Intentional Replantation as Treatment of Extrusive Luxation: A Case Report

Accurate diagnosis, immediate care and proper treatment planning are important factors for the successful treatment of dental traumatic injuries. In extrusive luxation, postponement in treatment may lead to the need for new strategies for the resolution of unwanted consequences. The present case report describes an unusual condition of delayed treatment regarding extrusive luxation of two anterior teeth treated by intentional replantation. An 18-year-old female patient attended the Dental School for the treatment of a traumatic injury to the anterior teeth 5 days after a fall from a bicycle. Clinically, teeth #21 and #22 were extruded in incisal edges for 5 mm from their neighboring teeth, had edematous gingiva, showed grade II mobility and were painful to percussion. Radiographically, the roots were intact and the periodontal ligament space was thickened along its entire length. As immediate repositioning could not be performed, intentional replantation was recommended. After detaching the periodontal ligament, the teeth were extracted and the alveolus was curetted and irrigated with saline solution to remove the already-formed clot. After replantation, the teeth were restrained and the patient was medicated with antibiotics as well as analgesics. After 10 days, the splint was removed, the root canals were instrumented and then, filled with calcium hydroxide. After 30 days, they were completely obturated using gutta-percha. The 5-year follow-up showed root integrity, absence of mobility and normal periodontium. The outcomes of the current case report revealed that when intentional replantation was properly conducted, it could be considered an option for the treatment of extrusive luxation where the teeth were not to be immediately repositioned

Delayed Tooth Replantation after Root Surface Treatment with Papain and Sodium Fluoride in Rats: A Histological and Histomorphometrical Evaluation

Introduction: The aim of this study was to examine the histological effect of papain and sodium fluoride in delayed replantation of rat incisor teeth on the repair process. Methods and Materials: Forty upper incisors of Wistar rats were randomly assigned to four groups (n=10). In group I, the dental papilla and the pulp tissue of extracted teeth were removed before immediate replantation in their sockets. In the other groups, the extracted teeth were maintained in dry storage for 60 min and subjected to different root surface treatments. In group II, the teeth were immersed in 10% papain for 20 min, scrubbed with gauze soaked in saline for 1 min, and immersed in a 2% acidulated-phosphate sodium fluoride solution for 20 min. In group III, the teeth were immersed in saline for 20 min, scrubbed with gauze soaked in saline for 1 min, and immersed in a 2% acidulated-phosphate sodium fluoride solution for 20 min. In group IV, root surface treatment was not applied. The root canals were treated and filled with a calcium hydroxide paste and the teeth were replanted. The animals were euthanized after 60 days and anatomic specimens containing the teeth were subjected to routine histochemical processing and staining with hematoxylin and eosin. The Kruskal-Wallis test was used, followed by the Dunn’s test for multiple comparisons. Results: Groups I and II had less inflammatory root resorption and total area of root resorption (P<0.05) than groups III and IV respectively. Conclusions: Based on this animal study, root surface treatment with papain and sodium fluoride in delayed tooth replantation showed greater efficacy in controlling inflammatory root resorption and may be a viable option for clinical application

