Effect of Casearia sylvestris on the obliteration of dentinal tubules and the control of dental sensitivity / Efecto de Casearia sylvestris sobre la obliteración de los túbulos dentinarios y el control de la sensibilidad dental

The present study evaluated the efficacy of the mineralizing action of Casearia sylvestris ethanolic extract on bovine dentin blocks in its pure form and in dental paste, through scanning electron microscopy. The dentin blocks were immersed in artificial saliva and incubat ed at 37°C for 7 days. Subsequently, six groups were treated with different test substances and analysed qualitatively and quantitatively at 30 and 60 days. The tests used were Kruskal - Wallis and Dunn's. Shapiro - Wilk and ANOVA. The qualitative analysis at 30 days showed a difference between the groups treated with ethanolic extract and toothpaste. Quantitatively, at 30 days, treatment with ethanolic extract of Casearia showed a greater number of open dentinal tubules. At 60 days, the difference persisted on ly for the blocks treated with toothpaste. The results obtained indicated that there is a positive relationship between the use of Casearia sylvestris and obliteration of dentinal tubules

El presente estudio evaluó la eficacia de la acción mineralizante del extracto etanólico de Casearia sylvestris sobre bloques de dentina bovina en su forma pura y en pasta dental, mediante microscopía electrónica de barrido. Los bloques de dentina se sumergieron en saliva artificial y se incubaron a 37°C durante 7 días. Posteriormente, se trataron seis grupos con diferentes sustancias de ensayo y se analizaron cualitativa y cuantitativamente a los 30 y 60 días. Las p ruebas utilizadas fueron Kruskal - Wallis y Dunn's. Shapiro - Wilk y ANOVA. El análisis cualitativo a los 30 días mostró una diferencia entre los grupos tratados con extracto etanólico y pasta dentífrica. Cuantitativamente, a los 30 días, el tratamiento con ex tracto etanólico de Casearia mostró un mayor número de túbulos dentinarios abiertos. A los 60 días, la diferencia persistió sólo para los bloques tratados con pasta dentífrica. Los resultados obtenidos indicaron que existe una relación positiva entre el us o de Casearia sylvestris y la obliteración de los túbulos dentinarios

Comparison of the Physicochemical Properties, Antimicrobial Action, and Cytotoxicity of Ambroxol Hydrochloride, N-acetylcysteine, and Calcium Hydroxide Pastes.

OBJECTIVE: To evaluate the solubility, pH, antimicrobial action, and cytotoxicity of ambroxol hydrochloride (AMB), N-acetylcysteine (NAC), and calcium hydroxide (CH) pastes for use as intracanal medications. METHODS: Solubility was determined by micro-CT, based on the paste volume remaining after immersion in water for 7 days. pH was measured by immersing acrylic tubes containing the pastes in ultrapure water and then measuring pH after 3 hours, 3 days, and 7 days. Antimicrobial action against Enterococcus faecalis was assessed based on the percentage of living cells, using the live/dead staining method under confocal microscopy. Cytotoxicity was assessed based on the cell viability of L929 fibroblast-like cells after 6, 24, and 48 hours. Cytotoxicity data were compared using the ANOVA and Tukey tests, and the antimicrobial data were compared using the Kruskal-Wallis and Dunn tests. The significance level used was 5% (α=0.05). RESULTS: The solubility values for all the study groups were significantly different (P<0.05), where the highest values were for NAC, followed by AMB, and then CH. Likewise, the pH levels were all significantly different (P<0.05), where NAC and AMB levels were acidic, and CH levels were alkaline. The antimicrobial action of AMB was significantly higher than that of CH (P<0.05), and that of NAC was also higher than that of CH, albeit not significantly. AMB and NAC were more cytotoxic than CH, and higher dilutions of CH promoted higher cell viability levels than lower dilutions of the same paste (P<0.05). CONCLUSION: The NAC and AMB pastes were more soluble and cytotoxic than the CH paste and had acidic pH levels. The AMB paste displayed the highest antimicrobial action against Enterococcus faecalis biofilm.

Antibióticos potencializam a ação antimicrobiana de cimentos endodônticos, em diferentes períodos, após a presa / Antibiotics increase the antimicrobial action of endodontic seal-ers, in different periods, after setting time

O objetivo do presenteestudo foi avaliar a atividade antibacteriana dos cimentos endodôn-ticos MTA Fillapex, Sealapex, Sealer 26 e Endofill puros e acrescidos de amoxicilina e ci-profloxacina frente a duas linhagens ATCC de Enterococcus faecalis (ATCC 29212 e ATCC 4083). Os testes foram realizados pela técnica de difusão radial dos cimentos aplicados di-retamente no ágar e impregnados em discos de papel e pelo teste de contato direto. Para a análise estatística, utilizaram-se os testes de ANOVA e Tukey com nível de significância de 5%. Os resultados mostraram que pela técnica da difusão radial, considerando os cimentos puros, o Sealapex foi o único que apresentou halos de inibição frente às duas linhagens. Já quando da associação de amoxicilina e ciprofloxacina, o MTA Fillapex revelou os melhores halos de inibição para as duas linhagens. Todos os cimentos tiveram a ação potencializada pela adição dos antibióticos (p<0,05). Pela técnica de difusão dos cimentos impregnados em discos de papel, o cimento Sealapex puro fresco demonstrou atividade antimicrobiana em todas as variáveis de tempo. Quando acrescidos dos antibióticos, todos os cimentos ti-veram a ação antimicrobiana potencializada pelas drogas, em todas as variáveis de tempo. Esse mesmo resultado foi observado na técnica do contato direto dos cimentos com ambas as linhagens. A atividade antibacteriana, frente ao E. faecalis, dos cimentos MTA Fillapex, Endofill, Sealer e Sealapex, acrescidos dos antibióticos amoxicilina e ciprofloxacina, foi potencializada mesmo após um longo período da presa dos cimentos.

