Biocompatibility of Acetazolamide and Its Association with Calcium Hydroxide in Rat Subcutaneous Tissue

Introduction: The aim of this study was to evaluate the biocompatibility of acetazolamide and its association with the calcium hydroxide in rat subcutaneous tissues as an intracanal medication for an avulsed tooth. Methods and Materials: Three medications with acetazolamide base were evaluated: group 1 liquid acetazolamide associated with calcium hydroxide powder (LACH); group 2 liquid acetazolamide (LA); and group 3 acetazolamide powder associated with physiological saline (PAPS). The calcium hydroxide associated to physiological saline represented the control group. The medications were implanted in subcutaneous tissues of thirty-nine male rats for 7, 15 and 45 days; after surgery the animals were sacrificed and the sections were stained with hematoxylin and eosin to be evaluated qualitatively or semi-quantitatively with an optical microscope. The inflammation intensity and type of inflammatory cells and the repair process, were assessed. The obtained data were statistically compared through the Kruskal-Wallis test conducted at the 5% level of significance. Results: On the seventh day, there was statistically significant difference between PAPS and LA, in relation to the number of neutrophils (P=0.0016). There was a statistically significant difference in the total number of inflammatory cells in PAPS compared to LACH (P=0.0038) on the fifth day. The total number of inflammatory cells from PAPS was significantly higher in relation to LACH (P=0.0038), as well as LA from LACH (P=0.0038) on forty fifth day. A statistically significant reduction in the value of lymphocytes was also observed in LACH (P=0.0072) and LA (P=0.0010) groups in the same period. Conclusion: The results of this animal study suggest that the association of the liquid acetazolamide with the calcium hydroxide promoted an inflammation reduction and a faster repair process than in the LA and PAPS groups evaluated in 15 and 45 days. Keywords: Acetazolamide; Calcium Hydroxide; Root Resorptio

Influência do EDTA, do laser de Nd: YAG e da associação de ambos na obturação de canais laterais artificiais

Este estudo teve como objetivo avaliar a ação do EDTA, do laser de Nd:YAG e a associação de ambos na obturação dos canais laterais artificiais. Foram utilizados 45 dentes pré-molares inferiores humanos, nos quais foram confeccionados três canais laterais com o auxílio de um alargador com diâmetro compatível de uma lima do tipo K número 15. Os dentes foram instrumentados pela técnica regressiva utilizando brocas de Gates Glidden nos terços cervical e médio e limas manuais no terço apical e irrigação com hipoclorito de sódio a 1 %. Os dentes foram divididos em três grupos: Grupo I EDTA por 5 minutos, Grupo II aplicação de laser de Nd:YAG com 15 Hz, 100mJ e 1,5 Watts e Grupo III a associação de ambos. As raízes foram obturadas pela técnica Híbrida de Tagger, radiografadas e as radiografias escaneadas. Para o preenchimento dos canais laterais foram dados escores. A análise estatística mostrou não haver diferença significante entre os grupos analisados globalmente e nem quando analisados por terços.This study aimed at evaluating the influence of EDTA, Nd:YAG laser and the combination of both for filling of artificial lateral root canals. Forty-five human mandibular premolars were employed, on which three artificial lateral root canals were prepared by means of a reamer with a similar diameter to a K file #15. The teeth were instrumented through the stepback technique employing Gates Glidden burs at the middle and cervical thirds and manual files at the apical portion, and irrigation with 1% sodium hypochloride. The teeth were divided in three groups: Group 1 -EDTA for 5 minutes; Group 2 -application of Nd:YAG laser at 15 Hz, 100 mJ and 1.5 Watts; and Group 3 - association of both. Roots were filled through the Tagger's hybrid technique, radiographed and the radiographs were digitized. Scores were assigned to the filling of the lateral root canals. Statistical analysis revealed no significant differences between the entire groups and also on the analysis of each third

Cognitive level, quality of life and oral health of a Prader-Willi Syndrome patient - case report with long-term follow-up / Nível cognitivo, qualidade de vida e saúde bucal de um paciente com síndrome de Prader-Willi - Relato de caso com acompanhamento de longo prazo

