Dental age estimation by assessing the pulp volume of five teeth in a peruvian population using cone beam computed tomography images / Estimación de la edad dental evaluando el volumen pulpar de cinco dientes utilizando imágenes de tomografías computarizadas de haz cónico en una población peruana

Abstract Dental age estimation is very important for individual identification in criminal and civil forensic investigations. One of the methods for age estimation is studying age related changes in pulp volume of teeth. The objective of the current study was to estimate dental age from the pulp volume of five different categories of teeth of a Peruvian sample using cone beam computed tomography (CBCT). Retrospective CBCT records of 231 patients (females (134), males (97), age: 12-60 years) were included in the study, categorized into five different age groups (12-19, 20-29, 30-39, 40-49, 50-59, 60 years and older). Dental pulp volume of five categories of teeth(upper canines, left upper central incisors, left upper first molars, lower left first premolars, first molars) were analyzed using Romexis® 5.3.3.5 software for each patient. There was a reduction in the pulp volume of upper right and left canine with age. The Pulp volume was lowest in people aged 60 years and over. Linear regression analysis of the pulp volume and chronological age showed a coefficient of determination of 30%, suggesting a weak correlation. A weak correlation between dental pulp and age is derived. But, a robust large homogenous sample of teeth in future for different age groups may establish a reliable regression equation.

Resumen La estimación de la edad dental en personas vivas y cadáveres es muy importante para la Odontología Forense, sobre todo en casos de identificación en investigaciones legales y sociales. El objetivo del estudio fue estimación de la edad dental mediante la medición del volumen pulpar de imágenes dentales en tomografía computarizada de haz cónico (TCHC) de pacientes peruanos. Fueron analizadas 231 TCHC de pacientes entre 12 a 60 años a más. (Mujeres (134), hombres (97)) se dividieron en seis grupos de edad (12-19, 20-29, 30-39, 40-49, 50-59, 60 años a más). El análisis volumétrico de la pulpa dental se realizó en un total de 1155 dientes (caninos superiores, incisivos centrales superiores izquierdos, primeros molares superiores izquierdos y primeros premolares inferiores izquierdos), mediante el software Romexis® 5.3.3.5. El análisis de regresión lineal mostró un coeficiente de determinación del 30% que sugiere una correlación débil entre la relación del volumen pulpar de los dientes y la edad. El volumen pulpar de los caninos superiores derecho e izquierdo disminuyó a medida que aumentaba la edad y el volumen pulpar en dientes de personas de 60 años a más fue el más bajo. Sin embargo, se pueden proponer estudios futuros para incluir una gran muestra homogénea de dientes en diferentes categorías y grupos de edad para confirmar la correlación y establecer una ecuación de regresión confiable.

Uso de dientes bovinos como elección para trabajos de investigación en odontología / The use of bovine teeth as a choice for dental investigation papers

Los dientes animales de las diferentes especies (hu- mano, equino, cerdo, etc.) están constituidos histológi- camente por cuatro tejidos fundamentales. Ellos son: esmalte, dentina, cemento y pulpa dental. Su compo- sición, estructura, morfología y tamaño son disímiles para cada género. Según numerosas investigaciones, los dientes de bovino serían los de elección por ser de fácil obtención y por tener muy pocas, o ninguna, diferencias tanto a nivel macro como microscópico con respecto a los dientes humanos. El objetivo de la presente revisión es aportar información actualizada acerca de las características histológicas de los tejidos dentarios bovinos y profundizar el conocimiento de las similitudes y diferencias de los dientes bovinos y humanos dando soporte a otros estudios compa- rativos y promoviendo la utilización de las piezas dentarias bovinas en trabajos de investigación en odontología (AU)

The animal teeth of the different species (human, equine, pig, etc.) are histologically constituted by four fundamental tissues: enamel, dentin, cement and dental pulp. Their composition, structure, morphology and size are dissimilar for each gender. According to numerous investigations, bovine teeth would be the ones of choice because they are easy to obtain and have very few or no differences, both at the macro and microscopic levels, with respect to human teeth. The objective of this review is to provide updated information about the histological characteristics of bovine dental tissues and deepen the knowledge of the similarities and differences between bovine and human teeth, supporting other comparative studies and promoting the use of bovine dental pieces in research work in dentistry (AU)

Tooth and pulp chamber automatic segmentation with artificial intelligence network and morphometry method in cone-beam CT / Segmentación automática de cámaras dentales y pulpares con red de inteligencia artificial y método de morfometría en TC de haz cónico

SUMMARY: This study aims to extract teeth and alveolar bone structures in CBCT images automatically, which is a key step in CBCT image analysis in the field of stomatology. In this study, semantic segmentation was used for automatic segmentation. Five marked classes of CBCT images were input for U-net neural network training. Tooth hard tissue (including enamel, dentin, and cementum), dental pulp cavity, cortical bone, cancellous bone, and other tissues were marked manually in each class. The output data were from different regions of interest. The network configuration and training parameters were optimized and adjusted according to the prediction effect. This method can be used to segment teeth and peripheral bone structures using CBCT. The time of the automatic segmentation process for each CBCT was less than 13 min. The Dice of the evaluation reference image was 98 %. The U-net model combined with the watershed method can effectively segment the teeth, pulp cavity, and cortical bone in CBCT images. It can provide morphological information for clinical treatment.

