Mechanical removal of necrotic periodontal ligament by either Robinson bristle brush with pumice or scalpel blade. Histomorphometric analysis and scanning electron microscopy

One of the important factors accounting for successful delayed replantation of avulsed teeth is seemingly the type of root surface treatment. Removal of necrotic cemental periodontal ligament remnants may prevent the occurrence of external root resorption, which is the major cause of loss of teeth replanted in such conditions. The purpose of this study was to compare the efficacy of two mechanical techniques for removal of root-adhered periodontal ligament. Preservation or removal of the cementum layer concomitantly with these procedures was also assessed. Forty-five roots of healthy premolars extracted for orthodontic purposes were selected. After extraction, the teeth were kept dry at room temperature for 1 h and then immersed in saline for rehydration for an additional 10 min. Thereafter, the roots were assigned to three groups, as follows: group 1 (control) - the cemental periodontal ligament was preserved; group 2 - removal of the periodontal ligament by scraping root surface with a scalpel blade (SBS); group 3 - periodontal ligament remnants were removed using a Robinson bristle brush at low-speed with pumice/water slurry (RBP). The specimens were analysed histomorphometrically and examined by scanning electron microscopy. The quantitative and qualitative analyses of the results showed that the RBP technique was significantly more effective than the SBS technique for removal of the periodontal ligament remnants adhered to root surface. Both techniques preserved the cementum layer.

Healing process after surgical treatment with scalpel, electrocautery and laser radiation: histomorphologic and histomorphometric analysis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Modified radical mastectomy: A pilot clinical trial comparing the use of conventional electric scalpel and harmonic scalpel

Background: The aim of this study was to compare the rates of local postoperative complications among women undergoing modified radical mastectomy with an electric scalpel (ES) or a harmonic scalpel (HS). It is thought that HS use has less postoperative complications, mainly seroma formation. Methods: This study was a prospective non-randomised clinical trial (NCT01391988) among consecutive patients, performed in parallel. Patients underwent modified radical mastectomy using an HS or ES. We analysed the following operative variables: time, blood loss and seroma volume drainage. Postoperative complications, including seroma, flap necrosis, haematoma and infection were evaluated on the 7th and 14th days. Results: Forty-six patients underwent a MRM with ES and 49 with HS; no differences were observed between the groups. The rate of local complications was 29% in the HS group and 52% in the ES group (p=0.024). The rates of seroma (16.3% versus 28.3%; p=0.161), necrosis (4.1% vs. 21.7%; p=0.013; OR=0.15), haematoma (2.0% vs. 8.7%; p=0.195) and infection (2.0% vs. 6.5%; p=0.351) were lower in the HS group. Adding the findings of all comparative studies using HSs in MRM to the seroma rates in the current study, the seroma rate, expressed as a categorical variable, did not decrease with HS. Seroma was present in 60/219 cases using an HS and in 69/239 cases utilising an ES (p=0.72). Based on a multivariate analysis, HS decreased the risk of skin necrosis (p=0.015). Conclusions: HSs do not decrease the seroma rate. However, this method may be useful in skin sparing mastectomy because it decreases skin flap necrosis. © 2013 Surgical Associates Ltd.

Evaluation of the Integrity of Horse Hoof Dermal and Epidermal Tissues Collected by Dorsal Transmural Access

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Tratamento da úlcera corneana experimental com membrana amniótica

Objetivo: Avaliar a evolução da úlcera de córnea experimental tratada com enxerto de membrana amniótica (MA) homóloga. Métodos: Foram utilizados 18 coelhos, divididos em dois grupos experimentais: úlcera corneana (G1) e úlcera corneana tratada com enxerto de MA (G2). A ulceração corneana foi induzida na córnea toda, com álcool absoluto e lâmina de bisturi. Os animais foram sacrificados em três momentos experimentais: 7 dias (M1), 15 dias (M2) e 30 dias (M3) após a indução da ulceração. Os defeitos corneanos foram avaliados com fotodocumentação por analisador de imagem Luzex-F e exames histopatológicos, comparando-se os resultados por meio da análise de variância. Resultados: O resultado do exame morfométrico mostrou desepitelização maior em G2 no M1; a opacidade corneana foi mais intensa na área central da córnea, sendo significativamente maior em G1 no M3. Os neovasos corneanos também foram mais intensos em G1. A avaliação histopatológica revelou ulceração epitelial em dois animais de G1 no M2 e em dois de G2 no M1; o edema estromal foi mais intenso em G1, assim como a presença de neovasos. Conclusão: O uso de MA homóloga no tratamento da úlcera corneana experimental não acelerou a cicatrização, porém preveniu o edema estromal e a formação de neovascularização corneana. A cicatrização se mostrou mais deficiente na área central da córnea.

