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1.
Rev. Assoc. Med. Bras. (1992) ; 66(supl.1): s31-s36, 2020.
Article in English | LILACS | ID: biblio-1057105

ABSTRACT

SUMMARY Hyperkalemia is a frequent finding in patients with chronic kidney disease (CKD). This increase in serum potassium levels is associated with decreased renal ion excretion, as well as the use of medications to reduce the progression of CKD or to control associated diseases such as diabetes mellitus and heart failure. Hyperkalemia increases the risk of cardiac arrhythmia episodes and sudden death. Thus, the control of potassium elevation is essential for reducing the mortality rate in this population. Initially, the management of hyperkalemia includes orientation of low potassium diets and monitoring of patients' adherence to this procedure. It is also important to know the medications in use and the presence of comorbidities to guide dose reduction or even temporary withdrawal of any of the potassium retention-related drugs. And finally, the use of potassium binders is indicated in both acute episodes and chronic hyperkalemia.


RESUMO A hiperpotassemia é um achado frequente em pacientes com doença renal crônica (DRC). Esta elevação do nível sérico de potássio está associada à diminuição da excreção renal do íon, assim como ao uso de medicações para retardar a progressão da DRC ou para controlar doenças associadas, como diabetes mellitus e insuficiência cardíaca. A hiperpotassemia aumenta o risco de episódios de arritmia cardíaca e morte súbita. Assim, o controle da elevação de potássio é essencial para a diminuição da taxa de mortalidade nessa população. O manejo da hiperpotassemia inclui, inicialmente, orientação de dietas com baixo teor de potássio e acompanhamento da aderência dos pacientes a esse procedimento. Também é importante conhecer as medicações em uso e a presença de comorbidades, a fim de orientar a redução de doses ou até mesmo a suspensão temporária de alguma das drogas relacionadas à retenção de potássio. E, finalmente, o uso de quelantes de potássio é indicado tanto em episódios agudos como nos casos de hiperpotassemia crônica.


Subject(s)
Humans , Potassium/adverse effects , Renal Insufficiency, Chronic/complications , Hyperkalemia/etiology , Polystyrenes/therapeutic use , Potassium/blood , Comorbidity , Silicates/therapeutic use , Renal Insufficiency, Chronic/blood , Hyperkalemia/drug therapy , Hyperkalemia/blood
2.
J. bras. nefrol ; 41(3): 440-444, July-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040241

ABSTRACT

Abstract Hyperkalemia is one of the most common electrolyte disorders, responsible for a high number of adverse outcomes, including life-threatening arrhythmias. Potassium binders are largely prescribed drugs used for hyperkalemia treatment but unfortunately, there are many adverse events associated with its use, mostly gastrointestinal. Identification of patients at highest risk for the serious complications associated with the current potassium binders, such as colon necrosis and perforation, could prevent fatal outcomes. The authors present a case of a 56-year-old man with secondary diabetes and chronic renal disease that was treated for hyperkalemia with Calcium Polystyrene Sulfonate (CPS). He later presented with acute abdomen due to cecum perforation and underwent ileocecal resection but ultimately died from septic shock a week later. During surgery, a solid white mass was isolated in the lumen of the colon. The mass was identified as a CPS bezoar, a rare drug-mass formed in the gastrointestinal tract that contributed to the perforation. A previous history of partial gastrectomy and vagothomy was identified as a probable risk factor for the CPS bezoar development. Hopefully, the two new potassium binders patiromer and (ZS-9) Sodium Zirconium Cyclosilicate will help treat such high-risk patients, in the near future.


Resumo A hipercalemia é um dos distúrbios eletrolíticos mais comuns, responsável por um grande número de desfechos adversos, incluindo arritmias potencialmente fatais. Quelantes de potássio são amplamente prescritos para o tratamento da hipercalemia, mas infelizmente são muitos os eventos adversos associados ao seu uso, em particular os gastrointestinais. A identificação de pacientes com risco mais elevado para complicações graves associadas aos quelantes de potássio atualmente em uso, como necrose e perfuração do cólon, pode evitar desfechos fatais. O presente artigo descreve o caso de um homem de 56 anos com diabetes secundário e doença renal crônica em tratamento por hipercalemia com poliestirenossulfonato de cálcio (PSC). Posteriormente o paciente apresentou abdômen agudo devido a perfuração do ceco e foi submetido a uma ressecção ileocecal, mas acabou indo a óbito por choque séptico uma semana mais tarde. Durante a cirurgia, uma massa branca sólida foi isolada no lúmen do cólon. A massa foi identificada como um bezoar de PSC, uma massa de fármaco de rara ocorrência formada no trato gastrointestinal que contribuiu para a perfuração. História pregressa de gastrectomia parcial e vagotomia foi identificada como provável fator de risco para o desenvolvimento do bezoar de PSC. Espera-se que os dois novos quelantes de potássio - patiromer e ciclossilicato de zircônio sódico - ajudem a tratar pacientes de alto risco em um futuro próximo.


