Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 621
Filter
1.
Rev. bras. oftalmol ; 80(2): 133-135, Mar.-Apr. 2021. tab
Article in English | LILACS | ID: biblio-1280114

ABSTRACT

ABSTRACT Objetive: To evaluate the success rate of initial and repeated probing as treatment approach for congenital nasolacrimal duct obstruction (CNLDO) in children between 2 and 46 months. Methods: A restrospective review of 73 children diagnosed with CNLDO who underwent probing of the NLD from March 2010 to 2020 was conducted. Data were colected from Hospital Oftalmológico de Anápolis in Anápolis, Goiás. Results: The procedure was performed in 90 eyes. The study sample was constituted of 36 males and 37 females. Bilateral involvement occurred in 18 (24.6%) children whereas 55 (75.3%) of them were unilaterally affected. The age ranges of the patients were divided into 4 groups: A - up to 6 months old (5.5% of the eyes), B - 7 to 12 months (27.5%), group C - 13 to 24 months (39.5%) and group D - older than 24 months (26.4%). The mean age of the sample was 18.6 months. Initial probing obtained an overall success rate of 88.8% and group B showed the best percentage (96%) from all age ranges. The second intervention had a lower outcome, successfuly in 55.5% of the cases. Conclusion: All age ranges showed high success rates for initial probing, although there was a decrease in subsequent procedures outcomes. Our results demonstrate that the success rate for primary probing is not affected by age.


RESUMO Objetivo: avaliar a taxa de sucesso de sondagem inicial e de repetição como abordagem de tratamento para obstrução congênita do ducto nasolacrimal em crianças entre 2 e 46 meses. Métodos: conduziu-se uma revisão retrospectiva de 73 crianças diagnosticadas com obstrução congênita do ducto nasolacrimal que se submeteram à sondagem do ducto nasolacrimal de março de 2010 a 2020. Os dados foram coletados no Hospital Oftalmológico de Anápolis em Anápolis, Goiás. Resultados: o procedimento foi realizado em 90 olhos. A amostra do estudo constitui-se em 36 pacientes do sexo masculino e 37 do sexo feminino. O acometimento foi bilateral em 18 crianças, enquanto 55 (75,3%) delas foram afetadas de forma unilateral. Os pacientes foram divididos em 4 grupos, de acordo com a faixa etária: A- até 6 meses de vida (5,5% dos olhos); B- 7 a 12 meses (27,5%); grupo C- 13 a 24 meses (39,5%) e grupo D- mais que 24 meses (26,4). A média de idade de amostra foi de 18,6 meses. A sondagem inicial teve uma taxa de sucesso global de 88,8%, e o grupo B mostrou a melhor porcentagem (96%) de todas as faixas etárias. A segunda intervenção teve uma taxa de sucesso menor, de 55,5% dos casos. Conclusão: todas as faixas etárias mostraram altas taxas de sucesso na sondagem, embora tenha havido um decréscimo nos resultados dos procedimentos subsequentes. Nossos resultados demonstram que a taxa de sucesso na sondagem primária não é afetada pela idade


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Lacrimal Duct Obstruction/congenital , Lacrimal Duct Obstruction/therapy , Medical Records , Retrospective Studies , Intubation/methods , Therapeutic Irrigation , Nasolacrimal Duct/abnormalities
2.
Int. braz. j. urol ; 47(2): 350-356, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1154451

ABSTRACT

ABSTRACT Purpose: High intra-renal pressures during flexible ureteroscopy have been associated with adverse renal tissue changes as well as pyelovenous backflow. Our objective was to investigate the effect of various intra-renal pressures on histologic changes and fluid extravasation during simulated ureteroscopy. Materials and Methods: Twenty-four juvenile pig kidneys with intact ureters were cannulated with an Olympus flexible ureteroscope with and without a ureteral access sheath and subjected to India ink-infused saline irrigation for 30 minutes at constant pressures ranging from sphygmomanometer settings of 50mm, 100mm and 200mmHg. Renal tissue samples were collected, processed and stained, and were evaluated by a blinded pathologist for depth of ink penetration into renal parenchyma as a percentage of total parenchymal thickness from urothelium to renal capsule. Results: The mean percentage of tissue penetration for kidneys with ink present in the cortical tubules at sphygmomanometer pressure settings of 50, 100, and 200mm Hg without a ureteral access sheath was 33.1, 31.0 and 99.3%, respectively and with ureteral access sheath was 0, 0 and 18.8%, respectively. Overall, kidneys with an access sheath demonstrated a smaller mean tissue penetration among all pressure compared to kidneys without a sheath (6.3% vs. 54.5%, p=0.0354). Of kidneys with sheath placement, 11% demonstrated any ink compared to 56% of kidneys without sheath placement. Conclusions: Pressurized endoscopic irrigation leads to significant extravasation of fluid into the renal parenchyma. Higher intra-renal pressures were associated with increased penetration of irrigant during ureteroscopy in an ex-vivo porcine model.


Subject(s)
Animals , Ureter , Ureteroscopes , Pressure , Swine , Ureteroscopy , Therapeutic Irrigation , Kidney
3.
Rev. bras. anestesiol ; 70(6): 583-587, Nov.-Dec. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1155765

ABSTRACT

Abstract Background and objectives Several airway complications can occur during shoulder arthroscopy including airway obstruction, pleural puncture, and subcutaneous emphysema. It was hypothesized that the irrigation fluid used during a shoulder arthroscopic procedure might increase the cuff pressure of the endotracheal tube, which can cause edema and ischemic damage to the endotracheal mucosa. Therefore, this study aimed to evaluate the relationship between irrigation fluid and endotracheal tube cuff pressures. Methods Forty patients aged 20 to 70 years with an American Society of Anesthesiologists (ASA) score I or II, scheduled for elective arthroscopic shoulder surgery under general anesthesia, participated in our study. We recorded endotracheal tube cuff pressures and neck circumferences every hour from the start of the operation. We also recorded the total duration of the anesthesia, operation, and the total volume of fluid used for irrigation. Results A positive correlation was shown between endotracheal tube cuff pressures and the amount of irrigation fluid (r = 0.385, 95% CI 0.084 to 0.62, p = 0.0141). The endotracheal tube cuff pressure significantly increased at 2 and 3 hours after starting the operation (p = 0.0368 and p = 0.0245, respectively). However, neck circumference showed no significant difference. Conclusions Endotracheal tube cuff pressures increased with operation time and with increased volumes of irrigation fluid used in patients who underwent shoulder arthroscopy. We recommend close monitoring of endotracheal tube cuff pressures during shoulder arthroscopy, especially during long operations using a large amount of irrigation fluid, to prevent complications caused by raised cuff pressures.


