Eficácia do etidronato na remoção da smear layer dos canais radiculares: um estudo com microscopia eletrônica de varredura / Effectiveness of etidronate in root canal smear layer removal: A study with scanning electron microscopy

Avaliar, por microscopia eletrônica de varredura (MEV), o efeito do uso individual e combinado do etidronato 18% (HEBP) na remoção da smear layer do canal radicular. Métodos: Trinta dentes humanos unirradiculares foram utilizados. As raízes foram preparadas com instrumentos rotatórios do Sistema ProTaper Universal e divididas aleatoriamente em três grupos, de acordo com o protocolo de irrigação empregado: G1 = hipoclorito de sódio 2,5% (NaOCl) e ácido etilenodiaminotetracético 17% (EDTA); G2 = NaOCl 2,5% e HEBP 18%; e G3 = NaOCl 2,5% + HEBP 18%, misturados em partes iguais. As raízes foram seccionadas longitudinalmente e metalizadas, para análise em MEV. As fotomicrografias obtidas dos terços cervical, médio e apical foram avaliadas por três examinadores calibrados, que atribuíram escores de 1 a 5 às imagens. Os grupos experimentais foram comparados usando o teste de Kruskal-Wallis e o teste de Student-New- man-Keuls. Os terços radiculares foram comparados pelo teste de Friedman. O nível de significância foi estabelecido em 5%. Resultados: A capacidade de remoção da smear layer com NaOCl 2,5% e 18% HEBP (G2) foi semelhante à obtida com NaOCl 2,5% e EDTA 17% (G1) no terço médio e cervical da raiz; o nível de limpeza do terço apical foi semelhante, independentemente do protocolo de irrigação utilizado. Conclusão: HEBP é uma solução promissora para uso em tratamentos endodônticos (AU).

Introduction: We evaluated the effect of individual and combined use of 18% etidronate (HEBP) in root canal smear layer removal using scanning electron microscopy (SEM). Methods: Thirty human single-rooted teeth were used. The roots were prepared with ProTaper Universal System rotary files and randomly divided into three groups according to the irrigation protocol used. G1: 2.5% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA); G2: 2.5% NaOCl and 18% HEBP; and G3: 2.5% NaOCl + HEBP 18%, mixed in equal parts. The roots were sectioned longitudinally and metallized for SEM analysis. The photomicrographs obtained from the cervical, middle, and apical thirds were evaluated by three calibrated examiners, who assigned scores from 1 to 5 to the images. The experimental groups were compared using the Kruskal-Wallis test and the Student-Newman-Keuls test. Root thirds were compared by the Friedman test. The level of significance was set at 5%. Results: The capacity for removal of the smear layer by 2.5% NaOCl and 18% HEBP (G2) was similar to that achieved with 2.5% NaOCl and 17% EDTA (G1) in the cervical and middle thirds of the root; the cleansing level of the apical third was similar, regardless of the irrigation protocol used. Conclusion: HEBP is a promising solution for use in endodontic treatments (AU).

Absence of cytomegalovirus in gingivitis and chronic periodontitis in HIV-1 patients in Northern Brazil

Abstract INTRODUCTION The influence of cytomegalovirus (CMV) on the progression of chronic periodontitis in HIV patients is poorly investigated. METHODS ELISA was used for anti-CMV antibody IgG titer measurements and real-time polymerase chain reaction for qualitative and quantitative CMV detection. Data on the CD4 + T lymphocyte count and plasma HIV viral load were obtained from patient records. RESULTS CMV DNA was detected in samples of subgingival biofilm in only three individuals, two of them with chronic periodontitis (4%) and one with gingivitis (3.3%). CONCLUSIONS The prevalence of CMV is very low both in HIV-1 patients with gingivitis and chronic periodontitis.

Analysis of IL-10 in HIV-1 patients with chronic periodontitis in northern Brazil

The objective of this study was to investigate the levels of IL-10 in the gingival crevicular fluid in HIV-1 positive patients with chronic periodontitis and to compare with HIV-1 negative patients with chronic periodontitis, also to correlate clinical periodontal parameters, viral load and count of CD4 + and CD8 + lymphocytes (LTCD4 + and LTCD8 +). Methods: 33 patients were selected and splitted into two groups: 16 HIV-1 positive patients and 17 HIV-1 negative patients and all with chronic periodontitis. The clinical periodontal parameters recorded were: Probing Depth (PD) and Clinical Attachment Level (CAL); the sistemical parameters LTCD4 +, LTCD8 + and viral load were analized by the gingival crevicular fluid collected from all patients. Enzymelinked immunosorbent assay (ELISA) was used to determine the concentrations of Interleukin (IL)-10. For the statistical analysis the Student t, Mann-Whitney and Spearman tests were performed. IL-10 levels were significantly lower in both patients groups. Results: There was statistical difference betwen groups for probing depth (p=0.015) and clinical attachment level (p=0.011), no significant correlation was found among the analyzed variables. Conclusion: The IL-10 levels in HIV-1 positive patients had no influence in periodontal and medical parameters (AU)