NEUROVISÃO E O TRANSTORNO DE DÉFICIT DE ATENÇÃO E HIPERATIVIDADE

The Attention Deficit Hyperactivity Disorder (ADHD) is still a topic of discussion among health researchers. There is no consensus on its etiology, and it usually brings along associations with other disorders, both psychiatric and visual, for example. This becomes a barrier that hinders the conclusion of more precise diagnoses about this disorder. Its symptoms can be easily confused with those of other disorders and lead health professionals to misdiagnoses, especially when there is no multidisciplinary team. In this review, we sought to understand the pathophysiology and the association of ADHD with visual disorders, considering the hypotheses of the ADHD relationship with ocular and visual alterations such as light and contrast sensitivity, convergence insufficiency and even refractive errors such as hyperopia, astigmatism and myopia, and also to bring up the need to seek alternative treatments besides pharmacological ones, which are not harmful in other aspects, but effective in the treatment of ADHD, understanding that this effectiveness will be given by the knowledge from several health areas.    El Trastorno por Déficit de Atención con Hiperactividad (TDAH) sigue siendo una agenda de discusión entre los investigadores de la salud, su etiología no tiene consenso, y suele traer consigo asociaciones con otros trastornos, tanto psiquiátricos como de visión, por ejemplo. Convirtiéndose en una barrera que dificulta completar diagnósticos más precisos sobre este trastorno. Sus síntomas pueden confundirse fácilmente con los de otros trastornos y llevar a los profesionales de la salud a diagnósticos erróneos, especialmente cuando no se cuenta con un equipo multidisciplinario. Esta revisión buscó comprender la fisiopatología y la asociación del TDAH con trastornos visuales, considerando las hipótesis de la relación entre el TDAH y alteraciones visuales como la sensibilidad a la luz y al contraste, la insuficiencia de convergencia e incluso los errores refractivos como la hipermetropía, el astigmatismo y la miopía, y también plantear la necesidad de buscar tratamientos alternativos más allá de los farmacológicos, que no son perjudiciales en otros aspectos, pero eficaces en el tratamiento del TDAH, entendiendo que esta eficacia se producirá a través de todos los conocimientos de diversas áreas de la salud.O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) ainda é uma pauta de discussão entre pesquisadores da área da saúde, sua etiologia não tem consenso, e normalmente traz consigo associações com outros transtornos, tanto psiquiátricos como de visão, por exemplo. Se tornando uma barreira que dificulta a conclusão de diagnósticos mais precisos sobre esse transtorno. Seus sintomas podem ser facilmente confundidos com os de outros distúrbios e conduzir profissionais da saúde a diagnósticos equivocados, principalmente quando não se tem uma equipe multidisciplinar. Nesta revisão, procurou-se entender a fisiopatologia e a associação do TDAH com distúrbios visuais, considerando as hipóteses da relação do TDAH com alterações oculares e visuais como sensibilidade a luz e contraste, insuficiência de convergência e até erros refrativos como hipermetropia, astigmatismo e miopia, e também trazer à tona a necessidade de se buscar tratamentos alternativos para além dos farmacológicos, que não sejam nocivos em outros aspectos, mas eficazes no tratamento do TDAH, compreendendo que essa eficácia se dará pelo conjunto dos saberes de várias áreas da saúde.  O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) ainda é uma pauta de discussão entre pesquisadores da área da saúde, sua etiologia não tem consenso, e normalmente traz consigo associações com outros transtornos, tanto psiquiátricos como de visão, por exemplo. Se tornando uma barreira que dificulta a conclusão de diagnósticos mais precisos sobre esse transtorno. Seus sintomas podem ser facilmente confundidos com os de outros distúrbios e conduzir profissionais da saúde a diagnósticos equivocados, principalmente quando não se tem uma equipe multidisciplinar. Nesta revisão, procurou-se entender a fisiopatologia e a associação do TDAH com distúrbios visuais, considerando as hipóteses da relação do TDAH com alterações oculares e visuais como sensibilidade a luz e contraste, insuficiência de convergência e até erros refrativos como hipermetropia, astigmatismo e miopia, e também trazer à tona a necessidade de se buscar tratamentos alternativos para além dos farmacológicos, que não sejam nocivos em outros aspectos, mas eficazes no tratamento do TDAH, compreendendo que essa eficácia se dará pelo conjunto dos saberes de várias áreas da saúde. 

Conservative Condylectomy for Management of Osteochondroma of the Mandibular Condyle

Osteochondroma is one of the most common benign tumors of the skeleton. This tumor is rare in the craniofacial region, with the most common sites of occurrence being the coronoid process of the mandible and the mandibular condyle. Traditionally, the treatments of these lesions include total condylectomy or local resection of the lesion. Conservative condylectomy procedure with reshaping of the remaining condylar neck and repositioning of the articular disk has been suggested. This article aimed to describe a 35-year-old woman with osteochondroma in the left mandibular condyle who was treated by conservative condylectomy. The patient has been free of recurrence for 2 years, showing good aesthetic and functional stability.243E209E21

Venomous Noodles: The Evolution of Toxins in Nemertea through Positive Selection and Gene Duplication

