Root canal curvature influences uncontrolled removal of dentin and cleaning efficacy after ultrasonic activation

Abstract This study evaluated the correlation between root canal curvature and the effects of ultrasonic irrigation in the following parameters: volume of uncontrolled dentin removal (UDRVol), maximum depth of dentin defects, removal of accumulated hard tissue debris (AHTD), and canal transportation in prepared curved root canals. Twenty-four human permanent mandibular molars were divided into two groups according to root canal curvature: moderate curvature (MC: mean 25°); and severe curvature (SC: mean 48°). The specimens were scanned using an X-ray microcomputed scanner (Skyscan 1172) before and after cleaning and shaping and after the final irrigation protocol with ultrasonic irrigation. There was a moderate correlation between the degree of root canal curvature and the volume of remaining AHTD (p<0.05) and between the degree of root canal curvature and maximum depth of defects due to uncontrolled removal of dentin (p<0.05). The teeth in the SC group had a greater maximum depth of defects on the dentin wall in the apical third than the teeth in the MC group (p <0.05). Both groups had a significant reduction of AHTD in all canal thirds, but the amount of remaining AHTD in the middle and apical thirds and the whole canal was significantly greater in the SC than in the MC group (p <0.05). Canal transportation was not influenced by the canal curvature in all thirds (p >0.05). This study concluded that root canal curvature affects significantly the uncontrolled removal of dentin and remaining AHTD volume after the final irrigation protocol with ultrasonic irrigation.

Resumo Este estudo avaliou a correlação entre a curvatura do canal radicular e os efeitos da irrigação ultrassônica nos seguintes parâmetros: volume de remoção não controlada de dentina (UDRVol), profundidade máxima do desgaste de dentina, remoção de debris de tecido duro acumulado (AHTD) e transporte em canais radiculares curvos. Vinte e quatro molares inferiores humanos permanentes foram divididos em dois grupos de acordo com a curvatura do canal radicular: curvatura moderada (MC: média de 25°); e curvatura acentuada (SC: média de 48°). Os espécimes foram digitalizados usando um scanner microcomputador de raios X (Skyscan 1172) antes e depois da limpeza e modelagem e após a irrigação ultrassônica. Houve uma correlação moderada entre o grau de curvatura do canal radicular e o volume de AHTD remanescente (p<0,05) e entre o grau de curvatura do canal radicular e a profundidade máxima de defeitos devido à remoção descontrolada de dentina (p<0,05). Os dentes do grupo SC apresentaram maior profundidade máxima de defeitos na parede dentinária no terço apical do que os dentes do grupo MC (p<0,05). Ambos os grupos tiveram uma redução significativa de AHTD em todos os terços do canal, mas a quantidade de AHTD remanescente nos terços médio e apical e em todo o canal foi significativamente maior no grupo SC do que no grupo MC (p <0,05). O transporte do canal não foi influenciado pela curvatura do canal em todos os terços (p > 0,05). Este estudo concluiu que a curvatura do canal radicular afeta significativamente a remoção descontrolada de dentina e o volume remanescente de AHTD após a irrigação ultrassônica.

Susceptibility of fluorotic enamel to dental erosion-abrasion

Abstract Dental hard tissue conditions can be of pre- or post-eruptive nature, such as enamel fluorosis and erosive tooth wear (ETW), respectively. Dental enamel fluorosis is caused by the chronic and excessive intake of fluoride during enamel development, leading to increased fluoride concentration and increased porosity. ETW has become a common clinical condition and often impairs dental function and aesthetics. This in vitro study tested the hypothesis that fluorotic enamel presents different susceptibility to dental erosion-abrasion. It consisted of a 3×3×2 factorial design, considering a) fluorosis severity: sound (TF0), mild (TF1-2), moderate (TF3-4); b) abrasive challenge: low, medium, and high; and c) erosive challenge: yes or no. A total of 144 human teeth were selected according to the three fluorosis severity levels (n=48), and subdivided into six groups (n = 8) generated by the association of the different erosive and abrasive challenges. Enamel blocks (4×4 mm) were prepared from each tooth and their natural enamel surfaces subjected to an erosion-abrasion cycling model. After cycling, the depth of the lesions in enamel was assessed by profilometry. ANOVA showed that the three-way and two-way interactions among the factors were not significant (p > 0.20). Enamel fluorosis level (p=0.638) and abrasion level (p = 0.390) had no significant effect on lesion depth. Acid exposure caused significantly more enamel surface loss than water (p < 0.001). Considering the limitations of this in vitro study, fluorosis did not affect the susceptibility of enamel to dental erosion-abrasion.

