Background: Inflammatory/immunological serum markers are useful for the early detection of organ dysfunction, helping the diagnosis of sepsis. Although the detection of blood biomarkers is a standard practice, the use of noninvasive samples (eg saliva) would be beneficial. Aim: To investigate the saliva of hospitalized patients with and without sepsis and identify the levels of inflammatory markers such as C-reactive protein (CRP), procalcitonin (PCT), interleukin 6 (IL-6) and nitric oxide (NO). Methods: Saliva samples were collected from 26 patients in intensive care unit with diagnosis of sepsis and from 26 without sepsis (control). The levels of CRP were determined by using latex agglutination test, whereas those of procalcitonin and IL-6 by ELISA and NO by the Griess reaction. Results: Of 26 patients with sepsis, 14 were males (54%) with a mean age of 63.81 ± 3.48 years. The control group had the same distribution for gender, with mean age 65.04 ± 4.07 years. Sepsis group showed higher salivary concentrations of CRP, PCT, IL-6 and NO, with only levels of IL-6 being statistically different (P = .0001). Conclusions: Patients with sepsis had significantly higher levels of IL-6 in their saliva, suggesting that this biological sample could be useful in the diagnosis of this condition. K E Y W O R D Sbiomarkers, intensive care unit, saliva, sepsis

Os implantes tornaram-se uma alternativa viável no âmbito odontológico devolvendo a função, estética e conforto para o paciente. A escolha do tipo de conexão final da prótese é baseada na situação clínica de cada caso e por preferência do profissional. Existem dois tipos de restaurações protéticas comumente utilizadas na Implantodontia: as próteses cimentadas e parafusadas; ambas com suas vantagens e limitações. O objetivo desse estudo foi de analisar e identificar, através de uma revisão de literatura narrativa, a relação dos diferentes tipos de próteses (cimentada e parafusada) com a perda óssea marginal peri-implantar, assim como, correlacionar o tipo de prótese utilizada com a taxa de sobrevivência do implante. A decisão sobre qual sistema protético usar tem início durante a etapa de planejamento e pode implicar na estética, oclusão, retenção, efeito sobre os tecidos peri-implantares, além de outras complicações, influenciando na taxa de sobrevivência do implante. A perda óssea marginal peri-implantar é um dos problemas relacionados com a falha tardia dos implantes osseointegrados, sendo uma das causas de insucessos, podendo resultar na perda de osseointegração. Sendo assim, conclui-se que, a perda óssea marginal peri-implantar possui etiologia multifatorial; as próteses parafusadas apresentaram mais complicações biomecânicas, como o afrouxamento de parafuso e fratura da cerâmica e as próteses cimentadas apresentaram mais complicações biológicas envolvendo os tecidos peri-implantares.

It has been reported that 58% of individuals with chronic kidney disease (CKD) have moderate to advanced periodontitis due to alterations of pH and biochemical composition in the saliva. In fact, the composition of this important biofluid may be modulated by systemic disorders. Here we investigate the micro-reflectance Fourier-transform infrared spectroscopy (FTIR) spectra of saliva that CKD patients submitted to periodontal treatment, aiming to identify spectral biomarkers of kidney disease evolution and the effectiveness of periodontal treatment, proposing possible biomarkers of disease evolution. Saliva from 24 CKD patients—stage-5 men, 29 to 64 years old—was evaluated in (i) patients starting periodontal treatment; (ii) patients 30 days after periodontal treatment; and (iii) patients 90 days after periodontal treatment. Our findings indicated that there are statistically relevant changes among the groups after 30 and 90 days of periodontal treatment, when considering the overall spectra in the fingerprint region (800−1800cm−1). The key bands presenting good prediction power (area under the receiver operating characteristic curve >0.70) were related to poly (ADP-ribose) polymerase (PARP) conjugated to DNA at 883, 1031, and 1060cm−1 (carbohydrates at 1043 and 1049cm−1) and triglycerides (1461cm−1). Interestingly when analyzing the derivative spectra in the secondary structure region (1590−1700cm−1), we detected over-expression of the β-sheet class of secondary structures in 90 days of periodontal treatment, possibly related to over-expression of human B-defensins. Conformational changes in ribose sugar in this region corroborate the interpretation concerning PARP detection. To our knowledge, PARP was detected for the first time in saliva samples of stage-5 CKD patients by FTIR. All observed changes were correctly interpreted in terms of intensive apoptosis and dyslipidemia due to kidney disease progression. Biomarkers due to CKD predominate in saliva, and the relative improvement in the periodontal state did not cause remarkable changes in the spectra of saliva.

Aim. Alveolar deficiency is considered one of the main limitations for placement of osseointegrated implants, as well as for their long-term success, especially in the anterior region of the maxilla. Objective. To report a clinical case of reconstruction of atrophic maxilla with deproteinized bovine bone associated with platelet-rich fibrin (PRF) and titanium mesh and to assess the linear and volumetric bone gains and rehabilitation with implants in a 5-year follow-up. Case. Patient with bone deficiency in the anterior maxilla region underwent bone reconstruction with deproteinized bovine bone associated with PRF and titanium mesh. After six months, the necessary bone height and volume were obtained for placement of implants, and the bone contour was restored in the anterior region, providing functional and aesthetic improvement. The amount of linear and volumetric bone gains was compared to baseline computed tomography scans. Three implants were placed in the grafted region, and a bone tissue sample was obtained at the time of their placement. Histological analysis showed neo-formed bone tissue in contact with the remaining particles of the biomaterial. After six months, the implants were activated, and the prosthesis was placed on the implants, which were monitored for five years. Conclusion. Implants can be placed predictably in regions with vertical and horizontal bone augmentations by using xenogeneic bone grafts associated with titanium mesh and PRF.

Introduction: Mucositis has been a complication of great importance in antineoplastic treatments of head and neck tumors because when not treated properly it can lead to the interruption of radiotherapy or chemotherapy. Knowing that mucositis is a common inflammatory condition in patients undergoing radiotherapy and that nitric oxide (NO) can be a marker of inflammation. Aim: to seek an association between mucositis, pain and NO levels in patients diagnosed with squamous cell carcinoma (SCC) in different periods of radiotherapy. Methodology: Clinical examination was performed weekly to investigate presence of mucositis, in which the degree and intensity of pain were evaluated by using the visual analogue scale (VAS) and mouthwash samples were collected from twenty patients. In the collected samples, the concentrations of NO were measured by using the Griess method. Results: of the twenty patients, two were excluded due to worsening of the clinical picture. Of the 18 patients who had their treatment finished, ten had some degree of mucositis and pain, with the highest levels being observed in the last week of treatment. As for the levels of NO, it was observed that low values varied widely among the patients and weeks studied. There was a statistically significant positive correlation between mucositis degrees and pain intensities, although the NO levels were correlated neither with mucositis nor with pain intensity throughout the experimental weeks. Conclusion: Although NO is an inflammatory mediator involved in diseases of the oral cavity, its presence cannot be associated with mucositis and pain in patients with head and neck cancer who are on radiotherapy.