Efectividad de anticoagulación regional con citrato en terapia de reemplazo renal continua / Effectiveness of regional citrate anticoagulation in continuous renal replacement therapy

BACKGROUND: Anticoagulation in continuous renal replacement therapy (CRRT) is essential to counteract the coagulation cascade activation, induced by the dialysis circuit. Heparin is the most widely used anticoagulant, followed by regional citrate anticoagulation (RCA). AIM: To determine the effectiveness and safety of anticoagulant treatment with citrate in CRRT. Material and Methods: Retrospective study of adults in CRRT hospitalized between the years 2014 and 2020 in critical units, who required change to RCA according to established protocols. RESULTS: We studied 24 patients aged 63 ± 13 years (12 females). The reasons for admission were acute kidney injury (AKI) in 80% and stage 5 chronic kidney disease in 20%. The indication of RCA in 75% of patients was by coagulation of more than 3 circuits in 24 hours. The duration of the circuit in RCA was 18.5 ± 4.8 hours versus 11.9 ± 4.9 hours with heparin (p < 0.0001). There were 19 mild complications that did not affect the RCA. Conclusions: RCA is feasible to perform, it is a safe and efficient procedure if it is protocolized, allowing a longer duration of the dialysis circuit.

Eficacia de bioacondicionadores cementarios en el nivel de cobertura e inserción radicular / Efficacy of bioconditioners inserted in the level of coverage and root inclusion

Introducción: La presente investigación tuvo por objeto determinar la eficacia de la cefalexina, la terramicina y del ácido cítrico como bioacondicionadores en los niveles de cobertura radicular y de inserción en pacientes con recesión gingival clase II de Miller intervenidos a colgajo desplazado coronalmente. Materiales y método: Se trata de un ensayo clínico randomizado intergrupo, con pretest y postest múltiple, se conformaron 3 grupos: dos experimentales (1 y 2) que recibieron respectivamente la cefalexina y la terramicina; y un grupo control en el que se le aplicó ácido cítrico, como bioacondicionadores cementarios. Cada grupo estuvo constituido por 20 recesiones gingivales clase II de Miller, con indicación básica de colgajo desplazado coronalmente, los datos se evluaron mediante las pruebas Chi Cuadrado de Pearson y ANOVA. Resultados: No hubo diferencia estadística significativa en el efecto de la cefalexina, la terramicina y en el ácido cítrico en el nivel de cobertura radicular a los 30 días. El contraste ANOVA mostró en cambio, a los 60 días una diferencia estadística significativa, en el efecto de dichos bioacondicionadores en la ganancia de inserción. Conclusiones:El uso de bioacondicionares genera resultados significativos en el manejo de recesiones gingivales, siendo más afectivos a largo plazo. (AU)

Introduction: The present study was designed to determine the efficacy of cefalexin, the terramycin and citric acid as bioconditioners in root coverage and levels of insertion in patients with class II Miller gingival recession intervened to displaced face flap. Materials and method: is of a trial clinical randomized Intergroup, with pretest and posttest multiple, is formed 3 groups: two experimental (1 and 2) that received respectively the cephalexin and the terramycin; and a group control in which is it applied acid citric, as bioconditioners inserted. Each group was made up of 20 gingival recessions class Miller II, with basic indication of flap displaced face, the data is evluaron using ANOVA and Pearson Chi square tests. Results: There was No statistical significant difference in the effect of cefalexin, the terramycin and citric acid at the level of root coverage within 30 days. The contrast ANOVA showed instead, to them 60 days a difference statistical significant, in the effect of such bioconditioners in the gain of inclusion. Conclusions: the use of bioconditioners generates results significant at the handling of recessions gingival, being more affec tive to long term. (AU)

Smear layer removal efficacy of different irrigating solutions: A comparative scanning electron microscope evaluation.

