New occurrences of mosquitoes (Diptera: Culicidae) in the Atlantic Forest biome of the Brazilian Northeast

ABSTRACT Background: Information regarding the distribution of Culicidae species in the northeastern region of Brazil is scarce. Methods: Immatures were collected from approximately four fragments of the Atlantic Forest. Results: This study presents new occurrences of 18 Culicidae species in Pernambuco state: Anopheles kompi, Georgecraigius fluviatilis, Culex bidens, Culex chidesteri, Culex bastagarius, Culex imitator, Mansonia humeralis, Wyeomyia incaudata, Uranotaenia apicalis, Culex mollis, Culex usquatus, Culex dunni, Culex serratimarge, Culex ybarmis, Culex microphyllus, Sabethes purpureus, Wyeomyia pilicauda, and Wyeomyia airosai. The last nine species were also new records for the northeast region. Conclusions: With the inclusion of these newly recorded species, the total number of mosquitoes documented in Pernambuco state now rises to 94.

Cunoniaceae, nuevo registro de familia de plantas hospederas para los géneros altoandinos Penaincisalia y Micandra (Lycaenidae: Theclinae: Eumaeini) / Cunoniaceae, new family food plant record for the high altitude Andean genera Penaincisalia and Micandra (Lycaenidae: Theclinae: Eumaeini)

Resumen Orugas de dos especies altoandinas de Eumaeini (Lycaenidae: Theclinae) fueron halladas consumiendo hojas de Weinmannia crassifolia Ruiz & Pav., 1802 (Cunoniaceae). La colecta se realizó usando la técnica de colecta por golpeo. Esta familia de plantas es registrada por primera vez como planta alimenticia de los Eumaeini. Aunque no pudimos completar la crianza, las especies de Lycaenidae fueron identificadas mediante sus códigos de barra de ADN. Las orugas de Penaincisalia purpurea (K. Johnson, 1992) y Micandra dignota (Draudt, 1919) se describen e ilustran por primera vez. También se presentan datos sobre su ecología y relaciones con especies similares. Una tercera especie, registrada en estadio pupal en la misma planta de W. crassifolia fue un Nymphalidae, Perisama diotima (Hewitson, 1852).

Abstract Caterpillars of two Andean species of Eumaeini (Lycaenidae: Theclinae) were found eating leaves of Weinmannia crassifolia Ruiz & Pav., 1802 (Cunoniaceae). They were collected by "beating" the leaves. This plant family is reported for the first time as a food plant for Eumaeini. Although it was not possible to rear the caterpillars to the adult stage, we identified them using DNA barcodes. The caterpillars of Penaincisalia purpurea (K. Johnson, 1992) and Micandra dignota (Draudt, 1919) are described and illustrated for the first time. Data on their ecology and relationships with similar species are also presented. A third species collected on the same plant of W. crassifolia in the pupal stage was a Nymphalidae, Perisama diotima (Hewitson, 1852).

Utility of immature granulocyte in severity of helicobacter pylori infection

Introduction: Helicobacter pylori infection is a chronic bacterial infection associated with some extragastric diseases as well as gastric involvements that occur most commonly worldwide. In our study, we aimed to investigate the usability of immature granulocytes as a basic indicator that can reflect the severity of helicobacter pylori inflammation, to the best of our knowledge, for the first time. Materials and Methods: Patients who underwent upper gastrointestinal endoscopy between April 2019 and April 2020 and were diagnosed with antral gastritis were included in this study. The relationship between helicobacter infection and its severity detected in gastric biopsies of patients and immature granulocyte count (IGC), immature granulocyte percentage (IG%), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) were investigated. Results: Of the 868 patients, 210 were HP negative, 658 were HP positive (218 mild HP positive, 293 moderate HP positive, and 147 severe HP positive). There were statistically significant differences between the HP negative and HP positive groups in terms of IGC, IG%, NLR, and PLR. However, IG% and IGC were not clinically useful because the median IG% (0.3 vs 0.3) and IGC (0.02 vs 0.02) were the same in the HP negative and total HP positive groups. Conclusion: In our study, IGC and IG% were not found useful to detect H. pylori intensity and severity of inflammation.

