Browsing by Author "Fernandes, Gustavo Vicentis de Oliveira"
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- #080 Alongamento coronário com o uso do laser díodo e sistema piezoelétrico: relato de casoPublication . Raso, Mariaselene; Marques, Tiago Miguel; Sousa, Manuel Correia; Santos, Nuno Bernardo Malta dos; Fernandes, Gustavo Vicentis de OliveiraIntrodução: O uso do laser de díodo de alta intensidade em cirurgias periodontais proporciona maior precisão do corte cirúrgico e permite pouca absorção de luz pelos tecidos duros quando se utilizam parâmetros adequados, não gerando assim qualquer dano térmico. Outras vantagens seriam a mais rápida coagulação tecidual, a redução do tempo cirúrgico e a diminuição do risco de infeções pós?operatórias. Outro equipamento com crescente uso é o piezoelétrico, o qual também está indicado em cirurgias orais, a proporcionar também osteotomias mais precisas, limpas e com menor trauma para os tecidos moles. Portanto, o objetivo deste relato foi mostrar a utilização de tecnologias em procedimento estético periodontal. Descrição do caso clínico: Paciente do sexo feminino, 25 anos, saudável, com tratamento ortodôntico prévio, com queixa principal de grande exposição gengival ao sorrir. Planeou?se um alongamento coronário com uso do laser de díodo, em região estética superior (1.4 – 2.4). Após uso do laser para corte gengival, foi feito retalho de espessura total para visualização do osso de sustentação e posterior osteotomia com piezoelétrico, a seguir mensurações e proporções estéticas. Posteriormente, retalho foi reposicionado e suturado. No pós?operatório de 7 dias e 14 dias, pode? se confirmar a excelente recuperação do tecido local e da paciente. Discussão e conclusões: Existem evidências de que a cirurgia em tecidos moles com laser a díodo, e a cirurgia de tecidos duros com aparelho piezoelétrico, proporcionam um bom prognóstico e melhorando assim o pós? cirúrgico do paciente. O laser de díodo permite ter um campo cirúrgico limpo, sem hemorragia, diminuindo o risco de inflamação e infeção pós? cirúrgica quando comparado a sistema tradicional de cirurgias. A osteotomia com piezoeléctrico permite um corte preciso e menos traumático, proporcionando um menor perfil inflamatório a nível ósseo. As vantagens para o paciente são: diminuição da dor e do edema. Enquanto as vantagens para o profissional são: maior sensibilidade tátil e uma melhor visibilidade do campo operatório. Também proporciona proteção dos tecidos moles e das estruturas nobres adjacentes, incluindo um maior controlo da assepsia. A utilização destas tecnologias em cirurgia periodontal mostrou maior exequibilidade e visibilidade, campo cirúrgico mais limpo e menor hemorragia e edema. Inclusive, estas técnicas permitiram reparo ósseo e gengival mais favorável.
- #102 Comparação da resistência á tração de diferentes membranas de fibrina rica em plaquetasPublication . Pascoal, Martim; Santos, Nuno Bernardo Malta dos; Fernandes, Gustavo Vicentis de OliveiraObjetivos: Este estudo teve por objectivo fazer comparação directa da resistência à tração entre membranas produzidas com diferentes protocolos de centrifugação, Leucocyte?Platelet Rich Fibrin (L? PRF) versus advanced? Platelet Rich Fibrin (a?PRF). Materiais e métodos: Após a colheita de sangue de uma pessoa saudável e sem histórico de toma de anticoagulantes ou outro medicamento, sob controlo alimentar, procedeu? se à confeção de membranas segundo os protocolos de L? PRF e a? PRF previamente descritos na literatura. De seguida, as membranas, n=26 (13 para cada protocolo), foram submetidas a um teste mecânico de tração, para os quais foram obtidos valores de tração máxima e de tração média. A análise estatística dos dados foi feita com o teste t?Student não pareado. Resultados: Relativamente à tração média, o protocolo a? PRF e L?PRF, respetivamente, foram de 0.0288 N.mm? 2 e 0.0192 N.mm? 2 (p
- A 3D digital analysis of the hard palate wound healing after free gingival graft harvestPublication . Marques, Tiago; Ramos, Sara; Santos, Nuno Bernardo Malta dos; Borges, Tiago; Montero, Javier; Correia, André; Fernandes, Gustavo Vicentis de OliveiraPurpose: Within this context, this pilot study aimed to evaluate the healing dynamics process of the hard palate after free gingival graft harvesting in the short term (3 months), utilizing digital imaging technology and tridimensional analysis software. Furthermore, assessing the results found to verify the existence of a relationship between gender or age with tissue loss. Materials and Methods: For connective-tissue harvesting, fifteen patients with gingival recessions type (RT) 1 and RT2 were selected. On the surgery day (before the procedure) and after three months, palatal impressions were taken in all patients, and cast models were done for posterior model scanning. The following variables were analyzed: mean thickness alterations (x¯ TA), maximum thickness loss (MTL), mean maximum thickness loss (x¯ MTL), and volume alterations (VA). A descriptive and bivariate analysis of the data was done. The data were submitted for statistical evaluation and were significant if p < 0.05. Results: Fifteen patients were analyzed, 11 females (73.3%) and four males (26.7%). The patients’ average age was 28 ± 8.52 years (ranging between 16 and 48 years old). The palatal wound region’s mean thickness and volume changes were −0.26 mm (±0.31) and 46.99 mm3 (±47.47 mm3) at three months. There was no statistically significant result correlating age/gender with any variable evaluated. Conclusions: Connective tissue graft harvesting promoted changes with a standard volume and thickness loss of palatal soft tissue. A 3D digital evaluation was a non-invasive method with a reproducible technique for measuring thickness or volume after connective tissue is collected. There was no relationship between age/gender and any variables analyzed.