Aims: Comparative evaluation of cleaning efficacy of smear layer removal by different irrigating solutions such as 2.5% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA) with 2.5% NaOCl, 10% citric acid with 2.5% NaOCl and 1% tetracycline Hydrochloride (HCl) with 2.5% NaOCl for smear layer removal in the apical third of root canal. Settings and Design: In vitro material science study. Materials and Methods: Seventy-five single rooted permanent maxillary central incisor teeth were subjected to standardized root canal instrumentation (crown down technique). The teeth were randomly divided into five groups with 15 teeth in each groups: (1) Normal saline (n = 15) (2) 2.5% NaOCl (n = 15) (3) 17% EDTA + 2.5% NaOCl (n = 15) (4) 10% citric acid + 2.5% NaOCl (n = 15) (5) 1.0% tetracycline HCL + 2.5% NaOCl (n = 15). After final irrigation, the teeth were prepared for scanning electron microscope analysis to evaluate the cleaning of apical third of radicular dentine to determine the presence or absence of smear layer. Statistical Analysis Used: The results were analyzed by nonparametric statistical analysis techniques. Kruskal-Wallis test, Mann-Whitney test and Chi-square tests were carried out. Results: There was no significant statistical difference in the efficacy of smear layer removal when 2.5% NaOCl was compared with 17% EDTA with 2.5% NaOCl, 10% citric acid with 2.5% NaOCl and 1% tetracycline HCl with 2.5% NaOCl in apical third of root canals. Conclusions: The present study suggests that irrigating agents, citric acid and tetracycline HCl can be used as an alternative to EDTA for the removal of smear layer in endodontics.

Comportamento de células do sistema imune frente ao desafio com Salmonella Enteritidis em aves tratadas e não tratadas com ácidos orgânicos / Behavior of cells of immune system to the challenge with Salmonella Enteritidis in birds treated and untreated with organic acids

A Salmonelose é uma importante zoonose, considerada a principal causa de infecções bacterianas, sendo associada ao consumo de produtos avícolas. Como alternativa de controle, ácidos orgânicos têm sido amplamente usados. No entanto, pouco se conhece sobre o estado imunológico de aves de produção, e uma avaliação deste status é necessária para proteger frente a enfermidades e para garantir à aplicação segura de agentes terapêuticos ou imunização profilática. Este trabalho teve como objetivo verificar o comportamento do sistema imunológico das aves previamente infectadas com Salmonella Enteritidis (SE) tratadas com um composto de ácidos orgânicos em diferentes concentrações administrado via água e ração comparando com as aves infectadas e não tratadas. Foram inoculados 120 frangos de corte com 1mL de SE, via oral, na concentração de 1,0 x 108 UFC/mL, no 1º e 2º dia de idade, divididos em seis tratamentos com duas repetições, utilizando 200, 400, 500 e 1000ppm do ácido orgânico. Aos 35 dias de vida das aves, foram coletados, de todos os grupos, alíquotas de sangue de 3mL em tubo contendo EDTA para a avaliação das células imunes através de citometria de fluxo. Foram analisadas as porcentagens circulantes de células CD4+, CD8β+, MHC I+, MHC II+, TCRVβ1+, TCRVβ2+ e CD28+. Para análise microbiológica foram coletadas tonsilas cecais destas aves. Observou-se com esse estudo que os ácidos orgânicos nas dosagens 1000ppm na água e 500ppm na ração durante, dois e sete dias respectivamente antes do abate, foram eficazes na redução da infecção por SE em frangos de corte, comprovadas pelo método microbiológico e demonstradas através do comportamento das células do sistema imune. No presente estudo as aves infectadas apresentaram uma proporção menor de células T auxiliares circulantes quando comparadas às aves infectadas, mas tratadas com o AO ou com o grupo não infectado. A mesma tendência pode ser observada para as células CD28+, TCRVβ1+ e MHC IIbright+, e, com menor resolução, para CD8β+.

Salmonellosis is an important zoonosis, considered the leading cause of bacterial infections, and is associated with the consumption of poultry products. As alternative control, organic acids have been widely used. However, little is known about the immune status of poultry production, and an evaluation of this status is necessary to protect against disease and to ensure the safe application of therapeutic agents or prophylactic vaccination. This study aimed to verify the behavior of the immune system of birds previously infected with Salmonella Enteritidis (SE) treated with a compound of organic acids in different concentrations administered via water and food, compared with the infected birds and untreated. One hundred and twenty broilers were orally inoculated with 1ml of SE at a concentration of 1.0x108 CFU/mL, at 1 and 2-days-old and divided into six treatments with two repetitions of 200, 400, 500 and 1000ppm organic acid. From 35-days-old birds of all groups were collected aliquots of 3mL of blood into a tube containing EDTA for the evaluation of immune cells by flow cytometry. We then analyzed the percentages of circulating CD4+, CD8β+, MHC I+ MHC II+, TCRVβ1+, CD28+ + and TCRVβ2. For microbiological analysis were collected caecal tonsils of these birds. We found that organic acids in dosages 1000ppm 500ppm in water and in feed for 2 to 7 days before slaughter, respectively, were effective in reducing SE infection in broilers, proven by microbiological method and demonstrated through the behavior of immune cells. The infected birds showed a lower proportion of circulating T helper cells compared with infected poultry, but treated with AO or with the uninfected group. The same trend can be observed for CD28+ cells, and MHC IIbright+ TCRVβ 1+, and with lower resolution, for CD8β+.

