Clinical and radiological analysis of traumatized teeth treated with a intracanal medication protocol combining calcium hydroxide, chlorhexidine 2% gel and zinc oxide with no periodical replacements

Orientador: Francisco Jose de Souza FilhoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O objetivo do presente estudo foi investigar uma proposta de protocolo terapêutico utilizando a associação do hidróxido de cálcio, clorexidina gel 2% e óxido de zinco (2:1:2) como medicação intracanal, sem substituições periódicas, em dentes traumatizados. Foram examinados 55 dentes unirradiculares, desvitalizados, 15 com ápices incompletos (Grupo I) e 40 com ápices completos (Grupo II), de 33 pacientes de ambos os gêneros, atendidos no Serviço de Atendimento de Traumatismos Dentários da Faculdade de Odontologia de Piracicaba - UNICAMP, Área de Endodontia. No Grupo I, o período médio de permanência da medicação foi de 9,1 meses e no Grupo II, de 8,2. Clinicamente, observaram-se sinais e sintomas presentes antes e depois do período de medicação intracanal, como: presença de mobilidade, fístula, abscesso, dor espontânea e sensibilidade à percussão. A avaliação radiográfica visou identificar a presença de espessamento do ligamento periodontal, lâmina dura, reabsorções inflamatórias e/ou por substituição, áreas de radioluscência apical, além da formação e tipo de barreira periapical. Os dentes do Grupo I foram submetidos a avaliações adicionais para uma análise comparativa dos processos de apicificação dos dentes tratados e de apicigênese de dentes vitais homólogos ou adjacentes aos traumatizados (Grupo Controle). Para tanto, desenvolveu-se o Índice de Convergência Apical (ICAp). Após a análise estatística observou-se que: (1) a ocorrência de sensibilidade à percussão e de presença de mobilidade apresentaram reduções estatisticamente significantes nos Grupos I e II, sendo que os aspectos radiográficos apresentaram, em ambos os grupos, aumento da presença de lâmina dura e redução do espessamento do ligamento periodontal, estatisticamente significantes; (2) o processo de apicificação induzido pelo protocolo de medicação intracanal proposto não diferiu, estatisticamente, da apicigênese de dentes não traumatizados, e (3) ocorreu uma redução estatisticamente significante da radioluscência periapical, nos dentes com formação radicular incompleta. Dessa forma, concluiu-se que o presente protocolo de medicação intracanal pode ser proposto como alternativa para o tratamento de dentes traumatizados desvitalizados, em especial, nos casos com rizogênese incompletaAbstract: The aim of the present study was to evaluate approaches, the use of an intracanal medication protocol combining calcium hydroxide, chlorhexidine 2% gel and zinc oxide (2:1:2), with no periodical replacements, for the treatment of traumatized teeth. Fifty five single root, non vital teeth were studied. Fifteen had uncompleted apices (Group I), and other forty had complete apices (Group II). All teeth were selected from 33 patients, of both genders, which had been followed by The Center of Dental Traumatisms, of Piracicaba Dental College ? University of Campinas, Endodontics. The mean time of medication permanence was 9.1 and 8.2 months for Group I and II, respectively. Clinical evaluation considered symptoms and signs which were present before and after medication time, such as: dental mobility, fistula, abscess, spontaneous pain and percussion sensibility. Radiological evaluation was performed to verify the presence of cortical alveolar bone, inflammatory and/or replacement resorptions, apical radioluscency areas, and formation and type of periapical barrier. Group I teeth were submitted to aditional evaluations in order to compare its apexification with the apicegenesis process of healthy contralateral or adjacent teeth (Control Group). This was done by means of the development of the Apical Convergence Index (ICap). After statistical approaches, it was showed in the results that: (1) percussion sensibility and dental mobility occurrence showed statistically significant reductions for Group I and II, and concerning radiographic aspects, it was noted that both groups showed statistically significant modifications as the increase of the presence of cortical alveolar bone and the reduction of the periodontal ligament thickness; (2) the apexification process induced by the proposed intracanal medication protocol was not statistically different if compared to the apicegenesis process of healthy contralateral or adjacent teeth, and (3) there was a statistically significant reduction of periapical radiolucency of teeth with uncompleted apices. These findings concluded that the present intracanal medication protocol as an alternative for the treatment of traumatized non vital teeth, mainly those with uncompleted apicesDoutoradoEndodontiaDoutor em Clínica Odontológic