RESUMEN: El objetivo del presente estudio fue extraer estructuras dentarias y óseas alveolares desde imágenes CBCT automáticamente, lo cual es un paso clave en el análisis de imágenes CBCT en el campo de la estomatología. En este estudio, se utilizó la segmentación de tipo emántica para la segmentación automática. Se ingresaron cinco clases de imágenes CBCT marcadas, para el entrenamiento de la red neuronal U-net. El tejido duro del diente (incluidos esmalte, dentina y cemento), la cavidad de la pulpa dentaria, hueso cortical, hueso esponjoso y otros tejidos se marcaron manualmente en cada clase. Los datos se obtuvieron de diferentes regiones de interés. La configuración de la red y los parámetros de entrenamiento se optimizaron y ajustaron de acuerdo con un análisis predictivo. Este método se puede utilizar para segmentar dientes y estructuras óseas periféricas mediante CBCT. El tiempo del proceso de segmentación automática para cada CBCT fue menor a 13 min. El "Dice" de evaluación de la imagen de referencia fue de 98 %. El modelo U-net combinado con el método "watershed"puede segmentar eficazmente los dientes, la cavidad pulpar y el hueso cortical en imágenes CBCT. Puede proporcionar información morfológica para el tratamiento clínico.

Estimación de edad mediante la relación área pulpa/diente en caninos mandibulares: estudio en una muestra chilena utilizando el Método de Cameriere / Dental age estimation by pulp/tooth ratio in mandibular canines: study in a Chilean sample by Camerierer's Method

La estimación de edad compone un aspecto importante en investigaciones forenses. Diferentes métodos se han descrito en odontología forense basadas en la correlación entre la edad y estructuras dentales. Cameriere et al. proponen un método cuantitativo para estimación de edad en adultos, a partir de la evaluación de la relación del área pulpa/diente, en base a la aposición de dentina secundaria. El objetivo del estudio fue desarrollar modelos de regresión para la estimación de edad dental mediante la relación área pulpa/diente en caninos inferiores en una muestra Chilena. Se analizaron 212 radiografías periapicales digitales (RPD) (86 hombres y 126 mujeres) de caninos mandibulares mediante el programa Image J para establecer el área de la pulpa y el diente. Se registraron los datos de sexo y edad de las RPD seleccionadas en forma ciega. Fueron desarrollados modelos de regresión lineal simples para la estimación de edad. El coeficiente de determinación para R33 fue 27,8 % y de 29,6 % para R44, con un error absoluto medio de 11,02 años y 10,37 años respectivamente. El análisis de ANOVA no mostró diferencias estadísticamente significativas para las relaciones área pulpa/diente de caninos según sexo (p> 0,05). Según los resultados obtenidos, la metodología propuesta por Cameriere et al. es fiable para estimar la edad dental mediante la relación área pulpa/diente en adultos. Sin embargo, en los modelos de regresión desarrollados para la población Chilena, se puede afirmar que el ajuste indicado por los coeficientes de determinación muestran incerteza entre las variables área pulpa/diente y edad cronológica en caninos inferiores, por lo tanto se sugiere considerar otros métodos adicionales para estimar edad en esta población.

Age estimation is an important aspect In forensic investigations. Different methods in forensic odontology based on the correlation between age estimation in adults, from the analysis of the pulp/tooth area, based on the apposition of secondary dentine. The aim of the study was to develop regression models for the dental age estimation by the relation pulp/tooth area, in lower canines in a Chilean sample, using digital peri-apical radiographs (DPR) applying Cameriere's method. We analyzed 212 DPR (86 males and 126 females) mandibular canines through Image J program to measure the pulp/tooth area. Age and sex information was obtained of the DPR's blindly selected. We developed simple linear regression models for age estimation. The coefficient of determination to R33 was R2 age and dental structures have been described. Cameriere et al. proposed a quantitative method for 27.8 % and R2 29.6 % to R44, with a mean absolute error of 11.02 years, to R33 and 10.37 years to R44. ANOVA analysis showed no statistically significant differences for the pulp/tooth relation area of canines according to sex (p> 0.05). According to the results, the Cameriere's et al., method is reliable for dental age estimation according to pulp/tooth ratio in adults. However, in the regression models developed for Chilean population, it can be stated that the adjustment indicated by the coefficients of determination, show uncertainty between the pulp / tooth area and chronological age in lower canines, therefore it is suggested to use additional estimation methods for age in this population.

