A 12-month Follow-Up Study of Pulp Oxygen Saturation in Deciduous Molars After Selective and Nonselective Carious-Tissue Removal: A Randomized Pilot Trial

ABSTRACT Objective: To compare the pulp vitality of deciduous molars before and after selective caries removal (SCR) or nonselective caries removal to hard dentin (NSCR) over one year, using oxygen saturation percentage (%SaO2). Material and Methods: Deciduous molars with deep occlusal/proximal-occlusal caries lesions were randomized to SCR (n=22) or NSCR groups (n=22). After the caries removal, the teeth were protected with calcium hydroxide cement and restored with composite resin (Filtek Z250). The pulp condition diagnosis was evaluated at baseline, immediately after caries removal, and follow-up (7 days, 1-, 6- and 12-months) by %SaO2. Pulp exposure and pulp necrosis were primary outcomes, and %SaO2 was secondary. Results: Intraoperative pulp exposure occurred in four teeth of the NSCR group (18.2%) and one tooth of the SCR group (4.5%) (p>0.05). Two cases of pulp necrosis occurred in the NSCR group (10%). No difference in %SaO2 pulp was observed in the inter-and intragroup comparison over time (p>0.05). Conclusion: Advantageously, the %SaO2 minimizes preoperatory pulp vitality diagnosis subjectivity before SCR/ NSCR treatments. Furthermore, the pilot study results suggest the pulp response of deciduous molars, when evaluated by clinical, radiographic, and pulp %SaO2 seems not to differ between teeth treated with SCR or NSCR.

Lesão endo-perio: classificação e diagnóstico / Endo-perio lesions: classifi cation and diagnosis

Lesões endo-perio são lesões inflamatórias que acometem, em diversos graus, tanto os tecidos periodontais como a polpa dental. O objetivo deste artigo é mostrar, através de uma revisão da literatura, a importância da classificação das lesões endo-perio, assim como o diagnóstico dessas lesões. A partir dos trabalhos revisados, conclui-se que as lesões endo-perio apresentam uma etiologia variada, sendo de fundamental importância o conhecimento do profissional quanto às causas e seu correto diagnóstico. Assim, para o sucesso e a resolução das lesões endo-perio, uma avaliação clínica e radiográfica eficaz determinará a correta classificação e, consequentemente, a melhor forma de tratamento.

Endo-periodontal lesions are inflammatory conditions that affect the periodontal tissues and the dental pulp. The aim of this article is to show the importance of the classification and the diagnosis of the endo-perio lesions. From the studies reviewed, it is concluded that endo-perio lesions present a varied etiology, being of fundamental importance the knowledge of the professional as to its causative factors and its correct diagnosis. Thus, for the success and resolution of endo-perio lesions an effective clinical and radiographic evaluation will determine the correct classification and consequently the best form of treatment.

Manejo de exacerbación en endodoncia / Exacerbation management in endodontics

Introducción: la exacerbación endodóntica es un problema con bajo reporte de incidencia que puede ocurrir después de un tratamiento de endodoncia por la agudización de una condición pulpar asintomática, así como por una afección perirradicular. Lesiones mecánicas y químicas se asocian con frecuencia con su aparición, sin embargo, la lesión causada por microorganismos y sus productos es la causa principal y más común de ella. Puede presentarse posterior a la realización del tratamiento en una cita o entre sesiones. Objetivo: reportar un caso de exacerbación en endodoncia y el manejo de esta. Presentación del caso: paciente femenina de 49 años que acude a consulta por dolor e inflamación luego de haber iniciado tratamiento de endodoncia. Se llevó a cabo el manejo clínico y farmacológico de la exacerbación en un diente con diagnóstico de periodontitis apical asintomática. Luego de 5 días se termina el tratamiento de conducto usando mineral trióxido agregado y gutapercha. Posteriormente el diente es restaurado y se realizan controles clínicos y radiográficos. Conclusiones: es posible prevenir este tipo de complicaciones de causa variable identificando factores de riesgo, así como por medio de la experiencia del clínico e instauración de protocolos de atención adecuados(AU)

