A new calcium silicate-based material (Biodentine) for filling radicular perforation in an endodontic-periodontal lesion: a case report

This case report presents an apical radicular perforation management using new calcium silicate-based cement (Biodentine) in a combined endodontic-periodontal lesion. The presence of apical radicular perforation may interfere in the endodontic treatment prognosis. Radicular perforation filling with bioactive cement through endodontic surgery is a possible treatment. This study presents an apical radicular perforation with periodontal involvement, due to alveolar bone loss on the buccal radicular surface from an incorrect intracanal preparation for the fiber post placing. The chosen alternative was a periapical surgery, the perforation was filled with a silicate and calcium chloride bioactive cement (Biodentine; Septodont, Saint-Maur-des-Fosses Cedex, France), and the radicular surface was etched with citric acid, because the access from root canal was impossible. The follow-up was for 8 months, through clinical and radiographic analysis. At the end of the follow-up, radiographic analyses showed the bone healing, and no clinical changes in periodontal probing depth, gingival recession, and the height of the interproximal mesial and distal papillae were observed. The root perforation treatment has a difficult management, especially when the dental root has a simultaneous periodontal commitment. The Biodentine proves to be a promising material for use in these situations.

Replantation as treatment for extrusive luxation

In the treatment of extrusive luxation cases, it is important that the repositioning of extruded tooth in the socket is done as soon as possible. If this does not occur, periapical clot becomes organized and makes replantation difficult reposition. In this article the patient referred to the Clinics for dental trauma sustaining extrusive luxation of the maxillary right central incisor. The patient reported having suffered a bicycle accident 12 days before, which caused traumatic tooth injuries. The repositioning was attempted without success and an alternative form of treatment was necessary to solve the case. Intentional tooth replantation, which is the deliberate extraction of the tooth and its replantation, was indicated. This technique allows clot removal and correct repositioning of the extruded tooth. Care should be taken as endodontic treatment is required for the prevention of subsequent infection-related resorption. Intracanal dressing with calcium hydroxide was used for 30 days before final root filling. Splint, systemic antibiotics and avoidance of further damage to the root surface is also important. After 49 months, showed clinical and radiographic characteristics of normality and demonstrates the availability of this technique to adversity in trauma.

Understanding growth mechanisms and tribocorrosion behaviour of porous TiO2 anodic films containing calcium, phosphorous and magnesium

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Supercritical carbonation treatment on extruded fibre-cement reinforced with vegetable fibres

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

Characterization of calcium phosphate coating produced by biomimetic method

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

Surgical Treatment of Severe Frontal Bone Fracture

Craniofacial trauma can lead to several complications. The combined fractures of anterior and posterior walls of the frontal bone are almost always followed by lesions in nasofrontal orifices and disruption of nasofrontal ostia or ducts, a significant factor for the development of early and late complications after sinus fractures. This article reports a case of trauma patient, who underwent neurological evaluation and at first showed good general condition. Computed tomography noted fracture of the anterior and posterior walls of the frontal sinus and small foci of pneumocephalus in the cerebral cortex. The patient was monitored periodically and 9 days after trauma showed increased areas of pneumocephalus in prefrontal cortex, cerebrospinal fluid draining, and large dura mater lesion, with signs of necrosis and inflammation (meningitis). The necrotic tissues were removed, and dura mater was repaired through the approximation with resorbable wire polyglactin 910 5-0, oxidized cellulose application, and bonding with human fibrin sealant (fibrinogen, thrombin, and calcium chloride). Sinusectomy, frontal sinus, and nasofrontal duct obliteration with pedicled pericranium flap were performed. Tomographically, a reanatomization was noted in frontal region, and a 12-month follow-up showed no complication. The use of fibrin glue to repair dura mater lacerations, as well as the pedicle pericranium flap for frontal sinus and nasofrontal duct obliteration, is an efficient method for treating fractures of the frontal bone.

Chemical composition and in vitro digestibility of fresh sugarcane hydrolysed with calcium oxide (CaO)

The objective was to evaluate the chemical composition and in vitro digestibility of sugarcane hydrolysed with increasing doses of calcium oxide and varying air exposure times. A completely randomised, split plot design was used; the doses were allocated to the plots, and the air exposure times were allocated to the subplots, with four repetitions. The data underwent analysis of variance and were laid out according to the effect of the treatment on the components of polynomial regressions, and evaluated at the 5% probability. The increase in the dosage negatively affected the quantities of neutral-detergent fibre (NDF), acid-detergent fibre (ADF), lignin (LIG), total carbohydrates (TC), cellulose (CEL), crude protein (CP), and ether extract (EE); and positively affected the quantities of non-fibrous carbohydrates (NFC) and mineral matter (MM). The addition of calcium oxide improved the in vitro digestible dry matter (IVDMD) coefficients and was able to keep up to 72 hours. The in vitro digestibility of the neutral-detergent fibre (IVDNDF) and of the acid-detergent fibre (IVDADF) coefficients decreased when calcium oxide was added. Calcium oxide has the ability to hydrolyse the fibrous fraction and conserve chopped sugarcane. Doses of 0.5 and 1.0% lime exhibited similar results to those achieved at higher doses; therefore, higher doses are not required in the hydrolyses of sugarcane. Over time, the sugarcane deteriorates, but this deterioration is reduced by the addition of calcium oxide.