Effect of root surface treatment with propolis and fluoride in delayed tooth replantation in rats

Replantation is an acceptable option for treatment of an avulsed permanent tooth. Nevertheless, an extended extraoral period damages the periodontal ligament and results in external root resorption. The purpose of this study was to assess by histologic and histometric analysis, the influence of propolis 15% (natural resinous substance collected by Apis mellifera bees from various plants) and the fluoride solution used as root surface treatment on the healing process after delayed tooth replantation. Thirty Wistar (Rattus norvegicus albinus) rats were submitted to extraction of their upper right incisor. The teeth were maintained in a dry environment for 60 min. After this, the pulp was extirpated and the papilla, enamel organ and periodontal ligament were removed with scalpel. The teeth were divided into three experimental groups: Group I - teeth immersed in 20 ml of physiologic saline; Group II - teeth immersed in 20 ml of 2% acidulated phosphate sodium fluoride; Group III - teeth immersed in 20 ml of 15% propolis. After 10 min of immersion in the solutions, the root canals were dried and filled with calcium hydroxide paste and the teeth were replanted. The animals were euthanized 60 days after replantation. The results showed that similar external root resorption was seen in the propolis and fluoride groups. Teeth treated with physiologic saline tended to have more inflammatory root resorption compared with those treated with fluoride or propolis. However, the comparative analysis did not reveal statistically significant differences (P > 0.05) between the treatment modalities when used for delayed tooth replantation.

Effect of photodynamic therapy on the healing of cutaneous third-degree-burn: histological study in rats

The aim of this study was to conduct a histological assessment of the effect of photodynamic therapy (PDT) on the repairing of third-degree-burn wounds made on the backs of rats with a heated scalpel. Ninety-six rats were divided into groups: G1, control (n = 24), cold scalpel; G2, burned, heated scalpel (n = 24); G3, low-level laser therapy (LLLT) (n = 24), on burns; and G4, photodynamic therapy (PDT) (n = 24), toluidine-O blue (100 A mu g/ml) and LLLT treatment on burns. The laser (685 nm) was applied in continuous mode, 50 mW, 4.5 J/cm(2), contact mode at nine points (9 s/point). Eight animals in each group were killed at 3 days, 7 days or 14 days after surgery, and tissue specimens containing the whole wounded area were removed and processed for histological analysis; the results were statistically analyzed with Kruskal-Wallis and Dunn's tests (P < 0.05). The results demonstrated significant differences between G2 and G3, and between G2 and G4, at both 3 days and 7 days, with regard to acute inflammation scores; G1 and G2 showed significant differences when compared with G4 at 3 days, with regard to neo-angiogenesis scores; G1 and G2 were statistically different from G3 and G4 at both 3 days and 7 days, with regard to re-epithelization scores; G2 showed statistically significant differences when compared with G3 and G4 with regard to collagen fiber scores at 7 days. LLLT and PDT acted as a biostimulating coadjuvant agent, balancing the undesirable effect of the burn on the wound healing process, acting mainly in the early healing stages, hastening inflammation and increasing collagen deposition.

Effects of the Er,Cr:YSGG laser on bone and soft tissue in a rat model

The purpose of this study was to investigate the histological changes that occur in rat soft and hard tissues after Er,Cr:YSGG laser surgery. Each of 20 rats was submitted to four procedures which were randomly distributed to the right and left sides of the animal: procedure 1 dorsal incision with a scalpel; procedure 2 dorsal incision with a 2.0-W Er,Cr:YSGG laser; procedure 3 skull defect created with a diamond bur; procedure 4 skull defect created with a 3.0-W Er,Cr:YSGG laser. The animals were killed 3, 7, 15 and 30 days after surgery, and histological examinations were performed. The histometric analysis of the bone defects was evaluated using an unpaired t-test. Initially, the dorsum showed more histological signs of repair following procedure 1, although similar healing responses following procedures 1 and 2 were seen on day 30 after surgery. By day 30 the bone formation observed following procedure 4 was much more evident than following procedure 3. The unpaired t-test identified significant differences in bone formation on day 30 (p = 0.01), whereas a greater bone percentage was seen following procedure 4 than following procedure 3 (79.96 +/- 10.30% and 58.23 +/- 9.99%, respectively). Thus, histological repair of the Er,Cr:YSGG laser wounds was similar to that of the scalpel wounds. However, skull defects created with the Er,Cr:YSGG laser showed greater bone formation than defects created with the bur. Within the limitations of this study, we can conclude that the Er,Cr:YSGG laser is a promising surgical instrument in vivo, particularly for bone surgery.

Morphology and bacterial colonisation of tooth/ceramic restoration interface after different cement excess removal techniques