Introduction: endodontic exacerbation is a problem with low incidence that can occur after endodontic treatment due to the aggravation of an asymptomatic pulp condition, as well as a periradicular affection. Mechanical and chemical injuries are frequently associated with their onset; however, the injury caused by microorganisms and their products is the main and most common cause for it. It can occur after the treatment is performed at an appointment or between sessions. Objective: to report a case of endodontic exacerbation and its management. Case presentation: a 49-year-old female patient presented with pain and inflammation after beginning the endodontic treatment. The clinical and pharmacological management of the exacerbation was carried out in a tooth with diagnosis of asymptomatic apical periodontitis. After 5 days, the root canal treatment is finished using mineral trioxide aggregate and gutta-percha. The tooth is then restored and clinical and radiographic controls are carried out. Conclusions: it is possible to prevent this type of complications of variable cause by identifying risk factors, as well as through the experience of the clinician and the establishment of proper management protocols(AU)

O Tabagismo e suas implicações na saúde pulpar e periodontal / El tabaquismo y sus consecuencias para la pulpa y la salud periodontal / Smoking and its impact on pulp and periodontal health

Introdução: o tabagismo é considerado um dos maiores problemas de saúde pública do mundo segundo a Organização Mundial de Saúde. Sabe-se que o tabagismo interfere de diferentes maneiras na saúde dos tecidos da cavidade oral, estando diretamente relacionado aos problemas de saúde bucal. Objetivo: realizar uma revisão bibliográfica sobre o tema Tabagismo e suas implicações na saúde pulpar e periodontal. Métodos: realizou-se um estudo por revisão criteriosa da literatura em artigos científicos publicados nos últimos 5 anos (2012-2016) sobre temas relacionados às seguintes combinações de descritores: polpa dentária e pulpectomia e periodontia e tabaco; polpa dentária e pulpectomia e tabaco; pulpectomia e tabaco; periodontia e tabaco. As bases de dados utilizadas foram: Pubmed; Google Acadêmico; Science Direct; SciELO e Lilacs. Foram encontrados 36 estudos com os descritores instituídos. Análise e integração de informações: os estudos demostraram que o consumo do tabaco e seus derivados influenciam diretamente na saúde e homeostasia dos tecidos pulpar e periodontal, estando relacionado à perda dentária e a um incremento na necessidade de tratamento endodôntico. Conclusão: O Tabagismo possui importantes implicações na saúde pulpar e periodontal, influenciando na fisiologia, no metabolismo e em alterações teciduais nos tecidos conjuntivo pulpar e no tecido periodontal(AU)

Introducción: el tabaquismo es considerado uno de los mayores problemas de salud pública del mundo, según la Organización Mundial de la Salud. Se sabe que fumar interfiere en diferentes formas sobre la salud del tejido de la cavidade bucal, está directamente relacionado con problemas de salud bucal. Objetivo: realizar una revisión de la literatura sobre el tema Tabaquismo y sus consecuencias para la pulpa y la salud periodontal. Métodos: se realizó una cuidadosa revisión de la literatura en los artículos científicos publicados en los últimos cinco años (2012-2016) en temas relacionados con las siguientes combinaciones de descriptores: pulpa dental y pulpectomía y periodoncia y tabaco; pulpa dental y pulpectomía y Tabaco; Pulpectomía y tabaco; periodoncia y tabaco. Las bases de datos utilizadas fueron: Pubmed; Google Académico; Science Direct; SciELO y Lilacs. Se encontraron 36 estudios con descriptores establecidos. Análisis e integración de la información: los estudios demostraron que el consumo de tabaco y sus derivados influyen directamente en la salud y la homeostasis de la pulpa y de los tejidos periodontales y se relaciona con la pérdida de dientes y un aumento en la necesidad de un tratamiento de endodoncia. Conclusiones: El tabaco tiene implicaciones significativas en la pulpa y la salud periodontal, de manera que influye en las alteraciones de la fisiología, el metabolismo y el tejido conectivo de la pulpa y el tejido periodontal(AU)