Resumo Justificativa e objetivos Diversas complicações das vias aéreas podem ocorrer durante a artroscopia do ombro, incluindo obstrução das vias aéreas, punção pleural e enfisema subcutâneo. Levantou‐se a hipótese de que o fluido de irrigação utilizado durante artroscopia do ombro possa aumentar a pressão do balonete do tubo endotraqueal, podendo causar edema e lesão isquêmica na mucosa traqueal. Portanto, este estudo teve como objetivo avaliar a relação entre o fluido de irrigação e a pressão do balonete do tubo endotraqueal. Métodos Participaram do estudo 40 pacientes com idades entre 20 e 70 anos com classificação do estado físico I ou II da American Society of Anesthesiologists (ASA), programados para cirurgia artroscópica do ombro, eletiva e sob anestesia geral. Registramos as pressões do balonete do tubo endotraqueal e as circunferências do pescoço a cada hora, a partir do início da cirurgia. Também registramos a duração anestésica e cirúrgica, assim como o volume total de líquido de irrigação empregado. Resultados Foi encontrada correlação positiva entre a pressão do balonete do tubo endotraqueal e a quantidade de líquido de irrigação (r = 0,385; 95% IC 0,084 a 0,62; p = 0,0141). A pressão do balonete do tubo endotraqueal registrou aumento significante 2 e 3 horas após o início da cirurgia (p = 0,0368 e p = 0,0245, respectivamente). No entanto, a circunferência do pescoço não mostrou diferença significante. Conclusões As pressões do balonete do tubo endotraqueal aumentaram com o tempo de cirurgia e com o aumento do volume de líquido de irrigação utilizado em pacientes submetidos a artroscopia do ombro. Recomendamos a monitorização rigorosa da pressão do balonete do tubo endotraqueal durante artroscopia do ombro, especialmente nos procedimentos longos em que grandes volumes de fluido de irrigação são empregados, para evitar complicações causadas por pressões elevadas do balonete.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Pressure/adverse effects , Shoulder Joint/surgery , Intubation, Intratracheal/adverse effects , Time Factors , Elective Surgical Procedures/adverse effects , Elective Surgical Procedures/methods , Operative Time , Intubation, Intratracheal/instrumentation , Therapeutic Irrigation/adverse effects , Anesthesia, General/statistics & numerical data , Neck/anatomy & histology
4.
Rev. cuba. invest. bioméd ; 39(3): e689, jul.-set. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1138939

ABSTRACT

Introducción: Resulta fundamental la remoción por completo del hidróxido de calcio previo a la obturación del canal radicular que podría impedir la penetración de los selladores en los túbulos dentinarios. Objetivo: Determinar la efectividad de la eliminación de la medicación con hidróxido de calcio del canal radicular de dientes utilizando diferentes sistemas de irrigación. Métodos: Se irrigaron con hipoclorito de sodio 148 conductos radiculares rectos de dientes humanos. Se utilizó Ca(OH)2 mezclado con tinta negra para rellenar los canales radiculares y facilitar la visualización. Los dientes se dividieron en 5 grupos de acuerdo al protocolo de eliminación. En cada uno de los grupos, la extrusión apical se midió durante la etapa de irrigación por el método Huang X, después de la eliminación del Ca(OH)2, se seccionaron longitudinalmente y luego, en un portaobjetos, se observaron las muestras bajo un microscopio óptico. Finalmente, se analizó el contenido para cuantificar el grado de extrusión causado durante el procedimiento clínico. Se utilizó el test de ANOVA para el análisis estadístico Resultados: Se encontró diferencias significativas entre los grupos 1-2, 1-3, 1-4 y 1-5. El promedio de remanecía fue superior (66,4 por ciento). Los grupos 2 (41,6 por ciento) y 5 (34,8 por ciento) obtuvieron mayor eficacia en la remoción. ANOVA (α = 0,05) determina que no existieron diferencias significativas entre los 5 grupos. Conclusiones: Los dispositivos de activación ultrasónica mostraron una mayor eliminación de la medicación con hidróxido de calcio desde las paredes dentinarias a las técnicas manuales, sin embargo, demostró ser una terapia más invasiva debido a una mayor extrusión de detritus(AU)


Introduction: Root canal sealing should indispensably be preceded by complete calcium hydroxide removal, otherwise the latter might prevent the penetration of the sealers into the dentinal tubules. Objective: Determine the effectiveness of eliminating calcium hydroxide medication from the root canal of teeth using various irrigation systems. Methods: Preparation was conducted of 148 straight root canals of human teeth irrigating with sodium hypochlorite. The root canals were filled with Ca(OH)2 mixed with black ink to facilitate visualization. The teeth were divided into 5 groups in compliance with the removal protocol. Apical extrusion was measured in each group during the irrigation stage using the Huang X method. After Ca(OH)2 removal they were sectioned longitudinally and placed on a slide for observation of the samples under an optical microscope. Finally the content was analyzed to quantify the degree of extrusion obtained during the clinical procedure. The ANOVA test was used for statistical analysis. Results: Significant differences were found between the groups 1-2, 1-3, 1-4 and 1-5. Average remanence was above 66.4 percent. Groups 2 (41.6 percent) and 5 (34.8 percent) displayed higher removal efficacy. ANOVA (α = 0.05) did not determine any significant differences between the 5 groups. Conclusions: Ultrasonic activation obtained greater calcium hydroxide removal from the dentinal walls than manual techniques. However, it proved to be a more invasive therapy due to the greater detritus extrusion(AU)


