Comparison between the rotary (Hyflex EDM®) and manual (k-file) technique for instrumentation of primary molars: a 12-month randomized clinical follow-up study

Abstract Rotational instrumentation is an alternative for the clinical practice of pediatric dentists. However, there are few records in the literature on the clinical and radiographic aspects of treated teeth over time. Objectives: Compare instrumentation time and filling quality between manual (k-file) and rotary (Hyflex EDM®) files, and clinically and radiographically follow-up the treated teeth for 12 months. Moreover, the characteristics of glass ionomer restorations and their interference in the treatment prognosis over time were evaluated. Methodology: In total, 40 children with pulp involvement in primary molars received treatment with Hyflex EDM® or manual rotary files, performed by an operator. Clinical and radiographic aspects were observed at different times to determine the effectiveness of each technique. Results: The rotary system reduced instrumentation time when compared to the use of manual files (p≤0.05), but there was no difference in filling quality between the groups (p≥0.05). Moreover, both types of instrumentation were effective for 12 months (p≥0.05), and restoration retention influenced the emergence of periapical lesions (p≤0.05). Conclusion: Although rotary files reduce clinical time, the clinical and radiographic aspects of both techniques were similar over 12 months. Moreover, restoration retention has been shown to be related to treatment prognosis.

Initial inflammatory response after the pulpotomy of rat molars with MTA or ferric sulfate

Abstract Purpose To compare, both qualitatively and quantitatively, the inflammatory cells, vascular density and IL-6 immunolabeled cells present in the pulp after pulpotomy with white MTA versus 15.5% ferric sulfate (FS). Methodology Forty-eight mandibular first molars from 24 Wistar rats were divided into MTA or FS groups and subdivided according to the period after pulpotomy procedure (24, 48 and 72 hours). Four teeth (sound and untreated) were used as controls. Histological sections were obtained and assessed through the descriptive analysis of morphological aspects of pulp tissue and the quantification of inflammatory cells, vascular density and interleukin-6 (IL-6) expression. Data were statistically analyzed (p<0.05). Results The number of inflammatory cells was similar in both groups, being predominantly localized at the cervical radicular third. In the MTA group, increased inflammation was observed at 48 hours. Vascular density was similar in both groups and over time, being predominant in the medium radicular third. No correlation was found between the number of inflammatory cells and the vascular density. Pulp tissue was more organized in MTA-treated teeth. In both groups, a weak to moderate IL-6 expression was detected in odontoblasts and inflammatory cells. Comparing both groups, there was a greater IL-6 expression in the cervical radicular third of teeth treated with MTA at 24 hours and in the medium and apical thirds at 72 hours, while in the FS group a greater IL-6 expression was found in the apical third at 24 hours. Conclusion The MTA group presented better histological features and greater IL-6 expression than the FS group. However, no difference was observed between the groups regarding the inflammatory status and vascularization, suggesting the usefulness of FS as a low-cost alternative to MTA.

Antimicrobial activity of various brands of children's toothpastes formulated with Triclosan, fluoride and xylitol / Atividade antimicrobiana de dentifrícios infantis formulados com Triclosa, xylitol e fluoreto, disponíveis no mercado

Objective: Evaluate and compare the antimicrobial efficacy of four different commercially available children's toothpastes on bacteria growth inhibition from oral microbiota of young children. Material and Method: The toothpastes tested contained: 1100 ppm sodium fluoride, xylitol and 750 ppm sodium fluoride, xylitol and 500 ppm sodium fluoride, and xylitol and triclosan. Twenty 18 to 36 month-old children were selected. Nonstimulated saliva samples were collected and inoculated on brain heart infusion (BHI) agar. Toothpaste dilutions were applied into the agar wells and incubated at 37 ºC for 24 hours in microaerophilic conditions. Saline and 0.12% chlorhexidine were used as controls. Antimicrobial activity was determined in duplicate by agar-well diffusion technique. Bacterial growth inhibition zones were recorded in mm. Statistical analysis was performed using ANOVA and Tukey's test (p < 0.05). Results: All toothpastes showed antimicrobial activity when compared to negative control (p < 0.05). Toothpaste containing triclosan presented the highest antimicrobial activity followed, in this order, by xylitol and 750 ppm sodium fluoride, chlorhexidine, 1100 ppm sodium fluoride, xylitol and 500 ppm sodium fluoride and saline. Conclusion: Toothpaste containing triclosan and xylitol presented excellent antimicrobial activity, and may be considered a good option for young children. (AU)

