and E2. E0 and E1 corresponding to sharp and mild deviation from normality, respectively; while E2 corresponding to the gold standard. Due to the combination of the assigned scores, filling was classified as perfect (PF), with three E2 scores; satisfactory (ST), with two E2 scores; or deficient (DF), with one or no E2 score. In addition, periapical status was considered to be a healthy periodontium; thickening of the periodontal ligament and presence of apical periodontitis. Coronary restorations were classified according to the presence and type of restoration. Associations between variables were analyzed using Spearman's Correlation test (p<0.05). Result Two hundred and twenty-one teeth had DF filling (53.1%). The apical extension was the parameter with the highest number of E0, accounting for 38.94% of assigned scores. Individually, the observed parameters did not show statistically significant association with periapical status (p>0.05); however, it was significantly associated with the general filling quality (p=0.021). Conclusion Fillings presented low quality standard, being the most critical parameter, negatively influencing the periapical status of the entire sample. i ii iii taper E normality respectively standard scores PF, PF , (PF) ST, ST (ST) DF, (DF) score addition periodontium periodontitis restoration Spearmans Spearman s p<0.05. p005 p p<0.05 . 0 05 (p<0.05) twentyone twenty 53.1%. 531 53.1% 53 1 (53.1%) 3894 38 94 38.94 Individually p>0.05 (p>0.05) however p=0.021. p0021 p=0.021 021 (p=0.021) sample (PF (ST (DF p00 p<0.0 (p<0.05 53.1 5 (53.1% 389 3 9 38.9 p>0.0 (p>0.05 p002 p=0.02 02 (p=0.021 p0 p<0. (p<0.0 53. (53.1 38. p>0. (p>0.0 p=0.0 (p=0.02 p<0 (p<0. (53. p>0 (p>0. p=0. (p=0.0 p< (p<0 (53 p> (p>0 p=0 (p=0. (p< (5 (p> p= (p=0 (p ( (p=

Resumo A perda óssea causada pela periodontite pode ser potencializada pela diabetes. Apesar dos efeitos benéficos, anti-inflamatórios e antirreabsortivos, da Atorvastatina (ATV) na periodontite tem sido relatado o aumento para o risco de diabetes o que pode modificar o curso da doença periodontal. Portanto, este estudo objetiva avaliar o efeito da ATV no osso alveolar de ratos com periodontite e diabetes. Pra tanto, 72 ratos Wistar foram divididos em 4 grupos: Naïve (N), periodontite experimental (EP), diabetes mellitus (DM) e ATV. A DM foi induzida através da estreptozotocina (60 mg/kg-ip. em dose única) após 12 horas de jejum. Em seguida todos os animais foram submetidos a EP. A ATV foi administrada (27 mg/kg, v.o) 30 minutos antes da ligadura e diariamente por 11 dias. Animais do grupo N não foram submetidos a nenhuma intervenção. Após 1 dias de EP, todos os animais foram submetidos a medição da glicemia e em seguida eutanasiados. As maxilas foram coletadas para análises macroscópicas, micro-tomográficas e microscópicas. A DM causou intensa perda óssea (60%) marcada pela redução da espessura trabecular e do volume ósseo (p<0.05). Foi observado uma redução significante em osteoblastos com aumento da contagem de osteoclastos, bem como aumento do infiltrado inflamatório no periodonto. A ATV não foi capaz de proteger o osso alveolar nos animais diabéticos, aumentando a perda óssea em 21%. A ATV causou aumento significante dos níveis de glicose no sangue (20%). Em suma, a ATV não protegeu a perda do osso alveolar e não modulou a inflamação da EP nos animais diabéticos. A ATV aumentou os níveis de glicose no sangue desse grupo de animais. Portanto, o uso sistêmico de ATV em diabéticos não-controlados deve ser cuidadosamente avaliada. benéficos antiinflamatórios anti inflamatórios antirreabsortivos (ATV periodontal Portanto tanto 7 grupos N, , (N) (EP) (DM 60 (6 mg/kgip. mgkgip mg/kg ip. mg kg ip mg/kg-ip única jejum 27 (2 mgkg v.o vo v 3 intervenção eutanasiados macroscópicas microtomográficas micro tomográficas microscópicas 60% (60% p<0.05. p005 p p<0.05 . 0 05 (p<0.05) osteoclastos periodonto 21 21% 20%. 20 20% (20%) suma nãocontrolados controlados avaliada (N (EP 6 ( kgip mg/kgip 2 p00 p<0.0 (p<0.05 (20% p0 p<0. (p<0.0 (20 p<0 (p<0. p< (p<0 (p< (p

