Francisco Humberto Nociti Júnior

University of Campinas, Conceição de Campinas, São Paulo, Brazil

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Publications (39)42.1 Total impact

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    ABSTRACT: Background: This study investigated the effect of photodynamic therapy (PDT) as monotherapy during supportive periodontal therapy. Methods: A split-mouth, randomized controlled trial was conducted in chronic periodontitis patients (n=22) presenting at least three residual pockets [probing depth>5mm with bleeding upon probing (BoP)]. The selected sites randomly received: 1) PDT, 2) photosensitizer (PS), or 3) scaling and root planning (SRP). At baseline, three, and six months, clinical, microbiological (real-time PCR analyses), cytokine pattern (multiplexed bead immunoassay), and patient-centered (regarding morbidity) evaluations were performed. Results: All therapies promoted similar improvements in clinical parameters throughout the study (p<0.05), except that BoP was not reduced in the PS protocol (p>0.05). Lower levels of A. actinomycetemcomitans were observed in the PDT and SRP protocols at 3 months when compared to the PS protocol (p<0.05). An inferior frequency detection of P. gingivalis was observed in the PDT protocol at 3 and 6 months and in the SRP protocol at 6 months from baseline (p<0.05). In addition, PDT protocol presented inferior frequency of P. gingivalis at 3 months when compared to the other therapies (p<0.05). Only patients in the PDT protocol exhibited augmented levels of anti-inflammatory interleukin (IL)-4 and reduced pro-inflammatory IL-1β, and IL-6 throughout the study (p<0.05). Inter-group analyses showed reduced IL-10 and increased interferon (IFN)-γ, and IL-1β levels in the PS protocol when compared to the other therapies during follow-ups (p<0.05). No differences in morbidity were observed between the therapies (p>0.05), although the need for anesthesia was higher in SRP-treated sites (p<0.05). Conclusion: PDT as an exclusive therapy may be considered a non-invasive alternative for treating residual pockets, offering advantages in the modulation of cytokines.
    Journal of Periodontology 02/2014; · 2.40 Impact Factor
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    ABSTRACT: BACKGROUND AND OBJECTIVE: Occlusal trauma (OT) and smoking are both factors that alter alveolar bone metabolism and therefore could synergistically act on alveolar bone loss. The aim of this experimental study was to evaluate the influence of short-term cigarette smoke inhalation (CSI) on inter-radicular alveolar bone loss promoted by primary OT in a rat model. MATERIAL AND METHODS: Forty-eight animals were randomly assigned to one of three groups based on treatment type: OT + CSI (n = 16), animals were exposed to CSI three times per day, for 8 min per exposure, and they concomitantly received unilateral vertical augmentation creating an occlusal interference inducing experimental OT; OT (n = 16), animals received only unilateral vertical augmentation; negative control (NC; n = 16), animals maintained for equal periods to achieve periodontal baseline values of periodontal ligament dimension. Each group was divided into two subgroups (n = 8) based on treatment length: 7 or 14 d. RESULTS: After 7 d, the OT + CSI group exhibited significantly higher bone loss compared to the NC group (p = 0.0022). After 14 d, the OT (p < 0.0001) and OT + CSI (p < 0.0001) groups presented significantly higher bone loss compared to the NC group, and OT + CSI resulted in significantly higher bone loss than OT alone (p = 0.0241). The number of tartrate-resistant acid phosphatase-positive cells on the linear surface of the bone crest after 7 d was significantly higher in the OT + CSI group as compared to the NC and OT groups (p < 0.0001 and p = 0.0045, respectively) and remained significantly higher in the OT + CSI group after 14 d, compared to the OT group (p < 0.0001). CONCLUSION: Short-term CSI increases early bone loss in association with OT after 7 d, and this worsens in severity after 14 d of exposure.