Novel management of internal root resorption with vertical root fracture using mineral trioxide aggregate - A case report

Introduction: This case report presents the diagnosis and management of extensive internal root resorption (IRR) in a 17?year?old male patient, with a 9?year?old history of trauma. Method: The affected tooth 21 was associated with vertical root fracture (VRF) and incomplete apex closure with a substantial loss of tooth structure, including dentin and cementum. Encouraged by a healthy periodontal condition, the choice was made to use mineral trioxide aggregate (MTA) to reconstruct and reinforce the resorptive defect and the fractured segment. A composite veneer was placed to enhance the aesthetics. Result: A follow?up of the patient after 2 years revealed healing with a resolution of the lesion. Conclusion: This case report highlights the use of MTA as a lone?standing filling material for the treatment of IRR with VRF in a non?vital immature tooth

A segmental root development as an unusual healing response to the revitalization of mandibular second premolar

A 15-year-old patient reported persistent pain in the left mandibular second premolar (#35) following a traumatic bite 3 months ago. Clinical examination revealed a fractured central cusp suggestive of dens evaginatus. Intraoral periapical radiograph revealed an immature permanent tooth with a periapical radiolucency. A diagnosis of pulp necrosis with symptomatic apical periodontitis was made. The tooth was treated according to the revised guidelines of regenerative endodontic procedure by the American Association of Endodontics. The follow-up evaluation revealed a complete resolution of periapical pathology. A detached radiopaque tissue was appreciated at the 12-month follow-up. It resembled a broken root tip at the 24-month follow-up. Both the main root body and disjointed root tip developed independently. A cone-beam computed tomography evaluation at the 36-month follow-up confirmed the segmented development of the apical root tip.

Immature cystic teratoma with contralateral mature cystic teratoma in a pediatric patient: Operative and ethical considerations to management

@#Immature cystic teratoma (IMCT) is a rare ovarian malignancy, usually presenting as a huge unilateral pelvoabdominal mass in the pediatric age. Even rarer is the occurrence of a concomitant contralateral mature cystic teratoma. Management issues include use of fertility sparing versus complete surgical staging, and the use of chemotherapy. Fortunately, IMCT carries a good prognosis, especially when diagnosed early. Chemotherapy is used only in higher stage disease and recurrence.

A case report of primary renal immature teratoma / 中华泌尿外科杂志

Teratoma is a rare tumor, mainly occurring in the ovary, sacrococcygeal region, testis, central nervous system and mediastinum, rarely occurring in the kidney, and adult immature teratoma originating in the kidney is extremely rare. A case of adult left renal immature teratoma was reported in this paper. After radical nephrectomy, pathological examination found that the tumor tissue contains malignant epithelial tissue and a small number of brain tissue. BEP regimen chemotherapy was performed after operation.The patient was followed up for 26 months, and died of organ failure caused by systemic metastasis.

The osteogenic niche-targeted arsenic nanoparticles prevent colonization of disseminated breast tumor cells in the bone

Up to 70% of patients with late-stage breast cancer have bone metastasis. Current treatment regimens for breast cancer bone metastasis are palliative with no therapeutic cure. Disseminated tumor cells (DTCs) colonize inside the osteogenic niches in the early stage of bone metastasis. Drug delivery into osteogenic niches to inhibit DTC colonization can prevent bone metastasis from entering its late stage and therefore cure bone metastasis. Here, we constructed a 50% DSS6 peptide conjugated nanoparticle to target the osteogenic niche. The osteogenic niche was always located at the endosteum with immature hydroxyapatite. Arsenic-manganese nanocrystals (around 14 nm) were loaded in osteogenic niche-targeted PEG-PLGA nanoparticles with an acidic environment-triggered arsenic release. Arsenic formulations greatly reduced 4T1 cell adhesion to mesenchymal stem cells (MSCs)/preosteoblasts (pre-OBs) and osteogenic differentiation of osteoblastic cells. Arsenic formulations also prevented tumor cell colonization and dormancy via altering the direct interaction between 4T1 cells and MSCs/pre-OBs. The chemotactic migration of 4T1 cells toward osteogenic cells was blocked by arsenic in mimic 3D osteogenic niche. Systemic administration of osteogenic niche-targeted arsenic nanoparticles significantly extended the survival of mice with 4T1 syngeneic bone metastasis. Our findings provide an effective approach for osteogenic niche-specific drug delivery and suggest that bone metastasis can be effectively inhibited by blockage of tumor cell colonization in the bone microenvironment.

