Conduta cirúrgica em terceiro molar incluso com geminação / Surgical conduct for impacted third molar with gemination

Este trabalho objetiva apresentar o relato de paciente, sexo feminino, 29 anos de idade que compareceu para exodontia do elemento 38 parcialmente erupcionado. Na radiografia panorâmica observa-se o 38 associado a elemento dentário extranumerário, que se estende do rebordo a bem próximo a basilar, ultrapassando os limites do canal mandibular. Na tomografia cone beam observa-se coroa com diâmetro mesiodistal comproporções elevadas, sendo uma coroa dentária, uma câmara pulpar ampliada e três raízes, compatível com geminação. Duas das raízes estavam acima do canal mandibular e uma abaixo. A conduta cirúrgica proposta foi remoção da coroa e das raízes superiores e sepultamento da inferior, para evitar fratura mandibular e parestesia. Realizou-se acesso, osteotomia para exposição da coroa dentária até a região das furcas, seguida odontosecção para separação da coroa das raízes, clivagem e remoção da coroa. Na remoção do fragmento coronário observa--se presença da raiz mais profunda aderida a coroa, não sendo possível realizar clivagem total. As raízes superiores ao canal foram removidas sem maiores problemas. O alvéolo foi curetado, o retalho reposicionado na sua posição, seguido de sutura. Ressalta-se a importância da solicitação de exames de imagem e do planejamento de modo a evitar possíveis complicações no ato cirúrgico.

This paper reports the case of a 29-year-old female patient who visited the dental clinic for the extraction of partially eruption tooth 38. The panoramic radiograph revealed that tooth 38 was associated with an extranumerary tooth extending from the rim to near the basal lamina, surpassing the limits of the mandibular canal. Cone-beam tomography revealed a dental crown with a large mesio-distal diameter, large pulp chamber and three roots, compatible with gemination. Two of the rootswere above the mandibular canal and one was below. The proposedsurgical conduct was the removal of the crown and upper roots and burying of the lower root to avoid mandibular fracture and paresthesia. The region was accessed and osteotomy was performed to expose the dental crown to the furcation region, followed by sectioning for the separation of the crown from the roots, cleavage and removal of the crown. During this procedure, it was noted that the deepest root was adhered to the crown and complete cleavage was not possible. The roots above the canal were removed without incident. The alveolus was curetted and the flap was repositioned and sutured. This case underscores the importance of imaging exams and adequate planning toavoid possible complications during the act of surgery.

Effect of low-level laser therapy on the modulation of the mitochondrial activity of macrophages / Efeito da laserterapia em baixa intensidade na modulação da atividade mitocondrial de macrófagos

BACKGROUND: Macrophages play a major role among the inflammatory cells that invade muscle tissue following an injury. Low-level laser therapy (LLLT) has long been used in clinical practice to accelerate the muscle repair process. However, little is known regarding its effect on macrophages. OBJECTIVE: This study evaluated the effect of LLLT on the mitochondrial activity (MA) of macrophages. METHOD: J774 macrophages were treated with lipopolysaccharide (LPS) and interferon - gamma (IFN-γ) (activation) for 24 h to simulate an inflammatory process, then irradiated with LLLT using two sets of parameters (780 nm; 70 mW; 3 J/cm2 and 660 nm; 15 mW; 7.5 J/cm2). Non-activated/non-irradiated cells composed the control group. MA was evaluated by the cell mitochondrial activity (MTT) assay (after 1, 3 and 5 days) in three independent experiments. The data were analyzed statistically. RESULTS: After 1 day of culture, activated and 780 nm irradiated macrophages showed lower MA than activated macrophages, but activated and 660 nm irradiated macrophages showed MA similar to activated cells. After 3 days, activated and irradiated (660 nm and 780 nm) macrophages showed greater MA than activated macrophages, and after 5 days, the activated and irradiated (660 nm and 780 nm) macrophages showed similar MA to the activated macrophages. CONCLUSIONS: These results show that 660 nm and 780 nm LLLT can modulate the cellular activation status of macrophages in inflammation, highlighting the importance of this resource and of the correct determination of its parameters in the repair process of skeletal muscle. .