The objective of this study was to evaluate the antibacterial activity of different endodon-tic cements (MTA Fillapex, Sealapex, Sealer 26, and Endofill), both pure and mixed with 5% of amoxicillin or ciprofloxacin, against two strains of Enterococcus faecalis (ATCC 29212 and ATCC 4083). Bacterial susceptibility testing was conducted by radial diffusion methods and direct contact test after different periods. Data were subjected to ANO-VA and Tukey test with a significance level of 5%. Sealapex was the only pure sealer to promote the inhibition of bacterial growth against both strains in different experimental periods. However, all cements present an increase in antibacterial activity by the addition of antibiotics (p<0.05). MTA Fillapex and Sealapex associated with amoxicillin promoted increased values for bacterial growth against ATCC 29212 and ATCC 4083 in comparison to other groups (p<0.001), including extended periods after setting time. The association of antibiotic agents increased the antibacterial effect of the evaluated sealers against the strains of E. faecalis.

Effect of association of non-steroidal anti-inflammatory and antibiotic agents with calcium hydroxide pastes on their cytotoxicity and biocompatibility.

OBJECTIVES: Evaluate the cytotoxicity and biocompatibility of calcium hydroxide paste [Ca (OH)2] associated with 5% diclofenac sodium, ibuprofen, or amoxicillin. MATERIALS AND METHODS: Pre-osteoblast-like cells were cultivated and the MTT test was used to determine the cytotoxicity of the paste extracts after time intervals of 24, 48, 72 h, and 7 days. Tubes containing Ca (OH)2 pastes associated with the drugs and empty tubes were implanted in subcutaneous tissue of 30 rats. After 7 and 30 days, the specimens were removed and submitted to histological analysis. The data obtained were submitted to Kruskal-Wallis and Dunn tests (p ≤ 0.05). RESULTS: All the Ca (OH)2 pastes promoted cell viability after all periods. At 7 days, there was greater inflammatory tissue reaction adjacent to the implants. At 30 days, there was a significant reduction in the number of inflammatory cells, and increase in fibroblasts in all groups. In this period, a lower number of inflammatory cells and a higher number of fibroblasts were observed in the capsules adjacent to the association with diclofenac, when compared with the other mixtures (p ≤ 0.05); the capsule thickness was greater at 7 days than at 30 days. CONCLUSIONS: The Ca (OH)2 pastes associated with the drugs were not cytotoxic and presented biocompatibility after implantation in rat subcutaneous tissues. CLINICAL RELEVANCE: Ca (OH)2 pastes with anti-inflammatory or antibiotic may be clinical alternatives as intracanal medication to reduce resistant microorganisms in root canal system.

Análise do efeito do tratamento com nanopartículas de prata (AGNO3 ) revestidas com pectina sobre a angiogênese induzida pelas células do Tumor de Ehrlich em modelo da membrana corioalantoidea / Analysis of the effect of treatment of silver nanoparticles (AgNO3 ) with pectin-coated on ehrlich tumor cell-induced angiogenes in the chorioalantoid membrane model

Avaliou-se a interferência das nanopartículas de prata sobre a angiogênese relacionada ao crescimento tumoral. A pesquisa científica foi realizada através da incubação de 42 ovos embrionados de galinhas. Após 24 horas de incubação, esses mesmos ovos foram separados em seis grupos contendo sete ovos cada, para os tratamentos com: Grupo 1: Soro fisiológico; Grupo 2: Tumor de Ehrlich (TE); Grupo 3: Nanopartículas de prata; Grupo 4: Prednisolona; Grupo 5: Nanopartículas de prata e Tumor de Ehrlich; Grupo 6: Prednisolona e Tumor de Ehrlich. Após o tempo total de incubação, as membranas corioalantoideas (MCAs) foram removidas, e analisadas através do microscópio de luz e fotografadas. O grupo 1 apresentou um padrão normal de crescimento e foi utilizado como controle negativo; O grupo 2 apresentou um aumento na quantidade de vasos sanguíneos; o grupo 3 apresentou baixa interferência na angiogenese embrionária e não contribuiu para o desenvolvimento do tumor; O grupo 4 demonstrou diminuição no desenvolvimento de vasos sanguíneos; O grupo 5 indicou que as nanopartículas de prata, quando associadas ao TE, não favorece o desenvolvimento tumoral e o grupo 6 demonstrou que o fármaco prednisolona associado ao TE, se comporta como um excelente inibidor de neoangiogese tumoral. Considera-se através da técnica realizada a possibilidade de utilizar nanopartículas de prata para o tratamento de células tumorais de Ehrlich, porém devem ser realizados testes confirmatórios para estudar a relação da substância descrita às células tumorais empregadas.

The interference of silver nanoparticles on angiogenesis related to tumor growth was evaluated. Scientific research was carried out by incubating 42 embryonated chicken eggs. After 24 hours of incubation, these same eggs were separated into six groups containing seven eggs each, for treatments with: Group 1: Saline; Group 2: Ehrlich's tumor (ET); Group 3: Silver nanoparticles; Group 4: Prednisolone; Group 5: Silver nanoparticles and Ehrlich's Tumor; Group 6: Prednisolone and Ehrlich's Tumor. After the total incubation time, the chorioallantoid membranes (MCAs) were removed, and analyzed using a light microscope and photographed. Group 1 showed a normal growth pattern and was used as a negative control; Group 2 showed an increase in the amount of blood vessels; group 3 showed low interference in embryonic angiogenesis and did not contribute to the development of the tumor; Group 4 demonstrated a decrease in the development of blood vessels; Group 5 indicated that silver nanoparticles, when associated with TE, do not favor tumor development and group 6 demonstrated that the drug prednisolone associated with TE, behaves as an excellent inhibitor of tumor neoangiogenesis. Through the technique performed, the possibility of using silver nanoparticles for the treatment of Ehrlich tumor cells is considered, however, confirmatory tests should be performed to study the relationship of the substance described to the tumor cells employed.