Fluorotic Enamel Susceptibility to Dental Erosion and Fluoride Treatment

Abstract The purpose of this in vitro study was to test the hypothesis that fluoride treatment can prevent dental erosion on fluorotic enamel of different severities. It followed a 3×2 factorial design, considering a) fluorosis severity: sound (TF0, Thylstrup-Fejerskov Index), mild (TF1-2), moderate (TF3-4); and b) fluoride treatment: 0 (negative control) and 1150ppmF. Human molars with the three fluorosis severities (n=16, each) were selected and randomly assigned to the two fluoride treatments (n=8). Enamel blocks (4×4mm) were prepared from each tooth and subjected to a dental erosion cycling model, for 10 days. The daily cycling protocol consisted of erosive challenges (1% citric acid, pH 2.4), interspersed by periods of immersion in artificial saliva, and three 2-minute treatments with either 0 or 1150ppm F. The enamel volume loss (mm3) was calculated by subtracting values obtained by microtomography before and after cycling. Two-Way ANOVA showed no significant interaction between fluorosis severity and fluoride treatment (p=0.691), and no significant effect for either fluorosis severity (TF0 mean±standard-deviation: 13.5(10-2±0.42(10-2, TF1-2: 1.50(10-2±0.52(10-2, TF3-4: 1.24(10-2±0.52(10-2, p=0.416) or treatment (0ppmF: 1.49(10-2±0.53(10-2; 1150ppmF: 1.21(10-2±0.42(10-2; p=0.093), when evaluated independently. Considering the limitations of this in vitro study, the presence and severity of fluorosis in enamel do not appear to affect its susceptibility to dental erosion. Fluoride treatment was not effective in preventing the development of dental erosion in both sound and fluorotic enamel substrates under our experimental conditions.

Resumo Este estudo in vitro foi testou a hipótese de que o tratamento com flúor pode prevenir a erosão dentária no esmalte fluorótico de diferentes severidades. O objetivo deste estudo foi: investigar o efeito protetor dos fluoretos contra a erosão e abrasão simuladas no esmalte fluorótico. Seguiu um desenho fatorial 3×2, considerando a) severidade da fluorose em 3 níveis: hígido (TF0, Índice Thylstrup-Fejerskov), suave (TF1-2), moderada (TF3-4); b) tratamento com flúor: 0 (controle negativo) e 1150ppmF. Molares humanos com as três severidades de fluorose (n=16, cada) foram selecionados e distribuídos aleatoriamente para os dois tratamentos com flúor (n=8). Blocos de esmalte (4×4mm) foram preparados a partir de cada dente e submetidos a um modelo de ciclo de erosão dentária, por 10 dias. O protocolo de ciclagem diária consistiu em seis desafios erosivos de 5 minutos (1% de ácido cítrico, pH 2,4), intercalados por seis períodos de imersão em saliva artificial e três tratamentos de 2 minutos com 0 ou 1150ppmF. O volume do esmalte perdido foi calculado subtraindo o perfil superficial 3D obtido por microtomografia antes e depois da ciclagem. A ANOVA de dois fatores não mostrou interação significativa entre a severidade da fluorose e o tratamento com flúor (p = 0,691) e nenhum efeito significativo para a severidade da fluorose (TF0 média+/desvio padrão: 13,5(10-2±0,42(10-2, TF1-2: 1,50(10-2±0,52(10-2, TF3-4: 1,24(10-2±0,52(10-2, p=0,416) ou tratamento (0: 1,49(10-2±0,53(10-2; 1150ppmF: 1,21(10-2±0,42(10-2, p=0,093), quando avaliados independentemente. Considerando as limitações deste estudo in vitro, a presença e severidade da fluorose no esmalte não parece afetar sua suscetibilidade à erosão dentária. O tratamento com flúor não foi eficaz na prevenção do desenvolvimento da erosão dentária em esmalte hígido e fluorótico, sob as condições experimentais utilizadas.

