Uso del plasma rico en fibrina en endodoncia para regeneración ósea. Reporte de dos casos clínicos / Use of fibrin-rich plasma in bone-repair endondontic procedures. Report of two clinical cases

Resumen: Introducción: Las lesiones periapicales crónicas producen defectos óseos en la zona apical del diente comprometido. La terapia estándar requiere de una osteotomía, remoción del ápice, un profuso curetaje para remover el tejido infectado y granulomatoso, dejando un defecto óseo. Reporte de casos: Dos pacientes con lesiones periapicales fueron sometidos a una apicectomía donde se les colocó como relleno óseo plasma rico en fibrina. El tratamiento fue efectivo, ya que en 30 días se observó radiográficamente una zona radiopaca sugiriendo una formación ósea. Conclusión: La utilización de plasma rico en fibrina para rellenos óseos después de cirugías paraendodónticas podría ser una buena alternativa a los rellenos óseos comerciales por tener propiedades óseo-inductoras.

Abstract Introduction: Chronic periapical lesions cause bone defects in the apical area of compromised teeth. Standard therapy requires osteotomy, apex removal and profuse curettage to remove granulomatous and infected tissue, thus leaving a bone defect in its wake. Report of two cases: Two patients with periapical lesions were subjected to apicoectomy procedure where fibrin-rich plasma was placed as bone filling. Treatment was effective, since after 30 days a radio opaque area was radiographically observed, suggesting bone formation. Conclusion: Use of fibrin-rich plasma as bone filling after paraendodontic surgeries could represent a suitable alternative to commercial bone fillings, due to its bone induction properties.

Evidence of Heterokaryon compatibility on Candida albicans biofilm

Aims: Candida species, especially Candida albicans, are frequently found associated with biomaterials and immunosuppressed patients, and have been described as the most virulent yeasts in human fungi diseases. These yeasts have recently been isolated from periodontal pockets, revealing the penetration of hyphae into the periodontal connective tissue. Methods: In this study, 7 periodontal C. Albicans strains were applied individually in biofilm development on titanium discs and the samples were thereafter analyzed as for the number of colony forming units per milliliter (CFU/mL), dry-weight and scanning electron microscopy (SEM). Results: Counting of CFU/ mL and determination of dry-weight showed that all samples formed biofilm. SEM analysis showed the development of a polymorphic network in the biofilms and the presence of hyphal anastomosis in the sites where fusion between the hyphae occurred. Conclusion: periodontal C. albicans strains present heterokaryon compatibility.

Susceptibility of Candida spp. Oral isolates for azolic antifungals and amphotericin B

Aims: Among the oral infections, candidosis may be considered the most frequent, and C. albicans the most prevalent species. Meanwhile, the non-albicans species may also be related to other infections processes and be able to affect the oral cavity, including periodontal disease. In this sense, understanding the relationship between Candida spp. and host, it is necessary and justified the search of mechanisms modulators of infections and treatments against diseases associated with these yeasts. Methods: Nineteen patients with periodontal disease were involved in this study. The aim was evaluate the susceptibility to azoles antifungals fluconozole, itraconazole, ketoconazole and the polienic anfotericin B against Candida spp isolated from three different sites of the oral cavity from these patients (periodontal disease, being periodontal pocket, oral mucosa and ridge gingival), by the minimum inhibitory concentration method – MIC. Results: Among the samples of C. albicans, 88% showed susceptibility depending on the concentration (SCD) and 3.6 % were resistant to at least one antifungal azole studied. Among the others species, 57% presented SDC and 42.8% showed resistance to at least one of the antifungal azole tested. Regarding to Anfotericin B, 90% of the C. albicans isolates and 3% of the nonalbicans showed resistance. There was no occurrence of resistance to the fluconazole and only 3.6% of C. albicans and 40% of the non-albicans were SDC to this antifungal. Conclusions: Patients with periondontal disease showed relevant levels of colonization by Candida spp, mainly at the oral mucosa and periodontal pocket showing important occurrence of SDC and resistance to the antifungals drugs tested.