Abstract Periodontal bone loss is potentiated by diabetes. Despite the beneficial anti-inflammatory and antiresorptive effects of Atorvastatin (ATV) on periodontitis, it has been reported to increase the risk of diabetes, which may modify the course of periodontal disease. Therefore, this study aimed to evaluate the effect of ATV on alveolar bone in rats with periodontitis and diabetes. For this, 72 Wistar rats were divided into groups: Naïve (N) not submitted to any procedure; Experimental periodontitis (EP) group submitted to ligature-induced periodontitis; diabetes mellitus (DM), submitted to EP and receiving single dose of streptozotocin (60 mg/kg, i.p.) after 12 hours of fasting; and ATV DM, submitted to EP and DM and receiving orally 27 mg/kg of ATV, 30 minutes before ligature placement, and continued daily until the 11th day. Animals from EP and DM received saline solution 0.9% as placebo. Glycemic levels measured in all animals and then were euthanized. Maxillae were collected for macroscopic, micro-tomographic, and microscopic analyses. DM caused intense bone loss (60%), characterized by a reduction in trabecular thickness and bone volume. DM reduced osteoblasts, increasing osteoclast counts, and induced an inflammatory infiltrate in the periodontium. ATV was found ineffective in protecting bone in diabetic rats, exacerbating bone loss by 21%. Additionally, ATV significantly increased blood glucose levels. In summary, ATV did not prevent alveolar bone loss or modulate inflammation in DM animals undergoing EP. ATV also increased blood glucose levels in these animals. Therefore, the systemic use of ATV in uncontrolled diabetic conditions should be carefully evaluated. antiinflammatory anti (ATV disease Therefore 7 groups N (N procedure (EP ligatureinduced , (DM) 60 (6 mgkg mg kg i.p. ip i p 1 fasting 2 3 placement th day 09 0 9 0.9 placebo euthanized macroscopic microtomographic, microtomographic micro tomographic, tomographic micro-tomographic analyses 60%, 60% (60%) volume osteoblasts counts periodontium 21 21% Additionally summary evaluated (DM 6 ( i.p 0. (60%

RESUMO A movimentação dentária ortodôntica é um processo de remodelação óssea induzida mecanicamente com o objetivo de alinhar dentes mal posicionados. A periodontite é uma infecção polimicrobiana dos tecidos de suporte dos dentes que resulta na destruição do periodonto. O Diabetes Mellitus é um distúrbio metabólico que contribui para vários tipos de comorbidades e até mesmo a morte prematura de um indivíduo. Devido a grande demanda de pacientes diabéticos com periodontite e apresentando a necessidade da terapia ortodôntica para atingir melhor saúde periodontal, tivemos como objetivo realizar uma revisão bibliográfica sobre a movimentação dentária ortodôntica em pacientes com periodontite e diabetes mellitus. A busca pelos artigos desta revisão de literatura ocorreu entre fevereiro de 2022 e março de 2023. Os artigos foram pesquisados, selecionados e extraídos por meio das bases de dados: PUBMED, LILACS e GOOGLE SCHOLAR disponíveis online, no intervalo entre 1990 até 2022. Diabetes e periodontite podem afetar adversamente a remodelação óssea na movimentação dentária ortodôntica. No entanto, apesar da necessidade de mais estudos a longo prazo para elucidar o mecanismo da movimentação dentária ortodôntica em pacientes diabéticos com histórico de periodontite, a literatura nos sugere que se houver uma terapia periodontal-ortodôntica bem estabelecida associada ao controle glicêmico do paciente, o tratamento será bem-sucedido. posicionados periodonto indivíduo periodontal mellitus 202 2023 pesquisados dados PUBMED online 199 entanto periodontalortodôntica paciente bemsucedido. bemsucedido sucedido. sucedido bem-sucedido 20 19 2 1