Subject(s)
Humans , Male , Middle Aged , Polystyrenes/therapeutic use , Bezoars/complications , Cecum/pathology , Hyperkalemia/drug therapy , Intestinal Perforation/etiology , Silicates/therapeutic use , Fatal Outcome , Diabetes Mellitus/etiology , Hyperkalemia/etiology
3.
Braz. oral res. (Online) ; 33: e084, 2019. graf
Article in English | LILACS | ID: biblio-1019612

ABSTRACT

Abstract This study aimed to evaluate the role of photobiomodulation (PBM) in apexification and apexogenesis of necrotic rat molars with an open apex. Rat molars were exposed to the oral environment for 3 weeks. Canals were rinsed with 2.5% NaOCl and 17% EDTA, filled with antibiotic paste and sealed. After 7 days, canals were rinsed and divided into six groups (n=6): mineral trioxide aggregate (MTA); blood clot (BC); human dental pulp stem cells (hDPSC); MTA+PBM; BC+PBM; and hDPSC+PBM. In hDPSC groups, a 1% agarose gel scaffold was used. Two groups were not exposed: healthy tooth+PBM (n = 6), healthy tooth (n = 3); and one was exposed throughout the experiment: necrotic tooth (n = 3). In PBM groups, irradiation was performed with aluminum gallium indium phosphide (InGaAlP) diode laser for 30 days within 24-h intervals. After that, the specimens were processed for histological and immunohistochemical analyses. Necrotic tooth showed greater neutrophil infiltrate (p < 0.05). Necrotic tooth, healthy tooth, and healthy tooth+PBM groups showed absence of a thin layer of fibrous condensation in the periapical area. All the other groups stimulated the formation of a thicker layer of fibers (p < 0.05). All groups formed more mineralized tissue than necrotic tooth (p < 0.05). PBM associated with MTA, BC, or hDPSC formed more mineralized tissue (p < 0.05). MTA+PBM induced apexification (p < 0.05). Rabbit polyclonal anti-bone sialoprotein (BSP) antibody confirmed the histological findings of mineralized tissue formation, and hDPSC groups exhibited higher percentage of BSP-positive cells. It can be concluded that PBM improved apexification and favored apexogenesis in necrotic rat molars with an open apex.


Subject(s)
Animals , Tooth Diseases/radiotherapy , Dental Pulp Necrosis/radiotherapy , Tooth Apex/radiation effects , Low-Level Light Therapy/methods , Dental Pulp Cavity/radiation effects , Lasers, Semiconductor/therapeutic use , Apexification/methods , Oxides/therapeutic use , Stem Cells , Tooth Diseases/pathology , Immunohistochemistry , Random Allocation , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Silicates/therapeutic use , Calcium Compounds/therapeutic use , Aluminum Compounds/therapeutic use , Dental Pulp Necrosis/pathology , Tooth Apex/pathology , Dental Pulp/cytology , Dental Pulp Cavity/pathology , Drug Combinations , Integrin-Binding Sialoprotein/analysis
4.
J. appl. oral sci ; 27: e20180700, 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-1012509

ABSTRACT

Abstract Alternatives for the treatment of caries disease, such as minimally invasive approaches, have been developed in recent years. Objective: To carry out clinical and radiographic evaluations of three cavity liners after selective caries removal. Methodology: Thirty-six primary molars with deep occlusal caries lesions without pulp involvement (from children of both genders, aged between 5 and 8 years) were randomly divided into the following groups: calcium hydroxide cement (CHC) group; mineral trioxide aggregate (MTA) group and Portland cement with added zirconium oxide (PCZ) group. The following-up period was 6- and 12-month. The clinical and radiographic success rates were evaluated through chi-square test. The radiographic measurements were compared by ANOVA followed by Tukey's test (p<0.05). Results: Thirty-six patients were included, but thirty-four returned for 12-month follow-up. The overall success rate of the therapy for the three groups was 94.11% and no statistically significant differences occurred in the comparison among groups (p>0.05). Nineteen radiographs were selected to measure the dentin barrier thickness. The intragroup comparison presented a statistically significant increase of the dentin barrier for all groups, at 12-month follow-up. However, the MTA group showed increase of the dentin barrier, over time, 6- to 12-month follow-up. The intergroup comparison revealed no statistically significant differences (p>0.05). Conclusion: The clinical and radiographic data showed that all cavity liners provided effective treatment of primary teeth after selective caries removal.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Oxides/therapeutic use , Zirconium/therapeutic use , Silicates/therapeutic use , Calcium Compounds/therapeutic use , Aluminum Compounds/therapeutic use , Dental Caries/therapy , Dental Cavity Lining/methods , Time Factors , Tooth, Deciduous , Radiography, Dental , Analysis of Variance , Follow-Up Studies , Treatment Outcome , Dental Caries/diagnostic imaging , Dental Cements/therapeutic use , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/drug effects , Dental Restoration, Permanent/methods , Drug Combinations
5.
J. appl. oral sci ; 27: e20180030, 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-1002410

ABSTRACT

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


Subject(s)
Humans , Child, Preschool , Child , Oxides/therapeutic use , Pulpotomy/methods , Tooth, Deciduous/surgery , Calcium Hydroxide/therapeutic use , Silicates/therapeutic use , Calcium Compounds/therapeutic use , Aluminum Compounds/therapeutic use , Pulp Capping and Pulpectomy Agents/therapeutic use , Time Factors , Tooth, Deciduous/diagnostic imaging , Calcium Hydroxide/chemistry , Radiography, Dental , Prospective Studies , Follow-Up Studies , Treatment Outcome , Drug Combinations , Pulp Capping and Pulpectomy Agents/chemistry , Saline Solution/therapeutic use , Saline Solution/chemistry
6.
Acta cir. bras ; 30(2): 160-164, 02/2015. tab, graf
Article in English | LILACS | ID: lil-741024

ABSTRACT

PURPOSE: To assess periradicular lesions clinically and by computed tomography (CT) after endodontic surgery using either Portland cement or mineral trioxide aggregate (MTA) as a root-end filling material. METHODS: Three patients diagnosed with periradicular lesions by cone-beam CT underwent endodontic surgery with root-end filling. Patient A was treated with MTA as the root-end filling material, patient B was treated with Portland cement and patient C had two teeth treated, one with MTA and the other with Portland cement. Six months after surgery, the patients were assessed clinically and by CT scan and the obtained results were compared. RESULTS: Periradicular tissue regeneration was observed in all cases, with no significant differences in bone formation when comparing the use of MTA and Portland cement as root-end filling materials. CONCLUSION: Both mineral trioxide aggregate and Portland cement were successful in the treatment of periradicular lesions. .