Objetivo: Avaliar e comparar a atividade antimicrobiana de 4 dentifrícios infantis, comercialmente disponíveis, com relação à inibição do crescimento da microbiota oral em crianças. Material e Métodos: Os dentifrícios testados continham: 1100 ppm de fluoreto de sódio - xilitol e 750 ppm de fluoreto de sódio - xilitol e 500 ppm de fluoreto de sódio - xilitol e triclosan. Vinte crianças de 18 a 36 meses participaram dessa pesquisa. Amostras de saliva não estimulada foram coletadas e inoculadas em ágar de infusão cérebro-coração (ICC). Dentifrícios diluídos foram aplicados sobre os poços contendo ICC e incubados a 37 ºC por 24 horas em condições microaerofílicas. Solução salina e clorexidina a 0,12% foram usadas como controles. A atividade antimicrobiana foi determinada em duplicata pela técnica de difusão nos poços de ágar. Os halos de inibição do crescimento bacteriano foram registrados em mm. A análise estatística foi realizada usando ANOVA e teste de Tukey (p < 0,05). Resultados: Todos os dentifrícios mostraram atividade antimicrobiana, quando comparados com os controles negativos. O dentifrício contendo triclosan mostrou a maior atividade antimicrobiana, seguido, nessa ordem por dentifrício contendo xilitol e 750 ppm de fluoreto de sódio, clorexidina, dentifrício contendo 1100 ppm de fluoreto de sódio, dentifrício contendo xilitol e 500 ppm de fluoreto de sódio e pela solução salina. Conclusão: O dentifrício contendo triclosan e xylitol apresentou excelente atividade antimicrobiana podendo ser considerado uma vantajosa opção para crianças, contribuindo para o controle das cáries dentárias e reduzindo a ingestão de fluoretos.(AU)

Comparison between calcium hydroxide mixtures and mineral trioxide aggregate in primary teeth pulpotomy: a randomized controlled trial

Abstract Objectives: To evaluate the effect of calcium hydroxide (CH) associated with two different vehicles as a capping material for pulp tissue in primary molars, compared with mineral trioxide aggregate (MTA). Methodology: Forty-five primary mandibular molars with dental caries were treated by conventional pulpotomy using one of the following materials: MTA only (MTA group), CH with saline (CH+saline group) and CH with polyethylene glycol (CH+PEG group) (15 teeth/group). Clinical and periapical radiographic examinations of the pulpotomized teeth were performed 3, 6, and 12 months after treatment. Data were tested by chi-squared analysis and a multiple comparison post-test. Results: The MTA group showed both clinical and radiographic treatment success in 14/14 teeth (100%), at all follow-up appointments. By clinical evaluation, no teeth in the CH+saline and CH+PEG groups had signs of mobility, fistula, swelling or inflammation of the surrounding gingival tissue. However, in the CH+saline group, radiographic analysis detected internal resorption in up to 9/15 teeth (67%), and inter-radicular bone resorption and furcation radiolucency in up to 5/15 teeth (36%), from 3 to 12 months of follow-up. In the CH+PEG group, 2/11 teeth (18%) had internal resorption and 1/11 teeth (9%) presented bone resorption and furcation radiolucency at all follow-up appointments. Conclusion: CH with PEG performed better than CH with saline as capping material for pulpotomy of primary teeth. However, both combinations yielded clinical and radiographic results inferior to those of MTA alone.

Effects of mineral trioxide aggregate, BiodentineTM and calcium hydroxide on viability, proliferation, migration and differentiation of stem cells from human exfoliated deciduous teeth

Abstract Objective: The aim of the study was to evaluate the effects of the capping materials mineral trioxide aggregate (MTA), calcium hydroxide (CH) and BiodentineTM (BD) on stem cells from human exfoliated deciduous teeth (SHED) in vitro. Material and Methods: SHED were cultured for 1 - 7 days in medium conditioned by incubation with MTA, BD or CH (1 mg/mL), and tested for viability (MTT assay) and proliferation (SRB assay). Also, the migration of serum-starved SHED towards conditioned media was assayed in companion plates, with 8 μm-pore-sized membranes, for 24 h. Gene expression of dentin matrix protein-1 (DMP-1) was evaluated by reverse-transcription polymerase chain reaction. Regular culture medium with 10% FBS (without conditioning) and culture medium supplemented with 20% FBS were used as controls. Results: MTA, CH and BD conditioned media maintained cell viability and allowed continuous SHED proliferation, with CH conditioned medium causing the highest positive effect on proliferation at the end of the treatment period (compared with BD and MTA) (p<0.05). In contrast, we observed increased SHED migration towards BD and MTA conditioned media (compared with CH) (p<0.05). A greater amount of DMP-1 gene was expressed in MTA group compared with the other groups from day 7 up to day 21. Conclusion: Our results show that the three capping materials are biocompatible, maintain viability and stimulate proliferation, migration and differentiation in a key dental stem cell population.

