Comprovação da real comunicação entre o endodonto e o periodonto através do canal cavo inter-radicular e sua prevalência em molares inferiores humanos

The neurovascular system of the pulp and of the periodontium is interconnected and among the possible intercommunications between these two tissues, there is the cavo inter-radicular canal. It is a small canal that goes through any inter-radicular dentine and arises in the furca region of the multi-radicular teeth. Its predominance has been studied in the literature, by several methodologies, with divergent results. The objective of this work was to establish, in vitro, the predominance of the cavo inter-radicular canal, in human lower molars, through the diaphanization technique and dye leakage. For this research, 140 teeth (100 first and second 40 lower molars) were selected, extracted due to different reasons, belonging to a teeth bank of the Endodontics discipline of the Dentistry College at Federal University of Rio Grande do Norte. The teeth were preserved in formol until the moment of use and immersed in physiological solution. Had the endodontic access fulfilled and the whole external surface, except for the furcation, sealed with two layers of nail enamel. The cleaning of the pulpar chamber floor was carried out with sodium hypochlorite solution 5%, being this solution renewed every 5 minutes, during 1 hour. The teeth were immersed in Indian dye and, after drying of the dye, they had their crowns split up in the amelo-cemental junction. Then, they were examined in a stereomicroscope, where marks of the coloring were observed in the furcation and on the pulpar floor. After this recording, the sample was diaphanized and with the transparent teeth, it was possible to observe in the stereomicroscope, the true inter-radicular canals. As a result of this experiment, the presence of these canals was observed in 13 % of the first and 7, 5 % of the second evaluated molars. The study showed that both the presence of the cavo inter-radicular canal is real and the diaphanization and dye leakage is an efficient method for this type of research

Biocompatibility in vitro tests of mineral trioxide aggregate and regular and white Portland cements

Mineral trioxide aggregate (MTA) and Portland cement are being used in dentistry as root end-filling materials. However, biocompatibility data concerning genotoxicity and cytotoxicity are needed for complete risk assessment of these compounds. In the present study, genotoxic and cytotoxic effects of MTA and Portland cements were evaluated in vitro using the alkaline single cell gel (comet) assay and trypan blue exclusion test, respectively, on mouse lymphoma cells. The results demonstrated that the single cell gel (comet) assay failed to detect DNA damage after a treatment of cells by MTA and Portland cements for concentrations up to 1000 mu g/ml. Similarly, results showed that none of the compounds tested were cytotoxic. Taken together, these results seem to indicate that MTA and Portland cements are not genotoxins and do not induce cellular death.

Genotoxicity of antimicrobial endodontic compounds by single cell gel (comet) assay in Chinese hamster ovary (CHO) cells

Objective. In the current study, the potential DNA damage associated with exposure to a number of antimicrobial endodontic compounds was assessed by the single cell gel (comet) assay in vitro.Study design. Chinese hamster ovary (CHO) cells were exposed to formocresol, paramonochlorophenol, calcium hydroxide, or chlorhexidine at final concentration ranging from 0.01% to 1%.Results. Formocresol, paramonochlorophenol, and calcium hydroxide, as well as chlorhexidine in all concentrations tested did not contribute to the DNA damage.Conclusion. These findings are clinically relevant since they represent an important contribution to the correct evaluation of the potential health risk associated with exposure to dental agents.

Lipopolysaccharide-induced Stem Cell Factor Messenger RNA Expression and Production in Odontoblast-like Cells

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

Studies on the Expression of Fibroblast Growth Factor-2 from Odontoblast-like Cells

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

Treatment of root perforation by intentional reimplantation: a case report

Intentional reimplantation is defined as a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth into its own alveolus. Int his paper, intentional reimplantation is described and discussed as a treatment approach to root canal instrument separation in conjunction with root perforation. An 8-year follow-up case report is presented. The reimplanted tooth is now a fixed bridge abutment. Although successful in this case, the intentional reimplantation procedure should be considered a treatment of last resort, that is, when another treatment option is not viable for the treatment of root perforation/instrument retrieval.

Severe lateral luxation and root fracture: report of a case with 5-year follow-up

A case of severe lateral luxation and root fracture in upper incisors is reported. Treatment involved the repositioning and fixation of the injured teeth and endodontic treatment with calcium hydroxide. The importance of long-term follow-up is emphasized.