Biodentine Induce Proteínas Apoptóticas Caspasa 3 y PARP-1 en Células de la Pulpa Dental Humana / Biodentine Induces Apoptotic Proteins Caspase 3 and PARP - 1 on Human Dental Pulp Cells

RESUMEN: Las patologías pulpares han sido un verdadero reto para la odontología principalmente por su tratamiento. Actualmente, existen numerosos biomateriales en el mercado que reportan tener propiedades inherentes en los tejidos dentarios. Sin embargo, diferentes estudios sobre múltiples líneas celulares expuestas a estos biomateriales demuestran resultados controversiales como biocompatiblidad y citotoxicidad celular. Biodentine, es un cemento endodóntico en base a silicatos cálcico de múltiples aplicaciones, que prestaría propiedades de biocompatibilidad como bioactividad celular, características que le permitirían incluso ser utilizado en contacto directo con la pulpa dental. El objetivo de este estudio es la evaluación in-vitro de Biodentine, sobre cultivos de células de la pulpa dental humana (CCPDH). Se prepararon discos de cemento de Biodentine™ de 2 x 6 mm, los que se expusieron a cultivos de células aisladas de la pulpa dental humana. Luego de 24, 48 y 72 horas de exposición, se realizaron ensayos de viabilidad celular utilizando el método colorimétrico MTT. También se realizaron ensayos de expresión proteica de dos proteínas involucradas en la vía de señalización de la apoptosis celular: Caspasa - 3 clivada y Poli (ADP-Ribosa) Polimerasa, PARP - 1. Existen diferencias estadísticamente significativas (p<0,05) en los ensayos de viabilidad celular entre las células expuestas a Biodentine y el grupo control, como también a medida que aumenta el tiempo de exposición (p<0,05). Por otra parte, también existen diferencias significativas (p<0,05) en la expresión de PARP- 1 en los grupos sometidos a Biodentine. Los resultados obtenidos en este estudio demuestran que Biodentine genera citotoxicidad celular en cultivos celulares de pulpa dental humana, por disminución de la viabilidad celular como por la expresión de proteínas apoptóticas. Es por esto que la utilización de este biomaterial debería ser estudiado y considerarse en cada caso clínico, especialmente como recubridor pulpar directo.

ABSTRACT: Oral pathologies have been a real challenge for dentistry, mainly due to its treatment. Currently, there are numerous biomaterials on the market that may present inherent properties in dental tissues. However, studies on multiple cell lines are based on biocompatible results such as biocompatibility and cellular cytotoxicity. Biodentine is endodontic cement based on calcium silicates of multiple applications, which would provide biocompatibility properties as cellular bioactivity, characteristics that will allow it to be used in direct contact with the dental pulp. The objective of this study is the in vitro evaluation of Biodentine, on cultures of cells of the human dental pulp (HDPC). Biodentine cement disks of 2 x 6 mm were prepared, and HDPC culture plates were introduced. After 24, 48 and 72 hours of exposure, cell viability tests were performed using the MTT colorimetric method. On the other hand, protein expression assays of two proteins involved in the signaling pathway of cell apoptosis Caspase-3 cleaved (cas-3 clv) and PARP-1 are carried out. There are statistically significant differences (p <0,05) in the cell viability tests between Biodentine and control group, as well as the exposure time increases (p <0,05). Otherwise, there are also significant differences (p <0,05) in the expression of PARP-1 in the groups, sometimes a Biodentine. The results in this study that Biodentine generates a cellular cytotoxicity in HDPC cultures, therefore, cell viability as the expression of apoptotic proteins. This is why the use of this biomaterial should be studied for each particular clinical case, especially as a direct pulp capping agent.

Age estimation by pulp/tooth area ratio in anterior teeth using cone-beam computed tomography: comparison of four teeth

Abstract Objectives Age estimation is one of the most important factors in forensic medicine. Measuring secondary dentin deposition using cone-beam computed tomography images is an easy and noninvasive method. The aim of this study was to evaluate cone-beam computed tomography images as a reliable method to estimate chronological age by pulp/teeth ratio in anterior teeth in Iranian population. Methodology A total of 649 CBCT images from 377 Iranian patients aged between 20 and 69 years were evaluated. Pulp/teeth ratio (PTR) in maxillary and mandibular canine and central incisor teeth was measured in the axial and sagittal sections using OnDemand 3D Dental software. The Pearson correlation coefficient was determined to evaluate the correlation between the variables. Linear regression analysis, as well as age estimation formula, was used for each tooth separately. Results The regression analyses indicated that maxillary central incisors were more reliable for age estimation (R2=0.586 and standard error of estimate=7.045) compared with the other anterior teeth studied. Maxillary canine teeth had the lowest predictive power (R2=0.392 and standard error of estimate=8.387). Also, comparison of the axial and sagittal sections showed that the axial sections had a higher predictive power. (R2=0.48 for axial plans and R2=0.328 for sagittal plans) Conclusion The use of cone-beam computed tomography in age estimation by pulp/teeth ratio of anterior teeth is useful and a reliable method for age estimation in Iranian population.