ABSTRACT Orthodontic tooth movement is a mechanically induced bone remodeling process aimed at aligning malpositioned teeth. Periodontitis is a polymicrobial infection of the supporting tissues of the teeth that results in the destruction of the periodontium. Diabetes Mellitus is a metabolic disorder that contributes to several types of comorbidities and even premature death of an individual. Due to the high demand of diabetic patients with periodontitis and the need for orthodontic therapy to achieve better periodontal health, we aimed to carry out a bibliographic review on orthodontic tooth movement in patients with periodontitis and diabetes mellitus. The search for articles in this literature review took place between February 2022 and March 2023. The articles were researched, selected and extracted through the database: PUBMED, LILACS and GOOGLE SCHOLAR available online, in the range of years between 1990 and 2022. Diabetes and periodontitis may adversely affect bone remodeling in orthodontic tooth movement. However, despite the need for further long-term studies to elucidate the mechanism of orthodontic tooth movement in diabetic patients with a history of periodontitis, the literature suggests that if there is a well-established periodontal-orthodontic therapy associated with the patient’s glycemic control, the treatment will be successful. periodontium individual health mellitus 202 2023 researched database PUBMED online 199 However longterm long term wellestablished well established periodontalorthodontic patient s control successful 20 19 2 1

SUMMARY: The dentogingival junction (DGJ) is an adaptation of the oral mucosa composed of epithelial and connective tissues intimately related with the mineralised tissues of the tooth. The histological evidence available is mainly based on studies in animals, separate evaluations of hard and soft tissues, and studies using conventional histological techniques that eliminate the enamel from preparations. The aim of this study was to carry out a review of the existing evidence on histological techniques available for study of the tooth and periodontium in conjunction in humans. A scoping review was carried out of the available literature referring to study of the tooth and the periodontium in conjunction in humans, in the Web of Science (WoS), EMBASE, Scopus and SciELO databases, using the terms "Histological Techniques"[Mesh]) and "Epithelial Attachment"[Mesh]. One hundred and fifty-nine articles were found, of which 54 were selected for full- text reading. Ten were finally included in the qualitative synthesis, and we applied the Anatomical Quality Assurance (AQUA) checklist for analysis the methodological quality of the selected articles. The results showed that the only articles with a low risk of bias in all five domains according to the AQUA criteria corresponded to Silva et al. (2011) and Agustín-Panadero et al. (2020). Finally, we conclude that the quality of the histological sections to observe tissues that simultaneously contain the tooth and the periodontium, is conditioned by the selected technique and by the care required in certain specific tasks during the histological processing of the samples.

RESUMEN: La unión dentogingival (DGJ) es una adaptación de la mucosa oral compuesta por tejidos epitelial y conectivo íntimamente relacionados con los tejidos mineralizados del diente. La evidencia histológica disponible se basa principalmente en estudios en animales, evaluaciones separadas de tejidos duros y blandos y estudios utilizando técnicas histológicas convencionales que eliminan el esmalte de las preparaciones. El objetivo de este estudio fue realizar una revisión de la evidencia existente sobre las técnicas histológicas disponibles para el estudio del diente y el periodonto en conjunto en humanos. Se realizó un scoping review de la literatura disponible referente al estudio del diente y el periodonto en conjunto en humanos, en las bases de datos Web of Science (WoS), EMBASE, Scopus y SciELO, utilizando los términos “Histological Techniques”[Mesh]) y "Epithelial Attachment"[Mesh]. Se encontraron 159 artículos, de los cuales 54 fueron seleccionados para lectura de texto completo. Diez fueron finalmente incluidos en la síntesis cualitativa, y se aplicó la lista de verificación Anatómica Quality Assurance (AQUA) para el análisis de la calidad metodológica de los artículos seleccionados. Los resultados mostraron que los únicos artículos con bajo riesgo de sesgo en los cinco dominios según los criterios AQUA correspondían a Silva et al. (2011) y Agustín-Panadero et al. (2020). Finalmente, concluimos que la calidad de los cortes histológicos para observar los tejidos que contienen simultáneamente el diente y el periodonto, está condicionada por la técnica seleccionada y por el cuidado requerido en ciertas tareas específicas durante el procesamiento histológico de las muestras.

