Medicações intracanal e sistêmica preconizadas nas faculdades de Odontologia brasileiras para o tratamento de urgência do abscesso periapical agudo / Intracanal and systemic medications recommended at Brazilian dental schools for urgency treatment of acute periapical abscess

Objetivo: Este estudo objetivou avaliar a medicação intracanal (MIC) e a medicação sistêmica (MS) preconizadas nas Faculdades de Odontologia (FO) do Brasil para atendimento de urgência do abscesso periapical agudo (APA). Metodologia: Questionários foram enviados para 141 FO brasileiras endereçados ao responsável pela Disciplina de Endodontia. As questões abordaram as MIC e MS prescritas na unidade para o tratamento de urgência do APA em suas três fases de progressão: inicial, em evolução e evoluída. Resultados: O tricresol formalina foi a MIC mais empregada, independente da fase do APA, seguida por paramonoclorofenol, hidróxido de cálcio, clorexidina e hipoclorito de sódio. A MS mais utilizada foi o antibiótico, independente da fase do APA, seguido por analgésico e antiinflamatório. A associação sistêmica medicamentosa mais preconizada foi antibiótico/analgésico, seguida de antibiótico/antiinflamatório. O paracetamol, o diclofenaco e a amoxicilina foram o analgésico, o antiinflamatório e o antibiótico de primeira escolha, respectivamente. Nas fases em evolução e evoluída do APA, analgésicos mais potentes como o paracetamol associado à codeína e o dextropropoxifeno foram preconizados. Conclusão: Apesar de existir uma série de MIC e MS utilizadas em Endodontia, não existe consenso entre as FO brasileiras sobre qual a melhor medicação a ser usada em casos de APA.

Purpose: The aim of this study was to evaluate the prescription of intracanal medication (ICM) and systemic medication (SM) for urgency treatment of acute periapical abscess (APA) in Brazilian Dental Schools. Methods: Questionnaires were mailed to 141 Brazilian Dental Schools addressed to the Head of the Discipline of Endodontics. Questions focused on prescribed intracanal and systemic medication for urgency treatment of APA under various stages according to its progress: early stage, in evolution, and evolved stage. Results Tricresol formalin was the most used ICM regardless of APA stage, followed by paramonochlorophenol, calcium hydroxide, chlorhexidine, and sodium hypochlorite. The most used SM was antibiotics for all APA stages, followed by analgesics and antiinflammatory drugs. The most recommended systemic drug association was antibiotics/ analgesics, followed by antibiotics/anti-inflammatory drug. Paracetamol, diclofenac, and amoxicillin were the first-choice analgesics, anti-inflammatory drug, and antibiotics, respectively. For 'in evolution' and 'evolved' APA stages, prescriptions comprised more powerful analgesics, such as paracetamol associated with codeine and dextropropoxyphen. Conclusion: Although there is a plethora of intracanal and systemic medications available for endodontic purposes, there is no consensus amongst Brazilian Dental Schools on the best protocol for APA treatment.

Influência do paramonoclorofenol canforado na dor pósoperatória em casos de abscesso periapical agudo / Influence of paramonochlorophenol camphorated on the pain of acute apical periodontitis

O objetivo desse trabalho foi verificar se o uso do Paramonoclorofenol Canforado (PMCC) comomedicação após o atendimento de urgência em casos de abscesso periapical agudo é o fator determinanteda ausência de dor pós-operatória dos pacientes. O tratamento de urgência em 33 pacientes com abscessoperiapical sintomático foi dividido em dois grupos. Nos pacientes do grupo I, após o atendimento foi colocadauma bolinha de algodão embebida em PMCC na câmara pulpar e no grupo II foi colocada uma bolinha dealgodão seca, sem nenhum medicamento. Os resultados mostram que não houve diferença significanteentre os dois grupos.

The aim of this work was to verify if PMCC, as a local medication after emergency treatment, exertsany influence on patient pain after treatment. To do so, 33 teeth with acute periapical abscess were treatedand divided in two groups. In teeth of group I, a cotton pellet with PMCC was puted in pulp chamber and ingroup II a dry cotton pellet was used without any medicament. Results show that there was no significantdifference between the two groups.

Isolation and identification of bacteria from the root canal of the teeth diagnosed as the acute pulpitis and acute periapical abscess / 대한치과보존학회지

The aim of this study was to identify the bacteria isolated from acute endodontic lesions by cell culture and 16S rDNA sequencing. The necrotic pulpal tissue was collected from 17 infected root canals, which were diagnosed as being either an acute pulpitis or acute periapical abscess. Samples were collected aseptically from the infected pulpal tissue of the infected root canals using a barbed broach and a paper point. The cut barbed broaches and paper points were transferred to an eppendorf tube containing 500 ul of 1 X PBS. The sample solution was briefly mixed and plated onto a BHI-agar plate containing 5% sheep blood. The agar plates were incubated in a 37degrees C anaerobic chamber for 7 days. The bacteria growing on the agar plate were identified by 16S rRNA coding gene (rDNA) cloning and sequencing at the species level. Among the 71 colonies grown on the agar plates, 56 strains survived and were identified. In dental caries involving the root canals, Streptococcus spp. were mainly isolated. Actinomyces, Clostridia, Bacteroides and Fusobacteria were isolated in the periapical lesion without dental caries. Interestingly, two new Actinomyces spp. (ChDC B639 and ChDC B631) were isolated in this study. These results showed that there was diversity among the species in endodontic lesions. This suggests that an endodontic infection is a mixed infection with a polymicrobial etiology. These results may offer the bacterial strains for pathogenesis studies related to an endodontic infection.