Retrospective analysis of survival of avulsed and replanted permanent teeth according to 2012 or 2020 IADT Guidelines

Abstract This study aimed to compare the survival of replanted teeth that followed the 2012 or the 2020 International Association of Dental Traumatology (IADT) guidelines. Sixty-two permanent replanted teeth were retrospectively assessed (IADT 2012, n = 45; IADT 2020, n = 17). Five years after replantation (from January 2017 to December 2021), clinical and radiographic examinations were performed. A significance level of 95% was considered to evaluate the outcomes. Thirty-one teeth (50.0%) remained in their sockets and 31 (50.0%) were lost due to external root resorption. Of the 25 (40.3%) teeth replanted within one hour, 16 (64.0%) remained in their sockets, and 9 (36.0%) were lost. Twenty-two (71.0%) of all 31 lost teeth had an extra-alveolar time of more than one hour. Twelve teeth remained in their sockets without resorption: 8 (66.7%) were replanted within one hour, 2 (16.7%) followed the 2012 IADT, and 2 (16.7%) the 2020 IADT guidelines for late replantation. There was a significant difference (p <0.05) in the extra-alveolar time (< one hour), but without difference between the guidelines in late replantation (p > 0.05). Replanted teeth following both, 2012 or 2020 IADT guidelines, have similar clinical outcomes. The extra-alveolar time of less than one hour was demonstrated to be important to keep the permanent tooth in its socket.

Resumo Este estudo teve como objetivo comparar a sobrevida, por cinco anos, de dentes reimplantados que seguiram as diretrizes de 2012 ou 2020 da International Association of Dental Traumatology (IADT). Sessenta e dois dentes permanentes reimplantados foram avaliados retrospectivamente (IADT 2012, n = 45; IADT 2020, n = 17). Cinco anos após o reimplante, foram realizados exames clínicos e radiográficos. Foi considerado um nível de significância de 95% para avaliar os desfechos. Trinta e um dentes (50,0%) permaneceram em seus alvéolos e 31 (50,0%) foram perdidos por reabsorção radicular externa. Dos 25 (40,3%) dentes reimplantados em uma hora, 16 (64,0%) permaneceram em seus alvéolos e 9 (36,0%) foram perdidos. Vinte e dois (71,0%) de todos os 31 dentes perdidos tiveram um tempo extra-alveolar superior a uma hora. Doze dentes permaneceram em seus alvéolos sem reabsorção: 8 (66,7%) foram reimplantados em uma hora, 2 (16,7%) seguiram a IADT de 2012 e 2 (16,7%) as diretrizes da IADT de 2020 para reimplante tardio. Houve diferença significativa (p<0,05) no tempo extra-alveolar (< uma hora), mas sem diferença entre as diretrizes no reimplante tardio (p > 0,05). Dentes reimplantados seguindo as diretrizes de 2012 ou 2020 da IADT, tiveram taxas de sucesso semelhantes. O tempo extra-alveolar inferior a uma hora demonstrou ser importante para manter o dente permanente em seu alvéolo.

Investigating the association between dental age and polymorphisms in genes encoding estrogen receptors

Abstract Background Genetic polymorphisms have been shown to influence several physiological traits, including dental and craniofacial characteristics. Understanding the clinical relevance of genetic polymorphisms in dental practice is crucial to personalize treatment plans and improve treatment outcomes. Objective to evaluate the association between dental age and genetic polymorphisms in genes encoding estrogen receptors alpha and beta (ESR1 and ESR2, respectively) in a sample of Brazilian children. Methodology This retrospective cross-sectional study was performed with children undergoing orthodontic treatment. Patients with syndromes, congenital anomalies, craniofacial deformities, under hormonal or systemic treatment, and with a previous history of facial trauma were excluded. Panoramic radiographs were used to assess dental age according to the Demirjian, Goldstein, and Tanner method. A delta [dental age-chronological age (DA-CA)] was obtained, which shows whether the patient tends to have a normal, delayed (negative values), or advanced (positive values) dental age. DNA isolated from buccal cells was used to genotype four genetic polymorphisms: rs9340799 (A>G) and rs2234693 (C>T), located in ESR1; and rs1256049 (C>T) and rs4986938 (C>T), located in ESR2. A statistical analysis was performed and values of p<0.05 indicated statistical difference. Results A total of 79 patients were included, 44 (55.70%) girls and 35 (44.30%) boys. The Demirjian, Goldstein, and Tanner method, in general, overestimated patients' age by 0.75 years. There was no difference in the delta of dental age between the sexes (p>0.05). Genetic polymorphisms in ESR1 and ESR2 were not associated with dental age (p>0.05). Conclusion The studied genetic polymorphisms in ESR1 and ESR2 were not associated with dental age in Brazilian children.

