13 research outputs found
Comparison between calcium hydroxide mixtures and mineral trioxide aggregate in primary teeth pulpotomy: a randomized controlled trial
Objectives: To evaluate the effect of calcium hydroxide (CH) associated with two different vehicles as a capping material for pulp tissue in primary molars, compared with mineral trioxide aggregate (MTA). Methodology: Forty-five primary mandibular molars with dental caries were treated by conventional pulpotomy using one of the following materials: MTA only (MTA group), CH with saline (CH+saline group) and CH with polyethylene glycol (CH+PEG group) (15 teeth/group). Clinical and periapical radiographic examinations of the pulpotomized teeth were performed 3, 6, and 12 months after treatment. Data were tested by chi-squared analysis and a multiple comparison post-test. Results: The MTA group showed both clinical and radiographic treatment success in 14/14 teeth (100%), at all followup appointments. By clinical evaluation, no teeth in the CH+saline and CH+PEG groups had signs of mobility, fistula, swelling or inflammation of the surrounding gingival tissue. However, in the CH+saline group, radiographic analysis detected internal resorption in up to 9/15 teeth (67%), and interradicular bone resorption and furcation radiolucency in up to 5/15 teeth (36%), from 3 to 12 months of follow-up. In the CH+PEG group, 2/11 teeth (18%) had internal resorption and 1/11 teeth (9%) presented bone resorption and furcation radiolucency at all follow-up appointments. Conclusion: CH with PEG performed better than CH with saline as capping material for pulpotomy of primary teeth. However, both combinations yielded clinical and radiographic results inferior to those of MTA alone
Expression of Matrix Metalloproteinases-8 and Myeloperoxidase in Pulp Tissue after Pulpotomy with Calcium Silicate Cements
Objective: To evaluate the pulp tissue of rat molars after pulpotomies with mineral trioxide aggregate (MTA), BiodentineTM (BDT) and calcium hydroxide (CH) mixed with sterile saline solution (24 hours, 72 hours, 7 days and 15 days), through correlating MPO activity with active neutrophils and MMP8 activity with tissue remodeling. Material and Methods: Thirty-eight Wistar rats were randomly distributed into groups (control, I (MTA gray), II (BDT), and III (CH)) and subdivided according to the study period of 24 hours, 72 hours, 7 days or 15 days after pulpotomy. MMP8 activity was assessed through fluorescence technique, and MPO activity was determined using the MPO assay. Results: A gradual decrease of MPO and MM8 activity occurred in the group MTA over the experimental periods (p<0.05). Groups BDT and CH exhibited an increase in the activity at 7 and 15 days (p<0.05). Conclusion: MTA demonstrated a decrease in the values of MPO e MMP8. BDT and CH showed high neutrophilic and collagenase activity over the experimental periods
Expression of Matrix Metalloproteinases-8 and Myeloperoxidase in Pulp Tissue after Pulpotomy with Calcium Silicate Cements
Objective: To evaluate the pulp tissue of rat molars after pulpotomies with mineral trioxide aggregate (MTA), BiodentineTM (BDT) and calcium hydroxide (CH) mixed with sterile saline solution (24 hours, 72 hours, 7 days and 15 days), through correlating MPO activity with active neutrophils and MMP8 activity with tissue remodeling. Material and Methods: Thirty-eight Wistar rats were randomly distributed into groups (control, I (MTA gray), II (BDT), and III (CH)) and subdivided according to the study period of 24 hours, 72 hours, 7 days or 15 days after pulpotomy. MMP8 activity was assessed through fluorescence technique, and MPO activity was determined using the MPO assay. Results: A gradual decrease of MPO and MM8 activity occurred in the group MTA over the experimental periods (p<0.05). Groups BDT and CH exhibited an increase in the activity at 7 and 15 days (p<0.05). Conclusion: MTA demonstrated a decrease in the values of MPO e MMP8. BDT and CH showed high neutrophilic and collagenase activity over the experimental periods
Comparison between the rotary (Hyflex EDM®) and manual (k-file) technique for instrumentation of primary molars: a 12-month randomized clinical follow-up study
