Brain abscesses due to odontogenic infection: Case series.

Brain abscesses due to odontogenic infection are infrequent, but they deserve attention due to the high incidence of serious complications and the high mortality rate. This article aimed to report five cases of cerebral abscess due to odontogenic infection, of patients attended in the Clinical Hospital of Medical School of the University of São Paulo (HCFMUSP). In all cases, treatment consisted of draining the brain abscess, antibiotic therapy and extraction of all teeth responsible for the infection. Streptococcus spp. was the causative agent of all the cases reported in this article. The purpose of the study was to highlight the importance of the dental approach for the resolution of cases.

Cardiovascular effects of combined hyaluronidase and mepivacaine in dental anesthesia: A randomized clinical trial.

PURPOSE: To evaluate the effects of combined administration of mepivacaine with epinephrine and the diffusion agent hyaluronidase on hemodynamic and electrocardiographic parameters in healthy individuals undergoing dental surgery. METHODS: In a double-blind, split-mouth, randomized clinical trial, the cardiovascular effects induced by 2.7 mL of 2% mepivacaine with 1:100,000 epinephrine injected concomitantly with 1 mL of 75 TRU/mL hyaluronidase or placebo for inferior alveolar nerve block was evaluated in systemically healthy subjects that underwent bilateral third molar extraction in two separate sessions. Systolic and diastolic blood pressure and heart rate were monitored using oscillometric and photoplethysmographic methods in 10 clinical stages, while electrocardiographic records of 12 leads were obtained in four stages. RESULTS: Hyaluronidase injected concomitantly with local anesthetic did not induce changes in blood pressure and heart rate compared to placebo. There were no instances of ST segment depression or elevation, or wide or narrow QRS complex extrasystoles in ECG. The use of mepivacaine injected concomitantly with 75 TRU/mL hyaluronidase was safe, from a cardiovascular standpoint.

Antifungal effect of electrospun nanofibers containing cetylpyridinium chloride against Candida albicans.

It is known that cetylpyridinium chloride (CPC) has in vitro and in vivo antifungal action against Candida albicans, with advantages over other common antiseptics. A CPC delivery-controlled system, transported in polymer nanofibers (PVP/PMMA), was developed to increase the bioavailability of the drug in contact with the oral mucosa. The objectives of this study were to determine if CPC in nanofiber has antifungal action against C. albicans, and in what concentration it must be incorporated, so that the fraction released can yield an inhibitory concentration. The nanofiber was prepared by electrospinning, and sterilized with gamma irradiation. Nanofiber disks with 0.05%, 1.25%, 2.5% and 5% CPC, with 5% miconazole (MCZ) and with no drug, as well as filter paper disks with 5% CPC, with 5% MCZ and with no drug were used in this study. A Candida albicans suspension (ATCC 90028) was inoculated in Mueller-Hinton Agar plates. The disks were placed on the plates and the inhibition zone diameters were measured 48h later. The nanopolymeric disks contracted in contact with the agar. All the concentrations of CPC incorporated in the nanofiber presented inhibitory action against C. albicans. Concentrations of 2.5% and 5% CPC presented a significant advantage over the nanofiber with no drug, proving the antifungal action of CPC. Under these experimental conditions, 5% CPC has greater inhibitory action against C. albicans than 5% MCZ, both in nanofiber and in filter paper. A modification made in the polymer to decrease the contraction rate may allow a larger inhibition zone to be maintained, thereby increasing the clinical usefulness of the polymer.