Effects of low-level laser therapy on stem cells from human exfoliated deciduous teeth

ABSTRACT Low-Level Laser Therapy stimulates the proliferation of a variety of types of cells. However, very little is known about its effect on stem cells from human exfoliated deciduous teeth (SHED). Objective This study aimed to evaluate the influence of different laser therapy energy densities on SHED viability and proliferation. Material and Methods SHED were irradiated according to the groups: I (1.2 J/cm2 - 0.5 mW – 10 s), II (2.5 J/cm2 – 10 mW – 10 s), III (3.7 J/cm2 – 15 mW – 10 s), IV (5.0 J/cm2 – 20 mW – 10 s), V (6.2 J/cm2 – 25 mW – 10 s), and VI (not irradiated – control group). Cell viability was assessed 6 and 24 h after irradiation measuring the mitochondrial activity and using the Crystal Violet assay. Cell proliferation was assessed after 24, 48, and 72 h of irradiation by SRB assay. Results MTT assay demonstrated differences from 6 to 24 hours after irradiation. After 24 h, groups I and IV showed higher absorbance values than those of control group. Crystal Violet assay showed statistically differences in the absorbance rate from 6 to 24 h after irradiation for groups III and VI. At 24 h after irradiation, Group III absorbance rate was greater than that of groups I, II, and IV. Group VI absorbance rate was greater than that of groups I and IV. SRB assay showed that the group I had higher rates than those of groups II, III, V, and VI, at 24 h after irradiation. After 48 h, group I exhibited the greatest cell proliferation rate followed by groups III, V, and VI. After 72 h, group III exhibited the lowest cell proliferation rate than those of groups II, IV, and V. Conclusions The Low-Level Laser Therapy energy densities used in this study did not cause loss of cell viability and stimulated SHED proliferation within the parameters described in this study.

Effect of EDTA on TGF-ß1 released from the dentin matrix and its influence on dental pulp stem cell migration

Abstract: Bioactive molecules stored in dentin, such as transforming growth factor beta1 (TGF-b1), may be involved in the signaling events related to dental tissue repair. The authors conducted an in vitro evaluation of the amount of TGF-b1 released from dentin slices after treatment with 10% ethylenediaminetetraacetic acid (EDTA), 2.5% sodium hypochlorite (NaOCl) or phosphate-buffered saline (PBS), and the effect of this growth factor on stem cell migration from human exfoliated deciduous teeth (SHED). Sixty 1-mm-thick tooth slices were prepared with or without the predentin layer, and treated with either 10% EDTA for 1 minute, 2.5% NaOCl for 5 days or kept in PBS. Tooth slice conditioned media were prepared and used for TGF-b1 ELISA and migration assays. Culture medium with different concentrations of recombinant human TGF-b1 (0.5, 1.0, 5.0 or 10.0 ng/mL) was also tested by migration assay. The data were evaluated by ANOVA and Tukey's test. Optical density values corresponding to media conditioned by tooth slices either containing or not containing the predentin layer and treated with 10% EDTA were statistically greater than the other groups and close to 1 ng/mL. Increased rates of migration toward media conditioned by tooth slices containing the predentin layer and treated with PBS, 10% EDTA or 2.5% NaOCl were observed. Recombinant human TGF-b1 also stimulated migration of SHED, irrespective of the concentration used. EDTA may be considered an effective extractant of TGF-b1 from the dentin matrix. However, it does not impact SHED migration, suggesting that other components may account for the cell migration.