Assessment of combination techniques in enhancing the regenerative potential of tricalcium phosphate graft in treatment of infrabony periodontal defects.

Aims: The purpose of the present study was to evaluate and compare the clinical outcome of infrabony defects following reconstructive surgery with the use of tricalcium phosphate (TCP) alone; TCP and citric acid (CA) root conditioning; and TCP, CA, and oxidized regenerated cellulose (ORC) membrane. Materials and Methods: Thirty-nine systemically healthy subjects with vertical infrabony defect were initially selected based on intraoral periapical radiographs and clinical examination to record probing pocket depth (PPD) and clinical attachment level (CAL). Only 21 defects revealed two-walled configuration on surgical debridement. These defects were selected and randomly allotted to the study groups. Group 1 defects were treated with TCP, group 2 with TCP+CA, and group 3 with TCP+CA+ORC. PPD, CAL, defect depth (DD), and level of alveolar crest (AC) were evaluated at the time of initial surgery and after 6 months at surgical re-entry. These measurements were utilized to calculate PPD reduction, CAL gain, defect fill (DF), %defect fill (%DF), and crestal resorption (CR). Statistical Analysis: A paired t-test was used for assessing changes in each group. Unpaired t-test was used for intergroup comparisons. Results: All three groups showed statistically significant PPD reduction, CAL gain, DF, and %DF, but insignificant CR at the end of 6 months. On intergroup comparison, no statistically significant differences were noted between the groups for all the parameters. Conclusion: Efficacy of combination techniques using TCP+CA; TCP+CA+ORC in treatment of periodontal infrabony defects is at least equal to that of TCP alone.

Influence of dental exposure to oral environment on smear layer removal and collagen exhibition after using different conditioning agents

Although in vitro studies have shown encouraging results for root surface conditioning with demineralizing agents, in vivo studies have failed to show its benefits in periodontal healing. This can be attributed to several factors, among which, the hypermineralization of dental surface. Therefore, this in vitro study compared, using scanning electron microscopy (SEM), the effect of root surface conditioning with different conditioners (1% and 25% citric acid, 24% EDTA and 50 mg/mL tetracycline hydrochloride) in impacted teeth and in teeth that had their roots exposed to the oral environment. One trained examiner assessed the SEM micrographs using a root surface modification index. There was a tendency of more root surface modification in the group of impacted teeth, suggesting that the degree of root mineralization influences its chemical demineralization.

Apesar de estudos in vitro terem demonstrado resultados favoráveis ao condicionamento da superfície radicular com agentes desmineralizantes, estudos in vivo não mostraram seus benefícios na cicatrização periodontal. Isto pode ser atribuído a vários fatores, entre os quais, a hipermineralização da superfície dental. Portanto, este estudo in vitro comparou, usando microscopia eletrônica de varredura, o efeito do condicionamento da superfície radicular com diferentes condicionadores (1% e 25% de ácido cítrico, EDTA 24% e 50 mg/mL de cloridrato de tetraciclina) em dentes impactados e dentes que tinham suas raízes expostas ao meio bucal. Um examinador treinado avaliou as microscopias eletrônicas de varredura utilizando um índice de modificação da superfície radicular. Houve uma tendência de maior modificação da superfície radicular no grupo de dentes impactados, sugerindo que o grau de mineralização da raiz influencia a sua desmineralização química.

The effect of irrigation solutions on the apical sealing ability in different root canal sealers

The aim of this study was to assess the effect of three root canal irrigation solutions on the apical sealing ability of three root canal obturation materials: gutta-percha/AH plus or MM-seal and Resilon/Epiphany SE. A total of 100 teeth with single straight root canals were randomly divided into three equal groups of 30 samples each, with the other 10 teeth (5 positive and 5 negative) used as controls. Each irrigation group was divided into three groups according to the use of three different root canal obturation materials (n = 10): Gutta-percha with AH plus or MM-seal, Resilon with Epiphany SE. The crowns were removed at the cementoenamel junction with a diamond disc under water coolant. The root canals were prepared using step-back technique and irrigation with either sodium hypochlorite (2.5 percent), chlorhexidine (2 percent), or MTAD solutions. The roots were obturated with lateral condensation technique using one of the obturation materials. The root surfaces was coated with two layer nail varnish (except apex), placed in 2 percent methylene blue dye solution, and centrifuged at 3,000 rpm for 5 minutes. Irrigation solutions affected the apical sealing ability of all the sealers. The chlorhexidine irrigation solution exhibited higher apical leakage values than did MTAD and NaOCl in all canal sealers, although the MTAD irrigation solution groups showed the least leakage values. The apical sealing ability of AH plus, Epiphany SE and MM-seal root canal sealers decreased when the chlorhexidine was used as an irrigation solution.

