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Romano F, Perotto S, Baima G, Macrì G, Picollo F, Romandini M, Mariani GM, Aimetti M. Estimates and multivariable risk assessment of mid-buccal gingival recessions in an Italian adult population according to the 2018 World Workshop Classification System. Clin Oral Investig 2022; 26:4769-4780. [PMID: 35301598 PMCID: PMC9276566 DOI: 10.1007/s00784-022-04441-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/04/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this cross-sectional study was to provide estimate of mid-buccal gingival recession (GR) according to the 2018 World Workshop Classification System and to explore GR risk indicators in a representative urban population in North-West of Italy. MATERIAL AND METHODS This is a secondary analysis using data collected in an epidemiological study enrolling a representative sample of 736 adults, living in Turin. GR prevalence was defined as the presence of at least one mid-buccal GR ≥ 1 mm. GRs were categorized according to the 2018 classification system (RT1, RT2, RT3) and to different severity cutoffs. Logistic regression analysis was performed to identify RT GR risk indicators. RESULTS Mid-buccal GR ≥ 1 mm affected 57.20% of subjects and 14.56% of teeth. When considering RT1 GRs, their prevalence was 40.90% and 6.29% at the patient and tooth level. RT2 and RT3 GRs affected 25.82% and 36.68% of the study population, respectively. RT1 GRs occurred mostly on maxillary and mandibular premolars and maxillary canines, while RT2 and RT3 GRs on maxillary molars and mandibular incisors. Older age, high education, and full-mouth plaque score (FMPS) < 30% were risk indicators for RT1 GRs, while older age, poor education, periodontitis, and FMPS > 60% were significant contributors to RT2 and RT3 GRs. CONCLUSIONS RT1 and RT3 are fairly common findings in this Italian population and are significantly associated to different contributing factors and tooth type distribution pattern. CLINICAL RELEVANCE Prevention strategies should target different socio-demographic, behavioral, and clinical risk indicators based on the RT classes.
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Affiliation(s)
- Federica Romano
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy.
| | - Stefano Perotto
- Postgraduate Program in Periodontology, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Giacomo Baima
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Gianfranco Macrì
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Fabrizio Picollo
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Mario Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Giulia Maria Mariani
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Mario Aimetti
- Periodontology Unit, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126, Turin, Italy
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The use of medium bristle toothbrushes is associated with the incidence of gingival fissures. Clin Oral Investig 2021; 26:1657-1666. [PMID: 34435253 DOI: 10.1007/s00784-021-04138-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The objective of this study was to compare the incidence of gingival fissures (GF) associated with the use of soft and medium bristle toothbrushes over three months. MATERIAL AND METHODS A blind randomized crossover clinical trial was conducted with 20 high school students (14 females, 14-24 years old) using both toothbrushes type (soft and medium bristle) during 3 months each. Periodontal examinations and photographs of premolars and molars were recorded on days 0, 30, 60, and 90 of 1st phase. Following a 10-day washout period, the 2nd phase was carried out with the participants changing the assigned brush type. Toothbrushing perception was evaluated at the end of study through a questionnaire. A calibrated and blind examiner analyzed the photographs for GF presence. Differences in the GF incidence between toothbrushes type were analyzed by McNemar test, while factors associated with GF incidence were investigated by Poisson regression. RESULTS Sixty-five percent (n = 13) of participants had at least one GF throughout the study, with 40% (n = 8) of them while using medium brushes only (p = 0.039). GF occurrence was significantly associated with medium brushes (IRR, 3.582; 95% CI 1.459-8.795; p = 0.005). 58.8% of participants reported gingival soreness or bleeding with medium brushes. CONCLUSIONS Both toothbrushes led to the GF occurrence. Nonetheless, medium bristles toothbrushes determined a 3.58 times greater risk of developing these lesions. Clinical relevance The use of medium bristle brush is associated with greater incidence of gingival fissures. The presence of gingival fissures should be considered by the clinician when evaluating the toothbrushing habits of patients.