Subject(s)
Adult , Female , Humans , Male , Young Adult , Aluminum Compounds/therapeutic use , Calcium Compounds/therapeutic use , Dental Cements/therapeutic use , Oxides/therapeutic use , Periapical Diseases/surgery , Root Canal Filling Materials/therapeutic use , Root Canal Therapy/methods , Silicates/therapeutic use , Tooth Root/surgery , Drug Combinations , Materials Testing , Pilot Projects , Postoperative Period , Prospective Studies , Periapical Diseases , Reproducibility of Results , Time Factors , Treatment Outcome , Tomography, X-Ray Computed/methods , Tooth Root
7.
Bauru; s.n; 2015. 183 p. ilus, tab, graf.
Thesis in Portuguese | LILACS, BBO | ID: biblio-867253

ABSTRACT

O objetivo deste estudo foi avaliar as propriedades físico-químicas, antimicrobianas e biocompatibilidade do MTA branco manipulado com extratos aquoso e/ou em propilenoglicol da Arctium lappa L., Casearia sylvestris Sw. e própolis. Dentre os testes físico-químicos foram avaliados o tempo de presa, escoamento, pH, liberação de íons cálcio e alteração volumétrica. Para verificar o efeito antimicrobiano foram aplicadas as metodologias do contato direto (Enterococcus faecalis e a Cândida albicans) e da descontaminação dentinária, empregando a microscopia confocal de varredura laser para verificar a viabilidade de Enterococcus faecalis. Para a avaliação da biocompatibilidade, 162 ratos Wistar foram utilizados, onde cada animal recebeu dois implantes subcutâneos e um alveolar. Após os períodos experimentais de 15, 30 e 60 dias foram realizadas análises microtomográfica, histológica descritiva e histomorfométrica. Adicionalmente amostras do tecido alveolar foram processadas para dosagem das citocinas TNF-α e IL-10 por meio do ensaio imunoenzimático (ELISA). Os dados obtidos foram analisados estatisticamente com os testes ANOVA e Tukey ou Kruskal-Wallis e Dunn. Os resultados revelaram que a variação do veículo associado ao MTA aumentou significativamente o tempo de presa, no entanto, não houve influência na alteração volumétrica (P>0,05) e na capacidade do cimento em manter o meio alcalino e liberar íons cálcio. Os cimentos manipulados com extratos em propilenoglicol apresentaram maior escoamento (P<0,05). Apenas o extrato da própolis agregou ao MTA efeito contra o Enterococcus faecalis após 24 e 48 horas (descontaminação dentinária e contato direto respectivamente) e contra a Cândida albicans após 10 horas (P<0,05). De acordo com as avaliações histológica e histomorfométrica dos implantes em tecidos subcutâneo e alveolar não foi constatada diferença significativa entre os grupos experimentais quando comparados com o grupo no qual o MTA foi manipulado...


The aim of this study was to evaluate the physicochemical, antimicrobial properties and biocompatibility of white MTA mixed with aqueous or propylene glycol extracts of Arctium lappa L., Casearia sylvestris Sw. and propolis. Among physicochemical tests were evaluated the setting time, flowability, pH, ion calcium release and volumetric change. To verify the antimicrobial effects were applied the methods of direct contact (Enterococcus faecalis and Candida albicans) and dentin decontamination by using the confocal laser scanning microscopy to verify the Enterococcus faecalis viability. To evaluate the biocompatibility were used 162 Wistar rats. Each animal received one alveolar and two subcutaneous implants. After the experimental periods of 15, 30 and 60 days were performed the microtomography, histological description and histomorphometric analyses. Additionally alveolar tissue samples were processed for the measurement of TNF-α e IL-10 cytokines by enzyme-linked immunosorbent assay (ELISA). The data were statistically analyzed by the ANOVA and Tukey or KruskalWallis and Dunns tests. The results revealed that the variation of the vehicle associated to MTA significantly increased its setting time, however did not influence the volumetric change (P>0,05) and the cement's ability to maintain the alkaline medium and ion calcium release. Cements mixed with propylene glycol extracts showed higher flowability (P<0,05). Only propolis extract added to MTA the effect against E. faecalis after 24 and 48 hours (dentin decontamination and direct contact respectively) and against Candida albicans after 10 hours (P<0,05). According to the histological and histomorphometric evaluation of the implants in subcutaneous and alveolar tissue was not observed significant differences between the experimental groups in comparison to the reference group (MTA was mixed with distilled water). The microtomography analysis and expression of TNF-α and IL-10 showed...


