Antimicrobial Efficacy of Triple Antibiotic-Eluting Polymer Nanofibers against Multispecies Biofilm

The elimination of microbial flora in cases of immature permanent teeth with necrotic pulp is both key and a challenging goal for the long-term success of regenerative therapy. Recent research has focused on the development of cell-friendly intracanal drug delivery systems. This in vitro study aimed to investigate the antimicrobial action of 3-dimensional (3D) tubular-shaped triple antibiotic-eluting nanofibrous constructs against a multispecies biofilm on human dentin. Polydioxanone polymer solutions, antibiotic-free or incorporated with metronidazole, ciprofloxacin, and minocycline, were electrospun into 3D tubular-shaped constructs. A multispecies biofilm consisting of Actinomyces naeslundii, Streptococcus sanguinis, and Enterococcus faecalis was forced inside the dentinal tubules via centrifugation in a dentin slice in vitro model. The infected specimens were exposed to 2 experimental groups (ie, 3D tubular-shaped triple antibiotic-eluting constructs and triple antibiotic paste [TAP]) and 2 control groups (7-day biofilm untreated and antibiotic-free 3D tubular-shaped constructs). Biofilm elimination was quantitatively analyzed with confocal laser scanning microscopy. Confocal laser scanning microscopic (CLSM) analysis showed a dense population of viable (green) bacteria adhered to dentin and penetrated into the dentinal tubules. Upon 3D tubular-shaped triple antibiotic-eluting nanofibrous construct exposure, nearly complete elimination of viable bacteria on the dentin surface and inside the dentinal tubules was shown in the CLSM images, which was similar (P < .05) to the bacterial death promoted by the TAP group but significantly greater when compared with both the antibiotic-free 3D tubular-shaped constructs and the control (saline). The proposed 3D tubular-shaped antibiotic-eluting construct showed pronounced antimicrobial effects against the multispecies biofilm tested and therefore holds significant clinical potential as a disinfection strategy before regenerative endodontics

Avaliação radiográfica da adenoide - sugestão de parâmetros de referência

OBJECTIVE:this study aimed to evaluate the usefulness of current radiographic measurements, which were originally conceived to evaluate adenoid hypertrophy, as potential referral parameters.METHODS:children aged from 4 to 14 years, of both genders, who presented nasal obstruction complaints, were subjected to cavum radiography. Radiographic examinations (n = 120) were evaluated according to categorical and quantitative parameters, and data were compared to gold-standard videonasopharyngoscopic examination, regarding accuracy (sensitivity, negative predictive value, specificity, and positive predictive value).RESULTS:radiographic grading systems presented low sensitivity for the identification of patients with two-thirds choanal space obstruction. However, some of these parameters presented relatively high specificity rates when three-quarters adenoid obstruction was the threshold of interest. Amongst the quantitative variables, a mathematical model was found to be more suitable for identifying patients with more than two-thirds obstruction.CONCLUSION:this model was shown to be potentially useful as a screening tool to include patients with, at least, two-thirds adenoid obstruction. Moreover, one of the categorical parameters was demonstrated to be relatively more useful, as well as a potentially safer assessment tool to exclude patients with less than three-quarters obstruction, to be indicated for adenoidectomy.OBJETIVO:o objetivo deste estudo foi de investigar a utilidade de medidas radiográficas destinadas à avaliação da tonsila faríngea a serem utilizadas como potenciais parâmetros de encaminhamento.MÉTODOS:crianças de quatro a 14 anos, de ambos os gêneros, que apresentavam queixas referentes à obstrução nasal foram submetidas à radiografia do cavum. Os registros radiográficos (n = 120) foram avaliados de acordo com parâmetros categóricos e quantitativos, e dados resultantes foram comparados ao exame padrão-ouro de videonasofaringoscopia, em relação às suas taxas de acurácia (sensibilidade, valor preditivo negativo, especificidade e valor preditivo positivo).RESULTADOS:os parâmetros radiográficos categóricos apresentaram baixa sensibilidade para a identificação de pacientes portadores de 2/3 de obstrução do espaço coanal. No entanto, alguns destes parâmetros apresentaram especificidades relativamente altas quando 3/4 de obstrução coanal era o ponto de corte de interesse. Dentre as variáveis quantitativas, um modelo matemático se mostrou mais adequado para identificar pacientes com mais de 2/3 de obstrução coanal.CONCLUSÃO:este modelo demonstrou, assim, ser potencialmente útil como método de rastreamento para identificação de pacientes com pelo menos 2/3 de obstrução adenoidiana. Além disso, um dos parâmetros categóricos analisados demonstrou ser relativamente mais útil e potencialmente seguro para eliminar pacientes queixosos com menos de 3/4 de obstrução a serem indicados à adenoidectomia.Universidade São Francisco Faculdade de OdontologiaUniversidade Federal de São Paulo (UNIFESP) Department of Otorhinolaryngology, Head and Neck SurgeryUNIFESP, Department of Otorhinolaryngology, Head and Neck SurgerySciEL

Plexiform Schwannoma of the nasal tip: surgical approach

UNIFESP-EPMUNIFESP, EPMSciEL

Evaluation of the disolution profile of drugs by multivariate electronic spectroscopy

In this work the evaluation of the dissolution profile of captopril-hydrochlorothiazide and zidovudine-lamivudine associations were carried out by multivariate spectroscopic method. The models were developed by partial least square regression from 20 synthetic mixtures using mean-centered spectral data. The external validation was accomplished with 5 synthetic mixtures shown mean prevision error of about 1%. Good agreement was observed in the analyses of commercial drugs (content uniformity and dissolution profile), considering the results obtained by the standard chromatographic method, with prevision error lower than 10%.Universidade Federal do Paraná Departamento de QuímicaUniversidade Federal de São Paulo (UNIFESP) Departamento de Ciências Exatas e da TerraUNIFESP, Depto. de Ciências Exatas e da TerraSciEL

