Abstract Introduction the caregiver's demand to meet the needs of individuals with autism spectrum disorder (ASD) can influence their quality of life. Objective the objective of the present study was to compare the burden on caregivers of individuals with ASD with individuals neurotypical (N) and to evaluate the correlation of the impact of oral health with the burden on these caregivers. Material and method participants were divided into two groups: ASD Group (ASD; n=35) and Neurotypical Group (N; n=35). A sociodemographic characteristics questionnaire was administered to caregivers. Caregiver burden was measured using the Burden Interview (BI) questionnaire. The visible plaque index (VPI) of children was analyzed. The data were submitted to statistical analysis (α=5%). Result in the group ASD, the majority of participants were partially dependent, with the majority being dependent on oral hygiene. In group N, the majority were independent and self-sufficient in oral hygiene. Half of the caregivers in the group ASD felt mild to moderate burden (54.3%), while in group N it was found that more than half of them had no burden (65.7%). In the comparative analysis of data from the BI questionnaire, significant differences were observed between the groups in questions (p <0.001), which are directly related to childcare. Regarding the VPI of children in the group ASD and N groups compared to the level of burden, it was observed that there were no significant differences between the groups. Conclusion ASD caregivers have a greater burden when compared to N caregivers and the degree of burden did not influence the oral hygiene of the child with ASD. caregiver s (ASD life (N n=35 n35 n 35 n=35. . (BI (VPI analyzed α=5%. α5 α α=5% 5 (α=5%) selfsufficient self sufficient 54.3%, 543 54.3% , 54 3 (54.3%) 65.7%. 657 65.7% 65 7 (65.7%) p <0.001, 0001 <0.001 0 001 <0.001) childcare n=3 n3 α=5 (α=5% 54.3 (54.3% 65.7 6 (65.7% 000 <0.00 00 n= α= (α=5 54. (54.3 65. (65.7 <0.0 (α= (54. (65. <0. (α (54 (65 <0 (5 (6 < (

Resumo Introdução a demanda do cuidador em atender as necessidades de indivíduos com transtorno do espectro autista (TEA), pode influenciar na sua qualidade de vida. Objetivo o objetivo do presente estudo foi comparar a sobrecarga de cuidadores de indivíduos com TEA com indivíduos neurotípicos (N) e avaliar a correlação do impacto da saúde bucal com a sobrecarga desses cuidadores. Material e método os participantes foram divididos em dois grupos: Grupo TEA (TEA; n=35) e Grupo Neurotípico (N; n=35). Foi aplicado aos cuidadores um questionário de características sociodemográficas. A sobrecarga dos cuidadores foi medida pelo questionário Burden Interview (BI). Foi analisado o índice de placa visível (IPV) das crianças. Os dados foram submetidos a análise estatística (α=5%). Resultado no grupo TEA a maioria dos participantes eram parcialmente dependentes, sendo a maioria dependentes na higienização bucal. No grupo N a maioria eram independentes e autossuficientes na higienização bucal. Metade dos cuidadores do grupo TEA apresentaram sobrecargas leve à moderada (54,3%). No grupo N constatou-se que a maioria enquadrava-se em nenhuma sobrecarga (65,7%). Na análise comparativa dos dados do questionário BI foram observadas diferenças significantes entre os grupos nas questões (p<0,001) que são diretamente relacionadas com os cuidados com os filhos. Com relação ao IPV das crianças do grupo TEA e N comparadas ao nível de sobrecarga, observou-se que não houve diferenças significativas entre os grupos. Conclusão os cuidadores do grupo TEA apresentam maior sobrecarga quando comparados ao grupo N e não houve correlação entre a sobrecarga e o grau de higiene bucal. TEA, , (TEA) vida (N (TEA n=35 n35 n 35 n=35. . sociodemográficas BI. (BI) (IPV α=5%. α5 α α=5% 5 (α=5%) 54,3%. 543 54,3% 54 3 (54,3%) constatouse constatou se enquadravase enquadrava 65,7%. 657 65,7% 65 7 (65,7%) p<0,001 p0001 p 0 001 (p<0,001 filhos observouse observou n=3 n3 (BI α=5 (α=5% 54,3 (54,3% 65,7 6 (65,7% p<0,00 p000 00 (p<0,00 n= α= (α=5 54, (54,3 65, (65,7 p<0,0 p00 (p<0,0 (α= (54, (65, p<0, p0 (p<0, (α (54 (65 p<0 (p<0 (5 (6 p< (p< ( (p

