ABSTRACT
The present study developed an experimental metronidazole-based gel and evaluated its efficacy for the adjuvant treatment of chronic periodontitis. Sixteen patients were randomly allocated into two groups of eight subjects according to the following proposed treatments: (1) scaling and root planing (active control) or (2) scaling and root planing and direct periodontal intrapocket application of 15% metronidazole-based gel in two sites (≥5 mm in depth) (experimental group). Potential changes in the subgingival microbiota were assessed using a DNA Checkerboard method at three proposed times: baseline and following 7 or 30 days of drug administration. High-performance liquid chromatography (HPLC) monitored metronidazole concentrations in the crevicular fluid during treatment. The metronidazole experimental group presented lower bacterial counts than the control group at the three evaluated times (p<0.01 for baseline, p<0.001 for 7 or 30 days) when the target species were analyzed as a pool of bacteria. Samples revealed significantly lower counts 7 days after drug administration compared with baseline or after 30 days (p<0.05). HPLC analysis detected gel 1 h after application. The metronidazole-based gel significantly decreased the total bacterial count at the three evaluated times. Periodontopathogenic species were not different after gel administration.
Subject(s)
Anti-Infective Agents, Local/administration & dosage , Chemotherapy, Adjuvant/methods , Chronic Periodontitis/drug therapy , Gels/administration & dosage , Metronidazole/administration & dosage , Administration, Topical , Adult , Aged , Anti-Infective Agents, Local/pharmacokinetics , Anti-Infective Agents, Local/pharmacology , Bacteria/classification , Bacteria/isolation & purification , Bacterial Load , Chromatography, High Pressure Liquid , Female , Humans , Male , Metronidazole/pharmacokinetics , Metronidazole/pharmacology , Middle Aged , Treatment OutcomeABSTRACT
AIM: An intra-buccal acrylic bioadhesive device designated for drug programmed release that can stay adhered to dental enamel, and also on removable prosthetic restorations, with preventive and/or therapeutic purpose for a large clinical applications based on polymethyl methacrylate/methyl methacrylate/2 hydroxyethyl methacrylate (PMMA/MMA/HEMA) was developed, using the sodium fluoride as an active principle. This bioadhesive was evaluated for its shear bond strength when bonded with different adhesive systems. METHODS: Two substrates (recently extracted human teeth and acrylic prosthesis basis) were used to obtain the 96 test-specimens. Four adhesive systems (Cyanoacrylate ester, 3M Concise Enamel Bond Resin with or without previous enamel etching, MMA/HEMA or PMMA/MMA/ HEMA) were chosen for the fixation of the bioadhesives to substrate. Artificial saliva or distilled water was used as medium for maintaining the specimens until test. RESULTS: Statistical analysis showed that the interaction bioadhesives/acrylic prosthesis basis/cyanoacrylate ester adhesive was the most resistant to the physical removal by shearing. CONCLUSION: The newly rounded semi-convex format of acrylic device developed in this study presented satisfactory shear bond strength and might contribute to the comfort of intra-buccal use.
Subject(s)
Biocompatible Materials/administration & dosage , Dental Cements , Drug Delivery Systems , Shear Strength , Dental Prosthesis , Humans , ToothABSTRACT
BACKGROUND: Endodontic treatment of root canals or root canal treatment is a frequently performed dental procedure and is carried out on teeth in which irreversible pulpitis has led to necrosis (death) of the dental pulp (nerve). Removal of the necrotic tissue remnants and cleaning and shaping of the root canal are important phases of root canal treatment. Treatment options include the use of hand and rotary instruments and methods using ultrasonic or sonic equipment. OBJECTIVES: The objectives of this review were to determine the relative clinical effectiveness of ultrasonic versus hand instrumentation for orthograde root canal treatment of permanent teeth. SEARCH STRATEGY: We searched the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. We searched the reference lists of relevant articles and personal database of trial reports in an attempt to locate additional published and unpublished trials. No language restriction was applied. The last electronic search was conducted in September 2006. SELECTION CRITERIA: Randomised controlled trials involving people over 18 years of age with single and multiple permanent teeth with a completely formed apex and with no evidence of internal resorption, requiring root canal treatment were included. Patients undertaking re-treatment of a tooth were excluded. DATA COLLECTION AND ANALYSIS: Screening of eligible studies was conducted in duplicate and independently by two review authors. Results were to be expressed as fixed or random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. Heterogeneity was to be investigated including both clinical and methodological factors. MAIN RESULTS: No eligible randomised controlled trials were identified. AUTHORS' CONCLUSIONS: This review illustrates that there are no published or ongoing randomised controlled clinical trials relevant to this review question and that there is currently insufficient evidence for the effectiveness of ultrasonic instrumentation used alone for orthograde root canal treatment. Future randomised controlled trials might focus more closely on evaluating the effectiveness of hand instrumentation compared with hand instrumentation and adjunctive ultrasonic instrumentation.