Recent advances on the role of various cells-derived exosomes in ocular surface / 中华实验眼科杂志

Exosomes are membranous vesicles secreted by cells and can be widely involved in intercellular communication, anti-inflammation, immunoregulation, etc.Mesenchymal stem cell (MSC), regulatory T cell (Treg), immature dendritic cell (imDC) and myeloid-derived suppressor cell (MDSC) are the main ocular surface-related exosomes origins.Exosomes derived from different cells play their roles by delivering different biological molecules to recipient cells.Exosomes derived from MSC play a positive role in ocular surface inflammation and immune-related diseases by inhibiting T cell proliferation, transforming macrophage phenotype, regulating T helper (Th) cell differentiation and up-regulating Treg expression, reduce neovascularization and inflammation, and foster a microenvironment to promote corneal wound healing at the same time.Exosomes derived from Treg contain inducible NO synthase and microRNA (miRNA) including miR-503, miR-330 and miR-9, which can interfere with cell cycle progression, induce apoptosis, induce the differentiation of other T cells into Treg phenotype, inhibit T cell allograft rejection to induce immune tolerance.Exosomes derived from imDC inhibit corneal allograft rejection by delivering miR-682.MDSC-derived exosomes promote Treg expansion in vivo and in vitro, inhibit the proliferation and cytotoxicity of activated T cells, and express miR-29a-3p and miR-93-5p, which can inhibit the differentiation of Th1 and Th17 cells.Given the anti-inflammatory and immunosuppressive effects of exosomes, this paper reviewed the studies on ocular surface inflammation and immune-related diseases such as corneal injury, mucopolysaccharide storage disease, dry eye, Sj?gren syndrome and ocular graft-versus-host disease.

Immature Brain Teratoma of An Infant In A University Hospital: A Case Report

@#Teratomatous tumours of the head are rather uncommon. We report a 3-month-old child who presented with acute signs of raised intracranial pressure, needing craniectomy and subtotal tumour removal. The patient was diagnosed as intracranial immature teratoma grade 3, from the pathological study and elevated alpha-fetoprotein (AFP). Managing brain teratoma posed a challenge to the managing team due to the location of the tumour, the unavailability of standardized chemotherapy protocol and the dilemma of commencing adjuvant chemotherapy in a very young infant. The tumour was partially removed due to its critical location. And chemotherapy was delayed until the patient achieved 7 months of age. After four rounds of chemotherapy, the patient remained in remission for more than three years follow up.

First record of Pachybrachis Chevrolat, 1836 (Coleoptera: Chrysomelidae: Cryptocephalinae) on Spermacoce verticillata L. (Rubiaceae) and synthesis of its plant associations in Brazil

This study reports Pachybrachis sp. association with a new host, Spermacoce verticillata L. (Rubiaceae). It synthesizes Brazil locality records and host plant records from literature. Specimens of adults and larvae were collected on the host in an urban area of Maceió, Alagoas, Brazil. Larvae and adults were reared on the host plant in the laboratory, using fresh plant tissue daily.

Este estudio presenta la asociación de Pachybrachis sp. con un nuevo huésped, Spermacoce verticillata L. (Rubiaceae). En este trabajo se dan a conocer las localidades registradas en Brasil para la especie y los registros de plantas huésped mencionados en la literatura. Se recolectaron especímenes de adultos y larvas sobre el huésped en un área urbana de Maceió, Alagoas, Brasil. Las larvas y los adultos se criaron en la planta huésped en el laboratorio, utilizando tejido vegetal fresco a diario.

Fracture resistance of simulated immature teeth reinforced with different mineral aggregate-based materials

Abstract This study assessed the fracture resistance of simulated immature teeth reinforced with calcium aluminate cement (CAC) or mineral trioxide aggregate (MTA) containing calcium carbonate nanoparticles (nano-CaCO3). The microstructural arrangement of the cements and their chemical constitution were also evaluated. Forty-eight canines simulating immature teeth were distributed into 6 groups (n=8): Negative control - no apical plug or root canal filling; CAC - apical plug with CAC; CAC/nano-CaCO3 - apical plug with CAC+5% nano-CaCO3; MTA - apical plug with MTA; MTA/nano-CaCO3 - apical plug with MTA+5% nano-CaCO3; and Positive control - root canal filling with MTA. The fracture resistance was evaluated in a universal testing machine. Samples of the cements were analyzed under Scanning Electron Microscope (SEM) to determine their microstructural arrangement. Chemical analysis of the cements was performed by Energy Dispersive X-ray Spectroscopy (EDS). The fracture resistance of CAC/nano-CaCO3 was significantly higher than the negative control (p<0.05). There was no significant difference among the other groups (p>0.05). Both cements had a more regular microstructure with the addition of nano-CaCO3. MTA samples had more calcium available in soluble forms than CAC. The addition of nano-CaCO3 to CAC increased the fracture resistance of teeth in comparison with the non-reinforced teeth. The microstructure of both cements containing nano-CaCO3 was similar, with a more homogeneous distribution of lamellar- and prismatic-shaped crystals. MTA had more calcium available in soluble forms than CAC.

