Resumen Objetivo La periodontitis en dentición primaria es excepcional en niños sin enfermedades sistémicas. El objetivo de este informe es describir las características clínicas y radiográficas de dos casos de niños de 3 años sistémicamente sanos con periodontitis, y su tratamiento con seguimiento a 5 años. Casos clínicos En ambos casos, a los 3 años de edad los niños fueron derivados al especialista en periodoncia por su odontopediatra debido a la pérdida muy temprana de incisivos inferiores. El examen clínico y radiográfico mostró pérdida de inserción clínica, pérdida ósea y movilidad dental en otros incisivos superiores e inferiores. Se realizó la interconsulta médica y se descartó que los niños padecieran enfermedades relacionadas con el diagnóstico de periodontitis como manifestación de una enfermedad sistémica. El tratamiento consistió en la instrucción de medidas de higiene bucal que debían ser ejecutadas por los padres, instrumentación subgingival, antisépticos locales, medicación antibiótica sistémica y mantenimiento periodontal. No se realizaron extracciones como parte del tratamiento. En ambos casos uno de los incisivos presentes al momento de la consulta se perdió prematuramente, antes de los 4 años. El resto de los incisivos primarios cumplieron su ciclo normal. Luego de 5 años de seguimiento, a la edad de 8 años, ambos niños presentaban los incisivos y los primeros molares permanentes periodontalmente sanos y el resto de los dientes primarios sin signos de periodontitis.

Abstract Aim Periodontitis in primary dentition is exceptional in children without systemic diseases. The objective of this article is to describe the clinical and radiographic characteristics of two cases of systemically healthy 3-year-old children with periodontitis, and their treatment, with a 5-year follow-up. Clinical cases In both cases, at 3 years of age, the children were referred to a periodontic specialist by their pediatric dentist, due to the very early loss of lower incisors. Clinical and radiographic examination showed loss of clinical attachment, bone loss and dental mobility in other upper and lower incisors. A medical consultation was carried out and diseases related to the diagnosis of periodontitis as a manifestation of a systemic disease were ruled out. The treatment consisted of instruction on oral hygiene measures that had to be carried out by the parents, subgingival instrumentation, local antiseptics, systemic antibiotic medication, and periodontal maintenance. No extractions were performed as part of the treatment. In both cases, one of the incisors present at the time of consultation was lost prematurely, before the age of 4 years. The rest of the primary incisors completed their normal cycle. After 5 years of follow-up, at the age of 8 years, both children showed periodontally healthy incisors and first permanent molars, and the rest of the primary teeth without signs of periodontitis.

Resumen Este año la Revista de la Asociación Odontológica Argentina inaugura la publicación continua. Esta nueva modalidad de publicación cuenta con numerosas ventajas, tanto para los autores interesados en compartir sus trabajos como para los lectores, que tendrán la información disponible con mayor rapidez. Se seguirán editando tres números anuales, pero cada uno de los artículos se irá publicando a medida que se complete su edición. En cuanto a la citación, cada artículo contará con un numero único que indica su ubicación en la revista y su correspondiente identificador de objeto digital (DOI).

Abstract This year the Journal of the Argentine Dental Association inaugurates the continuous publication model. This new publication modality has numerous advantages, both for authors interested in sharing their work, and for readers who will have the information available more quickly. The journal will continue publishing three annual issues, but each one of the articles will be published as their edition is completed. Regarding the citation, each article will have a unique number that indicates its location in the journal and its corresponding digital object identifier (DOI).

Abstract The aim of this study was to investigate the impact of smoking on gingival inflammation in a representative sample of 1,650 adults from Santiago (Chile), Porto Alegre (Brazil), and Tucumán (Argentina). A questionnaire was administered to participants to gather demographic and behavioral characteristics, including smoking habits. The participants were clinically examined to obtain gingival index (GI), gingival bleeding index (GBI), visible plaque index (VPI), and calculus presence values. Gingival inflammation was defined as a mean GI > 0.5. Heavy smokers presented significantly lower levels of gingival inflammation, as reflected by both GI and GBI, than both light and moderate smokers, despite their having increased amounts of plaque and calculus. Being 50 years old or older [odds ratio (OR), 1.93], a VPI ≥ 30% (OR, 28.1), and self-reported diabetes (OR, 2.79) were positively associated with detection of gingival inflammation. In conclusion, the occurrence of clinically detectable gingival inflammation was lower in heavy smokers than light and moderate smokers. Older age, diabetes, and visible plaque emerged as risk indicators of gingivitis. Plaque and gingival indices are significantly associated regardless of the smoking status.

