A comparative evaluation of healing with a computed tomography scan of bilateral periapical lesions treated with and without the use of platelet-rich plasma.

Periradicular surgery aims to achieve complete wound healing and regeneration of the periodontal unit. Platelet-rich plasma (PRP) is a platelet concentrate that is widely used to promote tissue healing, and bone induction through its various growth factors has been used in this study. This case report describes the use of PRP unilaterally in a bilateral periapical lesion in the same patient. The site treated with PRP showed better healing than the untreated site. This was confirmed with computed tomography (CT) scan readings. It was hypothesized that PRP could promote tissue regeneration and alveolar bone repair.

Estimation of salivary amylase and total proteins in leukemia patients and its correlation with clinical feature and radiographic finding.

Background: Leukemia is a fatal disease. The oral manifestations of the leukemias occur early in the course of the disease and these oral features can at times act as a diagnostic indicator. Saliva has been used as a diagnostic aid in a number of systemic diseases. Materials and Methods: In our study, samples of unstimulated saliva of 30 leukemia patients who were not on chemotherapy were collected and analyzed for salivary amylase and total protein. The oral manifestations and radiographic changes (OPG) were recorded. The correlation between the oral manifestations and the salivary components (salivary amylase and total protein) was assessed for prognostic significance. Results: In the present study when the mean values of salivary amylase (1280±754 U/ml) and total protein (647.2±320.7 mg%) were compared with that in control subjects. There was a statistically significant difference for amylase levels (P<.05). On intraoral examination the study subjects showed pallor, gingivitis, gingival enlargement, petechiae, and ecchymosis. On the OPG, the radiographic features included generalized rarefaction of bone (20%), thinning of lamina dura (3.4%), generalized alveolar crest bone resorption (30%), thinning of walls of alveolar crypts (6.7%), besides others, e.g., periapical abscess (10%). Conclusions: The saliva of leukemic patients demonstrated obvious changes in composition. A rise in salivary amylase and total protein levels was evident, with the increase in amylase levels being statistically significant.

Antibioticoterapia no tratamento de abscessos periapicais agudos: quando indicar e como proceder? / Antibiotics for acute apical periodontitis in adults: how to procede?

O objetivo desta revisão é auxiliar o cirurgião dentista na indicação e aplicação da antibioticoterapia no abscesso periapical agudo, em casos de alergia e infecções resistentes, obtendo o sucesso clínico desejado e evitando a resistência bacteriana.

The aim of this study is assist the dentists on indication and application of antibiotic therapy on acute apical periodontits, in allergies cases and resistants infections, obtaining a wished clinical success and avoiding acquired bacterin resistance.

Clinical and radiographic comparison of primary molars after formocresol and electrosurgical pulpotomy: a randomized clinical trial.

BACKGROUND: Vital pulpotomy is a single-stage procedure defined as the surgical amputation of the coronal portion of exposed vital pulp, usually as a means of preserving the vitality and function of the remaining radicular portion. OBJECTIVES : The aim of this study was to compare the clinical and radiographic success rates for electrosurgical vs formocresol pulpotomy in human primary molar teeth. SETTINGS AND DESIGN: This was a prospective, randomized clinical trial. MATERIALS AND METHODS: In this randomized clinical trial, pulpotomies were performed on 70 primary molars in children aged 5-10 years. The teeth were treated using either a conventional formocresol (35 teeth) or electrosurgical technique (35 teeth). Following the pulpotomy procedure, the teeth were evaluated for clinical and radiographic success for three, six and nine months. The teeth were evaluated for the presence of pain, abscess, fistula, mobility, internal and external resorption, and radiolucency. STATISTICAL ANALYSIS: The data were assessed with Fishers' Exact test. RESULTS: After nine months of follow-up, the clinical and radiographic success rates were 96 and 84% respectively in the electrosurgical group and 100 and 96.8% respectively in the formocresol group. There was no statistically significant difference between the success rates in the two groups ( P > 0.05). CONCLUSIONS: Our results showed the failure rates for electrosurgical pulpotomy to be equal to those for formocresol pulpotomy. Although electrosurgical pulpotomy is a nonpharmacological technique giving favorable results, it is still a preservative technique. Further studies using larger samples and longer evaluation periods are recommended.