Rotational instrumentation is an alternative for the clinical practice of pediatric dentists. However, there are few records in the literature on the clinical and radiographic aspects of treated teeth over time. Objectives: Compare instrumentation time and filling quality between manual (k-file) and rotary (Hyflex EDM®) files, and clinically and radiographically follow-up the treated teeth for 12 months. Moreover, the characteristics of glass ionomer restorations and their interference in the treatment prognosis over time were evaluated. Methodology: In total, 40 children with pulp involvement in primary molars received treatment with Hyflex EDM® or manual rotary files, performed by an operator. Clinical and radiographic aspects were observed at different times to determine the effectiveness of each technique. Results: The rotary system reduced instrumentation time when compared to the use of manual files (p≤0.05), but there was no difference in filling quality between the groups (p≥0.05). Moreover, both types of instrumentation were effective for 12 months (p≥0.05), and restoration retention influenced the emergence of periapical lesions (p≤0.05). Conclusion: Although rotary files reduce clinical time, the clinical and radiographic aspects of both techniques were similar over 12 months. Moreover, restoration retention has been shown to be related to treatment prognosis
Pulp therapy in deciduous teeth: therapeutic possibilities based on evidences
Introduction: Pulpotomy of primary teeth has been the treatment of choice in cases of inflammation of the coronal pulp caused by caries or trauma with no involvement of the radicular pulp, thus avoiding the premature loss of the teeth. Not only is the diagnosis of the inflamed dental pulp required for this therapy to succeed, but also the selection of an effective and biocompatible medicament. However, none of the drugs available and recommended for pulpotomy therapy present all the requirements of an ideal pulp capping agent. Objective: Through a systematic literature review, between the years of 2000 and 2011, focusing in randomized clinical trials, systematic reviews and meta-analysis, aiming to analyze and discuss based on alternatives for the treatment of pulpotomy in human deciduous teeth. Conclusion: Scientific evidences showed that the medicaments and techniques influence were few. Thus, further and well-designed studies are suggested for clarification. The information generated in such experiments may contribute to a better understanding of the mechanisms of pulp therapy to new therapeutic approaches aimed at improving pulp therapy in deciduous teeth.Introdução: A pulpotomia em dentes decíduos é uma técnica conservadora de terapia pulpar amplamente utilizada \ud
em Odontopediatria, sendo de fundamental importância para evitar a perda prematura desses dentes, quer seja \ud
por alterações provocadas pela cárie dentária ou traumatismo dentário. Apesar de ser uma técnica estudada há \ud
muitos anos, causa muitas controvérsias e discussões, principalmente em termos de biocompatibilidade dos \ud
medicamentos empregados e pelas dificuldades e falhas no diagnóstico da condição pulpar. Objetivo: Por meio \ud
de uma revisão sistemática da literatura, no período compreendido entre 2000 e 2011, e com enfoque em estudos \ud
clínicos randomizados, revisões sistemáticas e meta-análises, este trabalho teve como objetivo discutir, com base em \ud
evidências científicas, alternativas para o tratamento de pulpotomia em dentes decíduos humanos. Conclusão: As \ud
evidências científicas fidedignas com o uso de materiais capeadores pulpares e as técnicas de Eletrocirurgia e Laser \ud
de Baixa Potência foram escassas. Desta forma, sugere-se a realização de estudos complementares bem delineados \ud
estatisticamente para maiores esclarecimentos. As informações geradas em tais experimentos poderão contribuir \ud
para um melhor entendimento dos mecanismos da terapia pulpar, podendo gerar o desenvolvimento de protocolos \ud
com novas formas terapêuticas, que visam a melhorar a terapia pulpar em dentes decíduo