Subject(s)
Humans , Root Canal Filling Materials/analysis , Calcium Hydroxide/analysis , Therapeutic Irrigation/methods , Endodontics/methods
6.
J. oral res. (Impresa) ; 9(1): 36-48, feb. 28, 2020. ilus, graf
Article in English | LILACS | ID: biblio-1151442

ABSTRACT

Endodontic treatment consists of the cleaning and disinfecting the root canal system, which is achieved using adequate mechanical instru-mentation and chemical irrigation. Endodontic microorganisms are present in root canals in the form of a biofilm, and their elimination ensures the success of endodontic treatment. Irrigation is a key factor contributing to the elimination of this intraconduct biofilm, and different irrigator agents and irrigation techniques, such as irrigation with negative apical pressure, a novel automated irrigation mechanism based on suction intraconduct, have been used. In this study, we evaluated the ability of a negative apical pressure system with different concentrations of sodium hypochlorite and durations to reduce the microbial load. Materials and Methods: An intraradicular biofilm composed of Enterococcus faecalis and Candida albicans was generated during twenty-one days of static culture on one hundred mesio-vestibular roots of upper molars with complex curvatures greater than 30°C, and the roots were classified in six groups with different concentrations and contact times of sodium hypochlorite. Subsequently, the reduction in the microbial load was measured with McFarland scale and the enumeration of colony forming units and was evaluated with scanning electronic microscopy. Results: We observed a significant difference in the reduction of the microbial load prior to instrumentation compared with postinstrumentation between the groups treated with 2.25% and 5.25% NaOCl for 30, 60 and 90 seconds of contact time (p<0.05), but we did not observe differences in the reduction of microbial load between different contact times and concentrations of sodium hypochlorite employed (p>0.05). Conclusion: Negative apical pressure is a good option for irrigation in endodontics, as it allows the passage of the irrigation fluid along the total length of the root canal and produces a better antimicrobial effect.


El tratamiento de endodoncia consiste en la limpieza y desinfección del sistema de conducto radicular, lo que se logra utilizando instrumentación mecánica adecuada y riego químico. Los microorganismos endodónticos están presentes en los conductos radiculares en forma de una biopelícula, y su eliminación asegura el éxito del tratamiento endodóntico. La irrigación es un factor clave que contribuye a la eliminación de esta biopelícula intraconductora, y se han utilizado diferentes agentes irrigadores y técnicas de irrigación, como la irrigación con presión apical negativa, un nuevo mecanismo automatizado de irrigación basado en la intraconducción de succión. En este estudio, evaluamos la capacidad de un sistema de presión apical negativa con diferentes concentraciones de hipoclorito de sodio y duraciones para reducir la carga microbiana. Material y Métodos: Se generó una biopelícula intraradicular compuesta por Enterococcus faecalisy Candida albicans durante veintiún días de cultivo estático en cien raíces mesio-vestibulares de molares superiores con curvaturas complejas superiores a 30°C, y las raíces se clasificaron en seis grupos con diferentes concentraciones y tiempos de contacto de hipoclorito de sodio. Posteriormente, la reducción en la carga microbiana se midió con la escala de McFarland y la enumeración de las unidades formadoras de colonias y se evaluó con microscopía electrónica de barrido. Resultado: Observamos una diferencia significativa en la reducción de la carga microbiana antes de la instrumentación en comparación con la postinstrumentación entre los grupos tratados con NaOCl 2.25% y 5.25% durante 30, 60 y 90 segundos de tiempo de contacto (p<0.05), pero lo hicimos No se observan diferencias en la reducción de la carga microbiana entre los diferentes tiempos de contacto y las concentraciones de hipoclorito de sodio empleado (p>0.05). Conclusión:La presión apical negativa es una buena opción para el riego en endodoncia, ya que permite el paso del líquido de riego a lo largo de todo el conducto radicular y produce un mejor efecto antimicrobiano.


Subject(s)
Humans , Root Canal Therapy/methods , Candida albicans/physiology , Candidiasis , Enterococcus faecalis/physiology , Biofilms , Sodium Hypochlorite , In Vitro Techniques , Endodontics , Therapeutic Irrigation
7.
Article in Korean | WPRIM | ID: wpr-811446

ABSTRACT

Optimal bowel preparation is essential for a more accurate, comfortable, and safe colonoscopy. The majority of postcolonoscopy colorectal cancers can be explained by procedural factors, mainly missed polyps or inadequate examination. Therefore the most important goal of optimal bowel preparation is to reduce the incidence of colorectal cancer. Although adequate preparation should be achieved in 85–90% or more of all colonoscopy as a quality indicator, unfortunately 20–30% shows inadequate preparation. Laxatives for oral colonoscopy bowel preparation can be classified into polyethylene glycol (PEG)-electrolyte lavage solution, osmotic laxatives, stimulant laxatives, and divided into high-volume solution (≥3 L) and low-volume solution (<3 L). The updated 2019 European Society of Gastrointestinal Endoscopy (ESGE) guideline is broadly similar to the 2014 American Society for Gastrointestinal Endoscopy (ASGE) recommendations and reaffirms the importance of split-dosing. However, new ESGE guideline, unlike the 2014 ASGE recommendation, suggests the use of high volume or low volume PEG-based regimens as well as that of non-PEG based agents that have been clinically validated for most outpatient scenarios. For effective, safe, and highly adherent bowel preparation, physicians who prescribe and implement colonoscopy should properly know the advantages and limitations, the dosing, and the timing of regimens. Recently many studies have attempted to find the most ideal regimens, and more convenient, effective, and safe regimens have been developed by reducing the dosing volume and improving the taste. The high tolerability and acceptability of the new low-volume regimens suggest us how we should use it to increase the participation of the national colorectal cancer screening program.


