Determina la influencia de la edad en la prevalencia y severidad de la inflamación gingival durante la gestación. Participan 60 mujeres grávidas durante el tercer trimestre de gestación divididas en tres niveles etáreos: jóvenes (15-19), en edad fértil ideal (20-35) y añosas (35 a más); las cuales serán seleccionadas a partir de un control de placa bacteriana. Asimismo se considera 30 mujeres no gestantes como grupo control divididas en los mismo niveles etáreos. Se descarta la presencia de enfermedades sistémicas y otras condiciones que influencien en la exactitud de los resultados. La condición gingival se evaluará usando el índice de Loe y Silness.

Trabajo de Investigación Requisito para optar al Magister en Ciencias Odontológicas con Mención en Periodontologia / las especies reactivas de oxígeno (ERO), entre ellas H202, son liberadas durante la inflamación crónica inducen la destrucción tisular por medio de la sobreexpresión de citoquinas proinflamatorias y la activación de metaloproteinasas de matriz (MMP), en ocasiones involucrando la activación de la vía de señalización NFκB. Si bien, los fibroblastos del ligamento periodontal (FLP) regulan la homeostasis del periodonto, no se conoce el efecto de las ERO sobre la síntesis y actividad de las MMPs y las vías de señalización involucradas. Objetivo: Evaluar la actividad de MMPs -2 y -9 en conjunto con la participación de la vía NFκB en cultivos primarios de FLP humano tratados o no con dosis subletales de H2O2. Metodología: FLP fueron aislados y cultivados a partir de 14 terceros molares sanos de 14 sujetos con indicación de extracción y expuestos a dosis subletales de peróxido. La activación de NFκB se determinó mediante la translocación nuclear de la subunidad p65 en presencia de H2O2 y/o SN50, un péptido inhibidor de la subunidad p50 de la vía NFκB y controles respectivos mediante inmunofluorescencia. Los FLP fueron estimulados con dosis subletales de H2O2 (2,5-10 µM) por 24 h y/o SN50 como control negativo. Los sobrenadantes fueron recolectados y procesados. La actividad de las proformas y formas activas de MMP-2 y MMP-9 fueron determinadas mediante zimografías en gelatina y evaluadas por densitometría. Los resultados fueron expresados como unidades arbitrarias densitométricas (ua) por mg de proteínas totales. Los resultados fueron analizados por medio del test estadístico ANOVA con el software StataV11.1. Resultados: La viabilidad celular se mantuvo en los grupos estimulados con H2O2 en dosis de 2,5-10 µM por 24 h. El H2O2 Indujo la translocación nuclear de NFκB. El porcentaje de activación (% A) de MMP-9 fue mayor en el grupo H2O2 5 μM que en el grupo 5 μM/ SN50 (p=0,051); mientras que el % A de MMP-2, aumentó significativamente en el grupo H2O2 5 μM comparado con el control. La actividad de MMP-9 fue significativamente mayor en el grupo H2o2 2,5 μM comparado con el de 5 μM/ SN50 y el de 10 μM; mientras que la actividad de MMP-2 aumentó significativamente en el grupo de 5 μM en comparación con el grupo control, 10 μM y el grupo de 5 μM + SN50. Conclusiones: La actividad gelatinolítica de MMP-2 aumenta con dosis subletales de H2O2 (<10 µM), en parte vía NFκB en FLP humano. La actividad de MMP-9 en FLP humano, está regulada parcialmente por la vía NFκB. El aumento en la actividad de MMP-2 inducido por H2O2, podría estar relacionado con la destrucción de tejido en las enfermedades periodontales. / FINANCIAMIENTO FONDECYT 1090461

Faculty of Health sciences School of Medicine 0420338r juneteare@yahoo.co.uk / This study, in non-human primates (Papio ursinus), evaluated the healing potential of recombinant human transforming growth factor-3 (rhTGF-3) when implanted in exposed periodontal furcation defects either by direct application to the defect or by transplantation of rhTGF-3-instigated heterotopic bone as source of autogenous bone. Class II furcation defects were surgically created bilaterally in the first and second molars of both the mandible and the maxilla of four clinically healthy adult baboons. Simultaneously, autogenous bone was induced bilaterally within the rectus abdominis muscle of the baboons using rhTGF-3. Forty days later, the periodontal defects were implanted with rhTGF-3 in Matrigel® as delivery system, or rhTGF-3 plus muscle tissue in Matrigel®, or with the harvested rhTGF-3-induced autogenous bone. Sixty days after periodontal implantation, the animals were euthanased and the molars harvested together with the surrounding tissue. Histological analysis was performed by light microscopy and digital imaging computer software. The extent of regeneration was assessed by measuring area and volume of new alveolar bone, height of new alveolar bone and height of new cementum. The results, compared to controls, showed pronounced periodontal tissue regeneration in experimental defects. The most noteworthy healing was observed in defects implanted with heterotopically induced autogenous bone as well as those implanted with rhTGF-3 plus muscle tissue. The findings of this study suggest that rhTGF-3 applied directly to a defect, or rhTGF-3-induced autogenous bone, transplanted to a defect, have significant regenerative capabilities in periodontal tissue regeneration of nonhuman primates Papio ursinus.