Clinical, radiographic and microscopic study on 1:5 dilution of Buckley\'s formocresol, calcium hydroxide and trioxide mineral agregate a used for pulpotomies of human primary teeth
O objetivo deste estudo foi comparar a eficácia clínica, radiográfica e microscópica do formocresol (FC) de Buckley diluído a 1/5, hidróxido de cálcio PA (HC) e Agregado Trióxido Mineral (MTA) como agentes capeadores pulpares em dentes decíduos humanos acometidos por cárie extensa. Quarenta e cinco molares decíduos inferiores de 23 crianças com idades entre 5 e 9 anos foram tratados pela técnica convencional de pulpotomia. Os dentes foram aleatoriamente divididos entre os grupos experimentais (HC e MTA) e o grupo controle (FC). Após a remoção da polpa coronária e hemostasia, o tecido pulpar remanescente foi coberto com pasta de MTA ou pó de HC nos grupos experimentais. No grupo controle, uma bolinha de algodão umedecida na solução de FC diluído foi colocada por 5 minutos sobre o remanescente pulpar e então a câmara pulpar preenchida com óxido de zinco e eugenol. Todos os dentes foram restaurados com uma base de óxido de zinco e eugenol reforçado (IRM) e cimento de ionômero de vidro modificado por resina. As avaliações clínicas e radiográficas foram realizadas nos períodos de 3, 6, 12, 18, 24 e 30 meses do pós-operatório. Durante as avaliações, os dentes que se apresentavam no período normal de esfoliação, bem como, dentes considerados fracasso ao tratamento foram extraídos e processados para análise microscópica. Os cortes foram feitos seriadamente, no sentido vestíbulo-lingual e corados pela hematoxilina e eosina. A análise microscópica foi realizada de forma descritiva dos fenômenos mais marcantes ocorridos no tecido pulpar remanescente. Pelos resultados clínicos e radiográficos obtidos foi possível observar uma taxa de sucesso para os grupos FC, HC e MTA de 100%, 35,7% e 100%, respectivamente. Diferença estatisticamente significativa foi observada quanto à presença de reabsorção interna, lesão inter- radicular, mobilidade e fístula para o grupo HC (p < 0,05). A análise microscópica para o grupo FC revelou presença de intenso infiltrado inflamatório e deposição de tecido mineralizado, irregular por todo canal radicular. Para o grupo MTA, notou-se deposição de material mineralizado de aspecto dentinóide, obliterando todo o canal radicular, além de áreas centrais preenchidas por tecido conjuntivo frouxo com inúmeros vasos sanguíneos. O grupo HC apresentou, na maioria dos cortes, extensa área de necrose tanto na câmara pulpar quanto no canal radicular. Em outros poucos cortes, presença de barreira de dentina reacional, obliterando a abertura coronária do canal radicular, com discreto infiltrado inflamatório crônico. O MTA parece ser um possível substituto do FC, no entanto, o hidróxido de cálcio mostrou ser uma técnica muito sensível e, portanto, não indicada para pulpotomias de dentes decíduos.The aim of this study was to compare the clinical, radiographic and microscopic effectiveness of formocresol (FC), calcium hydroxide (CH) and trioxide mineral aggregate (MTA) as pulp dressing agents in carious primary teeth. Forty-five primary mandibular molars of 23 children between 5 and 9 years old were treated by conventional pulpotomy technique. The teeth were randomly assigned to the experimental (CH and MTA) or control (FC) groups. After coronal pulp removal and hemostasis, remaining pulp tissue was covered with a MTA paste or CH powder in the experimental groups. In the control group, diluted FC was placed over the pulp tissue with a cotton pellet for 5 minutes and removed; the pulp tissue was covered then with zinc oxide-eugenol (ZOE) paste. All the teeth were restored with reinforced zinc oxide-eugenol base and resin modified glass ionomer cement. Clinical and radiographic evaluations were recorded at 3, 6, 12, 18, 24 and 30-month follow-up. During the assessments, the teeth in the regular exfoliation period, as well as those considered as treatment failures were extracted and further processed for microscopic analysis. Serial sections were performed in the bucco-lingual direction and stained with hematoxylin