Uso do ultrassom na otimização do tratamento endodôntico: relato de caso / Use of ultrasonics to optimize endodontic treatment: case report

Objetivo: o objetivo do presente relato de caso foi demonstrar o emprego do ultrassom em diversas etapas do tratamento endodôntico de um segundo molar inferior com anatomia em forma de C, possibilitando um aumento na previsibilidade no tratamento em dentes com complexidades anatômicas. Relato de caso: paciente do sexo masculino, relatou sensibilidade dolorosa no lado direito inferior da face. O exame clínico mostrou ausência de vitalidade pulpar, e o exame radiográfico detectou a presença de lesão cariosa no dente #47, lesão periapical e uma anatomia em forma de C. Assim, o tratamento de escolha foi a necropulpectomia. Após abertura coronária, foi realizado o refinamento da câmara pulpar e das embocaduras dos canais, com ponta de ultrassom. O preparo biomecânico foi realizado com instrumento Reciproc 25.08 e Mtwo 40.04, sendo a agitação final do hipoclorito de sódio e do EDTA realizada com a ponta ultrassônica Irrisonic. A medicação intracanal empregada foi a pasta de hidróxido de cálcio. Após 15 dias, a medicação foi removida por meio de irrigação ultrassônica passiva, e os canais foram secos com pontas de papel absorvente esterilizadas. A obturação dos canais foi realizada com o cimento AH Plus, o qual foi inserido com espiral de Lentulo #40 e, em seguida, agitado por 1 minuto com ultrassom. Então, a técnica de obturação híbrida de Tagger foi realizada. Conclusão: o controle radiográfico após 1 ano e 8 meses mostrou o reparo total da lesão periapical, demonstrando que uso o ultrassom nas diversas etapas da terapia endodôntica pode contribuir para uma maior previsibilidade do tratamento (AU).

The aim of this case report was to describe the use of ultrasonic in several endodontics steps during root canal treatment of second C-shaped mandibular molar, favoring more predictable outcome of endodontic treatment of teeth with complex anatomy. A male patient reported painful symptoms on the right and lower side of the face. Clinical examination revealed absence of pulp vitality of tooth 47 and the radiographic examination showed carious lesion, apical periodontitis and C-shaped anatomy. Therefore, the necropulpectomy treatment was selected. After the coronal access, an ultrasonic tip was used to remove the irregularities of the pulp chamber. The root canal preparation was performed using Reciproc 25.08 and Mtwo 40.04 and a final passive ultrasonic irrigation of the sodium hypochlorite and EDTA was performed with Irrisonic tip. Calcium hydroxide paste was used as intracanal dressing, which was introduced by Lentulo #40 and ultrasonic agitated. After 15 days, a passive ultrasonic irrigation was performed to remove the intracanal dressing and the canals were dried with sterilized paper points. The root filling was performed with AH Plus sealer, which was introduced by Lentulo #40 in a electric motor at 350 rpm and ultrasonic agitated during 1 minute. Then, the hybrid Tagger technique was performed to root canal filling. The radiographic examination showed the suitable isthmus and lateral canals filling. After 1 year and 8 months, the radiographic examination revealed complete apical healing, showing that the use of ultrasonic in several steps of endodontic treatment can favor a more predictable outcomes (AU).

Avaliação in vitro da atividade antifúngica da pasta de hidróxido de cálcio associada a diferentes fármacos, frente à Candida albicans / In vitro evaluation of antifungal activity of calcium hydroxide paste mixed to different drugs, against Candida albicans

Introdução: a frequência de micoses invasivas causadas por patógenos fúngicos oportunistas tem aumentado significativamente nas últimas décadas. Entre os principais agentes etiológicos de micoses oportunistas está a Candida albicans. Essa levedura apresenta vários fatores de virulência importantes para produção de doença. Alguns estudos têm demonstrado que C. albicans coloniza canais radiculares e túbulos dentinários. O espectro de atividade antimicrobiana do curativo de hidróxido de cálcio deve incluir essa levedura. Objetivos: o objetivo da presente pesquisa foi determinar a suscetibilidade in vitro de quatro linhagens de C. albicans coletadas da cavidade oral e uma estirpe padrão ATCC 10231 a pastas de hidróxido de cálcio associadas a drogas antifúngicas, antibióticas e anti-inflamatórias. A eficiência das pastas de Ca(OH)2 associadas às drogas sobre as leveduras foram analisadas pelo método da difusão radial e, também, pela técnica do contato direto com os medicamentos. Os dados foram analisados pelo teste de Kruskal-Wallis e o pós-teste de Dunn, para indicar as diferenças entres os grupos, com um nível de significância de 5%. Resultados: todas as medicações antifúngicas potencializaram a ação das pastas de hidróxido de cálcio contra a Candida albicans. Conclusões: a associação de medicações antifúngicas às pastas de Ca(OH)2 pode ser uma alternativa como medicação intracanal. (AU)

Introduction: the frequency of invasive mycoses caused by opportunistic fungal pathogens has increased significantly in the last decades. Among the main etiological agents of opportunistic mycoses is Candida albicans. This yeast has several important virulence factors for producing disease. Some studies have demonstrated that C. albicans colonized root canals and dentinal tubules. The spectrum of antimicrobial activity of calcium hydroxide dressing should include this yeast. Objectives: the aim of the present study was to determine the in vitro susceptibility of four C. albicans strains collected from the oral cavity and a standard strain ATCC 10231 to calcium hydroxide paste associated with antifungal, antibiotic and anti-inflammatory drugs. The efficiency of the Ca(OH)2 paste associated with the drugs on the yeasts was analyzed by the radial diffusion method and also by the direct contact method. Data were analyzed by Kruskal Wallis test and the Dunn post-test were used to indicate the differences between the groups with a significance level of 5%. Results: all antifungal drugs increased the action of the calcium hydroxide pastes against Candida albicans. Conclusions: the association of antifungals with Ca(OH)2 may be considered for use as intracanal medicaments (AU).