RESUMEN La pulpa dental y el periodonto presentan diferentes vías de comunicación. El foramen apical, los conductos accesorios y los túbulos dentinarios son ejemplos de ellos. Durante los procedimientos peri-odontales regenerativos se realiza el raspaje, alisado y tratamiento de la superficie radicular con un acondicionador a base de ácido etilendiaminotetraacético (EDTA). Este tratamiento podría generar una comunicación patológica entre ambas estructuras debido a la interrupción del pedículo vascular o a la migración de bacterias y/o subproductos inflamatorios provenientes de bolsas periodontales profundas que generen patología pulpar. Objetivo: El objetivo del presente estudio fue evaluar la influencia de la cirugía periodontal regenerativa mínimamente invasiva sobre el estado de vitalidad pulpar de piezas dentarias unirradiculares y multirradiculares con defectos infraóseos que se extendían hasta el tercio medio y apical. Materiales y Método: Se analizaron de forma retrospectiva 30 piezas dentarias de 14 pacientes atendidos entre el mes de agosto 2018 y agosto 2019 en el posgrado de la Especial-ización en Periodoncia de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA). Se realizó el diagnóstico endodóntico de forma clínica y radiográfica a los 6 meses post-tratamiento periodontal regenerativo mínimamente invasivo. Resultados: De las 30 piezas solo 2 presentaron cambios en el estado pulpar luego del procedimiento periodontal regenerativo, pulpitis irreversibles a los 30 días y necrosis pulpar a los 180 días post-tratamiento. La tasa de riesgo de cambios en el estado de vitalidad pulpar fue del 6,7%. En relación a las piezas dentarias que presentaban lesiones de furcación grado I y II (n=9) ninguna presentó cambios en su estado pulpar. Conclusiones: La cirugía periodontal regenerativa no tuvo influencia significativa en el estado pulpar de piezas unirradiculares y multirra-diculares con defectos infraóseos que se extendían a nivel del tercio medio y apical.

ABSTRACT Dental pulp and periodontium have different communication routes including, e.g., apical foramen, accessory canals and dentin tubules. Scaling, planing and root surface treatment with ethylenediaminetetraacetic acid (EDTA)-based conditioner are used in regenerative periodontal procedures. Such treatment may generate pathological communication between the two structures due to interruption of the vascular pedicle or migration of bacteria and/or inflammatory byproducts from deep periodontal pockets, which may generate pulp pathology. Aim: The aim of this study was to evaluate the influence of minimally invasive periodontal regenerative surgery on pulp vitality status in single-rooted and multi-rooted teeth associated to infraosseous defects extending to the middle and apical thirds. Materials and Method: This was a retrospective study on 30 teeth from 14 patients who received care between August 2018 and August 2019 at the postgraduate Department of Specialization in Periodontics of the Buenos Aires University School ofDentistry (FOUBA). Clinical and radiographic endodontic diagnosis was performed 6 months after the minimally invasive regenerative periodontal treatment. Results: Only two out of the 30 teeth presented changes in pulp status following regenerative periodontal procedure: irreversible pulpitis at 30 days and pulp necrosis at 180 days post-treatment. The rate for risk of change in pulp vitality status was 6.7%. Teeth with grade I and II furcation lesions (n=9) presented no change in pulp status. Conclusions: Regenerative periodontal surgery had no significant influence on pulp status in single-rooted and multi-rooted teeth with infraosseous defects extending to the level of the middle and apical third