CONTEXTUALIZAÇÃO: O macrófago tem papel de destaque dentre as células inflamatórias que invadem o músculo após as lesões. Por outro lado, o laser em baixa intensidade (LBI) tem sido muito utilizado na clínica para acelerar o reparo muscular, e pouco se conhece sobre seu efeito nos macrófagos. OBJETIVO: Avaliar o efeito do LBI sobre a atividade mitocondrial (AM) de macrófagos ativados para simular um processo inflamatório. MÉTODO: Macrófagos J774 foram tratados com lipopolissacarídeo (LPS) e IFN-gamma (ativação) por 24 horas para simular um processo inflamatório e então foram irradiados com LBI (780 nm; 70 mW; 3 J/cm(2) e 660 nm; 15mW; 7,5 J/cm(2)). A AM foi avaliada pela técnica MTT após um, três e cinco dias das irradiações. Foram realizados três experimentos independentes, e os dados, submetidos à análise estatística. RESULTADOS: Após um dia de cultivo, os macrófagos ativados e irradiados com o laser de 780 nm mostraram AM menor que os somente ativados, já os macrófagos ativados e irradiados com o laser de 660 mostraram AM semelhante aos somente ativados. Após três dias, os macrófagos ativados e irradiados (660 e 780 nm) mostraram AM maior que os macrófagos ativados; já após cinco dias, os grupos ativados e irradiados (660 e 780 nm) mostraram AM semelhante aos macrófagos somente ativados. CONCLUSÕES: Esses resultados mostram que tanto o LBI de 660 nm como o de 780 nm são capazes de modular a ativação celular de macrófagos em situação de inflamação, ressaltando a importância desse recurso e da determinação de seus parâmetros dosimétricos no processo de reparo do músculo esquelético. .

No effect of low-level lasers on in vitro myoblast culture.

Effects of phototherapy using low-level lasers depend on irradiation parameters and the type of laser used. The aim of the present study was to evaluate the effect of phototherapy on the proliferation of cultured C2C12 myoblasts under different nutritional conditions using low-level GaAlAs and InGaAlP lasers with different parameters and incubation periods. C2C12 cells cultured in regular and nutrient-deficient medium were irradiated with low-level GaAlAs (780 nm) and InGaAlP (660 nm) lasers with energy densities of 3.8, 6.3 and 10 J/cm2, and 3.8, 10 and 17.5 J/cm2, respectively. Cell proliferation was assessed 48 and 72 h after irradiation by MTT assay. There were no significant differences in cell proliferation between laser-treated myoblasts and control cultures for any of the parameters and incubation periods. Further studies are necessary to determine the correct laser parameters for optimizing the biostimulation of myoblasts.

Association between temporomandibular disorder and body mass index in institutionalized children

Temporomandibular disorders (TMD) is a term applied to functional changes of the temporomandibular joint (TMJ) and associated structures of mastication. Aim: To investigate the correlation between body mass index (BMI) and TMD in children. Methods: 70 children between 6 and 14 years enrolled in the Rogationist Benevolent Institute of charity in the city of São Paulo (Brazil) underwent clinical examination by one calibrated examiner for the use of Research Diagnostic Criteria for TMD. Weight and height were determined by anthropometric assessment for the diagnosis of nutritional status, and BMI was calculated by dividing weight in kilograms by height in meters squared (kg/m2). Descriptive analysis (mean and standard deviation) was used to characterize the sample. ANOVA complemented by the Least Significant Difference test was used to compare the mean anthropometric measurements between the genders and the groups with and without TMD. The significance level was set at 0.05. Results: We found a significantly high prevalence of TMD, as well as a significant association between TMD light and low body weight. Conclusions: The results show a high prevalence of TMD and a slight association between TMD and children with low body weight.

Aesthetic restoration of deciduous anterior teeth after removal of carious tissue with Papacárie.

The development of conservative techniques for the removal of carious tissue and the improvement of dental restoration materials allow better preservation of the dental structure. Chemomechanical caries removal is a conservative and atraumatic alternative. Papacárie is a papain-based material developed to act only on the carious dentin, allowing its easy removal with a blunt curette. This study aims to present a clinical case of aesthetic restoration of both upper deciduous central incisors after the removal of carious tissue with Papacárie.