Advancements in the knowledge of induced tooth movement: idiopathic osteosclerosis, cortical bone and orthodontic movement

Movimentar ortodonticamente os dentes por áreas densas do trabeculado ósseo e pelas corticais pode requerer uma redução na intensidade e/ou na concentração das forças aplicadas. em parte, as forças ortodônticas aplicadas são dissipadas e reduzidas pela deflexão óssea que ocorre pelo discreto grau de elasticidade do tecido ósseo em condições de normalidade. Nas áreas de trabeculado denso e nas corticais, essa deflexão deve ser irrisória ou inexistente. Se não houver uma redução na intensidade das forças nessas regiões citadas, toda a força incidirá sobre a estrutura do ligamento periodontal, aumentando o risco de morte dos cementoblastos, hialinização e reabsorções radiculares. Novos trabalhos poderiam avaliar a prevalência dessas consequências em casuísticas selecionadas para essa finalidade, que, assim, deixariam de ser observações aleatórias.

Microbiological profile of donor corneas stored for tectonic transplantation purposes in rabbits

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

Filling of extraction sockets with autogenous bone in cats

OBJETIVO: Avaliar a regeneração óssea de alvéolos dentais de gatos após enxertia. MÉTODOS: Dezoito gatos adultos, distribuídos em três grupos de 6 animais cada, foram submetidos a extração do canino mandibular direito ou esquerdo. No grupo 1, controle, o alvéolo foi deixado vazio. No grupo 2, o alvéolo foi preenchido com osso esponjoso autógeno do osso ilíaco e no grupo 3, com raspa de osso cortical do osso ilíaco. Os animais foram submetidos à eutanásia 6 semanas após a cirurgia. RESULTADOS: Nas radiografias realizadas no pós-operatório imediato na projeção ventrodorsal observou-se uma área de radiolucência correspondente ao local da alveolectomia e extração dentária. Diminuição da radiolucência foi verificada nas radiografias realizadas seis semanas após a cirurgia. Nos cortes histológicos verificou-se a presença de trabéculas ósseas. A porcentagem de tecido ósseo esponjoso presente nos alvéolos dentais foi quantificada por exames histométricos. Não houve diferença estatisticamente significante entre os grupos (Teste de Kruskal-Wallis p > 0.05) (grupo 1: 52,54 ± 15,4; grupo 2: 50,51 ± 5,01; grupo 3: 51,85 ± 9,52). CONCLUSÃO: Os alvéolos dentais de gatos preenchidos com osso esponjoso autógeno ou raspa de osso cortical autógeno apresentaram regeneração óssea similar àquela observada no grupo controle, após um período de observação de seis semanas.

Complete atrioventricular block during renal transplantation in a patient with Alport's syndrome: case report

CONTEXTO: A síndrome de Alport é responsável por aproximadamente 5% dos pacientes com insuficiência renal crônica. Nessa doença, anormalidades no sistema de condução cardíaco são mais freqüentes que na população em geral. OBJETIVO: Relatar caso de síndrome de Alport que desenvolveu bloqueio atrioventricular total durante um transplante renal. RELATO DE CASO: Paciente masculino, 21 anos de idade, com insuficiência renal crônica secundária à síndrome de Alport, foi submetido a transplante renal sob anestesia peridural. Durante o procedimento anestésico-cirúrgico apresentou bloqueio atrioventricular total, que foi tratado rapidamente, e com sucesso, usando-se um marcapasso transcutâneo. O bloqueio simpático extenso pode contribuir para o desenvolvimento de distúrbios no sistema de condução cardíaco, particularmente em pacientes com insuficiência renal crônica em esquema de diálise. Mesmo em pacientes com eletrocardiograma pré-operatório normal e sem distúrbios de condução, graus variáveis de bloqueio atrioventricular, incluindo bloqueio atrioventricular total, podem ocorrer. Nesse caso, o uso de marcapasso transcutâneo é tratamento rápido e efetivo na sala de operação até o final da cirurgia, quando o tratamento definitivo pode ser planejado.

EFFECTS OF CYCLOSPORINE-A IMMUNOSUPPRESSION ON PANCREATICODUODENAL TRANSPLANTATION IN ALLOXAN-DIABETIC RATS

1. Forty-five outbred Wistar rats were randomly assigned to three experimental groups: GI, 10 non-diabetic control rats; GII, 10 alloxan-diabetic control rats; GIII, 25 alloxan-diabetic tats which received pancreaticoduodenal transplantation (PDT) from normal Wistar donor rats and were immunosuppressed with cyclosporin A (Cy-A), 10 mg kg body weight-1 day-1, administered intraperitoneally for 30 days.2. In parallel, 15 alloxan-diabetic inbred Wistar rats received isogeneic PDT from normal Wistar donor rats.3. Cy-A prevented graft rejection in the 15 surviving animals in group III. These observations were confirmed by clinical and biochemical parameters (body weight, urine output, water and food intake, blood and urinary glucose and plasma insulin) and by histology and immunohistochemistry of the pancreas.4. However, Cy-A was associated with 60% of the infectious complications in transplanted rats leading to 40% mortality. Pulmonary infections were the main cause of death. There were no side effects of immunosuppression on the pancreas. Infections were not significant in inbred rats submitted to PDT.