Abstract Surgical procedures, radiotherapy, and chemotherapy, individually or in association, are current oncological treatments. Among the most used chemotherapy drugs, 5-fluorouracil (5FU) is an antimetabolite with a broad spectrum of action. This study evaluated the effects of probiotics (PRO) as an adjuvant to the treatment of experimental periodontitis (EP) in rats immunosuppressed with 5FU. Methodology 108 rats were randomly allocated to six different groups: EP; SS – systemic treatment with saline solution (SS); 5FU – systemic treatment with 5FU; 5FU+PRO – systemic treatment with 5FU, followed by the local administration of Saccharomyces cerevisiae ; 5FU+SRP – systemic treatment with 5-FU, followed by scaling and root planing (SRP); and 5FU+SRP+PRO – systemic treatment with 5FU followed by local treatments with SRP and PRO. Immunosuppression was obtained at two points: at the time of ligature installation and after 48 h. Six animals from each group were euthanized at seven, 15, and 30 d and hemimandibles were collected and processed for histopathological, histometric, and immunohistochemical analysis. Data were subjected to statistical analysis (α=5%). Results At 7 d, the 5FU+PRO group showed less bone resorption and better structured connective tissue compared with the EP, SS, 5FU+SRP, and 5FU+SRP+PRO groups. At 15 d, the 5FU+SRP group showed a greater intensity of the inflammatory response (p<0.05). At 30 d, the 5FU+SRP+PRO group showed better structured bone tissue and a higher percentage of bone tissue (PBT) than the EP, SS, 5FU, and 5FU+PRO groups (p<0.05). Conclusion The use of Saccharomyces cerevisiae as monotherapy or as an adjuvant to periodontal therapy may have a positive effect on bone repair in immunosuppressed conditions. procedures radiotherapy association drugs 5fluorouracil fluorouracil 5 FU (5FU action PRO (PRO EP (EP 10 (SS) 5FUPRO FUPRO 5FUSRP FUSRP FU, 5-FU (SRP) 5FUSRPPRO FUSRPPRO points 4 h seven 3 histopathological histometric α=5%. α5 α α=5% . (α=5%) 1 p<0.05. p005 p p<0.05 0 05 (p<0.05) PBT (PBT conditions (SS (SRP α=5 (α=5% p00 p<0.0 (p<0.05 α= (α=5 p0 p<0. (p<0.0 (α= p<0 (p<0. (α p< (p<0 (p< (p

Resumo Introdução o transtorno do espectro autista é uma condição do neurodesenvolvimento que afeta o estabelecimento de vínculos e a comunicação. Cuidados odontológicos são mais difíceis em portadores desse transtorno, pois além da dificuldade de comunicação são comuns a não cooperação na higiene bucal e uso contínuo de medicamentos. Maior predisposição à cárie, alterações no fluxo e na concentração de proteínas salivares foram relatadas nesses indivíduos. Objetivo considerando que o gênero pode afetar fluxo salivar e concentração proteica, nosso objetivo foi analisar esses parâmetros na saliva de crianças com autismo. Material e método saliva total não estimulada foi obtida de 12 meninos e 12 meninas com idades entre 5 e 15 anos, com auxílio de um cateter, após 2 horas de jejum e higienização da cavidade bucal. O fluxo salivar foi determinado estimando-se a massa de saliva e o total de proteínas foi determinado no sobrenadante obtido após centrifugação a 10.000 x g, por 10 minutos, pelo método de Lowry, com albumina bovina como padrão. Os resultados foram expressos como média e desvio padrão, sendo submetidos aos testes de Shapiro-Wilk e Mann Whitney, com nível de significância em 5%. Resultado os valores de fluxo salivar não foram significativamente diferentes quando comparados meninos (0.3555 ± 0.24 ml/min) e meninas (0.2522 ± 0.1727 mL/min), bem como os valores de proteínas (meninos: 1.430 ± 0.7480 mg/mL; meninas 1,075 ± 0,3702 mg/mL). Conclusão em crianças com transtorno do espectro autista o gênero não influencia os valores de fluxo não estimulado e proteínas salivares.