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Evaluation of teeth injuries in Beagle dogs caused by autoclaved beef bones used as a chewing item to remove dental calculus. PLoS One 2020; 15:e0228146. [PMID: 32053619 PMCID: PMC7018081 DOI: 10.1371/journal.pone.0228146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 01/08/2020] [Indexed: 11/30/2022] Open
Abstract
Dental calculus (DC) is the most widespread oral problem in domestic dogs. Chewing items are used to remove DC from the tooth surface; they also favor oral health and animal welfare. Raw beef bone mastication also shortly reduces DC in adult dogs. However, it can cause oral lesions and hence is not popular. This study evaluated the impact of bone mastication on the dental roots, enamel, and gingiva of dogs. Twelve adult Beagle dogs were randomly divided into 2 treatment groups in a completely randomized block design: cortical bone (CB) or spongy bone (SB). Intraoral radiographs were obtained on days 0 and 14, and calculus assessment was performed using images captured on days 0, 3, 6, 9, 12, and 14; an integration program was used to measure the proportion between the area covered by calculus and the total area of teeth. DC was completely removed from the first and second premolars and molars from both the arcades in less than 3 days of supplementation, indicating that these teeth were frequently used for chewing (P < 0.10). Bones were highly effective for DC removal and gingival inflammation reduction. Despite the hardness of bones, no lesions or teeth root and enamel fracture, or esophageal or intestinal obstructions—complications related to bone ingestion—were noted. However, SB showed some gingival lesions (n = 4) and bone remnants between teeth (n = 2). Gingival lesions were caused by the daily and continuous supply of new pieces of bone for 13 days. Specific pieces of bone should be used for oral home care programs because they shortly remove almost 90% of DC, allowing longer intervals between periodontal cleaning procedures. Long-term studies are required to evaluate the use of bones and evaluate their impact on teeth and periodontium after prolonged supplementation.
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Vignoletti F, Di Martino M, Clementini M, Di Domenico GL, de Sanctis M. Prevalence and risk indicators of gingival recessions in an Italian school of dentistry and dental hygiene: a cross-sectional study. Clin Oral Investig 2019; 24:991-1000. [DOI: 10.1007/s00784-019-02996-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 06/28/2019] [Indexed: 10/26/2022]
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Ranzan N, Muniz FWMG, Rösing CK. Are bristle stiffness and bristle end-shape related to adverse effects on soft tissues during toothbrushing? A systematic review. Int Dent J 2019; 69:171-182. [DOI: 10.1111/idj.12421] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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De Nutte M, Behaeghe E, van der Weijden GA, Coucke W, Teughels W, Quirynen M. Healing of toothbrush-induced abrasions to keratinized mucosa of the palate in humans: A pilot study. J Periodontal Res 2018; 53:506-513. [PMID: 29492983 DOI: 10.1111/jre.12540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE To the best of our knowledge, the healing time for toothbrush-induced gingival abrasions in humans has not yet been explored. The aim of this study was to evaluate the time needed to heal for toothbrush-induced abrasions of the keratinized mucosa of the palate. MATERIAL AND METHODS In patients without, with mild periodontitis or with periodontitis, gingival abrasion lesions were induced at the keratinized mucosa of the palate by brushing up to 2 minutes. Healing as observed clinically was followed via calibrated digital photographs of the lesion after staining, every 24 hours until the lesion had resolved. In patients without or with only mild periodontitis, the healing time of lesions caused by 30 seconds and 1 minute of brushing was also recorded. RESULTS Thirty-one participants (11 without or with mild periodontitis, 20 with periodontitis) met the inclusion criteria. In patients without or with mild periodontitis, the lesions induced by brushing for 2 minutes diminished by 48.7% of their original surface area within 24 hours. In patients with periodontitis the respective outcome was 45.4% (P = .87). Abrasions caused by 2 minutes of brushing needed more than 24 hours to heal completely. When decreasing the time exposed to trauma, fewer lesions were visible at baseline and the time needed to heal decreased. The subgroup of smokers was too small to evaluate any effect. CONCLUSION The longer the exposure time of the keratinized mucosa of the palate to trauma, the more lesions were visible, the larger the abrasions were and the more time they needed to heal completely. More studies are needed to investigate the role of smoking, gingival biotype and to link these findings with gingival recessions.
