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1.
Iran Endod J ; 17(2): 78-84, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36704016

RESUMO

Pulp canal obliteration (PCO) is a challenging clinical scenario in which canals must be located in progressively narrowing roots. Recently, proof of concept papers have, in parallel, introduced the combination of cone-beam computed tomography and surface scans for the construction of guides to pilot the negotiation and preparation of partially or completely obliterated pulp chambers and canals in anterior and posterior teeth. Authors' purpose is to describe the treatment approach for teeth with PCO and previous iatrogenic deviation using guided endodontic technique. The clinical cases reported here show that technological evolutions should make guided endodontic procedures more widespread because their execution is relatively fast and safe even in the cases of root canal deviation. Treatment of teeth with pulp canal obliteration with deviations or perforation may be more effective with designed 3D printed access guides that seems to be a safe and clinically feasible method to locate root canals.

2.
Clin Oral Investig ; 25(3): 1403-1410, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32666350

RESUMO

OBJECTIVES: To evaluate the mRNA expression levels of cytokines interferon-γ, tumour necrosis factor-α, interleukin IL-1ß, IL-10, and the chemokine CCL2/MCP-1, CCL4, and CXCR4 in the periapical interstitial fluid from root canal infections before and after bacterial load reduction in patients undergoing haematopoietic stem cell transplantation (HSCT). MATERIALS AND METHODS: The case group was composed of 10 patients undergoing HSCT, and our control group included 10 healthy patients. Clinical samples were taken from teeth with pulp necrosis. Three paper points were placed in the RCS and maintained for 2 min for microbial evaluation before cleaning and shaping procedures. After cleaning and drying the canal, three paper points were introduced into the root canal, passing passively through the root apex (2 mm) into the periapical tissues for 1 min. Samples were collected immediately after root canal cleaning and 7 days later (restrained root canal bacterial load) to characterize gene expression using real-time PCR. RESULTS: The results showed significantly reduction in the microbial load on day 7. An increased expression level of TNF-α and IFN-γ on day 7 in control and case groups was observed (p < 0.05). The mRNA levels of IL-1ß and IL-10 in the pre-HSCT group increased in the samples from day 7 (p < 0.05). The chemokine CCL-2/MCP-1 was not detected in pre-HSCT group. Chemokine receptor CXCR4 levels increased in samples obtained from the day 7 in the control group (p < 0.05). CONCLUSIONS: Individuals undergoing HSTC presented similar cytokine and chemokine mRNA expression compared with healthy individuals. However, it was observed the total absence of mRNA MCP-1/CCL2 expression in those individuals undergoing HSCT. CLINICAL RELEVANCE: Patients undergoing HSCT are at higher risk of infection. No study has analysed the periapical immune responses to root canal infections in HSCT individuals.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Periodontite Periapical , Citocinas , Necrose da Polpa Dentária , Humanos , Periodontite Periapical/terapia , Tecido Periapical , Tratamento do Canal Radicular
3.
Braz Oral Res ; 31: e50, 2017 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-28678969

RESUMO

The aim of this study is to investigate the relationship between the epidemiological and clinical profiles of patients before and after hematopoietic stem cell transplantation (HSCT) and the need for endodontic treatment. The subjects included 188 individuals enrolled in the dental care program for transplanted patients of the School of Dentistry, Federal University of Minas Gerais (Faculdade de Odontologia da Universidade Federal de Minas Gerais, FO-UFMG) from March 2011 through March 2016. The patients were subjected to an HSCT conditioning dental regimen based on a thorough clinical and radiographic evaluation. Intraoral periapical and bite-wing X-rays were obtained, and after evaluation, specific dental treatment was planned and performed. The following demographic and clinical data were collected from the patients' medical records: age, gender, transplantation stage, primary disease, transplant type, medication used, complete blood count at the time of visit, and need for endodontic treatment. The Kolmogorov-Smirnov and the chi-square tests were used. Leukemia (31.3%) and multiple myeloma (17.9%) were the most prevalent primary diseases. Most patients were subjected to allogeneic-related transplantation (83.6%). Most patients exhibited platelet counts and hemoglobin concentrations below the reference values in the pre-transplantation stage, while the neutrophil and platelet counts and the hemoglobin levels were within the reference ranges in the post-transplantation stage. The proportions of individuals requiring endodontic treatment were similar between the pre- and post-transplantation groups: 24.3% and 24.7%, respectively. The systemic conditions of the patients referred for dental treatment were compromised.


Assuntos
Assistência Odontológica para Doentes Crônicos/estatística & dados numéricos , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/estatística & dados numéricos , Avaliação das Necessidades/estatística & dados numéricos , Tratamento do Canal Radicular/estatística & dados numéricos , Adolescente , Adulto , Idoso , Contagem de Células Sanguíneas , Doenças da Medula Óssea/imunologia , Doenças da Medula Óssea/cirurgia , Criança , Feminino , Humanos , Terapia de Imunossupressão/efeitos adversos , Leucemia/imunologia , Leucemia/cirurgia , Linfoma/imunologia , Linfoma/cirurgia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/imunologia , Mieloma Múltiplo/cirurgia , Fatores de Risco , Estatísticas não Paramétricas , Transplante Homólogo/efeitos adversos , Transplante Homólogo/estatística & dados numéricos , Adulto Jovem
4.
Braz. oral res. (Online) ; 31: e50, 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-952114

RESUMO

Abstract The aim of this study is to investigate the relationship between the epidemiological and clinical profiles of patients before and after hematopoietic stem cell transplantation (HSCT) and the need for endodontic treatment. The subjects included 188 individuals enrolled in the dental care program for transplanted patients of the School of Dentistry, Federal University of Minas Gerais (Faculdade de Odontologia da Universidade Federal de Minas Gerais, FO-UFMG) from March 2011 through March 2016. The patients were subjected to an HSCT conditioning dental regimen based on a thorough clinical and radiographic evaluation. Intraoral periapical and bite-wing X-rays were obtained, and after evaluation, specific dental treatment was planned and performed. The following demographic and clinical data were collected from the patients' medical records: age, gender, transplantation stage, primary disease, transplant type, medication used, complete blood count at the time of visit, and need for endodontic treatment. The Kolmogorov-Smirnov and the chi-square tests were used. Leukemia (31.3%) and multiple myeloma (17.9%) were the most prevalent primary diseases. Most patients were subjected to allogeneic-related transplantation (83.6%). Most patients exhibited platelet counts and hemoglobin concentrations below the reference values in the pre-transplantation stage, while the neutrophil and platelet counts and the hemoglobin levels were within the reference ranges in the post-transplantation stage. The proportions of individuals requiring endodontic treatment were similar between the pre- and post-transplantation groups: 24.3% and 24.7%, respectively. The systemic conditions of the patients referred for dental treatment were compromised.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Tratamento do Canal Radicular/estatística & dados numéricos , Assistência Odontológica para Doentes Crônicos/estatística & dados numéricos , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/estatística & dados numéricos , Avaliação das Necessidades/estatística & dados numéricos , Transplante Homólogo/efeitos adversos , Transplante Homólogo/estatística & dados numéricos , Contagem de Células Sanguíneas , Doenças da Medula Óssea/cirurgia , Doenças da Medula Óssea/imunologia , Leucemia/cirurgia , Leucemia/imunologia , Fatores de Risco , Terapia de Imunossupressão/efeitos adversos , Estatísticas não Paramétricas , Linfoma/cirurgia , Linfoma/imunologia , Pessoa de Meia-Idade , Mieloma Múltiplo/cirurgia , Mieloma Múltiplo/imunologia
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