- Antisclerostin effect on osseointegration and bone remodelingPublication . Couto, Bárbara Alexandra do Amaral; Fernandes, Juliana Campos Hasse; Saavedra-Silva, Mariana; Roca, Hernan; Castilho, Rogério Moraes; Fernandes, Gustavo Vicentis de OliveiraObjective: This study reviewed the literature on local or systemic administration of antisclerostin, presenting results associated with osseointegration of dental/orthopedic implants and stimulation of bone remodeling. Materials and Methods: An extensive electronic search was conducted through MED-LINE/PubMed, PubMed Central, Web of Science databases and specific peer-reviewed journals to identify case reports, case series, randomized controlled trials, clinical trials and animal studies comparing either the systemic or local administration of antisclerostin and its effect in osseointegration and bone remodeling. Articles in English and with no restriction on period were included. Results: Twenty articles were selected for a full-text, and one was excluded. Finally, 19 articles were included in the study (16 animal studies and 3 randomized control trials). These studies were divided into two groups, which evaluated (i) osseointegration and (ii) bone remodeling potential. Initially 4560 humans and 1191 animals were identified. At least 1017 were excluded from the studies (981 humans and 36 animals), totaling 4724 subjects who completed (3579 humans and 1145 animals). (a) Osseointegration: 7 studies described this phenomenon; 4 reported bone-implant contact, which increased in all included studies. Similar results were found for bone mineral density, bone area/volume and bone thickness. (b) Bone remodeling: 13 studies were used for description. The studies reported an increase in BMD with sclerostin antibody treatment. A similar effect was found for bone mineral density/area/volume, trabecular bone and bone formation. Three biomarkers of bone formation were identified: bone-specific alkaline phosphatase (BSAP), osteocalcin and procollagen type 1 N-terminal Pro-peptide (P1NP); and markers for bone resorption were: serum C-telopeptide (sCTX), C-terminal telopeptides of type I collagen (CTX-1), β-isomer of C-terminal telopeptides of type I collagen (β-CTX) and tartrate-resistant acid phosphatase 5b (TRACP-5b). There were limitations: low number of human studies identified; high divergence in the model used (animal or human); the variance in the type of Scl-Ab and doses of administration; and the lack of reference quantitative values in the parameters analyzed by authors’ studies (many articles only reported qualitative information). Conclusion: Within the limitations of this review and carefully observing all data, due to the number of articles included and the heterogeneity existing, more studies must be carried out to better evaluate the action of the antisclerostin on the osseointegration of dental implants. Otherwise, these findings can accelerate and stimulate bone remodeling and neoformation.