Subject(s)
Animals , Male , Rats , Anti-Infective Agents/chemistry , Aluminum Compounds/chemistry , Calcium Compounds/chemistry , Oxides/chemistry , Phytotherapeutic Drugs , Propolis/chemistry , Silicates/chemistry , Anti-Infective Agents/therapeutic use , Biocompatible Materials , Candida albicans , Aluminum Compounds/therapeutic use , Calcium Compounds/therapeutic use , Drug Combinations , Enterococcus faecalis , Materials Testing , Oxides/therapeutic use , Propolis/therapeutic use , Rats, Wistar , Reproducibility of Results , Silicates/therapeutic use , Time Factors
8.
Bauru; s.n; 2015. 183 p. ilus, tab, graf.
Thesis in Portuguese | LILACS | ID: lil-756760

ABSTRACT

O objetivo deste estudo foi avaliar as propriedades físico-químicas, antimicrobianas e biocompatibilidade do MTA branco manipulado com extratos aquoso e/ou em propilenoglicol da Arctium lappa L., Casearia sylvestris Sw. e própolis. Dentre os testes físico-químicos foram avaliados o tempo de presa, escoamento, pH, liberação de íons cálcio e alteração volumétrica. Para verificar o efeito antimicrobiano foram aplicadas as metodologias do contato direto (Enterococcus faecalis e a Cândida albicans) e da descontaminação dentinária, empregando a microscopia confocal de varredura laser para verificar a viabilidade de Enterococcus faecalis. Para a avaliação da biocompatibilidade, 162 ratos Wistar foram utilizados, onde cada animal recebeu dois implantes subcutâneos e um alveolar. Após os períodos experimentais de 15, 30 e 60 dias foram realizadas análises microtomográfica, histológica descritiva e histomorfométrica. Adicionalmente amostras do tecido alveolar foram processadas para dosagem das citocinas TNF-α e IL-10 por meio do ensaio imunoenzimático (ELISA). Os dados obtidos foram analisados estatisticamente com os testes ANOVA e Tukey ou Kruskal-Wallis e Dunn. Os resultados revelaram que a variação do veículo associado ao MTA aumentou significativamente o tempo de presa, no entanto, não houve influência na alteração volumétrica (P>0,05) e na capacidade do cimento em manter o meio alcalino e liberar íons cálcio. Os cimentos manipulados com extratos em propilenoglicol apresentaram maior escoamento (P<0,05). Apenas o extrato da própolis agregou ao MTA efeito contra o Enterococcus faecalis após 24 e 48 horas (descontaminação dentinária e contato direto respectivamente) e contra a Cândida albicans após 10 horas (P<0,05). De acordo com as avaliações histológica e histomorfométrica dos implantes em tecidos subcutâneo e alveolar não foi constatada diferença significativa entre os grupos experimentais quando comparados com o grupo no qual o MTA foi manipulado...


The aim of this study was to evaluate the physicochemical, antimicrobial properties and biocompatibility of white MTA mixed with aqueous or propylene glycol extracts of Arctium lappa L., Casearia sylvestris Sw. and propolis. Among physicochemical tests were evaluated the setting time, flowability, pH, ion calcium release and volumetric change. To verify the antimicrobial effects were applied the methods of direct contact (Enterococcus faecalis and Candida albicans) and dentin decontamination by using the confocal laser scanning microscopy to verify the Enterococcus faecalis viability. To evaluate the biocompatibility were used 162 Wistar rats. Each animal received one alveolar and two subcutaneous implants. After the experimental periods of 15, 30 and 60 days were performed the microtomography, histological description and histomorphometric analyses. Additionally alveolar tissue samples were processed for the measurement of TNF-α e IL-10 cytokines by enzyme-linked immunosorbent assay (ELISA). The data were statistically analyzed by the ANOVA and Tukey or KruskalWallis and Dunns tests. The results revealed that the variation of the vehicle associated to MTA significantly increased its setting time, however did not influence the volumetric change (P>0,05) and the cement's ability to maintain the alkaline medium and ion calcium release. Cements mixed with propylene glycol extracts showed higher flowability (P<0,05). Only propolis extract added to MTA the effect against E. faecalis after 24 and 48 hours (dentin decontamination and direct contact respectively) and against Candida albicans after 10 hours (P<0,05). According to the histological and histomorphometric evaluation of the implants in subcutaneous and alveolar tissue was not observed significant differences between the experimental groups in comparison to the reference group (MTA was mixed with distilled water). The microtomography analysis and expression of TNF-α and IL-10 showed...


Subject(s)
Animals , Male , Rats , Anti-Infective Agents/chemistry , Aluminum Compounds/chemistry , Calcium Compounds/chemistry , Oxides/chemistry , Phytotherapeutic Drugs , Propolis/chemistry , Silicates/chemistry , Anti-Infective Agents/therapeutic use , Biocompatible Materials , Candida albicans , Aluminum Compounds/therapeutic use , Calcium Compounds/therapeutic use , Drug Combinations , Enterococcus faecalis , Materials Testing , Oxides/therapeutic use , Propolis/therapeutic use , Rats, Wistar , Reproducibility of Results , Silicates/therapeutic use , Time Factors
9.
Rio de janeiro; s.n; 2015. 56 p. ilus.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1015204