Clinical and radiographic outcomes of the use of capping materials in vital pulp therapy of human primary teeth / Resultados clínicos e radiográficos do uso de materiais de capeamento na terapia de polpa vita de dentes decíduos humanos

O objetivo deste estudo foi comparar os resultados clínicos e radiográficos de hidróxido de cálcio (CH), hidróxido de cálcio precedido de solução corticosteróide / antibiótico (O + CH) e formocresol diluído (FC) na terapia de polpa vital de dentes decíduos humanos. Material e Métodos: Quarenta e cinco molares decíduos inferiores de crianças com idade entre 5-9 anos foram divididos aleatoriamente em três grupos: FC, CH e O + CH e receberam tratamento convencional de pulpotomia. Acompanhamento clínico e radiográfico foi realizado após 3, 6 e 12 meses. Resultados: Nenhum sinal de falha clínica foi observado nos três grupos de estudo durante todos os períodos de avaliação. A análise radiográfica mostrou um total de seis falhas de reabsorção radicular interna nos grupos CH e O + CH após 12 meses de acompanhamento, com diferença estatisticamente significativa em comparação com o grupo FC. O grupo FC não mostrou formação da barreira de tecido duro, o que foi observado nos grupos CH e O + CH em todos os períodos de acompanhamento. Conclusão: Todos os materiais empregados apresentaram taxas de sucesso clínico e radiográfico aceitáveis. Os resultados mostraram que o uso de uma solução anti-inflamatória antes do material de capeamento tem propriedades terapêuticas que ajudam na cicatrização pulpar. São recomendadas investigações clínicas contínuas utilizando estes medicamentos no tratamento de pulpotomia vital em molares decíduos...

Objective: The aim of this study was to compare the clinical and radiographic outcomes of Calcium Hydroxide (CH), Calcium Hydroxide preceded by corticosteroid/antibiotic solution (O+CH) and diluted formocresol (FC) in the vital pulp therapy of human primary teeth. Material and methods: Forty-five mandibular primary molars of children aged between 5-9 years were randomly assigned in the three study groups, FC, CH and O+CH and received conventional pulpotomy treatment. Clinical and radiographic follow-up was made at 3, 6 and 12-months. Results: No sign of clinical failure was observed in the three study groups during all the periods of evaluation. Radiographic analysis showed a total of six failures of internal root resorption in CH and O+CH groups after the 12 months follow-up, with statistically significant difference as compared with FC group. FC group did not show hard tissue barrier formation, which was observed in CH and O+CH groups in all the followup periods. Conclusion: All employed materials showed acceptable clinical and radiographic success rates. The results showed that the use of an antiinflammatory solution prior the dressing material has therapeutic properties that help with pulpal healing. Continued clinical investigations using these medicaments as vital pulpotomy treatment in primary molars are recommended...

Surgical techniques for the treatment of ankyloglossia in children: a case series

This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort.

Oral antibacterial effect of chlorhexidine treatments and professional prophylaxis in children

Aim: The primary aim of this longitudinal study was to evaluate additional effects of 4-weekchlorhexidine digluconate (CHX) gel treatments to control Aggregatibacter actinomycetemcomitanscounts in children after professional dental prophylaxis. Porphyromonas gingivalis and Streptococcusmutans counts were also determined to evaluate the secondary effects of anti-plaque treatments onmicrobial shifts. Methods: Twenty-six children with A. actinomycetemcomitans counts >4 log10/mL of saliva and/or Quigley-Hein plaque index >3.0 were enrolled in this study. Patients wererandomly assigned to groups GI (placebo gel), GII (0.5% CHX gel), GIII (1% CHX gel), and GIV(2% CHX gel). Four sessions of treatment were performed during 4 weeks after a session ofprofessional dental prophylaxis. Real-Time polymerase chain reaction (PCR) was used todetermine viable microorganism counts in non-stimulated whole saliva samples collected atbaseline, one week, one month and three months after interruption of treatments. Results: Areduction of all bacterial counts was detected after the 3-month follow-up in all groups. Lowercounts of P. gingivalis were achieved from 1 week on after treatments. The 2% CHX concentrationseemed to contribute to lower A. actinomycetemcomitans levels and increase S. mutans levels.Conclusions: Professional dental prophylaxis was effective to control salivary levels of A.actinomycetemcomitans, P. gingivalis and S. mutans. Additional antimicrobial effects, however,were not observed by the combination of professional dental prophylaxis and 4-week chlorhexidinegel treatments.