    Journal of Periodontal Research 05/2013; · 1.99 Impact Factor
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    ABSTRACT: To clinically evaluate proximal furcations treated with hydroxyapatite/β-tricalcium phosphate (HA/β-TCP) isolated or combined with enamel matrix derivative (EMD). Thirty patients, presenting at least one proximal class II furcation defect, probing pocket depth (PPD) ≥5 mm and bleeding on probing, were included. The defects were assigned to the HA/β-TCP group (n = 15); open-flap debridement (OFD) + HA/β-TCP filling, or, HA/β-TCP-EMD group (n = 15); OFD + HA/β-TCP + EMD filling. Plaque (PI) and gingival index (GI), PPD, relative gingival margin position (RGMP), vertical and horizontal attachment level (RVAL and RHAL), vertical and horizontal bone level (RVBL and RHBL), and furcation diagnosis were evaluated at baseline and at 6 months. Both groups presented improvements after therapies (p < 0.05); however, no inter-group differences could be seen in any single parameter (p > 0.05). At 6 months, the gains in rVCAL in the HA/β-TCP and HA/β-TCP-EMD groups were 1.47 ± 0.99 and 2.10 ± 0.87 mm, while the RHCAL gains were 1.47 ± 1.46 and 1.57 ± 1.58 mm (p > 0.05). The RVBL and RHBL gains for the HA/β-TCP and HA/β-TCP-EMD group were 1.47 ± 1.13 and 1.70 ± 1.26 mm, and 1.90 ± 1.11 and 1.70 ± 1.37 mm respectively (p > 0.05). The HA/β-TCP-EMD group showed seven closed furcations versus four in the HA/β-TCP group (p > 0.05). Both treatments lead to improvements in all clinical variables studied in the present trial. However, the closure of proximal class II furcation defects is still unpredictable.
    Journal Of Clinical Periodontology 03/2013; 40(3):252-9. · 3.69 Impact Factor
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    ABSTRACT: OBJECTIVES: This 12-month randomized, controlled trial evaluated the clinical effects and microbiological changes of minimally invasive nonsurgical and surgical approaches for the therapy of intrabony defects. MATERIALS AND METHODS: Twenty-nine subjects with intrabony defects in single-rooted tooth were randomly assigned to; (1) minimally invasive nonsurgical technique (MINST) or (2) minimally invasive surgical technique (MIST). Quantities of Aggregatibacter actinomycetemcomitans, Tannerella forsythia, and Porphyromonas gingivalis, determined by using real-time PCR, were evaluated at baseline, 3, 6, and 12 months after the treatments. Clinical recordings-probing depth (PD), position of the gingival margin (PGM), and relative clinical attachment level (RCAL)-were obtained at baseline and 12 months post-therapy. The primary outcome variable of the study was RCAL. RESULTS: Both treatment modalities resulted in an improvement in all clinical recordings, with significant PD reductions (p < 0.05), RCAL gains (p < 0.05), and no change in the PGM (p > 0.05) after 12 months in both MINST and MIST groups. No clinical differences were observed between groups (p > 0.05). Regarding the microbiological outcomes, at the re-examinations, a significant decrease was observed for T. forsythia and P. gingivalis when compared with baseline (p < 0.05) for both treatments. The amount of A. actinomycetemcomitans did not reduced decrease throughout the study (p > 0.05). Intergroup differences in the microbiological assay were not found at any time point (p > 0.05). CONCLUSIONS: Both MINST and MIST provided comparable clinical results and microbiological changes in the treatment of intrabony defects over 12 months follow-up. CLINICAL RELEVANCE: This randomized, controlled, parallel trial revealed that both therapeutic modalities may promote clinical and microbiological benefits at 12 months post-therapy.
    Clinical Oral Investigations 10/2012; · 2.20 Impact Factor
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    ABSTRACT: Buccal gingival recession is a prevalent problem in populations with a high standard of oral hygiene and is often associated with noncarious cervical lesions (NCCLs), leading to the need for a combined periodontal-restorative approach for better esthetic and functional results. In the literature, resin-modified glass ionomer (RMGI) restorations associated with periodontal surgery have been shown to achieve significant root coverage and reduction of dentin sensitivity; however, changes to the color of some of those restorations have been observed, which could compromise esthetics. Therefore, the aim of the present case report is to describe and discuss the current understanding of treatment for a gingival recession associated with an NCCL with a periodontal-restorative approach, and to describe treatment of RMGI color alteration problems two years after treatment.
    General dentistry 07/2012; 60(4):306-11.