Root and canal morphology of permanent mandibular incisors / Morfología de raíz y ranal de incisivos molares permanentes

There are no studies in the literature reporting the prevalence of root canal ramifications in samples of lower incisors in the population of northern Brazil. The knowledge of the usual endodontic morphology and its possible anatomical variations is important. The aim of this study was to evaluate the prevalence of canals in the lower incisors in the population of northern Brazil using the descaling and diaphanization method. In addition, external measurements were performed and the direction of the apical foramen was observed. One hundred teeth were used for this study, and 18 % of them had two canals, with type 3 being the most prevalent, and the lowest incidence was type 5. The average length of the teeth was 18.5 mm, with 76.31 % of the teeth having a foramen that coincided with the long axis of the tooth. Prior knowledge of such changes should be considered before endodontic therapy.

No hay estudios en la literatura que reporten la prevalencia de las ramificaciones del canal radicular en muestras de incisivos inferiores en la población del Norte de Brasil. El conocimiento de la morfología dentaria en endodoncia y sus posibles variaciones anatómicas es importante. El objetivo del estudio fue evaluar la prevalencia de canales en los incisivos inferiores en la población del Norte de Brasil utilizando el método de descalcificación y diafanización. Además, se realizaron mediciones externas y se observó la dirección del foramen apical. Cien dientes fueron utilizados en este estudio, 18 % tenían dos canales, siendo el tipo 3 el más prevalente, y solo un diente presentó el tipo 5. La longitud promedio de los dientes fue de 18,5 mm, de los cuales en el 76,31 % de éstos se observó un foramen que coincidió con el eje longitudinal del diente. El conocimiento previo de éstas variaciones debe ser considerado antes de la terapia endodóntica.

Knowledge and attitudes of pregnant women about oral health / Conocimientos y actitudes de las mujeres embarazadas sobre la salud oral

There are evidences that maternal profile, habits and health knowledge, influence in the oral health of children. The aim of this study was to assess pregnant women knowledge on oral hygiene practices and maintenance of Baby´s oral cavity. A descriptive epidemiological survey was conducted with 147 pregnant women. Sample was predominantly formed by young women and 33.33 % had incomplete primary education and most were housewives with family income between 1-2 minimum wages. Family was considered the primary means in the transfer of information about oral hygiene.

Hay evidencia de que los perfiles, hábitos y conocimientos de la salud influyen en la salud oral de los niños. El objetivo de este estudio fue evaluar el conocimiento de las mujeres embarazadas en las prácticas de higiene oral y el cuidado de la cavidad oral del bebé. Una encuesta epidemiológica se llevó a cabo en 147 mujeres embarazadas. La muestra estuvo compuesta predominantemente por mujeres jóvenes, de las cuales el 33,33 % no había completado la escuela primaria y la mayoría eran amas de casa con ingresos familiares entre 1-2 salarios mínimos. La familia fue considerado el principal medio de transmisión de información sobre la higiene oral.

Conditions for oral health in patients with autism / Condiciones de salud oral en pacientes con autismo

Autism is characterized as a behavioral disorder. The autistic patient has some difficulties with common life routines, such as oral hygiene and also improper diet. As a consequence the refusal of physical contact, the implementation of brushing and flossing by caregivers is difficult. The present study aimed to conduct an epidemiological study of autistic patients in treatment at the Rehabilitation Center and Neurological Organization in North of Brazil, adopting the CPO-D and ceo-d. The clinical examination has been performed with the patient sitting in chairs, at the Rehabilitation Centre itself, under artificial fluorescent light intended for room lighting. From 26 patients included in the study, 76.9 % of subjects were male with a mean age of 13 years. Fifty percent had caries, and 11.5% had lesions on the gums. The mean ceo-d of children 2­8 years was 0.67. In patients 10­15 years and 20­40 years, the mean CPO-D was 0.70, and 3.00, respectively. From the study, the most significant data, seen was that half of autistic patients had carious lesions. It is vital to improve oral health conditions in these patients and by using preventive dentistry, analyze their susceptibility to oral diseases.