Influence of different working lengths on the shaping ability of Reciproc Blue in the apical third and apical foramen: a micro-computed tomographic study

Aim: This study aimed to assess the shaping ability of Reciproc Blue in the apical third and apical foramen of moderately curved canals at different working lengths (WLs), by micro-computed tomography. Methods: Thirty-six mesial roots (mesiobuccal and mesiolingual canals) were included, each with 2 separate root canals and independent apical foramina, according to type IV of Vertucci's classification of first and second mandibular molars. The canals were instrumented at three different WLs: G-1, 1mm short of the major apical foramen; G0, at the major apical foramen; G+1, 1mm beyond the major apical foramen. The groups were assessed for changes in root canal volume and untouched wall area in the apical third. Groups G0 and G+1 were also compared for percentage of untouched walls at the apical foramen. One-way ANOVA (post hoc Tukey test) and Student's t-test adopted a 5% level of significance. Results: Root canal volumes (mm3) in the apical third were 22.86±10.46, 44.48±24.91, and 55.71±21.32 in G-1, G0 and G+1, respectively. G-1 volume following instrumentation increased significantly less than that of G0 or G+1 (P>.05); G0 did not differ from G+1. The percentage of untouched wall area in the apical third did not differ among the three groups (P>.05). G0 and G+1 did not differ regarding untouched walls in the major apical foramem walls. Conclusion: Extending the WL from 1mm short of the apical foramen to a point at and beyond the WL increases the apical third volume without increasing the prepared area. Untouched surface areas of the apical foramen were not modified by instrumentation at or beyond the foramen

Orofacial antinociceptive effects of perillyl alcohol associated with codeine and its possible modes of action

Abstract This study evaluated the orofacial antinociceptive effect of (S)-(-)-perillyl alcohol (PA) associated with codeine (C) and investigated the possible molecular anchorage mechanisms of PA. Mice (n = 5 per group) were treated with PA alone and associated with codeine and assigned to the following groups: 75.0 mg/kg PA; 75.0 mg/kg PA + C 30 mg/kg; PA 37.5 mg/kg + C 15.0 mg/kg; C 30.0 mg/kg; and control. Nociception was induced by formalin, capsaicin, and glutamate, and was quantified based on the duration (in seconds) of face grooming. The possible mechanisms of action were evaluated by molecular docking study. In the formalin test, PA75/C30 presented an effect in the neurogenic (p < 0.0001) and inflammatory (p < 0.005) phases. Mice treated with PA75 (p < 0.0001) and PA75/C30 (p < 0.0005) showed a reduced nociceptive behavior in the capsaicin test. Glutamate-induced nociception also was blocked by PA75 (p < 0.0005) and C30 (p < 0.0005). The molecular anchorage analysis indicated high negative binding energy values for the evaluated receptors, especially glutamate receptors (AMPA -79.57 Kcal/mol, mGLUR6 -71.25, and NMDA -66.33 Kcal/mol). PA associated with codeine showed orofacial antinociceptive activity, with theoretical evidence of interaction with glutamate receptors.

Orofacial antinociceptive activity and anchorage molecular mechanism in silico of geraniol

Abstract We aimed to evaluate the orofacial antinociceptive effect of geraniol in mice and its molecular anchorage mechanism. Seven mice per group (probabilistic sample) were treated with geraniol (12.5, 25 and 50 mg/kg, i.p.), morphine (6 mg/kg, i.p.) and vehicle (saline + Tween 80 at 0.2%, i.p.) 30 minutes prior to the beginning of the experiment. Injecting glutamate (25 μM), capsaicin (2.5 μg) and formalin (2%) into the right upper lip (perinasal) of the mouse induced nociception. Behavioral analysis of the animals considered the friction time (in seconds) of the mentioned region using hind or front paws by a researcher blinded to the treatment groups. The statistical analysis was performed blindly, considering α = 5%. The results showed that in the glutamate and capsaicin tests, concentrations of 25 mg/kg and 50 mg/kg presented antinociceptive activity (p < 0.005, power> 80%). In the formalin test, geraniol was able to reduce nociception at a concentration of 50 mg/kg (p < 0.005, power> 80%). In the molecular anchorage study, high values of binding between the evaluated substance and receptors of glutamate were observed (metabotropic glutamate receptor, -87.8501 Kcal/mol; N-methyl-D-aspartate, -86.4451 Kcal/mol; α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid, -85.6755 Kcal/mol). Geraniol presented orofacial antinociceptive activity, probably by interacting with glutamate-related receptors.