Abscessos dentários periapicais em leitões com síndrome multissistêmica do definhamento / Dental periapical abscesses in piglets affected by postweaning multisystemic wasting syndrome PMWS

Duzentos e oitenta leitões, entre 40 e 70 dias de idade, afetados pela sindrome multissistêmica do definhamento (SMD) foram examinados após eutanásia para pesquisa de lesões dentárias. Pelo menos um abscesso periapical foi observado em 58 leitões (20,7 por cento), dos quais 12 apresentaram abscessos múltiplos. Terceiros incisivos superiores, 3os incisivos inferiores, caninos superiores, caninos inferiores e outros dentes apresentaram respectivamente 22 (31,4 por cento), 16 (22,9 por cento), 4 (5,7 por cento), 23 (32,9 por cento) e 5 (7,1 por cento) abscessos periapicais. A maior prevalência de abscessos observada nos dentes 3os incisivos e caninos inferiores está provavelmente associada com a maior área de corte ou desgaste que sofrem esses dentes. Entre as bactérias isoladas de amostras de 65 abscessos, Streptococcus sp. foi a mais prevalente e esteve presente em 21,48 por cento e 27,7 por cento dos isolados em aerobiose e anaerobiose, respectivamente. Na segunda posição em prevalência estiveram as bactérias corineformes, as quais foram mais freqüentemente isoladas em atmosfera anaeróbica do que aeróbica. Houve preponderância de isolamentos de bactérias Gram-positivas. Não foi possível determinar se as co-infecções bacterianas predispuseram às lesões características de SMD ou foram conseqüentes à imunossupressão causada pela infecção com PCV2.

Swine producers have historically resected needle teeth of newborn pigs to prevent potential injuries to the sow mammary gland and faces of littermates. However, the possible impact of this practice on pig performance has been questioned. As part of a study, 280 PMWS affected piglets, with 40-70 days of age, were examined for the presence of dental lesions immediately after euthanasia. Most pigs were confirmed as PMWS by the detection of typical microscopic lesions and immunohistochemical pattern. At least one periapical abscess was observed in 58 piglets (20.7 percent), of which 12 had multiple abscesses. There were 22 (31.4 percent), 16 (22.9 percent), 4 (5.7 percent), 23 (32.9 percent), and 5 (7.1 percent) abscesses in 3rd upper incisives, 3rd lower incisives, upper canines, lower canines, and other teeth, respectively. The higher prevalence of dental abscesses observed in 3rd incisives and lower canines is probably associated with the wider area of grinding or clipping to which these teeth were subjected. Among bacteria isolated from samples collected from 65 abscesses, Streptococcus sp. was the most prevalent bacteria and was present in 21.48 percent and 27.7 percent of the aerobic and anaerobic isolates, respectively. In the second most frequent group were coryneform microorganisms, which showed higher rate of isolation under anaerobic atmosphere than in aerobic culture. There was preponderance of Gram-positive isolates. It could not be determined whether these bacterial co-infections predisposed pigs to development of PMWS-type lesions or if were subsequent to the PCV2 infection.

Tratamiento dental en pacientes con cetoacidosis diabética: caso clínico / Dental treatment in patients with diabetic ketoacidosis: a clinical case

La cetoacidosis diabética (CD) es un estado de deficiencia relativa o absoluta de insulina. Se da principalmente en pacientes con diabetes tipo 1. La causas más comunes son infecciones subyacentes, interrupción del tratamiento con insulina y el inicio de una diabetes. La CD está típicamente caracterizada por hiperglicemia y acidosis con cetonemia y cetonuria. Presentamos un caso de absceso dentoalveolar en un paciente con CD. El reconocimiento y tratamiento de los factores desencadenantes y monitoreo frecuente de los pacientes son considerados los aspectos más cruciales del manejo de la CD.