Resumo No caso de infecção endodôntica, a presença de canais cavo inter-radiculares pode estar na origem de uma lesão periodontal localizada na região de furca. Sendo a furca muito próxima do periodonto marginal, esse tipo de lesão pode ser favorável à fomação de uma lesão endo-periodontal. Esses canais estão localizados no assoalho da câmara pulpar e constituem uma das inúmeras vias de comunicação fisiológica entre os tecidos endodônticos e periodontais. Esses canais são na maioria das vezes difíceis de localizar, instrumentar e obturar por causa do diâmetro e comprimento reduzidos. A desinfecção do assoalho da câmara pulpar com solução de hipoclorito de sódio pode contribuir para a desinfecção dos canais cavo inter-radiculares quando eles não são localizados, instrumentamos e/ou obturados. Os casos clínicos descritos ilustram o manejo endodôntico de canais cavo inter-radiculares visíveis associados a uma lesão endo-periodontal. Esses canais cavo inter-radiculares tinham um grande diâmetro que permitiu sua localização durante o tratamento endodôntico. endodôntica interradiculares inter radiculares marginal endoperiodontal. endoperiodontal endo periodontal. endo-periodontal periodontais localizar reduzidos eou ou obturados

Abstract In the case of endodontic infection, the presence of furcation canals can be at the origin of a periodontal lesion located in the furcation. The furcation being very close to the marginal periodontium, this type of lesion can be favorable to the genesis of an endo-periodontal lesion. These furcation canals are lateral canals located on the pulp chamber floor and constitute one of the many physiological communication pathways between endodontic and periodontal tissues. These canals are most often difficult to localize, shape, and to fill because of their small diameter and length. The disinfection of the pulp chamber floor with sodium hypochlorite solution may contribute to the disinfection of furcation canals when they are not identified, shaped, and/or filled. This case series illustrates the endodontic management of visible furcation canals associated with an endo-periodontal lesion. These furcation canals had a large diameter which allowed their identification during the endodontic treatment. infection periodontium endoperiodontal endo tissues localize shape length identified shaped andor or filled treatment

Resumo Introdução A periodontite é uma doença infecto-inflamatória, resultante da disbiose microbiana e da resposta do hospedeiro, que leva à destruição dos tecidos de suporte dentário, inclusive das fibras colágenas periodontais, podendo culminar na perda do elemento dental. Objetivo Avaliar o comportamento das fibras colágenas periodontais durante a progressão da periodontite experimental induzida em ratos. Material e método Doze ratos Wistar foram distribuídos nos grupos: Controle (C), Periodontite Experimental 14-dias (PE-14d), Periodontite Experimental 21-dias (PE-21d) e Periodontite Experimental 42-dias (PE-42d). No dia 0, os animais do grupo C foram eutanasiados. Neste mesmo dia, os animais remanescentes foram submetidos à instalação de uma ligadura de algodão ao redor do primeiro molar inferior esquerdo para indução da periodontite experimental. Tais animais foram eutanasiados aos 14 (PE-14d), 21 (PE-21d) e 42 (PE-42d) dias após a instalação da ligadura. Executou-se o processamento histológico das hemimandíbulas e as secções foram submetidas à reação histoquímica pelo vermelho picro-sirius. A análise qualitativa descritiva foi realizada sob microscopia de luz polarizada, na região de furca dental, evidenciando as fibras do ligamento periodontal. Resultado O grupo C exibiu feixes espessos e orientados de fibras colágenas maduras, condizentes com aspecto de normalidade. Os grupos com periodontite experimental exibiram desestruturação tecidual severa, com fibras colágenas imaturas e de menor espessura, sendo tais condições mais exacerbadas nos grupos PE-14d e PE-21d. Conclusão As fases iniciais da periodontite apresentam caráter agudo e, portanto, resultam na rápida destruição dos tecidos periodontais de suporte, prejudicando potencialmente a fibrilogênese e a reestruturação do colágeno no ligamento periodontal. infectoinflamatória, infectoinflamatória infecto inflamatória, inflamatória infecto-inflamatória hospedeiro dentário dental C, , (C) 14dias PE14d, PE14d PEd PE 14d d (PE-14d) 21dias PE21d 21d (PE-21d 42dias PE42d. PE42d 42d . 0 1 2 4 (PE-42d Executouse Executou se picrosirius. picrosirius picro sirius. sirius picro-sirius polarizada periodontal maduras normalidade severa espessura PE21d. 21d. PE-21d portanto (C (PE-14d

