Effect of enamel matrix proteins on the treatment of intrabony defects: a split-mouth randomized controlled trial study

The objective of this split-mouth, double-blind, randomized controlled trial was to compare the clinical effect of treatment of 2- or 3-wall intrabony defects with open flap debridement (OFD) combined or not with enamel matrix proteins (EMP). Thirteen volunteers were selected with one pair of or more intrabony defects and probing pocket depth (PPD) > or = 5 mm. All individuals received instructions regarding oral hygiene and were submitted to scaling and root planing. Each participant received the two treatment modalities: test sites were treated with OFD and EMP, and control sites received only OFD. After 6 months, a significant reduction was observed in PPD for the EMP group (from 6.42 +/- 1.08 mm to 2.67 +/- 1.15 mm) and for the OFD group (from 6.08 +/- 1.00 mm to 2.00 +/- 0.95 mm) (p < 0.0001), but with no significant difference between groups (p = 0.13). A significant gain in relative attachment level (RAL) was observed in both groups (EMP: from 13.42 +/- 1.88 mm to 10.75 +/- 2.26 mm, p < 0.001; OFD: from 12.42 +/- 1.98 mm to 10.58 +/- 2.23 mm, p = 0.013), but with no significant difference between groups (p = 0.85). Gingival recession (GR) was higher in the EMP group (from 1.08 +/- 1.50 mm to 2.33 +/- 1.43 mm; p = 0.0009) than in the OFD group (from 0.66 +/- 1.15 mm to 1.16 +/- 1.33 mm; p = 0.16), but this difference was not significant (p = 0.06). In conclusion, the results showed that OFD combined with EMP was not able to improve treatment of intrabony defects compared to OFD alone.     

Brazilian gutta-percha points. Part II: thermal properties

This study was undertaken to explore the effect of heating on gutta-percha, analyzing the occurrence of endothermic peaks corresponding to the transformation that occurs in the crystalline structure of the polymer during thermal manipulation. This study also sought to determine the temperature at which these peaks occur, causing a transformation from the beta- to the alpha-form, and from the alpha- to the amorphous phase. Eight nonstandardized gutta-percha points commercially available in Brazil (Konne, Tanari, Endopoint, Odous, Dentsply 0.04, Dentsply 0.06, Dentsply TP, Dentsply FM) and pure gutta-percha (control) were analysed using differential scanning calorimetry (DSC) and thermogravimetry analysis (TGA). The transition temperatures were determined and analysed. With the exception of Dentsply 0.04 and Dentsply 0.06, the majority of the products showed thermal behaviour typical of beta-gutta-percha, with two endothermic peaks, exhibiting two crystalline transformations upon heating from ambient temperature to 130 degrees. Upon cooling and reheating, few samples presented two endothermic peaks. It was concluded that heating dental gutta-percha to 130 degrees C causes changes to its chemical structure which permanently alter its physical properties.     

Multiple hyperdontia: Report of an unusual case

Supernumerary teeth are an infrequent developmental anomaly that can appear in any area of the dental arch and can affect any dental organ. Multiple supernumerary teeth, or hyperdontia, is rare in people with no other associated diseases or syndromes. Conditions commonly associated with hyperdontia include cleft lip and palate, trichorhinophalangeal syndrome, cleidocranial dysplasia, and Gardner's syndrome. A black girl, aged 11 years 8 months, came for consultation; radiographs showed 81 teeth: 18 deciduous, 32 permanent, and 31 supernumerary. The main concern initially was to determine whether she was syndromic, and she was referred to a geneticist. G banding analysis showed pericentric inversion of chromosome 9; the chromosome formula was 46, XX, inv (9) (p13q21). Orthodontic treatment for this patient will be a clinical challenge because of the great number of teeth to be extracted and the alterations in the shapes of the teeth. Treatment goals should be established by a multidisciplinary team, where oral surgeon, orthodontist, periodontist, and prosthodontist come together to solve a medical and dental puzzle, eliminating the pieces that do not fit and searching for new ones to obtain an occlusion that will give the patient physiologic conditions of normality and esthetic satisfaction.     

Early implant failure. Prognostic capacity of Periotest: retrospective study of a large sample

Objectives: The objectives of this study were to determine the accuracy of Periotest^® to monitor primary implant stability at first‐stage surgery, to identify by multivariate analysis the variables associated with early implant failure and to compare Periotest^® with radiographic study in the diagnosis of implant stability at second‐stage surgery (during osseointegration period). Material and methods: A 10‐year retrospective study was conducted on 1084 Brånemark^® implants placed in 316 patients. Clinical variables, implant diameter and length, Periotest^® values (PTVs) and radiological variables were analyzed in bivariate and multivariate studies in order to determine their influence on early implant failure. Results: After examination of the sensitivity and specificity values obtained for different PTV cutoff points, a cutoff PTV of ?2 was selected (84% sensitivity and 39% specificity). In the bivariate analysis, early failure was significantly related to smoking habits, implant location, bone type, implant features and PTVs (?2 and ≥?2). In the final multiple logistic model, only age (odds ratio (OR)=4.53; 95% confidence interval (CI), 1.34–15.27), smoking habits (OR=2.5; 95% CI, 1.3–4.79), bone type (OR=1.93; 95% CI, 1.01–3.7) and PTV at first surgery (OR=3.01; 95% CI, 1.5–6.02) were independently related to early failure. Conclusions: The Periotest^® (with ?2 cutoff) at first surgery offers high sensitivity in the prognosis of early implant loss and shows a greater capacity to evaluate stability during the osseointegration period compared with radiographic study.