Introduction: according to the World Health Organization, smoking is one of the greatest public health problems worldwide. It is a well known fact that smoking interferes in different ways with the health of oral tissue, and is directly related to oral health problems. Objective: conduct a bibliographic review on the topic Smoking and its impact on pulp and periodontal health. Methods: a careful review was conducted of scientific papers published in the last five years (2012-2016) about topics related to the following descriptor combinations: dental pulp and pulpectomy and periodontics and tobacco; dental pulp and pulpectomy and tobacco; pulpectomy and tobacco; periodontics and tobacco. The databases used were PubMed, Google Scholar, Science Direct, SciELO and Lilacs. 36 studies were found based on the above descriptors. Data analyse and integration: the studies showed that the use of tobacco and its by-products directly impact the health and homeostasis of the pulp and periodontal tissues, and is related to tooth loss and an increase in the need for endodontic treatment. Conclusions: tobacco use significantly impacts pulp and periodontal health, causing physiological and metabolic alterations, and affecting the pulp connective tissue and the periodontal tissue(AU)

Evaluación in vitro de la adhesión de células troncales mesenquimales a matrices dentales impresas en tercera dimensión / In vitro Evaluation of the Mesenchymal Stem Cell Adhesion to 3D-Printed Dental Matrices

Antecedentes: En ingeniería de tejidos es fundamental estudiar el sinergismo entre las células troncales mesenquimales y el biomaterial para tener un mayor control sobre los biomiméticos. De esto depende el éxito de tratamientos de lesiones de tamaño crítico.Objetivo: Evaluar la adhesión celular in vitro de células troncales de la pulpa dental humana (CTPD) en matrices impresas con ácido poliláctico {API.).Métodos: Se utilizaron muestras de CTPD criopreservadas y expandidas, cultivadas sobre 24 matrices dentales impresas en 3D con APL, y que se analizaron los días 1, 7 y 15. Se evaluó la fenotipificacion de la CTPD por citometría de flujo y la adhesión celular a la matriz por medio de microscopio electrónico de barrido (SEM). Los datos se agruparon en porcentajes, tanto para el marcador analizado como para la cantidad de células adheridas. Resultados: Las CTPD expresaron positivamente anticuerpos CD73 y CD90 en casi un 100 % y CD 105 en un 56,7 %. Asimismo, expresaron negativamente anticuerpos CD34 y CD45 en más del 98 %. Se observó en SEM que a los 15 días el 99,88 % de las CTPD presentó forma fusiforme o estrellada, lo que significa que estas células se adhirieron a la matriz de APP.Conclusión : El APL no es citotóxico para las CTPD por su composición y características biocompatibles, lo que hizo posible que las células se adhirieran y proliferaran sobre la matriz dental impresa en 3D. Este fue un método in vitro efectivo para emplear en futuros estudios de regeneración de tejidos en odontología.

Background: In tissue engineering it is quite important to study the synergy between mesenchymal stem cells and biomaterials to better control the biomimetic elements. Success in the treatment of critical-size lesions depends strongly on this fact. Objective: To evaluate the in vitro human Dental Pulpal Stem Cell (DPSC) adhesion in printed matrices developed with polylactic acid (PLA). Methods'. Cryopreserved and enlarged DPSC samples were used in the culture of 24 dental 3D-printed matrices developed with PLA that were analyzed on days 1, 7 and 15. The DPSC typification was analyzed with flow cytometry and the cell adhesion to the matrix was analyzed under the scanning electron microscope (SEM). Data were gathered as percentages for both the analyzed marker and the amounts of adhered cells. Results: DPSCs expressed positively the CD73 and CD90 antibodies in almost 100%and the CD 105 in 56.7%. Likewise, DPSCs expressed negatively the CD34 and CD45 in more than 98%. After 15 days it was observed in the SEM that 99.88% of the DPSCs had either a star-like or fusiform shape, which means that they adhered successfully to the PLA matrix. Conclusion: The PLA is not cytotoxic on the DPSCs thanks to its composition and biocompatible features, which allowed the cell adhesion and proliferation in the 3D-printed dental matrix. This in vitro method was effective and should be use in future studies on tissue regeneration in dentistry.