Abstract Introduction autism spectrum disorder is a neurodevelopmental condition that affects the establishment of bonds and communication. Dental care is more difficult for people with this disorder, because in addition to communication difficulties, non-cooperation with respect to oral hygiene and continuous use of medication are common. Greater predisposition to caries, as well as alterations in the flow and concentration of salivary proteins were reported in these individuals. Objective considering that sex can affect salivary flow and protein concentration, our objective was to analyze these parameters in the saliva of children with autism. Material and method total unstimulated saliva was obtained from 12 boys and 12 girls aged between 5 and 15 years, with the aid of a catheter, after 2 hours of fasting and oral hygiene. Salivary flow was determined by estimating the mass of saliva. Total protein was determined in the supernatant obtained after centrifugation at 10,000 x g, for 10 minutes, by the Lowry method, with bovine albumin as standard. The results are expressed as mean and standard deviation. The data were submitted to the Shapiro-Wilk and Mann Whitney tests, with a significance level of 5%. Result salivary flow values for boys (0.3555 ± 0.24 ml/min) and girls (0.2522 ± 0.1727 ml/min), and protein values for boys (1.430 ± 0.7480 mg/mL) and girls (1.075 ± 0.3702 mg/mL) were not significantly different between sexes. Conclusion in children with autism spectrum disorder, sex does not influence unstimulated flow and salivary protein values.

Resumo Introdução o nascimento de uma criança com deficiência intelectual exige dos pais a definição de suas funções em relação aos cuidados com a criança. Objetivo investigar o quanto as práticas de cuidados parentais, características sociodemográficas, comportamentais e o conhecimento familiar podem ter impacto na saúde bucal de crianças com deficiência intelectual na faixa etária de zero a seis anos de idade. Material e método foi avaliado o nível de ajuda cedida à criança na prática de higiene bucal de acordo com a escala de independência funcional adaptada. A Escala de Crenças Parentais e Práticas de Cuidado avaliou os cuidados primários e a estimulação oferecida à criança. Foram analisados a presença de placa dentária e o índice ceo-d. O nível de significância foi de 5%. Resultado a porcentagem relativa de placa dentária foi de 11,4%. O índice ceo-d foi de 2. A prevalência de dentes com extração indicada é maior em crianças que recebem ajuda total para higienização, quando comparadas as que recebem ajuda máxima, moderada ou supervisão. Níveis mais elevados de placa dentária e dentes cariados foram encontrados nas crianças cujos pais avaliaram a saúde dental como ruim, a higiene como deficiente e quando acreditavam que os filhos podem sentir desconforto em razão de seu estado de saúde bucal. Baixa frequência de estimulação resultou em maior índice de placa e número de dentes cariados. Conclusão a frequência de estimulação dos cuidados parentais influenciou na porcentagem do índice de placa e no número de dentes cariados nas crianças com deficiência intelectual.

Abstract Introduction the birth of a child with an intellectual disability requires the definition of the parents' roles in relation to the care of the child. Objective evaluate how much parental care practices, sociodemographic and behavioral characteristics and family knowledge can have an impact on the oral health of children with intellectual disabilities in the age group from zero to six years of age. Material and method the level of help given to the child in the practice of oral hygiene was evaluated according to the adapted functional independence scale. The Parental Beliefs and Care Practices Scale assessed primary care and stimulation offered to the child. The presence of dental plaque and the decay-missing-filled teeth (DMFT) index were analyzed. The significance level was 5%. Result the relative percentage of dental plaque was 11.4%. The DMFT was 2. The prevalence of teeth with indicated extraction is higher in children who receive full assistance for cleaning, when compared to those who receive maximum, moderate help or supervision. Higher levels of dental plaque and decayed teeth were found in children whose parents rated their dental health as poor, hygiene as deficient, and when they believed their children might feel discomfort due to their oral health. Low stimulation frequency resulted in a higher plaque index and number of decayed teeth. Conclusion the frequency of parental care stimulation influenced the percentage of plaque index and the number of decayed teeth in children with intellectual disabilities.

Abstract There are several studies that evaluate the use of lasers in periodontal treatment in non-surgical or surgical therapy. However, while several studies showed clinically beneficial effects of some lasers in periodontal treatment, there are few clinical reports of additional advantages of lasers as adjunctive treatments in periodontology. The aim of this paper is to demonstrate and critically analyze the level of scientific evidence of effects of low-level lasers and high-power lasers in periodontology. A narrative review of the studies was carried out in each topic and type of laser or periodontal treatment. In nonsurgical periodontal therapy the results showed that there is an additional clinical benefit when using a diode laser (DL) associated with scaling and root planing (SRP) in patients with moderate to severe periodontitis. The Er:YAG laser seems to be the most suitable for nonsurgical periodontal therapy and promotes the same clinical effects as conventional therapy. In periodontal surgery vaporization of the gingival or mucosal tissue can be carried out with DL, CO2, Nd:YAG, Er:YAG and Er,Cr:YSGG lasers. Photobiomodulation (PBM), mediated by low-level lasers associated with non-surgical periodontal therapy, promotes additional benefits in the short term and accelerates the bone and gingival tissue repair process and also reduces postoperative symptoms of periodontal surgery. The effect of antimicrobial Photodynamic Therapy is relevant in the initial reevaluation periods. Studies have shown controversial results of the use of lasers in periodontics, and this fact may be due to the lack of standard parameters of irradiation in each clinical application.