- Blood and salivary inflammatory biomarkers profile in patients with chronic kidney disease and periodontal disease: a systematic reviewPublication . Tavares, Lisandra Taísa Reginaldo; Saavedra-Silva, Mariana; López-Marcos, Joaquín Francisco; Veiga, Nélio Jorge; Castilho, Rogerio de Moraes; Fernandes, Gustavo Vicentis de OliveiraIntroduction: Periodontitis is the most prevalent inflammatory disease worldwide. Its inflammatory levels spread systemically, which can be associated with chronic kidney disease. Biomarkers have the potential to diagnose and correlate periodontitis and chronic kidney disease, helping to monitor systemic inflammation. Thereby, this study aimed to analyze the association between chronic kidney disease and periodontitis by conducting a biomarker analysis on blood and saliva. Material and methods: An electronic search through PubMed/MEDLINE, EMBASE, and Web of Science databases was conducted to identify clinical studies published in the last ten years, with no language restrictions. Twelve articles met all the inclusion criteria, two randomized controlled trials, one cohort study, and nine observational studies. Results: The studies included a total of 117 patients for saliva biomarkers, with a mean age of approximately 57 years old, and 56.68% of the subjects were female. After analyzing all the included studies, it was possible to verify the following biomarkers assessed: CRP, WBC, fibrinogen, IL-4 and -6, cardiac troponin T, NOx, ADMA, albumin, osteocalcin, cystatin C, PGLYRP1, cholesterol, HDL, LDL, triglycerides, and hemoglobin. Conclusion: A direct cause–effect association between periodontitis and CKD could not be established. However, it was possible to conclude that there was a correlating effect present, through the analyzed biomarkers.
- Clinical performance comparing titanium and titanium–zirconium or zirconia dental implantsPublication . Fernandes, Paulo Rafael Esteves; Otero, Ada Isis Pelaez; Fernandes, Juliana Campos Hasse; Nassani, Leonardo Mohamad; Castilho, Rogerio Moraes; Fernandes, Gustavo Vicentis de OliveiraObjectives: This study aimed to compare clinical results between titanium (Ti), zirconia (Zr), or titanium–zirconium (TZ) dental implants and to analyze survival rate (SR), bleeding on probing (BoP), marginal bone loss (MBL), and/or probing depth (PD). Data source: Manual and electronic searches were conducted (PubMed and Web of Science) to identify randomized controlled trials that compared the outcomes of at least two implant types (control and test group) within the same study. The focused question was determined according to the PICOT strategy. Seven studies were included out of 202 research studies initially found. The follow-up periods ranged from 12 to 80 months, and the mean age was from 43.3 to 65.8 years old. The SR for Ti, TZ, and Zr implants ranged from 92.6% to 100%, 95.8% to 100%, and 87.5% to 91.25%, respectively; MBL for Ti, TZ, and Zr implants varied from −1.17 mm to −0.125 mm for Ti, −0.6 mm to −0.32 mm for TZ, and −0.25 mm to −1.38 mm for Zr. Studies showed a low incidence of mucositis and peri-implantitis; however, BoP for Zr was 16.43%, Ti ranged between 10% and 20%, and TZ from 10% to 13.8%. PD for Ti ranged from 1.6 mm to 3.05 mm, TZ was 3.12 mm (only one study), and Zr ranged from 2.21 mm to 2.6 mm. Conclusion: All three types of implants showed similar tissue behavior. However, the TZ group had better results when compared with Ti and Zr for SR, MBL, and BoP, except for PD. Furthermore, the worst SR was found in the Zr implants group.
- Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysisPublication . Leitão, Celina Inês Miranda Brito; Fernandes, Gustavo Vicentis de Oliveira; Azevedo, Luís Pedro Pereira; Araújo, Filipe Miguel; Donato, Helena; Correia, André Ricardo MaiaPurpose: The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns supported by teeth made up in monolithic zirconia with CAD/CAM technology. Study selection: An extensive electronic search was conducted through Medline/PubMed, Embase, and Cochrane Library databases. Additional manual search was performed on the references of included articles to identify relevant publica- tions. Two reviewers independently performed the selection and electronic and manual search. Results: From nine articles included, there was a total of 594 participants and 1657 single-tooth restorations with a mean exposure time of 1.07 years, and follow-up period between 0.3 and 2.1 years. All studies showed a moderate level of qual- ity, with a consequent moderate possibility of associated bias, using the Newcastle-Ottawa Scale (NOS), with survival rate (SR) ranging between 91% to 100%. Bleeding on probing (BOP) were reported with an average value of 29.12%. Marginal integrity showed high success rate values for the observation periods, except for one that included patients with bruxism which obtained a SR of 31.60%. Failures and/or fractures, mostly total and requiring replacement, were observed in three studies. Linear regression showed that there was no statistical correlation between survival rate and type of cementation and the average years of follow-up (p=0.730 e p=0.454). There was high heterogeneity between studies (I2 = 93.74% and Q = 79.672). Conclusions: Within the limitation of this study, monolithic zirconia might be considered as a possible option for restoring single crowns, especially in the posterior zone.