Lesões endodôntico-periodontais: do diagnóstico ao tratamento / Endodontic-periodontal lesions: from diagnosis to treatment

As doenças endodôntico-periodontais até hoje representam um desafio para o cirurgião-dentista. Uma única lesão pode apresentar sinais de envolvimento endodôntico e periodontal, o que pode induzir o cirurgião-dentista à realização de um tratamento inadequado. O diagnóstico da doença geralmente é difícil devido às íntimas conexões anatômicas e vasculares entre a polpa e o periodonto. Além disso, o fato dessas doenças serem frequentemente avaliadas como entidades diferentes dificulta ainda mais o diagnóstico. A avaliação do prognóstico e o tratamento também podem ser desafiadores. Microrganismos, trauma, reabsorções radiculares e perfurações estão entre os fatores etiológicos e contribuintes para o desenvolvimento e progressão da doença. Frequentemente, o dente acometido por uma lesão endodôntico-periodontal é condenado devido à falta de conhecimento do cirurgião-dentista. É fundamental reconhecer a relação entre as doenças para o manejo adequado da lesão. A realização de um diagnóstico preciso é um determinante crítico do resultado do tratamento. O presente estudo revisou a literatura relacionada à etiologia, classificação e tratamento dessa doença. A revisão foi feita através de consulta ao pubmed e foram incluídos artigos publicados entre 1974 e 2016. Os termos "lesão endoperio", "lesão endodôntico-periodontal" e "doença endodônticoperiodontal" foram as palavras-chave utilizadas no levantamento. Concluiu-se que é necessário abordar e tratar de forma multidisciplinar, sendo o tratamento direcionado à causa principal diagnosticada. Na lesão combinada verdadeira, o tratamento endodôntico deve preceder o periodontal.(AU)

Until these days endodontic-periodontal lesions remains a challenge to dentists. A single lesion may show signs of endodontic and periodontal involvement, which can induce the dentist to perform an inadequate treatment. The diagnosis is often difficult due to the intimate anatomical and vascular connections between the pulp and periodontium. Furthermore, the fact that these diseases are often evaluated as different entities complicates the diagnosis. Prognosis assessment and treatment can also be challenging. Microorganisms, trauma, perforations and radicular resorptions are among the etiologic factors and contributors to the development and progression of the disease. Often the tooth affected by an endodontic-periodontal lesion is doomed due to lack of knowledge of the dentist. It is important to recognize the relationship between the diseases for the proper management of the injury. This study reviewed the literature related to the etiology, classification and treatment of this disease. The reviewwas done through consultation with pubmed and articles published between 1974 and 2016 were included. The terms "endo perio lesion", "endodontic periodontal lesion" and "endodontic periodontal disease" were the key words used in the survey.It was concluded that it must be addressed and treated in a multidisciplinary way. Treatment should be directed to the main cause. In true combine lesion, endodontic treatment should precede periodontal.(AU)

Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study

Abstract This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child's age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7%) had clinical sequelae and 185 teeth (32.7%), radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%). Clinical sequelae increased with injury severity (p < 0.001), whereas radiographic sequelae did not (0.236). The predicted risk of color change was 29.0% (95%CI 19-41) for teeth with enamel fracture, and 26.0% (95%CI 14-40) for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35-82) and those with subluxation (15.8% 95%CI 10-22). Risk of premature loss was 27.3% (95%CI 13-45) for teeth with extrusive luxation, and 10.2% (95%CI 5-17) for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.

A Biological Approach in Repair of Damaged Dental Pulp and Periapical Tissues using Platelet Rich Fibrin, Mineral Trioxide Aggregate and Laser Biostimulation.