Use of the probability of stone formation (PSF) score to assess stone forming risk and treatment response in a cohort of Brazilian stone formers

Introduction: The aim was to confirm that PSF (probability of stone formation) changed appropriately following medical therapy on recurrent stone formers.Materials and Methods: Data were collected on 26 Brazilian stone-formers. A baseline 24-hour urine collection was performed prior to treatment. Details of the medical treatment initiated for stone-disease were recorded. A PSF calculation was performed on the 24 hour urine sample using the 7 urinary parameters required: voided volume, oxalate, calcium, urate, pH, citrate and magnesium. A repeat 24-hour urine sample was performed for PSF calculation after treatment. Comparison was made between the PSF scores before and during treatment.Results: At baseline, 20 of the 26 patients (77%) had a high PSF score (> 0.5). Of the 26 patients, 17 (65%) showed an overall reduction in their PSF profiles with a medical treatment regimen. Eleven patients (42%) changed from a high risk (PSF > 0.5) to a low risk (PSF < 0.5) and 6 patients reduced their risk score but did not change risk category. Six (23%) patients remained in a high risk category (> 0.5) during both assessments.Conclusions: The PSF score reduced following medical treatment in the majority of patients in this cohort.

Fracture resistance of weakened bovine teeth after long-term use of calcium hydroxide

In some parts of the world, revascularization may not be the most feasible treatment option for necrotic immature teeth. Therefore, apexification remains the most widely utilized treatment option for these cases. This study aimed to evaluate the fracture resistance of weakened bovine tooth roots treated with various irrigant solutions as well as long-term application of calcium hydroxide intracanal medication (ICM). One hundred seventy bovine teeth were randomly divided into three experimental groups (n = 50) and two control groups (n = 10). Group SS was irrigated with physiologic solution; group CHX was treated with 2% chlorhexidine gel and group NaOCl was irrigated with 1% sodium hypochlorite. After instrumentation, root canals were dressed with calcium hydroxide and evaluated at different periods (15, 60, 90, 180, and 360 days). The specimens were loaded at a 45° angle to measure fracture resistance through the use of an EMIC test machine. A decrease in fracture resistance was observed during the time of ICM dressing. The highest values of fracture resistance were observed in group SS with 15 days of ICM, not differing from the control group. Irrigation with NaOCl associated with ICM for 15 days presented the lowest fracture resistance; however, a statistically significant difference was not observed when compared with SS and CHX in the same time period. In longer periods of exposure to ICM (180 and 360 days), root canals irrigated with NaOCl and CHX showed significantly lower fracture resistance than SS (P < 0.05). Apexification with periodic changes of calcium hydroxide medicament leads to weakness of the teeth independent of the irrigation solution used.

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.

Treatment of traumatic dental intrusion by surgical repositioning: clinical case report

The prevalence of dental trauma and its consequences are challenging. This article presents a clinical case of a 9-year-old female who was in a bicycling accident and had a dental intrusion of the left maxillary lateral incisor with extensive dislocation. In the emergency department, surgical repositioning of the intruded tooth and a splinting with steel wire and composite resin was performed and the soft-tissue lesions were sutured. Two weeks after the first visit, pulp necrosis was found and endodontic treatment of the intruded tooth was started with a calcium hydroxide dressing. Despite the traumatic nature of the dental injury, the result of treatment was favorable. After 3 years of follow-up, repair of the resorptions and no signs of ankylosis of the teeth involved were evident. Considering the patient's age and the extent of intrusion, it was concluded that surgical repositioning associated with adequate endodontic therapy was an effective alternative treatment for this case.

Influence of hypertension on oral infections and endodontic treatment

Hypertension is characterized by peripheral vascular resistancethat leads to blood pressure increase and severalsystemic changes that may negatively influence one s oralhealth. Thus, the aim of this study was to conduct a literaturereview on the influence of hypertension over oral conditionsand endodontic treatment. Hypertension mainly affects theblood vessels, brain and kidneys. A hypertensive conditioncan lead to increased levels of parathyroid hormones, abnormalvitamin D metabolism, reduction in the concentrationof ionized calcium and decreased calcium absorption.Therefore, hypertension can be closely associated with oralproblems such as periodontal diseases, implant loss, difficultyin bone healing, reduced salivary flow and protein concentrationin saliva, increased number of neutrophils and, as a consequence,favoring of inflammatory processes. It has alsobeen suggested that the success rate of endodontic treatmentin hypertensive patients is lower than in normotensiveones. The response of hypertensive patients to root canaltreatment, intracanal medications and sealers should be furtherstudied in order to provide knowledge on the changes,failures and success of endodontic treatment.