Resumo Este estudo avaliou a resistência à fratura de dentes imaturos simulados reforçados com cimento de aluminato de cálcio (CAC) ou trióxido agregado mineral (MTA) contendo nanopartículas de carbonato de cálcio (nano-CaCO3). O arranjo microestrutural dos cimentos e sua constituição química também foram avaliados. Quarenta e oito caninos simulando dentes imaturos foram distribuídos em 6 grupos (n=8): Controle negativo - sem plug apical ou obturação do canal radicular; CAC - plug apical com CAC; CAC/nano-CaCO3 - plug apical com CAC + 5% nano-CaCO3; MTA - plug apical com MTA; MTA/nano-CaCO3 - plug apical com MTA + 5% nano-CaCO3; e Controle positivo - obturação dos canais radiculares com MTA. A resistência à fratura foi avaliada em máquina universal de ensaios. Amostras dos cimentos foram analisadas em Microscópio Eletrônico de Varredura (MEV) para determinar seu arranjo microestrutural. A análise química dos cimentos foi realizada por Espectroscopia de Energia Dispersiva de Raio-X (EDS). A resistência à fratura de CAC/nano-CaCO3 foi significativamente maior do que o controle negativo (p<0,05). Não houve diferença significativa entre os outros grupos (p>0,05). Ambos os cimentos apresentaram microestrutura mais regular com a adição de nano-CaCO3. As amostras de MTA apresentaram mais cálcio disponível em formas solúveis do que CAC. A adição de nano-CaCO3 ao CAC aumentou a resistência à fratura dos dentes em comparação aos dentes não reforçados. A microestrutura de ambos os cimentos contendo nano-CaCO3 foi semelhante, com uma distribuição mais homogênea de cristais de formato lamelar e prismático. MTA apresentou mais cálcio disponível nas formas solúveis do que CAC.

Distribución espacial y variables explicativas de capturas de Thunnus albacares (Perciformes: Scombridae) y especies no objetivo por la flota internacional de cerco en el Pacífico de Costa Rica / Spatial distribution and correlates for catches of Thunnus albacares (Perciformes: Scombridae) and non-target species by the international purse-seine fleet in the Pacific of Costa Rica

Introducción: En los ambientes marinos del Pacífico de Costa Rica, la actividad pesquera por la flota cerquera internacional es importante debido a su amplio alcance y fuerte impacto. Objetivo: Evaluar la distribución espacial de la captura de atún aleta amarilla y especies no objetivo por esa flota, y posibles correlaciones con variables ambientales y pesqueras. Métodos: Aplicamos estadísticas geoespaciales y modelos de regresión múltiple en datos de la Comisión Interamericana del Atún Tropical, del 2002 al 2011. Utilizamos una grilla del tamaño de la Zona Económica Exclusiva (ZEE) con 1 124 celdas de 22 x 22 km (unidad de análisis), para un total de 11 240 celdas-año. Resultados: El atún mediano (presumiblemente inmaduro en su mayoría), delfines, mantas y rayas fueron capturados mayormente dentro del Domo Térmico (noreste de la ZEE). Las más altas capturas de atún pequeño (inmaduro en su totalidad), tiburones, picudos, dorado, peto y diversas especies pequeñas, ocurrieron en el extremo sur. El atún grande (maduro) fue capturado especialmente en el centro de la ZEE, hacia el este del Área Marina de Manejo Montes Submarinos y el Parque Nacional Marino Isla del Coco. Los atunes, dorado, delfines, mantas y rayas mostraron gran fidelidad de sitio por asociación con variables geográficas y ambientales, a la vez que el atún pequeño estuvo asociado a lances sobre objetos flotantes y el atún grande a lances sobre delfines. La heterogeneidad de las especies no objetivo probablemente escondió la mayoría de las correlaciones. Conclusiones: La pesca está afectando los niveles tróficos más altos y es necesario un diseño de zonificación ajustado para proteger mejor el domo térmico y considerar la susceptibilidad al uso de redes de cerco.

Introduction: In the Pacific marine ecosystems of Costa Rica, fishing activity by the international purse-seine fleet is important for its wide scope and large impact. Objective: To evaluate the spatial distribution of the catch of yellowfin tuna and non-target species by this fleet, and possible correlates with environmental and fishing variables. Methods: We applied geospatial statistics and multiple regression models to Inter-American Tropical Tuna Commission data, covering from 2002 to 2011. We used a grid the size of the Exclusive Economic Zone (EEZ) with 1 124 cells of 22 x 22 km (unit of analysis), for a total of 11 240 year-cells. Results: The medium tuna (presumably immature for the most part), dolphins, mantas and rays dominated catches within the Thermal Dome (Northeast of the EEZ). Small tuna (all immature), sharks, billfishes, dorado, wahoo, and various small species were caught mostly in the extreme South. Large tuna (mature) was caught specially in the zone center, towards the east of the Submarine Mounts Marine Management Area and the Isla del Coco National Marine Park. Tuna, dorado, dolphins, mantas and rays showed high site fidelity due to their association with geographic and environmental variables, at the time small tuna was associated with sets on floating objects, and big tuna was associated with sets on dolphins. The heterogeneity of non-target species probably hid most correlations. Conclusions: Fishing is affecting the highest trophic levels and an adjusted zoning design is needed to better protect the thermal dome and to take into account susceptibility to the use of purse seines.