Maxillary canine-first premolar transposition - Restoring normal tooth order with segmented mechanics

Tooth transpositions present at a relatively low incidence in the world population and primarily affect maxillary canines and premolars. Treatment of this disturbance should take into account aspects such as facial pattern, age, malocclusion, tooth-size discrepancy, stage of eruption, and magnitude of the transposition. Mechanics for correction should be entirely individualized, reducing the risks and adverse effects. Practitioners often select simpler options, indicating extraction of permanent teeth, which is an irreversible procedure that may bring about damages to the patient. This study presents a case report and treatment of unilateral transposition of maxillary canine and premolar with repositioning of affected teeth to their respective normal positions.

Interferon Alpha-2B and liver resection to treat multifocal hepatic epithelioid hemangioendothelioma: A relevant approach to avoid liver transplantation

Background. Hepatic epithelioid hemangioendothelioma is a rare malignant tumor of vascular origin with frequent multifocal appearance. Liver resection may cause tumor spread. Liver transplantation has been indicated for unresectable nodules. We hypothesized that adjuvant interferon treatment is effective to prevent metastasis after liver resection. We report a case of multifocal hepatic epithelioid hemangioendothelioma successfully treated with interferon pulse therapy and bilobar hepatic resection.Methodology. CT scan and magnetic resonance imaging diagnosed three nodules in the liver (segments IV, VI and VII). Histopathology and specific immunostaining of a percutaneous nodule biopsy confirmed the diagnosis of hepatic epithelioid hemangioendothelioma. The treatment protocol included daily interferon alpha 2b 9 weeks before and 1 week after resection of liver segments IV, VI and VII.Results. The postoperative outcome was complicated by a self-limited biliary fistula. The patient remains tumor free at 3 years after liver resection and currently enjoys excellent health.Conclusion. Interferon pulse therapy and hepatic resection was a good option to treat multifocal bilobar hepatic epithelioid hemangioendothelioma; it may prevent metastasis dissemination.

Effect of pancreas transplantation on the prevention of nephropathy in alloxan-induced diabetic rats

We studied the effects of pancreas transplantation on kidney lesions of rats with alloxan-induced diabetes. Ninety inbred male Lewis rats were randomly assigned to 3 experimental groups: group NC included 30 non-diabetic control rats, group DC included 30 alloxan-induced diabetic control rats, and group PT included 30 alloxan-induced diabetic rats that received pancreas transplants from normal donor Lewis rats. Each group was further divided into 3 subgroups of 10 rats which were sacrificed at 1, 3, and 6 months of follow-up, respectively. Clinical and laboratory parameters during these periods were documented. The kidneys of 5 rats in each subgroup were studied and 50 glomeruli and tubules from each kidney were analyzed by light microscopy by two different investigators in a double-blind study. There was progressive glomerular basement membrane thickening (GBMT), mesangial enlargement (ME), and Bowman's capsule thickening (BCT) in kidneys of rats in the 3 experimental groups during follow-up. These alterations were significantly higher in DC rats (GBMT: 1.99 +/- 0.31; ME: 2.00 +/- 0.33; BCT: 1.88 +/- 0.27) when compared to NC(GBMT: 1.54 +/- 0.30; ME: 1.56 +/- 0.47; BCT: 1.36 +/- 0.35) and PT rats (GBMT: 1.49 +/- 0.29; ME: 1.57 +/- 0.36; BCT: 1.35 +/- 0.28) at 6 months (P<0.01). The extent of GBMT, ME, and BCT observed in DC rats at 1 and 3 months was not significantly different from NC and PT rats. The amount of kidney lesions in PT rats was similar to that of NC rats and lower than those of DC rats at 6 months (P<0.01). In addition, Armanni-Ebstein lesions of the tubules (AE) and tubular lumen protein (PRO) observed in DC rats were not present in NC or PT rats. We conclude that pancreas transplantation in alloxan-induced diabetic rats prevents the development of kidney lesions beginning at 6 months after transplantation.

Radiopacity of esthetic restorative materials compared with human tooth structure

Purpose : To compare the radiopacity of 13 restorative materials, (a conventional glass-ionomer cement, three resin-modified glass-ionomer cements, six polyacid-modified resin-based composites, and three resin-based composites) to sound tooth structure. Materials and Methods: 315 specimens were made of the restorative materials (n= 21), of 2 min height and 4.1 mm diameter. Radiographs were taken of the specimens, together with the tooth structure sample and an aluminum step wedge. The radiopacity values of each specimen were taken using a transmission densitometer. Results: ANOVA and Tukey's test (95% level of confidence) revealed that, except for a resin-based composite, a polyacid-modified resin-based composite, a resin-modified glass-ionomer cement and the conventional glass-ionomer cement, all the evaluated restorative materials were more radiopaque than the tooth structure.