O ajuste oclusal (AO) como parte da terapia periodontal é um tema controverso, principalmente porque a literatura não fornece evidências suficientes sobre a influência do trauma de oclusão (TO) na doença periodontal (DP). A necessidade de ajuste oclusal na terapia periodontal é considerada incerta e requer investigação. O objetivo desta revisão sistemática foi identificar e analisar estudos que investigaram os efeitos do AO associado à terapia periodontal, sobre os parâmetros periodontais. Um protocolo foi desenvolvido incluindo todos os aspectos de uma revisão sistemática: estratégia de busca, critérios de seleção, seleção de métodos, coleta de dados e extração de dados. A pesquisa bibliográfica foi realizada utilizando MEDLINE via PubMed, Cochrane Central Register de estudos controlados e EMBASE. Os títulos e resumos de artigos foram selecionados de acordo com critérios estabelecidos na metodologia. Cada artigo que indicava uma possível correspondência com estes critérios, ou não poderia ser excluído baseado nas informações presentes no título ou no resumo, foi considerado e avaliado. Na seleção final, quatro artigos foram incluídos. Embora os estudos selecionados sugerem uma associação entre AO e uma melhora nos parâmetros periodontais, suas questões metodológicas (exploradas nesta revisão) sugerem a necessidade de novos estudos com maior qualidade. Atualmente as evidências presentes são insuficientes para presumir que AO é necessário para reduzir a progressão da doença periodontal. / Occlusal adjustment (OA) as part of periodontal therapy is a controversial theme, mostly because the literature does not provide enough evidence regarding the influence of trauma from occlusion (TO) on periodontitis. The need for occlusal adjustment in periodontal therapy is considered uncertain and requires investigation. The aim of this systematic review was to identify and analyze those studies that investigated the effects of OA, associated with periodontal therapy, on periodontal parameters. It was developed a protocol, which included all aspects of a systematic review: search strategy, selection criteria, selection methods, data collection and data extraction. A literature search was conducted using MEDLINE via PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE. Titles and abstracts of articles were selected according to established criteria. Every article that indicated a possible match, or could not be excluded based on the information given in the title or abstract, was considered and evaluated. On final selection, four articles were included. Although the selected studies suggest an association between OA and an improvement in periodontal parameters, their methodological issues (explored in this review) suggest the need for new trials of a higher quality. There is insufficient evidence at present to presume that OA is necessary to reduce the progression of periodontal disease.