Reaction of the lateral periodontium of dogs' teeth to contaminated and noncontaminated perforations filled with mineral trioxide aggregate

It has been shown that the mineral trioxide aggregate (MTA) used to seal lateral/furcal perforations stimulates the deposition of newly formed cementum. Nevertheless, when the site of the perforation is contaminated, the healing process might occur under less favorable conditions. This study evaluated the repair healing process of noncontaminated and contaminated lateral perforations filled with MTA and the effect of previously filling the contaminated perforations with a bactericidal agent. Thirty lateral root perforations were prepared in endodontically treated dog's teeth, thus forming 3 groups with 10 specimens each. In group 1 the perforations were immediately sealed with MTA. In group 2 the perforations were left open for 7 days and thereafter sealed with MTA. In group 3 the perforations were left open for 7 days, filled temporarily with a calcium hydroxide-based paste for 14 days, and then sealed with MTA. The animals were killed after 90 days, and the pieces were prepared for histomorphologic and histomicrobiologic evaluations. The statistical analysis showed that group 1 had significantly better repair than groups 2 (P <.05) and 3 (P <.05), which validates the superior results obtained when MTA was immediately used to seal root perforations. Groups 2 and 3 had statistically similar repair to each other (P >.05). There were a larger number of cases of complete or partial biologic seal in group 1 compared with the contaminated groups. It might be concluded that the lateral root perforations sealed with MTA after contamination presented worse repair than the noncontaminated, immediately sealed perforations. The temporary filling with a bactericidal agent (calcium hydroxide-based paste) did not improve the repair of perforations exposed to contamination, and the contaminated groups presented similar results to each other.

Influence of the type of vehicle and limit of obturation on apical and periapical tissue response in dogs' teeth after root canal filling with mineral trioxide aggregate

The purpose of this study was to investigate the influence of the type of vehicle (distilled water or propyleneglycol) on the response of apical tissues of dogs' teeth after root canal filling with mineral trioxide aggregate (MTA) at two different limits. Forty roots of incisors and premolars of two adult dogs were used. After pulpectomy, the root canals were prepared biomechanically, and the roots had the apical cemental barrier penetrated with a #15 K-file and widened to a #25 K-file. The root canals were assigned to four groups according to the vehicle used for MTA (ProRoot-MTA; Tulsa Dental, Tulsa, OK) preparation and the limit of root canal filling: group 1, filling with MTA/distilled water to the limit of the cemental canal; group 2, overfilling with MTA/distilled water, group 3, filling with MTA/propyleneglycol to the limit of the cemental canal; and group 4, overfilling with MTAlpropyleneglycol. The animals were killed by anesthetic overdose 90 days after endodontic treatment and the anatomic pieces were prepared for histomorphological analysis. The sections were stained with hematoxylin and eosin and Brown and Brenn techniques. The results showed that MTA pastes prepared with either distilled water or propyleneglycol as vehicles had similar biological behavior (p > 0.05); root fillings placed at the cemental canal limit showed better results than the overfillings (p = 0.01), and MTA/propyleneglycol paste was more easily placed into the root canals than MTA/distilled water paste.

Estudo longitudinal do sucesso clínico-radiográfico de dentes tratados com medicação intracanal de hidróxido de cálcio

INTRODUÇÃO: O tratamento endodôntico é de fundamental importância para abolir a infecção presente em dentes que apresentam necrose pulpar. OBJETIVO: O objetivo do presente estudo foi avaliar clínica e radiograficamente a eficácia dos tratamentos de canais radiculares de dentes com lesão periapical crônica, efetuados pelos graduandos em Odontologia, da Faculdade de Odontologia de Araçatuba - UNESP. MATERIAL E MÉTODO: Foram selecionados 100 pacientes que possuíam dentes com lesão periapical crônica para serem tratados. Após o preparo biomecânico, os canais radiculares receberam uma medicação intracanal de hidróxido de cálcio durante o período de 14 dias. Os canais radiculares foram obturados com cimento endodôntico à base de hidróxido de cálcio. Foi realizada a proservação por um período entre oito e 11 meses. RESULTADO: A análise dos resultados permitiu constatar a porcentagem de 78,46% dos casos com reparo total da lesão periapical e de 21,54% dos casos em que não houve evidências de reparo. CONCLUSÃO: Ocorreu reparo das lesões periapicais nos dentes tratados pelos graduandos da Faculdade de Odontologia de Araçatuba - UNESP.

Tissue Reaction to a Triantibiotic Paste Used for Endodontic Tissue Self-regeneration of Nonvital Immature Permanent Teeth

Introduction: The endodontic regenerative procedure (ERP), which is an alternative to calcium hydroxide induced apexification, involves the use of a triple antibiotic paste (TAP) as a dressing material. The aim of this study was to evaluate the response of rat subcutaneous tissue to implanted polyethylene tubes that were filled with TAP or calcium hydroxide. Methods: Thirty rats received 2 individual implants of polyethylene tubes filled with TAP or calcium hydroxide paste (CHP) and another empty tube as a control. Thirty additional rats received 2 individual implants consisting of polyethylene tubes filled with dressing material carriers (macrogol and propylene glycol) and a sham procedure. After 7, 15, 30, 60, and 90 days, 12 animals were euthanized, and the tubes and surrounding tissue were removed and processed for histology by using glycol methacrylate and stained with hematoxylin and eosin. The histological score ranged from 0 to 3 depending on the content of inflammatory cells; the fibrous capsule was considered thin or thick, and necrosis and calcification were recorded as present or absent. The results were analyzed using the Kruskal-Wallis test. Results: Both dressing materials induced moderate reactions at 7 and 15 days. These reactions were similar to the control (P>.05) and reduced in intensity (to mild) from day 30 onward (P>.05). The carriers did not interfere with the reaction of the dressing materials. Conclusions: TAP and CHP were biocompatible over the different experimental periods examined. (J Endod 2012;38:91-94)