Subject(s)
Colonoscopy , Colorectal Neoplasms , Endoscopy, Gastrointestinal , Humans , Incidence , Laxatives , Mass Screening , Outpatients , Polyethylene Glycols , Polyps , Therapeutic Irrigation
8.
J. appl. oral sci ; 28: e20190100, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1056594

ABSTRACT

Abstract Objective: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. Methodology: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. Results: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). Conclusion: Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Periapical Periodontitis/therapy , Root Canal Therapy/instrumentation , Ultrasonic Therapy/instrumentation , Dental Pulp Cavity/microbiology , Root Canal Irrigants/therapeutic use , Root Canal Therapy/methods , Sodium Hypochlorite/therapeutic use , Bacteria/isolation & purification , Ultrasonic Therapy/methods , Colony Count, Microbial , DNA Probes , Linear Models , Analysis of Variance , Treatment Outcome , Cone-Beam Computed Tomography , Bacterial Load , Therapeutic Irrigation/instrumentation , Therapeutic Irrigation/methods
9.
Int. j. odontostomatol. (Print) ; 13(4): 392-397, dic. 2019. graf
Article in English | LILACS | ID: biblio-1056474

ABSTRACT

ABSTRACT: The objective of this study is to discuss and analyze whether extrusion of endodontic material constitutes avoidable intercurrence, discussing the clinical, ethical and legal implications. Patient LSR, 31 years old, female, attended a dental consultation complaining of pain in the second left maxillary premolar (tooth 25). Radiographically, a single root canal and thickening of the periodontal ligament associated with extravasation of 8 mm of gutta percha to the maxillary sinus were observed. The first endodontic session aimed to performing the desobturation, root canal preparation and intracanal medication placement. The root canal obturation was performed in the second session. Was carried out an apical surgery that removed 2 mm from the root apex and also performed the covered with a collagen membrane. A 22 months follow-up revealed a tooth function, absence of painful symptomatology or infection, and radiographically normal periodontal ligament and bone neoformation. The second single-root premolar is the type of premolar with less distance with the floor of the maxillary sinus. In this case, the extrusion of the obturator material occurred due to the superinstrumentation of the root canal associated with the proximity of the root with the membrane of the maxillary sinus. From the ethical and legal point of view, the patient has the right to be informed about any intercurrences that may arise during or after the treatment, and the informed consent form is essencial. This document will allow the patient to make a decision about performing an endodontic treatment in which the risk of an accident or complication is imminent or that treatment failure is already expected. It is important that professionals make appropriate diagnosis and treatment plan for each case, since this conduct may avoid clinical intercurrences. In addition, if the intercurrences occur, the patient should be advised of how to proceed.


RESUMEN: El objetivo de este estudio fue discutir y analizar si la extrusión de material endodóntico constituye una intercurrencia evitable, discutiendo las implicaciones clínicas, éticas y legales. Paciente LSR, de 31 años de edad, mujer, asistió a una consulta dental quejándose de dolor en el segundo premolar maxilar izquierdo (diente 25). Radiográficamente, se observó un solo conducto radicular y engrosamiento del ligamento periodontal asociado con la extravasación de 8 mm de gutapercha al seno maxilar. La primera sesión de endodoncia tuvo como objetivo realizar la desobturación, la preparación del conducto radicular y la colocación de medicación intracanal. La obturación del conducto radicular se realizó en la segunda sesión. Se llevó a cabo una cirugía apical que extrajo 2 mm del ápice de la raíz y también se realizó el recubrimiento con una membrana de colágeno. Un seguimiento de 22 meses reveló función dental, ausencia de sintomatología dolorosa o infección y ligamento periodontal radiográficamente normal y neoformación ósea. El segundo premolar de una sola raíz es el tipo de premolar con menos distancia con el piso del seno maxilar. En este caso, la extrusión del material obturador se produjo debido a la superinstrumentación del conducto radicular asociada con la proximidad de la raíz con la membrana del seno maxilar. Desde el punto de vista ético y legal, el paciente tiene derecho a ser informado acerca de cualquier inter-ocurrencia que pueda surgir durante o después del tratamiento, y el formulario de consentimiento informado es esencial. Este documento le permitirá al paciente tomar una decisión sobre la realización de un tratamiento de endodoncia en el que el riesgo de un accidente o complicación sea inminente o de que ya se espera un fracaso del tratamiento. Es importante que los profesionales realicen un diagnóstico y un plan de tratamiento adecuados para cada caso, ya que esta conducta puede evitar las intercurrencias clínicas. Además, si se producen intercurrencias, se debe informar al paciente sobre cómo proceder.


Subject(s)
Humans , Female , Adult , Root Canal Irrigants/administration & dosage , Root Canal Preparation/instrumentation , Tooth Apex , Extravasation of Diagnostic and Therapeutic Materials , Therapeutic Irrigation/instrumentation , Maxillary Sinus/diagnostic imaging , Apicoectomy , Surgery, Oral/methods , Radiography, Dental/methods , Maxillary Sinus/physiology
10.
Int. j. odontostomatol. (Print) ; 13(4): 442-445, dic. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056482

ABSTRACT

ABSTRACT: The objective of this study was to determine the effect of the subgingival irrigation of chlorhexidine 0.12 % of the total anaerobic microbiota. Microbial sampling to 30 subjects with periodontitis stage II Grade B, in pockets with a periodontal probing depth > 4 mm. The subgingival irrigation was made with 5 mL of chlorhexidine in the test group and with 5 mL of distilled water in the control group. 24 hours after the procedure was obtained a second sample to compare. It was found that the subgingival irrigation with chlorhexidine at 0.12 % achieved a statistically significant decrease in anaerobic microbiota (p< 0.05).


RESUMEN: El objetivo del presente estudio fue determinar el efecto de la irrigación subgingival de la clorhexidina 0,12 % sobre la microbiota anaeróbica total. Se tomaron muestras microbiológicas a 30 sujetos con periodontitis estadio II grado B, en sacos periodontales con una profundidad de sondaje > 4 mm. Se realizó la irrigación subgingival con 5 mL. de clorhexidina en el grupo test y con 5 mL. de agua destilada en el grupo control. 24 horas después del procedimiento se obtuvo una segunda muestra a comparar. Se detectó que la irrigación subgingival con clorhexidina al 0,12 % logra disminuir en forma estadísticamente significativa la microbiota anaeróbica total (p< 0,05).