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    ABSTRACT: The aim of this study was to evaluate, histometrically, the bone healing of the molar extraction socket just after cigarette smoke inhalation (CSI). Forty male Wistar rats were randomly assigned to a test group (animals exposed to CSI, starting 3 days before teeth extraction and maintained until sacrifice; n=20) and a control group (animals never exposed to CSI; n=20). Second mandibular molars were bilaterally extracted and the animals (n=5/group/period) were sacrificed at 3, 7, 10 and 14 days after surgery. Digital images were analyzed according to the following histometric parameters: osteoid tissue (OT), remaining area (RA), mineralized tissue (MT) and non-mineralized tissue (NMT) in the molar socket. Intergroup analysis showed no significant differences at day 3 (p>0.05) for all parameters. On the 7(th) day, CSI affected negatively (p<0.05) bone formation with respect to NMT and RA (MT: 36%, NMT: 53%, RA: 12%; and MT: 39%, NMT: 29%, RA: 32%, for the control and test groups, respectively). In contrast, no statistically significant differences (p>0.05) were found at days 10 and 14. It may be concluded that CSI may affect socket healing from the early events involved in the healing process, which may be critical for the amount and quality of new-bone formation in smokers.
    Brazilian dental journal 01/2012; 23(3):228-34.
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    ABSTRACT: Cowden syndrome, also known as multiple hamartoma syndrome, is a rare autosomal dominant disorder characterized by multiple hamartomas and a high risk of development of malignancy. Oral findings, such as papillomatous lesions and fibromas, are common features; however, a periodontal phenotype has not been reported previously. Therefore, this report presents a case of gingival overgrowth associated with Cowden syndrome, its successful surgical management, and the 12-month follow-up results. Additionally, we discuss the implications for clinicians. A 23-year-old woman was referred to the Department of Periodontics, Piracicaba Dental School, presenting with generalized gingival overgrowth. A detailed dental and medical history and clinical examination confirmed the systemic diagnosis of Cowden syndrome. Histology, radiographs, and clinical data document the entire clinical approach and follow-up. Clinically, there were minor signs of recurrence of gingival overgrowth in a 12-month period after gingivectomy; however, papular lesions reappeared in keratinized gingiva immediately after healing. No signs of bone loss related to the systemic condition were observed radiographically. Histologically, a dense connective tissue with a moderate chronic inflammatory infiltrate and epithelial acanthosis, which is characteristic of gingival hyperplasia, were demonstrated. Gingival overgrowth may occur as an oral phenotype related to Cowden syndrome and can be successfully treated by means of external bevel gingivectomy, followed by regular maintenance therapy, contributing to the patient's well-being, both functionally and esthetically.
    Quintessence international (Berlin, Germany: 1985) 05/2011; 42(5):e60-4. · 0.64 Impact Factor
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    ABSTRACT: The present study aims to compare the performance of minimally invasive non-surgical and surgical approaches for the therapy of intrabony defects. Twenty-nine patients who presented with intrabony defects were randomly assigned to: 1) a minimally invasive non-surgical technique (MINST) group, or 2) minimally invasive surgical technique (MIST) group. The chair time of each therapeutic procedure was calculated. The probing depth (PD), position of the gingival margin (PGM) and relative clinical attachment level (RCAL) were evaluated at 3 and 6 months after treatments. The patient perception of discomfort/pain experienced during and after therapy and patient satisfaction regarding treatments were also evaluated. Significant PD reductions, RCAL gains, and no changes in the PGM were obtained at 3 and 6 months in MINST and MIST groups (P <0.05). No differences were observed between groups at any time points (P >0.05). Patient-oriented outcomes did not demonstrate differences between therapeutic approaches (P >0.05). Significant higher chair times were required in the MIST group than in the MINST group (P <0.05). Minimally invasive non-surgical and surgical approaches were successfully used for the treatment of intrabony defects and achieved periodontal health in association with negligible morbidity and suitable patient satisfaction. However, non-surgical therapeutic modality presented an advantage in terms of a reduction of treatment chair time.