The ability of platelet-rich plasma to regenerate a non-vital immature permanent teeth / Capacidade do plasma rico em plaquetas de regenerar dentes permanentes imaturos não vitais

Objective: To test the ability of platelet-rich plasma clinically and radiologically for pulp regeneration of immature teeth with apical periodontitis. Material and Methods: An experimental study was conducted From (March/2018-July/2020) 12 upper central immature incisors with acute apical periodontitis and necrotic pulp from six patients receiving regenerative endodontic treatment using concentrated platelets rich plasma were performed by the same endodontist at Mediclinic Middle East Hospitals. Informed consent, including explanation of risks and alternative treatments or no treatment were prepared and filled by the patient parents. The therapeutic protocol was involved accessing the pulp chamber; irrigation copiously with sodium hypochlorite; applying calcium hydroxide as intracanal medicament and a provisionally sealing it after 4 weeks. The canal was cleaned, dried and injected with concentrated platelets rich plasma which serve as a scaffold for pulp regeneration. MTA was used to seal the chamber before final filling with composite. Evaluations: All teeth were monitored clinically (mobility, palpation, percussion, and sensitivity cold test) and radiographically. Results: Twenty months follow-up all teeth showed resolution of periapical radiolucencies, continued root development with positive response to sensitivity cold test and no discoloration. Conclusion: The results of this study confirmed the previous finding that pulp regeneration can be gained by using cPRP successfully. (AU)

Objetivo: Testar a capacidade do plasma rico em plaquetas clinicamente e radiograficamente para a regeneração pulpar em dentes imaturos com periodontite apical. Material e Métodos: O estudo experimental foi realizado em Março/2018 e Julho/2020, 12 incisivos centrais imaturos com periodontite apical aguda e necrose pulpar em 6 pacientes recebendo tratamento endodôntico regenerativo usando concentrado de plasma ricas em plaquetas. Foram realizadas pelo mesmo endodontista no Hospital Mediclinic Middle East. O consentimento informado incluindo explicação do risco e tratamentos alternativos ou de nenhum tratamento foi preenchido pelos responsáveis do paciente. O protocolo terapêutico envolveu acesso à câmara pulpar, irrigação abundante com hipoclorito de sódio, aplicação de hidróxido de cálcio como medicação intracanal e selado intracanal por 4 semanas. O canal foi limpo, seco e injetado concentrado de plasma rico em plaquetas que servem como um scaffold para a regeneração pulpar. Usou-se MTA para selar a câmara antes do preenchimento final com compósitos. Avaliações: Todos os dentes foram monitorados clinicamente (mobilidade, palpação, percussão e teste de sensibilidade com frio) e radiograficamente. Resultados: Após 20 meses de acompanhamento, todos os dentes apresentaram a resolução das radioluscências periapicais, desenvolvimento contínuo da raiz com resposta positiva ao teste de sensibilidade ao frio e sem descoloração. Conclusão: O resultado do estudo confirmou descobertas anteriores que a regeneração pulpar pode ser obtida usando cPRP com sucesso. (AU)

Milky Stage Versus Dough Stage of Immature Wheat Grain: Effects on Phytic Acid and Fructan Contents, Antioxidant Activity, Textural Parameters, and Sensory Characteristics of Set-Type Yoghurts

HIGHLIGHTS Yoghurts were supplemented with milky and dough stage wheat grain flours. Total antioxidant capacity was improved by wheat grain flour supplementation. Milky stage wheat provided higher fructan content than that of dough stage wheat. Fermentation reduced phytic acid levels in yoghurts containing wheat grain flours.