Mechanical and acid root treatment on periodontally affected human teeth: a scanning electronic microscopy

Aim: To evaluate the root topography of human teeth affected by periodontitis, after different root surface treatments. Methods: Forty-two periodontally affected single-rooted human teeth were selected and randomly divided into 7 groups (n=6): Cont- control group, which received no treatment; Sca- root surface scaling and root planning with curettes; ScaPh- Sca followed by 37%phosphoric acid gel etching for 15 s; ScaEdta- Sca followed by 24% EDTA gel pH 7 for 1 min; ScaCi- Sca followed by 30% citric acid pH 1.6 for 5 min; ScaTe- Sca followed by - mixture obtained by 500 mg tetracycline capsule dissolved in saline solution for 3 min; ScaTeg- Sca followed by 0.2 g/mL tetracycline gel pH 1.8 for 1 min. The specimens were analyzed by scanning electronic microscopy to verify the presence of calculus, demineralization level and residues of the product. Results: Calculus deposits were found in all control specimens. ScaEdta, ScaCi and ScaTeg removed completely calculus deposits and resulted in adequate demineralization without smear layer and smear plug on root surface. ScaTe produced great tetracycline residues with several demineralization areas on root dentin surface. Conclusions: ScaEdta, ScaCi and ScaTeg produced clean root surfaces associated with regular dentin demineralization.

Análise de duas formas de tratamento da raiz distal do segundo molar inferior após exodontia do terceiro molar adjacente não-irrompido / Analysis of Two Ways of Treatment of the Second Molar Distal Root after extraction of the Adjacent Unerupted Third Mol

Estudou-se a cicatrização na distal de segundos molares inferiores após a exodontia dos terceiros molares adjacentes não-irrompidos. Foram operados 29 pacientes que possuíam terceiros molares inferiores não-irrompidos bilateralmente, que se apresentavam simétricos quanto ao posicionamento em relação ao segundo molar. Após a exodontia, a face distal das raízes dos segundos molares recebeu tratamentos distintos; no grupo-controle, realizou-se somente raspagem e irrigação com soro fisiológico, enquanto que, no grupo experimental, além da raspagem, foi aplicado um gel de ácido cítrico a 50% (pH1) por três minutos, seguido de irrigação com soro fisiológico. A análise consistiu de exames clínicos e radiográficos pré e pós-operatórios por meio da medição dos índices gengival e de placa, da profundidade de sondagem e da verificação radiográfica da altura da crista óssea alveolar à junção amelo-cementária; esses exames foram realizados no pré-operatório imediato, com 90 e 180 dias após a exodontia. Os resultados demonstraram que os critérios avaliados apresentaram melhora após a cirurgia, porém não houve diferenças estatisticamente significantes entre os grupos. Os resultados sugerem que a aplicação do ácido cítrico é uma etapa dispensável durante a exodontia de terceiros molares inferiores não-irrompidos, no que diz respeito à cicatrização na distal dos segundos molares adjacentes.

The healing of the distal root of the second lower molars following extraction of adjacent unerupted third molars was studied. Twenty-nine patients with unerupted lower third molars that were symmetrically positioned in relation to the second molar were operated on. After extraction the distal surface of the roots of the second molars received different treatments; in the control group only scraping and irrigation with saline was performed, whereas in the experimental group, in addition to scraping, a 50% citric acid gel (pH1) was applied for three minutes, followed by irrigation with saline. The analysis consisted of clinical and radiographic pre- and postoperative examinations through the measurement of plaque and gingival index, probing depth and radiographic verification of alveolar bone height; these examinations were performed preoperatively and at 90 and 180 days following surgery. The results demonstrated that the criteria evaluated showed an improvement after surgery, but there were no statistically significant differences between the groups. The results suggest that the application of citric acid is not a necessary step during extraction of unerupted lower third molars as far as the healing of the distal root of adjacent second molars is concerned.