Terapia pulpar em dentes decíduos: possibilidades terapêuticas baseadas em evidências / Pulp therapy in deciduous teeth: therapeutic possibilities based on evidences

Introdução: A pulpotomia em dentes decíduos é uma técnica conservadora de terapia pulpar amplamente utilizada em Odontopediatria, sendo de fundamental importância para evitar a perda prematura desses dentes, quer seja por alterações provocadas pela cárie dentária ou traumatismo dentário. Apesar de ser uma técnica estudada há muitos anos, causa muitas controvérsias e discussões, principalmente em termos de biocompatibilidade dos medicamentos empregados e pelas dificuldades e falhas no diagnóstico da condição pulpar. Objetivo: Por meio de uma revisão sistemática da literatura, no período compreendido entre 2000 e 2011, e com enfoque em estudos clínicos randomizados, revisões sistemáticas e meta-análises, este trabalho teve como objetivo discutir, com base em evidências científicas, alternativas para o tratamento de pulpotomia em dentes decíduos humanos. Conclusão: As evidências científicas fidedignas com o uso de materiais capeadores pulpares e as técnicas de Eletrocirurgia e Laser de Baixa Potência foram escassas. Desta forma, sugere-se a realização de estudos complementares bem delineados estatisticamente para maiores esclarecimentos. As informações geradas em tais experimentos poderão contribuir para um melhor entendimento dos mecanismos da terapia pulpar, podendo gerar o desenvolvimento de protocolos com novas formas terapêuticas, que visam a melhorar a terapia pulpar em dentes decíduos.

Introduction: Pulpotomy of primary teeth has been the treatment of choice in cases of inflammation of the coronal pulp caused by caries or trauma with no involvement of the radicular pulp, thus avoiding the premature loss of the teeth. Not only is the diagnosis of the inflamed dental pulp required for this therapy to succeed, but also the selection of an effective and biocompatible medicament. However, none of the drugs available and recommended for pulpotomy therapy present all the requirements of an ideal pulp capping agent. Objective: Through a systematic literature review, between the years of 2000 and 2011, focusing in randomized clinical trials, systematic reviews and meta-analysis, aiming to analyze and discuss based on alternatives for the treatment of pulpotomy in human deciduous teeth. Conclusion: Scientific evidences showed that the medicaments and techniques influence were few. Thus, further and well-designed studies are suggested for clarification. The information generated in such experiments may contribute to a better understanding of the mechanisms of pulp therapy to new therapeutic approaches aimed at improving pulp therapy in deciduous teeth.

Surgical excision of mucocele with local anesthesia in an 8-month-old baby / Excisão cirúrgica de mucocele sob anestesia local em um bebê de 8 meses de idade

Mucoceles are common disorders of the minor salivary glands, occurring specially on the lower lip. Their occurrence in newborn babies has rarely been reported. In addition, the surgical removal of oral lesions in babies has often been performed with general anesthesia, which option is usually related to the patients' ages, irrespective of the lesion's size and the access to anatomic region where it is located. The present report, however, details the treatment of a mucocele excision performed in an 8-month-old baby with local anesthesia. This case illustrates well that knowledge of the lesion and dentist's experience in the attendance of babies is important, as often only conservative treatment with local anesthesia is required. Therefore, clinicians and parents should be reassured that early surgical intervention under local anesthesia will provide a swift and satisfactory resolution to the problem.

Mucocele é uma ocorrência comum nas glândulas salivares menores, que acontece, principalmente, no lábio inferior. Em bebês, tem sido raramente reportada na literatura. Em adição, a remoção cirúrgica de lesões orais em bebês tem sido realizada sob anestesia geral, cuja opção geralmente se refere à idade do paciente, sem ter relação com o tamanho da lesão e o acesso à região anatômica onde está localizada. O presente caso clínico, no entanto, descreve a excisão da mucocele realizada em um bebê de 8 meses de idade, sob anestesia local. Esse caso ilustra bem que o conhecimento da lesão e a experiência do dentista no atendimento de bebês é muito importante, já que somente um tratamento conservador sob anestesia local é necessário. Portanto, clínicos e pais devem ser alertados para o fato de que uma intervenção cirúrgica precoce sob anestesia local irá proporcionar uma resolução rápida e satisfatória do problema.

