Microscopic evaluation of the dentinal walls of extracted human teeth following electrochemical dissolution of fragmented nickel-titanium instruments.

Electrochemical dissolution is a method in which fluoridated solution in direct contact with the fractured instrument receives an electrical current that speeds up fragment dissolution. The aim of this study was to assess the integrity of dentinal walls during the electrochemical dissolution of fractured rotary endodontic instruments in extracted human teeth. Forty-five human mandibular incisors subjected to the electrochemical dissolution process using fluoride solution with low NaCl concentration (LC group: NaF 12 g/L + NaCl 1 g/L, pH = 5.0), fluoride solution with saturating NaCl concentration (SC group: NaF 12 g/L + NaCl 180 g/L, pH = 5.0) and distilled water (control group) were evaluated. For each group, 15 incisors were submitted for the scanning electron microscopy (SEM) evaluation. The roots were sectioned longitudinally; each hemisection was analyzed (n = 30), and energy-dispersive spectroscopy (EDS) was performed. The amount of dentinal tubule openings was analyzed by SEM. Statistical analyses were performed. The test solutions did not alter the amount of dentinal tubule openings when compared with the control group. No Ni or Ti was impregnated into the dentinal tubules after electrochemical techniques. The dentinal structure remained unchanged following the electrochemical dissolution method.

The positive influence of atopy on the prognosis of avulsed and replanted teeth despite differences in post-trauma management.

INTRODUCTION: The aim of this study was to evaluate any potential influence of a patient's Th2 immunologic profile on the occurrence of root resorption in avulsed and replanted teeth; tooth replantation cases in which different post-trauma management protocols were examined. MATERIALS AND METHODS: In this study, the presence or absence of root resorption was evaluated in 88 avulsed and replanted teeth. In the International Association of Dental Traumatology (IADT) group, the replantation technique and endodontic treatments were performed in accordance with the IADT guidelines. In the non-IADT group, the teeth were replanted using techniques and protocols that deviated from the IADT guidelines in some way. Follow-up of the replanted teeth included monthly clinical and radiographic examinations over the course of 1 year. Evaluation of patients' atopy was based on a medical examination, personal and family allergic history, and a skin prick test. RESULTS: Of 47 teeth of atopic patients, 39 (82.98%) did not exhibit root resorption, whereas 8 (17.02%) did. Of the 41 teeth of nonatopic patients, 24 (58.54%) did not exhibit resorption, whereas 17 (41.46%) did. CONCLUSIONS: These results show the importance of a predominantly Th2 immunological profile, which was represented by atopic patients, in replantation after dental avulsion despite differences in post-trauma management.

Relationship between extra-alveolar time and atopy in the prognosis of the replantation of avulsed teeth.

BACKGROUND: The aim of this in vivo study was to evaluate the correlation between the occurrence of root resorption in avulsed and replanted teeth, extra-alveolar time, and the possible influence of Th2 immunologic profile, represented by patient's atopy and its influence in the prognosis of the tooth. METHODS: This study evaluated the presence or absence of root resorption in 57 avulsed and replanted teeth. The replantation technique and endodontic treatments were performed following the International Association of Dental Trauma guidelines. Follow-up of the replanted teeth included monthly clinical and radiographic examinations during 1 year. The patient's medical examination, including the personal and family allergic history, in conjunction with the skin prick test based the evaluation of patient's atopy. RESULTS: Of the 37 teeth of atopic patients, 33 (89.2%) teeth did not present root resorption. Of these, 27 (72.9%) had an extra-alveolar time of <1 hour and 6 (16.2%) had an extra-alveolar time >1 hour. Four (10.8%) teeth presented root resorption and an extra-alveolar period of time >1 hour. CONCLUSION: These results showed the importance of the extra-alveolar time and the predominantly Th2 immunologic profile, represented by atopic patients, that suffered replantation after dental avulsion in a 1-year follow-up.

Evaluation of care of dentoalveolar trauma.

OBJECTIVES: The aim of this study was to evaluate cases of dental trauma treated at the specialized center of Pontifical Catholic University of Paraná, Curitiba, Brazil, during a period of 2 years. MATERIAL AND METHODS: A total of 647 patients were evaluated and treated between 2003 and 2005. Data obtained from each patient were tabulated and analyzed as to gender, age, etiology, time elapsed after the injury, diagnosis (type of trauma), and affected teeth. RESULTS: The results revealed that male individuals aged 7 to 13 years presented the highest prevalence of injury, and falling was the main causal factor. In most cases, the time elapsed between the accident and the first care ranged from 4 to 24 h. A total of 1,747 teeth were affected, with higher incidence of concussion/subluxation and coronal fracture, followed by lateral luxation and avulsion. The permanent maxillary central incisors were the most commonly affected teeth. CONCLUSION: The frequency and causes of dentoalveolar trauma should be investigated for identification of risk groups, treatment demands and costs in order to allow for the establishment of effective preventive measures that can reduce the treatment duration and costs for both patients and oral health services.

Evaluation of care of dentoalveolar trauma

OBJECTIVES: The aim of this study was to evaluate cases of dental trauma treated at the specialized center of Pontifical Catholic University of Paraná, Curitiba, Brazil, during a period of 2 years. MATERIAL AND METHODS: A total of 647 patients were evaluated and treated between 2003 and 2005. Data obtained from each patient were tabulated and analyzed as to gender, age, etiology, time elapsed after the injury, diagnosis (type of trauma), and affected teeth. RESULTS: The results revealed that male individuals aged 7 to 13 years presented the highest prevalence of injury, and falling was the main causal factor. In most cases, the time elapsed between the accident and the first care ranged from 4 to 24 h. A total of 1,747 teeth were affected, with higher incidence of concussion/subluxation and coronal fracture, followed by lateral luxation and avulsion. The permanent maxillary central incisors were the most commonly affected teeth. CONCLUSION: The frequency and causes of dentoalveolar trauma should be investigated for identification of risk groups, treatment demands and costs in order to allow for the establishment of effective preventive measures that can reduce the treatment duration and costs for both patients and oral health services.

The influence of atopy in the prognosis of the replantation of avulsed teeth.

BACKGROUND: Replantation is the most indicated procedure for traumatic dental avulsion, but it invariably results in a greater or lower degree of root resorption. The outcomes of these cases can be affected by some well-known factors. Because studies have shown the importance of the innate and acquired immune response in the mechanisms involved in the resorption of bone tissues, an endeavor was made to verify if such an influence applies to dental resorption. METHODS: Fifty-seven avulsed, endodontically treated teeth were assessed in the Endodontics Clinic, Pontifical Catholic University of Paraná. Follow-up of the replanted teeth included periodical clinical examinations and radiographs, in accordance with the control rules of the International Association of Dental Traumatology. The evaluation of atopy was based on the patient's personal and family history in conjunction with the skin-prick test for five allergen extracts. RESULTS: Of the 46 teeth with a favorable outcome, 33 (71.74%) were in atopic patients, and 13 (28.26%) were in non-atopic patients. Of the 11 teeth with an unfavorable outcome, four (36.36%) were in atopic patients, and seven (63.64%) were in non-atopic patients; a greater prevalence of unfavorable prognoses occurred in non-atopic patients. CONCLUSION: The outcome after 1 year for avulsed and replanted teeth is more favorable in atopic patients.