Os tumores na região de cabeça e pescoço são frequentes ao redor do mundo, estando relacionados a altas taxas de morbidade e mortalidade. Recentemente, alguns estudos propuseram a associação entre doença periodontal, risco de câncer e piora na qualidade de vida de pacientes oncológicos. O objetivo deste estudo é investigar a possível associação clínica entre doença periodontal e neoplasias de cabeça e pescoço antes e após seu tratamento. Para isso, foram incluídos no grupo teste 40 pacientes de ambos os sexos, &#x2265;18 anos e com diagnóstico de câncer de cabeça e pescoço. Estes pacientes foram subdivididos em dois subgrupos: antes (T1; n=20) e após (T2; n=20) o tratamento quimio e/ou radioterápico. O grupo controle foi formado por 40 pacientes sistemicamente saudáveis selecionados aleatoriamente, sem diferenças significativas entre os grupos em relação à idade e sexo. Os pacientes responderam a um questionário de qualidade de vida relacionada à saúde oral (OHIP-14) e foram examinados periodontalmente em boca toda quanto às medidas de profundidade de sondagem (PS), recessão (REC)/hiperplasia (HP), nível de inserção clínica (NIC), índice de sangramento gengival (ISG) e índice de placa (IPl) e número de dentes perdidos. O nível ósseo proximal foi determinado a partir de imagens radiográficas pela distância entre junção cemento-esmalte e crista óssea alveolar (JCE-CA). O desfecho primário foi definido pelo diagnóstico de câncer pela equipe médica responsável, enquanto que a medida de exposição foi a doença periodontal. Houve maior número de dentes perdidos (p= 0.0017; ANOVA pós-teste Tukey) e maior quantidade de placa (p= 0.0003; Kruskal Wallis pós-teste Dunn) no grupo T2 comparativamente ao controle, porém sem diferenças em relação ao grupo T1. Não houve diferença entre os grupos (p> 0.05) quanto ao ISG, PS, REC/HP, NIC e prevalência de doença periodontal. A distância JCE-CA (p= 0.007; teste exato de Fischer) e a extensão da doença periodontal em &#x2265; 50% dos sítios (p= 0.0033; teste exato de Fischer) foram significativamente maiores no grupo teste. Foi observada associação entre câncer na região de cabeça e pescoço, presença de doença periodontal em &#x2265; 50% dos sítios (OR= 5,12; 95% CI: 1,76 14,91) e distância JCE-CA &#x2265; 4 mm (OR= 2.91; 95% CI: 1.14 7.39). Não houve associação entre câncer na região de cabeça e pescoço e exposição prévia ao fumo (p= 0.81; teste exato de Fischer) e etilismo (p= 0.15; teste exato de Fischer). Na análise da qualidade de vida relacionada à saúde oral, o grupo teste apresentou maior impacto do que o controle nas dimensões limitação funcional (p< 0.0001; Mann Whitney), dor física (p= 0.02; Mann Whitney), incapacidade social (p= 0.01; Mann Whitney), desvantagem social (p= 0.03; Mann Whitney) e na somatória das pontuações (p= 0.0092; Mann Whitney). Houve diferenças significantes entre os grupos T1 e T2 apenas no domínio limitação funcional (p= 0.0058; Kruskal Wallis pós-teste Dunn). Estes resultados sugerem que a extensão da doença periodontal em &#x2265; 50% dos sítios e a perda óssea interproximal média, determinada por meio da distância JCE-CA, &#x2265;4 mm estão associadas ao câncer na região de cabeça e pescoço. / Malignant tumors in the head and neck region are frequently observed all around the world, and are related to high morbidity and mortality rates. Recently, some studies have proposed an association among periodontal disease, risk of cancer and worsening of quality of life of oncologic patients. The aim of this study is to investigate the possible clinical association between periodontal disease and neoplastic lesions in head and neck before and after its treatment. It was included in the test group 40 patients, both genders, &#x2265;18 years old, diagnosed with cancer in the head and neck region. Patients were divided into two subgroups: before (T1; n= 20) and after (T2; n= 20) oncologic treatment. Control group was constituted by 40 systemically healthy patients randomly selected, with no significant differences in age and gender when compared with test group. All patients answered a quality of life questionnaire (OHIP-14) and were periodontally full-mouth examined according to probing depth (PD), recession (REC)/hyperplasia (HP), clinical attachment level (CAL), gingival bleeding index (GBI) and plaque index (PlI) and number of lost teeth. Interproximal bone level was determined from X-ray images as the distance between cementum-enamel junction and alveolar crest (CEJ-AC). Primary outcome was defined by the diagnosis of cancer in the head and neck region by medical staff, and the measure of exposure was periodontal disease. A higher number of missing teeth (p= 0.0017; ANOVA post hoc Tukey) and plaque accumulation (p= 0.0003; Kruskal Wallis post hoc Dunn) was observed at T2 compared to control, but with no differences when compared to T1. No differences between groups (p> 0.05) were found in GBI, PD, REC/HP, CAL and prevalence of periodontal disease. CEJ-AC (p= 0.007; Fischers exact test) and extension of periodontal disease in &#x2265; 50% of sites (p= 0.0033; Fischers exact test) were significantly higher in test than control group. It was observed a significant association between head and neck cancer, presence of periodontal disease in &#x2265; 50% sites (OR= 5,12; 95% CI: 1,76 14,91) and CEJ-AC distance &#x2265; 4 mm (OR= 2.91; 95% CI: 1.14 7.39). There was no association between head and neck cancer and previous exposition to smoking (p= 0.81; Fischers exact test) and alcohol consumption (p= 0.15; Fischers exact test). In the analysis of quality of life related to oral health, test group showed more impact than controls in the domains functional limitation (p< 0.0001; Mann Whitney), physical pain (p= 0.02; Mann Whitney), social disability (p= 0.01; Mann Whitney), handicap (p= 0.03; Mann Whitney) and total score (p= 0.0092; Mann Whitney). Significant differences between T1 and T2 groups were found only at functional limitation domain (p= 0.0058; Kruskal Wallis pós-teste Dunn). These results suggest that extension of periodontal disease in &#x2265; 50% sites and mean interproximal bone loss, determined by the distance CEJ-AC, &#x2265;4 mm are associated to head and neck cancer.

