Efetividade in vitro de agentes irrigantes na neutralização de endotoxinas em canais radiculares

Pós-graduação em Biopatologia Bucal - ICT

Avaliação e correlação da presença de endotoxinas e MMP-3, -8 e -9 em canais radiculares com necrose pulpar submetidos ao tratamento endodôntico - estudo in vivo

It is know that endotoxin and various matrix metalloproteinases (MMPs) are involved in the development of periapical lesions. The purpose of this study was to evaluate and correlate the presence of endotoxins and MMP- 3, MMP-8 and MMP-9 in root canals of teeth with necrotic pulp and periapical lesion before, during and after the biomechanical preparation (PBM) using a combination of different irrigations solutions and intracanal dressing. Thirty-three single-root teeth with a diagnosis of pulp necrosis and periapical lesion radiographically visible were selected. Immediately after the coronal opening was collected the first sample from the root canal content. Then, all canals were prepared (cervical and middle thirds) by oscillatory instruments (EndoEze) and irrigated by 2.5% NaOCl. After, a manual preparation was made for the apical third and the teeth were divided into three groups according to the irrigation protocol: G1) 2.5% NaOCl (4 manual files); G2) 2.5% NaOCl (2 manual files) + [Ca (OH)2 0.14%] (2 manual files) and G3) 2.5% NaOCl (2 manual files) + polymyxin B (2 manual files). After the PBM, the second sample was collected; then the third collect was performed after using EDTA final flush. The fourth sample was collected 14 days after placing the dressing [2% chlorhexidine gel + Ca(OH)2]. Quantification of endotoxins was performed by a kinetic chromogenic lysate from amoebocytes of Limulus (LAL) and quantification of MMPs by ELISA assay. The results were analyzed statistically by Kruskal-Wallis and Dunn's test (5%) and ordinal Spearman correlation. Presence of endotoxin was observed in 100% of cases and G3 showed the greatest reduction of endotoxins from the 1st to the 2nd samples (97%), being statistically similar to G2 (84.2%) and different from G1 (49.4%) (p<0.05). The intracanal dressing promoted a significant reduction of endotoxin, no difference among the groups. For...

Interação entre Sorgo Sacarino e plantas daninhas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Reação de araçazeiros a Meloidogyne enterolobii e enxertia da goiabeira ‘Paluma’ em portaenxertos resistentes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação de uma nova abordagem cirúrgico-restauradora para tratamento de recessões gengivais associadas à lesão cervical não-cariosa: estudo clínico controlado randomizado

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Comparação de dois tipos de retalho para enxerto de tecido conjuntivo no tratamento de recessões gengivais: estudo clínico controlado randomizado

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Interdisciplinaridade do plano de tratamento após reimplante dentário: relato de caso

O tratamento de escolha para a avulsão dentária é o reimplante dentário, no entanto diversos fatores interferem no prognóstico e a reabsorção radicular é a principal seqüela podendo levar a perda dentária. O objetivo do trabalho foi relatar um caso clínico de reimplante dentário com perda dentária por extensa reabsorção radicular e os planos de tratamento instituídos para reposição do dente perdido. Paciente após acidente motociclístico apresentou avulsão dentária e fratura coronária do elemento 21 e subluxação e fratura coronária do 11. Após quatro anos do reimplante o dente foi perdido por reabsorção radicular externa. Um novo plano de tratamento foi instituído e como a paciente apresentava uma maloclusão foi realizado um tratamento ortodôntico e uma cirurgia ortognática seguido da colocação de um implante para reposição do 21. Como não ocorreu a osseointegração do implante após três tentativas foi realizada uma prótese fixa adesiva associada à laminado de porcelana para o restabelecimento da função e a estética. Desta forma a interdisciplinaridade permitiu a elaboração de planos de tratamento, capaz de eliminar os imprevistos e conduzir o caso a um sucesso.