Evaluation of elementary education teachers’ knowledge on avulsion and tooth replantation

Introduction: Dental trauma care emergency is very important issue, especially in cases of avulsion and it is crucial for the prognosis. A preventive-educational approach had not been effective and there are many failures in handling dental trauma, mainly by lack of knowledge by health professionals, teachers and lay people. Objective: The aim of this study was to assess the knowledge of 89 teachers about dental trauma. Material and methods: A questionnaire divided into three parts containing questions about the emergency procedures in cases of dental trauma was applied. Results: Only 13% of teachers would replant the tooth in the socket, and only 7% said they would put the tooth in some liquid and 58% would store in a piece of paper, cloth or clean container. In relation to replantation, 75% reported that they would hold the tooth by the crown, 79% reported that first they would refer to the dentist, and 80% thought that the treatment had to be immediate. With regard to tooth preparation, 46% would keep it in saline, 24% in water, and only 11% in milk. Concerning to the avulsed tooth, only 15% correctly answered that they would replant the avulsed tooth and then referred to the dentist. Conclusion: It was concluded that the knowledge of teachers must be improved by educational and preventive campaigns on management of traumatized teeth

Comportamento em condições de campo de cafeeiros (Coffea arabica L.) propagados vegetativamente e por semeadura

Cutting is an alternative method for vegetative propagation of Coffea arabica L. hybrids for commercial purpose. However, the use of such method requires the understanding of the plant growth characteristics under filed conditions. Thus, the objective of the present study was to evaluate and compare the vegetative growth and first yield of Coffea arabica cv. Acaiá plants obtained by cuttings and with seed propagated plants. The experiment was installed in the year 2003 and carried out in the Department of Agriculture at Federal University of Lavras-UFLA. For cutting propagation, stems were treated with three concentrations (0, 2000 e 4000 mg.L-1) of Indol butiric acid (AIB), in the presence or absence of supplemental warming. The development and growth of the cuttings were compared to the plantlets obtained by traditional seed propagation. A randomized blocks design, with six plants per plot, considering four useful plants and three replications was used. The vegetative growth, height, and yield of the plants of coffee obtained from cutting and treated with 2000 mg.L-1 AIB, were significantly greater than those not treated. Also, the production of plagiotropic branches by the plants originated from cuttings was greater than those originated from seeds.A propagação vegetativa por meio do enraizamento de estacas é uma alternativa para a propagação de híbridos de Coffea arabica L. em escala comercial. Entretanto, para a utilização da propagação via enraizamento de estacas, é necessário o conhecimento das características de crescimento das plantas no campo. Assim, objetivou-se neste trabalho avaliar o crescimento vegetativo e a primeira produção de plantas de Coffea arabica cv. Acaiá, provenientes de estaquia, bem como compará-las com plantas provenientes de semeadura. O experimento foi instalado em 2003 no Departamento de Agricultura da Universidade Federal de Lavras – UFLA. Foram utilizadas mudas provenientes de estaquia, tratadas na fase de enraizamento com ácido indol–butírico (AIB), nas concentrações de (0, 2000 e 4000 mg.L-1) com e sem aquecimento no leito de enraizamento. Como tratamento adicional, foram utilizadas mudas provenientes de semeadura. O delineamento experimental foi em blocos casualizados, com três repetições e parcelas de seis plantas, sendo quatro plantas úteis. Avaliações do crescimento vegetativo e da produção possibilitaram concluir que plantas provenientes de estaquia, tratadas com AIB, apresentaram maior altura e produção em relação às não-tratadas. Observou-se maior número de pares de ramos plagiotrópicos e produção das plantas provenientes de estaquia em relação às plantas provenientes de semeadura

Comparação entre sistemas radiculares de mudas de Coffea arabica L. obtidas por estaquia e por sementes