Calcium hydroxide diffusion after agitation of endodontic irrigants: an ex vivo study

Aim: To compare the influence of two methods of agitation of endodontics irrigants, by diffusion of calcium hydroxide [Ca(OH)2] through the dentinal tubules, measuring the pH of the medium where they were kept. Methods: Twenty mandibular incisors were prepared using a WaveOne Gold Large file, in a reciprocating movement, and then divided into (n = 10): gutta-percha cone (GPC) or Easy Clean system (ECS) agitation of 1% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. The specimens were filled with Ca(OH)2 paste, placed in flasks with 4 mL of deionized water, and stored in an incubator. The pH was read using a digital pH meter immediately after storage (T0), after 7 (T1), 14 (T2), 21 (T3), and 35 (T4) days. Results: Statistical difference between groups was observed regardless of the day pH was measured (p < 0.01). From T2 on, ECS presented higher pH values in comparison with GPC, with significant difference (p < 0.01). Conclusion: Agitation of endodontic irrigants with ECS enhances the Ca(OH)2 diffusion, providing higher pH values, from the 14th day on, when compared with GPC

Temporomandibular disorder in construction workers associated with ANKK1 and DRD2 genes

Abstract The study aimed to explore the influence of genetic polymorphisms in ANKK1 and DRD2 on the signs and symptoms of temporomandibular disorder (TMD) in construction workers. This cross-sectional study included only male subjects. All construction workers were healthy and over 18 years age. Illiterate workers and functionally illiterate workers were excluded. The diagnosis of TMD was established according to the Research Diagnostic Criteria for TMD (RDC/TMD). Genomic DNA was used to evaluate the genetic polymorphisms ANKK1 (rs1800497) and DRD2 (rs6275; rs6276) using Real-Time PCR. Chi-square or Fisher exact tests were used to evaluate genotypes and allele distribution among the studied phenotypes. The established alpha of this study was 5%. The sample included a total of 115 patients. The age of the patients ranged from 19 to 70 years (mean age 38.2; standard deviation 11.7). Chronic pain (87.7%), disc displacement (38.2%), and joint inflammation (26.9%) were the most frequently observed signs and symptoms. The genetic polymorphism rs6276 in DRD2 was associated with chronic pain (p=0.033). In conclusion, our study suggests that genetic polymorphisms in DRD2 and ANKK1 may influence TMD signs and symptoms in a group of male construction workers.

Resumo O objetivo do estudo foi explorar a influência de polimorfismos genéticos em ANKK1 e DRD2 sobre os sinais e sintomas da disfunção temporomandibular (DTM) em trabalhadores da construção civil. Este estudo transversal incluiu apenas indivíduos do sexo masculino. Todos os trabalhadores da construção civil eram saudáveis ​​e maiores de 18 anos. Foram excluídos os trabalhadores analfabetos e analfabetos funcionais. O diagnóstico de DTM foi estabelecido de acordo com o Research Diagnostic Criteria para DTM (RDC/TMD). O DNA genômico foi usado para avaliar os polimorfismos genéticos ANKK1 (rs1800497) e DRD2 (rs6275; rs6276) usando PCR em tempo real. Testes qui-quadrado ou exato de Fisher foram utilizados para avaliar genótipos e distribuição de alelos entre os fenótipos estudados. O alfa estabelecido deste estudo foi de 5%. A amostra incluiu um total de 115 pacientes. A idade dos pacientes variou de 19 a 70 anos (média de idade 38,2; desvio padrão 11,7). Dor crônica (87,7%), deslocamento de disco (38,2%) e inflamação articular (26,9%) foram os sinais e sintomas mais observados. O polimorfismo genético rs6276 em DRD2 foi associado a dor crônica (p=0,033). Em conclusão, nosso estudo sugere que polimorfismos genéticos em DRD2 e ANKK1 podem influenciar sinais e sintomas de DTM em um grupo de trabalhadores da construção civil do sexo masculino.