Delayed tooth replantation after treatment of necrotic periodontal ligament with citric acid

Objective: to evaluated the effect of treating root-adhered necrotic periodontal ligament (PDL) with citric acid on the healing process in delayed rat tooth replantation. Material and Methods: Forty Wistar rats, assigned to 4 groups (n=10), had their upper right incisor extracted and kept dry on a workbench. For Group I (control), the teeth were replanted after a 5 min extra-alveolar time. For the other groups, replantation was hydroxide-based paste and the teeth were replanted with no root surface treatment. In Group III, the teeth were immersed in citric acid (pH 1) for replanted. In Group IV, instead of the immersion, the roots were scrubbed with gauze soaked in citric acid and the teeth were replanted. The animals difference (p > 0.05) was found among the groups regarding the areas difference (p < 0.05) between the control group and Group IV regarding ankylosis. The control group showed the least replacement resorption percent means compared to the other groups (p < 0.05). The root structure was more affected by replacement resorption and ankylosis in Group IV statistically (p > 0.05). Conclusion: the treatment of root surface-adhered necrotic periodontal ligament with citric acid was not able to prevent the delayed rat tooth replantation.

Multidisciplinary approach for crown-root fracture treatment after trauma: case report

The development of an accurate diagnosis and appropriate treatment plan can be a complex task, especially in cases of dentoalveolar trauma. The authors present a case report of crown-root fracture caused by trauma and highlight the importance of a multidisciplinary approach for the treatment. An eighteen year-old boy had a bicycle accident resulting in dental trauma. The upper right first molar showed a complicated crownroot fracture and the lower left second pre-molar showed an uncomplicated crown-root fracture. Endodontic treatment, controlled tooth extrusion, periodontal surgery for recovery of biological width, and porcelain crown and onlay restorations were performed. Esthetic and functional results were achieved. At the two-year follow-up it was observed that the tooth/onlay interface of the upper right first molar was stained and the onlay of the left lower second pre-molar was fractured. Therefore, the interface stained was repaired and a porcelain crown was made for the lower second premolar. The clinical case presented herein leads to the conclusion that a multidisciplinary treatment plan is extremely important for a proper resolution in cases of dentoalveolar trauma.

Delayed tooth repalantetion after treatment of necrotic periodontal ligament with citric acid

Objective: to evaluated the effect of treating root-adhered necrotic periodontal ligament (PDL) with citric acid on the healing process in delayed rat tooth replantation. Material and Methods: Forty Wistar rats, assigned to 4 groups (n=10), had their upper right incisor extracted and kept dry on a workbench. For Group I (control), the teeth were replanted after a 5 min extra-alveolar time. For the other groups, replantation was done after 60 min. In Group II, the root canals were filled with a calcium hydroxide-based paste and the teeth were replanted with no root surface treatment. In Group III, the teeth were immersed in citric acid (pH 1) for 3 min, the canals were filled with calcium hydroxide and the teeth were replanted. In Group IV, instead of the immersion, the roots were scrubbed with gauze soaked in citric acid and the teeth were replanted. The animals were sacrificed 60 days postoperatively. Results: Regarding replacement resorption, there was statistically significant difference (p < 0.05) between the control group and the other three groups. No statistically significant difference (p > 0.05) was found among the groups regarding the areas of inflammatory resorption. There was also a statistically significant difference (p < 0.05) between the control group and Group IV regarding ankylosis. The control group showed the least replacement resorption percent means compared to the other groups (p < 0.05). The root structure was more affected by replacement resorption and ankylosis in Group IV compared to the Groups II and III, but this difference was not significant statistically (p > 0.05). Conclusion: the treatment of root surface-adhered necrotic periodontal ligament with citric acid was not able to prevent the occurrence of ankylosis, root resorption and inflammatory resorption in delayed rat tooth replantation.

Storage media for avulsed teeth: a literature review

Dental avulsion is the most severe type of traumatic tooth injuries because it causes damageto several structures and results in the complete displacement of the tooth from its socketin the alveolar bone. The ideal situation is to replant an exarticulated tooth immediatelyafter avulsion because the extraoral time is a determinant factor for treatment successand for a good prognosis. However, it is not always possible. The success of replantationdepends on a number of factors that may contribute to accelerate or minimize theoccurrence of root resorption or ankylosis, among which is the type and characteristicsof the medium used for temporary storage during the time elapsed between avulsionand replantation. Maintaining the tooth in an adequate wet medium that can preserve,as longer as possible, the vitality of the periodontal ligament cells that remain on rootsurface is the key to success of replantation. Recent research has led to the developmentof storage media that produce conditions that closely resemble the original socketenvironment, with adequate osmolality (cell pressure), pH, nutritional metabolites andglucose, and thus create the best possible conditions for storage. Although these storagemedia can now be purchased in the form of retail products, the most common scenariois that such a product will not be readily available at the moment of the accident Thispaper reviews the literature on the different storage media that have been investigatedfor avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs, BBOand SciELO electronic databases using the key words storage medium , transportationmedium , avulsion , tooth avulsion , replantation , tooth replantation , milk and propolis .After application of inclusion and exclusion criteria, 39 papers were selected and criticallyreviewed with respect to the characteristics, efficacy and ease of access of the storagemedium. The review of the lite