Vegetative propagation or cloning of F1 hybrids represents an economy of time and resources for Coffea arabica L. breeding programs. Nevertheless, not much is known about the rooting system of coffee plants propagated by cuttings. An essay was carried out aiming to evaluate Coffea arabica rooting system of plants obtained by vegetative and seedling propagation. Cuttins of the Acaiá and Rubi cultivar with previously developed roots, about 3cm long, that have been free for 90 days of any contact with plant growth regulators were transplanted to plastic bags. At the same time, seeds from the same cultivars were planted on the same plastic bags and stored on a covered commercial nursery with 50% shading. Common cultivation methods were used during seedling development. Bioplant was used as substratum and Osmocote as fertilizer supplier. Root length and diameter were evaluated by using the computational program QUANTRAIZ. It was observed that young coffee plants originated by cuttings produced fine root system longer and heavier than the root system of plants formed by seeds. Most part of the roots developed by the seedlings, more than 98%, was composed by fine roots by which the plant is able to absorb water and mineral salts.A clonagem de híbridos F1 de Coffea arabica L., pode representar uma diminuição significativa de tempo e recursos despendidos nos programas de melhoramento. Entretanto, pouco se sabe sobre o sistema radicular de plantas de café propagadas vegetativamente. Objetivando avaliar o sistema radicular de mudas de C. arabica, obtidas por meio de estaquia e por semeadura, foi conduzido um experimento no qual estacas previamente enraizadas, após 90 dias sem o uso de regulador de crescimento, com raízes entorno de 3 cm, das cultivares Acaiá e Rubi, foram transplantadas para sacolas plásticas. Na mesma ocasião foi feita a semeadura das duas cultivares no mesmo tipo de sacola e colocadas em viveiro do tipo comercial, de cobertura, com sombreamento de aproximadamente 50%. Durante o desenvolvimento das mudas foram feitos os tratos culturais conforme o sistema convencional de produção de mudas. Como substrato foi utilizado o Bioplant® e como suprimento foi utilizado o fertilizante Osmocote. As mudas atingiram o padrão de muda de ano. As medições dos comprimentos e diâmetros das raízes foram feitas utilizando-se o programa computacional QUANTRAÍZ. Observou-se que mudas obtidas por meio de estacas possuem maior comprimento total das raízes e maior peso da matéria seca que mudas formadas por sementes. A maior parte do sistema radicular de todas as mudas, mais de 98%, constituiu de raízes finas por meio das quais as plantas absorvem água e os sais minerais

Multivariate analysis of chemical parameters of cocoa: a contribution to origin designation / Análise multivariada de parâmetros químicos do cacau: uma contribuição para a denominação de origem

Brazil has been trying to become a key player in the specialized market through the production of fine chocolate. However, there is still no rules about the chemical quality of cocoa beans that allows it to be grouped by micro-regions. In this context, the objective of this work was to determine some chemical parameters of cocoa samples, aiming to contribute to the creation of the designation of origin for the cocoa produced in the south of Bahia. For this propose, proteins, lipids, total minerals, and fatty acid profile analysis were performed. The results obtained were correlated using multivariate statistical tests. The chemical composition of the cocoa beans, allowed to differentiate samples of cocoa, revealing the formation of three groups of samples. The two main components (lipids and proteins) were analysed together, characterizing the producing region. Regarding the analysis of the fatty acid profile, they showed that the cocoa harvested in the main season presents a higher influence of saturated fatty acids, while in the early season the higher influence is of unsaturated fatty acids. Multivariate techniques were able to group the different types of cocoa according to their chemical profile, helping to create an origin denomination for those produced in Southern Bahia

Inclusão do aluno surdo na rede regular de ensino / Inclusion of the deaf student in the regular education network