This article describes about a biological approach in the repair of dental pulp and periapical tissues using biomaterials (platelet rich fibrin [PRF] and mineral trioxide aggregate [MTA]) and laser biostimulation. Case 1: Pulpotomy with PRF, MTA, and laser biostimulation. Patient follow-up was done at 1, 3, and 6 months. On 6 months follow-up, the patient was asymptomatic and tooth responded positively to pulp tests. Radiograph revealed normal periodontal ligament space and trabecular bone pattern. Case 2: Apexification procedure using PRF, MTA, and laser biostimulation in 31 and 41. Patient follow-up was done at 1, 3, and 6 months. On 6 months follow-up, radiograph revealed relative root lengthening, thickening of the canal walls in the apical one-third of root, and a healing lesion. Repair and regenerative potential of PRF, an enhanced cellular metabolism with laser biostimulation in combination with the sealing ability of MTA enhances the clinical success outcomes in pulpotomy and apexification procedures.

Effects of bleaching agents and adhesive systems in dental pulp: a literature review

The dental pulp may be exposed to several irritants that are potentially noxious to the health and functions of this tissue. Each type of irritant or injury has different effects on the pulp, which are generally characterized by acute inflammation, chronic inflammation or necrosis. Common examples of irritants are dental caries, cavity preparation procedures, traumatic injuries, and chemical substances like bleaching agents and adhesive systems. The present study aimed to review the current knowledge about the effect of bleaching agents and adhesive systems in the human dental pulp. The review covered literature from 2004 to 2009, and only relevant manuscripts were included. Hand search of the references completed the review. Based on literature review, it may be concluded that all dental procedures associated with bleaching agents or adhesive systems involve risks to cause pulp damage. However, these risks can be minimized if the causal factors were known and avoided.

Furcal-perforation repair with mineral trioxide aggregate: Two years follow-up.

Furcal perforations are significant iatrogenic complications of endodontic treatment and could lead to endodontic failure. Mineral trioxide aggregate (MTA) has been regarded as an ideal material for perforation repair, retrograde filling, pulp capping, and apexification. This case report describes a furcal perforation in a maxillary first molar, which was repaired using MTA. The tooth was endodontically treated and coronally restored with resin composite. After 2 years, the absence of periradicular radiolucent lesions, pain, and swelling along with functional tooth stability indicated a successful outcome of sealing the perforation using MTA.

Fuerzas ortodóncicas como agentes vulnerantes de la salud pulpar: reporte de dos casos / Orthodontic forces causing damage in pulpal condition: report of two cases

La literatura ya ha sugerido la implicancia del uso de fuerzas ortodóncicas como productoras de daño mecánico, reacción inflamatoria periodontal, lesión periapical y reabsorción radicular. Los parámetros más comúnmente explorados en investigaciones de la respuesta tisular a fuerzas ortodónticas consisten en medir los niveles de oxígeno pulpar, la vasculatura y los cambios en la circulación sanguínea. Se ha demostrado que la irrigación pulpar disminuye tempranamente cuando se realizan aplicaciones continuas de fuerzas ortodóncicas, aun si éstas son de intensidad suave, concluyendo que la magnitud de las fuerzas no necesariamente debe ser excesiva para originar daño celular, el que eventualmente podría derivar en cuadros que van desde simples cambios de color coronario hasta obliteraciones camerales o la misma necrosis pulpar. Se presentan dos casos de pacientes tratados ortodóncicamente con extravasación hemorrágica y necrosis pulpar (canino e incisivo lateral superiores izquierdos respectivamente), con ausencia informada de traumatismo previo, y se discuten protocolos diagnósticos para la evaluación de la salud pulpar.