Response of the periapical tissue of dogs' teeth to the action of citric acid and EDTA

The purpose of this study was to analyze the inflammatory response of dog's periapical tissues to 17 percent trisodium EDTA salt (pH 8.0) and 1 percent citric acid (pH 2.0). Saline was used as a control. Six adult dogs were used as the biological model of the study. The experimental units comprised 56 roots of mandibular molars (first and second) and premolars (first, second and third). After coronal opening, pulpectomy and root canal instrumentation were performed using the above-mentioned irrigating solutions. After 24 and 48 hours, the animals were euthanized and the teeth and their supporting tissues were removed and histologically processed. The sections were stained with hematoxylin and eosin and analyzed histopathologically with a light microscope at x100 magnification. The histological analysis focused on the occurrence of acute inflammatory response. The presence of swelling, vasodilatation and inflammatory cells were evaluated and the degree of inflammation was determined for each case. Data were analyzed by Fisher's exact test using the SPSS software with a confidence interval of 95 percent (p<0.05). 17 percent EDTA and 1 percent citric acid caused inflammatory responses in dog's periapical tissues with no significant differences to each other or to saline (control) at either the 24-hour (p=0.482) or 48-hour (p=0.377) periods. It may be concluded that the inflammatory response was of mild intensity for the tested substances.

Type 1 renal tubular acidosis with sensorineural deafness.

We report a case of Type 1 Renal Tubular Acidosis (RTA) in association with sensorineural deafness. Inherited Type 1 RTA is usually autosomal dominant, though there is a rarer recessive form associated with nerve deafness. Simple alkali replacement can correct the systemic metabolic defect, but does not appear to ameliorate hearing loss.

Periodontal healing after Root conditioning using TTC-HCI or citric acid: A histological study in rats

O reparo tecidual após terapia periodontal consta da cicatrização epitelial e conjuntiva pela a biocompatibilização da superfície radicular. O objetivo deste estudo foi investigar se o uso de soluções condicionantes como o cloridrato de tetraciclina (TTC-HCl) ou o ácido cítrico podem melhorar o reparo após a terapia periodontal em ratos. A doença periodontal foi induzida pela inserção de uma ligadura nos 2º molares superiores esquerdos em 36 ratos Wistar. O sítio experimental foi tratado mecanicamente e uma marcação na porção mais apical da bolsa foi preparada com uma lima endodôntica de Hedstroen. Os sítios experimentais foram então irrigados com de solução de cloridrato de tetraciclina à 10% ou, de solução de ácido cítrico à 8% ou, de solução de NaCl à 0,9% formando 3 grupos de 12 animais. Os animais foram sacrificados 3, 7, ou 21 dias após o tratamento e as peças cirúrgicas foram processadas para a análise histomorfométrica. Os resultados mostraram maturação da cicatrização de forma normal, sem regeneração nos sítios experimentais. Utilizando-se um retículo de contagem e a análise de variância a dois critérios observou-se que o te-cido que preencheu a marcação não diferiu significativamente entre os sítios irrigados com soluções condicionantes. Entretanto, o tecido que preenchia a marcação era menor nestes grupos em relação ao controle e apresentava uma área ocupada por tecido conjuntivo com inflamação mais estreita. Baseado nestes resultados pode-se concluir que a irrigação com soluções ácidas pode melhorar o reparo após a terapia periodontal.

Análise em microscopia eletrônica de varredura de superfícies radiculares antes e após raspagem e condicionamento com ácido cítrico e EDTA: um estudo "in vitro" / Scanning electron microscopy analysis on root surfaces before and after scalling and citric and EDTA conditioning

A superfície radicular mais benéfica para a regeneraçäo do periodonto ainda näo está estabelecida. Visando uma busca por esta superfície este trabalho utilizou 14 dentes de humanos recém extraídos, seccionados em corpos de prova e tratados com raspagem e condicionamentos com ácido cítrico e EDTA e analisados em microscopia eletrônica de varredura. As superfícies hígidas apresentavam grânulos regulares provenientes de fibras do ligamento periodontal rompidas na exodontia. As superfícies contaminadas apresentavam massas de cálculo aderidas e áreas de reabsorçäo cementária. Quando raspadas com curetas manuais as superfícies foram cobertas por "smear layer". O condicionamento com ácido cítrico foi eficiente na remoçäo total do "smear layer", assim como o condicionamento com EDTA gel, e o condicionamento com EDTA líquido näo teve efetividade total na sua remoçäo. Tomando como padräo as superfícies hígidas, conclui-se que os tratamentos que mais se aproximam do ideal säo a raspagem e condicionamento com ácido cítrico e EDTA gel sem diferenças entre si