ABSTRACT

O protocolo atual para o tratamento das reabsorções inflamatórias externas radiculares utiliza o hidróxido de cálcio como agente de desinfecção, como curativo de demora, em várias trocas sucessivas e por longo período de tempo. Além da necessidade de várias consultas para a substituição do hidróxido de cálcio, a sua permanência nos canais por longo período de tempo, provoca o enfraquecimento das estruturas dentárias. Portanto, modificação desta terapia seria aconselhável. Nesta investigação clínica, três pacientes portadores de reabsorção inflamatória externa radicular foram tratados com a terapia de revascularização, usualmente utilizada em dentes com necrose pulpar e ápices abertos. Os dentes foram tratados com o protocolo da terapia de revascularização que consiste na desinfecção do sistema de canais radiculares com pasta tri-antibiótica, com posterior preenchimento do canal com coagulo sanguíneo e selamento do canal com agregado trióxido mineral e resina adesiva. Foi observado durante a proservação a paralização do processo patológico com neoformação tecidual nas áreas radiolúcidas preexistentes. Foi detectada a redução da mobilidade dos elementos dentários tratados. Os três casos foram acompanhados por 30, 18 e 15 meses, respectivamente. Todos os elementos dentários permaneceram assintomáticos, mantidos com função e mobilidade fisiológica. A terapia utilizada no procedimento de revascularização mostrou-se eficiente no tratamento da reabsorção inflamatória externa radicular, reduzindo o número de consultas e aumentando a adesão dos pacientes.


The current external inflammatory root resorption treatment protocol, which uses calcium hydroxide dressing, usually comprises multiple and long-term applications. In addition to the need for multiple appointments for calcium hydroxide replacement, the long-term maintenance of this compound in the root canal weakens dental structures. A modification of this therapy would be advisable. In this clinical investigation, three patients with external inflammatory root resorption were submitted to revascularization therapy protocol usually used in teeth with necrotic pulp and open apices. The teeth were treated with revascularization therapy protocol, which consisted of disinfecting the root canal system with tri-antibiotic paste, filling it with blood clot, and sealing of the root canal with mineral trioxide aggregate and bonded resin restoration. During the follow up, the pathological process was arrested with tissue repair in preexisting radiolucent areas. Reduced mobility was observed in the treated teeth. The three cases were followed up for 30, 18, and 15 months, respectively. All teeth remained asymptomatic and retained function and physiological mobility. The therapy used in the revascularization procedure was efficient in the treatment of external inflammatory root resorption, reducing the number of appointments and increasing patient compliance.


Subject(s)
Humans , Male , Child , Root Resorption/therapy , Tooth Injuries , Drug Combinations , Glass Ionomer Cements/therapeutic use , Anti-Bacterial Agents/therapeutic use , Oxides/therapeutic use , Calcium Hydroxide/therapeutic use , Treatment Outcome , Silicates/therapeutic use , Calcium Compounds/therapeutic use , Aluminum Compounds/therapeutic use
10.
Article in English | IMSEAR | ID: sea-156562

ABSTRACT

The absence of a natural apical constriction in a nonvital young permanent tooth makes endodontic treatment a challenge. There is a need to induce or create an apical barrier against, which the obturating material can be condensed. Traditionally, calcium hydroxide is the material of choice to induce apexification. Due to certain drawbacks such as prolonged treatment duration and unpredictable apical barrier formation, it is being replaced by materials, which have a more predictable outcome like mineral trioxide aggregate (MTA). One‑step apexification with MTA reduces the treatment time when compared with traditional calcium hydroxide apexification, which requires an average time of 12–19 months. In one‑step apexification using MTA, the technical problem encountered is controlling the overfill or underfill of MTA. The use of a matrix material helps to overcome this shortcoming. Platelet rich fibrin (PRF) is an immune platelet concentrate, which can be used as a matrix, it also promotes wound healing and repair. This case report presents a case of one step apexification using MTA as an apical barrier and autologous PRF as an internal matrix.


Subject(s)
Apexification/methods , Apexification/trends , Calcium Compounds/therapeutic use , Humans , Oxides/therapeutic use , /therapeutic use , Silicates/therapeutic use
11.
Article in English | IMSEAR | ID: sea-154553

ABSTRACT

Radicular fractures in permanent teeth are uncommon injuries among dental traumas, being only 0.5-7% of the cases. Management of horizontal root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This case report presents the management of horizontally fractured canine by approximation of fracture fragments, fiber splinting, and use of MTA - both as an obturating material and intra-radicular splint. Short-term follow-up of the case showed promising results both clinically and radiographically.


Subject(s)
Adult , /therapeutic use , Cuspid/therapy , Humans , Male , Periodontal Splints/methods , Polyethylenes/therapeutic use , Silicates/therapeutic use , Tooth Fractures/therapy
12.
J. appl. oral sci ; 21(3): 235-242, May/Jun/2013. graf
Article in English | LILACS | ID: lil-679324

ABSTRACT

Some manufacturers have recently added specific components to improve the ease of handling and insertion material properties of MTA in order to create MTA-based sealers. Objective The aim of this study was to evaluate the healing of periapical lesions in canine teeth after a single session of endodontic treatment with MTA Fillapex® compared with Sealapex® or Endo-CPM-Sealer®. Material and Methods Sixty-two root canals were performed on two 1-year-old male dogs. After coronal access and pulp extirpation, the canals were exposed to the oral cavity for 6 months in order to induce periapical lesions. The root canals were prepared, irrigated with a solution of 2.5% sodium hypochlorite and filled with gutta-percha and different sealers, according to the following groups: 1) Sealapex®; 2) Endo-CPM-Sealer®; and 3) MTA Fillapex®. Some teeth with periapical lesions were left untreated for use as positive controls. Healthy teeth were used as negative controls. After 6 months, the animals were sacrificed and serial sections from the roots were prepared for histomorphologic analysis and stained with hematoxylin and eosin and the Brown and Brenn technique. The lesions were scored according to pre-established histomorphologic parameters and the scores statistically analyzed using the Kruskal-Wallis test. Results All 3 materials produced similar patterns of healing (p>0.05); in particular, persistent inflammation and absence of complete periapical tissue healing were consistently noted. Conclusions Preparation of the infected root canals followed by filling with the materials studied was insufficient to provide complete healing of the periapical tissues. .