O presente artigo elucida a inclusão do aluno surdo no ensino regular, concordando com a importância desse direito, e assim, de forma sucinta destaca as bases legais que asseguram essa modalidade, define o que é a inclusão, as dificuldades enfrentadas pelo aluno surdo e ou com surdez nesse processo, expõe-se também o papel do professor e da escola, qual a real importância do intérprete de libras no processo de ensino e aprendizagem deste aluno, e aborda-se de maneira contextual o atendimento educacional especializado complementar, pontuando o objetivo desse serviço aos discentes incluídos. A pesquisa foi realizada através de levantamentos de revisão bibliográfica onde se utilizou de artigos científicos, livros e resumos online. Torna-se considerável nos dias atuais, defender que a educação é um direito de todos, e que o mesmo está assegurado na Constituição da República Federativa do Brasil de 1988 preocupando-se não só garantir o ingresso, mas estruturar de forma que o aluno surdo permaneça e tenha sucesso nesse percurso escolar, nos diferentes níveis de ensino ao qual deseja cursar, buscando compreender os principais acontecimentos da trajetória da comunidade surda, bem como, as bases legais e suportes necessários à inclusão do aluno surdo e/ou com surdez no ensino regular. É preciso que a escola se comprometa com a inclusão plena do surdo, compreendendo que para isto, o respeito à língua de sinais como língua natural e sua inclusão nos currículos é um dos principais movimentos neste sentido

Effects of high-dose isoflavones on rat uterus

OBJETIVO: Avaliar o efeito de altas doses de isoflavonas no útero de ratas adultas castradas. MÉTODOS: Ratas virgens ovariectomizadas (n = 40) foram tratadas por 30 dias consecutivos com veículo (GCtrl) ou genisteína nas concentrações 42 (GES42), 125 (GES125) e 250 (GES250) µg/g de peso corporal ao dia. O extrato de soja e o veículo (propilenoglicol) foram administrados por gavagem. Ao final do experimento, foi realizada dosagem sérica de 17 &#946;-estradiol e progesterona, avaliou-se o peso dos animais e dos úteros e foi feito exame colpocitológico. Fragmentos do terço médio dos cornos uterinos foram fixados em formol a 10% e processados para inclusão em parafina para estudo histológico. Cortes de 5 µm de espessura foram corados pelo HE e destinados a estudo em microscopia de luz. Analisou-se a histomorfologia do endométrio, área endometrial, número e área ocupada pelas glândulas, assim como a concentração de eosinófilos presentes na lâmina própria. Os dados numéricos obtidos foram submetidos à análise de variância complementada pelo teste de Tukey-Kramer (p < 0,05). RESULTADOS: Verificou-se que o peso do útero, as áreas endometrial e glandular e o número de glândulas e de eosinófilos foram maiores nos animais dos grupos GES250 &gt; GES125 do que nos outros grupos (GES250 &gt; GES125 &gt; GES42 = GCtrl; p < 0,05). Os dados morfológicos mostraram proliferação endometrial nos grupos ES125 e ES250, que apresentavam endométrio mais desenvolvido que outros grupos. Em todos os animais do grupo ES250 notou-se a presença de metaplasia escamosa. CONCLUSÃO: A administração de isoflavonas em altas doses promove metaplasia escamosa no endométrio.OBJECTIVE: To evaluate the effects of high-dose isoflavones on the uterus of castrated adult rats. METHODS: Adult, ovariectomized virgin rats (n = 40) were treated by gavage during 30 consecutive days with vehicle (propylene glycol, group GCtrl) or different doses of genistein: 42 (group GES42), 125 (GES125), or 250 (GES250) µg/g body weight per day. Animals were killed, weighed, vaginal and uterine samples were taken for cytologic evaluation, and serum levels of 17 &#946;-estradiol and progesterone were determined. The middle third of the uterine horns was dissected, fixed in 10% formaldehyde and processed for paraffin inclusion; 5-µm thick sections were obtained and stained with HE for further histological study under light microscopy. The endometrial morphology and area, number and area of glands, and number of eosinophils in the lamina propria were analyzed. ANOVA and the Tukey-Kramer test were used for statistical analyses. RESULTS: Uterine weight, endometrial glandular area, and number of glands and eosinophils were all higher in GES250 &gt; G125 than in the other groups (GES250 &gt; GES125 &gt; GES42 = GCtrl; p < 0.05). Morphological data showed signs of endometrial proliferation upon treatment with genistein, especially in animals in GES125 and GES250 compared to other groups. In all animals in GES250, signs of uterine squamous metaplasia were observed. CONCLUSION: A short treatment period with high daily doses of isoflavones can promote endometrial squamous metaplasia in ovariectomized rats.CNPqCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES

Dental discoloration caused by Grey-MTAFlow cement: analysis of its physicochemical, biological and antimicrobial properties

Tricalcium silicate-based cement are materials used in reparative and regenerative procedures in endodontics. A recently proposed formulation aimed to enhance handling during clinical use with a versatile material applicable by syringe. Although, the use of bismuth oxide as radiopacifier and grey raw powder are drawbacks considering aesthetics. Objectives: Evaluate physicochemical, biological, and antimicrobial properties of Grey-MTAFlow (Ultradent) and assess whether the addition of zinc oxide (ZnO) prevents dentinal discoloration caused by bismuth oxide. Methodology: Grey-MTAFlow was manipulated in 'thin' consistency for all tests. Luminosity, color change, ion migration to dentine, radiopacity, setting time, ISO 6876:2012 linear flow, volumetric lateral flow and central filling of simulated grooves scanned using micro-computed tomography (μCT), pH, calcium release, volumetric change using μCT, chemical characterisation, cytotoxicity, and antimicrobial activity were assessed. Addition of 5% ZnO to Grey-MTAFlow and a bismuth-containing experimental composition were comparatively tested. Statistical analyses used Shapiro-Wilk, T-test, ANOVA, and Kolmogorov-Smirnov (p&lt;0.05). Results: The addition of ZnO to Grey-MTAFlow prevented dentine darkening after 90 days due to bismuth migration reduction, although no statistical difference was found (p=0.863). ZnO addition significantly enhanced Grey-MTAFlow radiopacity without differences in initial setting time. Grey-MTAFlow presented an ISO linear flow of 10.9 mm and a balanced volumetric lateral flow with central filling in μCT evaluation. All compositions presented an alkaline pH after immersion. Grey-MTAFlow had a significantly higher calcium ion release after 28 days in comparison to 24 hours (p=0.011) and volumetric expansion of 0.4±1.8% after immersion. ZnO addition altered the hydrated cement matrix once calcium hydroxide (portlandite) could not be detected in characterisation. Neither of the materials produced inhibition halos nor reduced bacterial turbidity, but all presented cytocompatibility above 100%

Treatment outcomes of pulp revascularization in traumatized immature teeth using calcium hydroxide and 2% chlorhexidine gel as intracanal medication

Objective: Pulp revascularization is an effective treatment for immature necrotic teeth. Calcium hydroxide has been used in pulp revascularization as an intracanal medication due to its antimicrobial action and the non-exhibition of crown discoloration and cytotoxicity for stem cells from the apical papilla. Our study aimed to investigate the clinical success and quantitative radiographic changes of root development in immature traumatized teeth using calcium hydroxide plus 2% chlorhexidine gel as intracanal medication. Methodology: In this retrospective study, 16 patients were treated with a standardized pulp revascularization protocol. Calcium hydroxide and 2% chlorhexidine gel were manipulated in a 1:1 (v/v) ratio and inserted into root canals with Lentulo spirals (Dentsply Maillefer, Baillaigues, Switzerland). Patients were followed up for a period from 9 to 36 months for the evaluation of clinical and radiological data. Radiographic measurements of root length, root width, apical diameter, and MTA placement from the apex were quantified using software ImageJ. Wilcoxon test and t-test were used, according to nonparametric or parametric data, respectively, for changes over time in root length, root width, and apical diameter. Results: Fifteen teeth survived during the follow-up period (93.75%) and met the criteria for clinical success. Although the changes seem to be very small in many cases, significant increases in the average root length (14.28%, p&lt;0.0001), root width (8.12%, p=0.0196), and decrease in apical diameter (48.37%, p=0.0007) were observed. MTA placement from the apex and age at the time of treatment was not significantly associated with the quantitative radiographic outcomes. Conclusions: Pulp revascularization in traumatized immature teeth treated with calcium hydroxide plus 2% chlorhexidine gel as intracanal medication had high success and survival rates, showing periodontal healing and resolution of signs and symptoms. However, concerning the continued root development, the outcomes can still be considered unpredictable