The analyst's vitalizing function and the living word in the analysis room: from Thomas Ogden / A função vitalizadora do analista e a palavra viva na sala de análise: reflexões a partir de thomas ogden

RESUMO: O presente artigo tem como objetivo apresentar algumas ideias de Thomas Ogden sobre a importância dada aos sentimentos de vitalidade e desvitalização, como medida fundamental para o entendimento do que ocorre no processo analítico. Com o uso de duas vinhetas clínicas de uma das autoras, pretendeu-se a articulação com as ideias de Ogden, destacando-se o encaminhamento para um encontro vitalizado entre analista e paciente por meio de uma linguagem viva, visando a busca da verdade emocional conectada à vitalidade da sessão.

Abstract: This article aims to present some ideas by Thomas Ogden on the importance given to feelings of vitality and devitalization, as a fundamental measure for understanding what happens in the analytical process. With the use of two clinical vignettes by one of the authors, the intention was to articulate with Ogden's ideas, highlighting the referral to a vitalized encounter between the analyst and the patient through a living language, aiming at the search for connected emotional truth to the vitality of the session.

Early loss of primary molar and permanent tooth germ caused by the use of devitalizer during primary molar root canal therapy: Two cases report / 北京大学学报(医学版)

Devitalization has been widely used in the root canal therapy of primary and permanent teeth in China more than ten years ago. With the development of local anesthetic drugs and injection technologies, this treatment method with high potential risks has been gradually abandoned. However, a questionnaire survey targeted all the participants at the 2018 China Pediatric Dentistry Conference showed that the devitalizer utilization proportion was still as high as 38.1% (383/1 005), even though the ratio was much lower than 75.5% (105/139) in 2003. These doctors had pay more attention to tissue burn caused by devitalizer marginal leakage or direct leakage, and know how to identify and handle with devitalizer burn. Devitalizers were usually made of arsenic trioxide, metal arsenic or paraformaldehyde, which have cytotoxicity, allergenicity, mutagenicity, carcinogenicity, and teratogenic effects on animals. Marginal leakage of devitalizers have high risks of causing soft and hard tissue necrosis. Most of the dentists have an understanding of the potential damages of arsenic containing devitalizers, so they will choose parafor maldehyde with relatively less toxicity. Paraformaldehyde has a certain self limitation, and there are few cases reported, so some dentists lack of vigilance. Paraformaldehyde can also causes tissue necrosis if leakage happens, and the treatment methods are similar to that of arsenic containing devitalizers. When handling with devitalizers burn, the necrosed soft and hard tissue, for example gingiva, alveolar bone or teeth that cannot keep, must be completely removed until fresh blood appears, then rinse with large amount of saline and seal with iodoform gauze. This paper described two cases of devitalizer burn during the root canal treatment of primary molars, both of the doctors failed to identify the devitalizer burn symptoms in the early stage, thus didn't do proper treatments immediately after burning. Resulting in the necrosis of large area of gingiva and alveolar bone, loss of primary molars and permanent tooth germs 1-2 months after devitalizer burn. This paper reported these two cases in detail in order to warn dentists the high risks of using any kind of devitalizers, help them learn how to identify and treat devitalizer burn, and remind them to stop using devitalizers as soon as possible.

Exploration Study of the osteosarcoma devitalization technique by vacuum dehydra-tion at room temperature / 中国肿瘤临床

Objective:To demonstrate the feasibility of the osteosarcoma devitalization method by vacuum dehydration at room tem-perature. Methods:For the in vivo study, the VX2 tumor mass was treated by vacuum dehydration, rehydrated in ice water, and im-planted in the rabbit to determine the safety time to deactivate the tumor. For the in vitro study, the osteosarcoma mass was devital-ized by vacuum dehydration, and the dehydration rate and ATPase activity were determined. Histopathological changes in the tumor were also observed. The change in the biomechanical strength of rabbit bone and tendon after vacuum devitalization treatment was detected. Results:At room temperature, the safety time to deactivate the VX2 tumor was 60 min, and the dehydration rate was 93.8%at this time point. After vacuum dehydration, the tumor mass evidently shrunk, presenting a porous structure. The osteosarcoma cell became small, and cell structure damage was observed under light microscope. Disrupted cell membrane and organelles were seen un-der transmission electron microscope as well as broken down chromosomes. The activity of ATPase was evidently lower than in the control group. The strength of bone and tendon did not decrease significantly after vacuum dehydration. Conclusion:Treatment by vacuum dehydration at room temperature for 60 min does not result in differences of the bone and tendon strength. However, it can inactivate both soft tissue and bone tumor mass completely.

Aparato removible para tracción del canino retenido en el paladar / Removable device to draw out the canine retained in the palate

La corrección de los caninos retenidos en el paladar mediante aparatos fijos, ocasionan a veces desvitalización de los dientes vecinos, debido a la proximidad de la corona de estos con las raíces de los incisivos. La dirección de la fuerza de tracción lograda con técnicas fijas puede provocar estas desafortunadas secuelas. En este se trabajo se muestra la confección de un aparto removible, con el objetivo de traccionar al canino superior cuando se encuentra retenido en posición palatina. El diseño se realizó a partir de una placa de Hawley, que se le acopla un resorte en forma de imperdible, donde una parte de este queda dentro del acrílico y la otra, que constituye el elemento activo, será insertada al dispositivo pegado en el diente retenido. La ubicación de este elemento activo, permite orientar la dirección del vector de fuerza, de manera que evite lesionar a dientes vecinos. Se ha observado que este aparato mejora el pronóstico y reduce riesgo de reabsorción radicular, considerándose que es útil para el inicio del tratamiento de los caninos retenidos en el paladar.

The correction of the canines retained in the palate through fixed devices leads sometimes to the devitalization of the neighbor teeth, due to the proximity of their corona with the root of the incisive. The direction of the traction force achieved with fixed techniques can provoke these undesirable sequels. In this work we show the confection of a removable device to draw the superior canine out when it is retained in the palatal position. The design was made based in a Hawley plate, adding a spring in the form of a safety pin. A part of the spring stays inside the acrylic plate, and the other, the active element, is inserted in the device tied to the retained teeth. The position of this active element allows orientating the direction of the force vector, in a way avoiding the lesion of the neighbor teeth. We observed that this device improves the prognosis and reduces the risk of the root reabsorption, and it is useful to start the treatment of the canines retained in the palate.

Effects of different output power high frequency currents on experimental animals' pulp devitalization / 实用口腔医学杂志

Objective:To observe the effects of high-frequency current on rabbits dental pulp and to provide experimental evidences for clinic research.Methods:60 healthy 3 months old rabbits were divided into 4 experimental groups and 2 control groups.Dental pulps of experimental groups were treated with high-frequency currents with output power of 5 W,10 W,15 W and 20 W respectively.Then the devitalization degree of injury of dental capsule of experimental groups were compared with treated by complex toad composition,a type of traditional pulp devitalized medicine.Results:The effects between the devitalized effect of high-frequency current under 15 W and that of the traditional medicine were similarly.The concomitant injury of root canal tubal wall and periapical were not detected.Dental pulp of deactivation was easy to be extirpated and bled little while being extirpated.Conclusion:The reliability and safety of 15 W high-frequency output current could be the important parameter for clinic application research.