Subject(s)
Animals , Dogs , Male , Aluminum Compounds/therapeutic use , Calcium Compounds/therapeutic use , Calcium Hydroxide/therapeutic use , Oxides/therapeutic use , Periapical Tissue/drug effects , Root Canal Filling Materials/therapeutic use , Root Canal Preparation/methods , Salicylates/therapeutic use , Silicates/therapeutic use , Wound Healing/drug effects , Anti-Infective Agents/therapeutic use , Drug Combinations , Dental Pulp Cavity/drug effects , Dental Pulp Cavity/microbiology , Materials Testing , Periapical Tissue/injuries , Periapical Tissue/pathology , Reproducibility of Results , Root Canal Irrigants/therapeutic use , Time Factors
13.
Braz. dent. j ; 24(2): 163-166, Mar-Apr/2013. graf
Article in English | LILACS | ID: lil-675654

ABSTRACT

Two cases are reported in which incomplete placement of 4 mm mineral trioxide aggregate (MTA) plug was performed unintentionally at the apical third of permanent immature teeth with open apex and apical periodontitis. As confirmed radiographically, there were gaps between MTA and dentinal walls along the MTA-dentin interface. After setting of MTA was confirmed, endodontic treatment was completed and access was sealed with composite resin. At 6 to 16 months follow-up examinations, formation of dentin in contact with the MTA surface, as well as apical closure and periapical healing were ideied radiographically for both cases. The results of these cases showed that apical barrier formation and complete periapical healing is possible despite the incomplete apical placement of the MTA plug. This might be due to the biological properties of the MTA. Even so, an incomplete three-dimensional placement of the filling material is not advocated.


Subject(s)
Child , Female , Humans , Male , Aluminum Compounds/therapeutic use , Apexification/methods , Calcium Compounds/therapeutic use , Oxides/therapeutic use , Root Canal Filling Materials/therapeutic use , Silicates/therapeutic use , Tooth Apex/pathology , Aluminum Compounds/administration & dosage , Calcium Compounds/administration & dosage , Calcium Hydroxide/therapeutic use , Drug Combinations , Dental Pulp Necrosis/therapy , Dentin, Secondary/pathology , Dentin/pathology , Epoxy Resins/therapeutic use , Follow-Up Studies , Gutta-Percha/therapeutic use , Incisor/injuries , Oxides/administration & dosage , Periapical Periodontitis/therapy , Root Canal Irrigants/therapeutic use , Root Canal Obturation/methods , Root Canal Preparation/methods , Silicates/administration & dosage , Tooth Avulsion/therapy , Tooth Fractures/therapy
14.
Braz. dent. j ; 24(2): 107-110, Mar-Apr/2013. graf
Article in English | LILACS | ID: lil-675667

ABSTRACT

Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material.


Resumo O objetivo deste estudo foi avaliar in vitro, a influência da vibração sônica e ultrassônica no selamento marginal proporcionado pelo MTA. Trinta e quatro dentes humanos tiveram seus canais radiculares instrumentados e obturados com cimento Sealapex® pela técnica da condensação lateral ativa. Os dentes foram impermeabilizados e seccionados os 3 mm apicais. Retrocavidades (3 mm de profundidade e 1,4 mm de diâmetro) foram preparadas com pontas ultrassônicas diamantadas. As retrocavidades foram preenchidas com Pro-Root MTA® com auxílio da vibração ultrassônica, com auxílio da vibração sônica e sem vibração alguma. O grupo controle positivo não recebeu material retrobturador, enquanto que o negativo foi totalmente impermeabilizado. Após a presa do material, os espécimes foram mergulhados em Rodamina B por 15 min em vácuo, permanecendo nesta solução por mais 24 h. Em seguida, foram lavados, secados e clivados longitudinalmente para avaliação da infiltração do corante na interface dentina/material retrobturador. Os dados foram analisados utilizando a análise de variância e o teste de Tukey (p<0,05). Observou-se que apenas a vibração sônica foi diferente apresentando os menores índices de infiltração. Pode-se concluir que vibração sônica contribui com a melhora da capacidade de selamento marginal proporcionado pelo MTA quando empregado como material retrobturador. .


Subject(s)
Humans , Aluminum Compounds/therapeutic use , Calcium Compounds/therapeutic use , Dental Bonding , Oxides/therapeutic use , Retrograde Obturation/methods , Root Canal Filling Materials/therapeutic use , Silicates/therapeutic use , Apicoectomy/methods , Calcium Hydroxide/therapeutic use , Drug Combinations , Dentin/ultrastructure , Diamond/chemistry , Fluorescent Dyes , Gutta-Percha/therapeutic use , Rhodamines , Root Canal Preparation/instrumentation , Root Canal Preparation/methods , Sonication , Surface Properties , Salicylates/therapeutic use , Time Factors , Ultrasonics/instrumentation , Vibration
15.
Article in English | WPRIM | ID: wpr-25403