Resumo Introdução O autismo é uma desordem neurológica complexa de causas multifatoriais, que compromete habilidades físicas, psicológicas, emocionais e sociais, podendo dificultar os cuidados com a saúde bucal. A saliva, que pode ser coletada de forma fácil e não invasiva, vem sendo utilizada para diagnóstico e triagem de várias condições e patologias. A capacidade antioxidante total nesse fluido está reduzida em crianças com cárie e tem sido investigada como possível marcador para essa doença, mas são escassas as informações sobre antioxidantes na saliva de crianças com o Transtorno do Espectro do Autismo (TEA). Objetivo O objetivo desse estudo preliminar foi verificar a influência do gênero na diferença da capacidade antioxidante e no dano oxidativo proteico, na saliva de crianças com TEA. Material e método A saliva total foi obtida por aspiração, entre 8:00 e 11:00 horas, de 12 meninas e 12 meninos com idades entre 5 e 15 anos, com diagnóstico prévio de TEA. A capacidade antioxidante total, o ácido úrico, a concentração total de proteínas e o dano oxidativo proteico foram analisados por espectrofotometria. Os valores de média e desvio padrão foram testados quanto à normalidade (Shapiro-Wilk teste) e comparados com o teste Mann Whitney. O nível de significância foi estabelecido em 5%. Resultado Nenhuma diferença significativa entre os grupos foi observada, nos parâmetros analisados (P>0,05). Conclusão Com base nos resultados obtidos, concluímos que o gênero não influencia nos níveis de marcadores do estresse oxidativo na saliva de crianças com TEA.

Abstract Introduction Autism is a complex neurological disorder with multifactorial causes, which compromises physical, psychological, emotional and social skills. This disorder also impairs dental care and patient oral health. Saliva can be easily obtained using a non-invasive technique and has been used in the diagnosis and screening of many pathologies. Total antioxidant capacity of saliva is reduced in the presence of caries in children and has been studied as a possible marker for autism. However, data on salivary antioxidants in children with autism spectrum disorder (ASD) is scarce. Objective This preliminary study evaluated the existence of gender influence on non-enzymatic antioxidant capacity and protein oxidative damage in the saliva of children with this disorder. Our hypothesis is that there are gender differences in these biochemical parameters in children with austim. Material and method Whole saliva samples were collected by aspiration between 8:00-11:00 am from 12 girls and 12 boys aged 5 to 15 years, with previous diagnosis for this disorder. Total antioxidant capacity, uric acid, protein concentration and oxidative damage to proteins were analyzed by spectrophotometry. Values were presented as mean ± standard deviation and tested for adherence to normality (Shapiro-Wilk test). The data were then compared using the Mann-Whitney test, considering a 5% significance level. Result There was no significant difference between groups for all analyzed parameters (P>0.05). Conclusion Based on the results obtained, we concluded that gender does not influence the levels of oxidative stress markers in the saliva of children with ASD.

Abstract The aim of this study was to perform a systematic review and meta-analysis to examine the effect of systemic antibiotics in the periodontal treatment of smokers. The selection criteria were as follows: controlled randomized clinical trials; studies published in English; studies with smoker patients diagnosed with chronic periodontitis; patients without systemic diseases; studies that used systemic antibiotic therapy associated with periodontal treatment; studies that presented results for the test and control groups and assessments of clinical periodontal parameters, such as probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL). The differences in average weights were calculated with a confidence interval (CI) of 95% for PD reduction, CAL gain and BOP. The means of the periodontal clinical parameters were compared between the baseline and post-treatment periods between the test groups and the control groups. The heterogeneity was assessed using the Cochran Q test (Q (df = 3), α = 5%). A total of 67 articles were found, and after the selection process, three randomized controlled trials were included in the meta-analysis. The results indicate that SRP associated with systemic antibiotics promoted additional benefits when compared to SRP alone, with a greater reduction of PD (p = 0.0359, CI = -0.42, -0.01) and a gain of CAL (p = 0.0161, CI = -0.39, -0.04). There was a modest PD reduction (PD, DM -0.21) and a modest CAL gain (CAL, DM -0.22). The results of our meta-analysis reveal the clinical benefits of systemic antibiotics as an adjunct to the non-surgical periodontal treatment of smokers. These clinical improvements, although statistically significant, appeared to be of little clinical relevance.