O Sistema Renina-angiotensina (SRA), e um sistema capaz de gerar hormonios peptideos com grande impacto na regulacao cardiovascular e na patogenese das doencas cardiovasculares. Este sistema opera, por meio das acoes da Angiotensina II, tanto em nivel sistemico (endocrino) quanto tecidual (local, paracrino/autocrino) controlando importantes funcoes, varias delas relacionadas a facilitacao da instalacao e progressao do processo inflamatorio. Por este motivo, a producao desta proteina nos tecidos pode estar relacionada a patogenese de muitas doencas, dentre elas a doenca periodontal (DP), tendo em vista seu carater infeccioso-inflamatorio e os achados da literatura que mostram que a inibicao da formacao de Ang II, diminui a perda óssea da DP em animais. Desta forma, o presente trabalho teve como objetivos: Avaliar in vitro, a) A expressao de componentes do SRA (ANGT, RENINA, ECA, ECA-2, AT1, AT2 e Mas) por fibroblastos de gengiva e ligamento periodontal humanos, por RT-qPCR; b) A producao de componentes do SRA (RENINA, ECA, ECA-2) no sobrenadante de culturas de fibroblastos de gengiva e ligamento periodontal humanos, por ELISA; c) A producao dos receptores do SRA (AT1, AT2 e Mas), nestes fibroblastos, por Imunofluorescencia e d) Se a expressao e a producao dos componentes do SRA por fibroblastos de gengiva e ligamento periodontal humanos, se alteram com a estimulacao por LPS de P. gingivalis e E. coli. Apos a coleta, os dados foram analisados com o auxilio do programa GraphPad Prism 5.0. por meio da analise de variancia a 2 criterios (ANOVA-two way) seguida do pos teste de Bonferroni, com nivel de significancia de 5% para a verificacao das possíveis diferencas. Foi detectada a expressao genica para alguns dos componentes do SRA (ANGT, RENINA, ECA, AT1) por fibroblastos tanto de gengiva quanto de ligamento periodontal. Foi detectada ainda uma expressao genica diferenciada entre fibroblastos de gengiva e ligamento periodontal para a ECA, sendo significativamente maior nos fibroblastos da gengiva. Houve imunomarcacao positiva tanto nos fibroblastos de gengiva quanto de ligamento periodontal compativel com a presenca dos receptores AT1 e Mas. Pode-se observar por fim que o contato com LPS de P. gingivalis e E. coli, na concentracao de 10 g/mL/24 h, nao alteram a expressão dos componentes do SRA. Portanto, pode-se concluir que os fibroblastos tanto de gengiva quanto de ligamento periodontal apesar de nao expressarem e produzirem todos oscomponentes do SRA necessarios para a formacao local de Ang II, poderiam contribuir, ainda que parcialmente, com outras celulas do microambiente dos tecidos periodontais para a formacao e acao locais da Ang II, e assim, para a instalacao e progressao da DP. / The Renin-angiotensin system (RAS) can generate hormones that have a high-impact on cardiovascular regulation as well as in the pathogenesis of cardiovascular disease. This system acts through both systemic (endocrine) and local (paracrine/autocrine) effects of Angiotensin II, controlling important functions related to the facilitation of installation and progression of the inflammatory process. For this reason, this proteins production in tissues can be associated to the pathogenesis of many diseases, including periodontal disease (PD). In the PD setting, a infectious-inflammatory characterized disease, the literature findings shows that inhibition of the Ang II formation can decrease the bone loss in animals. In this context, the aims of the present study were: to investigate in vitro: a) the expression of RAS components (ANGT, RENIN, ECA, ECA- 2, AT1, AT2 and Mas) by human gingival and periodontal ligament fibroblasts by RT-qPCR; b) the production of RAS receptors (AT1, AT2 and Mas) by human cultured gingival