A comparison of one versus two appointment endodontic therapy in dogs' teeth with apical periodontitis

This study was conducted to observe the healing process in dogs' teeth with apical periodontitis after root canal treatment in one or two appointments. Premolars and anterior dogs' teeth had their root canals opened to the oral environment for 6 months before being treated. After root canal negotiation they were filled by the lateral condensation technique with gutta-percha points and Sealapex in one appointment or after a dressing with calcium hydroxide for 7 and 15 days. Six months after the treatment the animals were killed and the tissues prepared for histomorphological analysis. Scores attributed to the different histomorphological events were submitted to statistical analysis, which resulted in ranking the experimental groups from the best to the worst in the following way: (a) calcium hydroxide 14 days; (b) calcium hydroxide 7 days; and (c) one appointment. It was concluded that the use of a calcium hydroxide dressing helps to achieve better results (p < 0.01) than the treatment in one appointment.

Influence of age on the behavior of dental pulp of dog teeth after capping with an adhesive system or calcium hydroxide

This study evaluated histomorphologically the influence of chronological age of the dog on the dental pulp-healing process after capping with the All Bond 2 system or with calcium hydroxide paste. The animals were divided according to age into young and adult groups. Class 5-type cavities were prepared, and the pulp was submitted to an exposure of a diameter of 0.5 mm. The pulp of the teeth was then protected with the adhesive system or with a calcium hydroxide paste. Sixty days after treatment, the results obtained with the adhesive system in the young group were significantly better than those in the adult group. With calcium hydroxide, the results were similar for both groups. The pulp treated with calcium hydroxide exhibited a complete hard tissue bridge and a pulp without inflammatory reaction, a fact not observed when the adhesive system was used. In conclusion, the chronological age of the pulp influenced the comparative results only for the adhesive system (P = 0.1), and the total results were better with calcium hydroxide than with the All Bond 2 system (P = 0.01).

Ultrastructural and immunocytochemical evaluation of the effects of extracorporeal shock wave treatment in the hind limbs of horses with experimentally induced suspensory ligament desmitis

Objective-To evaluate the effects of extracorporeal shock wave therapy (ESWT) on affected ligaments in the hind limbs of horses with experimentally induced suspensory ligament desmitis by use of ultrasonographic, ultrastructural, and immunocytochemical techniques.Animals-10 horses.Procedure-Suspensory ligament desmitis was induced in both hind limbs of each horse by use of 2 collagenase injections (administered 2 weeks apart) in each suspensory ligament. Two weeks after the second injection, the right hind limb of each horse was treated with ESWT (3 treatments at 3-week intervals)- the left hind limb was not treated (control limb). Periodically during the study, the healing process was monitored ultrasonographically and the proportions of ligaments affected with lesions were assessed. Four weeks after the last ESWT treatment, biopsy specimens were collected from all ligaments for ultrastructural evaluation and immunocytochemical analysis of transforming growth factor beta-1.Results-The difference in the proportion of the lesion-affected ligament between ESWT-treated and control limbs was significant (P < 0.05) from 3 weeks after the second ESWT treatment to the end of the study. Compared with control ligaments, ESWT-treated ligaments had more small, newly formed collagen fibrils and greater expression of transforming growth factor beta-1 4 weeks after the last ESWT treatment was administered.Conclusions and Clinical Relevance-Results have indicated that ESWT appears to facilitate the healing process in horses with experimentally induced hind limb suspensory ligament desmitis.

Bone repair using mineral trioxide aggregate combined to a material carrier, associated or not with calcium hydroxide in bone defects

Mineral trioxide aggregate (MTA) is a powder aggregate containing mineral oxides with a good biological action and may facilitate the regeneration of the periodontal ligament and formation of bone. Calcium hydroxide demonstrates antibacterial properties, enhances tissue dissolution, and induces bone formation. The objective of this study was to evaluate the MTA in the bone healing process and verify if the calcium hydroxide P.A. can improve and accelerate this process. It was used forty rnale Wistar rats, which were divided into two groups, considering or not the use of calcium hydroxide P.A. solution before treatment. Thus, each one of these groups was divided in four groups with five animals each, according to the treatment and the defect filled by: animal's coagulum, monoolein gel, MTA in aqueous solution, and MTA combined with monoolein gel. After 10 days, the animals were perfused and the right hemimandibles removed for histological analysis. Statistical analysis of the data showed significant difference between all analyzed groups when it was made comparisons using or not calcium hydroxide P.A. (p < 0.0001). There was found statistical difference between the groups that was inserted or not MTA, independently the calcium hydroxide application (p < 0.05). Results showed that the MTA used was able to induce bone regeneration and had its action optimized when combined to calcium hydroxide P.A. (C) 2007 Elsevier Ltd. All rights reserved.