Pulp tissue from primary teeth: new source of stem cells

SHED (stem cells from human exfoliated deciduous teeth) represent a population of postnatal stem cells capable of extensive proliferation and multipotential differentiation. Primary teeth may be an ideal source of postnatal stem cells to regenerate tooth structures and bone, and possibly to treat neural tissue injury or degenerative diseases. SHED are highly proliferative cells derived from an accessible tissue source, and therefore hold potential for providing enough cells for clinical applications. In this review, we describe the current knowledge about dental pulp stem cells and discuss tissue engineering approaches that use SHED to replace irreversibly inflamed or necrotic pulps with a healthy and functionally competent tissue that is capable of forming new dentin.

Dental pulp tissue engineering

Dental pulp is a highly specialized mesenchymal tissue that has a limited regeneration capacity due to anatomical arrangement and post-mitotic nature of odontoblastic cells. Entire pulp amputation followed by pulp space disinfection and filling with an artificial material cause loss of a significant amount of dentin leaving as life-lasting sequelae a non-vital and weakened tooth. However, regenerative endodontics is an emerging field of modern tissue engineering that has demonstrated promising results using stem cells associated with scaffolds and responsive molecules. Thereby, this article reviews the most recent endeavors to regenerate pulp tissue based on tissue engineering principles and provides insightful information to readers about the different aspects involved in tissue engineering. Here, we speculate that the search for the ideal combination of cells, scaffolds, and morphogenic factors for dental pulp tissue engineering may be extended over future years and result in significant advances in other areas of dental and craniofacial research. The findings collected in this literature review show that we are now at a stage in which engineering a complex tissue, such as the dental pulp, is no longer an unachievable goal and the next decade will certainly be an exciting time for dental and craniofacial research.

A polpa dental é um tecido conjuntivo altamente especializado que possui uma restrita capacidade de regeneração, devido à sua disposição anatômica e à natureza pós-mitótica das células odontoblásticas. A remoção total da polpa, seguida da desinfecção do canal radicular e seu preenchimento com material artificial proporciona a perda de uma significante quantidade de dentina deixando como sequela um dente não vital e enfraquecido. Entretanto, a endodontia regenerativa é um campo emergente da engenharia tecidual, que demonstrou resultados promissores utilizando células-tronco associadas à scaffolds e moléculas bioativas. Desta forma, esse artigo revisa os recentes avanços obtidos na regeneração do tecido pulpar baseado nos princípios da engenharia tecidual e fornece aos leitores informações compreensivas sobre os diferentes aspectos envolvidos na engenharia tecidual. Assim, nós especulamos que a combinação ideal de células, scaffolds e moléculas bioativas pode resultar em significantes avanços em outras áreas da pesquisa odontológica. Os dados levantados em nossa revisão demonstraram que estamos em um estágio no qual, o desenvolvimento de tecidos complexos, tais como a polpa dental, não é mais inatingível e que a próxima década será um período extremamente interessante para a pesquisa odontológica.

Methodological model of chronic stress associated with ligature-induced periodontitis in rats: a radiographic study

This study evaluated the time efficiency of stress associated with ligature-induced periodontitis in rats. Sixty adult Wistar rats, housed in temperature-controlled rooms and receiving water and food ad libitum, were randomly separated into stress (n = 30) or control groups (n = 30). All animals were anesthetized, and nylon ligatures were placed at the gingival margin level of the maxillary right second molars. After the induction of periodontitis, rats in the stress group were subjected to physical restraint for 12 hours daily. The animals were euthanized after 7, 15 and 30 days by anesthetic overdose (10 animals per group per period). The right hemimaxillae were stored in formalin solution for 48 hours. Parallel radiographic images of the hemimaxillae were taken and processed following standard procedures. Radiographic examination was performed by a blinded and previously calibrated investigator. Bone height level was measured, and data were submitted to analysis of variance and post hoc Bonferroni tests (p < 0.05). Rats in the stress group had greater bone loss than those in the control group at 7 and 15 days post-induction (p < 0.05). After 30 days, there was no statistically significant difference between the groups (p > 0.05). Restraint stress modulates the short-term progression of periodontal disease in rats. Therefore, the 12-hour daily physical restraint stress model in rats applied for up to 15 days is suitable for the investigation of the combined effect of ligation and restraint stress on periodontal degradation.