A new technique for tongue brushing and halitosis reduction: the X technique.

The tongue is one of the primary sources of halitosis. The manual or mechanical removal of biofilm is known to decrease oral malodor. OBJECTIVE: To evaluate a new tongue hygiene technique hereby referred to as "the X technique" and its effects on both halitosis and the number of microorganisms based on microbiological parameters and diagnostic features of the breath. MATERIAL AND METHODS: The study included thirty patients divided into a control group (patients without systematized guidelines of lingual hygiene, but who performed the mechanical cleaning of tongue dorsum, each in its own way), the 3R group (instructed to perform the movements of the X technique for 3 repetitions at each brushing), and the 6R group (instructed to perform 6 repetitions of the technique at each brushing). After two weeks, a new data collection was performed. RESULTS: Patients in the 6R group presented the lowest score on the organoleptic assessment scale at the second consultation, followed by the 3R group and the controls. Regarding the self-perception of breath by the method of Visual Analog Scale (VAS), the control group did not perceive improvements in oral malodor; the results of the 3R group and the 6R group were similar. CONCLUSION: These results indicate that the X technique improves both measurements and perceptions of halitosis. Microbiological analyses revealed greatest reduction in the 6R group. The findings show that the X technique reduces both organoleptic scores and the number of bacterial colonies, and improves users' perceptions of their breath.

In vitro treatment of Enterococcus faecalis with calcium hydroxide impairs phagocytosis by human macrophages.

OBJECTIVE: Monocyte-derived macrophages (MDMs) ability to phagocytize and produce nitric oxide (NO) was tested against root-canal strains of Enterococcus faecalis submitted to alkaline stress. Root-canal strains were also compared with urine Enterococci. MATERIALS AND METHODS: Enterococcus faecalis were stressed with alkaline-BHI broth and incubated in vitro at a cell/bacteria ratio of 1:5. Phagocytosis was analyzed by fluorescence microscopy using acridine orange stain, and NO concentration was measured in supernatants. RESULTS AND CONCLUSIONS: Alkaline-stress significantly impaired MDMs phagocytosis of E. faecalis strains analyzed, except in ATCC4083 isolated from a pulpless tooth, but NO production was unchanged. Comparison of different strains showed the urine isolate had higher NO levels than root canal strains. Alterations in the bacterial cell wall structures after alkaline-stress possibly made bacteria less recognizable and phagocytized by MDMs but did not affect their ability to activate NO production. Furthermore, root canal strains elicited different responses by immune cells compared with strains from urine. Clinically, impaired phagocytosis of E. faecalis could contribute to their persistence in root canal systems previously treated with calcium hydroxide.

A new technique for tongue brushing and halitosis reduction: the X technique

Abstract The tongue is one of the primary sources of halitosis. The manual or mechanical removal of biofilm is known to decrease oral malodor. Objective: To evaluate a new tongue hygiene technique hereby referred to as "the X technique" and its effects on both halitosis and the number of microorganisms based on microbiological parameters and diagnostic features of the breath. Material and Methods: The study included thirty patients divided into a control group (patients without systematized guidelines of lingual hygiene, but who performed the mechanical cleaning of tongue dorsum, each in its own way), the 3R group (instructed to perform the movements of the X technique for 3 repetitions at each brushing), and the 6R group (instructed to perform 6 repetitions of the technique at each brushing). After two weeks, a new data collection was performed. Results: Patients in the 6R group presented the lowest score on the organoleptic assessment scale at the second consultation, followed by the 3R group and the controls. Regarding the self-perception of breath by the method of Visual Analog Scale (VAS), the control group did not perceive improvements in oral malodor; the results of the 3R group and the 6R group were similar. Conclusion: These results indicate that the X technique improves both measurements and perceptions of halitosis. Microbiological analyses revealed greatest reduction in the 6R group. The findings show that the X technique reduces both organoleptic scores and the number of bacterial colonies, and improves users' perceptions of their breath.

Detecção de nódulos pulpares em incisivos por meio de radiografia digital / Detection of pulp stones in incisors by digital dental radiography

Introdução: os nódulos pulpares são calcificações de etiologia controversa, presentes no tecido pulpar com tamanho variável. Sua detecção acontece durante exames radiográficos de rotina, apresentando-se como imagens radiopacas únicas ou múltiplas, de formato circular ou ovoide. Um planejamento adequado prévio ao tratamento endodôntico é necessário, e o reconhecimento dessas alterações faz parte dessa etapa. Objetivo: o objetivo desse trabalho foi determinar a prevalência de nódulos pulpares em incisivos superiores e inferiores, por meio de radiografias digitais. Métodos: foram utilizadas 793 radiografias periapicais digitais de dentes anteriores, totalizando 2.999 dentes. Os dados foram organizados em planilhas de Excel e, então, submetidos a uma análise descritiva e ao teste qui quadrado. Resultados: os resultados demonstraram que 15% dos dentes avaliados possuíam nódulo pulpar, sendo o mais acometido o incisivo lateral direito (dente #42), com 19% do total de dentes. Houve maior prevalência em mulheres e pacientes na faixa etária de 51 a 60 anos. Conclusão: a frequência dos nódulos pulpares para dentes anteriores, quando avaliados por meio de radiografias periapicais digitais, alcança os 15%, possuindo maior prevalência no sexo feminino e apresentando relação entre o aumento da idade e a incidência de nódulos pulpares, mas não entre a presença de restaurações e as alterações.