Estudo histológico comparativo entre dois métodos de obtenção de cortes de alvéolos de ratos.

The chronology of the wound healing process following tooth extraction was studied by means of two kinds of histological cuts. Two groups of 42 albino rats were employed. In the first one, the sockets were cut in a transversal way. In the second one the cuts were performed in a longitudinal way. The rats were sacrificed after 3, 6, 9, 15, 21, 24, and 28 days following the surgeries. After laboratorial outline the obtained pieces were stained by hematoxylin and eosin for histological purposes. It way be concluded that: 1. The results got from longitudinal cuts were in agreement to those described by other authors; 2. The transversal cuts allow us to detect intensive resorption of the lateral alveolar wall at the cervical thirs; 3. On the 21st day following dental extraction the incisor socket of the rat shows a great deal of areas not ossified; 4. The healing process of dental extraction wounds of the upper incisor of the rat is completed between 24 and 28 post operative days.

Efeitos da estimulação ultra-sônica sobre o processo de reparo em ferida de extração dental: estudo histológico em ratos.

The effects of ultrasound on the wound healing process after teeth extractions were studied histologically. The right upper incisor was extracted in 56 rats. They were divided into 2 groups, one control (I) and one experimental (II). Group II received ultrasound stimulation that was applied with the frequency of repetition of 1,000 Hz and pulse length of 2,000 us continuously, during five minutes daily since the extraction day until 24 hours before the death. The rats were sacrificed at 3, 6, 9, 12, 15, 18, and 21 postoperative days. The results showed a precocious granulation tissue formation, faster remodeling of osseous ridges, and consequently acceleration of the alveolar wound healing process.

A study of different calcification areas in newly formed bone 8 weeks after insertion of dental implants in rabbit tibias

In orofacial implantology there are many types of implants for the different systems. Among these is the implant surface type, e.g., a screw type, cylindrical and laminar. Furthermore, the implants are different in their dimensions, their metal composition, their surface condition, such as smooth, grit or layered surfaces and in their methods of application. Two different self-tapping implants, one smooth and the other grit-blasted, are screwed into the bone, and another one with a plasma of titanium coating, which is also in a screw form but with greater spaces between the screw threads are compared. The greatest amount of bone deposition in the bone/implant interface was encountered in the latter one, the smooth surfaced implant being in second place. All of these systems can alter the implant healing process and to demonstrate this, we injected bone markers in the rabbits over different periods of time so as to observe the different areas of bone deposition in the tibias where the implants had been inserted. The bone tracers used were Alizarin, Calcein and Xylenol-orange. The amount of deposition was calculated by using the method of surface morphometry.

Histological study of resection arthroplasty with and without tendon ball interposition in dogs

We studied an experimental model of resection arthroplasty with or without tendon ball interposition in the wrist of dogs. Animals were divided into two groups. Animals in group A were treated by resection of the os carpi radiale with interposition of a ball made from the tendon of the extensor carpi radialis and the group B underwent bone resection alone. Animals were assessed 1, 6, 12 and 24 weeks after operation. In all of them the wrist joint was stable and had good mobility, allowing walking supported by the operated limb. In both groups biological material filled the cavity created by bone resection. A progressive repair process resulted in fibroplasia with areas of fibrocartilaginous metaplasia. The tendon ball showed complete ischaemic necrosis at the end of the first week, which delayed the healing process. © 1999 The British Society for Surgery of the Hand.

Mineral trioxide aggregate repair of lateral root perforations

This study was conducted to observe the healing process of intentional lateral root perforation repaired with mineral trioxide aggregate (MTA). Forty-eight root canals of dogs' teeth were instrumented and filled. After partial removal of the filling, an intentional perforation was made with a bur in the lateral area of the root. The perforations were repaired with MTA or Sealapex (control group). Histological analysis occurred 30 and 180 days after treatment. Results showed no inflammation and deposition of cementum over MTA in the majority of the specimens. In the 180-day period, Sealapex exhibited chronic inflammation in all the specimens and slight deposition of cementum over the material in only three cases. In conclusion, MTA exhibited better results than the control group. Copyright © 2001 by The American Association of Endodontists.