Prevalence and morphometric analysis of three-rooted mandibular first molars in a Brazilian subpopulation

ABSTRACT The knowledge of the internal anatomy of three-rooted mandibular molars may help clinicians to diagnose and plan the root canal treatment in order to provide adequate therapy when this variation is present. Objectives: To determine the prevalence of three-rooted mandibular molars in a Brazilian population using cone beam computed tomography (CBCT) and to analyze the anatomy of mandibular first molars with three roots through micro-CT. Material and Methods: CBCT images of 116 patients were reviewed to determine the prevalence of three-rooted first mandibular molars in a Brazilian subpopulation. Furthermore, with the use of micro-CT, 55 extracted three-rooted mandibular first molars were scanned and reconstructed to assess root length, distance between canal orifices, apical diameter, Vertucci's classification, presence of apical delta, number of foramina and furcations, lateral and accessory canals. The distance between the orifice on the pulp chamber floor and the beginning of the curvature and the angle of canal curvature were analyzed in the distolingual root. Data were compared using the Kruskal-Wallis test (α=0.05). Results: The prevalence of three-rooted mandibular first molars was of 2.58%. Mesial roots showed complex distribution of the root canal system in comparison to the distal roots. The median of major diameters of mesiobuccal, mesiolingual and single mesial canals were: 0.34, 0.41 and 0.60 mm, respectively. The higher values of major diameters were found in the distobuccal canals (0.56 mm) and the lower diameters in the distolingual canals (0.29 mm). The lowest orifice distance was found between the mesial canals (MB-ML) and the highest distance between the distal root canals (DB-DL). Almost all distal roots had one root canal and one apical foramen with few accessory canals. Conclusions: Distolingual root generally has short length, severe curvature and a single root canal with low apical diameter.

Pulpa dentaria sana vs. pulpitis reversible: caracterización estereológica de fibroblastos / Healthy normal dental pulp vs. reversible pulpitis: stereological characterization of fibroblasts

La reacción y reparación de la dentina depende del número de células presentes en la pulpa, dentro de éstas fibroblastos. Los métodos diseñados para obtener una estimación fiable de la cantidad de elementos celulares de la pulpa han sido subjetivos y sesgados, sobre todo al evaluar los cambios cuantitativos y potencial capacidad reparadora en presencia de caries. El objetivo fue estimar y comparar cuantitativamente las densidades de número, volumen y superficie de fibroblastos en pulpas sanas y con diagnóstico de pulpitis reversible producto de caries en dientes humanos jóvenes. Se utilizaron dientes premolares humanos obtenidos de exodoncias, divididos en un grupo sano y cariado, los cuales fueron fijados y posteriormente descalcificados con ácido nítrico al 5 %. Siguiendo el protocolo del orientator se obtuvieron 5 secciones de 5 µm teñidas por H-E de cada diente. Se aplicó el recuento estereológico de los fibroblastos pulpares (FP) con el test multipropósito M42. Se estimaron las densidades de número (Nv), volumen (Vv) y superficie (Sv), y calcularon las Medias (±DE) por diente, y Medias (±EE) por grupo. Las diferencias entre grupos se analizaron mediante la prueba T, con un valor p 0,05 de significación estadística. En dientes sanos, la Media (±EE) para Nv de FP fue 0,393 x 105/mm3 (±0,020x105/mm3), para Vv 15,467 % (±1,334 %) y para Sv 16,330 mm2/mm3 (±1,274 mm2/mm3). En dientes cariados, la Nv fue 0,447 x 105/mm3 (±0,019x105/mm3), la Vv 20,171 % (±1,213 %) y la Sv 20,150 mm2/mm3 (±1,447 mm2/mm3). Al comparar las Nv, los FP del grupo con caries aumentaron significativamente (p= 0,047), al igual que la Vv (p= 0,0105) y Sv (p= 0,013). Existe un aumento del número de FP en los dientes con pulpitis reversible, lo que condicionaría su capacidad de respuesta. La metodología empleada puede ser aplicable para determinar el comportamiento pulpar y cuantificar variables de respuesta odontoblástica en tratamientos restauradores atraumáticos de manera imparcial y reproducible.

Dentine reaction and repair depends on the number of cells present in the pulp, within these fibroblasts. The methods designed to obtain a reliable estimate of the amount of cellular elements of the dental pulp have been subjective and biased, especially when evaluating quantitative changes and potential reparative capacity in the presence of caries. The aim of this study was to estimate and quantitatively compare with stereological tools, number, density, volume and surface of fibroblasts in healthy teeth and reversible pulpitis diagnosis due to caries. We obtained premolar teeth from human tooth extractions, divided into healthy and carious groups, which were fixed and decalcified with 5 % nitric. Following the orientator protocol we obtained 5 sections of 5 µm from each tooth which were stained by H-E. The stereological counting of pulp fibroblasts (FP) with M42 multipurpose test was applied. Number densities (Nv), volume (Vv) and surface (Sv) were estimated, and calculated the means (±SD) for a tooth, and Mean (±SE) per group. Differences between groups were analyzed by t-test, p 0.05 a statistically significant value. In healthy teeth, the mean (±SE) for Nv FP was 0.393x105/mm3 (±0.020x105/mm3), Vv 15.467 % (±1.334 %) and Sv 16.330 mm2/mm3 (±1.274 mm2/mm3). In decayed teeth, it was 0.447x105 Nv/mm3 (±0.019x105/mm3), the Vv 20.171 % (±1.213 %) and Sv 20.150 mm2/mm3 (± 1.447 mm2/mm3). Comparing Nv, the FP carious group increased significantly (p =0.047), as Vv (p =0.0105) and Sv (p =0.013). There is an increased number of FP teeth with reversible pulpitis, which would determine their responsiveness. The methodology can be applied to determine the pulp behavior and odontoblast quantify response variables in impartially and reproducible atraumatic restorative treatments.

