Revascularization in a maxillary lateral incisor using bioceramic sealer: case report: Revascularização pulpar em incisive lateral com cemento biocerâmico: relato de caso

Revascularization is a regenerative endodontic dental procedure, which aims to stimulate the penetration of periradicular tissue inside the root canal, allowing vascularization of necrotic teeth, leading to a tissue repair and regeneration. Currently, Biodentine cement has been used to perform this procedure. The aim of this study was to report a clinical case about the revascularization of a maxillary lateral incisor with incomplete root formation using Biodentine. The patient, male, 10 years old, attended the multidisciplinary clinic of CEULP/ULBRA accompanied by the responsible, asymptomatic, reporting trauma to element 22, sensitivity and vertical percussion tests were performed with negative results. Through periapical radiography, incomplete root formation and a radiolucent area in the periapical region were observed. The revascularization technique was performed, aiming to stimulate the root formation. In the first session, instrumentation with K-type instruments at working length and intracanal medication were performed. After 15 days, the revascularization procedure was performed with a 25/0.02 K file led beyond the working length to stimulate periapical bleeding, so the canal was filled with blood up to the cervical third. Blood clotting was awaited, Biodentine was placed, and the definitive restoration was performed with composite resin. Follow-up up to 1 year and four months was carried out and the root development was observed. Thus, in the reported case, the revascularization technique proved to be efficient, allowing the continuity of the root formation a compromised tooth

Istmos en conductos mesiales de primeros molares inferiores.

El estudio de la anatomía y complejidad de los conductos radiculares tiene relevancia clínica y puede relacionarse con causas frecuentes de fracaso endodóntico. Los istmos son comuni- caciones estrechas entre conductos, consideradas áreas de difícil acceso1, impidiendo la remoción de remanentes bacterianos y tejido pulpar2 , volviéndose un desafío para los endodoncistas. No hay lite- ratura de métodos de limpieza y modelado eficiente de estas áreas. La incidencia reportada de istmos es de 75-100% 1 en raíces mesiales de primeros molares superiores y 83%3 de raíces distales de mo- lares inferiores

Radix entomolaris, an anatomical variation of mandibular molars: clinically relevant considerations: Radix entomolaris, uma variação anatômica em molares inferiores:

Knowledge about both the external and internal anatomy of teeth is essential for the success of endodontic treatment. The mandibular molars are prone to anatomical variations such as the presence of an additional root located lingual to the tooth which is named Radix Entomolaris (RE). The aim of the present study was to describe the internal and external morphology of RE, as well as evaluate the prevalence, etiology, and clinical protocol of this atypical anatomy by means of a literature review. The knowledge of these anatomical variations as well as clinical guidelines for the diagnosis and endodontic treatment of RE can minimize procedural errors during root canal preparation, and provide an adapted clinical approach for the dentists, thus culminating in the success of endodontic treatment

Antimicrobial activity of per acetic acid for trans-operative disinfection of endodontic files

Reducing the accumulation of microorganisms on an endodontic file during endodontic treatment is important to limit recontamination of the root canal and increase likelihood of successful treatment outcome. Objective: To compare the antimicrobial activity of peracetic acid (PA), isopropyl alcohol and acetone against a range of bacteria and also for disinfection of contaminated endodontic K-files. Material and Methods: Antimicrobial activities of PA, isopropyl alcohol and acetone were compared against Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, vancomycin resistant E. faecalis (VRE) and meticillin resistant S. aureus (MRSA), using minimum bactericidal concentration (MBC) and time-kill assays. Test solutions at different exposure times (15 s and 30 s) were assessed for treatment of endodontic files acting as carriers of E. faecalis-contaminated dental debris. Results: All bacteria were susceptible to PA (MBC range 0.25-1%), acetone (MBC range 50-60%) and isopropyl alcohol (30-40%). Using a time-kill assay of the antimicrobials at the determined MBC, all test microorganisms, with the exception of E. faecalis (VRE) 7766 were killed after 15 s exposure. In the case of E. faecalis 7766, viable cells remained detectable after 120 s exposure to acetone. Testing disinfection of endodontic K-files, previously coated with dental debris containing E. faecalis, it was found that PA (2%) completely killed E. faecalis after 15 s exposure. However, even after 30 s exposure, isopropyl alcohol (80%) and acetone (80%) had limited disinfecting activity. Conclusion: Extrapolation of these results to clinical practice would suggest that PA would be the most effective agent for trans-operative disinfection of endodontic K-files during treatment of a single patient