The literature has suggested the implication of the use of orthodontic forces as producing mechanical damage, inflammatory reactions in the periodontium, periapical injury and root resorption. More commonly explored parameters in investigations of the tissue response to orthodontic forces consist of measuring the levels of pulpal oxygen and disturbances in dental pulp circulation. It has been demonstrated that the pulpal irrigation diminishes early when continuous applications of orthodontic forces are realized, even if these are of soft intensity, concluding that the magnitude of the forces must not necessarily be excessive to originate cell damage, which eventually might derive in signs such as simple crown discoloration to progressive obliteration or pulp necrosis. Two cases of orthodontically treated subjetcs with hemorrhagic extravasation and pulp necrosis (canine and lateral incisive respectively, both left upper) with absence of previous trauma are presented and the diagnostic protocols for the evaluation of the pulpal condition are discussed.

Isolamento, caracterização, diferenciação e uso terapêutico de células-tronco adultas obitidas da polpa dentária murina / Isolation, characterization, differentiation and therapeutic use of adult stem cell deaths in murine dental pulp

Diversos estudos têm demonstrado que a polpa dentária humana é uma fonte de células-tronco. Neste trabalho nós caracterizamos células obtidas da polpa do dente de camundongos (CTMDC) e o seu efeito terapêutico em um modelo de diabetes em camundongos. O tecido pulpar foi separado do dente incisivo e cultivado in vitro. Foi investigada a expressão de marcadores de células-tronco nas culturas celulares obtidas e a integridade genética. A diferenciação adipogênica e osteogênica foi induzida após o cultivo das células em meios específicos. Camundongos foram tratados com 80 mg/kg de estreptozotocina (ETZ) e transplantados após 10 dias com CTMDC ou salina. Os níveis de glicose no sangue, proteinúria, glicosúria e creatinina foram avaliados atmvés de dosagens bioquímicas. A migração celular para o pâncreas foi analisada por imunofluorescência. A diferenciação espontânea em adipócitos foi confirmada pela marcação com óleo vermelho, sudan black e por microscopia eletrônica. As CTMDC são aderentes ao plástico, polimórficas e altamente proliferativas. Algumas células alongadas adquiriram a capacidade de contração após 28 dias de cultura. As CTMDC apresentaram um cariótipo normal até a quinta passagem. A expressão de marcadores hematopoiéticos não foi detectada, enquanto que foi observada a expressão dos marcadores mesenquimais CD90, Sca-1, STRO-1 e CD73. Na análise da expressão de marcadores embrionários observou-se a expressão de SSEA-1 por imunofluorecência e dos fatores de transcrição REX-1 e OCT-4, mas não de NANOG, por RT-PCR. A diferenciação osteogênica e adipogênica foi observada após duas semanas de cultivo em meios específicos. Dezesseis dias após o transplante de CTMDC, camundongos com hiperglicemia induzida por ETZ apresentavam os níveis de glicose no sangue menores quando comparados com o grupo controle injetado apenas com salina. Os níveis de glicosúria, proteinúria e creatinina foram significantemente reduzidos nos camundongos transplantados com CTMDC...

Dental trauma involving root fracture and periodontal ligament injury: a 10-year retrospective study

The purpose of this retrospective study was to analyze the cases of traumatic dental injuries involving root fracture and/or periodontal ligament injury (except avulsion) treated at the Discipline of Integrated Clinic, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Brazil, from January 1992 to December 2002. Clinical and radiographic records from 161 patients with 287 traumatized teeth that had sustained root fracture and/or injuries to the periodontal ligament were examined. The results of this survey revealed that subluxation (25.09 percent) was the most common type of periodontal ligament injury, followed by extrusive luxation (19.86 percent). There was a predominance of young male patients and most of them did not present systemic alterations. Among the etiologic factors, the most frequent causes were falls and bicycle accidents. Injuries on extraoral soft tissues were mostly laceration and abrasion, while gingival and lip mucosa lacerations prevailed on intraoral soft tissues injuries. Radiographically, the most common finding was an increase of the periodontal ligament space. The most commonly performed treatment was root canal therapy. Within the limits of this study, it can be concluded that traumatic dental injuries occur more frequently in young male individuals, due to falls and bicycle accidents. Subluxation was the most common type of periodontal ligament injury. Root canal therapy was the type of treatment most commonly planned and performed.

