Correlation between the Periapical Index and Lesion Volume in Cone-Beam Computed Tomography Images

Introduction: The study aimed to correlate the Periapical Index (PAI), obtained by way of periapical radiographs, with the volume of chronic periapical lesion, obtained through cone-beam computed tomography (CBCT), in the permanent teeth. Methods and Materials: Radiographs and CBCT images were selected from 35 single-rooted permanent teeth, with fully formed apices, with a diagnosis of pulp necrosis and chronic apical periodontitis that was radiographically visible. Two independent raters evaluated the radiographs on two separate occasions and classified the periapical lesions in accordance with Ørstavik’s PAI. The periapical lesion volume was calculated in the CBCT images. The correlation between the PAI and the lesion volume was calculated using Spearman’s correlation test. Results: There was a positive, moderate correlation between the PAI and the volume (rs=0.596; P<0.001) where rs2 is equal to 0.355, showing that only 35% of the PAI variation was dependent upon the variation in periapical lesion volume. Conclusion: The radiographic evaluation of the periapical lesion does not reflect the lesion’s volumetric characteristics as the volume had a moderate effect on the choice of PAI score.Keywords: Apical Periodontitis; Cone-Beam Computed Tomography; Endodontics; Periapical Radiograph

Bacterial endotoxin adhesion to different types of orthodontic adhesives

Bacterial endotoxin (LPS) adhesion to orthodontic brackets is a known contributing factor to inflammation of the adjacent gingival tissues. Objective The aim of this study was to assess whether LPS adheres to orthodontic adhesive systems, comparing two commercial brands. Material and Methods Forty specimens were fabricated from Transbond XT and Light Bond composite and bonding agent components (n=10/component), then contaminated by immersion in a bacterial endotoxin solution. Contaminated and non-contaminated acrylic resin samples were used as positive and negative control groups, respectively. LPS quantification was performed by the Limulus Amebocyte Lysate QCL-1000™ test. Data obtained were scored and subjected to the Chi-square test using a significance level of 5%. Results There was endotoxin adhesion to all materials (p;0.05). There was no significant difference (p>;0.05) among commercial brands. Affinity of endotoxin was significantly greater for the bonding agents (p=0.0025). Conclusions LPS adhered to both orthodontic adhesive systems. Regardless of the brand, the endotoxin had higher affinity for the bonding agents than for the composites. There is no previous study assessing the affinity of LPS for orthodontic adhesive systems. This study revealed that LPS adheres to orthodontic adhesive systems. Therefore, additional care is recommended to orthodontic applications of these materials

Periapical repair after root canal filling with different root canal sealers

The aim of this study was to evaluate periapical repair after root canal filling with different endodontic sealers. Sixty-four root canals from dog&acute;s teeth were filled, divided into 4 groups (n=16). Root canals were instrumented with K-type files and irrigated with 1% sodium hypochlorite solution. Root canals were filled in the same session by active lateral condensation of the cones and sealers: Intrafill, AH Plus, Roeko Seal and Resilon/Epiphany System. After 90 days, the animals were euthanized and the tissues to be evaluated were processed and stained with hematoxylin and eosin. For histopathological analysis, the following parameters were evaluated: inflammatory process, mineralized tissue resorption, and apical mineralized tissue deposition. Histopathological analysis demonstrated that Intrafill had less favorable results in terms of apical and periapical repair, compared to the other sealers (p<0.05). AH Plus, Roeko Seal, and Epiphany sealers had similar and satisfactory results (p>0.05). In conclusion, AH Plus and the materials Roeko Seal and Epiphany are good options for clinical use in Endodontics.O objetivo deste estudo foi avaliar o reparo periapical após obturação de canal radicular usando os cimentos Roeko Seal e Epiphany. Sessenta e quatro canais radiculares de dentes de cães foram obturados, divididos em 4 grupos (n=16). Os canais radiculares foram instrumentados com limas tipo K e irrigados com solução de hipoclorito de sódio a 1%. Os canais radiculares foram obturados na mesma sessão usando condensação lateral ativa dos cones e os cimentos: Grupo I - Intra Fill; Grupo II - AH Plus; Grupo III - Roeko Seal e Grupo IV - Sistema Resilon/Epiphany. Após 90 dias, os animais foram mortos e os tecidos a serem avaliados foram processados e corados por hematoxilina e eosina. Para análise histopatológica, os seguintes parâmetros foram avaliados: processo inflamatório, reabsorção dos tecidos mineralizados e deposição de tecido mineralizado apical. A análise histopatológica demonstrou que o Intrafill teve resultados menos favoráveis em relação ao reparo apical e periapical comparado aos outros cimentos (p<0,05). AH Plus, Roeko Seal e Epiphany demonstraram resultados similares e satisfatórios (p>0,05). Conclui-se que o AH Plus e os materiais Roeko Seal e Epiphany são boas opções para uso clínico em endodontia.(FAPESP) São Paulo Research Foundatio