Tratamientos pulpares en dientes primarios / Pulp therapies in primary teeth

El mantenimiento de las piezas dentarias para desempeñar sus funciones en la alimentación, en la expresión oral, en el mantenimiento de espacios en las arcadas dentarias, en el estímulo para el crecimiento y desarrollo de los maxilares, entre otras acciones, ha sido considerado esencial para el logro de un desarrollo armónico. Por otro lado, y a pesar de los avances en la materia, la caries dental es la causa más frecuente de las patologías pulpares en los dientes primarios y constituye el principal motivo de su deterioro y/o su pérdida. Las características histo-patológicas de la pulpa dental, la brevedad de su ciclo vital, el tamaño relativo de las cámaras pulpares, favorecen el rápido compromiso pulpar y propician que el proceso infeccioso progrese rápidamente a la necrosis. Ello ha determinado y determina el desarrollo de numerosas técnicas y tratamientos, diferentes ofertas terapéuticas de las cuales ninguna ha alcanzado el consenso universal. Como establecen las Guías de Odontología Pediátrica sobre tratamientos pulpares en dientes primarios, la literatura dental en esta área ofrece escasa y pobre evidencia para sustentar las diferentes técnicas y constantemente señalan la necesidad de nuevos y rigurosos estudios que la avalen.

Análise histométrica do processo de reparo do reimplante dentário submetido à terapia com laser de baixa intensidade: estudo em ratos / Histommetric analyisis of tooth immediate replantation repair process submitted to low level laser therapy: study in rats

Para averiguar a influência da terapia com laser de baixa intensidade (LLLT) no processo de reparo em reimplante dentário, 90 ratos divididos em 3 grupos de 30 animais tiveram o incisivo superior direito extraído. No grupo C o incisivo foi reimplantado sem intervenção adicional. Nos grupos L1 e L2, os dentes foram irradiados com laser diodo antes, no interior do alvéolo, e logo após o reimplante, na parte externa do alvéolo. Essa dose foi repetida as 24, 48 e 72 horas pós-operatórias no grupo L1 e as 48, 96 e 144 horas no grupo L2. Após períodos de 7, 14 e 30 dias, os animais foram sacrificados para análise histológica em hematoxilina e eosina e Picrosirius Red. Observamos valores menores de inflamação no ligamento periodontal no grupo L1 (p<0,05) aos 7 dias. Maior extensão de ligamento periodontal reinserido, nos grupos L1 e L2, aos 7 e 14 dias. Maior extensão de tecido pulpar normal foi encontrada nos grupos L1 e L2 no período de 14 dias. Maior comprometimento pela reabsorção radicular foi observado no grupo C aos 30 dias. Pode-se concluir que a terapia com LLLT influiu positivamente no reparo do ligamento periodontal e tecido pulpar do dente reimplantado.

To investigate the influence of low intensity laser therapy (LLLT) in the repair process of dental reimplantation, 90 mice divided into 3 groups of 30 animals had the right upper incisor extracted. In group C the incisive was reimplanted without further intervention. In the groups L1 and L2, the teeth were irradiated with diode laser before, inside the socket, and after reimplantation, outside of the socket. This dose was repeated 24, 48 and 72 hours after surgery, the group L1 and 48, 96 and 144 hours in the L2 group. After periods of 7, 14 and 30 days, the animals were sacrificed for histological examination with hematoxylin and eosin and Picrosirius Red. We observed smaller values of inflammation in the periodontal ligament in the L1 group (p <0.05) at 7 days. Increased length of periodontal ligament reinserted in the L1 and L2 groups at 7 and 14 days. Greater extent normal pulp tissue was found in the groups L1 and L2 within 14 days. Greater commitment by root resorption was observed in group C at 30 days. It can be concluded that LLLT therapy had a positive influence on the repair of the periodontal ligament and the pulp tissue reimplanted tooth.

Caracterización estereológica de odontoblastos en pulpas dentarias humanas sanas y con pulpitis reversible / Stereological characterization of odontoblasts in normal healthy and reversible pulpitis in human dental pulps