INTRODUÇÃO: Estudos recentes são direcionados a explorar a relação da faixa da mucosa queratinizada com a saúde dos tecidos peri-implantares. Quando esta faixa não é suficiente, uma cirurgia para o aumento de mucosa queratinizada pode ser indicada, pois tem sido relatado que a presença ou a reconstrução de tecido queratinizado ao redor de implantes pode facilitar os procedimentos restauradores, promover a estética e ainda permitir a manutenção de uma higienização oral rotineira sem irritação ou desconforto ao paciente. Dentre os procedimentos cirúrgicos disponíveis, a técnica do enxerto gengival livre é consagrada na literatura periodontal para aumento da faixa de mucosa queratinizada. OBJETIVO: Este estudo relata um caso clínico em que foi realizada cirurgia de enxerto gengival livre com objetivo de aumentar a faixa da mucosa queratinizada na região de implantes previamente instalados na maxila, para suporte de prótese tipo protocolo. RELATO DO CASO: Foi realizada a cirurgia de enxerto gengival livre na região anterior da maxila, obtido do palato, na qual haviam sido instalados implantes osseointegrados para suporte de prótese tipo protocolo e a mucosa peri-implantar apresentava-se sem tecido queratinizado e inflamada. Após dois meses de reparação da cirurgia mucogengival, foi possível observar que o enxerto gengival livre favoreceu a saúde peri-implantar e os procedimentos protéticos de moldagem. CONCLUSÃO: Diante dos resultados clínicos, pode-se concluir que o enxerto gengival livre é uma técnica previsível e de fácil realização para aumento da faixa de mucosa queratinizada em mucosa peri-implantar de prótese protocolo.

INTRODUCTION: Recent studies have evaluated the relationship between the width of keratinized mucosa and peri-implant tissue health. Insufficiently wide keratinized tissue can be increased surgically, for example by free gingival grafting. The presence or reconstruction of keratinized tissue around the implant can facilitate restorative procedures, promote aesthetics and allow the maintenance of an oral hygiene routine without irritation or discomfort to the patient. OBJECTIVE: To describe a patient who underwent free gingival graft surgery to increase the width of keratinized tissue in the region of previously implants to support a type of prosthetic protocol. CASE REPORT: A patient who had received dental implants to support a type of prosthetic protocol presented with inflamed peri‑implant mucosa, but with no keratinized tissue. Free gingival tissue was obtained from the palate and grafted into the anterior maxilla. Sixty days after muco-gingival surgery, we observed that the free gingival graft favored peri-implant health and prosthetic casting. CONCLUSION: The free gingival graft technique is both easy to perform and effective in increasing the width of keratinized mucosa following implantation.

The aim of this study was to conduct an in vitro evaluation, by scanning electron microscopy (SEM), of the adhesion of blood components on root surfaces irradiated with Er,Cr:YSGG (2.78 µm) or Er:YAG (2.94 µm) laser, and of the irradiation effects on root surface morphology. Sixty samples of human teeth were previously scaled with manual instruments and divided into three groups of 20 samples each: G1 (control group) - no treatment; G2 - Er,Cr:YSGG laser irradiation; G3 - Er:YAG laser irradiation. After performing these treatments, blood tissue was applied to 10 samples of each group, whereas 10 samples received no blood tissue application. After performing the laboratory treatments, the samples were observed under SEM, and the resulting photomicrographs were classified according to a blood component adhesion scoring system and root morphology. The results were analyzed statistically (Kruskall-Wallis and Mann Whitney tests, α= 5%). The root surfaces irradiated with Er:YAG and Er,Cr:YSGG lasers presented greater roughness than those in the control group. Regarding blood component adhesion, the results showed a lower degree of adhesion in G2 than in G1 and G3 (G1 × G2: p = 0.002; G3 × G2: p = 0.017). The Er:YAG and Er,Cr:YSGG laser treatments caused more extensive root surface changes. The Er:YAG laser treatment promoted a greater degree of blood component adhesion to root surfaces, compared to the Er,Cr:YSGG treatment.