Subject(s)
Humans , Periodontitis/epidemiology , Bacteria, Anaerobic/classification , Bacterial Infections/chemically induced , Dental Prophylaxis , Periodontitis/therapy , Bacterial Infections/microbiology , Chile , Chlorhexidine/administration & dosage , Epidemiology, Experimental , Statistical Analysis , Demographic Data , Sample Size , Therapeutic Irrigation
11.
Int. j. odontostomatol. (Print) ; 13(3): 271-274, set. 2019. graf
Article in Spanish | LILACS | ID: biblio-1012421

ABSTRACT

RESUMEN: Entre los concentrados plaquetarios de segunda generación, ha suscitado creciente interés, el uso de fibrina rica en plaquetas y leucocitos inyectable (i-PRF); que se obtiene a partir de la centrifugación inmediata de sangre venosa del propio individuo, y que aporta concentraciones elevadas de factor de crecimiento vascular endotelial, factor de crecimiento transformante beta, y factor de crecimiento derivado de plaquetas, entre otras proteínas que inician y coordinan el proceso reparativo. Su nula citotoxicidad y consistencia líquida abren un nuevo campo de estudio y experimentación en el ámbito de la Cirugía Oral y de la Periodoncia, como sustancia para irrigar. El objetivo de este manuscrito fue reportar el uso del i-PRF como irrigador subgingival en el tratamiento periodontal convencional de defectos infra óseos con 6 meses de seguimiento. En ambos casos, se verificó un efecto positivo de irrigación, lo que abre el debate al uso de productos farmacéuticos tradicionales como la clorhexidina versus preparados autólogos sin efectos adversos reportados a la fecha.


ABSTRACT: Second generation platelet concentrates include the use of injectable platelet-rich fibrin (i-PRF), which has generated increasing interest because it is derived from immediate centrifugation of venous blood from the patients themselves. It provides high concentrations of vascular endothelial growth factor, transforming growth factor beta, and platelet-derived growth factor, among other proteins that initiate and coordinate the healing process. Its null cytotoxicity and liquid consistency has opened new research lines in the field of oral surgery and periodontics, as an irrigation substance. The aim of this manuscript was to report the use of i-PRF, as a subgingival irrigator in conventional periodontal treatment of infra osseous defects, with six months follow-up. In both cases, a positive effect of irrigation was confirmed. These findings, open the debate as regards the use of traditional pharmaceutical products (such as chlorhexidine), versus autonomous preparations without adverse effects reported to date.


Subject(s)
Humans , Female , Adult , Aged, 80 and over , Periodontics/methods , Regeneration/drug effects , Bone Substitutes/therapeutic use , Intercellular Signaling Peptides and Proteins/pharmacology , Platelet-Rich Fibrin , Biocompatible Materials/pharmacology , Bone Matrix , Radiography, Dental , Dental Occlusion , Control , Therapeutic Irrigation/methods
12.
Braz. dent. j ; 30(4): 363-367, July-Aug. 2019. tab
Article in English | LILACS | ID: biblio-1011565

ABSTRACT

Abstract The present study evaluated the amount of apically extruded debris after chemo-mechanical preparation (CMP) associated with passive ultrasonic irrigation (PUI) using four different root canal irrigants, namely, 6% sodium hypochlorite (NaOCl), 2% chlorhexidine gel + saline solution (2% CHXg+SS), 2% chlorhexidine solution (2% CHXs) and SS alone. Sixty mandibular premolars with single straight root canals were selected and randomly assigned into 4 groups (n=15) according to the root canal irrigant used as follows: G1 (PUI + NaOCl), G2 (PUI + CHXg+SS), G3 (PUI+CHXs) and G4 (PUI+SS). Reciproc® R25 files (25/.08) were used during CMP and the debris extruded from each tooth were collected in pre-weighted Eppendorf tubes and dried. The average weight of debris was assessed by using an analytical microbalance. Data were statistically analysed by using ANOVA and post-hoc Tukey's test (a=0.05). Debris extrusion was observed in all groups, irrespective of the root canal irrigating, with 2% CHXg + SS being associated with lower debris extrusion compared to other irrigants (p<0.05). No significant differences were observed between 6% NaOCl, 2% CHXs and SS. In conclusion, passive ultrasonic irrigation did not completely prevent apically extrusion of debris. PUI performed with 2% chlorhexidine gel + saline solution significantly minimized debris extrusion compared to 6% sodium hypochlorite, chlorhexidine solution and saline solution.


Resumo O presente estudo avaliou a quantidade de debris extruídos apicalmente após o preparo químico-mecânico (PQM) associado à irrigação ultrassônica passiva (IUP) em associação com quatro diferentes irrigantes - hipoclorito de sódio 6% (NaOCl), clorexidina gel 2% + solução salina (CLXg 2% + SS), solução de clorexidina 2% (CLXs 2%) e SS. Sessenta pré-molares inferiores com canais radiculares únicos e retos foram selecionados e aleatoriamente distribuídos em 4 grupos (n=15) de acordo com o irrigante utilizado: G1 (IUP + NaOCl), G2 (IUP + CLXg + SS), G3 (IUP + CLXs) e G4 (IUP + SS). Limas Reciproc® R25 (25/.08) foram utilizadas durante o PQM e os debris extruídos de cada dente foram coletados em tubos Eppendorf pré-pesados e secos. O peso médio de debris foi avaliado através de microbalança analítica, e os dados foram analisados estatisticamente utilizando ANOVA e teste de Tukey post hoc (a=0.05). Extrusão de debris foi observada em todos os grupos, independente do irrigante. CHXg 2% + SS foram associados a menor extrusão de debris comparado aos demais irrigantes (p<0.05). Não foram observadas diferenças estatisticamente significativas entre NaOCl 6%, CLXs 2% e SS. Concluindo, irrigação ultrassônica passiva não preveniu completamente a extrusão apical de debris, entretanto, IUP realizada com CLXg 2% + SS minimiza significativamente a extrusão de debris comparado ao NaOCl 6%, CLXs 2% e SS.