and eosin. Microscopic analysis was performed as a description of the most remarkable phenomena in the remaining pulp tissue. Through clinical and radiographic results, success rates of 100%, 35.7% and 100% for FC, CH and MTA were found, respectively. Statistically significant differences were observed regarding to the presence of internal resorption, inter-radicular bone destruction, mobility and fistula for CH group (p < 0.05). Microscopic analysis revealed the presence of intense inflammatory infiltrate and mineralized tissue deposition, which was irregular throughout the root canal, in the FC group. As far as MTA group, dentin-like mineralized material deposition obliterating the root canal, and central areas filled by loose conjunctive tissue with several blood vessels were noticed. CH group presented, in most of the sections, extensive necrotic areas both in pulp chamber and root canal. Other sections revealed the presence of extensive reactive dentin barrier, which obliterated the coronal opening of the root canal, and a discrete chronic inflammatory infiltrate. MTA may serve as an effective substitute of FC in primary molar pulpotomies. However, CH seems to be a technique sensitive-material and therefore not indicated for pulpotomies of primary teeth
Clinical, radiographic and microscopic study on 1:5 dilution of Buckley\'s formocresol, calcium hydroxide and trioxide mineral agregate a used for pulpotomies of human primary teeth
O objetivo deste estudo foi comparar a eficácia clínica, radiográfica e microscópica do formocresol (FC) de Buckley diluído a 1/5, hidróxido de cálcio PA (HC) e Agregado Trióxido Mineral (MTA) como agentes capeadores pulpares em dentes decíduos humanos acometidos por cárie extensa. Quarenta e cinco molares decíduos inferiores de 23 crianças com idades entre 5 e 9 anos foram tratados pela técnica convencional de pulpotomia. Os dentes foram aleatoriamente divididos entre os grupos experimentais (HC e MTA) e o grupo controle (FC). Após a remoção da polpa coronária e hemostasia, o tecido pulpar remanescente foi coberto com pasta de MTA ou pó de HC nos grupos experimentais. No grupo controle, uma bolinha de algodão umedecida na solução de FC diluído foi colocada por 5 minutos sobre o remanescente pulpar e então a câmara pulpar preenchida com óxido de zinco e eugenol. Todos os dentes foram restaurados com uma base de óxido de zinco e eugenol reforçado (IRM) e cimento de ionômero de vidro modificado por resina. As avaliações clínicas e radiográficas foram realizadas nos períodos de 3, 6, 12, 18, 24 e 30 meses do pós-operatório. Durante as avaliações, os dentes que se apresentavam no período normal de esfoliação, bem como, dentes considerados fracasso ao tratamento foram extraídos e processados para análise microscópica. Os cortes foram feitos seriadamente, no sentido vestíbulo-lingual e corados pela hematoxilina e eosina. A análise microscópica foi realizada de forma descritiva dos fenômenos mais marcantes ocorridos no tecido pulpar remanescente. Pelos resultados clínicos e radiográficos obtidos foi possível observar uma taxa de sucesso para os grupos FC, HC e MTA de 100%, 35,7% e 100%, respectivamente. Diferença estatisticamente significativa foi observada quanto à presença de reabsorção interna, lesão inter- radicular, mobilidade e fístula para o grupo HC (p < 0,05). A análise microscópica para o grupo FC revelou presença de intenso infiltrado inflamatório e deposição de tecido mineralizado, irregular por todo canal radicular. Para o grupo MTA, notou-se deposição de material mineralizado de aspecto dentinóide, obliterando todo o canal radicular, além de áreas centrais preenchidas por tecido conjuntivo frouxo com inúmeros vasos sanguíneos. O grupo HC apresentou, na maioria dos cortes, extensa área de necrose tanto na câmara pulpar quanto no canal radicular. Em outros poucos cortes, presença de barreira de dentina reacional, obliterando a abertura coronária do canal radicular, com discreto infiltrado inflamatório crônico. O MTA parece ser um possível substituto do FC, no entanto, o hidróxido de cálcio mostrou ser uma técnica muito sensível e, portanto, não indicada