Abstract Experimental design was performed by using immature wheat grain (IWG) harvested in two different maturation stages for set-type yoghurt production. IWG was harvested at milky (20 days after anthesis) and dough (30 days after anthesis) stages and was milled. Yoghurt samples were supplemented with milky stage grain flour (MSGF) and dough stage grain flour (DSGF) at 1, 2, and 3% concentrations except for control. All treatments were evaluated with respect to physicochemical, antioxidative, microbiological, textural, and sensorial aspects throughout the 28 days of storage. Phytic acid content of all samples diminished depending on increasing pH values over the storage while it was found higher in MSGF fortified yoghurts. The highest fructan content was determined in yoghurt fortified with 3% MSGF. Antioxidant activity and total phenolic content of yoghurts were improved with IWG fortification. MSGF showed higher antioxidant activity as compared to DSGF. On the other hand, DSGF addition presented better water holding capacity in comparison with MSGF. Likewise, DSGF provided higher firmness and consistency values. Firmness was enhanced with IWG supplementation by reducing syneresis except 1% MSGF added samples. The addition of IWG was found to slightly increase the growth of yoghurt bacteria. Both DSGF and MSGF had adverse effect on the sensory characteristics of yoghurts with their increasing concentrations. Based on the results of this study, to obtain better textural properties and higher antioxidant activity, IWG in different ripening stages can be tried with half combinations (total 3%) in yoghurt. Also, sensorial properties can be improved by flavoring agents.

Effect of orthodontic forces on root length of immature mandibular second premolars: a split-mouth randomized clinical trial

ABSTRACT Objective: To assess the effect of orthodontic forces on changes in root length of immature mandibular second premolars. Methods: Sixty-four mandibular second premolars (MSP) with immature apices (left and right sides) of 32 patients aged between 10 and 13 years were evaluated. Orthodontic treatment was started after obtaining periapical radiographs (T1) from the MSPs of each patient. Brackets were bonded, except the ones of MSPs (left or right by random as control MSP, and the other side as test MSP). After 9-12 months, a second periapical radiograph (T2) was obtained from the MSPs of each patient. Then, brackets were bonded to the control MSPs, which were not bonded before. After 18 ± 3 months, a third periapical radiograph (T3) was obtained. Changes in root length were evaluated by using a new formula. The test and control MSPs at T1, T2 and T3 were compared using repeated measures ANOVA and parametric tests. P-value smaller than 0.05 was statistically significant. Results: There was no significant difference between the test and control groups in the mean root length of MSP at T1 (p= 0.48) and T3 (p= 0.078). The root length at T2 (p= 0.001) was significantly different between test and control MSPs, and the test group showed longer root length than the control group. Conclusions: Orthodontic force applied for leveling and alignment of immature MSPs may not have destructive effects on the roots, and may accelerates root formation in short-term. Normal root length was achieved at the end of root development.

RESUMO Objetivo: Avaliar o efeito das forças ortodônticas nas mudanças do comprimento radicular de segundos pré-molares inferiores com raízes incompletas. Métodos: Foram avaliados 64 segundos pré-molares inferiores (SPI) com raízes incompletas (lados direito e esquerdo da mandíbula) de 32 pacientes com idades entre 10 e 13 anos. O tratamento ortodôntico teve início após a obtenção de radiografias periapicais (T1) dos SPIs de cada paciente. Foram colados braquetes em todos os dentes, com exceção dos SPIs (do lado esquerdo ou direito, de forma aleatória, como grupo controle; e o SPI contralateral como grupo teste). Após 9 a 12 meses, uma segunda radiografia periapical (T2) foi obtida dos SPIs de cada paciente. Então, braquetes foram colados nos SPIs do grupo controle, que não haviam sido colados anteriormente. Após 18 ± 3 meses, uma terceira radiografia periapical (T3) foi obtida. As mudanças no comprimento radicular foram avaliadas por meio de uma nova fórmula. Os SPIs teste e controle foram comparados em T1, T2 e T3 usando ANOVA para medidas repetidas e testes paramétricos. Valores de p< 0,05 foram considerados estatisticamente significativos. Resultados: Não foi encontrada diferença significativa no comprimento radicular médio dos SPIs entre os grupos teste e controle em T1 (p= 0,48) e T3(p= 0,078). O comprimento radicular dos SPIs em T2 (p= 0,001) foi significativamente diferente entre os lados teste e controle, sendo que o grupo teste apresentou maior comprimento radicular do que o grupo controle. Conclusões: As forças ortodônticas aplicadas para o alinhamento e nivelamento de SPIs com raízes incompletas podem não ter efeitos danosos nas raízes, podendo, inclusive, acelerar a formação radicular em curto prazo. O comprimento radicular normal foi alcançado ao fim da formação radicular.