Abstract Introduction Periodontitis is an infectious-inflammatory disease resulting from microbial dysbiosis and host response that leads to the destruction of tooth support tissues, including periodontal collagen fibers, which may culminate in tooth loss. Objective To evaluate the behavior of periodontal collagen fibers during the progression of induced experimental periodontitis in rats. Material and method Twelve Wistar rats were distributed into groups: Control (C), 14-days Experimental Periodontitis (PE-14d), 21-days Experimental Periodontitis (PE-21d) and 42-days Experimental Periodontitis (PE-42d). At day 0, the animals of group C were euthanized. At the same day, the remaining animals were submitted to the installation of a cotton ligature around the lower left first molar for the induction of experimental periodontitis. The animals were euthanized at 14 (PE-14d), 21 (PE-21d) and 42 (PE-42d) days after the installation of ligature. Histological processing of the hemi-mandibles was performed and the sections underwent histochemical reaction using picro-sirius red. The descriptive qualitative analysis was performed under polarized light microscopy, in the dental furcation region, evidencing the fibers of the periodontal ligament. Result Group C exhibited thick and oriented bundles of mature collagen fibers, consistent with a normal appearance. The groups with experimental periodontitis exhibited severe tissue disruption, with immature and thinner collagen fibers, with such conditions being more exacerbated in the PE-14d and PE-21d groups. Conclusion The early stages of periodontitis present acute response, and therefore result in rapid destruction of periodontal support tissues and potentially impair fibrillogenesis and collagen restructuring in the periodontal ligament. infectiousinflammatory infectious inflammatory loss C, , (C) 14days PE14d, PE14d PEd PE 14d d (PE-14d) 21days PE21d 21d (PE-21d 42days PE42d. PE42d 42d . 0 1 2 4 (PE-42d hemimandibles hemi mandibles picrosirius picro sirius red microscopy region ligament appearance disruption (C (PE-14d

RESUMO Introdução: As contenções ortodônticas fixas são muito importantes para a estabilidade do tratamento; no entanto, elas podem causar efeitos adversos na saúde do periodonto, como resultado da deposição de placa e cálculo. Objetivos: Comparar e determinar os efeitos na saúde periodontal de duas contenções inferiores coladas por lingual, e testar a hipótese nula de que não haveria diferença significativa na saúde periodontal entre os pacientes usando contenções fixas de compósito reforçado com fibra (FRC) ou de fio multitrançado (MSW). Métodos: No total, 60 indivíduos foram recrutados, dos quais 6 foram excluídos e 2 desistiram durante o estudo. Assim, foram incluídos no estudo 52 indivíduos com média de idade de 21,5 ± 3,6 anos. A amostra foi composta por 8 homens (15,4%) e 44 mulheres (84,6%). Os participantes foram divididos aleatoriamente em dois grupos: O Grupo 1 recebeu contenção de compósito reforçado com fibra, enquanto o Grupo 2 recebeu contenção de fio multitrançado. Após três meses (T1), seis meses (T2), nove meses (T3) e doze meses (T4) da colagem, foram comparados os índices de placa e de cálculo, índice gengival e sangramento à sondagem, usando o teste de Mann-Whitney com p ≤ 0,05 como significativo. Resultados: Pôde-se observar que a saúde periodontal piorou com o passar do tempo, de T1 a T4, em ambos os grupos de contenções. No entanto, não foram encontradas diferenças estatisticamente significativas entre os dois grupos (p> 0,05). Conclusão: Os resultados do estudo indicam que não houve diferença significativa na saúde periodontal entre os pacientes com contenções fixas FRC e MSW; portanto, a hipótese nula foi aceita. Introdução tratamento entanto periodonto cálculo Objetivos lingual (FRC MSW. MSW . (MSW) Métodos total recrutados Assim 5 215 21 21, 36 3 3, anos 15,4% 154 15 4 (15,4% 84,6%. 846 84,6% 84 (84,6%) T1, T , (T1) T2, T2 (T2) T3 (T3 T4 (T4 colagem sondagem MannWhitney Mann Whitney 005 0 05 0,0 significativo Resultados Pôdese Pôde se tempo p> (p 0,05. 0,05) Conclusão portanto aceita (MSW 15,4 (15,4 84,6 (84,6% (T1 (T2 (T 00 0, 15, (15, 84, (84,6 (15 (84, (1 (84 ( (8