La reacción y reparación dentinaria depende del número de odontoblastos. Los métodos para obtener estimaciones fiables sobre la cantidad de odontoblastos en la pulpa dental han sido subjetivos y sesgados, sobre todo al evaluar los cambios cuantitativos y la potencial capacidad reparativa en presencia de caries. El objetivo de este trabajo fue estimar y comparar cuantitativamente el número, densidad y volumen de odontoblastos en dientes sanos y con diagnóstico de pulpitis reversible producto de caries a través de herramientas estereológicas. Se utilizaron dientes premolares humanos obtenidos de exodoncias, divididos en un grupo sano y otro cariado. Fueron fijados y descalcificados con ácido nítrico al 5%. Siguiendo el protocolo del orientator se obtuvieron 5 secciones de 5 mm teñidas por H-E de cada diente. Se aplicó el recuento estereológico de los odontoblastos con el test multipropósito M42. Se estimaron las densidades de número (Nv), volumen (Vv) y superficie (Sv), y calcularon las Medias (±DE) por diente, y Medias (±EE) por grupo. Las diferencias entre grupos se analizaron mediante la prueba T, con un valor p 0,05 de significación estadística. En dientes sanos, la Media (±EE) para Nv de odontoblastos fue 0,409x105/mm3 (±0,018x105/mm3), para Vv 19,714% (±1,43%) y para Sv 21,016 mm2/mm3 (±1,425 mm2/mm3). En dientes cariados, la Nv fue 0,521x105 /mm3 (±0,023x105/mm3), la Vv 24,686% (±1,625%) y la Sv 23,203 mm2/mm3 (±1,364 mm2/mm3). Al comparar las Nv, los odontoblastos del grupo con caries aumentaron significativamente (p=0,0062), al igual que la Vv (p=0,0197). Existe un aumento del número de odontoblastos en los dientes con pulpitis reversible, lo que condicionaría su capacidad de respuesta. La metodología empleada puede ser aplicable para determinar el comportamiento pulpar y cuantificar variables de respuesta odontoblástica en tratamientos restauradores atraumáticos de manera imparcial y reproducible.

Dentinal reaction and repair depends on factors like the amount of odontoblasts. Methods for obtaining reliable estimates of the number of odontoblasts in the dental pulp have been subjective and biased, especially when assessing the potential quantitative changes and reparative capacity in the presence of cavities. The aim of this study was to estimate and quantitatively compare, through stereological tools, the number, density and volume of odontoblasts in healthy teeth, diagnosed with reversible pulpitis due to caries. We used human premolars obtained from extractions, divided into groups of healthy teeth and teeth with caries, fixed and decalcified in 5% nitric acid. Following the orientator protocol, five 5-µm-thick sections stained by HE were obtained from each tooth. Stereological counting for odontoblast with M42 multipurpose test was applied. Numerical density (Nv), volume density (Vv) and surface density (Sv) were estimated, and the mean (± SD) for each tooth, and Mean (± SE) per group were calculated. Differences between groups were analyzed by t test, with p 0.05 for statistical significance. In the healthy teeth group, the mean (± SE) for Nv was 0.409x105/mm3 (±0.018x105/mm3), Vv 19.714% (±1.43%) and to Sv 21.016 mm2/mm3 (±1.425 mm2/mm3) odontoblast cells. In the caries teeth group, the Nv was 0.521x105 /mm3 (±0.023x105/mm3), Vv 24.686% (±1.625%) and Sv 23.203 mm2/mm3 (±1.364 mm2/mm3). When comparing Nv, an increased in odontoblasts significantly (p = 0.0062), as well as Vv (p = 0.0197) in caries teeth group. There is an increased number of odontoblasts in teeth with reversible pulpitis, which would condition its responsiveness. The methodology can be applied to determine pulp behavior, and quantify variables of odontoblastic response in atraumatic restorative treatments in an impartial and reproducible form.

Dentina / Dentin

Si bien la dentina y la pulpa tienen marcadas diferencias en su composición y estructura, ambas están tan íntimamente ligadas por su origen embriológico, que cualquier cosa que afecte a la dentina lo hará sobre la pulpa y viceversa. El ejemplo más claro en ese sentido está dado por el líquido intersticial. Este líquido, semejante al plasma, pero con menos proteínas, constituye una continuidad entre ambos tejidos y sus efectos hidrodinámicos son muy importantes tanto en los estados fisiológicos como en los patológicos.

Dentina / Dentin

Si bien la dentina y la pulpa tienen marcadas diferencias en su composición y estructura, ambas están tan íntimamente ligadas por su origen embriológico, que cualquier cosa que afecte a la dentina lo hará sobre la pulpa y viceversa. El ejemplo más claro en ese sentido está dado por el líquido intersticial. Este líquido, semejante al plasma, pero con menos proteínas, constituye una continuidad entre ambos tejidos y sus efectos hidrodinámicos son muy importantes tanto en los estados fisiológicos como en los patológicos.

Apical stress distribution on maxillary central incisor during various orthodontic tooth movements by varying cemental and two different periodontal ligament thicknesses: A FEM study.