Influence of clinical factors, IL4 and IL6 genes polymorphisms in functional healing in late replantation

Abstract To investigate the genetic association in a sample of replanted teeth, it is necessary to observe the extreme phenotypes, such as, teeth that underwent functional healing and those extracted due to severe external root resorption. Thus, this study aimed to investigate the association of age of the patients, root development, storage media, and polymorphisms in the interleukin 4 (IL4) and interleukin 6 (IL6) genes with teeth that presented extreme outcomes, as functional healing or extraction, in a group whose replantation techniques did not follow the International Association of Dental Traumatology (IADT) 2012 guidelines. Forty-three avulsed and replanted teeth that did not follow IADT 2012 guidelines and underwent functional healing or were extracted were included. Periapical radiographs employed for this study were taken soon after tooth replantation and after 1 year. For genotypic IL4 and IL6 genes analysis, DNA of oral mucosa cells was extracted. Real-time- PCR performed for genotyping polymorphisms in IL4 and IL6 genes. Clinical and genetic variables were analyzed by the Chi-square test and the "Z" test. P values < .05 were considered significant. The results showed that functional healing and extraction were associated with storage media and with the rs2243268 of IL- 4 gene polymorphisms. As conclusion, the C rs2243268 allele of IL4 gene may have a positive relationship with functional healing teeth that were replanted not following the 2012 IADT guidelines. Keeping the tooth dry is associated to a fast loss of avulsed and replanted teeth after 1-year follow-up.

Resumo Para investigar a influência genética em uma amostra de dentes reimplantados, é necessário observar os fenótipos extremos, como os dentes que sofreram cura funcional e os extraídos devido à reabsorção radicular externa severa. Assim, este estudo teve como objetivo investigar a associação da idade dos pacientes, desenvolvimento radicular dos dentes, assim como o meio de transporte até o reimplante e polimorfismos nos genes da interleucina 4 (IL4) e da interleucina 6 (IL6) com dentes que apresentaram cura funcional ou extração, em um grupo cujas técnicas de reimplante não seguiu a International Association of Dental Traumatology (IADT) 2012. Foram incluídos 43 dentes avulsionados e reimplantados que não seguiram as diretrizes do IADT, e tiveram cura funcional ou foram extraídos. As radiografias periapicais utilizadas para este estudo foram feitas logo após o reimplante dentário e após 1 ano. Para a análise genotípica dos genes IL4 e IL6, foi extraído DNA de células da mucosa oral. PCR em tempo real realizou a análise dos polimorfismos dos genes. As variáveis ​​clínicas e genéticas foram analisadas pelos testes Qui-quadrado e "Z". Valores de p <0,05 foram considerados significativos. Os resultados mostraram que a cura ou perda dos dentes está associada ao meio de armazenamento e polimorfismos no gene rs2243268 da IL-4. Como conclusão, o alelo C rs2243268 do gene IL4 pode ter uma relação positiva com a cura functional do dente reimplantado. Manter o dente seco está associado a uma perda rápida de dentes avulsionados e reimplantados que não seguiram o IADT 2012.