Effect of Using Different Vehicles on the Physicochemical, Antimicrobial, and Biological Properties of White Mineral Trioxide Aggregate.

INTRODUCTION: This study evaluated the physicochemical, antimicrobial, and biological properties of white mineral trioxide aggregate (MTA) mixed with aqueous and propylene glycol extracts of Arctium lappa L. and Casearia sylvestris Sw. METHODS: The setting-time test was performed according to American Society for Testing and Materials 266/2008 and flowability by American National Standards Institute/American Dental Association 57/2012 standard specifications. The following parameters were assessed: volumetric change by micro-computed tomography; pH level and calcium ion release measured after 3 hours and 1, 3, 7, and 15 days; antimicrobial effect by the dentin decontamination method with intratubular Enterococcus faecalis viability, verified by using confocal laser scanning microscopy; and biocompatibility by histologic-morphometric analyses of inflammatory infiltrate at subcutaneous implant sites after 15, 30, and 60 days. In addition, rat alveolar tissues with implants were processed to measure tumor necrosis factor-alpha and interleukin-10 cytokines by enzyme-linked immunosorbent assay. RESULTS: The plant extracts associated with MTA significantly increased the final setting time; however, they did not influence volumetric change (P > .05) and maintained medium alkalinity and calcium ion release. Propylene glycol extracts showed higher flowability. Casearia sylvestris increased the cementing effect against E. faecalis after 24-hour and 168-hour periods. Histologic evaluation of inflammatory infiltrate showed no significant differences between plant extracts groups and the distilled water group for all periods. Tumor necrosis factor-alpha and interleukin-10 expression was similar among groups (P > .05). CONCLUSIONS: Casearia sylvestris extracts increased the antimicrobial effect of MTA and did not influence biocompatibility but changed some physicochemical properties.

Atividade antimicrobiana do cimento à base de silicato de cálcio acrescido de antibióticos, testada pelos métodos de difusão radial e concentração inibitória mínima / Antimicrobial activity of calcium silicate-based sealer containing antibiotics, tested by means of radial diffusion and minimum inhibitory concentration

Introdução: a substituição do MTA pelo cimento Portland tem sido recomendada pela semelhança em suas composições e propriedades físicas e biológicas. A adição de um antibiótico ao cimento promoveria vantagens clínicas, desde que esse fosse liberado antes e após a presa do cimento. Objetivo: avaliar a atividade antimicrobiana, pelos métodos da difusão e concentração inibitória mínima (CIM), do cimento Portland puro e acrescido de radiopacificador, adicionado de amoxicilina e ciprofloxacina, frente a cinco microrganismos: S. aureus, P. aeruginosa, E. coli, E. faecalis e C. albicans. Métodos: no teste de difusão, foram utilizadas 30 placas de Petri com ágar, escavadas com poços onde foram introduzidos os cimentos imediatamente após a manipulação e após presa de 24h. Para o teste de CIM, foram preparados 120 tubos de ensaio, contendo 10mL de caldo BHI, divididos em quatro grupos. Cada grupo foi semeado com um inóculo fresco de cada microrganismo, separadamente. Os tubos foram incubados em estufa a 37°C e a turbidez foi avaliada após 24h. Os resultados foram avaliados pela análise de variância ANOVA e a comparação dos grupos, pelo teste de Tukey, com significância de 5%. Resultados: o cimento Portland apresentou atividade antimicrobiana apenas contra C. albicans. A amoxicilina apresentou um tênue efeito antibacteriano, enquanto a ciprofloxacina inibiu o crescimento bacteriano em todas as concentrações testadas. Conclusão: a adição da ciprofloxacina ao cimento Portland a fim de incrementar a atividade antimicrobiana parece segura; entretanto, os resultados não sustentam sua aplicação clínica, sendo necessários novos estudos.

Effect of the Association of Nonsteroidal Anti-inflammatory and Antibiotic Drugs on Antibiofilm Activity and pH of Calcium Hydroxide Pastes.

INTRODUCTION: The objective of the present study was to evaluate the in vitro antibiofilm activity and pH of calcium hydroxide associated with different nonsteroidal anti-inflammatory drugs (NSAIDs). METHODS: The groups analyzed were as follows: group 1, calcium hydroxide paste with propylene glycol; group 2, calcium hydroxide paste with propylene glycol + 5% diclofenac sodium; group 3, calcium hydroxide paste with propylene glycol + 5% ibuprofen; group 4, calcium hydroxide paste with propylene glycol + 5% ciprofloxacin; and group 6, positive control (without medication). For analysis of the pH, the pastes were inserted into tubes and immersed in flasks containing ultrapure water. At the time intervals of 3, 24, 72, and 168 hours, the pH was measured with a calibrated pH meter. For microbial analysis, biofilm was induced in 30 bovine dentin blocks for 21 days. Subsequently, the pastes were placed on the blocks with biofilm for 7 days. Afterward, the pastes were removed by irrigation with sterile water, and the specimens were analyzed with a laser scanning confocal microscope with the 50 µL Live/Dead BacLight Bacterial Viability solution L7012 Kit (Molecular Probes, Inc, Eugene, OR). Data were subjected to statistical analysis at a significance level of 5%. RESULTS: The highest pH values were found for calcium hydroxide associated with ciprofloxacin in all periods analyzed. With the exception of pure calcium hydroxide paste, the other groups showed statistically significant differences (P < .05) in comparison with the positive control. CONCLUSIONS: The association of NSAIDs or antibiotic did not interfere with the pH of calcium hydroxide paste and increased the antimicrobial action of calcium hydroxide paste against Enterococcus faecalis biofilm formation.