Subject(s)
Humans , Root Canal Irrigants , Root Canal Preparation , Ultrasonics , Tooth Apex , Dental Pulp Cavity , Therapeutic Irrigation
13.
Braz. dent. j ; 30(3): 220-226, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1011555

ABSTRACT

Abstract The present study aimed to compare the effectiveness of QMiX and 17% EDTA associated to passive ultrasonic irrigation (PUI) or manual agitation (MA) on the reduction of E. faecalis, E. coli and LPS from root canals. Forty single rooted human teeth were randomly divided into four groups (n=10), according to the final irrigation protocol: EDTA+MA, QMiX+MA, EDTA+PUI, QMiX+PUI. Sample collections were obtained from the root canal content immediately before preparation (baseline-S1), after instrumentation (S2), after final irrigation protocol (S3) and 7 days after instrumentation and final irrigation (S4). The antimicrobial effectivity and on endotoxin content were analyzed by culture procedure (CFU/mL) and LAL assay (EU/mL), respectively. The results were statistically analyzed by Kruskal-Wallis and Friedman test (α=5%). QMiX+MA and QMiX+PUI reduced 100% of E. coli and E. faecalis bacteria and also prevented E. faecalisregrowth at S4. EDTA significantly reduced E. coli, but it was not effective in reducing E. faecalis. All protocols reduced EU/mL when compared to S1, however at S4 there was a significant reduction of EU/mL only in the QMiX+MA and QMiX+PUI groups in relation to S3 and S2, respectively. Final irrigation with QMiX associated with MA or PUI had superior antibacterial efficacy compared to EDTA, eliminating 100% of E. coli and E. faecalis strains. In addition, QMiX+PUI reduced 97.61% of the initial content of LPS.


Resumo O presente estudo objetivou comparar a eficácia do QMiX e do EDTA 17% associado à irrigação ultrassônica passiva (PUI) ou agitação manual (MA) na redução de E. faecalis, E. coli e LPS de canais radiculares. Quarenta dentes humanos unirradiculares foram divididos aleatoriamente em quatro grupos (n = 10), de acordo com o protocolo final de irrigação: EDTA+MA, QMiX+MA, EDTA+PUI, QMiX+PUI. Coletas das amostras foram obtidas a partir do conteúdo do canal radicular imediatamente antes do preparo (inicial-S1), após a instrumentação (S2), após o protocolo final de irrigação (S3) e 7 dias após a instrumentação e irrigação final (S4). A eficácia antimicrobiana e o conteúdo de endotoxina foram analisados ​​por procedimento de cultura (UFC/mL) e ensaio LAL (EU/mL), respectivamente. Os resultados foram analisados estatisticamente pelo teste de Kruskal-Wallis e Friedman (α = 5%). QMiX+MA e QMiX+PUI reduziram 100% das bactérias E. coli e E. faecalis e também preveniram a recolonização de E. faecalis em S4. O EDTA reduziu significativamente E. coli, mas não foi eficaz na redução de E. faecalis. Todos os protocolos reduziram EU/mL quando comparados com S1, no entanto, no S4 houve uma redução significativa de EU/mL apenas nos grupos QMiX+MA e QMiX+PUI em relação a S3 e S2, respectivamente. A irrigação final com QMiX associada a MA ou PUI apresentou eficácia antibacteriana superior em relação ao EDTA, eliminando 100% das cepas de E. coli e E. faecalis. Além disso, QMiX+PUI reduziu 97,61% do conteúdo inicial de LPS.


Subject(s)
Humans , Root Canal Irrigants , Dental Pulp Cavity , Sodium Hypochlorite , Ultrasonics , Edetic Acid , Root Canal Preparation , Endotoxins , Escherichia coli , Therapeutic Irrigation
14.
Int. braz. j. urol ; 45(2): 406-407, Mar.-Apr. 2019.
Article in English | LILACS | ID: biblio-1040055

ABSTRACT

ABSTRACT In complicated urinary tract infection with ureteral calculi, urinary diversion is inevitable. So, stenting or percutaneous drainage can be an option. In hemodynamically unstable patients, percutaneous drainage is superior to ureteral stenting (1). Once acute infection is controlled, definite treatment of the stone is necessary. According to a guideline, semirigid ureteroscopy is recommended for lower and mid - ureter stone and flexible ureteroscopy for upper ureter stone (2). Semi - rigid ureteroscopy can migrate stone to kidney, especially in upper ureter stone, lowering stone free rate (3). Not only flexible ureteroscopy creates additional costs but also is barely available in developing countries (4, 5). So, the authors would like to introduce anterograde irrigation - assisted ureteroscopic lithotripsy in patients with percutaneous nephrostomy. Retrograde irrigation was connected and flowed minimally enough to secure visual field. Once stone is noted, another saline irrigation, which is placed above 40 cm over the patient is connected to nephrostomy. Retrograde irrigation is disconnected from ureteroscope and the previous connected channel on ureteroscope is opened. Actual pressure detected by barometer from the opened channel of ureteroscope is usually about 30 cmH2 O while anterograde irrigation is administered in maximal flow, which means fully opened anterograde irrigation is not hazardous to kidney. There was no complication in 17 patients submitted to this method. Video shows advantages of our practice: clear visual field; reduced risk of stone migration into kidney; induced spontaneous passage of fragments without using instrumentation; and decreased operation time. In short, most of surgeons, even unexperienced, can perform an excellent procedure with less time consuming using our method.