    Journal of Periodontology 02/2011; 82(9):1256-66. · 2.40 Impact Factor
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    ABSTRACT: This study investigates the impact of enamel matrix derivative (EMD) proteins on the outcome of a minimally invasive surgical technique (MIST) for the treatment of intrabony defects. Thirty patients who presented with intrabony defects were randomly assigned to treatment with: 1) MIST plus EMD or 2) MIST alone. Probing depth (PD), position of the gingival margin (PGM), and relative clinical attachment level (RCAL) were evaluated at 3 and 6 months after treatment. Radiographs and markers in gingival crevicular fluid associated with periodontal regeneration were also evaluated. Significant PD reductions, RCAL gains, and no changes in PGM were obtained at 3 and 6 months in both groups. Clinical and radiographic evaluations and levels of mediators of wound healing did not present differences between therapies at any time. The use of EMD did not provide superior benefits on the outcome of the minimally invasive surgical approach for the treatment of intrabony defects.
    Journal of Periodontology 11/2010; 82(4):522-32. · 2.40 Impact Factor
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    ABSTRACT: This case series evaluated the clinical performance and patient-centered outcomes after a minimally invasive surgical technique (MIST) associated with enamel matrix protein derivative (EMD), for the treatment of intra-bony defects. Twelve patients presenting teeth with probing depth >or=5 mm and bleeding on probing associated with radiographic evidence of intra-bony defect were treated by MIST associated with EMD. Clinical parameters were measured at baseline, 3 and 6 months. Patient perception during the intraoperative period and during the first postoperative week was evaluated. The use of MIST with EMD promoted significant improvements in clinical parameters, minimal pain/discomfort and maximum esthetics satisfaction. Within of limits of the present study, it could be shown that MIST combined with EMD for the treatment of intra-bony defects promotes satisfactory clinical and patient-centered outcomes.
    Brazilian dental journal 01/2010; 21(1):60-7.
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    ABSTRACT: The aim of this clinical study was to evaluate the treatment of gingival recession, associated with non-carious cervical lesions by a connective tissue graft (CTG) alone, or in combination with a resin-modified glass ionomer restoration (CTG+R). Forty patients presenting Miller Class I buccal gingival recessions, associated with non-carious cervical lesions, were selected. The defects were randomly assigned to receive either CTG or CTG+R. Bleeding on probing (BOP), probing depth (PD), relative gingival recession (RGR), clinical attachment level (CAL) and cervical lesion height (CLH) coverage were measured at baseline and 45 days, and 2, 3 and 6 months after treatment. Both groups showed statistically significant gains in CAL and soft tissue coverage. The differences between groups were not statistically significant in BOP, PD, RGR and CAL, after 6 months. The percentages of CLH covered were 74.88 +/- 8.66% for CTG and 70.76 +/- 9.81% for CTG+R (p>0.05). The estimated root coverage was 91.91 +/- 17.76% for CTG and 88.64 +/- 11.9% for CTG+R (p>0.05). Within the limits of the present study, it can be concluded that both procedures provide comparable soft tissue coverage. The presence of the glass ionomer restoration may not prevent the root coverage achieved by CTG.
    Journal Of Clinical Periodontology 07/2009; 36(9):791-8. · 3.69 Impact Factor
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    ABSTRACT: This study assessed gene expression by quantitative polymerase chain reaction of inflammatory- [interleukin (IL)-12, tumor necrosis factor-alpha (TNF-alpha), IL-4, and IL-10] and osteoclastogenesis-related factors [receptor activator of NF-kappaB ligand (RANKL) and osteoprotegerin (OPG)] in sites exhibiting different severities of peri-implant disease. Peri-implant soft tissue biopsies (n=48) were harvested from healthy implant (HI), mucositis (MC), initial peri-implantitis (IP) and severe peri-implantitis (SP) sites. IL-12 and TNF-alpha mRNA levels were higher in SP, followed by IP and MC (P <0.05). IL-4 was higher in HI, followed by MC, SP and IP (P <0.05). IL-10 was the lowest in HI, while no differences were detected among the diseased groups (P>0.05). OPG mRNA levels were higher in HI, followed by IP, SP and MC, whereas RANKL was increased as the peri-implantitis severity increased (P<0.05). The highest OPG/RANKL ratio was observed in HI and the lowest in SP (P<0.01). These findings suggest that expressions of inflammatory- and osteoclastogenesis-related factors may play an important role in the onset and severity of the peri-implant diseases.