Polymerase Chain Reaction technique as a diagnostic tool for bacterial detection in root canals of cleft lip and palate patients / Técnica de Reação em Cadeia da Polimerase como ferramenta de identificação da microbiota de canais radiculares em pacientes com fissuras labiopalatinas

Objective: Polymerase chain reaction is the most sensitive of all microbiological methods for the detection of microorganisms. It consists of enzymatic amplification of DNA. PCR is faster, much more sensitive and more accurate than the culture method. This study investigated the occurrence of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in the root canals of cleft lip and palate patients. Methods: Samples were collected from 24 root canals followed by polymerase chain reaction. Results: A. actinomycetemcomitans was detected in 12.5% and P. gingivalis in 8.3% of the investigated root canals. The method proposed in this study was highly sensitive and specific for the direct detection of microorganisms in root canal samples. Conclusion: This new molecular-based dentistry provides useful information for clarifying the etiology of root canal microbiota and for developing new strategies for endodontic diagnosis and treatment.

Objetivo: A Reação em Cadeia da Polimerase é um método com alta sensibilidade e especificidade quando comparado com alguns métodos microbiológicos convencionais. Baseia-se na amplificação enzimática de uma sequência especifica de DNA, visando à produção de milhões de cópias desta sequência em um tubo de ensaio. Desta forma, recentemente as técnicas de biologia molecular têm sido usadas em endodontia pela sua rapidez e eficácia. Portanto, este estudo avaliou por meio da técnica de Reação em Cadeia da Polimerase a presença dos micro-organismos Actinobacillus actinomycetemcomitans e Porphyromonas gingivalis de canais radiculares em pacientes com fissuras lábio-palatais. Métodos: Foram coletadas amostras de 24 canais radiculares e realizada a técnica de Reação em Cadeia da Polimerase. Resultados: Das amostras estudadas, 12,5% mostraram resultado positivo para A. actinomycetemcomitans e 8,3% para P. gingivalis. O método proposto neste estudo foi altamente sensível e específico na detecção direta de amostras clínicas. Conclusão: A odontologia com base molecular fornece informações úteis para esclarecer a etiologia da microbiota de canais radiculares e o desenvolvimento de novas estratégias de diagnóstico e tratamento endodôntico.

Estudo clínico e radiográfco do formocresol de Buckley a 1/5 e do cimento Portland utilizados para pulpotomias em dentes decíduos humanos / Clinical and radiographic study on 1/5 dilution of Buckley?s formocresol and Portland cement used for pulpotomies of human primary teeth

O objetivo deste estudo foi comparar a eficácia clínica e radiográfca do formocresol de Buckley diluído a 1/5 e do cimento Portland como agentes capeadores pulpares em dentes decíduos humanos acometidos por cárie extensa, tratados pela técnica convencional de pulpotomia. Sessenta e oito primeiros molares inferiores em 52 crianças com idades entre 5 e 9 anos foram criteriosamente selecionados. De forma randômica, formaram-se dois grupos de 34 molares, cada qual sendo tratado com um dos agentes capeadores a serem comparados. Após a realização das pulpotomias, avaliações clínicas e radiográficas foram realizadas nos períodos de 3, 6 e 12 meses do pós-operatório. Nenhum sinal de falha clínica foi observado, para ambos os grupos, em todos os períodos avaliados. Diferença estatisticamente signifcativa entre os grupos foi observada apenas quando avaliada a coloração da coroa dentária e a obliteração do canal radicular, visto que todos os dentes tratados com o cimento Portland apresentaram discreta coloração acinzentada e estenose radicular. O cimento Portland foi tão efetivo quanto o formocresol como capeador pulpar em pulpotomias de dentes decíduos. Embora os resultados sejam encorajadores, estudos futuros e com acompanhamentos a longo prazo são necessários para se determinar a indicação clínica segura do cimento Portland.

This study aimed at comparing the clinical and radiographic effectiveness of 1:5 dilution of Buckley?s formocresol and Portland cement as pulp dressing agents in carious primary teeth treated by conventional pulpotomy. Sixty eight primary mandibular molars in 52 children between 5 and 9 years old were criteriously selected. Clinical and radiographic evaluations were recorded 3, 6 and 12-months postoperatively. No signs of clinical failure were observed at all follow-up appointments in both groups. Statistically signifcant difference between both groups was only observed when assessing tooth crown discoloration and pulp canal obliteration since all of the teeth treated with Portland cement presented dicrete grayish discoloration and root stenosis. Portland cement was equally effective as formocresol as pulp capping agent in pulpotomies of deciduous teeth. Although our results are very encouraging, further studies and longer follow-up assessments are needed in order to determine the safe clinical indication of Portland cement.

