Efeito antibacteriano do preparo biomecânico e do curativo de demora com pasta à base de hidróxido de cálcio (Calen) em dentes decíduos com lesão periapical

The aim of this study was to evaluate the antibacterial action of root canal mechanical preparation using 2.5% sodium hypochlorite as the irrigating solution and a calcium hydroxide paste as the antibacterial intracanal dressing in human primary teeth root canals with pulp necrosis and apical periodontitis by means of microbial culture. A total of 26 root canals of human primary teeth with pulp necrosis and apical periodontitis were used. Samples were collected before, 72h after biomechanical treatment and 72h after removal of the intracanal dressing. Comparison by Wilcoxon test showed that root canal mechanical preparation effectively eliminated all microorganisms in 20% of the root canals, and the intracanal dressing in 62.5%; however, the cumulative action of biomechanical treatment and intracanal dressing eliminated the microorganisms of 70% of the root canals (pO objetivo do presente estudo foi avaliar, por meio de cultura bacteriológica, a ação antibacteriana do preparo biomecânico utilizando como solução irrigadora o hipoclorito de sódio a 2,5% e da pasta Calen utilizada como curativo de demora em canais radiculares de dentes decíduos de humanos com necrose pulpar e lesão periapical. Foram selecionados 26 dentes decíduos de humanos portadores de necrose pulpar e lesão periapical. As colheitas microbiológicas foram efetuadas antes e 72 horas após o preparo biomecânico e 72 horas após a remoção do curativo de demora. A comparação por meio do teste de Wilcoxon mostrou que o preparo biomecânico foi eficaz na eliminação dos microrganismos dos canais radiculares em 20% dos casos e o curativo de demora em 62,5%, enquanto que a ação cumulativa do preparo biomecânico e do curativo de demora eliminou os microrganismos em 70,0% dos casos (

Prevalence of microorganisms in root canals of human deciduous teeth with necrotic pulp and chronic periapical lesions

O objetivo deste estudo foi avaliar, por meio de cultura bacteriológica, a prevalência de microorganismos em 31 canais radiculares de dentes decíduos humanos com necrose pulpar e lesão periapical. O material, colhido dos canais radiculares após a realização da cirurgia de acesso, foi submetido ao processamento microbiológico para a determinação das unidades formadoras de colônia de microorganismos. Os resultados mostram que os microorganismos anaeróbios foram quantificados em 96,7% dos casos, os bacilos pigmentados de negro (BPB) em 35,5%, os aeróbios em 93,5%, os estreptococos em 96,7% e os S. mutans em 48,4%. Assim, pôde-se concluir que a infecção em canais radiculares de dentes decíduos humanos portadores de necrose pulpar e lesão periapical é polimicrobiana, com grande quantidade de microorganismos e maior prevalência de estreptococos e microorganismos anaeróbios.The objective of this study was to evaluate bacterial prevalence in 31 root canals of human deciduous teeth with necrotic pulp and periapical lesions using bacterial culture. After crown access, the material was collected using absorbent paper points for microbiological evaluation and determination of colony forming units (CFU). Anaerobic microorganisms were found in 96.7% of the samples, black-pigmented bacilli in 35.5%, aerobic microorganisms in 93.5%, streptococci in 96.7%, and S. mutans in 48.4%. We concluded that in human deciduous teeth root canals with necrotic pulp and periapical lesions the infection is polymicrobial, with a large number of microorganisms and a predominance of streptococci and anaerobic microorganisms

Changes in Caries Risk and Activity of a 9-Year-Old Patient with Niemann-Pick Disease Type C

Objective. This case report describes the changes in caries risk and activity and dental treatment of a 9-year-old patient who presented with signs and symptoms of Niemann-Pick disease type C (NPC). Treatment. The preventive dental treatment included instructions to caregivers for oral hygiene and diet. A calcium hydroxide pulpotomy and restorative dental treatments were performed in a dental office with desensitization techniques and behavioral management. The patient was attended every 3 months for the control of dental plaque biofilm, for topical fluoride application, and for observing the pulpotomized tooth. Results. The bacterial plaque biofilm was being adequately controlled by the caregiver. After 2 years, the clinical and radiographic examination of the pulpotomized tooth showed the absence of internal root resorption and bone rarefaction, and clinical examination showed tooth sensitivity, dental pain, and gingival swelling. Conclusion. The pulpotomy prevented clinical and radiographic success. Dentists must be aware of and be able to identify systemic and local aspects associated with caries risk of children with NPC disease. Furthermore, dentists must employ stringent preventive measures and provide instructions to caregivers to reduce caries risk