Subject(s)
Humans , Nephrostomy, Percutaneous/methods , Lithotripsy/methods , Ureteral Calculi/surgery , Ureteroscopy/methods , Therapeutic Irrigation/methods , Lithotripsy/instrumentation
15.
J. coloproctol. (Rio J., Impr.) ; 39(1): 90-93, Jan.-Mar. 2019. tab, ilus
Article in English | LILACS | ID: biblio-984640

ABSTRACT

ABSTRACT Purpose: Treatment of persistent anal fistula implies a major challenge for surgeons, with risk of additional recurrence and potential continence impairment. We present a non-surgical treatment based on irrigation with silver nitrate 1% solution. Methods: This is a prospective study including patients with persistent anal fistula after surgery, who were treated with silver nitrate 1% solution irrigation from May 2015 to March 2017. Patients with evidence of abscess, presence of >1 external opening and those with bowel inflammatory disease were excluded. 3-5 cc of silver nitrate 1% solution were instilled through a catheter. The procedure was repeated on a weekly basis, conducting a maximum of 7 sessions per patient. Results: 18 patients (13 male, 72.2%) with a median age of 48 years old (IQR 41-55) were treated using silver nitrate 1% solution. A median of 5 sessions per patient was performed (IQR 3-6). The median follow-up period was 18 months (IQR 9-25). After the described period 8 patients' (44.4%) presented complete resolution of the fistula, 2 patients' (11.2%) were classified as partial healing and in 8 patients' (44.4%) the treatment was considered to fail. 6 patients' experienced self-limited pain during instillation, with persistence up to 24 h in 2 of them. Conclusions: Treatment with silver nitrate 1% solution is a minimally invasive procedure, with a favourable safety profile, that can be performed in an outpatients' basis achieving a complete healing rate of 44.4%. Therefore, this method should be considered for the treatment of recurrent or persistent anal fistula.


RESUMO Objetivo: O tratamento da fístula anal persistente é um grande desafio para os cirurgiões, com risco de recorrência adicional e potencial comprometimento da continência. Os autores apresentam um tratamento não cirúrgico baseado na irrigação com solução de nitrato de prata a 1%. Métodos: Este foi um estudo prospectivo incluindo pacientes com fístula anal persistente após a cirurgia que foram tratados com irrigação com solução de nitrato de prata a 1% entre maio de 2015 e março de 2017. Pacientes com evidência de abscesso, presença de mais de uma abertura externa e aqueles com doença inflamatória intestinal foram excluídos. Usando um cateter, instilou-se 3 a 5 cc. de solução de nitrato de prata a 1%. O procedimento foi repetido semanalmente, em um máximo de sete sessões por paciente. Resultados: Um total de 18 pacientes (13 homens, 72,2%) com idade mediana de 48 anos (IQR 41-55) foram tratados com solução de nitrato de prata a 1%. Uma mediana de cinco sessões por paciente foi realizada (IQR 3-6). A mediana do período de acompanhamento foi de 18 meses (IQR 9-25). Após o período descrito, oito pacientes (44,4%) apresentaram resolução completa da fístula, dois pacientes (11,2%) foram classificados como cicatrização parcial e em oito pacientes (44,4%) o tratamento falhou. Seis pacientes apresentaram dor autolimitada durante a instilação, que persistiu por até 24 horas em dois deles. Conclusões: O tratamento com solução de nitrato de prata a 1% é um procedimento minimamente invasivo, com perfil de segurança favorável, que pode ser realizado em regime ambulatorial, atingindo taxa de cura completa de 44,4%. Portanto, este método deve ser considerado para o tratamento da fístula anal recorrente ou persistente.


Subject(s)
Humans , Male , Female , Silver Nitrate/therapeutic use , Rectal Fistula/drug therapy , Therapeutic Irrigation , Anti-Infective Agents, Local/therapeutic use
16.
Int. j. odontostomatol. (Print) ; 13(1): 51-57, mar. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-990064

ABSTRACT

RESUMEN: El barro dentinario producido durante tratamiento endodóntico puede ser extruido hacia el tejido periradicular junto con el irrigante, produciendo inflamación y dolor postoperatorio. Comparar la cantidad de extrusión apical de barro dentinario e irrigante, producido durante la preparación químico-mecánica, por dos sistemas de instrumentación Rotatoria (Mtwo), y Reciprocante (Reciproc), complementado con irrigación pasiva o activa (Endoactivator). Cuarenta y ocho premolares (48) inferiores, fueron aleatoriamente distribuidos en cuatro grupos de estudio (n=12 dientes), (1) Rotatorio-pasiva, (2) Reciprocante-pasiva, (3) Rotatorio-activa y (4) Reciprocante-activa. Los conductos radiculares fueron instrumentados de acuerdo a las instrucciones del fabricante, e irrigados con hipoclorito de sodio al 5 %. El barro dentinario e irrigante extruido, fueron recolectados en tubos Eppendorf previamente pesados. Se calcularon los valores de extrusión de barro dentinario e irrigante para cada grupo. Los datos fueron analizados con el análisis de varianza ANOVA. En todos los grupos se produjo extrusión apical. No se encontraron diferencias estadísticamente significativas en la extrusión apical de barro dentinario, entre los grupos estudiados (P = 0,068), sin embargo, al analizar la extrusión de irrigantes, se evidenció diferencia estadísticamente significativa entre los grupos 1 y 4 (P< 0,05), entre los demás grupos no se observaron diferencias estadísticamente significativas. (P > 0,05). Bajo las condiciones de este estudio, los sistemas rotarios y reciprocante, extruyen sólido y líquido, siendo el sistema reciprocante el que produce mayor extrusión de líquido, tanto con irrigación activa como pasiva.


ABSTRACT: The smear layer produced during endodontic treatment can be extruded into the periradicular tissue together with the irrigant, producing inflammation and postoperative pain. The purpose of this in vitro study was to compare the amount of apical extrusion, produced during the endodontic preparations with two rotary instrumentation systems using passive and active irrigation. Forty-eight (48) mandibular premolars were randomly assigned to 4 groups (n = 12 teeth), (1) Rotatory - passive, (2) Reciprocating passive, (3) Rotatory-active, (4) Reciprocating- active. The root canals were instrumented according to the manufacturer's instructions and irrigated with 5 % sodium hypochlorite. Extruded debris and irrigant were collected in previously weighed Eppendorf tubes. The extrusion values were calculated for each group. The data were analyzed with the ANOVA analysis of variance. Results: Apical extrusion was produced in all groups. No statistically significant differences were found in the apical extrusion of smear layer, between the groups studied (P = 0.068), however, when analyzing the extrusion of irrigants, a statistically significant difference was evidenced between groups 1 and 4 (P <0.05). , among the other groups no statistically significant differences were observed. (P> 0.05). Under the conditions of this study, the reciprocating and rotary systems, extrude solid and liquid, being the reciprocating system the one that produces more extrusion of liquid, with both active and passive irrigation.