Abstract The aims of this study were to describe the self-reported oral hygiene habits, dental visit frequency, and gingival bleeding perception in adult populations from three South American cities, and also to assess the association of these variables with sociodemographic data and with the clinical presence of plaque and gingival inflammation. Five-hundred and fifty adult subjects from each city (Porto Alegre, Brazil; Tucumán, Argentina; Santiago, Chile) received full mouth examinations to determine visible plaque and gingival index. A structured questionnaire on demographics, habits, attitudes and knowledge of oral health was also administered. The data were analyzed according to dental visit frequency, toothbrushing frequency, interproximal tooth cleaning frequency, subjects’ perception of gum bleeding, and proportion of subject sites with VP and bleeding sites. Analysis of the association among the variables was performed using either a chi-square test or Fischer's exact test. Toothbrushing twice a day or more was reported by 84.2% of the subjects, but only 17.7% reported daily interdental cleaning, and 60.2% reported visiting a dental clinic only in an emergency. Only 2.97% had no bleeding sites, whereas 33.7% had 50% or more bleeding sites. Regular interdental self-cleaning and a dental visit every 3-6 months was associated with less plaque and less gingival bleeding. More than 12 years of education was associated with healthier habits, less bleeding and plaque scores. In conclusion, the oral health behavior of South American adult subjects from these cities is below the international recommendations, especially in relation to interdental cleaning and regular dental visits.

ABSTRACT Objectives: The aim of this study is to investigate the prevalence and severity of gingival inflammation and associated risk indicators in South American adults. Material and Methods: Multi-stage samples totaling 1,650 adults from Porto Alegre (Brazil), Tucumán (Argentina), and Santiago (Chile) were assessed. The sampling procedure consisted of a 4-stage process. Examinations were performed in mobile dental units by calibrated examiners. A multivariable logistic regression model was utilized for associating variables as indicators of gingival inflammation (GI) (Gingival Index ≥0.5). Statistical significance was set at 0.05. Results: A total of 96.5% of the adults have GI. Regarding the severity of GI, 22.5% of participants examined have mild GI, 74.0% have moderate GI, and 3.6% have severe GI. The multivariate analyses identify the main risk indicators for GI as adults with higher mean of Calculus Index (OR=18.59); with a Visible Plaque Index ≥30% (OR=14.56); living in Santiago (OR=7.17); having ≤12 years of schooling (OR=2.18), and females (OR=1.93). Conclusions: This study shows a high prevalence and severity of gingival inflammation, being the first one performed in adult populations in three cities of South America.

The aim of this study was to evaluate clinical and microbiological effects of subgingival minocycline microgranules when used as an adjunct to scaling and root planing in subjects with Chronic periodontitis. Twenty-six non-smoker volunteers participated in the study. Four opposite sites, clinically standardized, with bleeding on probing (BOP) and pocket depth (PD) = 6 mm were selected. Baseline BOP, PD and Clinical attachment level (CAL) were measured and microbiological samples were collected from the study sites and analyzed using PCR. Porphyromonas gingivalis (Pg) Tannerella forsythia (Tf), Treponema denticola (Td) and Aggregatibacter actinomycetemcomitans (Aa) were detected. One side of the mouth was randomly allocated to the experimental treatment: scaling and root planing plus minocycline microgranules (Test group=T) and the other side of the mouth to scaling and root planing alone (Control group=C). At days 30 and 90, clinical and microbiological examination was repeated. After 30 days BOP was reduced to 81% in C and to 12% in T and at day 90 to 58% in C and to 8% in T (p<0.05). PD was significantly reduced in both groups (C: 4.8mm, T: 4.2mm) favoring T at days 30 and 90 (p<0.05). CAL reduction at day 30 showed no difference between groups. At day 90, CAL reduction was higher in T (p<0.05). At days 30 and 90 Pg, Tf, Td and Aa was reduced in both groups. Pg reduction was significantly greater in group T. At day 90 frequency of sites with Td decreased in T and increased in C (p<0.05). No adverse effect was observed. This study showed that minocycline microgranules adjunct to scaling and root planing resulted in grater reduction of BOP and PD, higher CAL gain, increased probability of Pg suppression and retarded recolonization of Td than root instrumentation alone.

El objetivo de este estudio fue evaluar el efecto clinico y microbiologico de microgranulos de Minociclina, colocados subgingivalmente como coadyuvante del raspaje y alisado radicular en pacientes con Periodontitis cronica severa. Participaron 26 sujetos voluntarios con Periodontitis cronica, no fumadores. Se seleccionaron 4 sitios contralaterales con Sangrado al Sondaje (SS) y Profundidad al Sondaje (PS) = 6 mm. Condicion Basal (CB): se registro SS, PS y Nivel de Insercion (NI). Se determino mediante PCR presencia de Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td) y Aggregatibacter actinomycetemcomitans (Aa). Un lado de la boca fue aleatoriamente asignado al tratamiento experimental: grupo T, el otro al tratamiento control: grupo C. Al dia 30 y 90 se repitieron los examenes clinicos y micro - biologicos. Dia 30: el SS se redujo al 81% en el grupo C y al 12% en el grupo T (p<0,05).Estas diferencias se mantuvieron al dia 90 (C: 58%, T: 8%) (p<0.05).Dia 30 y 90: hubo dismi - nucion de la PS en ambos grupos, siendo significativamente mayor en el grupo T (p<0,05).En ambos grupos hubo disminucion significativa del NI (p<0,05), no hubo diferencias entre los grupos al dia 30 y si al dia 90. A los 30 y 90 dias en ambos grupos se redujo la prevalencia para Pg, Tf ,Td y Aa. A los 30 y 90 dias la reduccion de sitios con Pg fue mayor en el grupo T (p=0,002). A los 90 dia Td disminuyo en el grupo T y aumento en el grupo C (p=0,023).No se observaron efectos adversos. Los resultados mostraron que la aplicacion subgingival de microgranulos de minociclina adjunta al raspaje y alisado radicular produjo una reduccion mayor del SS, la PS y el NI que el raspaje y alisado solo,aumento la probabilidad de suprimir Pg y retardo la recolonizacion con Td.