A multi-disciplinary approach in the management of a traumatized tooth with complicated crown-root fracture: A case report.

A 13-year-old boy had fractured his maxillary right central incisor. The fracture line involved 2/3rd of the crown, compromising the pulp and extended subgingivally on the palatal aspect invading the biologic width. The procedure used to manage this case included endodontic treatment of residual tooth orthodontic extrusion to move the fracture line above the alveolar bone. Finally the tooth was restored prosthodontically.

Variaçäo de temperatura gerada durante a fotopolimerizaçäo de resinas compostas / Temperature variation generated during the light curing of the composite resins

O emprego das resinas compostas fotoativadas vem sendo freqüente nos dias atuais devido às suas propriedades físicas e estéticas. Conseqüentemente, o uso dos aparelhos fotopolimerizadores tornou-se rotina nos consultórios odontológicos. Este estudo objetivou avaliar a variaçäo de temperatura produzida pela ponta dos aparelhos, bem como a possibilidade dessa variaçäo produzir lesäo no tecido pulpar. Na metodologia usada, foram testados três aparelhos: Curing Light XL3000 (3M Dental Products), Opti Light 600 (Gnatus) e Ultralux Eletronic (Dabi Atlante), todos novos, evitando assim, a influência da degradaçäo dos seus componentes nos resultados obtidos. Também foram verificados os diâmetros das pontas ativas. Após revisäo de literatura e discussäo dos dados obtidos in vitro, pode-se observar que todos os aparelhos testados apresentaram uma elevaçäo de temperatura durante a polimerizaçäo de diversas camadas, o que pode resultar em alguma alteraçäo pulpar, dependendo de fatores como profundidade da cavidade, presença de bases protetoras, espessura e tipo de dentina remanescente

Reaçäo pulpar aos condicionadores ácidos / Pulp responses induced by acid etchants

O efeito de materiais restauradores colocados em contato e a 1 mm da polpa dental foi avaliado. Essa análise foi realizada em polpas inflamadas onde foi feita induçäo de cárie e em polpas sadias. Os materiais usados foram os adesivos dentinários One Step de quinta e última geraçäo, o Scotchbond Multi-Uso Plus e o Acido Poliacrílico. A biocompatibilidade desses materiais na estrutura pulpar foi mostrada por meio de análise histológica. Constatou-se que a agressäo pulpar é uma evidência histológica independentemente ou näo da presença de bactérias e do contato ou näo com a polpa. Os resultados mostraram que todos os materiais possuem potencial irritativo à polpa. Em ordem crescente de agressividade podem ser assim dispostos: One Step, ácido poliacrílico e o Scotchbond Multi-Uso Plus. O uso de tais produtos podem levar a problemas clínicos como perda da vitalidade pulpar

Aspectos biológicos para tratamientos en odontología restauradora / Biological aspects for dental restorative treatments

El concepto de protección dentinopulpar es algo que durante mucho tiempo formó parte de una etapa en la secuencia de pasos operatorios en la preparación de cavidades. En la actualidad ya no puede ser considerado "un paso más" sino que forma parte de una concepción básica dentro de la cual el operador debe reconocer que muchas de sus maniobras son modificadas en función de proteger las estructuras vivas del diente, ya que en la mayor parte de las oportunidades esto no puede ser desligado en la simple colocación de una película de material "protector"

Inter-relaçäo entre doença periodontal e comportamento endodôntico / The interrelationship between periodontal disease and endodontic involvement

Foi feita a revisäo da literatura sobre a inter-relaçäo entre a doença periodontal (periodontite) e a polpa dental, evidenciando principalmente a existência da correlaçäo entre a patologia pulpar e doença periodontal, via canais acessórios, especialmente quando a polpa encontra-se necrosada. Embora alteraçäo pulpar avançada só ocorra quando a destruiçäo periodontal atinge a regiäo do ápice radicular, uma avaliaçäo mais detalhada das condiçöes periodontais e pulpares é sugerida