ABSTRACT Introduction: Fixed orthodontic retainers are very important for treatment stability; however, adverse effects on the health of periodontium can be caused as a result of deposition of plaque and calculus. Objectives: To compare and determine the effects of two mandibular fixed lingual retainers on the periodontal status, and to test the null hypothesis that there would be no significant difference on the periodontium health between the patients using fiber-reinforced composite (FRC) or multistranded wire (MSW) fixed retainers. Methods: A total of 60 subjects were recruited, out of which 6 were excluded and 2 dropped out during the study. Hence, 52 subjects with mean age of 21.5 ± 3.6 years were included in the study. The sample was composed by 8 males (15.4%) and 44 females (84.6%). The participants were randomly divided into two groups: Group 1 received fiber-reinforced composite retainer, while Group 2 received multistranded wire retainer. After insertion, plaque index, calculus index, gingival index and bleeding on probing were compared, after three months (T1), six months (T2), nine months (T3) and twelve months (T4), using Mann-Whitney test with p-value ≤ 0.05 as significant. Results: It could be seen that the health of periodontium deteriorated with the passage of time from T1 to T4 in both group of retainers. However, no statistically significant differences were found between the two groups (p> 0.05). Conclusion: The results of the study indicate that there was no significant difference on the health of periodontium between the patients with FRC and MSW fixed retainers, hence, the null hypothesis was accepted. Introduction stability however Objectives status fiberreinforced fiber reinforced (FRC (MSW Methods recruited Hence 5 215 21 21. 36 3 3. 15.4% 154 15 4 (15.4% 84.6%. 846 84.6% . 84 (84.6%) retainer insertion compared T1, T , (T1) T2, T2 (T2) T3 (T3 T4, (T4) MannWhitney Mann Whitney pvalue p value 005 0 05 0.0 Results However p> (p 0.05. 0.05) Conclusion hence accepted 15.4 (15.4 84.6 (84.6% (T1 (T2 (T (T4 00 0. 15. (15. 84. (84.6 (15 (84. (1 (84 ( (8

ABSTRACT Introduction: odontogenic infection is that which has its origin in the structures that form the tooth and the periodontium, and which by extension will affect the maxillary or mandibular bone in its periapical region. This type of infection is usually superficial, localized and limited, but on some occasions a secondary dissemination of the odontogenic infection to other anatomical regions can be observed. Objective: to determine the risk factors for the instauration of odontogenic infections. Methods: a systematic literature review was carried out at the Universidad Regional Autónoma de los Andes between December 2022 and April 2023 on the risk factors for the dissemination of odontogenic infections. Articles in English, Spanish and Portuguese published in PubMed, SciELO and LILACS databases were studied. Development: Of the 512 articles recovered, eight were identified after the screening process, which studied the risk factors for the spread of odontogenic infections. Most belonged to the Journal of Applied Oral Science and 100 % were descriptive studies. Conclusions: Obesity, immunosuppression and diabetes mellitus have a direct influence on the aggravation of odontogenic infections. On the other hand, factors such as oral hygiene, diet, tobacco and drug use are associated with the spread of odontogenic infections.