Periapical repair after root canal filling with different root canal sealers

The aim of this study was to evaluate periapical repair after root canal filling with different endodontic sealers. Sixty-four root canals from dog&acute;s teeth were filled, divided into 4 groups (n=16). Root canals were instrumented with K-type files and irrigated with 1% sodium hypochlorite solution. Root canals were filled in the same session by active lateral condensation of the cones and sealers: Intrafill, AH Plus, Roeko Seal and Resilon/Epiphany System. After 90 days, the animals were euthanized and the tissues to be evaluated were processed and stained with hematoxylin and eosin. For histopathological analysis, the following parameters were evaluated: inflammatory process, mineralized tissue resorption, and apical mineralized tissue deposition. Histopathological analysis demonstrated that Intrafill had less favorable results in terms of apical and periapical repair, compared to the other sealers (p<0.05). AH Plus, Roeko Seal, and Epiphany sealers had similar and satisfactory results (p>0.05). In conclusion, AH Plus and the materials Roeko Seal and Epiphany are good options for clinical use in Endodontics.O objetivo deste estudo foi avaliar o reparo periapical após obturação de canal radicular usando os cimentos Roeko Seal e Epiphany. Sessenta e quatro canais radiculares de dentes de cães foram obturados, divididos em 4 grupos (n=16). Os canais radiculares foram instrumentados com limas tipo K e irrigados com solução de hipoclorito de sódio a 1%. Os canais radiculares foram obturados na mesma sessão usando condensação lateral ativa dos cones e os cimentos: Grupo I - Intra Fill; Grupo II - AH Plus; Grupo III - Roeko Seal e Grupo IV - Sistema Resilon/Epiphany. Após 90 dias, os animais foram mortos e os tecidos a serem avaliados foram processados e corados por hematoxilina e eosina. Para análise histopatológica, os seguintes parâmetros foram avaliados: processo inflamatório, reabsorção dos tecidos mineralizados e deposição de tecido mineralizado apical. A análise histopatológica demonstrou que o Intrafill teve resultados menos favoráveis em relação ao reparo apical e periapical comparado aos outros cimentos (p<0,05). AH Plus, Roeko Seal e Epiphany demonstraram resultados similares e satisfatórios (p>0,05). Conclui-se que o AH Plus e os materiais Roeko Seal e Epiphany são boas opções para uso clínico em endodontia.(FAPESP) São Paulo Research Foundatio

Immunohistochemical and mRNA expression of RANK, RANKL, OPG, TLR2 and MyD88 during apical periodontitis progression in mice

Objective: To evaluate and correlate, in the same research, the mRNA expression and the staining of RANK, RANKL, OPG, TLR2 and MyD88 by immunohistochemistry in the apical periodontitis (AP) progression in mice. Material and Methods: AP was induced in the lower first molars of thirty-five C57BL/6 mice. They were assigned to four groups according to their euthanasia periods (G0, G7, G21 and G42). The jaws were removed and subjected to histotechnical processing, immunohistochemistry and real-time reverse transcription-PCR (qRT-PCR). Data were analyzed with parametric and nonparametric tests (α=0.05). Results: An increase of positive immunoreactivity for RANK, RANKL, OPG, TLR2 and MyD88 was observed over time (p&lt;0.05). The RANKL expression was different between the groups G0 and G42, G21 and G42 (p=0.006), with G42 presenting the higher expression in both comparations. The OPG expression was statistically different between the groups G0 and G7, G7 and G21 and G7 and G42 (p&lt;0.001), with G7 presenting higher expression in all the time points. The TLR2 expression was different between the groups G0 and G42 (p=0.03), with G42 showing the higher expression. The MyD88 expression presented a statistical significant difference between groups G7, G21 and G42 compared with G0 (p=0.01), with G0 presenting the smallest expression in all the comparisons. The Tnfrsf11/Tnfrsf11b (RANKL/OPG) ratio increased with the AP progression (p=0.002). A moderate positive correlation between MyD88 and RANKL (r=0.42; p=0.03) and between MyD88 and TLR2 (r=0.48; p&lt;0.0001) was observed. Conclusion:The expression of the RANK, RANKL, OPG, MyD88 and TLR2 proteins as well as the ratio Tnfrsf11/Tnfrsf11b (RANKL/OPG) increased with AP progression. There was also a moderate positive correlation between the expression Myd88-Tnfrsf11 and Tlr2-Myd88, suggesting the relevance of Tlr2-Myd88 in bone loss due to bacterial infection

Crown dilaceration in permanent teeth after trauma to the primary predecessors: report of three cases

Crown dilaceration of permanent teeth occurs due to the non-axial displacement of the already formed hard tissue portion of the developing crown at an angle to their longitudinal axis due to trauma to the primary predecessors. This is a rare condition, representing only 3% of the total of injuries to developing teeth and usually occurs in permanent maxillary incisors because of the close proximity of their tooth germs to the primary incisors, which are more susceptible to trauma. This alteration frequently results from the intrusion of a primary tooth when the child is around 2 years of age, at which time half of the crown of the permanent successor is already formed. Teeth with dilacerated crowns may either erupt with buccal or lingual displacement or remain impacted. The treatment may involve endodontic, orthodontic, restorative and prosthetic procedures. This paper reports the restorative treatment proposed to reestablish the esthetics and function of the affected teeth in three cases of crown dilaceration in permanent maxillary incisors after trauma to their primary predecessors