Subject(s)
Dentition, Permanent , Root Canal Therapy/methods , Ultrasonic Therapy , Adult , Humans , Root Canal Therapy/instrumentationABSTRACT
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ABSTRACT
The clearance pattern of a specific substance is very important to estimate its oral availability. Devices or models that simulate clearance in the mouth are important to study the effects and retention time of foods and drugs. This report describes an efficient device which was assembled with low-cost materials in our laboratory and that can be used to study the clearance of cariogenic substrates, mouthwashes, programmed-release drugs as well as adsorption of drugs to enamel. The device can have up to three chambers with varying minimum and maximum volumes that can be eluted simultaneously at different flows. The simulated swallowed volumes are adjustable and the ratio between the maximum and minimum volumes can be programmed. We also present the results of an evaluation study using the device to determine the clearance of fluoride from a fluoride-containing mouthwash, the clearance of a 1% glucose solution and the programmed release of fluoride from a methacrylate bioadhesive using artificial saliva as eluent.
Subject(s)
Biopharmaceutics/instrumentation , Models, Biological , Mouth/metabolism , Adsorption , Cariogenic Agents/pharmacokinetics , Cariostatic Agents/pharmacokinetics , Dental Enamel/metabolism , Fluorides/pharmacokinetics , Glucose/pharmacokinetics , Humans , Metabolic Clearance Rate , Mouthwashes/pharmacokinetics , Polymethyl Methacrylate/chemistry , Reproducibility of Results , Saliva, Artificial/metabolismABSTRACT
The intra-bucal polymeric bioadhesive systems that can stay adhered to the oral soft tissues for drug programmed release, with the preventive and/or therapeutic purpose have been employed for large clinical situations. A system based on hydroxypropyl methyl cellulose/Carbopol 934TM/magnesium stearate (HPMC/Cp/StMg), was developed with the sodium fluoride as an active principle. This kind of system was evaluated according to its resistance to the removal by means of physical test of tensile strength. Swine buccal mucosa extracted immediately after animals' sacrifice was employed as a substrate for the physical trials to obtain 16 test bodies. Artificial saliva with or without mucin was used to involve the substrate/bioadhesive system sets during the trials. Artificial salivas viscosity were determined by means of Brookfield viscometer, and they showed 10.0 cP artificial saliva with mucin, and 7.5 cP artificial saliva without mucin. The tensile strength assays showed the following averages: 12.89 Pa for the group "artificial saliva with mucin", and 12.35 Pa for the group "without mucin". Statistical analysis showed no significant difference between the assays for both artificial salivas, and we can conclude that the variable mucin did not interfere with the bioadhesion process for the polymeric devices.
Subject(s)
Lactose/analogs & derivatives , Methylcellulose/analogs & derivatives , Mucins/chemistry , Polymers/chemistry , Acrylic Resins , Adhesives , Administration, Buccal , Excipients , Fluorides, Topical/administration & dosage , Fluorides, Topical/chemistry , Oxazines , Polyvinyls , Sodium Fluoride/administration & dosage , Sodium Fluoride/chemistry , Stearic Acids/chemistry , Tensile StrengthSubject(s)
Incisor/pathology , Occlusal Splints , Tooth Attrition/therapy , Adult , Centric Relation , Crowns , Dental Occlusion, Centric , Dental Occlusion, Traumatic/therapy , Denture, Partial, Fixed , Denture, Partial, Removable , Denture, Partial, Temporary , Humans , Male , Maxilla , Orthodontic Appliance Design , Tooth Attrition/rehabilitation , Vertical DimensionABSTRACT
The development of resin cements for use in fixed prostheses has suggested the possibility of a new direct restorative technique, the bonded amalgam. This restoration technique reportedly reduces microleakage and increases adhesion to dental structure compared to conventional amalgam restorative techniques. Factors such as tooth conservation, occlusion, patient age, and the time required for the execution of this type of restoration should also be considered. An amalgam restoration was placed with the adhesive technique in a 13-year-old patient with a nonvital mandibular left second molar and limited interocclusal space. After 3 years of observation, the restoration shows excellent function, suggesting its appropriateness for special clinical situations.