El autismo se caracteriza como un trastorno conductual. El paciente autista tiene algunas dificultades en las rutinas ordinarias de la vida, tales como la higiene oral. Como consecuencia, la negativa al contacto físico, la implementación del cepillado y uso de hilo dental es difícil para los cuidadores. Este estudio tuvo como objetivo llevar a cabo un estudio epidemiológico de los pacientes autistas en el Centro de Rehabilitación y la organización neurológica en el norte de Brasil, adoptando el CPOD y ceod. El examen clínico se realizó con el paciente sentado en una silla en el propio Centro de Rehabilitación, bajo una luz fluorescente artificial para la iluminación de la habitación. Veintiseis pacientes fueron incluidos en el estudio, el 76,9 % de los sujetos eran varones con una edad media de 13 años con un 50 % de caries, y en un 11,5 % se observaron lesiones gingivales. La media ceod de los niños de 2 a 8 años fue de 0,67. En los pacientes de 10­15 años y 20­40 años, el promedio CPOD fue de 0,70 y 3,00, respectivamente. A partir del estudio se pudo determinar que la mitad de los pacientes autistas tienen caries. Es importante la educación de estos pacientes para mejorar la salud oral y la aplicación de la odontología preventiva.

Manifestaciones orales en pacientes reumatológicos: una revisión de los conocimientos / Oral manifestations of rheumatologic patients: a knowledge review

La cavidad oral a través de sus estructuras, dientes y mucosas, desempeñan diversas funciones orgánicas. Actúan en el proceso masticatorio, en la percepción de los sabores, además de servir de vía respiratoria. La relación entre alteraciones sistémicas y manifestaciones orales está bien relatada en la literatura. Observándose en numerosos estudios, palabras claves de morbilidades primariamente bucales, seguidas del diagnóstico de trastornos sistémicos. Las enfermedades reumáticas pueden manifestarse con alteraciones de la condición bucal, además de las presentaciones clínicas peculiares a cada morbilidad. Para la realización de este trabajo fueron investigados en la literatura estudios que evidencien la presencia de manifestaciones orales en enfermedades reumáticas a través de la búsqueda en las bases de datos Lilacs, PubMed y Bireme, incluidos en el año 2009-2015. Las evidencias existentes en la literatura nos revelan la importancia de la inclusión de la evaluación clínica de la boca y sus estructuras anexas, como elemento importante en el diagnóstico auxiliar y orientación para el manejo adecuado de las quejas de estos pacientes.

The oral cavity has several physiological functions through their structures. Such structures act in the chewing process, the perception of flavors, besides serving airway. The relationship between systemic diseases and oral manifestations is well reported in the literature. It is observed in numerous studies, morbidity descriptions primarily mouth followed by a diagnosis of systemic disorders. Rheumatic diseases exemplify that these can manifest with changes in oral health in addition to the peculiar clinical presentations to each morbidity. For this work we investigated in the literature studies that provided evidence of the presence of oral manifestations in rheumatic diseases by searching Lilacs, PubMed and Bireme databases, included in the year 2009­2015. The available evidence in the literature, reveal the importance of including clinical evaluation of the mouth and its associated structures as an important element for the diagnosis and guidance for the proper handling of complaints of these patients.

Genetic Autosomal Dominant Disorders: A Knowledge Review / Trastornos Autosómicos Dominantes: Una Revisión de los Conocimientos

Genetic disorders occur by excess or absence of chromosomal material, and the consequence of these changes is reflected in morphological and physiological changes. Autosomal disorders, which have dominant inheritance, as cleidocranial dysostosis, Craniofacial syndrome Apert, Treacher Collins and Achondroplasia have peculiar and similar characteristics. Because of their implications in the dental field, the aim of this review is to report on dysostoses, through exposure of general clinical factors and highlighting the signs in the oral cavity. Articles were selected from Lilacs, PubMed and Bireme databases, included in the year 2007­2014, and the keywords were: cleidocranial dysplasia, craniofacial dysostosis, mandibulofacial dysostosis, dysostosis and oral. Alterations of maxillofacial bones and craniofacial are well documented in the literature, but studies reporting an association between treatment odontologic and dysostoses are scarce. In conclusion, Oral pathological manifestations developed cause difficulty in speech, chewing, breathing, social involvement, and in a general perspective, psychological impairment and physical limitations.

Las enfermedades genéticas se producen debido a un exceso o ausencia de material cromosómico, y la consecuencia de estos cambios se refleja en los cambios morfológicos y fisiológicos. Trastornos autosómicos dominantes que tienen herencia dominante, como la disostosis cleidocraneal, el síndrome craneofacial de Apert, Treacher Collins y acondroplasia tiene características peculiares y similares. Debido a sus implicaciones en el campo de la odontología, el objetivo de esta revisión es hablar, a través de la exposición de los factores clínicos y generales, destacando los signos en la cavidad oral. Se seleccionaron los artículos de las bases de datos Lilacs, PubMed y BIREME, incluyendo los años 2007-2014, y las palabras clave fueron: displasia cleidocraneal, craneofacial mandibulofacial disostosis, disostosis y oral. Los cambios de huesos maxilofaciales y craneofaciales están bien documentados en la literatura, pero los estudios que informaron una asociación entre el tratamiento dental y disostosis son escasos. En conclusion, las manifestaciones orales son causas de dificultades del habla, masticación, respiración y la participación social.