Tratamento regenerativo periodontal de defeitos infra-ósseos de duas ou três paredes realizados em animais e humanos, utilizando a membrana reabsorvível de osso cortical bovino (GEN-DERM), osso inorgânico bovino (GEN-OX) e ácido cítrico com / Periodontal regenerative treatment of two or three walls-defects intra bony made in animals and humans, using anorganic bovine bone, resorbable membrane of bovine cortical bone and citric acid with tetracycline

Este estudo teve como objetivo avaliar a biocompatibilidade em coelhos e a regeneração periodontal em defeitos intra-ósseos em humanos, utilizando o osso inorgânico bovino (Gen-Ox). Cinco grupos de coelhos, contendo 5 em cada um deles, foram sacrificados nos períodos de 30, 60, 90, 180 e 270 dias, após a colocação do enxerto ósseo. No estudo em humanos, a amostra constou de 10 indivíduos com idade entre 25 e 60 anos, apresentando um par de defeitos intra-ósseos, localizados no mesmo arco dentário em dentes do mesmo tipo (pré-molares ou molares) e com perda de inserção (PI) 5mm. Em cada indivíduo, o lado teste foi tratado na superfície radicular com aplicação de ácido cítrico com tetraciclina, preenchido o defeito com osso inorgânico bovino (Gen-Ox), e adaptada a membrana reabsorvível de osso cortical bovino (Gen-Derm), enquanto o lado controle foi tratado na superfície radicular com aplicação de ácido cítrico com tetraciclina e adaptada a membrana reabsorvível (Gen-Derm). Houve uma redução significante no nível de inserção nos dois grupos, quando avaliados na comparação entre os períodos pré-operatórios e aos seis meses de pós-operatório, tendo o grupo teste mostrado uma melhora significante quando comparado ao grupo controle (teste t pareado, p=0,038). Foram feitos controles radiográficos padronizados de ambos os grupos para a obtenção das medidas individuais, com posterior análise estatística das variações das medidas. MEDIDA 1, da Junção Cemento Esmalte até o final do ápice da raiz (J.C.E.-A). MEDIDA 2, da J.C.E.- RT (até o início da radiotransparência). MEDIDA 3, da J.C.E.-D (até o final do defeito). As variações ocorridas no período entre a radiografia inicial e 6 meses alcançaram significância estatística somente para a medida 1 (p=0,03), radiografia inicial e 12 meses para as medidas 1 (p=0,043) e 3 (p=0,001) pelo teste de Tukey. Conclui-se que na avaliação histológica em coelhos, nos períodos de 3 a 9 meses, ocorreu a remodelação óssea...

This study aimed at evaluating the biocompatibility in rabbits and the periodontal regeneration of intra-bony defects in humans, utilizing a bovine inorganic bone (Gen-Ox). Five groups of rabbits, containing 5 in each group, were sacrificed in the periods of 30, 60, 90, 180 and 270 days, following the bone graft. In the study in humans, the sample was comprised of 10 individuals in the age range 25 - 60 yrs, presenting a pair of intra-bony defects, located in the same dental arch, in teeth of the same type (pre-molars or molars) and with an insertion loss (IL) 5mm. In each individual, the test side was treated on the root surface, with the application of citric acid with tetracycline and the bone defect filled with bovine inorganic bone (Gen-Ox), being the resorbable membrane of bovine cortical bone (Gen-Derm) adapted, while the control side was treated on the root surface, with the application of citric acid with tetracycline, being the resorbable membrane (Gen-Derm) adapted. There was a significant reduction in the insertion level in the two groups, when evaluated between the pre-surgical periods and at six months, postoperatively, the test group showing a significant improvement as compared to the control (paired t test, p=0.038). Standardized radiographic controls were made of both groups, so as to obtain individual measurements, followed by statistical analysis of the measurement variations. MEASUREMENT 1, from the cementoenamel junction up to the end of the root apex (J.C.E.-A). MEASUREMENT 2, from the J.C.E.-RT (up to the beginning of radio-transparency). MEASUREMENT 3, from the J.C.E.-D (up to the end of defect). The variations occurred in the period between the initial radiography and 6 months, had statistical significance only for measurement 1 (p=0.03), initial radiography and 12 months for measurements 1 (p=0.043) and 3 (p=0.001), by Tukey´s test. It was concluded that in the histological evaluation of rabbits, in the periods...

