ABSTRACT
OBJECTIVE: This clinical case report addresses the step-by-step of the application of a core-and-post system that uses a single resin composite material to fiber post cementation and core build-up in a maxillary left central incisor. CLINICAL CONSIDERATIONS: The literature reports several materials and methods for the restoration of endodontically treated teeth with coronal destruction that require an intra-radicular fiber post for the core build-up. The present case report describes a core-and-post or "monoblock" technique. A dual resin composite (Core-X Flow; Dentsply DeTrey) highly filled material and cement was used for luting the fiber post (Blue X-Post) and build-up the core structure in an easy application. CONCLUSIONS: The "core-and-post" technique that uses a single material system protocol minimizes the material interfaces, steps of procedures, and chair-time in comparison to conventional techniques. CLINICAL SIGNIFICANCE: The use of different materials for post cementation and core build-up requires more steps, which increases the chair-time and number of interfaces among the materials. Since the "monoblock" technique uses only one material, it can streamline the clinical procedures, thus, saving time and materials. Moreover, techniques based on core-and-post systems are easily applied, versatile, and esthetics, and can be applicable to posterior and anterior teeth.
Subject(s)
Post and Core Technique , Tooth, Nonvital , Cementation , Composite Resins , Dental Materials , Humans , Resin CementsABSTRACT
Feline sporotrichosis is an endemic disease in Rio de Janeiro, Brazil, where zoonotic transmission of Sporothrix spp. has been reported since 1998. Itraconazole (ITZ) remains the first choice for treating this disease in cats. However, there have been reports of therapeutic failure and a long-term endeavor. Potassium iodide (KI), considered in the past as a drug with variable effectiveness in cats with sporotrichosis, arises as an important option in the treatment of cats from the endemic area of Rio de Janeiro. In order to evaluate the effectiveness of the association of ITZ and KI in naive cats with sporotrichosis, a prospective cohort study was conducted on 30 cats receiving ITZ 100 mg/day and KI 2.5 mg-20 mg/kg/day. Clinical and laboratory adverse effects were assessed once a month according to the standard care protocol. The cure rate was 96.15% within a median of 14 weeks of treatment. Adverse effects were observed in 50% of cats and were managed with a temporary drug suspension and/or a hepatoprotective therapy. The association of ITZ and KI emerges as an effective option for the treatment of feline sporotrichosis.
Subject(s)
Antifungal Agents/administration & dosage , Cat Diseases/drug therapy , Itraconazole/administration & dosage , Potassium Iodide/administration & dosage , Sporotrichosis/veterinary , Animals , Antifungal Agents/adverse effects , Brazil , Cats , Drug-Related Side Effects and Adverse Reactions/epidemiology , Drug-Related Side Effects and Adverse Reactions/pathology , Female , Itraconazole/adverse effects , Male , Potassium Iodide/adverse effects , Prospective Studies , Sporotrichosis/drug therapy , Treatment OutcomeABSTRACT
Sporotrichosis is a mycosis caused by Sporothrix schenckii. The most affected animal is the cat; it has played an important role in the zoonotic transmission of this disease, especially in Rio de Janeiro, Brazil, since 1998. In order to evaluate the treatment of feline sporotrichosis with potassium iodide, an observational cohort was conducted in 48 cats with sporotrichosis at Instituto de Pesquisa Clínica Evandro Chagas, Fiocruz. All cats received potassium iodide capsules, 2.5 mg/kg to 20 mg/kg q24h. The cure rate was 47.9%, treatment failure was 37.5%, treatment abandonment was 10.4% and death was 4.2%. Clinical adverse effects were observed in 52.1% of the cases. Thirteen cats had a mild increase in hepatic transaminase levels during the treatment, six of them presented clinical signs suggestive of hepatotoxicity. Compared to previous studies with itraconazole and iodide in saturated solution, potassium iodide capsules are an alternative for feline sporotrichosis treatment.
Subject(s)
Antifungal Agents/therapeutic use , Cat Diseases/drug therapy , Potassium Iodide/therapeutic use , Sporotrichosis/veterinary , Animals , Antifungal Agents/adverse effects , Capsules , Cat Diseases/microbiology , Cats , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Male , Potassium Iodide/adverse effects , Sporotrichosis/drug therapy , Treatment OutcomeABSTRACT
Sporotrichosis is caused by Sporothrix schenckii. The cat is the animal species most affected by this mycosis and plays an important role in the zoonotic transmission of this disease. The definitive diagnosis is made by isolation of the fungus in culture; however, cytopathological examination is frequently used in cats. Medical records from cats treated at Instituto de Pesquisa Clínica Evandro Chagas/Fiocruz, Rio de Janeiro, Brazil, between 2004 and 2006 were reviewed. Criteria for inclusion were a diagnosis by isolation of S schenckii in culture and cytopathological examination of the same lesion as that used for collection of the culture material. Eight hundred and six cats were included in the study. Yeast-like structures suggestive of S schenckii were observed in 636 cases. The sensitivity of the method was 78.9%. Its practicality, low cost and sensitivity validate cytopathology as a safe technique for the presumptive diagnosis of sporotrichosis in cats.