Avaliação do pH, liberação de íons cálcio e atividade antimicrobiana do cimento Portland associado a Bambusa textilis em diferentes proporções / Analysis of pH, calcium ion release and antibacterial activity of Portland cement associated to Bambusa textilis in different proportion

Introdução: há uma busca incessante por agentes fitoterápicos na medicina e odontologia. Dentro da endodontia, busca-se uma substância que potencialize os efeitos biológicos e antimicrobianos do hidróxido de cálcio como curativo de demora. Não há na literatura relatos sobre a associação do cimento Portland com a Bambusa textilis, uma planta nativa da China, onde é usada na elaboração de medicamentos, pois se trata de uma fonte importante de resinas, sendo, portanto utilizadas por seu poder anti-inflamatório, anticatarral, anticonvulsivante e antitérmico. Sabendo da semelhança do cimento Portland com o MTA, e que esse ultimo apresenta bons resultados físico-químicos, surge a dúvida da possibilidade da associação, com a finalidade de melhorar as atividades antimicrobianas, e a interferência na liberação de íons cálcio e hidroxila. Objetivo: avaliar o pH, liberação de íons cálcio e atividade antimicrobiana do cimento Portland associado a Bambusa textilis em diferentes proporções. Metodologia: os cimentos experimentais foram 3 g Cimento Portland + 1,2 ml de Bambusa textilis (G1); 3 g Cimento Portland + 0,6 ml de água + 0,6 de Bambusa textilis (G2); 3 g Cimento Portland + 0,9 ml água + 0,3 ml de Bambusa textilis (G3); 3 g Cimento Portland puro (controle) + 1,2 ml água (G4); Bambusa textilis (controle): 20 microlitros por poço. Para os testes de pH e liberação de íons cálcio foram utilizados tubos de polietileno, os quais foram preenchidos com os cimentos e imersos em frascos contendo água deionizada. As mensurações foram por meio de um peagâmetro e espectrofotômetro de absorção atômica. Para a análise da atividade antimicrobiana, foi utilizada a técnica de difusão radial com cepa de Enterococcus faecalis. Os halos de inibição foram mensurados com auxílio de um paquímetro digital. A análise estatística foi realizada pelo teste ANOVA para comparação global, e teste de Tukey para comparações individuais, com significância de 5%. Resultados: os valores de pH se mostraram próximos ao neutro para todos os grupos em todos os períodos experimentais. Houve liberação de íons cálcio e ocorreu em todos os grupos e em todos os períodos experimentais. Em relação à atividade antimicrobiana, nenhuma das proporções apresentou atividade. Conclusão: a associação da Bambusa textilis ao cimento Portland manteve seu pH e liberação de íons cálcio, mas não potencializou sua atividade antimicrobiana frente ao E. faecalis. (AU)

Introduction: there is a search for phytotherapeutic agents in medicine and dentistry. Within endodontics, a substance that potentiates the biological and antimicrobial effects of calcium hydroxide as a delay dressing is sought. There are no reports in the literature about the association of Portland cement with Bambusa textilis, a plant native to China, where it is used in the manufacture of medicines, since it is an important source of resins and is therefore used for its anti-inflammatory power, anticonvulsive and antipyretic. Knowing the similarity of the Portland cement with the MTA, and that the latter presents good physicochemical results, the possibility of the association arises, with the purpose of improving the antimicrobial activities, and the interference in the release of calcium and hydroxyl ions. Aim: to analyze the pH, calcium ion release and antibacterial activity of Portland cement associated to Bambusa textilis in different proportions. Methods: the experimental cements ́ proportions were: 3 g of Portland cement + 1.2 ml of Bambusa textilis (G1); 3 g of Portland cement + 0.6 ml of water + 0.6 of Bambusa textilis (G2); 3 g of Portland cement + 0.9 ml of water + 0.3 ml of Bambusa textilis (G3); 3 g of pure Portland cement (control group) + 1.2 ml of water (G4); Bambusa textilis (control group): 20 µLper well. Polyethylene tubes filled with the cements and immersed in deionized water were employed. Calcium ion release was analyzed using an atomic absorption spectrophotometer and the change in pH was determined through a pH meter. For the analysis of antibacterial activity, a digital radial diffusion assay with a Enterococcus faecalis strain was utilized. Statistical analysis was performed using ANOVA and Tukey's tests. The level of significance was set at P = 0.05. Results: pH values were close to neutral for all of the experimental groups in all periods evaluated. Calcium ion release was observed in all experimental groups and evaluation periods. Regarding the antibacterial activity, this property could not be detected in any of the proportions used in this study. Conclusions: the association of Bambusa textilis to Portland cement, preserved its pH values and its calcium ion release property. Nevertheless, it did not improve its antibacterial activity against E. faecalis strains. (AU)

The effects of a global postural exercise program on temporomandibular disorder

Abstract - Changes in the suboccipital muscles and the hamstrings may interfere with head posture and the biomechanics of the temporomandibular joint, both of which contribute to the severity of temporomandibular disorders (TMD). The objective of this investigation was to evaluate the effects of a global postural exercise program (GPEP) on pain intensity and mouth-opening range of motion (ROM) in women with TMD. The participants were comprised of 30 women with TMD who were divided into two groups: an experimental group (EG) and a control group (CG). A pressure algometer was used for pain assessment and a paquimeter was used to measure ROM. The duration of the GPEP was six weeks. In the EG, there was a reduction in pain intensity and an increase in mouth-opening ROM compared to the CG. Therefore, we concluded that the GPEP was effective in relieving pain in all of the evaluated muscles and regions, and in increasing mouth-opening ROM in women with TMD.

