Experimental alveolitis in rats: microbiological, acute phase response and histometric characterization of delayed alveolar healing

The pathogenesis of alveolitis is not well known and therefore experimental situations that mimic some features of this disease should be developed. OBJECTIVE: In this study, the evolution of the experimentally induced infection in rat sockets is characterized, which leads to clinical signs of suppurative alveolitis with remarkable wound healing disturbs. MATERIAL AND METHODS: Non-infected (Group I) and experimentally infected sockets in Rattus novergicus (Group II) were histometrically evaluated regarding the kinetics of alveolar healing. In addition, the characterization of the present bacteria in inoculation material and the serum levels of C-reactive protein (CRP) were performed. The detected species were Capnocytophaga ochracea, Fusobacterium nucleatum ss nucleatum, Prevotella melaninogenica, Streptococcus anginosus, Treponema socranskii and Streptococcus sanguis. RESULTS: All experimentally infected rats developed suppurative alveolitis, showing higher levels of CRP in comparison to those non-infected ones. Furthermore, infected rats presented a significant delayed wound healing as measured by the histometric analysis (higher persistent polymorphonuclear infiltrate and lower density of newly formed bone). CONCLUSION: These findings indicate that rat sockets with experimentally induced infection produced higher levels of serum CRP, showing the potential of disseminated infection and a disturb in the alveolar repair process in an interesting experimental model for alveolitis studies

Microscopic and histometric comparative analysis of a metronidazole ointment application and sodium iodide plus hydrogen peroxide irrigation in the treatment of infected tooth sockets of rats

O processo de reparo em alvéolo infectado de ratos foi avaliado após a utilização de três tipos de tratamento: (1) curetagem e irrigação com soro fisiológico seguida do preenchimento com uma pasta à base de metronidazol a 10%, lidocaína a 2%, menta e carboximetilcelulose, (2) irrigação única com solução de iodeto de sódio a 2% e peróxido de hidrogênio a 3% na proporção 1:1 e (3) irrigação diária, por 3 dias, com solução de iodeto sódio a 2% e peróxido de hidrogênio a 3% na proporção 1:1. Foram utilizados 75 ratos que constituíram os seguintes grupos: Grupo I: alvéolo não infectado (grupo controle positivo); Grupo II: alvéolo infectado sem nenhum tratamento; Grupo III: alvéolo infectado tratado com irrigação única de solução de iodeto de sódio a 2 % e peróxido de hidrogênio a 3% na proporção 1:1; Grupo IV: alvéolo infectado tratado com irrigação diária, por 3 dias, de solução de iodeto de sódio a 2 % e peróxido de hidrogênio a 3% na proporção 1:1; Grupo V: alvéolo infectado submetido à curetagem, irrigação com soro fisiológico e preenchimento com pasta à base de metronidazol a 10% e lidocaína a 2%, carboximetilcelulose e menta. Os animais, em número de 5 em cada grupo foram sacrificados aos 6, 15 e 28 dias após a exodontia do incisivo superior e as peças obtidas analisadas em microscopia óptica. Os resultados foram submetidos à análise qualitativa e quantitativa e evidenciaram melhor reparo nos grupos tratados em relação ao grupo sem tratamento. Com base nos resultados foi possível concluir que: os grupos III, IV e V apresentaram melhores condições de reparo frente ao grupo II, porém diferentes significantemente ao grupo I; o grupo V apresentou os melhores resultados quanto à neoformação óssea nos períodos de 15 e 28 dias, sendo uma opção interessante a ser considerada para o tratamento da alveolite.The healing process in infected tooth sockets was evaluated after application of three types of treatment.: (1) surgical cleaning of the socket with alveolar curettes, saline solution irrigation and complete filling of the socket with a 10% metronidazole, 2% lidocaine, carboxymethylcelullose and mint as flavoring, (2) Single irrigation with 2% sodium iodide and 3% hydrogen peroxide solution (1:1) and (3) Daily irrigation, for three days, with 2% sodium iodide and 3% hydrogen peroxide solution (1:1). Seventy-five rats were randomly assigned to the following groups: Group I: Non-infected tooth socket (positive control group); Group II: Infected tooth socket without treatment; Group III: Infected tooth socket treated with single irrigation of 2% sodium iodide and 3% hydrogen peroxide solution (1:1); Group IV: Infected tooth socket treated daily, for three days, with irrigation of 2% sodium iodide and 3% hydrogen peroxide solution (1:1); Group V: Infected tooth socket treated with surgical cleaning of the socket with alveolar curettes, saline solution irrigation and complete filling of the socket with a 10% metronidazole, 2% lidocaine, carboxymethylcelullose and mint as flavoring. The rats were killed in number of five at each group after 6, 15 e 28 days of superior incisor extraction. The histological findings were measured by qualitative and quantitative methods. The results demostrated better results of tooth socket healing in treated groups. Based on the results it was possible to conclude that groups III, IV and V exhibited better conditions of alveolar healing, compared to group II, although significant difference was observed with group I. Group V showed the best results in bone formation at 15 and 28 days, consisting in an interesting option for dry socket treatment

Unicystic Ameloblastoma with Mural Proliferation Managed by Conservative Treatment

Unicystic ameloblastoma is a distinguishable entity of ameloblastomas, characterized by slow growth and being relatively locally aggressive. Three histological types are recognized according to the degree of ameloblastomatous epithelial extension, namely, luminal, intraluminal, and mural types. This classification has a direct bearing on their biological behavior, treatment, and prognosis. However, there is difficulty in determining the most appropriate form of treatment for unicystic ameloblastoma. We present a case of unicystic ameloblastoma that occurred in the right posterior mandible of 19-year-old girl, which was enucleated and did not recur after 12-month follow-up

Dentigerous cyst: clinical and radiographic characteristics and criteria for treatment planning

The dentigerous cyst is the second most frequent odontogenic cyst in jaws. They are always radiolucent and commonly unilocular. They are usually found in routine exams or when a permanent tooth does not erupt. The third molars followed by maxillary canines and occasionally supernumerary teeth and odontomas may be involved with the formation of the dentigerous cyst, but its etiology is not yet completely known. The dentigerous cyst occurs mainly in the first three decades of life, and its growth is slow and asymptomatic, however, it may reach considerable dimensions causing facial deformity, impaction and displacement of teeth and/or adjacent structures. Decompression, marsupialization and enucleation are the most frequent forms of treatment used, nevertheless, some important criteria must be considered for the treatment plan such as cyst size, age, proximity to anatomical structures and clinical importance of the tooth involved. Despite the clinical peculiarities of each case and the treatment method chosen, prognosis of these lesions is favorable