Evaluation of Rat Alveolar Bone Response to Angelus MTA or Experimental Light-cured Mineral Trioxide Aggregate Using Fluorochromes

Introduction: The aim of this study was to evaluate the rat alveolar bone response after the implantation of experimental light-cured mineral trioxide aggregate (MTA) or Angelus MTA (Angelus, Londrina, Parana, Brazil) by histological and fluorescence analysis. Methods: Thirty Wistar Albino rats were divided into three groups. In the control group, empty polyethylene tubes were inserted into the rat alveolar sockets immediately after extraction. In the other groups, the tubes were filled with light-cured MTA or Angelus MTA. Five animals from each group were injected with calcein on day 7, alizarin on day 14, and oxytetracycline on day 21. on day 30, these animals were killed, and the right hemimaxillas were removed and histologically processed. Half of the maxillas were processed and stained with hematoxylin and eosin. The remaining maxillas were processed for fluorescence analysis and stained with Stevenel blue and alizarin red. New bone was histomorphometrically evaluated using a Merz grid. Results: The light-cured MTA presented a similar response when compared with Angelus MTA; it was characterized by a mild inflammatory response and complete bone healing. In the light-cured MTA group, the fluorescence areas were more evident at 21 days, showing an increase in bone formation. However, dystrophic mineralization was observed only with Angelus MTA. Conclusions: It was concluded that both materials present a similar inflammatory response and bone healing, but dystrophic mineralization was observed only with Angelus MTA. (J Endod 2011;37:250-254)

Evaluation of the Tissue Reaction to Fast Endodontic Cement (CER) and Angelus MTA

Introduction: A new cement (CER; Cimento Endodontico Rapido or fast endodontic cement) has been developed to improve handling properties. It is a formulation that has Portland cement in gel. However, there had not yet been any study evaluating its biologic properties. The purpose of this study was to evaluate the rat subcutaneous tissue response to CER and Angelus MTA. Methods: The materials were placed in polyethylene tubes and implanted into dorsal connective tissue of Wistar rats for 7, 30, and 60 days. The specimens were prepared to be stained with hematoxylin-eosin or von Kossa or not stained for polarized light. The presence of inflammation, predominant cell type, calcification, and thickness of fibrous connective tissue were recorded. Scores were defined as follows: 0, none or few inflammatory cells, no reaction; 1, <25 cells, mild reaction; 2, 25-125 cells, moderate reaction; 3, >125 cells, severe reaction. Fibrous capsule was categorized as thin when thickness was <150 mu m and thick at >150 mu m. Necrosis and formation of calcification were both recorded. Results: Both materials Angelus MTA and CER caused moderate reactions at 7 days, which decreased with time. The response was similar to the control at 30 and 60 days with Angelus MTA and CER, characterized by organized connective tissue and presence of some chronic inflammatory cells. Mineralization and granulations birefringent to polarized light were observed with both materials. Conclusions: It was possible to conclude that CER was biocompatible and stimulated mineralization. (J Endod 2009,35:1377-1380)

Evaluation of mineral trioxide aggregate and calcium hydroxide cement as pulp-capping agents in human teeth

This study evaluated the histomorphologic response of human dental pulps capped with mineral trioxide aggregate (MTA) and Ca(OH)(2) cement (CH). Pulp exposures were performed on the occlusal floor of 40 human permanent premolars. After that, the pulp was capped either with CH or MTA and restored with composite resin. After 30 and 60 days, teeth were extracted and processed for histologic exam and categorized in a histologic score system. The data were subjected to Kruskal-Wallis and Conover tests (alpha = .05). All groups performed well in terms of hard tissue bridge formation, inflammatory response, and other pulpal findings. However, a lower response of CH30 was observed for the dentin bridge formation, when compared with MTA30 and MTA60 groups. Although the pulp healing with calcium hydroxide was slower than that of MTA, both materials were successful for pulp capping in human teeth.

Mineral trioxide aggregate but not light-cure mineral trioxide aggregate stimulated mineralization

The purpose of this study was to evaluate the subcutaneous response of rat connective tissue to light-cure MTA and Angelus MTA. These materials were placed in polyethylene and dentin tubes and implanted into dorsal connective tissue of Wistar rats for 30 and 60 days. The specimens were prepared to be stained with hematoxylin-eosin, Von Kossa, and without stain for polarized light and evaluated in an optic microscope. The Angelus MTA showed a mild inflammatory response at 30 days and none at 60 days, characterized by organized connective tissue, presence of some chronic inflammatory cells, and induction of mineralized tissue formation. Light-cure MTA presented a moderate chronic inflammatory response at 30 days that decreased at 60 days but was more intense than with Angelus MTA and without dystrophic calcifications. It was possible to conclude that light-cure MTA was similar to MTA at 60 days, but it did not stimulate mineralization.