Antimicrobial Activity and Physicochemical Properties of Calcium Hydroxide Pastes Used as Intracanal Medication.

INTRODUCTION: The aim of the present study was to evaluate the pH, calcium release, solubility, and antimicrobial action against biofilms of calcium hydroxide + saline solution, Calen (SS White Artigos Dentários Ltd, Rio de Janeiro, Brazil) (CH/P), Calen camphorated paramonochlorophenol (CMCP) (CH/CMPC), and calcium hydroxide + chlorhexidine (CH/CHX) pastes. METHODS: The pH of the pastes was determined with a calibrated pH meter placed in direct contact with each paste. The root canals of acrylic teeth (N = 10) were filled with the previously mentioned intracanal dressings and immersed in ultrapure water to measure hydroxyl (pH meter) and calcium ion release (atomic absorption spectrophotometer) at time intervals of 3, 7, 15, and 30 days. To assess solubility, the root canals of acrylic teeth (N = 10) were filled with the previously mentioned pastes and scanned by micro-computed tomographic imaging before (initial) and after 7, 15, and 30 days of immersion in ultrapure water. The solubility of each specimen was the difference between the initial and final volume scanning. For antimicrobial analysis, monospecies and dual-species biofilms were in vitro induced on dentin blocks (N = 20). Afterward, they were treated with the pastes for 7 days. Live/dead dye and a confocal microscope were used to measure the percentage of living cells. Data were statistically compared (P < .05). RESULTS: The highest OH- ion release values were found in 3 and 30 days. Ca2+ releases were greater in CH/CMCP. CH/P and CH/CMCP showed a higher percentage of volume loss values. CH/CHX presented the greatest antimicrobial action. CONCLUSIONS: CH/P and CH/CMPC showed higher solubility values in the period analyzed. Seven days of contact may be insufficient for calcium hydroxide + saline solution, CH/P, and CH/CMCP pastes to kill bacterial cells in the biofilms studied. Chlorhexidine added to CH favored greater effectiveness against the previously mentioned bacterial biofilms.

Análise, com microscopia confocal de varredura a laser, da formação de biofilme de Bifidobacterium dentium e Fusobacterium nucleatum sobre diferentes substratos / Analysis of Bifidobacterium dentium and Fusobacterium nucleatum biofilm formation on different substrates by confocal laser scanning microscopy

Objetivo: o objetivo do presente estudo foi avaliar, por meio da microscopia confocal de varredura a laser (MCVL), a influência de diferentes substratos (dentina bovina em blocos, blocos de vidro) sobre o desenvolvimento de biofilmes de F. nucleatum e B. dentium. Métodos: placas para cultura de células com 24 poços foram usadas para induzir o biofilme sobre os substratos, com uma linhagem de F. nucleatum ATCC 25586 e uma de B. dentium ATCC 27534, durante 7 dias. Após o período de indução do crescimento, os espécimes foram corados com Live/Dead e analisados por MCVL. Os resultados obtidos pela MCVL foram analisados no software BioImage_L. Resultados: todos os resultados foram analisados pelo teste não paramétrico de Kruskal-Wallis, para comparação entre os grupos (p < 0,05). Houve formação de biofilme em todos os grupos experimentais. O biovolume total e a porcentagem de bactérias viáveis no biofilme de B. dentium nos blocos de dentina e nos blocos de vidro não mostraram diferenças estatísticas. O biovolume de bactérias viáveis não revelou diferença entre os substratos no biofilme de F. nucleatum nos blocos de dentina e nos blocos de vidro. Já o biovolume total mostrou-se maior no biofilme formado em blocos de dentina. B. dentium e F. nucleatum são capazes de formar biofilme em todos os substratos estudados. Conclusão: pela metodologia adotada, o tipo de substrato influencia as características do biofilme formado, sendo o bloco de dentina mais propício para a formação do biofilme dos microrganismos estudados.

Atividade antibacteriana de cimentos endodônticos puros e acrescidos de antibióticos contra duas linhagens ATCC de Enterococcus faecalis / Antibacterial activity of pure endodontic sealers and antibiotic-loaded sealers against two ATCC strains of Enterococcus faecalis

Introdução: canais radiculares necrosados e não tratados se caracterizam pela presença de uma microbiota mista e polimicrobiana.O E. faecalis demonstra alta resistência a medicamentos usados durante o tratamento endodôntico, sendo um dos poucos microrganismos que tem demonstrado in vitro resistir ao efeito antibacteriano do hidróxido de cálcio. Além disso, é a espécie bacteriana mais frequentemente isolada, com prevalência variando entre 29% e 77% nos canais radiculares de dentes com insucesso endodôntico. Objetivo: avaliar a atividade antibacteriana dos cimentos endodônticos MTA Fillapex, Sealapex, Sealer 26 e Endofill puros e acrescidos de amoxicilina e ciprofloxacina frente a duas linhagens ATCC de Enterococcus faecalis (ATCC 29212 e ATCC 4083). Método: os testes foram realizados pela técnica de difusão radial dos cimentos aplicados diretamente no ágar, impregnados em discos de papel aplicados sobre o ágar e pelo teste de contato direto. Para a análise estatística utilizaram-se os testes de ANOVA e Tukey com nível de significância de 5%. Resultados e Discussão: os resultados mostraram que pela técnica da difusão radial, considerando os cimentos puros, o Sealapex foi o único que apresentou halo de inibição frente às duas linhagens. Já, quando da associação da amoxicilina e ciprofloxacina o MTA Fillapex demonstrou os melhores halos de inibição para as duas linhagens. Todos os cimentos tiveram a ação potencializada pela adição dos antibióticos (p<0,05). Pela técnica de difusão dos cimentos impregnados em discos de papel, o cimento Sealapex puro fresco revelou atividade antimicrobiana e também em todas as variáveis de tempo. Quando acrescidos os antibióticos, todos os cimentos tiveram a ação antimicrobiana potencializada pelas drogas, em todas as variáveis de tempo. Este mesmo resultado foi observado na técnica do contato direto dos cimentos com ambas as linhagens. Conclusão: a atividade antibacteriana, frente ao E. faecalis, dos cimentos MTA Fillapex, Endofill, Sealer e Sealapex acrescidos os antibióticos amoxicilina e ciprofloxacina, é potencializada mesmo após um longo período da presa dos cimentos.