Cysticercosis in free-ranging agoutis (Dasyprocta leporina) in the Eastern Brazilian Amazon

Universidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia. Departamento de Patologia. São Paulo, SP, Brasil / Universidade Paulista. Instituto de Ciências da Saúde. Campinas, SP, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Centro Nacional de Primatas. Ananindeua, PA, Brasil.Universidade de São Paulo. Instituto de Medicina Tropical. Departamento de Gastroenterologia. São Paulo, SP, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.The study describes the occurrence of cysticercosis in liver of 22 wild agoutis (Dasyprocta leporina) in the Brazilian Amazon. The phylogenetic analysis and microscopic characteristics of metacestodes in liver tissue sections, associated with the geographic distribution of the intermediate hosts indicated that a possibly novel Taenia sp. metacestode caused the parasitism. Additionally, two cases of hepatic co-infection by Taenia sp., Calodium sp. and Echinococcus oligarthra were also observed among the analyzed animals. The results point to the need for a better understanding of hepatotropic parasites among wild rodents in the Brazilian Amazon

Antimicrobial activity of per acetic acid for trans-operative disinfection of endodontic files

Reducing the accumulation of microorganisms on an endodontic file during endodontic treatment is important to limit recontamination of the root canal and increase likelihood of successful treatment outcome. Objective: To compare the antimicrobial activity of peracetic acid (PA), isopropyl alcohol and acetone against a range of bacteria and also for disinfection of contaminated endodontic K-files. Material and Methods: Antimicrobial activities of PA, isopropyl alcohol and acetone were compared against Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, vancomycin resistant E. faecalis (VRE) and meticillin resistant S. aureus (MRSA), using minimum bactericidal concentration (MBC) and time-kill assays. Test solutions at different exposure times (15 s and 30 s) were assessed for treatment of endodontic files acting as carriers of E. faecalis-contaminated dental debris. Results: All bacteria were susceptible to PA (MBC range 0.25-1%), acetone (MBC range 50-60%) and isopropyl alcohol (30-40%). Using a time-kill assay of the antimicrobials at the determined MBC, all test microorganisms, with the exception of E. faecalis (VRE) 7766 were killed after 15 s exposure. In the case of E. faecalis 7766, viable cells remained detectable after 120 s exposure to acetone. Testing disinfection of endodontic K-files, previously coated with dental debris containing E. faecalis, it was found that PA (2%) completely killed E. faecalis after 15 s exposure. However, even after 30 s exposure, isopropyl alcohol (80%) and acetone (80%) had limited disinfecting activity. Conclusion: Extrapolation of these results to clinical practice would suggest that PA would be the most effective agent for trans-operative disinfection of endodontic K-files during treatment of a single patient

Laboratory reevaluation of hepatitis C virus infection in patients undergoing dialysis treatment in the 1990s, in Belém, Pará State, Brazil

Hospital Universitário João de Barros Barreto. Belém PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.NefroCentro. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.OBJETIVO: Descrever aspectos do diagnóstico laboratorial sorológico e molecular da infecção pelo vírus da hepatite C (HCV – do inglês hepatitis C virus), em pacientes submetidos a tratamento em uma clínica de diálise de Belém, estado do Pará, Brasil, no período de 1990 a 1993. MATERIAIS E MÉTODOS: Estudo retrospectivo para reavaliação de amostras de soro de pacientes dialisados, utilizando testes sorológicos para a detecção do HCV (anti-HCV e Ag-Ab HCV) e HCV-RNA, por meio de técnica molecular de RT-PCR. RESULTADOS: Foram incluídos 115 pacientes dialisados com amostras de soro coletadas no período do estudo. A análise dessas amostras mostrou prevalência de 16,5% de anti-HCV reagente, entre as quais 4,3% apresentaram indicador de replicação viral ativa (HCV-RNA reagente). Detectou-se taxa de soroconversão em 55,2% dos pacientes no período analisado. O grupo anti-HCV, Ag-Ab HCV e HCV-RNA reagente foi o mais prevalente (41,7%). Em relação às amostras anti-HCV não reagentes, verificou-se replicação viral com HCV-RNA reagente em 22,7%. Foram detectados os genótipos 1 e 3. O genótipo 1 foi prevalente em 73,0% das amostras. CONCLUSÃO: Quando se introduziu a triagem laboratorial para HCV (anti-HCV) na clínica de diálise, foi possível observar: alta prevalência de infecção pelo HCV entre os pacientes em tratamento; altos índices de soroconversão; equiparação entre resultados sorológicos, utilizando os métodos de ELISA de segunda e de terceira geração; presença de replicação viral entre os pacientes anti-HCV não reagentes; e maior prevalência do genótipo 1 do HCV