Influence of infiltrant application time on the reduction of opaqueness of proximal enamel caries

Introduction: Infiltrant resins were developed to hamper carious lesion progression and mask the whitish appearance of first evidence of caries. Objective: This study aimed at testing the hypothesis that a long application time of resin infiltrant in proximal enamel caries improves esthetic outcome compared to the commercially recommended time. Materials and Methods: Twenty teeth with uncavitated inactive proximal white enamel caries lesions (selected by two calibrated examiners; inter-examiner κ = 0.87) were divided into two groups (experimental and control group; n = 10) that agreed regarding lesion surface area. Lesions were infiltrated following the protocol recommended by the manufacturer (two applications, 3 min application first and another 1 min application later; control) and by the protocol tested in this study (one application of 30 min; experimental). Enamel opaqueness (esthetic outcome) was measured by a calibrated examiner (intra-class coefficient of 0.9) before and after infiltration using fluorescence microscopy. Results: Reduction of enamel opaqueness was significantly higher in the experimental group (40.0% ± 18.5%) than in the control group (18.6% ± 14.9%) (P = 0.0105, one-tailed t-test; Hedge's g of 1.28, 95% confidence interval of 0.43/2.13, and power of 86%). Conclusions: It can be concluded that the application time of 30 min provides a greater reduction in opaqueness of proximal enamel lesion compared to the application time recommended by the manufacturer. The high effect size could stimulate patients to comply with the treatment time.

TiF4 varnish protects the retention of brackets to enamel after in vitro mild erosive challenge

Abstract The effect of fluoride agents on the retention of orthodontic brackets to enamel under erosive challenge is little investigated. Objective: The aim of this study was to evaluate the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) agents on the shear bond strength of brackets to enamel and on the enamel microhardness around brackets under erosive challenge. Methods: Brackets were bonded to bovine incisors. Five groups were formed according to fluoride application (n=10): TiF4 varnish, TiF4 solution, NaF varnish, NaF solution and control (without application). The specimens were submitted to erosive challenge (90 s cola drink/2h artificial saliva, 4x per day for 7 days). Solutions were applied before each erosive cycle and varnishes were applied once. Vickers Microhardness (VHN) was obtained before and after all cycles of erosion and the percentage of microhardness loss was calculated. Shear bond strength, adhesive remnant index and polarized light microscopy were conducted after erosion. The data were analyzed by ANOVA, Tukey, Kruskal-Wallis and Mann-Whitney U tests (α=0.05). Results: The %VHN had no statistically significant differences among the experimental groups. However, considering the comparisons of all groups with the control group, TiF4 varnish showed the highest protection from enamel demineralization (effect size of 2.94, while the effect size for the other groups was >2.4). The TiF4 varnish group had significantly higher shear bond strength compared to other groups. There was no difference among groups for adhesive remnant index. Polarized light microscopy showed higher demineralization depth for the control group. Conclusions: Application of NaF and TiF4 agents during mild erosive challenge minimized the enamel mineral loss around brackets, however only the experimental TiF4 varnish was able to prevent the reduction of shear bond strength of brackets to enamel.