Dentinogenesis imperfecta type II: a case report of a 34-year follow-up

Dentinogenesis imperfecta (DI) is a hereditary developmental disorder of dentin formation that can occur associated with osteogenesis imperfecta (type I), isolated (type II), or in a specific isolated resident group of Brandywine, in southern Maryland (type III). This work aims at reporting a clinical case of DI type II in childhood with a 34-year follow up. The child at issue was taken to the dental health service at a very young age, which favored an appropriate treatment, avoiding complications, and portending a favorable long-term prognosis, besides safeguarding the patient physical and mental well-being. The clinical aspects of this condition are teeth with short crowns and gray-brown coloration, and an altered consistency of affected dental elements. Radiographically, the teeth present bulbous crowns, cervical constriction, thin roots, and early obliteration of the root canal and pulp chambers due to excessive dentin production. Rehabilitation treatment included the use of stainless-steel crowns for reconstructing deciduous molars and composite resin restorations on the anterior deciduous teeth. As for permanent dentition, it consisted of aesthetic-functional rehabilitation using metal crowns on the first molars and ceramic crowns and facets on the anterior teeth. Endodontic, prosthetic and restorative treatment was performed on other posterior teeth. Preventive measures were instituted. DI may cause serious changes in dentin structure, affecting function and aesthetics in both dentitions. The sooner it is administered, the more promising the multidisciplinary dental treatment will be in promoting health and minimizing damage to affected individuals.A dentinogênese imperfeita (DI) é uma doença de alteração hereditária que afeta o desenvolvimento dentinário, podendo ocorrer associada à presença de osteogênese imperfeita (tipo I), isoladamente (tipo II), ou especificamente associada ao povoado de Brandywine, no sul de Maryland (tipo III). O objetivo deste trabalho é relatar um caso clínico de DI tipo II na infância que recebeu acompanhamento por 34 anos. A criança em questão foi encaminhada ao serviço de assistência odontológica ainda muito pequena, o que favoreceu um tratamento adequado, evitando complicações e trazendo um prognóstico favorável a longo prazo, além de garantir o bem-estar físico e mental da paciente. Os aspectos clínicos desta condição são dentes com coroas curtas e coloração marrom acinzentada, além de uma consistência alterada nos elementos dentários afetados. Radiograficamente, foram identificados dentes com coroas bulbosas, constrição cervical, raízes afinadas, e obliteração precoce do canal radicular e câmaras pulpares devido à excessiva produção de dentina. Para o tratamento, utilizou-se coroas de aço cromado na reconstrução de molares decíduos e restaurações de resina composta nos dentes decíduos anteriores. Quanto à dentição permanente, o tratamento visou reestabelecer a função e a estética, utilizando-se de coroas metálicas nos primeiros molares e coroas e facetas cerâmicas nos dentes anteriores. Em outros dentes posteriores foram utilizados os tratamentos endodôntico, protético e restaurador. Medidas preventivas foram instituídas. Em conclusão, a DI pode causar sérias alterações na estrutura dentinária, afetando a função e a estética de ambas as dentições. A intervenção odontológica multidisciplinar será mais promissora quanto mais cedo for estabelecida, promovendo a saúde bucal e minimizando os danos aos indivíduos afetados

Changes in Caries Risk and Activity of a 9-Year-Old Patient with Niemann-Pick Disease Type C

Objective. This case report describes the changes in caries risk and activity and dental treatment of a 9-year-old patient who presented with signs and symptoms of Niemann-Pick disease type C (NPC). Treatment. The preventive dental treatment included instructions to caregivers for oral hygiene and diet. A calcium hydroxide pulpotomy and restorative dental treatments were performed in a dental office with desensitization techniques and behavioral management. The patient was attended every 3 months for the control of dental plaque biofilm, for topical fluoride application, and for observing the pulpotomized tooth. Results. The bacterial plaque biofilm was being adequately controlled by the caregiver. After 2 years, the clinical and radiographic examination of the pulpotomized tooth showed the absence of internal root resorption and bone rarefaction, and clinical examination showed tooth sensitivity, dental pain, and gingival swelling. Conclusion. The pulpotomy prevented clinical and radiographic success. Dentists must be aware of and be able to identify systemic and local aspects associated with caries risk of children with NPC disease. Furthermore, dentists must employ stringent preventive measures and provide instructions to caregivers to reduce caries risk

Bruxismo em crianças: relato de caso clínico.

Bruxismo em crianças: relato de caso clínico