    Clinical Oral Implants Research 03/2009; 20(5):514-20. · 3.43 Impact Factor
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    ABSTRACT: To evaluate the influence of tetracycline gel, brushed on tooth surfaces, on periodontal clinical parameters following root debridement. 20 subjects diagnosed with chronic periodontitis and presenting a minimum of two proximal sites on anterior teeth (maxillary or mandibular) with probing depth +/- 5 mm, were selected. Following oral hygiene instructions and ultrasonic supragingival instrumentation, subjects were assigned to one of the following groups: RDS--root debridement with Gracey curettes and root brushing with saline solution; and RDT--root debridement with Gracey curettes and root brushing with 40% tetracycline gel. Full-thickness flaps were reflected and instrumentation was performed using a clinical microscope to optimize calculus detection. Probing depth (PD), relative gingival margin level (RGML) and relative attachment level (RAL) measures were registered at five visits: baseline and days 30, 60, 90 and 120 postoperative. Both approaches were able to markedly reduce the PD values from baseline in all periods (P < 0.0001). No differences were found for RAL values in any of the groups. No differences were found between groups. In conclusion, the application of tetracycline gel does not seem to provide any additional improvement on clinical periodontal parameters after root debridement.
    American journal of dentistry 06/2008; 21(3):168-70. · 1.06 Impact Factor
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    ABSTRACT: O objetivo do presente trabalho é relatar três casos clínicos tratados com a técnica de enxerto gengival livre. Dois pacientes apresentaram recessões gengivais múltiplas e isoladas, classes II e III de Miller, na região ântero-inferior, e o terceiro apresentou ausência de gengiva queratinizada na região vestibular adjacente a implante osseointegrado. Em todos os casos procedeu-se à realização de enxerto gengival livre, tendo como área doadora o palato. Os pacientes foram acompanhados por até um ano. Após o período de cicatrização, todos os casos mostraram aumento na largura de gengiva queratinizada e, nos casos 1 e 2, redução das recessões gengivais. Durante todo o período de acompanhamento, não foram observados sinais de inflamação gengival ou sangramento à sondagem, e os pacientesmantiveram adequado controle de placa. Este relato de casos indica que a técnica de enxerto gengival livre pode ser realizada comsucesso para recobrimento de recessões gengivais múltiplas ou isoladas, bem como para aumentar a largura de gengiva queratinizadaperiimplantar.
    RGO : Revista Gaúcha de Odontologia. 01/2008;
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    ABSTRACT: The aim of this report is to show three cases treated by the free gingival graft technique. Two patients presented multiple andisolated Miller’s Class II and III gingival recessions, localized in the anterior region of mandible. The third patient showed absence ofqueratinized gingiva on the buccal aspect of an osseointegrated implant. All patients received free gingival grafts, and the palate was the donor area. The patients were followed up to one year. After the healing period, all cases showed an increase of the queratinized gingival width and, in cases 1 and 2, a reduction in gingival recession. During follow-up period, no signs of gingival inflammation and bleeding on probing were seen. The patients maintained appropriate plaque control and were satisfied with the final esthetics. This report indicates that free gingival graft technique can be used for successful treatment of multiple and isolated gingival recessions, as well as to increase periimplantar queratinized gingival width.
    RGO : Revista Gaúcha de Odontologia. 01/2008;
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    ABSTRACT: The aim of this study was to evaluate histometrically bone healing in surgically created dehiscence-type defects around titanium implants treated with an association of platelet-rich plasma (PRP) and guided bone regeneration (GBR). Ten male adult mongrel dogs were used, from which the three low premolars (P2, P3, P4) and the first molar were extracted. Three months after teeth extraction, two implant sites were bilaterally drilled, buccal bone dehiscences were created and four titanium implants were placed. Dehiscences were randomly assigned to the following groups: (1) PRP, (2) GBR, (3) PRP+GBR and (4) control. After 3 months, the animals were sacrificed and the implants and adjacent hard tissues were processed for undecalcified sections. Bone-to-implant contact (BIC), bone density within the limits of implant threads (BW), bone density (BD) and new bone area (BA) in a zone lateral to the implant corresponding to bone defects were obtained and measured. Intergroup analysis (two-way ANOVA -alpha=5%) demonstrated that when PRP was utilized,no differences were observed for all parameters (P>0.05). However, significant differences were observed for BIC and BW toward membrane-treated groups (P<0.05). Within the limits of this study, it was concluded that PRP does not exert additional effects on bone healing in bone defects created around dental implants and treated by GBR.