Tratamiento del Diente Permanente Necrótico. Un Cambio de Paradigma en el Campo de la Endodoncia / Treatment of the Necrotic Permanent Tooth. A Paradigm Shift in Endodontics

RESUMEN: El tratamiento de dientes inmaduros necróticos es hoy un gran desafío clínico. La ausencia de cierre del ápice y el reducido grosor de las paredes de la dentina hacen que el tratamiento endodóntico del diente sea difícil e impredecible. Tradicionalmente, estos dientes han sido tratados con apexificación y obturación del canal radicular, sin embargo, con este tratamiento el diente permanece desvitalizado y con paredes de dentina frágiles y cortas, lo que compromete su pronóstico. La endodoncia regenerativa, por el contrario, busca revitalizar el diente e inducir una maduración de la raíz, y se basa en la utilización de las células madre mesenquimales presentes en la región periapical, los factores de crecimiento presentes en la dentina y un andamio que permite el crecimiento de tejido nuevo al interior del canal. Los resultados clínicos son alentadores, ya que en general existe maduración de la raíz y revascularización del diente, sin embargo, el tejido neoformado es tejido de tipo reparativo y, a excepción de estudios ocasionales, no se ha observado regeneración de dentina y pulpa. La endodoncia regenerativa se originó para tratar dientes inmaduros necróticos. Sin embargo, recientemente, estudios preliminares han expandido la aplicación de la endodoncia regenerativa a dientes maduros necróticos, es decir, en pacientes adultos. Los resultados clínicos son positivos y similares a los del diente inmaduro, si n embargo, la investigación referente a la revitalización de dientes maduros se encuentra en etapas tempranas y requiere de un mayor nivel de evidencia antes de ser ofrecida sistemáticamente como terapia a pacientes adultos. Los beneficios potenciales justifican mayor investigación al respecto. Este artículo resume la evidencia científica disponible con respecto a la revitalización de dientes inmaduros y maduros necróticos, sus fundamentos biológicos, los resultados esperados y limitaciones, así como el protocolo clínico.

ABSTRACT: Nowadays, the treatment of immature necrotic teeth is an important clinical challenge. The absence of apex closure and low thickness of the dentin walls, make endodontic treatment unpredictable and difficult. Traditionally, these teeth have been treated with apexification and obturation of the root canal. As a result of this treatment, the tooth remains devitalized and with fragile and short dentin walls, which compromises its prognosis. Regenerative endodontics, on the other hand, seeks to revitalize the tooth and induce root maturation, and is based on the use of mesenchymal stem cells present in the periapical tissues, growth factors present in the dentin and a scaffold that allows growth of new tissue in the root ca- nal. The clinical results are encouraging, since generally, there is root maturation and revascularization of the tooth. However, the newly formed tissue is reparative tissue and with the exception of some studies, no regeneration of dentin and pulp has been reported. Regenerative endodontics emerged to treat necrotic immature teeth. However, recently, preliminary studies have applied regenerative endodontics in mature necrotic teeth, in adult patients. Preliminary results are positive and are similar to those of immature teeth. Nevertheless, research regarding the revitalization of mature teeth is in the early stages and requires further evidence before being systematically administered as therapy in adult patients. However, the potential benefits justify further research in this regard. This article summarizes the available scientific evidence regarding the revitalization of immature and mature necrotic teeth, their biological basis, the expected results and limitations, as well as the clinical protocols for each case.

Pulpotomía parcial con agregado de trióxido mineral (MTA) comparado con hidróxido de calcio en caries dentinaria profunda en pacientes con dientes permanentes inmaduros / Partial pulpotomy with mineral trioxide aggregate (MTA) versus calcium hydroxide in immature permanent teeth with deep caries

RESUMEN: Introducción: La pulpotomía parcial se utiliza para el tratamiento de caries con exposición pulpar en dientes permanentes inmaduros. El agregado de trióxido mineral (MTA) ha sido propuesto como uno de los biomateriales de elección para el tratamiento, pero existe incertidumbre en relación a su efectividad comparado con la del hidróxido de calcio. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Encontramos cinco revisiones sistemáticas, que incluyeron tres estudios primarios, de los cuales todos corresponden a ensayos aleatorizados. Concluimos que la pulpotomía parcial con agregado de trióxido mineral (MTA) podría resultar en poca o nula diferencia en la tasa de éxito comparado a la pulpotomía parcial con hidróxido de calcio, pero la certeza de la evidencia es baja.

ABSTRACT: Introduction: Partial pulpotomy is the treatment of choice following carious pulp exposure in immature permanent teeth. Mineral trioxide aggregate (MTA) has been suggested as the biomaterial first option for treatment, but there is still uncertainty regarding its effectiveness compared to calcium hydroxide. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and conclusions: We identified five systematic reviews including three studies overall, of which all were randomized trials. We conclude that partial pulpotomy with mineral trioxide aggregate (MTA) may make little or no difference to success rate compared to partial pulpotomy with calcium hydroxide, however, the certainty of the evidence has been assessed as low.