Objectives: To evaluate the influence of different protocols for resin cement removal during cementation on biofilm formation.Methods: Twenty-eight ceramic blocks, which were injected under pressure, were placed over enamel blocks obtained from freshly extracted bovine incisors. The ceramic blocks were cemented to the enamel blocks using a dual-cured resin cement and the excess resin was removed according to the experimental group: TS: Teflon spatula; BR: brush; BR+: brush and polishing; SB+: scalpel blade and polishing. After autoclaving, the samples were colonised by incubation in a sucrose broth suspension standardised with Streptococcus mutans in microaerophilic stove. Specimens were quantitatively analysed for bacterial adherence at the adhesive interface using confocal laser scanning microscopy and counting the colony forming units, and qualitatively analysed using SEM. The roughness (Ra/Rz/RSm) was also analysed. Data were analysed by 1-way ANOVA and Tukey's test (5%).Results: The roughness values ranged from 0.96 to 1.69 mu m for Ra (p > 0.05), from 11.59 to 22.80 mu m for Rz (p = 0.02 < 0.05) and from 293.2 to 534.3 mu m for RSm (p = 0.00). Bacterial adhesion varied between 1,974,000 and 2,814,000 CFU/ml (p = 0.00). Biofilm mean thickness ranged from 0.477 and 0.556 mu m (p > 0.05), whilst the biovolume values were between 0.388 and 0.547 mu m(3)/mu m(2) (p = 0.04). Lower values for roughness, bacterial adhesion, biofilm thickness and biovolume were found with BR, whilst TS presented the highest values for most of the parameters. SEM images confirmed the quantitative values.Conclusions: The restoration margin morphology and interface roughness affects bacterial accumulation. The brush technique promoted less bacterial colonisation at the adhesive interface than did the other removal methods.Clinical significance: The brush technique seems to be a good option for removing the excess resin cement after adhesive cementation in clinical practice, as indicated by its better results with lower bacterial colonisation. (C) 2012 Elsevier Ltd. All rights reserved.

Clinical comparison between conventional suture and vaporization with carbon dioxide laser in rat's skin

Objective: This study compares wound healing efficiency on a rat's skin when the incision was closed with a conventional suture versus vaporized with a CO2 laser. Materials and Methods: In this study, 24 rats were used, and two longitudinal incisions were made with a conventional scalpel in the dorsum of each rat. The left incision was sutured with nylon thread, and the right incision was closed by vaporization with a defocused CO2 laser in continuous mode with an 8-watt power density. Clinical photographs were taken immediately after the procedure, 24 h later, and after 3, 7, 14, and 21 days, documenting the healing of the incision. Results: the results showed that there was an initial delay in wound repair in the vaporized incision as compared to the scalpel incision, but after 21 days, both incisions showed the same clinical characteristics. However, the vaporized incision showed no trauma of the tissue, as opposed to the sutured incision, and no hemorrhagic complications. Conclusion: These results suggest that the CO2 laser can eventually replace the use of sutures.

Anestesia para colecistectomía videolaparoscópica en paciente portador de enfermedad de Steinert. Relato de caso y revisiõn de la literatura

BACKGROUND AND OBJECTIVES: Myotonic dystrophies are autosomal dominant neuromuscular diseases. Among them, myotonic dystrophy type 1 (MD1), or Steinert disease, is the most common in adults, and besides muscular involvement it also has important systemic manifestations. Myotonic dystrophy type 1 poses a challenge to the anesthesiologist. Those patients are more sensitive to anesthetics and prone to cardiac and pulmonary complications. Besides, the possibility of developing malignant hyperthermia and myotonic episodes is also present. CASE REPORT: This is a 39-year old patient with DM1 who underwent general anesthesia for videolaparoscopic cholecystectomy. Total intravenous anesthesia with propofol, remifentanil, and rocuronium was the technique chosen. Intercurrences were not observed in the 90-minute surgical procedure, but after extubation, the patient developed respiratory failure and myotonia, which made tracheal intubation impossible. A laryngeal mask was used, allowing adequate oxygenation, and mechanical ventilation was maintained until full recovery of the respiratory function. The patient did not develop further complications. CONCLUSIONS: Myotonic dystrophy type 1 presents several particularities to the anesthesiologist. Detailed knowledge of its systemic involvement along with the differentiated action of anesthetic drugs in those patients will provide safer anesthetic-surgical procedure.

Modelo experimental de úlcera traumática em mucosa jugal de ratos

Purpose: To establish an experimental model of traumatic ulcer in rat cheek mucosa for utilization in future alternative therapy studies. Methods: A total of 60 adult male rats (250 - 300g) were used. Ulceration of the left cheek mucosa was provoked by abrasion using a n o 15 scalpel blade. The animals were observed for 10 days, during which they were weighed and their ulcers were measured. The histological characteristics were analyzed and scored according to the ulcer phase. In the statistical analysis, a value of p<0.01 was considered a statistically significant response in all cases. Results: During the five first days, the animals lost weight (Student t test, p<0.01). The ulcerated area receded linearly over time and was almost completely cicatrized after 10 days (ANOVA, Tendency post-test, p<0.0001). Groups on days 1, 2 and 3 days displayed similar results, but a decrease in scores were observed after the 4th day. Conclusion: The proposed cheek mucosa ulcer model in rats can be considered an efficient, low-cost, reliable, and reproducible method.

Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program

Background: Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. Aims: To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. Materials and Methods: One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. Results: A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. Conclusion: The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described. © Indian Journal of Dermatology 2013.

Análise morfológica e imunocitoquímica do cérebro de abelhas africanizadas Apis mellifera após exposição à doses subletais do inseticida tiametoxam

Pós-graduação em Ciências Biológicas (Biologia Celular e Molecular) - IBRC

Utilização do bisturi harmônico em mastectomias radicas para câncer de mama com comparação com o bisturi elétrico convencional

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB