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1.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(2): 667-671, Apr.-June 2021. graf
Article in English | LILACS | ID: biblio-1340653

ABSTRACT

Abstract Introduction: the avulsion of primary teeth is a disturbing and unexpected event. Description: this report describes the clinical case of a three-year-old child who suffered an avulsion and replantation of the primary upper central incisors at the site of the injury. The guardians sought treatment for the child at the Federal University of Minas Gerais after the replantation. Four months later, the child suffered a new trauma and the replanted teeth presented advanced mobility, root resorption and fistula. The clinical conduct was extraction and rehabilitation with a fixed esthetic maintainer. Discussion: the literature describes two treatment options for avulsion of primary incisors: replantation and non-replantation. According to a recent systematic review, the difficulty in obtaining a consensus regarding the best clinical conduct is due, in part, to the scarcity of publications that present not only follow-ups with clinical success, but also with failures. The outcomes of replantation can be influenced by several factors. The time elapsed between replantation and splinting, and the new episode of trauma, negatively influenced the prognosis in the present case, leading to failure. Replantation of primary incisors is not yet evidence-based treatment. Therefore, this option must be chosen with caution and in ideal situations. It requires constant clinical and radiographic monitoring for evaluation of outcomes.


Resumo Introdução: a avulsão de dentes decíduos é um evento perturbador e inesperado. Descrição: o presente relato descreve o caso clínico de uma criança de três anos que sofreu avulsão e reimplante dos incisivos centrais superiores decíduos no local do acidente. Os responsáveis procuraram atendimento para a criança na Universidade Federal de Minas Gerais após reimplante. Quatro meses depois, a criança sofreu novo trauma e os dentes reimplantados apresentavam mobilidade avançada, reabsorção radicular e fístula. A conduta clínica foi extração e reabilitação com mantenedor estético fixo. Discussão: a literatura descreve duas opções de tratamento para avulsão de incisivos decíduos: o reimplante e o não reimplante. De acordo com revisão sistemática recente, a dificuldade de se obter um consenso sobre a melhor conduta clínica se deve, em parte, à escassez de publicações que apresentem não apenas acompanhamentos com sucesso clínico, mas também com falhas. O reimplante pode ser influenciado por vários fatores. O tempo decorrido entre o reimplante e a contenção, e o novo episódio de trauma, influenciaram negativamente o prognóstico do presente caso, levando ao insucesso. O reimplante de incisivos decí- duos ainda não é um tratamento baseado em evidências. Portanto, essa opção deve ser escolhida com cautela e em situações ideais. Requer monitoramento clínico e radiográfico para constante avaliação do desfecho.


Subject(s)
Humans , Child, Preschool , Tooth, Deciduous/surgery , Tooth, Deciduous/injuries , Tooth Avulsion/therapy , Tooth Replantation/adverse effects , Tooth Replantation/methods
2.
Article in English | LILACS, BBO | ID: biblio-1287483

ABSTRACT

Abstract Objective: To evaluate the knowledge of patients treated in a public University concerning dental avulsion and its emergency first-aid management. Material and Methods: Three hundred patients were invited to answer a questionnaire about demographic characteristics, attitude and knowledge of first-aid management of dental avulsion. Chi-square test was used to assess the association between knowledge about dental replantation and education level. Results: Female gender (66.7%) aged from 31 to 40 years (31.3%) with high school education (50.3%) predominated among all the participants. It was not found a difference between education level and management of avulsed permanent teeth (p=0.076), and 66% of the respondents were not able to do the replantation. In relation to the management of avulsed tooth, 42.7% of the respondents would brush the tooth and if the replantation was not possible, most of them would choose inappropriate media for storage. The association between the storage medium and educational level showed to be statistically significant (p=0.043). Conclusion: It was possible to notice the lack of knowledge about this subject, and it could result in the worst prognosis. In avulsion cases, the subsequent root resorptions may lead to the loss of the child's tooth. It is important to implement educational campaigns to spread knowledge and improve success rates of permanent avulsed teeth


Subject(s)
Humans , Male , Female , Adult , Tooth Avulsion/etiology , Tooth Replantation , Health Knowledge, Attitudes, Practice , Community Dentistry , Tooth Injuries/etiology , Dentition, Permanent , Toothbrushing , Brazil/epidemiology , Chi-Square Distribution , Demography , Cross-Sectional Studies , Surveys and Questionnaires , Data Interpretation, Statistical , First Aid
3.
Rev. Cient. CRO-RJ (Online) ; 5(3): 66-71, Dec. 2020.
Article in English | LILACS, BBO | ID: biblio-1343341

ABSTRACT

Introduction: Avulsion is a serious injury that causes damage to dental and supportive tissues, and is characterized by complete displacement of a tooth from its socket. In most situations, replantation is the treatment of choice for permanent tooth avulsion, and appropriate management is critical for a good prognosis in these cases. Previous studies have shown that the level of knowledge of dentists regarding the management of an avulsed tooth is deficient and have underscored the importance of continuing dental education to further the knowledge of general dentists in the urgency management of permanent avulsed teeth. Objective: This report aims to present a step-by-step clinical sequence involving the reimplantation of a mature permanent tooth that suffered avulsion,following the CARE guide. Case report: Tooth 21, stored in milk, was reimplanted 2 hours after avulsion and stabilized with flexible containment. The clinical steps were carried out according to the recommendations of the International Association of Dental Traumatology. Endodontic treatment was started five days after reimplantation, with periodic changes of intracanal medication. The patientis currently under follow-up, with no negative signs or symptoms related to avulsion. Conclusion: Dental reimplantation after avulsion should be performed after a thorough systemic and oral diagnosis and tooth storage conditions, with a clinical protocol based on scientific evidence of associations of dentoalveolar trauma.


Introdução: A avulsão é uma injuria grave que causa sérios danos aos tecidos de suporte do doente e é caracterizada pelo completo deslocamento do elemento dentário de dentro do alvéolo. O reimplante é, na maioria das situações, o tratamento de escolha para o dente permanente avulsionado e uma conduta correta é necessária para um bom prognostico nestes casos. Estudos prévios mostram que o conhecimento de dentistas sobre o manejo de um dente que sofreu avulsão é deficiente e destacam a importância da educação continuada, com a intenção de aumentar o nível de conhecimento de dentistas clínicos frente a urgências envolvendo dentes avulsionados. Objetivo: este relato tem como objetivo apresentar uma sequência clínica passo-a-passo envolvendo o reimplante de um dente permanente maduro que sofreu avulsão, seguindo o guia CARE. Relato do caso: O dente 21, armazenado em leite, foi reimplantado 2 horas após a avulsão e estabilizado com contenção flexível. As etapas clínicas foram realizadas conforme as recomendações da Associação Internacional de Traumatismos Dentários. O tratamento endodôntico foi iniciado cinco dias após o reimplante, com trocas periódicas de medicação intracanal. Atualmente o paciente encontra-se em acompanhamento, sem sinais ou sintomas negativos relacionados a avulsão. Conclusão: O reimplante dental após avulsão deve ser realizado após minucioso diagnóstico e condições de armazenamento do dente, com protocolo clínico embasado nas evidências científicas das associações de traumatismos dentoalveolares.


Subject(s)
Endodontics , Tooth Avulsion , Tooth Replantation , Tooth Injuries , Dentition, Permanent
4.
Dent. press endod ; 10(3): 15-26, Sept-Dec.2020. Ilus
Article in English | LILACS | ID: biblio-1344750

ABSTRACT

Introdução: A manutenção da dentição natural é preferível na maioria dos casos. Muito embora hoje em dia se possa contar com os implantes dentários, em casos com prognóstico menos limitado a preservação dos dentes ainda é mais aconselhável que os implantes. A Endodontia, e todas as suas possibilidades terapêuticas existentes, intenta e faz o papel de especialidade que tem como princípio prevenir ou eliminar a periodontite apical, dando condições de reparo e saúde ao periodonto apical e tecido ósseo. Com o advento tecnológico dos últimos anos, os tratamentos de canal se tornaram muito mais previsíveis e isso se reflete no aumento dos índices de sucesso, tanto de tratamentos primários quanto de retratamentos. Contudo, existem casos que falham, mas esses casos não são o fim da linha para o dente. Entre as manobras existentes para se reintervir em dentes que tiveram um tratamento que fracassou, são possíveis a microcirurgia endodôntica apical ou o reimplante intencional. Método: A manobra de reimplante intencional consiste de várias etapas cirúrgicas que vão desde a extração do elemento dental até a reposição de volta ao seu alvéolo. Neste artigo foram descritos dois casos clínicos limítrofes que foram tratados por meio desse procedimento. Resultados: Os casos apresentaram resultados excelentes, como remissão das lesões apicais, reparo ósseo e permanência dos elementos em boca, com acompanhamento de longo prazo (2 e 11 anos). Conclusões: Com altos índices de sucesso já relatados na literatura, essa modalidade de tratamento precisa ser mais explorada e divulgada no Brasil, principalmente entre alunos de pós-graduação e especialistas em Endodontia, pois comprovadamente pode evitar a indicação desnecessária de implantes dentais (AU).


Introduction: The maintenance of natural dentition is preferable in most of cases. However, nowadays it is possible to use dental implants in cases where prognosis is very limited. Endodontics and all of its therapeutic modalities play an important role, which has, in principle, to prevent or eliminate apical periodontitis providing better conditions for wound healing of periapical and bone tissues. In the past few years, with technological advances, root canal treatment became more predictable and this can be seen reflected in the increase of success rates of primary treatment as well as non-surgical retreatment. Nevertheless, some cases can failure but, it is not the end for the tooth, once some therapeutic approaches are possible, like apical microsurgery or intentional replantation. Method: Intentional replantation is an approach in which some surgical steps are done, since the dental extraction until its repositioning back to the socket. In this article two bordering cases were described. Results: 2 and 11 years follow-up confirm the favorable results of this technique. Both cases with no apical lesion, bone healing and dental elements developing their natural functions. Conclusions: The high successful rates described in the literature give to this treatment approach an important face, and that should be more explored and disclosed in Brazil, specially between specialists and post-graduation students, once can avoid unnecessary dental implants (AU).


Subject(s)
Humans , Periapical Periodontitis , Tooth Replantation , Therapeutic Approaches , Microsurgery , Students , Retreatment , Endodontics , Methods
5.
Rev. bras. odontol ; 77(1): 1-4, jan. 2020. Ilus
Article in English | LILACS | ID: biblio-1116460

ABSTRACT

Objetivo: este artigo tem como objetivo demonstrar a abordagem de um trauma alveolar dentário no qual o reimplante dentário foi realizado no Sistema Único de Saúde (SUS) e encaminhado para acompanhamento a longo prazo em uma Clínica Odontológica da Universidade do Nordeste do Brasil. Relato de caso: paciente do sexo masculino, 7 anos, encaminhado à Clínica Odontológica da Universidade Tiradentes para acompanhamento em longo prazo de um reimplante dentário do elemento 11. Durante o exame clínico, observa-se um grau severo de mobilidade dentária, além da presença de fístula na linha do muco gengival do dente. Radiograficamente, observou-se espessamento do ligamento periodontal e áreas de extensa reabsorção externa. O acompanhamento do caso durou aproximadamente 1 ano. Conclusão: portanto, é essencial que o profissional cirurgião-dentista tenha conhecimento para o correto diagnóstico e agilidade neste tratamento urgente, a fim de preservar o órgão dentário na cavidade oral por mais tempo


Introduction: dental trauma is an injury that mainly affects children and adolescents. Tooth avulsion is one of the most common causes of trauma, which is the expulsion of the alveolar tooth. The prognosis is due to pulp and support tissue repair, however, it is associated with complications such as functional, aesthetic and psychological problems, and is doubtful and dependent on rapid behavior. Objective: this article aims to demonstrate the approach of a dental alveolar trauma in which dental reimplantation was performed in the Unified Health System (SUS) and referred for long-term follow-up in a University Dental Clinic of Northeast Brazil. Case report: a 7-year-old male patient, referred to the Dental Clinic of Universidade Tiradentes for long-term follow-up of a dental reimplantation of element 11. During the clinical examination, a severe degree of tooth mobility can be observed, in addition to presence of fistula in the gingival mucus line of the tooth. Radiographically, thickening of the periodontal ligament and areas of extensive external resorption were observed. The follow-up of the case lasted approximately 1 year. Conclusion: thus, it is essential that the dental surgeon professional has knowledge for the correct diagnosis and agility in this urgent treatment, in order to preserve the dental organ in the oral cavity for a longer time.


Subject(s)
Humans , Child , Tooth Avulsion , Tooth Mobility , Tooth Replantation , Tooth Injuries
6.
Braz. oral res. (Online) ; 34: e087, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132726

ABSTRACT

Abstract Inflammatory external root resorption (IERR) is a pathological process defined by the progressive loss of dental hard tissue, dentin, and cementum, resulting from the combination of the loss of external root protective apparatus and root canal infection. It has been suggested that healing patterns after tooth replantation may be influenced by the genetic and immunological profiles of the patients. The purpose of the present investigation was to evaluate the DNA methylation patterns of 22 immune response-related genes in extracted human teeth presenting with IERR. Methylation assays were performed on samples of root fragments showing IERR and compared with healthy bone tissue collected during the surgical extraction of impacted teeth. The methylation patterns were quantified using EpiTect Methyl II Signature Human Cytokine Production PCR Array. The results revealed significantly higher hypermethylation of the FOXP3 gene promoter in IERR (65.95%) than in the bone group (23.43%) (p < 0.001). The ELANE gene was also highly methylated in the pooled IERR sample, although the difference was not statistically significant (p= 0.054). Our study suggests that the differential methylation patterns of immune response-related genes, such as FOXP3 and ELANE, may be involved in IERR modulation, and this could be related to the presence of root canal infection. However, further studies are needed to corroborate these findings to determine the functional relevance of these alterations and their role in the pathogenesis of IERR.


Subject(s)
Humans , Root Resorption , Tooth Replantation , Tooth Root , DNA Methylation , Dental Cementum
7.
Arq. odontol ; 56: 1-9, jan.-dez. 2020. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1088005

ABSTRACT

Objetivo:Avaliar o conhecimento e a conduta de médicos e enfermeiros atuantes no serviço público de atenção básica à saúde da zona urbana da cidade de Vitória da Conquista ­ BA, sobre avulsão dentária. Métodos:60 profissionais responderam a um questionário autoaplicável contendo questões biodemográficas e perguntas a respeito do conhecimento sobre o significado de avulsão e reimplante dentário, conduta em casos de avulsão dental e interesse em receber orientação sobre o tema. Resultados:A maioria dos entrevistados demonstrou não saber o que é avulsão dental, reimplante dental e que atitude tomar no caso de uma situação envolvendo avulsão (70%, n = 42; 51,67%, n = 31; 56,67%, n = 34, respectivamente). Consideraram-se incapazes de reimplantar um dente avulsionado em seu local de origem (83,33%, n = 50). Poucos foram capazes de responder corretamente o tempo ideal de reposicionamento (6,67%, n = 4) e local de armazenamento de um dente avulsionado (5%, n = 3), mas saberiam conduzir corretamente sua limpeza (28,34%, n = 17). Relataram nunca ter recebido orientação sobre a conduta diante desses casos (93,33%, n = 56) mas consideram informações a respeito do tema importantes e necessárias (96,66%, n = 58). Conclusão:Os médicos e enfermeiros possuem conhecimento insatisfatório sobre o significado de avulsão e reimplante dental e fatores que permeiam a conduta dessa situação.


Aim:To evaluate the knowledge and behavior of primary health care physicians and nurses working in public healthcare services in the urban area of Vitória da Conquista, BA, Brazil, regarding dental avulsion.Methods:Sixty professionals answered a self-administered questionnaire containing questions about biodemographic data, knowledge about the meaning of avulsion and tooth replantation, conduct in cases of dental avulsion, and interest in receiving training or guidance on the subject. Results:Most participants did not know what tooth avulsion and dental reimplantation were, not did they know what action to take in case of an dental avulsion situation (70%, n = 42; 51.67%, n = 31; 56.67%, n = 34, respectively). They found themselves unable to redeploy one avulsed tooth in its place of origin (83.33%, n = 50). Few were able to correctly answer the ideal time repositioning (6.67%, n = 4) and storage location of an avulsed tooth (5%, n = 3), but would know how to properly conduct its cleaning (28.34%, n = 17). They reported never having received guidance on how to proceed in these cases (93.33%, n = 56) but consider information regarding this issue important and necessary (96.66%, n = 58). Conclusion:Primary care physicians and nurses have little knowledge of the meaning of dental avulsion and replantation, as well as factors that underlie proper conduct in this situation.


Subject(s)
Physicians , Tooth Avulsion , Tooth Replantation , Health Education , Health Personnel , Education, Continuing , Nurses, Male , Primary Health Care , Surveys and Questionnaires
8.
Belo Horizonte; s.n; 2020. 124 p. ilus, graf, tab.
Thesis in English, Portuguese | LILACS, BBO | ID: biblio-1099625

ABSTRACT

A reabsorção radicular externa inflamatória (RREI) é um processo patológico definido como a perda progressiva de tecido mineralizado radicular, dentina e cemento, resultante da combinação entre a lesão às camadas protetoras da superfície externa da raiz e a presença de microrganismos no interior do sistema de canais radiculares. Estudos clínicos demonstraram o papel da idade e de fatores relacionados ao manejo e tratamento do dente avulsionado na etiopatogenia e evolução das RREI após reimplantes. Entretanto, não existem informações sobre a interação destes fatores, bem como poucos estudos avaliaram a influência do perfil genético e imunológico do paciente no padrão de cicatrização após reimplantes dentários. O presente estudo objetivou (1) avaliar a interação de fatores prognósticos para o desenvolvimento da RREI após o reimplante de dentes permanentes, bem como (2) investigar o papel da epigenética nos processos imunomediados das RREI pós-traumáticas. Para estudo dos determinantes clínicos e suas interações, o universo da pesquisa envolveu 427 pacientes (idade média de 12,6 anos) portadores de 581 dentes permanentes reimplantados, com rizogênese completa no momento do trauma, tratados na Clínica de Traumatismos dentários da Faculdade de Odontologia da Universidade Federal de Minas Gerais entre 1994 e 2018. Dados relativos à idade do paciente no momento do trauma, grau de rizogênese, condições de armazenamento e período extra alveolar do dente avulsionado, uso de antibioticoterapia sistêmica, tempo decorrido entre o reimplante e o início da terapia endodôntica radical (TER) e a duração do período de imobilização foram coletados dos prontuários dos pacientes. Tomadas radiográficas realizadas na consulta de início do TER foram utilizadas para diagnóstico da atividade de reabsorção. Sinais radiográficos de RREI foram encontrados em 80,7% da amostra (469 dentes). Os resultados demonstraram que a idade do paciente no momento do trauma e o tempo decorrido até o início do TER representaram importantes fatores prognósticos para a ocorrência de RREI. Além disso foi observada uma interação quantitativa entre estas duas variáveis uma vez que o aumento na idade do paciente atenuou significativamente o efeito do tempo até o início da terapia endodôntica. Este resultado inédito evidencia a maior vulnerabilidade do paciente mais jovem e enfatiza a importância de se considerar estas duas covariáveis conjuntamente durante a tomada de decisão clínica. Para o estudo epigenético, o perfil de metilação do DNA de 22 genes envolvidos na resposta imune foi avaliado em um pool de 08 amostras de fragmentos radiculares de dentes reimplantados portadores de RREI, indicados para exodontia. O grupo controle consistiu em um pool de 06 amostras de tecido ósseo saudável coletado durante a extração cirúrgica de dentes impactados. Os padrões de metilação do DNA dos 22 genes foram quantificados utilizando EpiTect Methyl II Signature Human Cytokine Production PCR Array. Os resultados do estudo da epigenética revelou que o pool de amostras com RREI apresentou nível mais alto de metilação do DNA na região promotora da FOXP3, em comparação com o pool de osso normal (65,95% e 23,43%, respectivamente). Esta é a primeira evidência de uma possível participação de eventos epigenéticos na modulação da RREI e especula-se se o padrão hipermetilado da FOXP3 poderia estar relacionado à presença da infecção endodôntica.


Inflammatory external root resorption (IERR) is a pathological process defined as the progressive loss of root mineralized tissue, dentin and cement, resulting from both: damage to the protective layers in the root external surface and the presence of endodontic infection inside the root canal. Clinical studies have demonstrated the role of age and factors related to the management and treatment of avulsed teeth in the etiopathogenesis and progression of RREI. However, there is no information on the interaction of these factors and few studies have evaluated the influence of the patient's genetic and immunological profile on the healing pattern after dental replantation. The present study aimed to (1) evaluate the interaction of prognostic factors for the development of RREI after replantation of permanent teeth, as well as (2) to investigate the role of epigenetics in the immunomediated processes of posttraumatic RREI. To study the clinical determinants and their interactions, the sample comprised 427 patients (mean age 12.6 years) with 581 replanted mature permanent teeth treated at the Dental Trauma Clinic of the Faculty of Dentistry from the Federal University of Minas Gerais between 1994 and 2018. Patients' records were evaluated to collect data such as patient's age at the time of the trauma, storage conditions and extra alveolar period of the avulsed tooth, systemic antibiotic therapy prescription, time elapsed between reimplantation and onset of endodontic therapy (TER) and splinting timing. The presence and index of IERR was assessed radiographically at the visit of pulpectomy. Radiographic signs of IEER were found in 80.7% of the sample (469 teeth) and were absent in 19.7% of cases (112 teeth). The results showed that the patient's age at the time of the trauma and the time that elapsed until the beginning of TER represented important prognostic factors for the occurrence of RREI. In addition, a quantitative interaction was observed between these two variables since the increase in the patient's age significantly attenuated the effect of time until the beginning of endodontic therapy. This is an original result that highlights the greater vulnerability of the younger patients and emphasizes the importance of considering these two covariates together during clinical decision-making. For the epigenetic study, the DNA methylation profile of 22 genes involved in the immune response was evaluated in a pool of 08 samples of root fragments of replanted teeth with RREI, referred to extraction. The control group consisted of a pool of 06 samples of healthy bone tissue collected during surgical extraction of impacted teeth. The DNA methylation pattern was quantified using EpiTect Methyl II Signature Human Cytokine Production PCR Array. The results of the epigenetics study revealed that the sample pool with RREI showed a higher level of DNA methylation in the FOXP3 promoter region, compared to the normal bone pool (65.95% and 23.43%, respectively). This is the first evidence of a possible participation of epigenetic events in the modulation of RREI and it is speculated whether the hypermethylated pattern of FOXP3 could be related to the presence of endodontic infection.


Subject(s)
Periodontal Ligament , Root Resorption , Tooth Avulsion , Tooth Replantation , Dentition, Permanent , DNA Methylation , Epigenomics , Cross-Sectional Studies , Anti-Bacterial Agents
9.
Int. j. odontostomatol. (Print) ; 14(3): 358-362, 2020. graf
Article in English | LILACS | ID: biblio-1114907

ABSTRACT

In patients who need endodontic re-treatment, and where the prognosis for surgical or non-surgical re-treatment is poor or treatment may be risky, one alternative is to opt for extraction of the affected tooth and replacement by an implant. However treatment by intentional reimplantation (IR) is also a possibility. The object of the present study was to present a case of a patient aged 71 years who needed endodontic re-treatment, where IR treatment was selected. The patient reported spontaneous pain which disappeared completely with the use of analgesics. This tooth had previously been treated endodontically around 1 year earlier, and no pain was reported in the first two months after treatment.Nonetheless, about 3 months before the present consultation, intensity of the symptoms had increased with a sensation of pressure in the apical-coronal direction. Cone-beam computerised tomography (CBCT) showed a periapical lesion in tooth 3.7. Based on the clinical and imaging examinations, acute apical periodontitis was diagnosed in tooth 3.7.The tooth was treated by IR. It was carefully extracted and inspected for cracks or perforations. It was treated under the microscope with root resection, and then retrograde obturation was carried out with bioceramic material. The tooth was then repositioned in its alveolus. It was immobilised for 15 days, after which the patient could return gradually to normal masticatory function. In the 6 months check-up the patient presented no pain or sensitivity to percussion. No root resorption or periapical radiolucency was observed in the periapical X-ray. We conclude that IR is an alternative to extraction followed or not by prosthetic treatment, for patients who need endodontic re-treatment. The treatment presents good levels of success, and of acceptance by the patient.


En pacientes que necesitan de retratamiento endodóntico y el retratamiento quirúrgico o no quirúrgico tiene un pronóstico desfavorable o puede ser riesgoso, se puede optar por la extracción del diente afectado y su reemplazo por implante o se puede elegir el tratamiento mediante la técnica de reimplante intencional (RI). El objetivo del presente estudio fue presentar un caso de paciente de 71 años con necesidad de retratamiento endodóntico, donde se optó por la realización del RI. Paciente relatava dolor espontáneo que desaparecia completamente con el uso de analgésicos. Este diente ya había sido tratado endodónticamente hace alrededor de 1 año, y el paciente noreportó dolor en los primeros dos meses después del tratamiento.No obstante, hace aproximadamente 3 meses la intensidad de los síntomas aumentó, junto con la sensación de presión en el sentido ápice-corona. La tomografía computarizada cone-beam (TCCB) mostró lesión periapical en el diente 3.7. Basado en el examen clínico e imagenológico se diagnosticó periodontitis apical aguda en el diente 3.7.Para el tratamiento se realizó la técnica de RI, siendo extraído el diente cuidadosamente, e inspeccionado a fin de localizar fisuras o perforaciones. El diente fue tratado bajo microscopio y se realizó la resección de la raíz. Se realizó la obturación retrógrada con material biocerámico. Enseguida el diente fue reposicionado en su alveolo, la inmovilización fue realizada durante 15 días y la paciente logró retornar gradualmente a su función masticatoria. En el seguimiento de 6 meses la paciente no presentó dolor o sensibilidad a la percusión. En la radiografía periapical no se observó resorción radicular o radiolucencia periapical. Concluimos que el RI en pacientes que necesitan retratamiento endodóntico es una alternativa a la realización de la exodoncia seguida o no, de tratamiento protético, donde existe una buena aceptación por parte del paciente y éxito en el tratamiento.


Subject(s)
Humans , Female , Aged , Periodontitis , Tooth Replantation/methods , Dental Pulp Cavity/surgery , Molar/surgery
10.
Ibom Medical Journal ; 13(1): 28-34, 2020. ilus
Article in English | AIM, AIM | ID: biblio-1262920

ABSTRACT

Context: Aesthetic considerations form a major aspect of dental material selection for tooth restorations. Anterior restorative materials exclusively used in anterior teeth. With the advances made, tooth-colored restorative materials are now used in posterior teeth restorations. Objective: The aim of this study was to evaluate the techniques employed, associated problems and the attitudes of dental practitioners to the placement of posterior composites. Method: This was a questionnaire-based study conducted among sixty-eight (68) dentists practicing in public/government-owned and private hospitals. Results: The results show that 86.8% of the respondents considered the conservation of tooth substance as the most common factor influencing their choice of composite materials for posterior teeth. On their perceptions of posterior composites generally, 77.9% of the respondents agreed that posterior composites needed less destruction of sound tooth substance while 35.0% considered moisture control as the most difficult problem faced during placement of the restoration. Wooden wedges were the most popular wedges while ultraviolet curing light were the most commonly used by the respondents. Majority (82.4%) agreed that calcium hydroxide and glass ionomer cement should only be used in cases of operatively exposed dentine in deep cavities. The percentage that never used rubber dam was 47.1 while incremental curing was the most commonly used method. Sectional matrices were more commonly used by respondents while the most commonly encountered post-treatment problem was the fracture of restorations. Conclusion: While more dental practitioners are embracing the use of composites for posterior restorations, there remains the need to get them to embrace the techniques of placement to ensure more satisfactory and predictable outcomes


Subject(s)
Nigeria , Tooth Replantation
11.
Dent. press endod ; 9(3): 82-88, Sept-Dec.2019. Ilus
Article in English | LILACS | ID: biblio-1343991

ABSTRACT

Objetivo: apresentar o relato de um caso de tratamento viável para molar inferior permanente endodonticamente tratado que apresentou sintomatologia após 6 meses do tratamento endodôntico. Uma vez que retratamento endodôntico ou cirurgia parendodôntica não eram indicados, o reimplante intencional foi a técnica escolhida. Relato de caso: uma hora antes do procedimento, o paciente fez bochecho com gluconato de clorexidina a 0,12% e foi preparado para cirurgia com anestesia dos nervos alveolar inferior e lingual, realizada com mepivacaína 2% contendo 1:100.000 de adrenalina. O procedimento teve início com extração menos traumática possível, envolvendo-se imediatamente o dente extraído em gaze umedecida com soro fisiológico, enquanto as raízes foram avaliadas para presença de fraturas, seguida da apicectomia. As cavidades foram retroinstrumentadas com broca de alta rotação sob irrigação com soro fisiológico e, para a retro-obturação, foi utilizado agregado de trióxido mineral (MTA) branco. Imediatamente, o dente foi reposicionado no alvéolo e estabilizado por suturas com fio de seda 4-0. Após um ano, o paciente retornou para controle radiográfico e clínico, o qual não revelou mais resposta à percussão vertical. Após 10 anos, a imagem radiográfica mostra reparo apical, sem indícios de reabsorção radicular ou lesão periapical. Conclusão: o exame clínico, associado à ausência dor e mobilidade normal do dente, confirmou o sucesso do tratamento, indicando esse como uma alternativa válida quando o implante não for acessível para o paciente. Essa técnica pode ajudar a restaurar a função de um dente original, em vez de substituí-lo por prótese ou implante dentário (AU).


Objective: This case report shows a successful viable treatment for an endodontically treated permanent mandibular molar which presented clinical symptoms 6 months after the endodontic treatment. Since endodontic retreatment or paraendodontic surgery were not indicated, the chosen technique was intentional replantation. Case Report: One hour before the procedure, the patient rinsed his mouth with chlorhexidine gluconate 0.12%. The patient was prepared for surgery and profound inferior alveolar and lingual nerve block anesthesia was achieved with 2% mepivacaine containing 1/100,000 adrenaline. The procedure started with the least traumatic extraction as possible and immediately wrapping the extracted tooth in physiological saline-moistened gauze, while the roots were evaluated for vertical fractures, followed by apicoectomy. The cavities were retro-prepared with high-speed bur under irrigation with physiological saline and white mineral trioxide aggregate (MTA) was used for retrofilling. Immediately, the tooth was repositioned in the alveolus. Two 4-0 silk sutures were used to suture and stabilize the tooth. After one year, the patient returned for radiographic and clinical control, which revealed no more response to vertical percussion. After 10 years, the images show radiographic apical repair, without evidence of root resorption or periapical lesion. Conclusion: Clinical examination associated with the reported absence of pain and normal mobility confirmed the procedure's success, indicating this treatment as a valid alternative when an implant is not viable. This technique may help restore an original tooth to function instead of replacing it with a prosthetic or a dental implant (AU).


Subject(s)
Humans , Apicoectomy , Tooth Replantation , Chlorhexidine , Prostheses and Implants , Tooth Apex , Molar
12.
Dent. press endod ; 9(1): 58-64, jan.-mar. 2019. Ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1008681

ABSTRACT

Introdução: a manutenção de um dente traumatizado na cavidade bucal depende de um tratamento emergencial correto, bem como de um longo e adequado período de acompanhamento clínico-imaginológico. Objetivo: relatar um caso clínico de avulsão e reimplante dentário do dente #11, em uma criança com 11 anos de idade, que permanecia na cavidade bucal há 13 anos. Relato de caso: foi feito reimplante dentário 45 minutos após a avulsão, tratamento endodôntico com 10 trocas mensais de medicação intracanal à base de hidróxido de cálcio, seguidas da obturação do canal radicular pela técnica de condensação lateral, e acompanhamento clínico e radiográfico. Resultados: após 13 anos de controle clínico e imaginológico, o dente #11 apresentava-se em função e esteticamente satisfatório. Conclusão: o incisivo central superior direito, avulsionado, reimplantado e anquilosado, apresentou um quadro evolutivo de reabsorção radicular por substituição, porém inativo até o último acompanhamento. Após tratamento endodôntico e acompanhamento clínico e imaginológico, o dente permaneceu na cavidade bucal em função, sem sintomatologia e esteticamente agradável após 13 anos do reimplante. (AU)


Introduction: The maintenance of a traumatized tooth in the oral cavity depends on a correct emergency treatment, as well as a long and adequate period of clinical-imaging follow-up. Objective: To report a clinical case of avulsion and replantation of tooth 11, in an 11-year-old child, who has been in the oral cavity for 13 years. Methods: tooth replantation 45 minutes after avulsion, endodontic treatment with 10 monthly exchanges of intracanal calcium hydroxide medication, followed by root canal filling using lateral condensation technique. Clinical and radiographic follow-up. Results: after 13 years of clinical and imaging control, tooth 11 presents aesthetically satisfactory function. Conclusion: The upper right central incisor, avulsed, replanted and ankylosed presented an evolutionary condition of root resorption by substitution, but inactive until the last follow-up. After endodontic treatment and clinical and imaging follow-up, the tooth remained in the oral cavity in function, without symptomatology and aesthetically pleasing after 13 years of replantation (AU).


Subject(s)
Humans , Male , Child , Tooth Avulsion , Tooth Replantation/methods , Endodontics , Incisor/surgery , Tooth Injuries
13.
Article in English | LILACS, BBO | ID: biblio-1056852

ABSTRACT

Abstract Objective: To evaluate the knowledge of elementary school teachers about the management of dental trauma. Material and Methods: An observational study, with the cross-sectional design, was conducted among primary school teachers in Hail, Saudi Arabia during January 2017. The questionnaire distributed among 400 primary school teachers from 18 different schools using convenient sampling. Data were gathered and analyzed using SPSS version 20 Results: 378 (94.5%) respondents to the questionnaire. It was found that only 37.8% of the primary school teachers were able to distinguish between the primary and permanent teeth. Only 59.5% reported starting the management of a child with trauma immediately. Merely 38.4% believed that it is important to search for the missing tooth or the broken pieces, whereas 31% would re-implant the permanent tooth into the socket by themselves. Regarding the storage media, only 16.6% respond correctly. According to school teachers, the best way of learning the management of dental trauma at school is through videos (36.2%) and phone application (33.9%) Conclusion: School teachers lack knowledge regarding the management of dental trauma. We strongly recommend planning for dental trauma educational based on the teacher's perception after pilot testing its effectiveness.


Subject(s)
Saudi Arabia/epidemiology , Tooth Replantation/instrumentation , Health Knowledge, Attitudes, Practice , Tooth Injuries/diagnostic imaging , School Teachers , Surveys and Questionnaires , Data Interpretation, Statistical
14.
Rev. Salusvita (Online) ; 38(4): 1001-1017, 2019.
Article in Portuguese | LILACS | ID: biblio-1117700

ABSTRACT

Introdução: o conhecimento da importância dos cuidados em saúde bucal é deficiente em âmbito escolar, ressalta-se que jovens capacitados, partilham o aprendizado assumindo papel importante na sociedade. Objetivos: capacitação de estudantes para difusão do conhecimento sobre cuidados em saúde bucal. Os temas de higienização dentária/prótese dentária e/ou implantossuportadadas e manejo após o traumatismo dentário foram abordados em escola pública. Métodos: Inicialmente, houve avaliação do conhecimento prévio dos alunos (n=25) por meio de questionários de saúde bucal, os questionários (GOHAI, higienização oral e de prótese dentária e manejo de traumatismo dentário) foram aplicados na sala de aula com supervisão. Em um próximo momento houve o treinamento dos discentes por palestras e material didático. Finalmente, após 2 meses do ciclo de formação os questionários foram aplicados novamente. Os dados foram tabulados e e análise estatística considerou o valor significativo para p<0,05, a fim de verificar o conhecimento adquirido durante o treinamento de todos os estudantes. Resultados: Identificou se pós-oficina que os jovens estavam mais satisfeitos com a aparência da boca (p<0,05). Nos questionários de higienização de próteses dentárias houve a conscientização do tempo para substituição das mesmas. Para o reimplante dentário, houve significativa percepção dos alunos como possibilidade de terapia real (p=0,016), após a realização das oficinas. Conclusão: com base nos dados, a proposta de promoção em saúde bucal para os adolescentes foi eficiente, e mais eventos (oficinas) com esta finalidade devem ser realizados em escolas de ensino médio.


Introduction: the knowledge of the importance of oral health care is deficient in the school environment, it is emphasized that empowered young people share learning, assuming an important role in society. Objectives: This study aimed to enable the training of students to disseminate knowledge about oral health care. The subjects of dental hygiene / dental prosthesis and / or implant supported and management after dental trauma were addressed in a public school. Methods: Initially, the students' prior knowledge (n = 25) was assessed through oral health questionnaires, the questionnaires (GOHAI, oral and dental hygiene and dental trauma management) were applied in the classroom with supervision. In a next moment there was the training of the students by lectures and didactic material. Finally, after 2 months of the training cycle, the questionnaires were applied again. Data were tabulated and statistical analysis considered the value significant for p students. Results: It was identified after the workshop that young people were more satisfied with the appearance of the mouth (p<0,05).In the dental prosthesis cleaning questionnaires, there was a time awareness for their replacement. For dental replantation, there was significant perception of students as a possibility of real therapy (p = 0.016), after the workshops. Conclusion: Based on the data, the proposal for oral health promotion for adolescents was efficient, and more events (workshops) for this purpose should be held in high schools.


Subject(s)
Humans , Male , Female , Adolescent , Oral Health , Health Promotion/methods , Time Factors , Tooth Avulsion , Tooth Replantation , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires , Tooth Injuries/surgery , Dentition , Emotions , Physical Appearance, Body
15.
Rev. odontol. UNESP (Online) ; 48: e20180144, 2019. tab, ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1014406

ABSTRACT

Resumo Introdução A busca por protocolos efetivos para reduzir a incidência de reabsorções radiculares e favorecer a reparação do ligamento periodontal perdido ainda representa um grande desafio, tendo em vista o prognóstico desfavorável dos reimplantes dentais tardios. Objetivo Avaliar, por meio da análise histológica, os efeitos do laser de alta potência e da fotobiomodulação na ocorrência de reabsorção radicular e no reparo periodontal, em dentes reimplantados tardiamente. Material e método Foram utilizados 50 incisivos centrais direitos de ratos Wistar. Após a extração, os espécimes foram divididos em cinco grupos (n = 10): G1 (controle positivo): reimplante imediato; G2 (controle negativo): reimplante tardio (RT): espécimes mantidos em ambiente seco por 60 minutos, sem tratamento adicional; G3: RT associado ao tratamento da superfície radicular com laser diodo de alta potência (810 nm, 1.5 W); G4: RT + superfícies radiculares e feridas alveolares tratadas com fotobiomodulação (laser diodo 660 nm, 30 mW e 780 nm, 40 mW, respectivamente); G5: RT + superfícies radiculares irradiadas com laser de alta e alvéolos com fotobiomodulação, nos mesmos parâmetros que G3 e G4, respectivamente. Após 60 dias, os animais foram eutanasiados. Os espécimes foram processados para análise histológica. Resultado G3 e G5 apresentaram as menores médias de scores com relação à ocorrência de reabsorções radiculares e anquilose, quando comparados a G2 e G4 (Teste Kruskall-Wallis, p<0,05). Com relação ao reparo periodontal, todos os grupos experimentais (G3, G4 e G5) apresentaram médias de escores inferiores (Teste Kruskall-Wallis, p<0,05) comparadas ao G1 e semelhantes ao G2 (Teste Kruskall-Wallis, p>0,05). Conclusão O laser de alta potência, associado ou não à fotobiomodulação, diminuiu a ocorrência das reabsorções radiculares e da anquilose, e a fotobiomodulação não favoreceu o controle das reabsorções radiculares nem o reparo periodontal.


Abstract Introduction The search for effective protocols for a lower incidence of root resorptions reduction and for a favor periodontal repair still represents a great challenge, considering the unfavorable prognostic of the delayed replanted tooth. Objective To evaluate by histologic analyses the effects of high power diode laser and photobiomodulation on the occurrence of root resorption and on the tissue repair of delayed replanted teeth. Material and method Fifty right central incisors of Wistar rats were used. After the extraction, the specimens were assigned to 5 groups (n=10): G1 and G2 were the control groups-with no treatment and they were respectively submitted to immediate and delayed replantation (DR- 60 minutes after the extraction). The other three groups received tissue repair treatment prior the DR: G3 - root surfaces were irradiated with high power laser (810 nm, 1.5 W); G4- root surfaces and the alveolar wounds were irradiated with low power laser (photobiomodulation), respectively with 660 nm, 90 mW and 780 nm, 40 mW; G5- root surfaces were irradiated with high power and the alveolar wound received photobiomodulation with the same parameters used in G3 and G4. After 60 days the animals were euthanized. The specimens were processed for histological analyses. Result The histologic analysis showed lower means values of scores of root reabsorptions and ankylosis in G3 and G5 when compared to G2 and G4 (Kruskall-Wallis test, p>0.05). Regarding the periodontal repair, all the experimental groups (G3, G4 and G5) presented lower means values of scores than G1 (Kruskall-Wallis test, p <0.05) and similar values to G2 (Kruskall-Wallis test, p>0.0.5). Conclusion High power laser reduced the occurrence of root resorption and photobiomodulation did not enhance the tissue healing process in delayed tooth replantation in rats.


Subject(s)
Animals , Male , Rats , Root Resorption , Tooth Avulsion , Tooth Replantation , Lasers, Semiconductor/therapeutic use , Phototherapy , Incidence , Rats, Wistar , Tooth Ankylosis
16.
Article in Korean | WPRIM | ID: wpr-764430

ABSTRACT

Although intentional replantation is frequently used as a treatment modality for endodontic problems, severe periodontal involvement has usually been regarded as a contraindication. However, there are some studies suggesting that intentional replantation could be a successful treatment alternative for periodontally involved teeth. This paper reports the treatment of a tooth with severe periodontal involvement using intentional replantation. The tooth, which had had root canal therapy due to endodontic-periodontal combined lesion but showed extensive bone loss, was gently extracted and replanted after thorough debridement of the root surface. By intentional replantation, a tooth with severe periodontal involvement in this case could be preserved, without extraction, over the course of a 3-year follow-up period.


Subject(s)
Alveolar Bone Loss , Debridement , Follow-Up Studies , Periodontal Attachment Loss , Periodontal Diseases , Replantation , Root Canal Therapy , Tooth Replantation , Tooth
17.
Article in English | WPRIM | ID: wpr-761306

ABSTRACT

Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.


Subject(s)
Acetazolamide , Ankylosis , Bandages , Calcium Hydroxide , Calcium , Dental Enamel , Diphosphonates , Gallium , Indomethacin , Miners , Pemetrexed , Replantation , Root Resorption , Tooth Ankylosis , Tooth Avulsion , Tooth Replantation , Tooth
18.
Araçatuba; s.n; 2018. 94 p. ilus, tab.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1009796

ABSTRACT

Objetivo: Avaliar, o reparo pulpar diante de dois antibióticos de uso sistêmico, tetraciclina e amoxicilina, em casos de reposicionamento (luxação extrusiva) ou reimplante (avulsão) dentários imediatos em ratos. Material e Métodos: Incisivos centrais maxilares superiores de ratos foram luxados e reposicionados após 5 minutos (n=90) ou extraídos, imersos em soro fisiológico por 5min e reimplantados (n=90). Os grupos foram divididos em três subgrupos (n=30) conforme o antibiótico e o controle (soro fisiológico) administrado após o ato cirúrgico e até sete dias. Os animais foram eutanasiados após 7, 15 ou 30 dias. Cortes histológicos longitudinais foram corados com HE para análise histomorfológica da camada de odontoblastos, deposição de dentina reparativa, bainha epitelial de Hertwig mantida junto com o dente, necrose e infiltrado inflamatório periapical. Para a análise estatística, utilizaram-se os testes de Mann-Whitney, Kruskal-Wallis e de Dunns (p<0,05). Resultado: Verificou-se haver diferença estatisticamente significativa entre os grupos amoxicilina e tetraciclina apenas na deposição de dentina reparativa no terço médio aos 15 dias após a luxação extrusiva. Para avulsão, a diferença ocorreu entre esses mesmos grupos aos 7 dias (presença da camada de odontoblastos, necrose e infiltrado inflamatório) e aos 15 dias (presença de necrose). Adicionalmente, verificaram-se diferenças entre o uso da amoxicilina ao longo do tempo tanto na avulsão como na luxação. Conclusão: A avaliação microscópica demonstrou a importância do uso de antibióticos de uso sistêmico na reação pulpar em casos de reposicionamento e reimplante dentários imediatos em ratos, uma vez que a amoxicilina contribuiu favoravelmente para o reparo pulpar após a realização de reimplante subsequente à avulsão dentária, porém, isto não ocorreu com a tetraciclina. No reposicionamento dentário após luxação extrusiva, o uso de antibióticos não afetou o reparo obtido(AU)


Aim: To evaluate the pulp repair in the presence of two systemic antibiotics, tetracycline and amoxicillin, in cases of immediate dental repositioning (extrusive luxation) or replantation (avulsion), in rats. Material and Methods: Upper maxillary central incisors of rats were dislocated and repositioned after 5min (n = 90), or extracted, immersed in physiological solution for 5min, and reimplanted (n = 90). The groups were divided into three subgroups (n=30) according to the antibiotic or saline (control) administered after the surgery and up to seven days. The animals were euthanized after 7, 15 or 30 days. Longitudinal histological sections were stained with HE for histomorphological analysis of the odontoblast layer, reparative dentin deposition, Hertwig epithelial sheath maintained along with the tooth, necrosis, and periapical inflammatory infiltrate. For the statistical analysis the Mann-Whitney, Kruskal-Wallis e de Dunns (p<0,05). Results: There was a statistically significant difference between the amoxicillin and tetracycline groups only in the reparative dentin deposition in the middle third at 15 days after the extrusive luxation. For avulsion, the difference occurred between these same groups at 7 days (presence of odontoblasts layer, necrosis and inflammatory infiltrate) and at 15 days (presence of necrosis). Additionally, there were differences between the use of amoxicillin over time in both avulsion and luxation. Conclusion: Microscopic evaluation demonstrated the importance of the use of systemic antibiotics in the pulp reaction in cases of immediate dental repositioning and reimplantation, in rats, since amoxicillin contributed favorably to the repair after reimplantation after dental avulsion, but this did not occur with tetracycline. In dental repositioning after extrusive luxation, the use of antibiotics did not affect the repair obtained(AU)


Subject(s)
Animals , Rats , Tetracycline , Tooth Injuries , Dental Pulp , Amoxicillin , Tooth Avulsion , Tooth Replantation , Rats, Wistar
19.
Araçatuba; s.n; 2018. 94 p. ilus, tab.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1021268

ABSTRACT

Objetivo: Avaliar, o reparo pulpar diante de dois antibióticos de uso sistêmico, tetraciclina e amoxicilina, em casos de reposicionamento (luxação extrusiva) ou reimplante (avulsão) dentários imediatos em ratos. Material e Métodos: Incisivos centrais maxilares superiores de ratos foram luxados e reposicionados após 5 minutos (n=90) ou extraídos, imersos em soro fisiológico por 5min e reimplantados (n=90). Os grupos foram divididos em três subgrupos (n=30) conforme o antibiótico e o controle (soro fisiológico) administrado após o ato cirúrgico e até sete dias. Os animais foram eutanasiados após 7, 15 ou 30 dias. Cortes histológicos longitudinais foram corados com HE para análise histomorfológica da camada de odontoblastos, deposição de dentina reparativa, bainha epitelial de Hertwig mantida junto com o dente, necrose e infiltrado inflamatório periapical. Para a análise estatística, utilizaram-se os testes de Mann-Whitney, Kruskal-Wallis e de Dunns (p<0,05). Resultado: Verificou-se haver diferença estatisticamente significativa entre os grupos amoxicilina e tetraciclina apenas na deposição de dentina reparativa no terço médio aos 15 dias após a luxação extrusiva. Para avulsão, a diferença ocorreu entre esses mesmos grupos aos 7 dias (presença da camada de odontoblastos, necrose e infiltrado inflamatório) e aos 15 dias (presença de necrose). Adicionalmente, verificaram-se diferenças entre o uso da amoxicilina ao longo do tempo tanto na avulsão como na luxação. Conclusão: A avaliação microscópica demonstrou a importância do uso de antibióticos de uso sistêmico na reação pulpar em casos de reposicionamento e reimplante dentários imediatos em ratos, uma vez que a amoxicilina contribuiu favoravelmente para o reparo pulpar após a realização de reimplante subsequente à avulsão dentária, porém, isto não ocorreu com a tetraciclina. No reposicionamento dentário após luxação extrusiva, o uso de antibióticos não afetou o reparo obtido(AU)


Aim: To evaluate the pulp repair in the presence of two systemic antibiotics, tetracycline and amoxicillin, in cases of immediate dental repositioning (extrusive luxation) or replantation (avulsion), in rats. Material and Methods: Upper maxillary central incisors of rats were dislocated and repositioned after 5min (n = 90), or extracted, immersed in physiological solution for 5min, and reimplanted (n = 90). The groups were divided into three subgroups (n=30) according to the antibiotic or saline (control) administered after the surgery and up to seven days. The animals were euthanized after 7, 15 or 30 days. Longitudinal histological sections were stained with HE for histomorphological analysis of the odontoblast layer, reparative dentin deposition, Hertwig epithelial sheath maintained along with the tooth, necrosis, and periapical inflammatory infiltrate. For the statistical analysis the Mann-Whitney, Kruskal-Wallis e de Dunns (p<0,05). Results: There was a statistically significant difference between the amoxicillin and tetracycline groups only in the reparative dentin deposition in the middle third at 15 days after the extrusive luxation. For avulsion, the difference occurred between these same groups at 7 days (presence of odontoblasts layer, necrosis and inflammatory infiltrate) and at 15 days (presence of necrosis). Additionally, there were differences between the use of amoxicillin over time in both avulsion and luxation. Conclusion: Microscopic evaluation demonstrated the importance of the use of systemic antibiotics in the pulp reaction in cases of immediate dental repositioning and reimplantation, in rats, since amoxicillin contributed favorably to the repair after reimplantation after dental avulsion, but this did not occur with tetracycline. In dental repositioning after extrusive luxation, the use of antibiotics did not affect the repair obtained(AU)


Subject(s)
Animals , Rats , Tetracycline , Tooth Injuries , Dental Pulp , Amoxicillin , Tooth Avulsion , Tooth Replantation , Rats, Wistar , Incisor
20.
Braz. oral res. (Online) ; 32: e7, 2018. tab, graf
Article in English | LILACS | ID: biblio-889497

ABSTRACT

Abstract The aim of this study is to evaluate the action of paramonochlorophenol associated with Furacin followed by calcium hydroxide (CH) dressing in the control of inflammatory root resorption in cases of immediate tooth replantation with delayed endodontic treatment. A total of 28 incisors of 3 male dogs were extracted and replanted after 15 minutes, and randomly divided into 3 groups: Group I (n = 8) - endodontic treatment was performed before the extraction and replantation; Group II (n = 10) - endodontic treatment was performed 30 days after replantation and the root canal was filled with CH dressing; Group III (n = 10) - endodontic treatment was performed 30 days after replantation and root canals received temporary medication of paramonochlorophenol-Furacin followed by CH dressing. The animals were euthanized 90 days after replantation. The histomorphological events analyzed at the epithelial reattachment site were the intensity and extent of acute and chronic inflammatory processes, periodontal ligament (PDL) organization, the intensity and extent of acute and chronic inflammatory processes in the PDL space, root resorption, bone tissue, and ankylosis. Data were submitted to the Wilcoxon Signed Ranks Test for group comparison (α = 5%). In Groups I, II and III the periodontal ligament was regenerated and most of the resorption areas were repaired by newly formed cementum. The depth and extent of root resorption were significantly higher in Group II than in Group III. The use of paramonochlorophenol-furacin followed by CH dressing was more effective in controlling inflammatory root resorption after immediate tooth replantation.


Subject(s)
Animals , Male , Dogs , Root Resorption/prevention & control , Tooth Replantation/methods , Chlorophenols/pharmacology , Tooth, Nonvital/drug therapy , Anti-Infective Agents, Local/pharmacology , Nitrofurazone/pharmacology , Periodontal Ligament/drug effects , Periodontal Ligament/pathology , Root Canal Filling Materials/pharmacology , Root Canal Therapy/methods , Root Resorption/pathology , Time Factors , Tooth Root/drug effects , Tooth Root/pathology , Calcium Hydroxide/pharmacology , Random Allocation , Reproducibility of Results , Treatment Outcome , Tooth, Nonvital/pathology , Medical Illustration
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