Efeito do gel de clorexidina em diferentes concentrações no controle do biofilme bacteriano e da inflamação gengival em crianças / Effect of clorexidina in different concentrations in the control on dental plaque and inflammation gingival in children

O presente estudo teve como objetivo avaliar a efetividade da utilização de géis de clorexidina nas concentrações de 0,5%, 1% e 2% para o controle do biofilme dentário e da inflamação gengival em crianças na faixa etária de 7 a 11 anos de idade. A amostra foi composta por 40 crianças, aleatoriamente divididas em quatro grupos: G1 (grupo controle - não utilização de agente químico), G2 (utilização de gel de clorexidina a 0,5%), G3 (utilização de gel de clorexidina a 1%) e G4 (utilização de gel de clorexidina a 2%) para determinação dos índices de placa e gengival. O gel de clorexidina foi aplicado com a utilização de moldeiras descartáveis pré-fabricadas (5 mL), por 1 minuto, uma vez por semana, durante 4 semanas. As avaliações clínicas foram feitas após 1 semana, 1 mês, 3 e 6 meses da última aplicação do gel. Os resultados obtidos foram analisados pela análise de variância a dois critérios, sendo adotado nível de significância igual a 5%. Os índices de placa e gengival reduziram durante o período experimental em todos os grupos. Não houve diferença significante (p <0.05) entre os grupos tratados com gel de clorexidina quando comparado com o grupo placebo na redução de placa e índice gengival. Os resultados mostraram que formulações diferentes de gel de clorexidina não produzem efeito inibidor da placa bacteriana e da inflamação gengival. Sendo assim, estudos adicionais são necessários para esclarecer o papel da clorexidina na prevenção de cárie e doença periodontal em crianças.

The purpose of the present study was to assess the effect of three different formulations of chlorhexidine gel in the concentrations of 0.2%, 1% and 2% for the control of plaque accumulation and gingivitis. This was a double-blind, longitudinal, non-crossover study in 48 children between 7 to 11 years of age. Subjects were randomly assigned to 4 different groups: G 1 (placebo), G 2 (0.2% chlorhexidine gel), G 3 (1% chlorhexidine gel) and G 4 (2% chlorhexidine gel). The chlorhexidine gel was administered once a week during 4 weeks. The clinical evaluations were made after 1 week, 1, 3 and 6 months of the last application of the chlorhexidine gel. Mean plaque and gingival scores were reduced over the four-week trial period for experimental and control groups. There was no significant difference (p<0.05) between the groups treated with chlorhexidine gel when compared with the placebo group in the reduction of plaque and gingival scores. The results indicated that different formulations of chlorhexidine gel did not produce an effective inhibitor of plaque growth. Within the limitations of the present study design, further studies are required to clarify the role of chlorhexidine to prevent caries and periodontal disease.

Aspectos clínicos da utilizaçãodo gel de papaína e cloramina na remoção da cárie dentária / Clinical aspects of the use of papain and chloramine gel for dental caries removal

O método químico-mecânico de remoção da dentina cariada permite preservação da estrutura dentária, pois remove a dentina infectada e mantém a afetada. Este trabalho teve como objetivo relatar, por meio de dois casos clínicos, a utilização de um gel a base de papaína em lesões de cárie em dentina de um dente decíduo e um permanente. Nos casos clínicos apresentados, o gel de papaína foi capaz de remover a dentina cariada; no entanto, sua aplicação em cavidade profunda não evitou a ocorrência de sensibilidade dolorosa e exposição pulpar. Também foi necessária a utilização de instrumentos rotatórios para obtenção de acesso à cavidade

Pulpotomies with portland cement in human primary molars

Two clinical cases in which Portland cement (PC) was applied as a medicament after pulpotomy of mandibular primary molars in children are presented. Pulpotomy using PC was carried out in two mandibular first molars and one mandibular second molar, which were further followed-up. At the 3, 6 and 12-month follow-up appointments, clinical and radiographic examinations of the pulpotomized teeth and their periradicular area revealed that the treatments were successful in maintaining the teeth asymptomatic and preserving pulpal vitality. Additionally, the formation of a dentin bridge immediately below the PC could be observed in the three molars treated. PC may be considered as an effective alternative for primary molar pulpotomies, at least in a short-term period. Randomized clinical trials with human teeth are required in order to determine the suitability of PC before unlimited clinical use can be recommended.