and periodontal ligament fibroblasts by Immunofluorescence and d) the production of RAS components (RENIN, ECA, ECA-2) if the expression and production of RAS components by gingival and periodontal ligament fibroblasts modify under P. gingivalis and E. coli LPS stimulation. After collected, the data were analysed using GraphPad Prism 5.0, by the two way ANOVA followed by Bonferroni post test with a significance level of 5%. Gene expression was detected for some of the RAS components (ANGT, RENIN, ECA, AT1) by both gingival and periodontal ligament fibroblasts. It was detected a differential gene expression between gingival and periodontal ligament fibroblasts for ECA, being significantly higher in gingival fibroblasts. There was a stain in Immunofluorescence compatible with the production of RAS receptors (AT1 and Mas). It must be noted that the stimulation with P. gingivalis and E. coli LPS, in a concentration of 10 g/mL/24 h, did not altered the expression of RAS components. In conclusion, despite of neither gingival or periodontal ligament fibroblasts express all components of RAS, needed to local formation of Ang II, they might also contribute to the local formation and action of Ang II and in consequence, to the installation and the progression of DP.

BACKGROUND: In the US 47.2% of adults have periodontitis. Alcohol affects the host response, impairs immune function, has toxic effects on the liver and affects with protein metabolism, and therefore may increase the risk of periodontitis. Alcohol may also interfere with homocysteine (Hcy) metabolism and result in hyperhomocysteinemia (HHcy), a risk factor for inflammatory diseases such as cardiovascular disease and possibly periodontal disease. Understanding the exact relationship between alcohol consumption, HHcy and periodontitis is incomplete. OBJECTIVES: To add to our understanding of the alcohol-periodontitis, periodontitis-Hcy and alcohol-Hcy associations longitudinally by addressing methodological issues that confound past research. Methods: The study used existing data from 562 male participants in the VA Dental Longitudinal Study (DLS) who answered food frequency questionnaires (FFQ), underwent periodontal examinations and had plasma . Hcy measurements (N=469). Periodontitis was defined using the CDC case definition (Eke et al., 2009) and categorized into none/mild/moderate or severe disease. HHcy was defined as Hcy ≥10.2 umol/L based on Spence et al., 2001. Alcohol intake was categorized as none, ≤ 1 drink/day, >1 but <2 drinks/day, or ≥ 2 drinks/day. RESULTS: In longitudinal analyses, the risk of developing severe periodontitis among alcohol consumers was 10-17% higher over a period of 19-years compared to non-drinkers after controlling for age, smoking, diabetes, education, and number of teeth present. These estimates were higher still among men with lower than average vitamin B6 or B12 intakes. However, these results were not statistically significant The analyses suggested that men with mild, moderate or severe periodontitis had greater hazards of developing HHcy compared to disease-free participants after adjusting for covariates, but these results were not statistically significant. Consuming more than 2 drinks of alcohol per day significantly increased the risk of developing HHcy by 76% (p= 0.037). SUMMARY: Our findings suggest that alcohol consumption may increase the hazards of developing severe periodontal disease especially if vitamin B complex intakes are low. These results also suggest that periodontal disease and alcohol consumption each increases the hazards of hyperhomocysteinemia. We believe this is the first prospective cohort study to examine associations among periodontitis, homocysteine and alcohol consumption.