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Affiliation(s)
- M De Nutte
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - E Behaeghe
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - G A van der Weijden
- Department of Periodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - W Coucke
- Department of Clinical Biology, Scientific Institute of Public Health, Brussels, Belgium
| | - W Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - M Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Dörfer CE, Staehle HJ, Wolff D. Three-year randomized study of manual and power toothbrush effects on pre-existing gingival recession. J Clin Periodontol 2016; 43:512-9. [PMID: 26810391 PMCID: PMC5084749 DOI: 10.1111/jcpe.12518] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 11/30/2022]
Abstract
AIM To compare long-term effects of brushing with an oscillating-rotating power toothbrush or an ADA reference manual toothbrush on pre-existing gingival recession. MATERIALS AND METHODS In this controlled, prospective, single-blind, parallel-group study, healthy subjects with pre-existing recession were randomized and brushed with a power toothbrush (n = 55) or an ADA reference manual toothbrush (n = 54) for a 3-year study period. Subjects were required to brush their teeth twice daily for 2 min. using a standard fluoride toothpaste. During the study, subjects were assessed for clinical attachment loss and probing pocket depths to the nearest mm at six sites per tooth by the same calibrated examiner. Gingival recession was calculated at pre-existing sites as the difference between clinical attachment loss and probing pocket depths. Hard and soft oral tissues were examined to assess safety. RESULTS After 35 ± 2 months, mean gingival recession did not differ significantly between groups, but was significantly reduced from baseline (p < 0.001), from 2.35 ± 0.35 mm to 1.90 ± 0.58 mm in the power and from 2.26 ± 0.31 mm to 1.81 ± 0.66 mm in the manual group. CONCLUSIONS Gingival recession in subjects with pre-existing recession was significantly reduced after 3 years of brushing with either a power or manual toothbrush.
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Affiliation(s)
- Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Oral Medicine, Christian-Albrechts-University at Kiel, Kiel, Germany
| | - Hans Jörg Staehle
- Department of Conservative Dentistry, Dental School, University of Heidelberg, Heidelberg, Germany
| | - Diana Wolff
- Department of Conservative Dentistry, Dental School, University of Heidelberg, Heidelberg, Germany
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Merijohn GK. Management and prevention of gingival recession. Periodontol 2000 2016; 71:228-42. [DOI: 10.1111/prd.12115] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2015] [Indexed: 01/10/2023]
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Cassini MA, Cerroni L, Ferlosio A, Orlandi A, Pilloni A. The gingival Stillman's clefts: histopathology and cellular characteristics. ANNALI DI STOMATOLOGIA 2016; 6:100-3. [PMID: 26941897 DOI: 10.11138/ads/2015.6.3.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM OF THE STUDY Stillman's cleft is a mucogingival triangular-shaped defect on the buccal surface of a root with unknown etiology and pathogenesis. The aim of this study is to examine the Stillman's cleft obtained from excision during root coverage surgical procedures at an histopathological level. MATERIALS AND METHOD Harvesting of cleft was obtained from two periodontally healthy patients with a scalpel and a bevel incision and then placed in a test tube with buffered solution to be processed for light microscopy. RESULTS Microscopic analysis has shown that Stillman's cleft presented a lichenoid hand-like inflammatory infiltration, while in the periodontal patient an inflammatory fibrous hyperplasia was identified. CONCLUSION Stillman's cleft remains to be investigated as for the possible causes of such lesion of the gingival margin, although an inflammatory response seems to be evident and active from a strictly histopathological standpoint.