Context: During fixed orthodontic therapy, when the stress levels in the periodontal ligament (PDL) exceedsan optimum level, it could lead to root resorption. Aims: To determine an apical stress incident on the maxillary central incisor during tooth movement with varying cemental and periodontal ligament thickness by Finite Element Method (FEM) modeling. Settings and Design: A three dimensional finite element model of a maxillary central incisor along with enamel, dentin, cementum, PDL and alveolar bone was recreated using EZIDCOM and AUTOCAD software. ALTAIR Hyper mesh 7.0 version was used to create the Finite Element meshwork of the tooth. This virtual model was transferred to Finite Element Analysis software, ANSYS where different tooth movements were performed. Materials and Methods: Cemental thickness at the root apex was varied from 200 μm to 1000 μm in increments of 200 μm. PDL thickness was varied as 0.24 mm and 0.15 mm. Intrusive, Extrusive, Rotation and Tipping forces were delivered to determine an apical stress for each set of parameters. Results: Results indicated that an apical stress induced in the cementum and PDL, increased with an increase in cementum and PDL thickness respectively. Apical stress induced in the cementum remained the same or decreased with an increase in the PDL thickness. Apical stress induced in the PDL decreased with an increase in the cementum thickness. Conclusion: The study concluded that the clinical delivery of an orthodontic forces will cause stress in the cementum and PDL. Hence, it is necessary to limit the orthodontic force to prevent root resorption.

Age estimation of indian adults from orthopantomographs

The aim of this study was to develop a method for estimating the chronological age of Indian adults based on the relationship between age and various morphological variables of canine teeth, obtained using orthopantomographs. Orthopantomographs of 120 selected patients were digitized, and radiographic images of the right maxillary canine in each case were processed using a computer aided drafting program. Pulp/tooth area ratio, pulp/root length ratio, pulp/tooth length ratio, pulp/root width ratio at the cemento-enamel junction level, pulp/root width ratio at midroot level, and pulp/root width ratio at the midpoint between the cemento-enamel junction and the midroot of the canine were calculated by measuring various features on the images. Pearson's correlation, multiple linear regression, one way analysis of variance (ANOVA), and Student's t-test were used for statistical analysis. Regression equations were developed to estimate age from morphological variables. The observed minus the estimated age in the total study sample ranged from -2.2 to +1.5 years, in males from -0.9 to +0.8 years, while in females it was from -1 to +0.8 years. Differences between observed and estimated ages of subjects were not statistically significant. In conclusion there is a linear relationship of pulp/root width ratio at mid-root level and pulp/tooth area ratio of the right maxillary canine with chronological age in the Indian population. Age of subjects can therefore be estimated with a good degree of accuracy using regression equations.

Response of human dental pulp to calcium hydroxide paste preceded by a corticosteroid/ antibiotic dressing agent

Aim: To evaluate the treatment with corticosteroid/antibiotic dressing in pulpotomy with calciumhydroxide. Methods: Forty-six premolars were pulpotomized and randomly assigned into 3groups. In Group I pulpal wound was directly capped with calcium hydroxide, and Group II and Group III received corticosteroid/antibiotic dressing for 10 min or 48 h, respectively, before pulp capping. Teeth were processed for histological analysis after 7, 30 or 60 days to determine inflammatory cell response, tissue disorganization, dentin bridge formation and presence of bacteria.Attributed scores were analyzed by Kruskal-Wallis and Mann-Whitney tests (á=0.05). Results:On the 7th day, all groups exhibited dilated and congested blood vessels in the tissue adjacent to pulpal wound. The inflammatory cell response was significantly greater in Group III (p<0.05). On the 30th day, in all groups, a thin dentin matrix layer was deposited adjacent to the pulpal wound and a continuous odontoblast-like cell layer underlying the dentin matrix was observed. On the60th day, all groups presented a thick hard barrier characterized by an outer zone of dystrophic calcification and an inner zone of tubular dentin matrix underlined by a defined odontoblast-like celllayer. Conclusions: Within the limitations of present study, considering that the treatment was performed in healthy teeth, it may be concluded that the use of a corticosteroid/antibiotic dressing before remaining tissue protection with calcium hydroxide had no influence on pulp tissue healing.

Prevalência de foraminas e canais acessórios em região de furca e assoalho pulpar e sua influência na etiologia da lesão endo-periodontal: [revisão] / Prevalence of foraminas and accessories canals in the furcation and the floor pulp and influence in the etiology of endo-periodontal lesion: [review]

Introdução: as ramificações do canal radicular podem ser denominadas de “canais acessórios”, sendo que tais ramificações podem variar quanto ao tamanho, número e localização na raiz. O forame apical, devido à sua amplitude, é a principal via de comunicação entre a polpa e o periodonto, mas participam também da comunicação pulpar/periodontal todo o sistema de canais radiculares como os canais laterais, secundários e acessórios. Objetivo: realizar uma revisão de literatura para avaliar a prevalência de canais acessórios na região de furca e assoalho e a influência na etiologia da lesão endo-periodontal. Revisão de literatura: várias técnicas e métodos têm sido empregados ao longo dos anos para identificar a presença de canais acessórios e, assim, abordar a importância e influência dos mesmos nas lesões endoperiodontais. Conclusões: em relação à prevalência de canais acessórios na região de furca e assoalho há variação entre 2,3% a 79%, dependendo da técnica de estudo empregada; em relação ao método de estudo empregado, o mais eficaz foi a infiltração de corante associada à diafanização; os canais acessórios são importantes no desenvolvimento das lesões endo-periodontais.