Introduction: necrotic root canals and untreated are characterized by the presence of a mixed and polymicrobial flora. E. faecalis show high resistance to drugs used during endodontic treatment, one of the few microorganisms which have shown in vitro to resist the antibacterial effect of calcium hydroxide. Furthermore, it is the bacterial species most often isolated, with a prevalence ranging between 29% and 77%, in root canals of teeth with endodontic failure. Objective: the aim of this study was to evaluate the antibacterial activity of the sealers MTA Fillapex, Sealapex, Sealer 26 and Endofill, pure and loaded with amoxicillin and ciprofloxacin against two ATCC strains of Enterococcus faecalis (ATCC 29212 and ATCC 4083). Method: the tests were conducted by means of radial diffusion technique of the cement applied in to the agar, impregnated paper discs applied on the agar and by the direct contact test. For the statistical analysis, the ANOVA and the Tukey?s test were used at a 5% significance level. Results and Discussion: results showed that, through the technique of radial diffusion, regarding the pure cements, the Sealapex was the only one that showed inhibition halo for the two strains. However, considering the association of amoxicillin and ciprofloxacin Fillapex, the MTA showed better inhibition zones for the two strains. All cements had their actions enhanced by with addition of antibiotics (p <0.05). Through the technique of diffusion of cements impregnated in paper discs, the Sealapex pure fresh cement revealed an antimicrobial activity and also in all the variables of time. When loaded with antibiotics, all cements had the antimicrobial action potentiated by drugs in all variables of time. The same result was observed in the technique of direct contact of cement with both strains. Conclusionn: the antibacterial activity against the E. faecalis, of the cements MTA Fillapex, Endofill, Sealer and Sealapex loaded with the antibiotics amoxicillin and ciprofloxacin, is enhanced even after a long period of use of cements.

Efeito antimicrobiano da indometacina no biofilme periodontal: estudo em ratos / Antimicrobial effect of indomethacin on periodontal biofilm: study in rats

Introdução: A doença periodontal é uma doença de caráter multifatorial que se desenvolve em decorrência da interação do biofilme bacteriano com a resposta imuno-inflamatória do hospedeiro que pode ser modulada por fatores sistêmicos e ambientais. Objetivo: o presente estudo teve como objetivo avaliar a ação antimicrobiana do anti-inflamatório não esteroidal indometacina sobre o biofilme retido em ligaduras inseridas subgengivalmente para indução de periodontite experimental em ratos. Método: assim, 20 animais foram divididos aleatoriamente em um dos grupos: grupo Indometacina (n=10); grupo água destilada (n=10). Os animais receberam gavagem diária da medicação (5 mg/kg indometacina) ou de água destilada (2 ml), durante 7 dias. As ligaduras ao redor dos dentes foram coletadas e o biofilme foi dispersado, diluído em 10-1, 10-2 e 10-3, semeado em ágar sangue e as placas foram cultivadas em anaerobiose durante 4 dias. As quantificações foram realizadas a partir da contagem das unidades formadoras de colônias (UFC) totais pelo programa Colony counter aplicativo para androide, caracterizadas pela presença de bactérias aeróbias e aeróbias facultativas relacionadas ao processo de saúde, e pela contagem manual de UFC grandes, que melhor caracterizam as bactérias anaeróbias relacionadas ao processo de doença. Resultado: constatou-se um número significativamente maior de UFC grandes no grupo indometacina quando comparado ao grupo água (p=0,004) e um número significativamente menor de UFC totais no grupo indometacina quando comparado ao grupo água (p=0,0013). Conclusão: dentro dos limites do presente estudo pôde-se concluir que a indometaciana agrava o processo infeccioso periodontal devido ao crescimento de UFC anaeróbias e redução de UFC facultativas.

Introduction: Periodontal disease is a multifactorial disease the develop as a result of the interaction of the bacterial biofilm and the immune-inflammatory response of the individual, which, in its turn, is modulate by systemic and environmental factors. Objective: This study aimed to evaluate the antimicrobial effect of indomethacin, a non-steroidal anti-inflammatory, on the biofilm retained in ligatures inserted in the subgingival region to induce experimental periodontitis in rats. Method: 20 animals were randomly assigned to one of the groups: Indomethacin (n = 10); distilled water (n = 10). The animals received daily gavage of drugs (5 mg / kg indomethacin) or distilled water (2 ml) for 7 days. The ligatures around the teeth were collected and the biofilm was dispersed, diluted 10-1, 10-2 and 10-3, seeded in blood agar and the plates were grown anaerobically for 4 days. The measurements were carried out from the counting of total colony forming units (CFU) by Colony counter application program for android, characterized by the presence of facultative aerobic and aerobic bacteria related health process, and the manual counting of large CFU, which better characterized the anaerobic bacteria-related disease process. Result: it was found a significantly higher number of large CFU in indomethacin group compared to the water group (p = 0.004) and a significantly lower number of total CFU in the indomethacin group compared to the water group (p = 0.0 013). Conclusion: within the limits of this study it was concluded that the indomethacin worsens periodontal infectious process due to the growth of anaerobic CFU and the reduction of facultative CFU.