OBJECTIVE: The aim of this study was to assess radiographically the effect of photodynamic therapy (PDT) as an adjunctive treatment to scaling and root planing (SRP) on induced periodontitis in dexamethasone-induced immunosuppressed rats. MATERIAL AND METHODS: The animals were divided into 2 groups: ND group (n=60): saline treatment; D group (n=60): dexamethasone treatment. In both ND and D groups, periodontal disease was induced by the placement of a ligature in the left first mandibular molar. After 7 days, ligature was removed and all animals received SRP, being divided according to the following treatments: SRP: saline and PDT: phenothiazinium dye (TBO) plus laser irradiation. Ten animals per treatment were killed at 7, 15 and 30 days. The distance between the cementoenamel junction and the height of the alveolar bone crest in the mesial surface of the mandibular left first molars was determined in millimeters in each radiograph. he radiographic values were analyzed statistically by ANOVA and Tukey's test at a p value <0.05. RESULTS: Intragroup radiographic assessment (ND and D groups) showed that there was statistically signifcant less bone loss in the animals treated with PDT in all experimental periods compared to those submitted to SRP. Intergroup radiographic analysis (ND and D groups) demonstrated that there was greater bone loss in the ND group treated with SRP compared to the D group treated with PDT at 7 and 30 days. CONCLUSION: PDT was an effective adjunctive treatment to SRP on induced periodontitis in dexamethasone-induced immunosuppressed rats.

A utilização do CarisolvTM tem sido proposta como um método auxiliar à raspagem e ao alisamento radicular (RAR), a fim de facilitar a descontaminação da superfície da raiz. O objetivo deste estudo foi avaliar, através da microscopia eletrônica de varredura (MEV), as características das superfícies radiculares, após a aplicação do CarisolvTM em associação à RAR. Sessenta dentes humanos extraídos devido à doença periodontal foram divididos em 6 grupos: 1) RAR ; 2) CarisolvTM (aplicação passiva) + RAR; 3) CarisolvTM (aplicação ativa) + RAR; 4) CarisolvTM (aplicações múltiplas) + RAR; 5) RAR + EDTA a 24%; 6) CarisolvTM + RAR + EDTA a 24%. CarisolvTM foi aplicado às superfícies radiculares por 30 s, seguido de raspagem e alisamento radicular, que consistiu de 50 movimentos com curetas de Gracey no sentido corono-apical, co o instrumento paralelo ao longo eixo do dente. A única exceção foi o grupo 4, no qual as raízes foram instrumentadas até obter uma superfície lisa, dura e com aspecto vítreo. Os espécimens tratados foram preparados e examinados em MEV. Os resultados demonstraram que a associação do CarisolvTM aos procedimentos periodontais mecânicos proporcionou modificações significativas na superfície radicular quando comparada à raspagem e ao alisamento radicular, apenas quando o CarisolvTM foi aplicado de forma ativa. A aplicação do CarisolvTM uma única vez, apresentou um efeito limitado na capacidade de remoção de smear layer, sendo que aplicações sucessivas apresentaram resultados comparáveis àqueles obtidos após a aplicação do EDTA.

The aim of this study was to analyze, under scanning electron microscopy (SEM), the morphologic characteristics of root surfaces after application of CarisolvTM gel in association with scaling and root planing (SRP). Sixty periodontally compromised extracted human teeth were randomly assigned to 6 groups: 1) SRP alone; 2) passive topical application of CarisolvTM + SRP; 3) active topical application of CarisolvTM + SRP; 4) multiple applications of CarisolvTM + SRP; 5) SRP + 24% EDTA; 6) topical application of CarisolvTM + SRP + 24% EDTA. CarisolvTM gel was applied to root surfaces for 30 s, followed by scaling and root planing, consisting of 50 strokes with Gracey curettes in an apical-coronal direction, parallel to the long axis of the tooth. The only exception was group 4, in which the roots were instrumented until a smooth, hard and glass-like surface was achieved. All specimens were further analyzed by SEM. The results showed that the treatment with CarisolvTM caused significant changes in root surface morphology of periodontally compromised teeth only when the chemical agent was actively applied (burnishing technique). CarisolvTM failed to remove the smear layer completely, especially with a single application, independently of the method of application. Multiple applications of CarisolvTM were necessary to achieve a smear layer reduction comparable to that obtained with 24% EDTA conditioning.

O objetivo do presente estudo foi comparar, através de microscopia eletrônica de varredura, a remoção de smear layer de superfícies radiculares após aplicação tópica de gel de EDTA com gel de EDTA-T (Texapon). Foram utilizados dentes humanos que foram submetidos a remoção de cemento radicular e raspagem. As amostras dos dentes foram divididas em 3 grupos: Grupo I- (controle) (n=20); Grupo II- gel de EDTA (pH 7,0) nas concentrações de 5%,10%,15%,20% e 24% (n=100); Grupo II -gel de EDTA-T (pH 7,0) nas concentrações acima descritas (n=100). As fotomicrografias foram avaliadas através de um índice e os dados foram estatisticamente analisados. Ambos os tratamentos com EDTA foram efetivos na remoção de smear layer quando comparados ao grupo controle. O gel de EDTA a 5% demonstrou maior capacidade na remoção de smear layer quando comparado com as concentrações de 15%, 20% e 24% (p<0,05). Não houve diferença entre as concentrações de géis de EDTA-T (p>0,05). Os géis de EDTA foram mais efetivos que o EDTA-T nas concentrações de 5 e 10%. Os resultados sugerem que a aplicação tópica de EDTA ou EDTA-T é efetiva na remoção de smear layer, principamente em baixas concentrações e a adição do Texapon não promove vantagens neste tratamento.