Some, probably most and perhaps all, members of the phylum Nemertea are poisonous, documented so far from marine and benthic specimens. Although the toxicity of these animals has been long known, systematic studies on the characterization of toxins, mechanisms of toxicity, and toxin evolution for this group are scarce. Here, we present the first investigation of the molecular evolution of toxins in Nemertea. Using a proteo-transcriptomic approach, we described toxins in the body and poisonous mucus of the pilidiophoran Lineus sanguineus and the hoplonemertean Nemertopsis pamelaroeae. Using these new and publicly available transcriptomes, we investigated the molecular evolution of six selected toxin gene families. In addition, we also characterized in silico the toxin genes found in the interstitial hoplonemertean, Ototyphlonemertes erneba, a meiofaunal taxa. We successfully identified over 200 toxin transcripts in each of these species. Evidence of positive selection and gene duplication was observed in all investigated toxin genes. We hypothesized that the increased rates of gene duplications observed for Pilidiophora could be involved with the expansion of toxin genes. Studies concerning the natural history of Nemertea are still needed to understand the evolution of their toxins. Nevertheless, our results show evolutionary mechanisms similar to other venomous groups

Reimplante dentário tardio após tratamento do ligamento periodontal necrótico com ácido cítrico

Objective: to evaluated the effect of treating root-adhered necrotic periodontal ligament (PDL) with citric acid on the healing process in delayed rat tooth replantation. Material and Methods: Forty Wistar rats, assigned to 4 groups (n=10), had their upper right incisor extracted and kept dry on a workbench. For Group I (control), the teeth were replanted after a 5 min extra-alveolar time. For the other groups, replantation was hydroxide-based paste and the teeth were replanted with no root surface treatment. In Group III, the teeth were immersed in citric acid (pH 1) for replanted. In Group IV, instead of the immersion, the roots were scrubbed with gauze soaked in citric acid and the teeth were replanted. The animals difference (p > 0.05) was found among the groups regarding the areas difference (p 0.05). Conclusion: the treatment of root surface-adhered necrotic periodontal ligament with citric acid was not able to prevent the delayed rat tooth replantation.Objetivo: avaliar o efeito do ácido cítrico no ligamento periodontal cementário necrótico no processo de reparo do reimplante dentário tardio em rato. Material e Método: Quarenta ratos Wistar após a extração do incisivo superior direito foram divididos em 4 grupos (n=10). No Grupo I (controle), os dentes foram reimplantados após 5 min extralveolar. Nos outros grupos o reimplante foi realizado após 60 min. No Grupo II, os canais foram obturados com pasta hidróxido de cálcio e os dentes foram reimplantados sem tratamento da superfície radicular. No Grupo III, os dentes foram imersos em ácido cítrico (pH1) por 3 min, os canais foram obturados com pasta de hidróxido de cálcio e reimplantados. No Grupo IV, a superfície radicular foi friccionada com gaze embebida em ácido cítrico e os dentes reimplandos. Os aminais sofreram eutanásia 60 dias após o reimplante. Resultados: Quanto à reabsorção por substituição houve diferença estatisticamente controle e do Grupo IV quanto a anquilose. O grupo controle apresentou menor reabsorção por substituição em comparação com os outros grupos (p < 0,05). A estrutura radicular foi mais comprometida pela reabsorção por substituição e anquilose no Grupo IV quando comparado aos grupos tratamento do ligamento periodontal cementário com ácido citrico reimplante dentário tardio em rato

Large Unicystic Ameloblastoma of the Mandible: Management Guided by Biological Behavior

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. It is a slow-growing benign tumor of the jaw, and patients usually present late after the tumor achieves considerable size to cause facial disfigurement. Diagnosis mainly from tissue biopsy and radiograph findings does assist in differentiating between types of ameloblastoma. Unicystic ameloblastoma is a tumor with a strong propensity for recurrence. There is a difference in biological behavior between mural unicystic ameloblastoma and those which are simply cystic or show intraluminal proliferation. The challenges in the management of this tumor are to provide complete excision in addition to reconstructing the bony defect, to provide the patient with reasonable cosmetic and functional outcome. The authors report a case of a mural unicystic ameloblastoma in a 23-year-old man who was treated by partial resection of the mandible. Biomedical prototypes were used because they provide acceptable precision and are useful for treatment planning