DETECÇÃO PRECOCE DE LESÕES BUCAIS E DOENÇAS INFECCIOSAS: O PAPEL DO DENTISTA NO PROGRAMA SAÚDE DA FAMÍLIA

Introdução: A detecção precoce de lesões bucais e doenças infecciosas é fundamental para o sucesso do Programa Saúde da Família. O dentista desempenha um papel crucial ao realizar exames regulares e educar a comunidade sobre a importância da saúde bucal, contribuindo para a prevenção e tratamento eficaz dessas condições. Objetivo: Analisar qual o papel do dentista na  detecção precoce de lesões bucais e doenças infecciosas, no contexto do programa saúde da família. Metodologia: Estudo do tipo revisão de literatura,  conduzida entre setembro de 2023 e janeiro de 2024, nas bases da LILACS, PUBMED e SCIELO, com os descritores: “Programa saúde da família”; “Dentista”; “Lesões”; “Doenças Infecciosas”. Os critérios de inclusão foram: disponibilidade gratuita, acesso integral, redigidos em português ou inglês, publicados nos últimos 10 anos (2014-2024), já os de exclusão, duplicatas. monografias e dissertações. Ao final, apenas 13 estudos foram selecionados para a amostra. Resultados e Discussões: A atuação proativa do dentista é crucial para impulsionar a promoção abrangente da saúde bucal no Programa Saúde da Família. Além de identificar precocemente lesões e doenças, o profissional estabelece uma conexão próxima com a comunidade, oferecendo orientações e intervenções oportunas, gerando um impacto positivo duradouro na saúde bucal da população atendida. Conclusão: Em conclusão, a atuação do dentista no PSF se destaca pela realização de exames clínicos periódicos, permitindo a identificação precoce de lesões bucais, como por exemplo, abusos e violências. Além disso, desempenha um papel vital na detecção precoce de condições como infecções periodontais e lesões ulcerativas

Outcomes of the first 54 pediatric patients on long-term home parenteral nutrition from a single Brazilian center

Objectives: Data on multidisciplinary programs dedicated to home parenteral nutrition (HPN) in Latin America are limited. This study describes the results of the first multidisciplinary pediatric intestinal rehabilitation program for HPN at a public tertiary hospital in Brazil. Methods: We retrospectively reviewed patients aged 0–18 years with intestinal failure (IF) who required parenteral nutrition (PN) for >60 days between January/2014 and December/2020. Results: Fifty-four patients were discharged on HPN (15 achieved enteral autonomy, 34 continued on HPN at the end of the study, 1 underwent intestinal transplantation, and 4 died). The median (IQR) age at the study endpoint of patients who achieved enteral autonomy was 14.1 (9.7–19) versus 34.7 (20.4–53.9) months in those who did not achieve enteral autonomy. Overall prevalence of catheter-related thrombosis was 66.7% and catheterrelated bloodstream infection rate was 0.39/1000 catheter-days. Intestinal failure-associated liver disease (IFALD) was present in 24% of all patients; none of the patients who achieved enteral autonomy had IFALD. All patients showed significant improvement in anthropometric parameters during the HPN period. The sociodemographic characteristics of the patients’ family members were mothers less than 20 years old (7.5%), schooling time more than 10 years (55.5%), and household income between 1 and 3 times the minimum wage (64.8%). The 5-year survival rate for HPN is 90%, and 27.7% of patients achieve enteral autonomy. Conclusion: The treatment of pediatric patients with IF followed by a multidisciplinary pediatric intestinal rehabilitation program with HPN is feasible and safe in the Brazilian public health system