ABSTRACT

Hepatoid adenocarcinoma (HAC) is a rare type of extrahepatic carcinoma whose morphology is similar to that of hepatocellular carcinoma (HCC). Metachronous HCC and HAC in the same patient is extremely rare. The case of a 68-year-old man with chronic hepatitis B infection who had both HCC and HAC of the stomach is reported herein. Nine years previously this patient had been diagnosed with HCC and received a right lobectomy. HCC that recurred at the caudate lobe at 6 months after the operation was successfully treated with transarterial chemoembolization. The patient was followed up regularly thereafter without evidence of tumor recurrence for 9 years. In July 2010 his serum alpha-fetoprotein (AFP) level elevated from 6.5 ng/mL to 625.4 ng/mL, and he developed a probable single metastatic lymph node around the hepatic artery without intrahepatic lesions. Subsequent evaluation with upper endoscopy revealed a 4-cm ulcerative lesion on the antrum of the stomach. Subtotal gastrectomy was performed with lymph-node dissection. Histologic examination revealed a special type of extrahepatic AFP-producing adenocarcinoma-HAC with lymph-node metastasis-which indicates that HAC can be a cause of elevated AFP even in patients with HCC. HAC should be considered if a patient with stable HCC exhibits unusual elevation of AFP.


Subject(s)
Adenocarcinoma/diagnosis , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Camptothecin/analogs & derivatives , Carcinoma, Hepatocellular/diagnosis , Chemoembolization, Therapeutic , Chemotherapy, Adjuvant , Fluorouracil/therapeutic use , Gastroscopy , Humans , Leucovorin/therapeutic use , Liver Neoplasms/diagnosis , Lymph Nodes/surgery , Lymphatic Metastasis , Male , Recurrence , Silicates/therapeutic use , Stomach Neoplasms/diagnosis , Titanium/therapeutic use , Tomography, X-Ray Computed , alpha-Fetoproteins/analysis
16.
Acta cir. bras ; 27(11): 809-814, Nov. 2012. ilus, tab
Article in English | LILACS | ID: lil-654249

ABSTRACT

PURPOSE: To evaluate the use of Portland cements with additives as furcation perforation repair materials and assess their biocompatibility. METHODS: The four maxillary and mandibular premolars of ten male mongrel dogs (1-1.5 years old, weighing 10-15 kg) received endodontic treatment (n=80 teeth). The furcations were perforated with a round diamond bur (1016 HL). The perforations involved the dentin, cementum, periodontal ligament, and alveolar bone. A calcium sulfate barrier was placed into the perforated bone to prevent extrusion of obturation material into the periradicular space. The obturation materials MTA (control), white, Type II, and Type V Portland cements were randomly allocated to the teeth. Treated teeth were restored with composite resin. After 120 days, the animals were sacrificed and samples containing the teeth were collected and prepared for histological analysis. RESULTS: There were no significant differences in the amount of newly formed bone between teeth treated with the different obturation materials (p=0.879). CONCLUSION: Biomineralization occurred for all obturation materials tested, suggesting that these materials have similar biocompatibility.


OBJETIVO: Avaliar o uso de cimentos Portland aditivados na reparação de perfurações radiculares e a biocompatibilidade destes materiais. MÉTODOS: Oitenta pré-molares, quatro da arcada dentária superior e quatro da arcada inferior de 10 cães machos, sem raça definida, com idade em torno de um a um ano e meio, pesando entre 10 e 15 kg foram submetidos a tratamento endodôntico, sendo realizadas perfurações nas furcas com broca de diamante 1016 HL. A cavidade envolveu dentina e cemento, como também periodonto e o osso alveolar. Na porção óssea da obturação, barreira de sulfato de cálcio foi utilizada evitando extravasamento do cimento para o espaço periodontal. Foi realizada a distribuição randomizada dos cimentos MTA (controle), Portland tipo II, Portland tipo V e Portland branco estrutural nas obturações. Os dentes foram restaurados com resina composta. Após 120 dias realizou-se eutanásia, retirada dos dentes, preparação e análise histológica. RESULTADOS: Entre os cimentos não houve diferença estatística significante quanto à neoformação óssea (p=0,879). CONCLUSÃO: Ocorreu biomineralização com os diferentes cimentos usados no estudo, sugerindo que estes são similares em termos de biocompatibilidade.


Subject(s)
Animals , Dogs , Male , Dental Cements/therapeutic use , Furcation Defects/drug therapy , Root Canal Filling Materials/therapeutic use , Root Canal Obturation/methods , Tooth Root/injuries , Aluminum Compounds/therapeutic use , Bicuspid , Bone Regeneration , Biocompatible Materials/chemistry , Biocompatible Materials/therapeutic use , Calcium Compounds/therapeutic use , Calcium Sulfate/chemistry , Calcium Sulfate/therapeutic use , Drug Combinations , Dental Cements/chemistry , Materials Testing , Oxides/therapeutic use , Root Canal Filling Materials/chemistry , Silicates/therapeutic use , Time Factors
17.
Article in English | IMSEAR | ID: sea-144135

ABSTRACT

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.


Subject(s)
Aluminum Compounds/therapeutic use , Chlorhexidine/therapeutic use , Dental Pulp Capping/methods , Dental Pulp/injuries , Dental Pulp/surgery , Dental Pulp Cavity/injuries , Dental Pulp Cavity/surgery , Dental Pulp Cavity/therapy , Humans , Lidocaine/therapeutic use , Silicates/therapeutic use , Tooth Injuries/etiology , Tooth Injuries/therapy
18.
Article in English | IMSEAR | ID: sea-140046

ABSTRACT

A 24-year-old female patient reported with a mutilated maxillary left central incisor. The coronal tooth structure remaining was very less, discolored, and brittle. She gave history of trauma about 15 years back when the tooth got fractured. An intraoral periapical radiograph revealed an open apex and a large periapical lesion. The case was managed successfully by conservative means using intracanal calcium hydroxide and mineral trioxide aggregate (MTA) apical barrier followed by a fiber post and a core. The final crown restored back esthetics and function. A 6-month follow-up demonstrated a clinically asymptomatic and adequately functional tooth, with radiological signs of healing.