Secretion of tumor necrosis factor-alpha by mouse peritoneal macrophages in the presence of dental sealers, sealapex and endomethasone

After filling root canals, the healing process depends on the chemical composition or physical-chemical properties of the material used, among other factors. All root canal sealers, whether solid or plastic, are foreign matter for the body if they remain in permanent contact with apical and periapical tissues. As a result, the first organic reaction that occurs is an attempt to phagocytize the material. During phagocytosis, macrophages release a large number of cell mediators into the area, among which are cytokines that are essential in intercellular communication and in many physiological and pathophysiological processes. One of these cytokines is tumor necrosis factor-alfa (TNF-α), which acts through links to specific receptors on the cell membrane initiating a cascade of events leading to induction, activation, or inhibition of numerous cytokine-regulated genes in the cell nucleus. The release of TNF-α in a cell culture of mouse peritoneal macrophages incubated with three concentrations (25, 50, and 100 mg/ml) of two endodontic sealers was measured. The solutions containing the calcium hydroxide-based root canal sealer (Sealapex) released fewer units of TNF-α than solutions containing the zinc oxide and eugenol-based sealer (Endomethasone).

Comparative study of MTA and other materials in retrofilling of pulpless dogs' teeth

This in vivo study compared the effect of mineral trioxide aggregate (MTA), IRM, Super EBA and ZOE in a puttylike consistency, used as retrofilling materials, in the healing process of periapical tissue of pulpless dogs' teeth submitted to a conventional retrofilling technique. Twenty-four premolars obtained from three dogs were used. At the first intervention, the animals were anesthetized, coronal access was obtained and pulpectomy was done. Root canals were kept open to the oral environment for 180 days to induce the formation of apical lesions. After surgical removal of the lesions with curettes, 2 mm of the apical root was cut out perpendicular to the long axis of the teeth, and root-end cavities were shaped with a low-speed round bur. The bone cavities were irrigated and dried, and the root-end cavities were filled with MTA, IRM, Super EBA and ZOE in a puttylike consistency. The bone cavities were passively filled with blood and flaps were sutured. The coronal access openings were cleaned and double-sealed with ZOE and amalgam. After 180 days, the animals were killed by anesthetic overdose, maxilla and mandible were removed and the pieces were processed for histomorphologic analysis. Data were evaluated blindly on the basis of several histopathologic events and the scores obtained were analyzed statistically using the Kruskal Wallis test. No significant differences were observed among MTA, Super EBA and IRM (p>0.05). However, ZOE had a significantly more negative influence on the apical healing (p<0.05). In conclusion, MTA, Super EBA and IRM had similar histopathologic effects among each other and better performance than ZOE used in a puttylike consistency. Furthermore, only MTA stimulated hard tissue deposition in direct contact with the retrofilling material, even when it was inserted under critical conditions.

Delayed tooth replantation after root surface treatment with sodium hypochlorite and sodium fluoride: Histomorphometric analysis in rats

In cases of delayed tooth replantation, non-vital periodontal ligament remnants have been removed with sodium hypochlorite in an attempt to control root resorption. Nevertheless, reports of its irritating potential in contact with the alveolar connective tissue have been described. Therefore, this study evaluated the healing process on delayed replantation of rat teeth, after periodontal ligament removal by different treatment modalities. Twenty-four rats, assigned to 3 groups (n=8), had their upper right incisor extracted and left on the workbench for desiccation during 60 min. Afterwards, the teeth in group I were immersed in saline for 2 min. In group II, root surfaces were scrubbed with gauze soaked in saline for 2 min; and in group III, scrubbing was done with gauze soaked in 1% sodium hypochlorite solution. Thereafter, root surfaces were etched with 37% phosphoric acid and immersed in 2% acidulate-phosphate sodium fluoride solution, at pH 5.5. Root canals were filled with a calcium hydroxide-based paste and the teeth were replanted. The animals were sacrificed 60 days postoperatively and the pieces containing the replanted teeth were processed and paraffin- embedded. Semi-serial transversally sections were obtained from the middle third of the root and stained with hematoxylin and eosin for histomorphometric analysis. Data were analyzed statistically using Kruskal-Wallis and Dunn's tests. The results showed that root structure and cementum extension were more affected by resorption in group III (p<0.05). All groups were affected by root resorption but the treatment performed in group III was the least effective for its control. The treatment accomplished in groups I and II yielded similar results to each other.