Our understanding of dental plaque biofilm has evolved since the nonspecific plaque hypothesis that considered plaque as a nonspecific mass of native microorganisms that, because of lack of oral hygiene, builds up in proportions great enough to overcome the host resistance threshold and affect the tooth structure and tooth supporting tissues. A great diversity of microorganisms-over 700 species-was detected in the oral cavity, and evidence shows that the investigation of specific microorganisms or associations of microorganisms as etiological agents for periodontal diseases and caries is not a simplistic approach. Although clinical evidence shows that oral mechanical hygiene is fundamental to prevent and control caries and periodontal disease, it is important to highlight that optimal control is not achieved by most individuals. Thus the complementary use of chemotherapeutic agents has been investigated as a way to overcome the deficiencies of mechanical oral hygiene habits, insofar as they reduce both plaque formation and gingival inflammation, and represent a valid strategy to change the biofilm and maintain dental and periodontal health. The role of the dental professional is to monitor patients and offer them the best recommendations to preserve oral health throughout their life. With this in mind, chemical control should be indicated as part of daily oral hygiene, together with mechanical procedures, for all individuals who present supragingival and/or subgingival biofilm, taking into account age, physical and/or psychological limitations, allergies, and other factors.

In clinical trials, Spiramycin has shown additional benefit over scaling and root planing on pocket depth reduction, but its effect on periodontal microbiota was evaluated only by darkfield microscopy. Therefore, this study was conducted to determine the effect of Spiramycin administration on Porphyromonas gingivalis and other periodontopathic bacteria using 16S rARN PCR technique. Thirty two non-smoker adults with untreated periodontitis and pocket depth ≥ 7 mm. were evaluated to participate in this randomized placebo-controlled clinical trial. Clinical measurements were performed on day -15, 15, 30 and 90 from baseline. Subgingival samples were analyzed for detection of Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td) and Aggregatibacter actinomycetemcomitans (Aa) on days -15, 30 and 90. On day 0, 25 Pg positive subjects were randomly assigned to receive either systemically administered Spiramycin for 7 days (Test group SP) or identical placebo tablets (Placebo group PL). After Spiramycin administration Pg, Tf and Td were suppressed showing statistically significant difference (p<0.05) with the Placebo group. None of the groups showed changes in Aa detection. These data indicate that bacteria currently associated with advanced periodontitis (Pg, Tf and Td) are suppressed after 7 days of systemic administration of Spiramycin.

Los estudios clinicos indican un efecto adicional beneficioso de la Espiramicina cuando se la utiliza junto con el raspaje y alisado radicular. Hasta el presente su efecto sobre la microbiota periodontal ha sido estudiado solo con microscopio de campo oscuro. El objetivo del presente estudio fue evaluar el efecto de la Espiramicina sobre Porphyromonas gingivalis y otros patogenos periodontales “clasicos” con la tecnica PCR utilizando el gen 16S del ARNr. Participaron de este estudio clinico-controlado randomizado 32 sujetos adultos, no fumadores, con enfermedad periodontal no tratada, con bolsas periodontales ≥ a 7 mm. Se registraron parametros clinicos en el dia -15, 15, 30 y 90 de iniciado el estudio. Se analizo el biofilm periodontal subgingival con PCR, identificandose Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td) y Aggregatibacter actinomycetemcomitans (Aa), en el dia 30 y 90. En el dia 0, 25 sujetos positivo para Porphyromonas gingivalis se dividieron aleatoriamente en dos grupos: Grupo Test (Espiramicina 7 dias) y Grupo Control (Placebo 7 dias). La Espiramicina fue efectiva sobre Pg, Tf, Td. Hubo diferencia (p<0,05) con el grupo control. Ninguno de los grupos mostro diferencias para Aa. Estos datos indicarian que la Espiramicina fue efectiva sobre las bacterias que actualmente se asocian con periodontitis severas (Pg, Tf, Td) luego de la administracion sistemica durante 7 dias.