The aim of the present study was to compare root surface smear layer removal following topical application of EDTA and EDTA-T (Texapon). Extracted human teeth had their cementum removed and were mechanically scaled. A total of 220 root specimens were obtained and were randomly assigned to the following groups: I-saline solution (control), II-EDTA; III-EDTA-T. Groups II and III specimens were assigned to different EDTA gel concentrations: 5%, 10%, 15%, 20% and 24%. Smear layer removal score was assessed for each specimen by scanning electron microscopy. The results demonstrated that EDTA and EDTA-T gel led to a higher root surface smear layer removal when compared to the control group. The 5% EDTA gel also showed a higher smear layer removal than the 15%, 20% and 24% EDTA gels (p<0.05). No difference could be found between the different concentrations of EDTA-T gels tested (p>0.05). EDTA gels had statistically significantly lower smear layer scores than the EDTA-T gels for the 5% and 10% concentrations. The results suggested that topical application of EDTA or EDTA-T gel led to significant smear layer removal of the mechanically treated root surfaces. The addition of a detergent to the EDTA gel formula did not improve smear layer removal of the root surface.

A raspagem gera "smear layer", a qual contém microrganismos e toxinas que podem interferir no reparo periodontal. Por esse motivo, diferentes substâncias têm sido empregadas para remover esta camada e expor fibras colágenas da superfície dental. A adesão de elementos sangüíneos a superfícies radiculares desmineralizadas e a estabilização do colágeno pelas fibras colágenas são de extrema importância no sucesso da cirurgia periodontal. O objetivo deste estudo foi avaliar os diferentes padrões de adsorção e adesão de elementos sangüíneos a superfícies radiculares apenas irrigadas com água destilada e após aplicação de um gel de EDTA manipulado ou um industrializado. Trinta amostras foram raspadas, eqüitativamente divididas em 3 grupos e tratadas com água destilada (controle), um gel de EDTA manipulado ou um industrializado. Imediatamente foram expostas a sangue fresco e preparadas para microscopia eletrônica de varredura. As superfícies dentinárias apenas raspadas apresentaram os melhores resultados, com moderada quantidade de células sangüíneas entremeadas em uma fina rede de fibrina. No grupo de EDTA manipulado, a rede de fibrina foi pouco visível com escassas células. Os piores resultados foram observados com o EDTA industrializado, caracterizados pela ausência de elementos sangüíneos. Estatisticamente houve diferença apenas entre os grupos controle e EDTA industrializado. As superfícies apenas irrigadas apresentaram rede de fibrina mais bem organizada com células entremeadas.

Root debridement generates a smear layer which contains microorganisms and toxins that could interfere in periodontal healing. For this reason, different substances have been used to remove it and to expose collagen fibers at the tooth surface. Blood element adhesion to demineralized roots and clot stabilization by collagen fibers are extremely important for the success of periodontal surgery. The aim of this study was to evaluate the different patterns of blood element adsorption and adhesion to root surfaces only irrigated with distilled water and after application of a manipulated or an industrialized EDTA gel. Thirty samples were planed, equally divided into three groups and treated with distilled water (control), a manipulated EDTA gel or an industrialized one. Immediately after, samples were exposed to fresh blood and prepared for scanning electron microscopy. Untreated planed dentin presented the best results with blood cells entrapped in a thick web of fibrin. In the manipulated EDTA group, the web of fibrin was thick with sparse blood elements. The worst result was seen with the industrialized EDTA group, in which no blood elements could be seen. Statistical difference was obtained between control and industrialized EDTA groups. Surfaces only irrigated presented the most organized fibrin network and cell entrapment.