Histomorphometric evaluation of calcium phosphate bone grafts on bone repair / Avaliação histomorfométrica de enxertos ósseos de cimento fosfato de cálcio no processo de reparo ósseo

Because of its biocompatibility and osteoconductive properties, calcium-phosphate cement has been used as bone surrogate. OBJECTIVE: The purpose of this study was to do a histomorphometric comparison of bone regeneration using hydroxyapatite biphasic ceramic, calcium-phosphate cement and autogenous bone graft. STUDY DESIGN: Prospective and laboratorial experiment. MATERIALS AND METHODS: Two 5mm in diameter cavities (left and right - test and control) were made in the parietal bone of 72 rats. The GI, GII, GIII and GIV test cavities were filled with calcium-phosphate cement, biphasic ceramic hydroxyapatite, autogenous bone graft and blood. The animals were killed at 30, 60 and 90 days and the specimens underwent histomorphometric analysis. RESULTS: The results showed that autogenous bone graft treated defects had significantly more new bone at 30 days compared to other test groups. Within 60 and 90 days, bone formation was more significant in the test groups GI, GII and GIII; GI and GII encompassed larger areas. Throughout the evaluation periods, GII tests showed more bone formation when compared to GI. CONCLUSIONS: Biomaterials depicted a significantly increase in bone content, when compared to autogenous bone graft, concerning bone regeneration.

Os materiais de fosfato de cálcio, pelas características de biocompatibilidade e osteocondução, estão sendo estudados como substitutos ósseos. OBJETIVO: Comparar histomorfometricamente o reparo ósseo promovido pela cerâmica bifásica de hidroxiapatita, cimento fosfato de cálcio e enxerto ósseo autógeno. FORMA DE ESTUDO: Prospectivo e experimental em laboratório. MATERIAL E MÉTODO: Foram criadas duas cavidades (esquerda e direita - teste e controle) de 5mm de diâmetro nos ossos parietais de 72 ratos Wistar. As cavidades testes GI, GII, GIII e GIV foram preenchidas com cimento fosfato de cálcio, cerâmica bifásica de hidroxiapatita, enxerto ósseo autógeno e coágulo sanguíneo. Os animais foram sacrificados aos 30, 60 e 90 dias e os espécimes avaliados histomorfometricamente. RESULTADOS: Os resultados mostraram maior formação óssea no período de 30 dias para o GIII quando comparado aos outros grupos testes. Nos períodos de 60 e 90 dias, a neoformação óssea foi mais acentuada nos grupos testes GI, GII e GIII, alcançando maiores áreas em GI e GII. Em todos os períodos de avaliação, as cavidades testes GII apresentaram maiores áreas frente às GI. CONCLUSÃO: Os biomateriais foram superiores ao enxerto autógeno no reparo ósseo.

Effects of Cymbopogon winterianus Jowitt ex Bor essential oil on the growth and morphogenesis of Trichophyton mentagrophytes / Efeitos do óleo essencial de Cymbopogon winterianus Jowitt ex Bor no crescimento e na morfogênese de Trichophyton mentagrophytes

Trichophyton mentagrophytes is a fungus causative agent of dermatophytosis, affecting humans worldwide. This has driven the search for products for the treatment of these infections. Accordingly, the aim of this study was to investigate the antifungal activity of the Cymbopogon winterianus essential oil against T. mentagrophytes. The antifungal tests consisted of antifungal screening, determination of MIC and MFC, analysis of the essential oil's effects on mycelial growth, germination of fungal spores, fungal viability, morphogenesis, cell wall (test with sorbitol) and cell membrane (cell leakage test) of T. mentagrophytes. Upon screening, the oil inhibited all strains, with zones of growth inhibition of 24-28 mm in diameter. The MIC was 312 μg/mL and CFM was 2500 μg/mL for almost all the strains tested. There were morphological changes in the conidia group, form and pigmentation of hyphae. The antifungal action of the product does not involve the cell wall and its action may involve the fungal plasma membrane. It is concluded that C. winterianus essential oil constitutes a potential antifungal product, especially for the treatment of dermatophytosis.

Trichophyton mentagrophytes é um fungo causador de dermatofitoses, afetando humanos em todo o mundo. Isto direciona a busca de produtos para o tratamento destas infecções. Assim, este estudo teve por objetivo investigar a atividade antifúngica do óleo essencial de Cymbopogon winterianus contra T. mentagrophytes. Os ensaios antifúngicos foram constituídos do screening antifúngico, da determinação CIM e CFM, da análise dos efeitos do óleo essencial no crescimento micelial, na germinação dos esporos, na viabilidade fúngica, na morfogênese, na parede celular (ensaio com sorbitol) e na membrana celular (ensaio de lise celular) de T. mentagrophytes. No screening, o óleo inibiu todas as cepas, com zonas de inibição de crescimento de 24-28 mm de diâmetro. A CIM foi de 312 μg/mL e a CFM foi de 2500 μg/mL para quase todas as cepas testadas. O óleo essencial inibiu o desenvolvimento micelial, a germinação dos esporos e a viabilidade fúngica. Houve alterações morfológicas no agrupamento dos conídios, na forma e pigmentação das hifas. A ação antifúngica do produto não envolve a parede celular e parece estar envolvida com a membrana celular fúngica. Pode-se concluir que o óleo essencial de C. winterianus se apresenta como um potencial produto antifúngico, especialmente para o tratamento das dermatofitoses.