The importance of oral health on systemic health is a highly researched area of study in recent years. There has been a shift in dental visits from acute emergencies to ongoing preventative care due to the knowledge connecting oral and systemic health. One of the commonly researched connections is the link between periodontal disease and heart disease. Periodontal disease is defined as inflammation of the gum tissue, resulting in periodontal pockets that can lead to infection, bone loss and even loss of the tooth. Cardiovascular disease, or heart disease, is a term that encompasses many different conditions of the heart, including heart failure, myocardial infarction, atherosclerosis and angina. There is constant research to better understand the relationship between the two diseases, as well as any causality that may exist. Recent studies have been able to link the diseases, but no causal link has been found. The role of the bacteria involved in both diseases has recently been considered to see if these organisms are related to a potential causal link. Two particular bacteria that are known to be involved with periodontal disease are Porphyromona gingivalis and Treponema denticola. These bacteria are present when a patient develops periodontal disease, but they are not usually present in a healthy individual. Additionally, the bacteria that make up the contents of plaque found in the heart have been studied to see if there are any similarities with oral microbes. It has been found that oral bacteria can be present in arterial plaque samples. This research may allow a better understanding of how and why heart disease occurs and potentially serve as a way to treat heart disease accompanied by periodontal disease, if a causal relationship is elucidated. Heart disease is usually a devastating disease, sometimes resulting in the death of the patient. If more patients attend the dentist as a preventative measure, the risk of periodontal disease and associated pathologies may be reduced. Additionally, those that have already developed periodontal disease can work with a dental professional to reverse the disease. It is known that the bacteria in the mouth can enter the bloodstream upon infection, so patients with suspected periodontitis should be treated to avoid the bacteria from entering the blood and affecting other organs such as the heart. An examination of the bacteria commonly found in the oral cavity at times of periodontal disease may lead to a better understanding of how and why these bacteria invade the bloodstream. It would be beneficial to compare the microbiota of both the plaque in the mouth and the plaque in a vessel supplying the heart in a patient suffers from heart disease. This understanding may lead to therapeutic interventions that aid in the prevention of bacteria traveling in the bloodstream. For many Americans, oral health care was believed to end at home by brushing and flossing. However, it is important to see a dental professional to avoid any possible complications that may not be apparent to the untrained eye. A simple dental cleaning may be important to detect the start of periodontal disease, and treatment can be initiated to end the potential spread of bacteria. It is important to maintain positive oral health in order to maintain overall systemic health, including the avoidance of heart disease.

O ajuste oclusal (AO) como parte da terapia periodontal é um tema controverso, principalmente porque a literatura não fornece evidências suficientes sobre a influência do trauma de oclusão (TO) na doença periodontal (DP). A necessidade de ajuste oclusal na terapia periodontal é considerada incerta e requer investigação. O objetivo desta revisão sistemática foi identificar e analisar estudos que investigaram os efeitos do AO associado à terapia periodontal, sobre os parâmetros periodontais. Um protocolo foi desenvolvido incluindo todos os aspectos de uma revisão sistemática: estratégia de busca, critérios de seleção, seleção de métodos, coleta de dados e extração de dados. A pesquisa bibliográfica foi realizada utilizando MEDLINE via PubMed, Cochrane Central Register de estudos controlados e EMBASE. Os títulos e resumos de artigos foram selecionados de acordo com critérios estabelecidos na metodologia. Cada artigo que indicava uma possível correspondência com estes critérios, ou não poderia ser excluído baseado nas informações presentes no título ou no resumo, foi considerado e avaliado. Na seleção final, quatro artigos foram incluídos. Embora os estudos selecionados sugerem uma associação entre AO e uma melhora nos parâmetros periodontais, suas questões metodológicas (exploradas nesta revisão) sugerem a necessidade de novos estudos com maior qualidade. Atualmente as evidências presentes são insuficientes para presumir que AO é necessário para reduzir a progressão da doença periodontal. / Occlusal adjustment (OA) as part of periodontal therapy is a controversial theme, mostly because the literature does not provide enough evidence regarding the influence of trauma from occlusion (TO) on periodontitis. The need for occlusal adjustment in periodontal therapy is considered uncertain and requires investigation. The aim of this systematic review was to identify and analyze those studies that investigated the effects of OA, associated with periodontal therapy, on periodontal parameters. It was developed a protocol, which included all aspects of a systematic review: search strategy, selection criteria, selection methods, data collection and data extraction. A literature search was conducted using MEDLINE via PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE. Titles and abstracts of articles were selected according to established criteria. Every article that indicated a possible match, or could not be excluded based on the information given in the title or abstract, was considered and evaluated. On final selection, four articles were included. Although the selected studies suggest an association between OA and an improvement in periodontal parameters, their methodological issues (explored in this review) suggest the need for new trials of a higher quality. There is insufficient evidence at present to presume that OA is necessary to reduce the progression of periodontal disease.

Bibliography: leaves 110-120. Reports immunohistochemical investigations into the biological response to the application of an orthodontic force to the buccal segment teeth of marmosets.