12-year follow-up of regenerative endodontic treatment of immature permanent upper incisors with acute abscess

Abstract This case report discusses the endodontic treatment of a 7-year-old girl who suffered trauma (intrusion) to the immature upper central incisors secondary to a fall from a bicycle. Thirty days after the accident the patient was brought by her mother for clinical and radiographic assessment with a chief complaint of swelling and tenderness to percussion and palpation. Acute apical abscess associated with immature teeth were diagnosed. A decision was made to perform regenerative endodontic treatment. Access cavities were made and the root canals were disinfected by irrigation with 2.5% sodium hypochlorite. Final irrigation was performed with 17% EDTA. Due to pain and presence of secretions, 2% chlorhexidine gel was applied as an intracanal medicament. Seven days later, at the second visit, the root canals were once again disinfected and the canals of the right and left permanent upper central incisors were filled with double antibiotic paste (metronidazole/ciprofloxacin) and calcium hydroxide paste, respectively. Zinc oxide was mixed in both pastes. At the third visit, after 21 more days, the pastes were removed and the periapical areas were stimulated with a #80 K-file to encourage clot formation within the pulp cavities. A mineral trioxide aggregate (MTA) paste cervical plug was placed and the teeth were restored with glass ionomer cement. Radiographs and CBCT scans demonstrated complete root formations. The patient has been followed for 12 years, with evidence of clinical success throughout.

Resumo Este relato de caso discute o tratamento endodôntico de uma menina de 7 anos que sofreu trauma nos incisivos centrais superiores imaturos, após queda de bicicleta. Trinta dias após o acidente, a paciente foi levada pela mãe para avaliação clínica e radiográfica com queixa principal de inchaço e sensibilidade à percussão e palpação. Foram diagnosticados abscessos apicais agudos em ambos os dentes. Foi decidido por realizar o tratamento endodôntico regenerativo. Após acessos coronários, os canais radiculares foram submetidos à protocolos de antissepsia com auxílio de irrigação com hipoclorito de sódio a 2,5% e EDTA 17%. Devido à dor e presença de secreções, foi utilizada medicação intracanal com clorexidina gel 2% por 7 dias. Na segunda sessão, os canais radiculares foram novamente submetidos aos procedimentos de antissepsia e os canais dos incisivos centrais superiores permanentes direito e esquerdo foram preenchidos com pasta antibiótica dupla (Metronidazol / Ciprofloxacina) e pasta de hidróxido de cálcio, respectivamente. Em ambas as pastas foi adicionado o óxido de zinco. Na terceira sessão, após mais 21 dias, as pastas foram removidas e as regiões periapicais foram estimuladas com lima K nº 80 para incentivar a formação de coágulos sanguíneos no interior das cavidades pulpares. Tampões cervicais de MTA foram adaptados e os dentes restaurados com cimento de ionômero de vidro resinoso. Radiografias e tomografias computadorizadas demonstraram formações radiculares completas. A paciente é acompanhada há 12 anos, com evidências clínicas e radiográficas de sucesso.

A retrospective study on analyzing the role of oocyte maturation arrest as a causative factor for infertility in unexplained infertility

Background: Birth is often referred to as “the miracle of life” and very rightly so since successful pregnancy represents a complex, a highly coordinated succession of biological processes. In this regard, it is remarkable that pregnancy ever occurs at all. Infertility is a reproductive system disorder affecting 10.7% to 15.5% of couples. Highly heterogeneous in etiology. Investigating the cause is necessary for guiding treatment options. Aim of the study was to determine the percentage of immature oocytes retrieved at the metaphase 1 stage and germinal vesicle stage and its outcome.Methods: Total 30 cases were included for this retrospective analysis of data done at ARC fertility center, Saveetha Medical College. This study analyzed the data of patients with unexplained infertility who underwent ICSI centers (affiliated to Saveetha University) meeting inclusion criteria and willing to participate in the study.Results: The mean number of fertilized oocytes among those with more than 25% immature oocyte proportion was 1.18 while among those with less than 25% immature oocyte proportion was 4.13. The chance of fertilization of the oocyte increases when the percentage of immature oocyte was less than or equal to 25%. The association was found to be statistically significant with p-value <0.05.Conclusions: Thus, some intrinsic oocyte factor could be involved in causing maturation arrest in such couples and resulting in multiple failed IVF cycles.so this oocyte factor could be a major cause in many cases of unexplained infertility.