para pulpotomias de dentes decíduos.The aim of this study was to compare the clinical, radiographic and microscopic effectiveness of formocresol (FC), calcium hydroxide (CH) and trioxide mineral aggregate (MTA) as pulp dressing agents in carious primary teeth. Forty-five primary mandibular molars of 23 children between 5 and 9 years old were treated by conventional pulpotomy technique. The teeth were randomly assigned to the experimental (CH and MTA) or control (FC) groups. After coronal pulp removal and hemostasis, remaining pulp tissue was covered with a MTA paste or CH powder in the experimental groups. In the control group, diluted FC was placed over the pulp tissue with a cotton pellet for 5 minutes and removed; the pulp tissue was covered then with zinc oxide-eugenol (ZOE) paste. All the teeth were restored with reinforced zinc oxide-eugenol base and resin modified glass ionomer cement. Clinical and radiographic evaluations were recorded at 3, 6, 12, 18, 24 and 30-month follow-up. During the assessments, the teeth in the regular exfoliation period, as well as those considered as treatment failures were extracted and further processed for microscopic analysis. Serial sections were performed in the bucco-lingual direction and stained with hematoxylin and eosin. Microscopic analysis was performed as a description of the most remarkable phenomena in the remaining pulp tissue. Through clinical and radiographic results, success rates of 100%, 35.7% and 100% for FC, CH and MTA were found, respectively. Statistically significant differences were observed regarding to the presence of internal resorption, inter-radicular bone destruction, mobility and fistula for CH group (p < 0.05). Microscopic analysis revealed the presence of intense inflammatory infiltrate and mineralized tissue deposition, which was irregular throughout the root canal, in the FC group. As far as MTA group, dentin-like mineralized material deposition obliterating the root canal, and central areas filled by loose conjunctive tissue with several blood vessels were noticed. CH group presented, in most of the sections, extensive necrotic areas both in pulp chamber and root canal. Other sections revealed the presence of extensive reactive dentin barrier, which obliterated the coronal opening of the root canal, and a discrete chronic inflammatory infiltrate. MTA may serve as an effective substitute of FC in primary molar pulpotomies. However, CH seems to be a technique sensitive-material and therefore not indicated for pulpotomies of primary teeth
Study of the effect of sanguinaria canadensis tincture associated to a chewing gum on biofilm.
O objetivo do estudo foi avaliar o efeito da tintura de Sanguinaria canadensis veiculada a uma goma de mascar em relação ao índice de placa dentária (O'Leary), número de UFCs de estreptococos sp.. Participaram do estudo duplo-cego, placebocontrolado, quarenta e quatro voluntários estudantes do 7o período de Odontologia da UNIFENAS, com faixa etária entre 18 e 25 anos, distribuídos após padronização da amostra em três grupos: grupo sanguinaria 4,2 mg/dia, grupo sanguinaria 2,1 mg/dia e grupo placebo. As gomas eram mascadas três vezes ao dia por dez dias. Na primeira fase, foi avaliada ação das gomas sobre o biofilme já formado, sendo que na segunda fase foi analisada sua ação sobre o biofilme em formação. Os resultados referentes aos valores do índice de O'Leary apresentaram diferenças significantes entres os grupos na primeira fase do estudo: I (33,21), II (21,74) E III (12,20) e na segunda fase: I (38,12), II (51,16) e III (60,01), todos com p.< 0,01; estatística Anova One Way- Teste de Tukey. Os resultados referentes aos valores do número de estreptococos sp. apresentaram diferença significante entre os grupos I, II e III, nos tempos 0, 5, 15 e 30 minutos após o uso das gomas (p.