Growth inhibition and morphological alterations of Trichophyton rubrum induced by essential oil from Cymbopogon winterianus Jowitt ex Bor

Trichophyton rubrum is one of the most common fungi causer of dermatophytosis, mycosis that affect humans and animals around the world. Researches aiming new products with antifungal activity become necessary to overcome difficulties on treatment of these infections. Accordingly, this study aimed to investigate the antifungal activity of essential oil from Cymbopogon winterianus against the dermatophyte T. rubrum. The antifungal screening was performed by solid medium diffusion method with 16 T. rubrum strains, minimum inhibitory concentration (MIC) and minimum fungicide concentration (MFC) were determined using the microdilution method. The effects on mycelial dry weight and morphology were also observed. Screening showed essential oil in natura inhibited all the tested strains, with inhibition zones between 24-28 mm diameter. MIC50 and MIC90 values of the essential oil were 312 µg/mL for nearly all the essayed strains (93.75 percent) while the MFC50 and MFC90 values were about eight times higher than MIC for all tested strains. All tested essential oil concentrations managed to inhibit strongly the mycelium development. Main morphological changes on the fungal strains observed under light microscopy, which were provided by the essential oil include loss of conidiation, alterations concerning form and pigmentation of hyphae. In the oil presence, colonies showed folds, cream color and slightly darker than the control, pigment production was absent on the reverse and with evident folds. It is concluded that C. winterianus essential oil showed activity against T. rubrum. Therefore, it could be known as potential antifungal compound especially for protection against dermatophytosis.

Effect of cinnamomum zeylanicum blume essential oil on the rowth and morphogenesis of some potentially pathogenic Aspergillus species

Cinnamomum zeylanicum Blume is known for a wide range of medicinal properties. This study aimed to assess the interference of C. zeylanicum essential oil on the growth and morphogenesis of some potentially pathogenic Aspergillus species. The essential oil presented strong antifungal effect causing the growth inhibition of the assayed strains and development of large growth inhibition zones. MIC50 and MIC90 values were 40 and 80 µL/mL, respectively. 80, 40 and 20 µL/mL of the oil strongly inhibited the radial mycelial growth of A. niger, A. flavus and A. fumigatus along 14 days. 80 and 40 µL/mL of the oil caused a 100 percent inhibition of the fungal spore germination. Main morphological changes observed under light microscopy provided by the essential oil in the fungal strains were decreased conidiation, leakage of cytoplasm, loss of pigmentation and disrupted cell structure indicating fungal wall degeneration. It is concluded that C. zeylanicum essential oil could be known as potential antifungal compound, particularly, to protect against the growth of Aspergillus species.

Cinnamomum zeylanicum Blume é uma planta conhecida por apresentar ampla variedade de propriedades medicinais. Portanto, este estudo teve por objetivo avaliar a interferência do óleo essencial C. zeylanicum sobre o crescimento e morfogênese de algumas espécies de Aspergillus potencialmente patogênicas. O óleo essencial testado apresentou potente efeito antifúngico demonstrado pela visualização de grandes zonas de inibição de crescimento de todas as linhagens testadas. Os valores de CIM50 e de CIM90 foram 40 e 80 µL/mL, respectivamente. Nas concentrações de 80, 40 e 20 µL/mL o óleo demonstrou um potente efeito fumigante, inibindo o crescimento micelial radial de A. niger, A. flavus e A. fumigatus ao longo de 14 dias de exposição. A 80 e 40 µL/mL o óleo essencial promoveu inibição de 100 por cento da germinação de esporos, das três espécies de Aspergillus citadas anteriormente. Além disso, alterações morfológicas no crescimento fúngico foram observadas sob microscopia óptica após exposição ao óleo essencial, como diminuição da conidiação, perda citoplasmática, perda de pigmentação e rompimento da estrutura fúngica (hifa) indicando degeneração da parede celular. Diante do exposto, conclui-se que o óleo essencial de C. zeylanicum poderia ser empregado como potente composto antifúngico, particularmente, prevenindo crescimento de espécies de Aspergillus.