Laryngeal sequelae of recurrent respiratory papillomatosis surgery in children

OBJECTIVE: To evaluate laryngeal sequelae from surgical treatment of recurrent respiratory papillomatosis in children, as well as associated risk factors. METHODS: Case-control study. Medical record data analysis of 50 children with recurrent respiratory papillomatosis, divided into two groups: with and without laryngeal sequelae. The group of patients with laryngeal sequelae was compared to those without sequelae in regard to the onset of disease, age at first surgery, number and frequency of surgeries, disease stage, and type of surgery (CO2 laser, cold forceps). RESULTS: 23 patients (46%) sustained laryngeal sequelae. The most frequent sequela was anterior commissure synechia (17 patients [34%]), followed by glottic stenosis (six patients [12%]). There was no statistically significant difference between groups with and without laryngeal sequelae regarding the disease onset (p = 0.93), age at first surgery (p = 0.68), number of surgeries (p = 0.22), annual frequency of surgery (p = 0.93), presence of papilloma in anterior (p = 0.430) or posterior commissure (p = 0.39), and type of surgery (p = 0.27). The Derkay anatomical score (a staging system that assesses the extent of the disease in the aerodigestive tract) was significantly higher in the laryngeal sequelae group (p = 0.04). CONCLUSION: Laryngeal sequelae are a frequent complication of recurrent respiratory papillomatosis surgical treatment in children, particularly anterior commissure synechiae and glottic stenosis. Advanced stages are associated with increased risk of laryngeal sequelae after surgery.Universidade Federal de São Paulo (UNIFESP) Department of Otorhinolaryngology and Head and Neck SurgeryUniversidade Federal de São Paulo (UNIFESP) Department of Otorhinolaryngology and Head and Neck Surgery Internal Clinic of the Pediatric Otorhinolaryngology DisciplineUNIFESPUNIFESP Pediatric Otorhinolaryngology DisciplineUNIFESP, Department of Otorhinolaryngology and Head and Neck SurgeryUNIFESP, Department of Otorhinolaryngology and Head and Neck Surgery Internal Clinic of the Pediatric Otorhinolaryngology DisciplineUNIFESP, Pediatric Otorhinolaryngology DisciplineSciEL

Apexification with a New Intra-Canal Medicament: A Multidisciplinary Case Report

Dental trauma generally requires multidisciplinary planning and treatment for good prognosis. When immature teeth are traumatized to a degree where pulp necrosis ensues, the objective of root canal treatment should be apexogenesis and root maturation. Apexification of the root is the conventional choice, which involves cleaning the canal and filling it with a temporary medication that stimulates the formation of a calcific apical barrier. Dental Trauma Service of Piracicaba Dental School, State University of Campinas (UNICAMP), Brazil employs a dressing for apexification treatments with calcium hydroxide, chlorhexidine gel 2% and zinc oxide. This paper reports the case of a dental trauma of the maxillary central incisors and subluxation on teeth 11, 12 and 21 that were treated with multidisciplinary collaboration (Endodontics, Periodontology and Operative Dentistry) to improve prognosis. After five-years there were no pathological conditions and the teeth showed every evidences of success

Análise da qualidade da obturação em tratamentos endodônticos realizados por alunos da graduação.

This study aimed to evaluate the quality of endodontic fillings performed by undergraduate students of the Dentistry School at the University of Tiradentes. Endodontic treatments in permanent teeth performed by undergraduate students from the 6th to 9th grade were collected between February 2017 and December 2017. A total of 109 radiographs were analyzed, of which the majority (51.3%) were unirradicular teeth, obturated with Apical Limit of root canal Obturation (LAO) coincident with the apical foramen (level = 0, 48.6%). It was also verified that 52.2% of the cases were diagnosed as irreversible pulpitis, 11% with pulp necrosis and 9.1% represented endodontic retreatment cases. Additionally, it was observed that the number of sessions to conclude endodontic treatment ranged from 1 to 6, and only 8.2% of the cases were concluded in a single session. Regarding the quality of obturation, 77.9% could be considered satisfactory and only 2.7% of the cases presented overfilling of material. The results suggest a high number of satisfactory root canal fillings in treatments performed by undergraduate students without manifestation of symptomatology or development of periapical radiolucency in patients that presented overfilling of obturation material.Este trabalho objetivou avaliar a qualidade das obturações endodônticas realizadas por alunos da graduação do curso de Odontologia da Universidade Tiradentes. Foram levantados os tratamentos endodônticos em dentes permanentes executados entre fevereiro de 2017 a dezembro de 2017 realizados por alunos do 6º ao 9º período de graduação. Um total de 109 radiografias foram analisadas, das quais a maioria (51,3%) eram dentes unirradiculares, obturados com Limite Apical de Obturação (LAO) coincidente com o forame apical (nível=0, 48,6%). Verificou-se ainda que 52,2% dos casos foram diagnosticados como pulpite irreversível, 11% com necrose pulpar e 9,1% representavam casos de retratamento endodôntico. Adicionalmente, observou-se que o número de sessões para a finalização do tratamento variou de 1 a 6 sessões, e apenas 8,2% dos casos foram concluídos em sessão única. Com relação à qualidade das obturações, 77,9% puderam ser consideradas satisfatórias e apenas 2,7% dos casos apresentavam extravasamento. Os resultados sugerem um índice elevado de obturações satisfatórias em tratamentos realizados por alunos de graduação sem manifestação de sintomatologia nem desenvolvimento de radioluscência periapical nos pacientes que apresentavam extravasamento