Introduction: Prader-Willi syndrome (PWS) is a rare, neurobehavioral genetic disorder that alters the child's development. Concerning oral health, PWS patients present dental aspects that are not completely understood. Objectives: The aim of this case report was to describe long-term follow-up of a patient with PWS, regarding to cognitive level, overall self-perceived quality of life and oral health, sleep quality, anxiety trait, and oral condition. Methods: The information about his cognitive ability and socio-behavioral behavior was collected applying the questionnaires: Mini-Mental State Examination (MMSE), simplified World Health Organization Abbreviated Quality of Life survey (WHOQOL-bref), Sleep Assessment Questionnaire (SAQ), State Trait Anxiety Inventory (STAI-T) Oral Health Impact Profile (OHIP-14). The clinical examination was performed according to the WHO methods for oral health surveys. Index of Decayed, Missing or Filled teeth (DMFT) and other changes in mineralized tissues, such as dental fluorosis or erosion, incisor molar hypomineralization, enamel hypoplasia, bruxism, dental trauma and positioning of teeth in dental arches were also recorded. In the periodontal analysis, the visible plaque index, bleeding on probing and final diagnosis of gingivitis were performed. Data about dental occlusion and temporomandibular disorders were also noted. After data collection and clinical examination, a saliva sample was collected to assess salivary flow rate, pH and buffering capacity. Results: The analysis of the questionnaires revealed an individual satisfied with his quality of life, but very anxious. Clinical examination point to gingival inflammation located in the region of anterior teeth, maxillary and mandibular anterior tooth crowding and malocclusion. Salivary parameters were normal. Conclusion: This case report suggests that the PWS patient perceives that his quality of life is good despite his anxiety episodes. Regarding oral health, gingival inflammation and malocclusion are the main problems.

Desórdenes orales potencialmente malignos. Lo que el odontólogo debe conocer

Objective: The objective of this study is to update scientific knowledge about OPMDs, emphasizing epidemiological data, clinical appearance, symptomatology, differential diagnosis and therapeutic management, as well as highlighting the role of the general dentist in the clinical examination. Material and methods: A literature search was carried out, making use of the keywords “Leukoplakia”, “Erythroplasia”, “Cheilitis”, “Nevus, Pigmented”, “Oral Submucous Fibrosis” and “Lichen Planus”. Prioritizing articles published in the last 5 years on the scientific databases “Medline”, “Pubmed” and “SciELO”. Results: As a result of the search, 165 articles were obtained, which were carefully reviewed to preserve only those that were dedicated to describe, compare or treat lesions with malignant potential, including relevant data such as epidemiology, clinical appearance, symptomatology, differential diagnosis and management. therapeutic. In this way, the study was limited to 41 articles. Conclusions: By taking preventive measures, as well as through a clinical examination of soft tissues, early detection of potentially malignant disorders can be facilitated. The removal of suspicious lesions or a control of their carcinogenic conditions can largely prevent the development of malignant tumors.Objetivo: El objetivo de este estudio es actualizar los conocimientos sobre Desordenes Orales Potencialmente Malignos, dando énfasis a datos epidemiológicos, apariencia clínica, sintomatología, diagnóstico diferencial y manejo terapéutico, así como también resaltar el rol del odontólogo general en el examen clínico. Material y métodos: Fue realizada una búsqueda de la literatura en las bases de datos científicas “Medline”, “Pubmed” y “SciELO”, utilizando las palabras clave “Leukoplakia”, “Erythroplasia”, “Cheilitis”, “Nevus, Pigmented”, “Oral Submucous Fibrosis”, “Lichen Planus”. La búsqueda fue orientada hacia artículos de revisión, estudios clínicos y reportes de caso, priorizando los artículos publicados en los últimos 5 años y sin hacer distinciones por el idioma. Resultados: Como resultado de la búsqueda se obtuvieron 165 artículos, los cuales fueron revisados cuidadosamente para conservar solo aquellos que se dedicaran a describir, comparar o tratar desordenes con potencial de malignidad, incluyendo datos de relevancia como epidemiología, apariencia clínica, sintomatología, diagnóstico diferencial y manejo terapéutico. De esta manera, el estudio se limitó a 41 artículos. Conclusiones: Al adoptar medidas preventivas, así como un meticuloso examen clínico sobre tejidos blandos, se puede facilitar la detección temprana de Desordenes Orales Potencialmente Malignos. La eliminación de lesiones sospechosas o un control de las condiciones cancerígenas puede evitar en gran mayoría el desarrollo de tumores malignos

Maintenance of Pulp after Horizontal Root Fractures in Three Maxillary Incisors: A Thirteen-Year Evaluation

This case report documents the clinical approach adopted for three upper incisors with horizontal root fracture in the middle or cervical third. The proposed procedures involved maintaining pulp vitality and periodontal stability of the fractured teeth with 13 years of follow-up.Keywords: Connective Tissue Cells; Dental Pulp; Tooth Fracture

Management of Dental Intrusion and Lateral Luxation: Case Report with 10 Years Follow-up

This case report documents the clinical approach adopted for two maxillary incisors with intrusion and lateral luxation trauma. The proposed procedures involved reposition of both teeth, one of them with surgical extrusion and endodontic procedure for both, with 10 years of follow-up.Keywords: Intrusion; Lateral Luxation; Multiple Traum

Regenerative Endodontic Treatment of a Traumatized Immature Necrotic Permanent Incisor: A Case Report