Subject(s)
Humans , Root Canal Irrigants , Smear Layer , Therapeutic Irrigation/instrumentation , Titanium/chemistry , Bicuspid , In Vitro Techniques , Analysis of Variance , Nickel/chemistry
17.
Braz. dent. j ; 30(1): 31-35, Jan.-Feb. 2019. graf
Article in English | LILACS | ID: biblio-989430

ABSTRACT

Abstract The aim of this study was to evaluate whether amplifying the volume and/or time of contact of NaOCl affects the fracture strength of endodontically treated bovine teeth. Four bovine incisors from 10 animals were allocated into 4 groups using a split-mouth design. Root canals were instrumented using a sequence of 4 manual stainless steel files and irrigated with a 5.25% alkalized NaOCl solution. The total volume and time of irrigation, per sample, varied among the groups as following: standard volume and time of contact - 15 mL/11.5 min; volume raise - 30 mL/11.5 min; time of contact raise - 15 mL/19 min; and volume and time of contact raise - 30 mL/19 min. Samples were subjected to a fracture resistance assay. At p=0.05, two-way ANOVA statistically scrutinized the results. Effect size of NaOCl time of contact and volume were also calculated (η2). The variation in time (p=0.000), volume of irrigation (p=0.000) and the combination of both (p=0.038) negatively influenced the fracture resistance. Standard volume and time of irrigation showed the highest fracture strength while isolated increase in volume or time reduced in 25% and 37%, respectively, the fracture resistance; the simultaneous increase in volume and time of irrigation promoted a reduction of 47%. Effect size of NaOCl time of contact was superior (0.746) than the volume (0.564). Raising the volume and/or time of a 5.25% alkalized NaOCl solution reduces the fracture resistance of endodontically treated bovine teeth.


Resumo O objetivo desse estudo foi o de avaliar se o aumento de volume e/ou tempo de contato do NaOCl afeta a resistência à fratura de dentes bovinos tratados endodonticamente. Quatro incisivos bovinos de 10 animais foram alocados em 4 grupos usando um desenho experimental de boca dividida. Os canais radiculares foram instrumentados usando uma sequência de 4 limas manuais de aço inoxidável e irrigados com uma solução de NaOCl alcalinizada a 5,25%. O volume total e o tempo de irrigação, por amostra, variaram entre os grupos da seguinte forma: volume e tempo de contato padrão (grupo controle) - 15 mL/11,5 min; aumento de volume - 30 mL/11,5 min; aumento no tempo de contato - 15 mL/19 min; e aumento no volume e no tempo de contato - 30 mL/19 min. As amostras foram submetidas a um ensaio de resistência à fratura. Com p=0.05, o teste two-way ANOVA analisou estatisticamente os resultados. O tamanho do efeito do tempo de contato e volume de NaOCl também foi calculado (h2). A variação no tempo (p=0,000), no volume de irrigação (p=0,000) e a interação entre ambos (p=0.038) influenciaram negativamente a resistência à fratura. O volume e o tempo padrão de irrigação apresentaram a maior resistência à fratura, enquanto o aumento isolado no volume ou no tempo de contato reduziram 25% e 37%, respectivamente, a resistência à fratura; o aumento simultâneo do volume e tempo de irrigação promoveu uma redução de 47%. O tamanho do efeito do tempo de contato com o NaOCl foi superior (0,746) ao volume (0,564). Aumentando o volume e/ou o tempo de uma solução de NaOCl alcalinizada a 5,25% reduz a resistência à fratura de dentes bovinos tratados endodonticamente.


Subject(s)
Animals , Root Canal Therapy , Sodium Hypochlorite/chemistry , Tooth Fractures , Sodium Hypochlorite/administration & dosage , Cattle , Dental Stress Analysis , Incisor , Therapeutic Irrigation/methods
18.
Article in English | WPRIM | ID: wpr-766315

ABSTRACT

OBJECTIVES: This study aimed to evaluate the effect of clinical factors on the outcome of arthrocentesis in the treatment of temporomandibular joint (TMJ) internal derangement. MATERIALS AND METHODS: Fifty patients with TMJ internal derangement underwent arthrocentesis using ringer's lactate. The present study evaluated the contribution of the clinical variables of age, time since onset, visual analogue scale (VAS) pain level, and range of motion (ROM) on the outcomes of TMJ arthrocentesis: age (≤25 years, >25 and ≤40 years, >40 and ≤60 years), VAS pain level (≤5, >5 and ≤7, >7 and ≤10), and ROM ( 7 (OR, 11.25; P=0.039), and a maximum vertical opening of < 25 mm (OR, 7.70; P=0.038). CONCLUSION: Lavage of the superior joint space with ringer's lactate resulted in significant reduction in pain and improvement in mouth opening. Patients with a greater inflammatory component and younger patients benefitted more from arthrocentesis. Evaluation of these clinical variables helped in predictive modelling, which may provide clinicians with the opportunity to identify “at-benefit” patients early and initiate specific treatment.


Subject(s)
Arthrocentesis , Humans , Joints , Lactic Acid , Logistic Models , Mouth , Odds Ratio , Range of Motion, Articular , Temporomandibular Joint , Therapeutic Irrigation
20.
Clinical Pain ; (2): 138-141, 2019.
Article in Korean | WPRIM | ID: wpr-811478

ABSTRACT

Lateral epicondylopathy represents pain in the lateral (radial aspect) of the elbow caused by degeneration in the common extensor tendon. Calcium deposit frequently developes in lateral epicondylopathy, with the prevalence up to 46%. There are considerable debates on its treatment protocols for lateral epicondylopathy so far, likewise, the effective treatment method for calcific lateral epicondylopathy has not been established. We report here a case of chronic intractable calcific lateral epicondylopathy treated with ultrasound-guided barbotage and focused type extracorporeal shock wave therapy (ESWT). To our knowledge, this is the first report of calcific lateral epicondylopathy treated by ultrasound-guided barbotage combined with ESWT.


Subject(s)
Calcium , Clinical Protocols , Elbow , Methods , Prevalence , Shock , Tendons , Therapeutic Irrigation
SELECTION OF CITATIONS
SEARCH DETAIL