Diabetic ketoacidosis (DKA) is a state of absolute or relative insulin deficiency. It is seen primarily in patients with type 1 diabetes. The most common causes are underlying infection, disruption of insulin treatment, and new onset of diabetes. DKA is typically characterized by hyperglycemia and acidosis with ketonemia and ketonuria. We reported a case of dental abscess in a patient with DKA. Recognition and treatment of precipitating factors and frequent monitoring of patients are considered the most crucial aspects of the management of DKA.

Preparo biomecânico e curativo de demora - efeitos antisséptico em canais radiculares de dentes de cães com lesão periapical crônica / Biomechanical preparation and intracanal dressing - antiseptic effect on root canls of dog teeth with chronic periapical lesion

O objetivo deste estudo foi avaliar a ação anti-septica do preparo biomacânico e da medicação intracanal, em dois períodos de ação, em dentes com necrose pulpar associada a áreas rediólucidas periapicais. Para tanto, lesões periapicais crônicas foram induzidas em 32 raízes de dentes pré-molares de dois cães, com aproximadamente um ano de idade. Amostras microbiológicas foram obtidas dos canais radiculares, seguindo-se a instrumentação seriada convencional, auxiliada pela solução de hipoclorito de sódio a 5, 25 porcento;. Noventa e seis horas após, obteve-se a segunda amostragem microbiológica e aplicou-se a pasta à base de hidróxido de cálcio, em veículo inerte - Calasept, por 15 e 30 dias. Noventa e seis horas após a remoção da pasta, obteve-se a terceira amostragem microbiológica. Verificou-se que o preparo biomecânico apresentou variável ação anti-séptica conta os microorganismos anaeróbios obrigatórios e Streptococcus viridans, com percentuais de culturas negativas oscilando de 66, 7 porcento a 94, 9 porcento. A ação complementar anti-séptica conferida pela pasta Calasept foi similar nos dois períodos de avaliação (p>0, 05), sendo obtidos percentuais de culturas negativas da ordem de 93, 4 porcento a 100, 0 porcento. Contudo, após os procedimentos de anti-sepsia utilizados, microorganismos em quantidades residuais, inferiores a 30UFC/mL, ainda estavam presentes em 28, 1 porcento dos canais radiculares

Principais transtornos ocasionados por dentes inclusos / Clinical and radiographic aspects related to the main perturbations caused by unerupted teeth

Säo apresentados os transtornos mais freqüentes ocasionados por dentes inclusos e suas soluçöes clínicas, além de se efetuar uma breve revisäo da literatura sobre o assunto. Em razäo do grande número de problemas que podem estar associados aos dentes inclusos e suas conseqüências nas diferentes especialidades, os autores sugerem que se façam proservaçöes radiográficas sempre que se detecte a presença de um dente incluso sem indicaçäo de remoçäo cirúrgica

Informe de 16 casos de angina de Ludwig: revisión de cinco años / Ludwig's angina: a report of 16 cases with a five-year follow-up

La angina de Ludwig es una induración gangrenosa del tejido conectivo del cuello bilateral y piso de la boca. Esta enfermedad causa rápida obstrucción de las vías aéreas, que afecta los espacios submaxilar, sublingual y submentoniano. Los segundos y terceros molares se citan como fuente de infección. En casos severos se deberá llevar a cabo una intervención quirúrgica temprana. En el presente trabajo se informa sobre la experiencia obtenida en 16 casos de angina de Ludwig en los últimos cinco años, los cuales tuvieron origen dental, y en los que hubo dos muertes. Los procedimientos quirúrgicos y antibióticos fueron el tratamiento de elección en todos los pacientes. La mayoría de ellos fueron tratados con penicilina G cristalina, metronidazol, dicloxacilina y amikacina; 12 pacientes fueron traqueostomizados y otros cuatro se manejaron con respiración controlada. Se sugiere un vigoroso tratamiento antimicrobiano, una temprana intervención quirúrgica, así como un cuidadoso monitoreo de los síntomas respiratorios para reducir la necesidad de la traqueostomía y disminuir la tasa de mortalidad. La angina de Ludwig en su inicio, no debe pasar inadvertida; siempre debe tomarse en cuenta el diagnóstico temprano