Reconstruction of Mandibular Segmental Defects Using the Guided-Bone Regeneration Technique With Polylactide Membranes and/or Autogenous Bone Graft: A Preliminary Study on the Influence of Membrane Permeability

Purpose: Bone maintenance after mandibular reconstruction with autogenous iliac crest may be disappointing due to extensive resorption in the long term. The potential of the guided-bone regeneration (GBR) technique to enhance the healing process in segmental defects lacks comprehensive scientific documentation. This study aimed to investigate the influence of polylactide membrane permeability on the fate of iliac bone graft (BG) used to treat mandibular segmental defects. Materials and Methods: Unilateral 10-mm-wide segmental defects were created through the mandibles of 34 mongrel dogs. All defects were mechanically stabilized, and the animals were divided into 6 treatment groups: control, BG alone, microporous membrane (poly L/DL-lactide 80/20%) (Mi); Mi plus BG; microporous laser-perforated (15 cm2 ratio) membrane (Mip), and Mip plus BG. Calcein fluorochrome was injected intravenously at 3 months, and animal euthanasia was carried out at 6 months postoperatively. Results: Histomorphometry showed that BG protected by Mip was consistently related to larger amounts of bone compared with other groups (P ≤ .0001). No difference was found between defects treated with Mip alone and BG alone. Mi alone rendered the least bone area and reduced the amount of grafted bone to control levels. Data from bone labeling indicated that the bone formation process was incipient in the BG group at 3 months postoperatively regardless of whether or not it was covered by membrane. In contrast, GBR with Mip tended to enhance bone formation activity at 3 months. Conclusions: The use of Mip alone could be a useful alternative to BG. The combination of Mip membrane and BG efficiently delivered increased bone amounts in segmental defects compared with other treatment modalities. © 2008 American Association of Oral and Maxillofacial Surgeons.

Effect of collagenase ointment on a radiofrequency induced abrasive wound

• Aim: Radiofrequency is one of the methods used to treat wrinkles and skin lesions, but its application may result in an abrasive wound. The purpose of this study was to evaluate the effect of collagenase ointment on the epithelial healing of an abrasive wound induced by a radiofrequency system. • Methods: An abrasive wound was produced using radiofrequency at the dorsal midline of 30 guinea pigs, which were randomly divided into 2 groups: one group were treated with saline solution and the other group treated with collagenase ointment; both used twice daily. The animals were sacrificed at 1, 7, 15, 30 and 60 postoperative days. Macroscopic, histological and morphometric evaluations were performed and the results were submitted to statistical analysis. • Results: The animals treated with collagenase ointment presented accelerated healing process and less inflammatory cell infiltration than the saline solution treated animals from one to fifteen postoperative days. Morphometric evaluation showed a thicker epidermis and a thinner dermis layer in the saline solution group at one and seven postoperative days, but significant differences between both groups were not observed at thirty and sixty postoperative days. • Conclusion: According to our results the use of collagenase ointment may accelerate the healing process of a radiofrequency induced abrasive wound.

Efeitos da fenilbutazona na cicatrização de feridas cutâneas experimentais em equinos

The purpose of this study was to investigate phenylbutazone effects on second intention wound healing, and to compare the healing process between the thoracic and lumbar areas. Ten horses were submitted to circular full-thickness wound produced on both sides of the thoracic and lumbar areas. Animals were gathered into two experimental groups, one receiving daily IV injections of phenylbutazone (4,4mg/kg) and the other (control group) distillated water for five days. All wounds were daily treated with local Dakin's solution. The wound contraction rates were determined by serial measurements each 72 hours. At the 6th and 15th post surgical days, biopsies were performed for histological analysis. Thoracic and lumbar wound contraction was decreased in the phenylbutazone group. The time to complete healing was significantly greater in phenylbutazone group (49 days) than in control group (37 days). There was no significant difference between thoracic and lumbar area in the same group. Gross and histopathology analysis showed the inhibitory effect of phenylbutazone on the second-intention wound healing when compared to the control group.