    Clinical Oral Implants Research 10/2007; 18(5):649-54. · 3.43 Impact Factor
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    ABSTRACT: The aim of the present study was to evaluate whether a stent should be used when assessing attachment level (AL) by an electronic probe (Florida Probe). Twenty patients were recruited and individual stents were obtained to measure relative AL (RAL) with the Florida stent probe. Conventional AL (CAL) measurements were obtained by adding pocket depth and gingival recession recorded by the Florida pocket probe. Duplicate RAL and CAL measurements were taken one hour apart from each other on anterior teeth, at six sites per tooth, by one examiner. Patients were treated and reassessed with both probes after 45 days so that the gain in RAL and CAL could also be compared. Pearson's correlation test showed that correlation was moderate (r = 0.57) and significant (p < 0.001) for duplicate CAL measurements. As for RAL values, correlation was higher (0.91) and significant (p < 0.001). The difference between RAL and CAL gain after 45 days was 0.04 mm (p = 0.85). Since the correlation was higher for duplicate RAL measurements than for CAL measurements, the use of a stent should be considered in clinical trials to ensure better reproducibility of measurement of attachment level gains.
    Journal of the International Academy of Periodontology 05/2007; 9(2):58-62.
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    ABSTRACT: The continuous search for improved surgical procedures to address gingival deformities is a consequence of an increasing demand for aesthetics in the periodontal clinical practice. Innovative techniques have been reported to help clinicians achieve predictability in root coverage. Significant progress can be attributed to the inclusion of the operative microscope in periodontal therapy, particularly in regards to obtaining primary closure. This article describes a microsurgical technique used to treat gingival recessions, showing its potential for obtaining optimal aesthetic results.
    Practical procedures & aesthetic dentistry: PPAD 09/2006; 18(7):449-54; quiz 456.
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    ABSTRACT: The purpose of this study was to evaluate the root surface roughness after instrumentation with hand curette and diamond-coated sonic and universal ultrasonic tips. Forty root surfaces of human teeth were randomly assigned to four treatment groups: control group (without instrumentation), curette instrumentation, ultrasonic instrumentation with universal tip and sonic instrumentation with diamond-coated tip. Each sample was instrumented with fifteen strokes. Before and after instrumentation, surface roughness was measured. In addition, the root surface topography was examined after treatment under the scanning electron microscope. Significant statistical differences (p <0.05) were observed when comparing the control group (0.48+/-0.07mm) to the treated groups (hand - 1.246+/-0.279mm, ultrasonic - 1.468+/-0.177mm and sonic instrumentation - 1.576+/-0.20mm). The highest roughness was produced by diamond-coated sonic tip and by ultrasonic universal tip (p >0.05). The diamond-coated tip with sonic scaler instrumentation and ultrasonic instrumentation produce similar root surface roughness, higher than curette instrumentation.
    Journal of applied oral science: revista FOB 04/2006; 14(2):124-9. · 0.39 Impact Factor
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    ABSTRACT: Ultrasonic and curette instrumentation produces a rougher root surface which could be influenced by working parameters such as instrumentation time, pressure and tip angulations. Thus, the aim of this in vitro study was to evaluate root roughness after ultrasonic instrumentation with different power settings and compared it to curette instrumentation. Ninety extracted human teeth were assigned to one of five groups: control group (without instrumentation), curette instrumentation, ultrasonic instrumentation with low, medium, and high power. Before and after instrumentation, surface roughness was measured with a profilometer and the surfaces were examined under the SEM. The mean roughness values of the treated roots were higher than the non-treated roots (0.40+0.08mm). Roots treated by ultrasonic instrumentation had higher roughness means than roots treated by curettes (1.120+0.241mm). Among ultrasonic groups, the higher power setting produced the higher roughness mean (1.58+0.23mm), which was significantly higher than the roughness obtained with the low power setting (1.39+0.18mm). These findings show that ultrasonic instrumentation with a high power setting produced a rougher root surface than ultrasonic instrumentation with a lower power setting. In addition, manual instrumentation with curettes produced lower roughness than ultrasonic instrumentation independent of power setting.
    Brazilian Journal of Oral Sciences (ISSN: 1677-3217) Vol 5 Num 17. 01/2006;