Tratamento regenerativo periodontal de defeitos infra-ósseos de duas ou três paredes realizados em animais e humanos, utilizando a membrana reabsorvível de osso cortical bovino (GEN-DERM), osso inorgânico bovino (GEN-OX) e ácido cítrico com / Periodontal regenerative treatment of two or three walls-defects intra bony made in animals and humans, using anorganic bovine bone, resorbable membrane of bovine cortical bone and citric acid with tetracycline

Este estudo teve como objetivo avaliar a biocompatibilidade em coelhos e a regeneração periodontal em defeitos intra-ósseos em humanos, utilizando o osso inorgânico bovino (Gen-Ox). Cinco grupos de coelhos, contendo 5 em cada um deles, foram sacrificados nos períodos de 30, 60, 90, 180 e 270 dias, após a colocação do enxerto ósseo. No estudo em humanos, a amostra constou de 10 indivíduos com idade entre 25 e 60 anos, apresentando um par de defeitos intra-ósseos, localizados no mesmo arco dentário em dentes do mesmo tipo (pré-molares ou molares) e com perda de inserção (PI) 5mm. Em cada indivíduo, o lado teste foi tratado na superfície radicular com aplicação de ácido cítrico com tetraciclina, preenchido o defeito com osso inorgânico bovino (Gen-Ox), e adaptada a membrana reabsorvível de osso cortical bovino (Gen-Derm), enquanto o lado controle foi tratado na superfície radicular com aplicação de ácido cítrico com tetraciclina e adaptada a membrana reabsorvível (Gen-Derm). Houve uma redução significante no nível de inserção nos dois grupos, quando avaliados na comparação entre os períodos pré-operatórios e aos seis meses de pós-operatório, tendo o grupo teste mostrado uma melhora significante quando comparado ao grupo controle (teste t pareado, p=0,038). Foram feitos controles radiográficos padronizados de ambos os grupos para a obtenção das medidas individuais, com posterior análise estatística das variações das medidas. MEDIDA 1, da Junção Cemento Esmalte até o final do ápice da raiz (J.C.E.-A). MEDIDA 2, da J.C.E.- RT (até o início da radiotransparência). MEDIDA 3, da J.C.E.-D (até o final do defeito). As variações ocorridas no período entre a radiografia inicial e 6 meses alcançaram significância estatística somente para a medida 1 (p=0,03), radiografia inicial e 12 meses para as medidas 1 (p=0,043) e 3 (p=0,001) pelo teste de Tukey. Conclui-se que na avaliação histológica em coelhos, nos períodos de 3 a 9 meses, ocorreu a remodelação óssea...

This study aimed at evaluating the biocompatibility in rabbits and the periodontal regeneration of intra-bony defects in humans, utilizing a bovine inorganic bone (Gen-Ox). Five groups of rabbits, containing 5 in each group, were sacrificed in the periods of 30, 60, 90, 180 and 270 days, following the bone graft. In the study in humans, the sample was comprised of 10 individuals in the age range 25 - 60 yrs, presenting a pair of intra-bony defects, located in the same dental arch, in teeth of the same type (pre-molars or molars) and with an insertion loss (IL) 5mm. In each individual, the test side was treated on the root surface, with the application of citric acid with tetracycline and the bone defect filled with bovine inorganic bone (Gen-Ox), being the resorbable membrane of bovine cortical bone (Gen-Derm) adapted, while the control side was treated on the root surface, with the application of citric acid with tetracycline, being the resorbable membrane (Gen-Derm) adapted. There was a significant reduction in the insertion level in the two groups, when evaluated between the pre-surgical periods and at six months, postoperatively, the test group showing a significant improvement as compared to the control (paired t test, p=0.038). Standardized radiographic controls were made of both groups, so as to obtain individual measurements, followed by statistical analysis of the measurement variations. MEASUREMENT 1, from the cementoenamel junction up to the end of the root apex (J.C.E.-A). MEASUREMENT 2, from the J.C.E.-RT (up to the beginning of radio-transparency). MEASUREMENT 3, from the J.C.E.-D (up to the end of defect). The variations occurred in the period between the initial radiography and 6 months, had statistical significance only for measurement 1 (p=0.03), initial radiography and 12 months for measurements 1 (p=0.043) and 3 (p=0.001), by Tukey´s test. It was concluded that in the histological evaluation of rabbits, in the periods...