< 0,01; estatística de Tukey Kramer). Estes valores sugerem que a Sanguinaria canadensis veiculada a goma de mascar, reduziu significativamente o índice de placa dental e o número de estreptococos sp. quando comparada ao uso de gomas-placebo.The aim of this study was to evaluate the effect of the sanguinaria canadensis tincture associated to a chewing gum regarding to dental plaque score (OLeary) and streptococcus CUFs. Forty eight students of the UNIFENAS took part in this double blind, placebo control study, with ages ranging from 18 to 25 years old, patterned into three groups: placebo group; sanguinaria canadensis 2.1 mg/day, and sanguinaria canadensis 4.2 mg/day. Chewing gums were used three times a day for ten days. During the first phase of the study, the chewing gum action was evaluated on dental plaque already installed and in the second phase its action was analyzed on the forming plaque. The results showed statistically significant differences among group I in the first and second phases of the study (p < 0.05 Anova One Way Tukey Test). The results related to the number of streptococcus sp. showed statistically significant differences among groups I, II and III, with 0, 5, 15 and 30 minutes after using the chewing gums (p < 0.01 t Student test), These values suggest that sanguinaria canadensis associated to a chewing gum decreased significantly dental plaque scores and number of streptococcus sp. when compared to placebo chewing gums
In vivo qualitative analysis of the biocompatibility of different cyanoacrylate-based adhesives
Cyanocrylates have been widely used in the medical and dental fields for several years. In Dentistry, cyanoacrylates have been used for suturing, pulp capping, as retrofilling material in endodontic surgeries, and as cervical plug for pulpless teeth bleaching. The biocompatibility of these adhesives has been the topic of many researches and subcutaneous implantation is an effective methodology for these studies. The present study evaluated the biocompatibility of three different cyanoacrylate-based adhesives. Thirty-six Wistar rats were used, divided into four groups of 9 animals each: A (control) - distilled water, B - cyanoacrylate ester (Super Bonder), C - n-butyl-cyanoacrylate (Histoacryl) and D - alpha-cyanoacrylate (Three Bond). The materials were dispensed in sponges of polyvinyl chloride, the animals were incised and the sponges were inserted in the subcutaneous tissue and sutured. Each group was sub-divided according to the time of sacrifice of the animals: 7, 21 and 45 days. Subjective analysis of the histologic material showed that all groups presented some degree of irritability, but the inflammatory reaction decreased with the experimental time in all groups. Group D showed an inflammatory reaction which was closer to that of the control group and was considered to have good biocompatibility. Groups B and C were similar and presented more aggressive inflammatory reactions when compared to the control group. Based on the results, it was concluded that alpha-cyanoacrylate (Three Bond) was the most biocompatible adhesive because it caused the lowest levels of inflammation
Dental bleaching gels do not alter the surface roughness and microhardness of feldspathic porcelain
ABSTRACT Objective: To evaluate whether two different bleaching gels affect the microhardness and surface roughness of feldspathic ceramic specimens, in vitro. Methods: A total of 48 feldspathic porcelain IPS In Line (Ivoclar-Vivadent) discs (16/treatment group) were immersed in distilled water (Group I, Untreated control, UN), or treated with the bleaching gels: Opalescence (15% carbamide peroxide; OPA) and Opalescence Xtra Boost (38%hydrogen peroxide; OPAXB), for 1h or 6h daily for 14 days. Surface roughness (Ra) and microhardness (Knoop, or KNP) measurements were made before and after treatment, and data were subjected to statistical analysis by paired Student’s t-test (p < 0.05). Results: Treatments using Opalescence and Opalescence Xtra Boost did not altered surface roughness (p=0.6199861) or microhardness (p=0.14286744) of the feldspathic porcelain tested in this study. Conclusion: Bleaching treatments using Opalescence and Opalescence Xtra Boost may be suitable for treatment in patients having ceramic prosthodontic treatment. Conclusion: Bleaching treatments using Opalescence and Opalescence Xtra Boost may be suitable for treatment in patients having ceramic prosthodontic treatment