RESUMEN Introducción: la infección odontogénica es aquella que tiene su origen en las estructuras que forman el diente y el periodonto, y que por extensión afectará al hueso maxilar o mandibular en su región periapical. Este tipo de infecciones generalmente suelen ser superficiales, localizadas y limitadas, pero en algunas ocasiones puede observarse una instauración secundaria de la infección odontogénica hacia otras regiones anatómicas. Objetivo: determinar los factores de riesgo para la para la instauración de infecciones odontogénicas. Métodos: se realizó una revisión sistemática de la literatura en la Universidad Regional Autónoma de los Andes entre diciembre de 2022 y abril de 2023 sobre los factores de riesgo para la instauración de infecciones odontogénicas. Se estudiaron artículos en inglés, español y portugués publicados en las bases de dato PubMed, SciELO y LILACS. Desarrollo: de los 512 artículos recuperados se identificaron ocho tras el proceso de cribado, los cuales estudiaron los factores de riesgo para la instauración de infecciones odontogénicas. La mayor parte pertenecieron a la revista Journal of Applied Oral Science y el 100 % fueron estudios descriptivos. Conclusiones: la obesidad, inmunosupresión, diabetes mellitus, influyen de manera directa en la agudización de las infecciones odontogénicas. Por su parte, factores como la higiene oral, dieta, consumo de tabaco y drogas se encuentran se asocian a la instauración de infecciones odontogénicas.

Abstract Periodontal disease (gingivitis and periodontitis) is an inflammatory process caused by the activity of pathogenic bacteria and their products on the gingival sulcus, with the consequent activation of the immune response. Saliva and crevicular fluid contain a wide variety of enzymes and antimicrobial factors that are in contact with the supragingival and subgingival region, including β-defensins (hBDs). hHBDs are non-glycosylated, cysteine-rich cationic peptides produced by epithelial cells with antimicrobial and immunoregulatory effects, thus contributing to maintaining homeostasis in periodontal tissues. The changes in the microbiota and the immune response from a healthy periodontium to gingivitis and, finally, to periodontitis are complex. Their severity depends on a dynamic balance between bacteria associated with plaque, genetic and environmental factors. Recent advances have made it possible to understand the implication of hBDs in the detection, diagnosis, and therapy of periodontal disease and the relationship between periodontitis and other inflammatory conditions. This review aims to describe the effect of hBDs on the immune response and its use as a possible marker of the inflammatory activity of the periodontal disease.

Resumen La enfermedad periodontal (gingivitis y periodontitis) es un proceso inflamatorio ocasionado por la actividad de bacterias patógenas y sus productos sobre el surco gingival, con la consecuente activación de la respuesta inmunitaria. La saliva y el fluido crevicular contienen una gran variedad de enzimas y factores antimicrobianos que están en contacto con la región supragingival y subgingival; entre ellos, las β-defensinas (hBDs). Las hBDs son péptidos catiónicos no glicosilados ricos en cisteína, producidos por las células epiteliales; tienen efecto antimicrobiano e inmunorregulador; de esta forma, contribuyen al mantenimiento de la homeostasis en los tejidos periodontales. Los cambios en la microbiota y en la respuesta inmunitaria de un periodonto sano a gingivitis y, finalmente, a periodontitis, es compleja. Su severidad depende de un equilibrio dinámico entre las bacterias asociadas a la placa, factores genéticos y ambientales. Los avances recientes han permitido comprender la implicación de las hBDs en la detección, el diagnóstico y la terapéutica de la enfermedad periodontal, así como la relación que hay entre la periodontitis y otras enfermedades inflamatorias. El objetivo de esta revisión es describir el efecto de las hBDs en la respuesta inmunitaria y su utilización como marcadores de la actividad inflamatoria de la enfermedad periodontal.