Dissecaçäo de lesöes cariosas: nova técnica de estudo histopatológico tridimensional / Dissection of carious lesions: a new technique for three-dimensional histopathological study

As análises bidimensionais no estudo histopatológico de lesöes cariosas apresentam vieses que podem comprometer o valor científico dos estudos. Neste artigo, os autores apresentam uma nova técnica de análise tridimensional de lesöes cariosas, sem perda de partes da lesäo, que consiste na dissecaçäo das áreas afetadas pela lesäo com brocas odontológicas de desgaste, sob refrigeraçäo, realizada com auxílio de um estereomicroscópio. Três casos de lesöes cariosas oclusais em primeiros e segundos molares permanentes säo apresentados, nos quais foi possível observar as reaçöes internas de esmalte e dentina em relaçäo às características macroscópicas das lesöes. Alguns aspectos comparativos entre a técnica da dissecaçäo e as técnicas bidimensionais säo discutidos

Doença cárie: Nem infecciosa, nem transmissível / Caries disease: No infections and no transmissible pathology

O conceito de infecciosidade e transmissibilidade da doença cárie tem sido confrontado com importantes descobertas no campo do diagnóstico, microbiologia, e patologia desta doença, que permitiram um melhor esclarecimento do seu caráter localizado e dos fatores responsáveis pela manutençäo da integridade dos tecidos dentais duros na cavidade oral. O presente trabalho levanta evidências básicas que divergem da concepçäo da doença cárie como uma patologia infecciosa e transmissível, e apontam para o papel da atriçäo mecânica intraoral como o principal fator controlador do crescimento de massas bacterianas com potencial cariogênico sobre as superfícies dentais, caracterizando a doença cárie como uma patologia localizada e com uma microbiota inespecífica

Restrições do uso da sonda exploradora / Restrictions in the use of explorer probe

A sonda exploradora tem sido invariavelmente usada pelos cirurgiões-dentistas durante o exame clínico, a fim de detectar áreas nas quais trave, sendo diagnosticadas como áreas cariadas. Essa conduta pode levar a uma alta porcentagem de diagnóstico falso-positivos, destruir a camada superficial de lesões brancas cariosas e transferir microrganismos cariogênicos de uma superfície dentária para outra. Os autores recomendam que a sonda exploradora seja aplicada levemente sobre a superfície dentária para auxiliar no diagnóstico de lesões brancas cariosas ativas, podendo-se substituir seu uso tradicional por métodos alternativos, sem significante prejuízo para a sensibilidade e a especificidade diagnóstica

Periodontite pré-pubertal versus periodontite juvenil: uma questäo de época de diagnóstico / Pré-pubertal periodontitis versus periodontose: a question of time of diagnosis

A doença periodontal destrutiva em crianças e adolescentes tem sido dividida em patologias diferentes, periodontite pré-pubertal (PP) e periodontite juvenil (PJ), respectivamente. Entretanto, vários estudos relataram casos de doença periodontal envolvendo as dentiçoes decídua e mista, que depois continuaram na dentiçao permanente, com características muito semelhantes à PJ, questionando a classificaçao de PP e PJ como entidades distintas. Novos conceitos surgidos no campo da patologia da doença periodontal revelam que lesoes periodontais prococes podem evoluir intensamente num curto intervalo de tempo, o que tem despertado o interesse pela identificaçao de indivíduos com sinais precoces de periodontite, pois estes podem ser os futuros portadores de PP ou PJ, sendo a classificaçao destas formas de periodontite uma questao de época de diagnóstico. Um exame mais meticuloso do periodonto de crianças e adolescentes é necessário, principalmente nas superfícies próximas dos dentes, onde a doença periodontal inicialmente se instala.