O objetivo do presente estudo foi comparar, através de microscopia eletrônica de varredura, o efeito da aplicação de gel de EDTA e de EDTA-T (texapon) em diferentes concentrações (5%, 10%, 15%, 20% e 24%) na remoção de "smear layer" de superfícies radiculares previamente raspadas com instrumentos manuais. Duzentos e vinte espécimes de superfícies radiculares submetidas à raspagem foram divididos em 3 grupos. Grupo I - (controle) solução salina (n = 20); Grupo II - gel de EDTA (pH 7,0) nas concentrações de 5%, 10%, 15%, 20% e 24% (n = 100); Grupo III - gel de EDTA-T (pH 7,0) nas concentrações acima descritas (n = 100). As fotomicrografias obtidas foram avaliadas por um examinador calibrado através da aplicação de um índice de remoção de "smear layer", e os dados foram analisados através de análise estatística (teste de Kruskal-Wallis). Os resultados demonstraram que todos os tratamentos com EDTA e EDTA-T foram mais efetivos na remoção de "smear layer" quando comparados com o grupo controle (p < 0,01), e que não houve diferenças estatisticamente significantes entre os grupos tratados com EDTA e EDTA-T nas diversas concentrações (Mann-Whitney, p > 0,05). Dentro dos limites deste estudo, pode-se concluir que todas as modalidades de tratamento foram efetivas na remoção de "smear layer" e a adição de texapon ao gel de EDTA não aumentou a efetividade do tratamento.

The purpose of this study was to compare the removal of root surface smear layer following active application of EDTA gel and EDTA-T (texapon) gel in different concentrations (5%, 10%, 15%, 20% and 24%), using scanning electron microscopy. A total of 220 dentin blocks obtained from the root surfaces of extracted teeth were divided into 3 groups: Group I - (control) application of saline solution (n = 20); Group II - EDTA gel (pH 7.0) was applied in the following concentrations: 5%, 10%, 15%, 20% and 24% (n = 100); Group III - EDTA-T gel (pH 7.0) applied in the same concentrations described above (n = 100). The photomicrographs were evaluated by one calibrated examiner using a smear layer removal index and following statistical analysis (Kruskal-Wallis test). The results demonstrated that the specimens treated with EDTA and EDTA-T gel presented a better smear layer removal than the control group (p < 0.01); no statistically significant differences were observed between the EDTA and EDTA-T groups and between the concentrations tested (Mann-Whitney, p > 0.05). Within the limits of this study, it can be concluded that all treatment modalities effectively removed the smear layer from the root surface. The addition of texapon into the EDTA gel formulation did not increase its effectiveness.

O objetivo do presente estudo foi analisar morfologicamente, através de microscopia eletrônica de varredura, os efeitos do laser de Er:YAG no tratamento de superfícies radiculares submetidas à raspagem e aplainamento radicular com instrumentos manuais. Foram utilizados 18 espécimes (n = 18) de superfícies radiculares que após ser submetidos à raspagem e aplainamento radicular foram divididos em 3 grupos (n = 6). O grupo controle (G1) não sofreu nenhum tratamento; Grupo 2 (G2) foi irradiado com laser de Er:YAG (2,94 mim) 47 mJ/10 Hz, focalizado,com refrigeração à água durante 15 s e fluência de pulso de 0,57 J/cm²; Grupo 3 (G3) foi irradiado com laser de Er:YAG (2,94 mim), 83 mJ/10 Hz, focalizado, com refrigeração à agua durante 15 s e fluência de pulso de 1,03 J/cm². Através da análise dos resultados podemos concluir que o laser de Er:YAG nos parâmetros utilizados no G3 promove a remoção de "smear layer" da superfície radicular e exposição dos túbulos dentinários, porém o laser promove aspecto irregular na superfície, apesar de não demonstrar crateras, fendas, fraturas e carbonização, necessitando de estudos que demonstrem a biocompatibilidade desta superfície no processo de reparo periodontal.

The purpose of this study was to morphologically evaluate, by means of scanning electron microscopy, the effects of Er:YAG laser on the treatment of root surfaces submitted to scaling and root planing with conventional periodontal instruments. Eighteen root surfaces (n = 18), which had been previously scaled and planed, were assigned to 3 groups (n = 6). The control Group (G1) received no further treatment; Group 2 (G2) was irradiated with Er:YAG laser (2.94 mum), with 47 mJ/10 Hz, in a focused mode with air/water spray during 15 s and with 0.57 J/cm² of fluency per pulse; Group 3 (G 3) was irradiated with Er:YAG laser (2.94 mum), with 83 mJ/10 Hz, in a focused mode with air/water spray during 15 s and with 1.03 J/cm² of fluency per pulse. We concluded that the parameters adopted for Group 3 removed the smear layer from the root surface, exposing the dentinal tubules. Although no fissures, cracks or carbonized areas were observed, an irregular surface was produced by Er:YAG laser irradiation. Thus, the biocompatibility of the irradiated root surface, within the periodontal healing process, must be assessed.