The current case report documents the clinical approach adopted for a traumatized immature necrotic permanent upper left central incisor after a bike accident. The treatment involved regenerative endodontic procedures (REPs) using “High Plasticity Mineral Trioxide Aggregate” (MTA Repair HP) as a cervical barrier over blood clot. The preservation included three years of follow-up appointments of clinical evaluations and periapical digital radiographs. Cone beam computer tomography (CBCT) was taken at six and thirty-six months for the evaluation of root development

Lack of correlation between tubular dentine cement penetration, adhesiveness and leakage in roots filled with gutta percha and an endodontic cement based on epoxy amine resin

Objective: To analyze possible correlations among tubular dentine cement penetration, adhesiveness and apical leakage in fillings performed with gutta percha and an endodontic cement based on epoxy amine resin. Material and Methods: Sixty similar, extracted human mandibular central incisors were irrigated, instrumented and filled following the same protocol. First, apical leakage was quantified by fluid filtration tests. Then, these same specimens were sectioned for analysis of tubular dentine cement penetration and the middle thirds were submitted to push-out tests to analyze the adhesiveness of the fillings. Results: In brief, the means and standard deviations with a confidence interval of 95% were as follows: tubular dentine cement penetration (8.875±4.540), adhesiveness (4.441±2.683) and apical leakage (0.318±0.215). The data were confronted using the Pearson's test (P>;0.05), and it was possible to prove that there was no correlation between (1) tubular dentine cement penetration and apical leakage (r2: 0.08276), (2) tubular dentine cement penetration and adhesiveness (r2: -0.2412) and (3) adhesiveness and apical leakage (r2: 0.1340). Conclusion: After analysis of these data, it could be observed that there exists no correlation among the variables analyzed in this study

Postoperative Endodontic Pain after Treatment Using XP-endo Finisher: A Randomized Clinical Trial

Introduction: This randomized clinical trial aimed to determine whether the XP-endo finisher combined with or without foraminal enlargement has any significant effect on the incidence and intensity of postoperative pain in necrotic pulps. Materials and Methods: Clinical pain levels were measured after 6, 12, 24, 48, and 72 hours and at 7 postoperative days. All treatments were performed by an endodontist in a single visit. One hundred and twenty patients were included. All patients had a single tooth treated. The patients were divided into four groups: No FE (None Foraminal Enlargement) (n=30), FE (Foraminal Enlargement) (n=30), No FE+XPF (None Foraminal Enlargement+XP-endo Finisher) (n=30) and XPF+FE (XP-endo Finisher and Foraminal Enlargement) (n=30). The canals were irrigated with sodium hypochlorite, shaped using WaveOne Gold Medium file, and then filled by using a matching single cone and AH-Plus sealer. The cavity was filled using glass ionomer cement. Pain intensity was assessed using the visual analog scale. The data were analyzed with the ANOVA and Games-Howell test. The significance level was 5%. Results: The XPF+FE group experienced a higher level of pain, being classified on the visual analog scale as moderate for 48 postoperative hours and mild for 7 postoperative days (P<0.05). In the other groups, the pain was mild, only with different time intervals (P>0.05). Conclusions: Foraminal enlargement associated with XP-endo Finisher may cause moderate postoperative pain

Dissimilar Sequelae Caused by Single Dental Trauma; A Case Report with Long-Term Follow-Up

Immediate care and accurate diagnosis are essential for treating dental trauma. This report presents a 7-year-old boy suffered a bicycle accident with direct trauma to the mouth and extrusive luxation of teeth #11 and #21. The emergency treatment was performed within the first hour. Clinical examinations showed that both teeth exhibited 3 mm extrusion from comparing their incisal edges to their neighboring teeth, had edematous gingiva, showed grade 3 mobility and were painful to percussion. Radiographic exams showed incomplete root formation, widened periodontal spaces along their entire lengths and absence of bone or root fractures. The treatment consisted of immediate repositioning and semi-rigid splinting. After 15 days, tooth #11 exhibited no clinical signor symptom and tooth #21 was diagnosed with pulp necrosis, with an acute dentoalveolar abscess and intraoral edema. Immediate endodontic treatment was initiated (intracanal dressing with calcium hydroxide paste). At 30 days, another pulp sensibility test was performed on tooth #11, which had a negative response. In the same visit, the intracanal dressing of tooth #21 was replaced. The Ca(OH)2 medication was replaced every 6 months until the formation of an apical barrier. The final dressing consisted of gutta-percha and Grossman’s sealer and was placed two and a half years after the first dressing appointment. The extrusive luxation resulted in two different sequelae: complete root obliteration in tooth #11 and anomalous root development after the formation of an apical barrier in tooth #21. The patient received orthodontic treatment after 6 years from the initial treatment with no negative outcome. After 18 years follow-up, both teeth were stabilized with no symptom or sign. It’s important to follow the evolution of every trauma case continuously because the sequelae can be unpredictable