Surgical-orthodontic tractio for impacted maxillary canines: a critical review and suggested protocol

Maxillary canine impaction is a common occurrence, especially in the palate, despite sufficient space in the arch for tooth alignment. A proper approach requires knowledge of different specialties of dentistry, such as orthodontics, surgery, radiology, and periodontology, which are generally not centered on a single professional. The causes for canine impaction may be either generalized or localized, and the diagnosis should be made through specific clinical and radiographic examination. The prognosis of surgical-orthodontic treatment depends on the position of the canine in relation to the neighboring teeth and height of the alveolar process, in addition to careful surgical technique, considering that there are risks involved, such as ankylosis, loss of tooth vitality, root resorption of the involved tooth and adjacent teeth, and damage to supporting tissues. Given the important role played by impacted maxillary canines, their traction is the treatment of choice in orthodontically treated patients. The present study reviews the literature on important factors to be considered when approaching impacted canines, such as therapeutic possibilities, their advantages and disadvantages.

Avaliação dos fatores críticos para a seleção e aplicação clínica dos pinos de fibra: relato de caso cliínico

Teeth that have lost much of their coronal tooth structure need intraradical devices to achieve a desired retention of the restorative material, restoring aesthetics and function to the patient. For this purpose, various types of intracanal posts have been studied, of wich the fiber posts have been highlighted with its increasing use in the dental market. The purpose of this study was to present a clinical case of using fiberglass post. As well as critically analyze the published works and points of controversy described by different authors related to factors such as different protocols cementation, surface treatments pins, fracture toughness and compression, the possibility of microleakage, diameter and length of the pin, and the various materials used in conjunction with the intracanal retainers. Thus, we concluded that fiber posts showed as an excellent alternative for anterior teeth, since have least 2 mm of tooth remaining.

Estética em sistema metal free associado a núcleos metalocerâmicos personalisados

The evolution of ceramic systems currently allows the manufacture of prosthesis similar to the natural teeth, meeting the expectations of patients. However, when using vitreous ceramic the color of substrate is significant for the esthetic result, requiring planning aesthetic cores when involved reconstruction of endodontically treated teeth without coronal structure. Thus, the aim of this study to describe a case report of aesthetic rehabilitation in upper anterior teeths using vitreous ceramic system for the reconstruction of elements: 11, 12, 21 and 22 after endodontically treated. It was emphasized the removal of crowns and manufacture of custom cast post and core with ceramic in coronal portion, prioritizing the aesthetic result. Through the clinical results observed can be seen that the use of custom cast post and core with ceramic in association lithium disilicate glass ceramics provided a satisfactory aesthetic result.

Sistemas de retenção intrarradicular: considerações teóricas e comportamento biomecânico

The aim of this study was to review the current scientific literature to discuss the biomechanical behavior and characteristics inherent to both cast post and core and the prefabricated posts used in the practice of restoring endodontically treated teeth. To identify studies of this review, it was performed a detailed and advanced search strategy to the databases PubMed and Medline. It was used as descriptors: endodontically treated teeth, post, core, fiber post and metal post. Inclusion criteria were: clinical trials, randomized controlled trials, in vitro studies, literature reviews and systematic reviews with or without meta-analysis of the last 10 years that addressed the theme. Exclusion criteria were: articles without abstracts, animal studies, articles whose language was not English and articles from journals that do not belong to the Dentistry field. Of a total of 35 articles, after an analysis according to inclusion and exclusion criteria, 23 articles were selected. Most of the current scientific literature indicates that the prefabricated fiber reinforced and ceramic posts should be appointed for endodontically treated teeth that have a minimum height of 2mm ferrule. As for the cast metal cores, along with pre-fabricated metal represent a good prosthetic option, when weakened teeth have to be restored for any reason. Despite the large number of studies, there is still a lack of longterm prospective studies that evaluate the effectiveness of these posts in the treatment of endodontically treated teeth.