Subject(s)
Aluminum Compounds/therapeutic use , Apexification/methods , Calcium Compounds/therapeutic use , Calcium Hydroxide/therapeutic use , Crowns , Dental Restoration Failure , Dental Restoration, Permanent/methods , Drug Combinations , Female , Follow-Up Studies , Humans , Incisor/injuries , Incisor/pathology , Maxilla , Oxides/therapeutic use , Periapical Diseases/etiology , Periapical Diseases/therapy , Post and Core Technique , Root Canal Filling Materials/therapeutic use , Root Canal Therapy , Silicates/therapeutic use , Tooth Crown/injuries , Tooth Fractures/complications , Tooth Fractures/therapy , Tooth, Nonvital/therapy , Treatment Outcome , Young Adult
19.
Article in English | IMSEAR | ID: sea-140030

ABSTRACT

Aim: To evaluate and compare mineral trioxide aggregate (MTA) and formocresol as pulpotomy medicaments by clinical and radiographic assessments and to assess the histological features of both pulpotomy medicaments in deciduous teeth. Materials and Methods: This study was performed on 100 mandibular deciduous molar teeth requiring pulpotomy treatment. Children between age four and six years were randomly selected and divided into formocresol or MTA group. The patients were recalled after 3, 6, 9, 12 months respectively and evaluated clinically and radiographically. Histological assessment was done on lower deciduous canine teeth, which were undergoing serial extraction for interceptive orthodontic purpose. Pulpotomy was done on four teeth with formocresol and another four teeth with MTA. The teeth were extracted after six months following pulpotomy procedure and histologically evaluated. Two freshly extracted carious teeth were taken as controls. Results: Clinical and radiographic criteria were laid and Chi analysis revealed significant difference in mobility ( P≤0.05), periodontal ligament widening ( P≤0.01 level) and inter - radicular radiolucency ( P≤0.02 level) between two groups at the end of 12 months. Histologically, in MTA group, a layer of new dentine formation with less dentinal tubules at the pulpotomized site was found. In formocresol group, increased inflammatory cells, a zone of atrophy, were noted in radicular portion of pulp. Conclusion: MTA is superior to formocresol clinically, radiographically. Histological analysis showed better reparative ability with hard tissue barrier formation with MTA compared to formocresol.


Subject(s)
Aluminum Compounds/therapeutic use , Calcium Compounds/therapeutic use , Child , Child, Preschool , Dental Pulp Capping/methods , Dentin, Secondary/drug effects , Tooth, Deciduous , Drug Combinations , Female , Follow-Up Studies , Formocresols/therapeutic use , Humans , Male , Mandible , Molar , Oxides/therapeutic use , Pulp Capping and Pulpectomy Agents/therapeutic use , Pulpotomy/methods , Silicates/therapeutic use , Tooth, Deciduous/surgery , Treatment Outcome
20.
Int. j. odontostomatol. (Print) ; 5(1): 77-82, abr. 2011. tab, ilus
Article in Spanish | LILACS | ID: lil-594282

ABSTRACT

En 11 pacientes se realizaron 7 pulpotomías con agregado trióxido mineral (MTA) y 6 con Sulfato Férrico (SF). Se incluyeron pacientes que presentaron dientes primarios con exposición accidental de la pulpa durante la remoción de caries en ausencia de signos y síntomas clínicos y/o radiográficos de patología pulpar. Las piezas tratadas fueron restauradas con coronas preformadas de acero inoxidable y controladas clínica y radiográficamente cada 6 meses. El seguimiento promedio fue de 15,6 meses para ambos grupos, con éxito clínico de un 100 por ciento para ambos medicamentos. El éxito radiográfico fue de 85,71 por ciento para el MTA y de 83,33 por ciento para el SF. Si bien ambos medicamentos presentaron un buen desempeño clínico y radiográfico durante el periodo de seguimiento, el SF fue más económico y necesitó un menor tiempo de trabajo, característica deseable en odontopediatría.


In eleven patients 7 pulpotomies were performed with Mineral Trioxide Aggregate (MTA) and 6 with ferric sulphate (FS). We included patients who had primary teeth with accidental exposure of the pulp during caries removal in the absence of clinical signs and symptoms and / or radiographic evidence of pulpal pathology. The treated pieces were restored with preformed stainless steel crowns and controlled clinically and radiographically every 6 months. The average follow-up was 15.6 months for both groups, with clinical success of 100 percent for both treatments. Radiographic success was 85.71 percent for the MTA and 83.33 percent for SF.ÊAlthough both procedures showed good performance during the clinical and radiographic follow-up period, the SF was cheaper and required less working time, a desirable characteristic in pediatric dentistry.


Subject(s)
Humans , Child, Preschool , Child , Aluminum/therapeutic use , Ferric Compounds/therapeutic use , Calcium Compounds/therapeutic use , Tooth, Deciduous , Dental Pulp Exposure/therapy , Pulpotomy/methods , Silicates/therapeutic use , Drug Combinations , Dental Pulp Exposure , Follow-Up Studies , Oxides/therapeutic use , Pulpotomy/adverse effects , Survival Analysis , Treatment Outcome
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