Introduction: the root canal ramifications, also known as accessory canals, may vary by size, number and location in the root. The apical for a men, due to its magnitude, is the main path of communication between the dental pulp and periodontal region, but the entire system of root canals such as lateral, secondary and accessory canals also participate of the communication between pulp and periodontal region. Aim: conducting a literature review to assess the prevalence of accessory canals in the furcation and the floor, and its influence in the etiology of endo-periodontal lesion. Literature review: several techniques and methods have been employed over the years to identify the presence of accessory canals and, thus, to address its importance and influence in the endo-periodontal disease. Conclusions: the prevalence of accessory canals in the furcation region and floor was 2.3% to 79%, varying according to the technique performed in the study. The most effective study method to assess accessory canals was the infiltration dye and decalcification method. The accessory canals are important essentially in the endo-periodontal relation.

Avaliação da biocompatibilidade do compósito: biocerâmica/ácido poli (lático-co-glicólico) em fibroblastos e macrófagos e da resposta pulpar após capeamento direto / The cell biocompatibility of a bioceramic/poly (lactic-co-glycolic acid) composite and its pulp response in vivo for pulp capping application

Biocerâmicas associadas a polímeros para capeamento pulpar estão sendo investigadas pela capacidade de induzir a formação de tecido mineralizado. Esses materiais são usados na ortopedia e implantodontia com resultados clínicos eficientes. Contudo, pouco se sabe sobre seu efeito sobre a polpa dental e seus componentes celulares. O objetivo deste estudo foi avaliar a biocompatibilidade do compósito: biocerâmica de B-tricálcio fosfato/hidroxiapatita (BC) e co-polímero ácido poli (lático-co-glicólico) (PLGA) (BC/PLGA), em cultura de fibroblastos da polpa dental humana (FP5) e de macrófagos peritoneais (MP), e avaliar a resposta pulpar após capeamento direto após 30 e 60 dias...

Analysis of the dentin-pulp complex in teeth submitted to orthodontic movement in rats

In order to microscopically analyze the pulpal effects of orthodontic movement, 49 maxillary first molars of rats were submitted to orthodontic appliance composed of a closed coil spring anchored to the maxillary incisors, placed for the achievement of mesial movement. MATERIAL AND METHODS: Ten animals were used as the control group and were not submitted to orthodontic force; the other animals were divided into groups according to the study period of tooth movement, namely 1, 2, 3, 4, 5, 6 and 7 days. The investigation of pulp and periodontal changes included hyalinization, fibrosis, reactive dentin and vascular congestion. Statistical evaluation was performed between control and experimental groups and between periods of observation using non-parametric chi-square, Kruskal-Wallis and Dunn tests. RESULTS: There was no statistically significant difference concerning pulpal changes between control and experimental groups nor between periods of observation. The control group, at 3 and 5 days, revealed greater hyalinization of the periodontal ligament (p<0.05), whereas root resorption was significantly greater at 5 and 7 days (p<0.05). CONCLUSION: No morphological change from the effect of induced tooth movement could be found in the dentin-pulp complex. In addition, no inflammatory or pulp degeneration, detectable in optical microscopy, was found in experimental groups.

Diagnóstico endodôntico: comparação entre aspectos clínicos e histológicos / Endodontic diagnosis: evaluation between clinical and histological findings

Objetivos: Neste estudo, nos propomos a analisar as alterações histológicas de trinta polpas dentárias correlacionando-as com os achadosclínicos para verificar a concordância entre o diagnóstico clínico e histopatológico e contribuir para o conhecimento sobre diagnósticoendodôntico. Métodos: Utilizando-se a metodologia de Oliveira4, as condições pulpares foram classificadas clinicamente como normal, pulpite reversível, pulpite em fase de transição, pulpite irreversível e necrose.Resultados: Foi observada falta de correlação entre os diagnósticos clínicos e histopatológicos nos casos classificados como reversíveis eem fase de transição, os quais histologicamente consistiram de lesões irreversíveis ou alterações degenerativas. Todos os casos classificadosclinicamente como irreversíveis corresponderam aos diagnósticos histopatológicos.Conclusão: Concluiu-se que a correlação entre o diagnóstico clínico e histopatológico da polpa dentária se mostra controversa, ainda quea semiotécnica utilizada tenha sido imprescindível para a orientação sobre a irreversibilidade da lesão pulpar.

Objective: In this study, the aim was to analyze the histologic alterations in thirty dental pulps and correlate them with the clinical findings to verify agreement between the clinical and histopathologic diagnosis and contribute to knowledge about endodontic diagnosis. Methods: Using the methodology of Oliveira4, the pulpal conditions were clinically classified as normal, reversible pulpitis, pulpitis at the stage of transition, irreversible pulpitis and necrosis. Results: Lack of correlation was observed between the clinical and histopathologic diagnoses in the cases classified as reversible and at the stage of transition, which histologically consisted of irreversible lesions or degenerative alterations. All the cases clinically classified as irreversible corresponded to the histologic diagnoses. Conclusion: It was concluded that the correlation between clinical and histopathologic diagnosis of dental pulp was shown to be controversial, even though the semiotechnique used had been imperative for guidance about the irreversibility of pulpal lesion.