Influence of different reciprocating systems on the apical extrusion of debris in flat-oval canals

Aim: To evaluate the apical extrusion of debris in flat-oval canals, using three reciprocating systems at two different working lengths (WL), 0 mm and 1 mm from the apical foramen. Methods: Ninety mandibular incisors were randomly divided into three groups based on the systems: WaveOne Gold #25.07 (WOG), ProDesign R #25.06 (PDR), and X1 Blue #25.06 (X1B). Extruded debris were collected and dried in pre-weighed Eppendorf tubes. Three consecutive weighings were performed for each tube, and the mean was calculated. If the assumptions of normality and homogeneity of variance were not met, the Kruskal-Wallis test was used to analyze the amount of extruded debris between groups with the same WL, and the Mann-Whitney U test was used for comparison within groups for each WL. Results: All groups had extruded debris, with higher median values occurring at 1 mm. No significant difference regarding the amount of debris extrusion was observed at 0 mm (p>0.05) and 1 mm (p>0.05) between groups. However, within the groups, at different WL, there was greater extrusion at 1 mm (p<0.05), with PDR differing significantly from the other systems (p<0.05). Conclusion: The extrusion of debris occurred regardless of the group, with higher values at 1 mm. However, using PDR at 1 mm from the apical foramen showed the highest values of extrusion

Nível de conhecimento sobre o pronto atendimento ao traumatismo alvéolo dentário e aquisição de conhecimento por meio de leitura de panfleto educativo

Objetivo: o objetivo deste trabalho é verificar a eficiência do uso de um folheto educativo na melhora do nível de conhecimento sobre o pronto atendimento em casos de traumatismo alvéolo dentário (TAD) por educadores de crianças do ensino fundamental. Sujeitos e método: foi aplicado questionário a 164 docentes do ensino fundamental no município de Almirante Tamandaré, PR, para avaliação do nível de conhecimento sobre a assistência prestada no pronto atendimento a crianças em caso de TAD. Os professores responderam ao Questionário sobre o pronto atendimento ao traumatismo alvé- olo dentário (QTDA) em dois momentos, antes da leitura do folheto educativo (QTDA1) e depois (QTDA2). Resultado: observou-se que 43,20% dos docentes não tinha conhecimento sobre os procedimentos corretos a serem adotados numa situação de TAD. Após a leitura do panfleto educativo, a taxa de acertos aumentou cerca de 21,83%, ou seja, houve diferença estatisticamente significante (p≤0,001) entre os escores antes e depois da leitura do panfleto, o que reflete uma melhora no nível de conhecimento por parte dos respondentes. Conclusão: o folheto educativo mostrou-se eficiente na aquisição de conhecimento sobre o tema TAD, pois o folheto educativo resultou em um percentual significativamente positivo, sendo um método barato e prático, cuja leitura pode ser realizada quando conveniente.

Análise comparativa da desobturaçäo/reinstrumentaçäo de canais retos realizada por técnica manual e com o sistema Profile.04 / Comparative analysis of root canal filling removal/retreatment performed by manual technique and with Profile.04 system

Os autores avaliaram a capacidade de desobturaçäo e reinstrumentaçäo do sistema Profile.04 frente a uma técnica manual, em canais retos de dentes naturais previamente obturados, verificando o tempo dispendido entre os dois métodos. Os resultados mostraram-se amplamente favoráveis ao sistema Profile.04 com um tempo significativamente menor em relaçäo à técnica manual empregada

Avaliaçäo da qualidade do preparo do canal radicular utilizando-se das brocas de Gates-Glidden e dos alargadores para contra-ângulo / Quality evaluation of root canal prepare using the Gates-Glidden burs and reamers for angle as an auxiliary aid and reamers for angle as an auxilliary aid

Os autores avaliaram a qualidade do preparo do canal radicular auxiliado pelas brocas de Gates-Glidden e pelos alargadores para contra-ângulo. Para tal, dentes pré-molares superiores com duas raízes foram selecionados e preparados com ambos os instrumentos, sendo um grupo de brocas de Gates-Glidden na raiz vestibular e alargadores para contra-ângulo na palatina e em outro grupo de forma inversa. Cortes seccionais longitudinais em quatro diferentes níveis a partir da junçäo esmalte-cemento foram realizados e analisados sobre lupa esterioscópica (Carl Zeiss) em 6 aumentos. A análise do preparo foi feita através dos critérios, alargamentos, regularidades das paredes e comprometimento de quaisquer delas. Os resultados näo apontaram diferenças significativas quanto aos itens analisados, de modo que ambos os instrumentos rotatórios mostraram-se eficientes como auxiliares do preparo do canal radicular