Objectives To assess and compare the pharmacological effect of different drugs on pain relief after periodontal surgery. Materials and methods Five databases were searched up to September 2019. The eligible studies comprised randomized clinical trials, involving only adult individuals that received any periodontal surgery and presenting two distinct groups of therapeutic regimens to control postoperative pain. Placebo groups could be included. The risk of bias was assessed with the RoB 2 Cochrane tool and the GRADE system. Meta-analyses were performed using different follow-up and drug comparisons. Results Overall, 2398 studies were identified, of which 35 were included. Low risk of bias was determined for the majority of the studies. The meta-analyses showed that the comparison of dexamethasone or non-steroidal anti-inflammatory drugs (NSAID) versus placebo favored the use of both interventions in a follow-up of 1 to 8 h for open flap procedures (OFP). However, no statistical difference was found for the comparison between NSAID and dexamethasone for OFP. Conclusions Patients may benefit from several pharmacological schemes for pain relief after periodontal surgeries. However, due to the high heterogeneity among studies, no fixed pharmacological protocol could be proposed. Clinical relevance There is not enough evidence to recommend one therapeutic scheme. However, untreated pain is harmful to the patients and it is not advisable.

Combined effect of end-rounded versus tapered bristles and a dentifrice on plaque removal and gingival abrasion Abstract: Two previous clinical studies evaluated the effect of end-rounded versus tapered bristles of soft manual brushes on the removal of plaque and gingival abrasion. However, the combined effect of an abrasive dentifrice on these outcomes has yet to be understood. The purpose of the present study was to compare the incidence of gingival abrasion and the degree of plaque removal obtained after the use of toothbrushes with tapered or end-rounded bristles in the presence or absence of an abrasive dentifrice. The study involved a randomized, single-blind, crossover model (n = 39) with a split-mouth design. Subjects were instructed to refrain from performing oral hygiene procedures for 72 hours. Quadrants were randomized and subjects brushed with both types of toothbrushes using a dentifrice (relative dentin abrasion = ± 160). Plaque and gingival abrasion were assessed before and after brushing. After 7 days, the experiment was repeated without the dentifrice. The average reduction in plaque scores and the average increase in the number of abrasion sites were assessed by repeated-measures ANOVA and Bonferroni's post-hoc tests. End-rounded bristles removed significantly more plaque than tapered bristles, regardless of the use of a dentifrice. The dentifrice did not improve plaque removal. In the marginal area (cervical free gingiva), no difference in the incidence of gingival abrasion was detected between toothbrush types when used with a dentifrice (p ≥ 0.05). However, the dentifrice increased the incidence of abrasion (p < 0.001), irrespective of the toothbrush type tested. End-rounded bristles therefore removed plaque more effectively without causing a higher incidence of gingival abrasion when compared with tapered bristles. An abrasive dentifrice can increase the incidence of abrasion, and should be used with caution by individuals who are at risk of developing gingival recession.

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Purpose: To evaluate the effect of two models of chronic stress in rats and their association with induced periodontitis on hematological parameters: mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), hematocrit (Ht), erythrocytes (Hm), hemoglobin (Hg) and leukocytes (Lk). Methods: Forty-eight adult Wistar rats were randomly distributed into four groups (n=12): physical stress (PSG), variable stress (VSG), ligature (LG) and control (CG) and then started the test of physical stress (restraint and exposure to cold) and variable stress (exposure to flashing light, isolation, examination of the oral cavity, congested environment, the smell of blood and noise). After 10 days of the stress test, the animals in Groups PS, VS and L were anesthetized, and a silk thread was adapted around the upper right second molar; subsequently, the stress test continued for 50 days. The animals were anesthetized and held up the incision and visualization of the posterior vena cava for blood puncture vacuum in tubes containing EDTA. Data were collected by blinded and trained examiners and were statistically analyzed by means of ANOVA and Bonferroni's test at the significance level of 0.05. Results: The two models of stress changed all of the hematological parameters tested, with the exception of VCM. Conclusion: The stress associated with periodontitis is able to modify blood parameters in rats.

Introduction Dental implant therapy, when well planned, can contribute to the patient's quality of life and is an important tool for solving a serious public health problem in various parts of the world. Objective This study investigated peri-implant health in fixed implants supported by an immediate loading technique and to associate those outcomes with sociodemographic conditions. Material and method After the disassembly of the prostheses on implants with the “Branemark Model” the peri-implant health of 93 patients was evaluated using dental plaque index (DPI), probing pocket depths (PPD), bleeding on probing (BOP), clinical attachment levels (CAL), and presence of gingival hyperplasia. Patients also answered a questionnaire about their gender, age, socioeconomic status (Brazilian Association of Research Companies - ABEP), general health and tobacco use. Result The most constant clinical findings were the presence of plaque, followed by gingival hyperplasia and periimplantitis, which was associated with disease progression. Most of the patients in the study were female, Caucasian, and under 60 years of age, with prostheses located in their lower arch, and they belonged to social classes A and B. Conclusion The presence of dental biofilm occurred in almost all implants and was not related to the presence of periimplantitis. The progression of periimplantitis with bone loss was related to sub gingival bleeding. The sociodemographic characteristics in the study did not present great correlations with the clinical variables of the dental implants studied.