Condicionamento ácido da superfície radicular em periodontia / Root surface conditioning in periodontal therapy

O objetivo principal da terapia periodontal vem sendo a biocompatibilizaçäo da superfície radicular com os tecidos periodontais adjacentes. A raspagem e alisamento säo ainda procedimentos fundamentais para se atingir este objetivo. No entanto, vem sendo sugerindo que a instrumentaçäo vigorosa da superfície radicular deva ser evitada, a fim de se manter cemento radicular, importante no processo de reparo dos tecidos periodontais de sustentaçäo. O uso de substâncias ácidas, como o ácido cítrico, ácido fosfórico e o EDTA, vem sendo preconizado para a remoçäo das endotoxinas e exposiçäo de fibras colágenas da superfície radicular, favorecendo a obtençäo de nova inserçäo conjuntiva apesar dos trabalhos ainda mostrarem-se inconclusivos quanto à efetividade clínica desse procedimento

Rat connective tissue response to implant of human dental root treated with citric acid and human recombinant platelet-derived growth factor-BB (rhPDGF-BB)

This study assessed the conective tissue response to periodontitis-affected root surface after treatment with PDGF-BB, comparing this therapy with root planning and surface demineralization with citric acid. After surface therapy all the rats and collected 3,7 and 15 days after implantation. Histologic and morphometric analysis included counts of cell densities and evaluation of the rapairing tissue adjacent to specimens. It was concluded that root specimen pathogenicity was reduced by citric acid demineralization. It seems that PDGF-BB stimulated connective tissue repair and fiber deposition during the first week

Análise da superfície dentinária, por meio de microscopia eletrônica, após condicionamento ácido / Sem analisys of dentin surface after etching conditioning

O objetivo deste trabalho foi avaliar a capacidade de limpeza do ácido fosfórico a 32 por cento, do ácido cítrico a 10 por cento e do creme de ENDO-PTC associado ao hipoclorito de sódio a 0,5 por cento aplicados sobre a superfície dentinária de 15 dentes. A avaliaçäo da eficácia da limpeza, por meio de microscopia eletrônica de varredura, foi estabelecida pela capacidade de remoçäo de magma dentinário e de abertura dos túbulos dentinários. O ácido fosfórico apresentou melhores resultados. O creme de ENDO-PTC associado ao hipoclorito de sódio a 0,5 por cento näo removeu o magma dentinário

Vesículas seminales e infertilidad masculina: método diagnóstico y efecto del tratamiento con citrato de clomifeno

El estudio está diseñado para establecer si hay alguna relación entre la función de las vesículas seminales y la infertilidad masculina para lo cual se estudiará la existencia de una asociación entre la respuesta de la testosterona sérica al estímulo con citrato de clomifeno y la respuesta de las vesículas seminales y la movilidad espermática, la viscosidad seminal y la sensibilidad de la cromatina. Se han estudiado 42 varones que asistieron al Laboratorio de Andrología en el Instituto de Investigaciones de la Altura, Lima, ya sea porque ellos o sus esposas eran infértiles, y en quienes se les realizó la prueba del citrato de clomifeno. La fructosa corregida verdadera se constituyó en el mejor marcador de la función de las vesículas seminales que la medición de la fructosa corregida o de la fructosa seminal. La movilidad de los espermatozoides, y la integridad funcional de la membrana espermática (prueba hipo- osmótica) estuvieron disminuídas, y la estabilidad de la cromatina espermática ante el SDS+EDTA, y el conteo de leucocitos neutrófilos significativamente aumentados en los varones con hipofunción de las vesículas seminales. la principal causa de hipofuncióñ de las vesículas seminales fue la leucocitospermia y/o la enfermedad de transmisióñ sexual (ETS); en menor porcentaje se observa como causa al hipoandrogenismo. Las prevalencias de hiperviscosidad seminal, astenozoospermia, e hiperestabilidad de la cromatina espermática post SDS+EDTA fueron reducidas singificativamente después del tratamiento con citrato de clomifeno, siempre y cuando hay respuestas de las vesículas seminales al estímulo androgénico. La ausencia de respuesta de las vesículas seminales al estímulo androgénico fue debida principalmente a la presencia de leucocitospermia y/o historia de ETS. En resumen, la fructosa corregida verdadera es un adecuado marcador de la función de las vesículas seminales; la hipofunción de las vesículas seminales se asocia a hiperviscosidad seminal astenozoospermia e hiperestabilidad de la cromatina espermática. El incremento de la función de las vesículas seminales con citrato de clomifeno revierte en buen porcentaje estas alteraciones. En conclusión, la hipofunción de las vesículas seminales cumple un rol importante en la infertilidad masculina, y el citrato de clomifeno puede emplearse en estos casos tanto como prueba diagnóstica, como para el tratamiento.