- Endodontic and periodontal treatment of complete buccal root and apex exposition: a challenging case report with 17 months follow-upPublication . Kahn, Sérgio; Dias, Alexandra Tavares; Nobre, Vitor; Oliveira, Larissa Zarjitsky de; Fernandes, Gustavo Vicentis de OliveiraIntroduction: This case report demonstrated a challenging clinical case addressed within a multidisciplinary approach to achieve its maintenance, even though had a poor prognosis. It was associated with the endodontic treatment with mucogingival techniques, including periodontal microsurgery and connective tissue graft. Case presentation: A patient presented a deep gingival recession with the apex-exposed non-vital tooth with interproximal bone loss (RT2) and without mobility. The treatment involved an initial endodontic approach and periodontal therapy (scaling and root planing), microsurgical techniques with coronally advanced flap (CAF), root preparation with PrefGel® (24% EDTA), enamel matrix derivatives (Emdogain®), and connective tissue graft. As a clinical result, it was verified an increase of keratinized tissue width and gingival thickness, and root coverage, reaching good esthetics and a stable result after 17 months. Conclusion: The correct diagnosis and technique selection may affect directly the outcome, especially in challenging cases. Even though there was a poor prognosis, an adequate treatment plan, patient cooperation, and technique mastery help to achieve a high level of root coverage, esthetic recovering, and successful outcome.
- Histological and immunohistochemical analysis of a nanobiomaterial in a maxillary sinus lift surgery: a case reportPublication . Lopes, João Carlos Amorim; Salviano, Saulo Henrique; Lins, Consuelo Antunes Barreto; Devita, Renan Lana; Brum, Igor da Silva; Fernandes, Gustavo Vicentis de OliveiraThe objective of this study was to histologically and immunologically analyze the level of bone substitution and the presence of new blood vessels in a nanobiomaterial composed of hydroxyapatite and BTCP in a maxillary sinus lift surgery. A case of a maxillary sinus lift was investigated. The patient had a 1.0 mm bone remnant on the left side and 2 grams of nanobiomaterial (80% hydroxyapatite and 20% β-tricalcium phosphate) were grafted into the pneumatized sinus. After 6 months, during dental implant placement surgery, grafted bone samples were collected with 4 mm trephines. These samples were sent to the laboratory for analysis where they were stained with masson'strichrome and immuno stained with osteonectin and osteopontin. After 6 months of bone regeneration a result of 14 mm of bone gain was reached, the analyzes in masson's trichrome showed an excellent gain of newly formed bone, in addition to a very high percentage of blood vessels. In the immunostaining, a very large number of osteoblasts and osteoclasts was observed, signaling an excellent osteoconduction and osteoinduction of the studied nanobiomaterial. The maxillary sinus lift surgery with nanobiomaterial provided a very favorable bone height and thickness gain, as well as the high vascularity and cellularity, which enabled the patient's oral rehabilitation with osseointegrated dental implants and permanent ceramic prostheses.
- Immediate implant with provisionalization and soft tissue grafting after 4-year follow-upPublication . Siqueira, Glaudemir Reinaldo Cavalcanti de; Tavares, José Rodolfo; Pedrosa, Ricardo Ferreira; Siqueira, Rafael Amorim Cavalcanti de; Fernandes, Gustavo Vicentis de OliveiraINTRODUCTION: This paper presents a case report of immediate implant placement (IIP) with a provisionalization technique to restore function and esthetics with follow-up after 4 years. CASE PRESENTATION: Minimally traumatic extraction was performed with IIP, soft-tissue grafting, and immediate provisional crown. Six months after optimal healing, the patient was submitted to an esthetic restorative work through veneers in lithium disilicate. Fourteen-month and 4-year follow-up visits revealed stability of the peri-implant soft-tissues with peri-implant health status, with the evaluation of the pink and white esthetic score, yielding to mean scores, respectively, in 14 months of 11.62 ± 2.07 (pink esthetic score [PES]) and 18.25 ± 1.46 (PES/white esthetic score [WES]) and in 4 years of 11.0 ± 1.32 (PES) and 17.62 ± 0.65 (PES/WES). Intraoral digital radiographs showed minimal crestal bone level changes throughout the follow-up period. Thus, IIP is a sensitive technique procedure, and a 3D implant position is crucial for success. CONCLUSION: Immediate implant with grafting to fill the gap and soft tissue augmentation led to less horizontal changes and stable mucosal margin, and immediate provisionalization helped to maintain soft tissue architecture, and proper case selection is key for clinical success.