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Affiliation(s)
- Maria Antonietta Cassini
- Department of Oral and Maxillofacial Sciences, Section of Periodontology "Sapienza", University of Rome, Italy; Department of Clinical Sciences and Translational Medicine, "Tor Vergata" University of Rome, Italy
| | - Loredana Cerroni
- Department of Clinical Sciences and Translational Medicine, "Tor Vergata" University of Rome, Italy
| | - Amedeo Ferlosio
- Department of Biomedicine and Prevention, Institute of Anatomic Pathology, "Tor Vergata" University of Rome, Italy
| | - Augusto Orlandi
- Department of Biomedicine and Prevention, Institute of Anatomic Pathology, "Tor Vergata" University of Rome, Italy
| | - Andrea Pilloni
- Department of Oral and Maxillofacial Sciences, Section of Periodontology "Sapienza", University of Rome, Italy
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Hennequin-Hoenderdos NL, Slot DE, Van der Sluijs E, Adam R, Grender JM, Van der Weijden GA. The effects of different levels of brush end rounding on gingival abrasion: a double-blind randomized clinical trial. Int J Dent Hyg 2016; 15:335-344. [DOI: 10.1111/idh.12212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- NL Hennequin-Hoenderdos
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam; Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
| | - DE Slot
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam; Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
| | - E Van der Sluijs
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam; Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
| | - R Adam
- Procter & Gamble Service GmbH; Kronberg Germany
| | | | - GA Van der Weijden
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam; Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
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CAPOROSSI LS, DUTRA DAM, MARTINS MR, PROCHNOW EP, MOREIRA CHC, KANTORSKI KZ. Combined effect of end-rounded versus tapered bristles and a dentifrice on plaque removal and gingival abrasion. Braz Oral Res 2016; 30:S1806-83242016000100227. [DOI: 10.1590/1807-3107bor-2016.vol30.0037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 11/19/2015] [Indexed: 11/21/2022] Open
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Heasman PA, Holliday R, Bryant A, Preshaw PM. Evidence for the occurrence of gingival recession and non-carious cervical lesions as a consequence of traumatic toothbrushing. J Clin Periodontol 2015; 42 Suppl 16:S237-55. [DOI: 10.1111/jcpe.12330] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2014] [Indexed: 12/31/2022]
Affiliation(s)
- Peter A. Heasman
- School of Dental Sciences; Newcastle University; Newcastle upon Tyne UK
| | | | - Andrew Bryant
- Institute of Health and Society; Newcastle University; Newcastle upon Tyne UK
| | - Philip M. Preshaw
- School of Dental Sciences; Newcastle University; Newcastle upon Tyne UK
- Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
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Rosema NAM, Adam R, Grender JM, Van der Sluijs E, Supranoto SC, Van der Weijden GA. Gingival abrasion and recession in manual and oscillating-rotating power brush users. Int J Dent Hyg 2014; 12:257-66. [PMID: 24871587 PMCID: PMC4265303 DOI: 10.1111/idh.12085] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess gingival recession (GR) in manual and power toothbrush users and evaluate the relationship between GR and gingival abrasion scores (GA). METHODS This was an observational (cross-sectional), single-centre, examiner-blind study involving a single-brushing exercise, with 181 young adult participants: 90 manual brush users and 91 oscillating-rotating power brush users. Participants were assessed for GR and GA as primary response variables. Secondary response variables were the level of gingival inflammation, plaque score reduction and brushing duration. Pearson correlation was used to describe the relationship between number of recession sites and number of abrasions. Prebrushing (baseline) and post-brushing GA and plaque scores were assessed and differences analysed using paired tests. Two-sample t-test was used to analyse group differences; ancova was used for analyses of post-brushing changes with baseline as covariate. RESULTS Overall, 97.8% of the study population had at least one site of ≥1 mm of gingival recession. For the manual group, this percentage was 98.9%, and for the power group, this percentage was 96.7% (P = 0.621). Post-brushing, the power group showed a significantly smaller GA increase than the manual group (P = 0.004); however, there was no significant correlation between number of recession sites and number of abrasions for either group (P ≥ 0.327). CONCLUSIONS Little gingival recession was observed in either toothbrush user group; the observed GR levels were comparable. Lower post-brushing gingival abrasion levels were seen in the power group. There was no correlation between gingival abrasion as a result of brushing and the observed gingival recession following use of either toothbrush.
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Affiliation(s)
- N A M Rosema
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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Rios FS, Costa RSA, Moura MS, Jardim JJ, Maltz M, Haas AN. Estimates and multivariable risk assessment of gingival recession in the population of adults from Porto Alegre, Brazil. J Clin Periodontol 2014; 41:1098-107. [DOI: 10.1111/jcpe.12303] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Fernando S. Rios
- Faculty of Dentistry; Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Ricardo S. A. Costa
- Faculty of Dentistry; Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Mauricio S. Moura
- Faculty of Dentistry; Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Juliana J. Jardim
- Faculty of Dentistry; Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Marisa Maltz
- Faculty of Dentistry; Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Alex N. Haas
- Faculty of Dentistry; Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
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