Eruption sequestrum - case report and histopathological findings

Eruption sequestrum is an uncommon disturbance in eruption and consists of small fragments of calcified tissue overlying the crowns of erupting permanent molar teeth, especially at the time of eruption of the mandibular first molars. This paper reports a case of unilateral eruption sequestrum in a 7-year-old Brazilian boy and describes its histopathological findings. A white small fragment, 0.5 cm in diameter, with hard consistency, irregular shape and located on the occlusal surface of the erupting mandibular left first molar was excised. Microscopic examination revealed large trabeculae with empty lacunae and a minimal amount of existing spongy bone consisting of acute inflammatory cells (neutrophils). Signs of necrosis were found on the periphery. The histological analysis was consistent with non-vital bone and the diagnosis of eruption sequestrum was established. Clinical and radiographic follow-up visits scheduled at short intervals and then every 6 months revealed normal postoperative conditions

Ler no ecrã: contributo para uma reflexão sobre estratégias de ensino da leitura na aula de Português

Resumo: A Escola assume, hoje, um papel cada vez mais ativo na formação dos (ciber)leitores, sendo chamada a reconfigurar um conjunto pré-existente de práticas em literacia onde predomina o texto impresso para um universo digital complexo, no qual o ecrã tem primazia. Assim, neste artigo procuraremos: (1) reforçar o modo como novas práticas em literacia emergem em permanência na nossa sociedade, repercutindo-se no percurso dos leitores em formação; (2) apontar para o modo como a leitura no ecrã de textos diversificados influencia a compreensão leitora, daí retirando ilações no que concerne à construção do percurso do leitor; (3) caracterizar a forma como a leitura online requer o desenvolvimento de um conjunto amplo de estratégias por parte do leitor, para que possa usufruir plenamente do prazer de ler em contexto escolar e extra-escolar. Finalmente, reflectimos criticamente sobre os desafios colocados hoje à Escola, relativamente à implementação e consolidação de percursos de leitura que estejam na base do exercício hodierno da cidadania

Quantification of pro-inflammatory cytokines and osteoclastogenesis markers in successful and failed orthodontic mini-implants

Objectives: Miniscrew has been frequently used, considering that anchorage control is a critical point in orthodontic treatment, and its failure, the main adverse problem. Using two groups of stable (successful) and unstable (failed) mini-implants, this &lt;i&gt;in vivo&lt;/i&gt; study aimed to quantify proinflammatory cytokines IL-1 α, IL-6, IL-17, and TNF-α and osteoclastogenesis marker RANK, RANKL, and OPG in gingival tissue, using the real-time polymerase chain reaction technique. Methodology: Thirteen patients of both sexes (11-49 years old) under orthodontic treatment were selected, obtaining 11 successful and 7 failed mini-implants. The mini-implants were placed and removed by the same surgeon, in both jaws. The mean time of permanence in the mouth was 29.4 months for successful and 7.6 months for failed mini-implants. At removal time, peri-mini-implant gingival tissue samples were collected and processed for quantification of the proinflammatory cytokines and osteoclastogenesis markers. Nonparametric Wilcoxon rank-sum test considering the clusters and Kruskal-Wallis test were used for statistical analysis (α=0.05). Results: No significant difference (p&gt;0.05) was observed between the groups for either quantification of cytokines or osteoclastogenesis markers, except for IL-6 (p&lt;0.05). Conclusions: It may be concluded that the expression of IL-1α, IL-17, TNF-α, RANK, RANKL, and OPG in peri-implant gingival tissue were not determinant for mini-implant stability loss, but the higher IL-6 expression could be associated with mini-implant failure

Successful and failed mini-implants: microbiological evaluation and quantification of bacterial endotoxin

Objectives: Using two groups of mini-implants (successful and failed) the objectives of this in vivo study were: to evaluate the microbial contamination by the checkerboard DNA-DNA hybridization technique and to quantify the bacterial endotoxin by the limulus amebocyte lysate assay. Material and Methods:The 15 successful and 10 failed mini-implants (1.6 mm diameter × 7.0 or 9.0 mm long), placed in the maxilla and/or mandible, were obtained from 15 patients undergoing orthodontic treatment. Data were analyzed statistically by the Wilcoxon rank-sum test using the SAS software (a=0.05). Results: All 40 microbial species were detected in both groups of mini-implants, with different frequencies. No differences were observed between the groups with respect to microbial complexes (blue, purple, yellow, green, orange, red and other species) and endotoxin quantification (p&gt;0.05). Conclusion: Neither microbial contamination nor endotoxin quantification was determinant for the early loss of stability of the mini-implant