Antimicrobial activity and pH evaluation of Calcium Hydroxide associated with natural products / Avaliação da atividade antimicrobiana e do pH do Hidróxido de Cálcio associado a produtos naturais

New intra-canal medications can be developed by the combination of natural products with calcium hydroxide (Ca(OH)2). The aim of this study was to evaluate the antimicrobial activity and pH values of Ca(OH)2 associated with propolis tincture 5% (S1); pomegranate tincture 5% (S2); essential oil from eucalyptus 0.5% (S3); inert solution (S4) and with CPMC - Camphorated Paramonochlorophenol (S5) on strains of Enterococcus faecalis (ATCC29212); Aggregatibacter actinomycetecomitans b (ATCC29522), Eikenella corrodens (ATCC23834) and Candida albicans (ATCC40277). Sterile paper cones were immersed for 1 minute in the solutions under test. The agar diffusion test was carried out and the plates were incubated at 37 °C in bacteriological incubator for 48 h. The mean diameter of growth inhibition (MDGI) produced by the formulations were calculated in millimeters and statistically analyzed by ANOVA and Tukey’s tests. The tests were performed in triplicate. The pH of substances was measured at room temperature. For E. faecalis, A. actinomycetecomitans b; E. corrodens and C. albicans MDGI for each substance was, respectively: 1.6, 3.1, 4.6 and 2.3 mm (S1), 1.5, 3.1, 8.8 and 0.3 mm (S2), 1.5, 3.5, 5.5 and 0.5 mm (S3), 1.5, 5.3; 11.6 and 3.1 mm (S4) and 3.0, 8.5, 17.3 and 7.3 mm (S5). The inhibition zones produced by S5 were larger than the ones from S1, S2 and S3 (p<0,05). The pHvalues found were: 11.55 (S1); 11.52 (S2); 11.48 (S3); 11.54 (S4); and 11.65 (S5). Commercial formulations of Ca(OH)2 showed better antimicrobial performance than the associations with natural products. The pH of tested formulations did not change significantly.

Novas medicações intra-canal podem ser desenvolvidas a partir da combinação de produtos naturais com hidróxido de cálcio (Ca(OH)2). Objetivou-se avaliar o pH e a ação antimicrobiana do Ca(OH)2 associados a tintura de própolis 5% (S1); tintura de romã 5% (S2); óleo essencial de eucalipto 0,5% (S3); solução inerte (S4); e ao PMCC – Paramonoclorofenol Canforado (S5) sobre cepas de Enterococcus faecalis (ATCC 29212); Aggregatibacter actinomycetecomitans b (ATCC 29522); Eikenella corrodens (ATCC 23834) e Candida albicans (ATCC 40277). Cones de papel estéreis foram imersos durante 1min nas soluções testadas. Realizou-se o teste de difusão em agar e as placas foram incubadas a 37 ºC em estufa bacteriológica por 48 h. Os diâmetros médios de inibição do crescimento (DMIC) produzido pelas substâncias foram calculados em milímetros e analisados estatisticamente pelos testes ANOVA e de Tukey. Os testes foram realizados em triplicata. A aferição do pH se deu em temperatura ambiente. Para E. faecalis; A. actinomycetecomitans b; E. corrodens e C. albicans a DMIC para cada substância foi, respectivamente: 1,6; 3,1; 4,6 e 2,3mm (S1); 1,5; 3,1; 8,8 e0,3mm (S2); 1,5; 3,5; 5,5 e 0,5mm (S3); 1,5; 5,3; 11,6 e 3,1mm (S4) e 3,0; 8,5; 17,3 e 7,3mm (S5). Os halos de inibição produzidos por S5 foram maiores do que os de S1, S2 e S3 (p<0,05). Os valores de pH encontrados foram: 11,55 (S1); 11,52 (S2); 11,48 (S3); 11,54 (S4); 11,65 (S5). As formulações comerciais de Ca(OH)2 mostraram melhor desempenho antimicrobiano do que as associações com produtos naturais. O pH das soluções testadas não variou significativamente.

Conservative management of severe intrusion in a primary tooth: a 4-year follow-up.

The purpose of this report was to describe the case of an 18-month-old boy who was referred to the pediatric clinic of the School of Dentistry of Araçatuba, São Paulo State University, Araçatuba, São Paulo, Brazil, 3 days after sustaining severe trauma that led to the complete intrusion of the primary maxillary right lateral incisor, a crown fracture of the primary maxillary right central incisor without pulp involvement, and disruption of the superior labial frenum. Four months later, spontaneous re-eruption was observed in the intruded tooth and no endodontic intervention was necessary in either traumatized teeth. Four years after the trauma, a morphological change in the germ of the permanent successor was noted. Clinical follow-up and periodic radiographies are necessary after traumatic intrusion of primary teeth to monitor possible sequelae in the permanent successors.

Comparison of the biocompatibility of different root canal irrigants.

The purpose of this study was to compare the reaction of rat subcutaneous connective tissue to 0.9% sterile saline, 2.5% sodium hypochlorite (NaOCl), 5.25% NaOCl and 2% chlorhexidine gluconate solution or gel. Six circles were demarcated on the dorsal skin of 24 male Wistar rats, leaving 2 cm between each circle. Using a syringe, 0.1 mL of each root canal irrigant was injected subcutaneously into 5 circles. In the 6th circle, the needle of an empty syringe was introduced into the skin, but no irrigant was injected (control group). Evaluations were undertaken at 2 h, 48 h, 14 days and 30 days post-procedure. Tissue samples were excised, embedded in paraffin blocks and 3-microm-thick sections were obtained and stained with hematoxylin and eosin. The areas of inflammatory reaction were evaluated and analyzed statistically by ANOVA and Tukey's test. The control group showed few or no inflammatory reaction areas in the subcutaneous tissue. 0.9% saline solution, 2.0% chlorhexidine solution and 2.5% NaOCl showed a good biocompatibility, as very mild inflammatory reaction was detected at 14 days and tissue repair occurred at 30 days. 5.25% NaOCl was the most toxic irrigant, as the number of inflammatory cells remained elevated at 14 and 30 days. The group treated with 2.0% chlorhexidine gluconate gel presented a moderate inflammatory response at 14 days, which decreased at 30 days, being considered similar to that of the control group, 0.9% saline solution, 2.0% chlorhexidine solution and 2.5% NaOCl at this experimental period.

Prevalence of dental trauma in patients with cerebral palsy.

This study presents the findings of a record review that evaluated the prevalence of dental trauma in patients with cerebral palsy and evaluated its possible relationship with age, type of palsy, and epilepsy. The dental records of 2,200 patients with special needs admitted to the special care clinic of the School of Dentistry of Araçatuba/UNESP, Brazil, between 1998 and 2003 were reviewed. Of the records that were analyzed, 500 patients who had cerebral palsy were selected for this study. Information regarding age, gender, type of palsy and dental trauma was collected and statistically analyzed. It was observed that 10.6% of the subjects (n = 53) had sustained dental trauma. The number of traumatized teeth was 84. Enamel or enamel/dentin fractures were the most frequent types of traumatic injury (84.9%). The permanent maxillary central incisors were the most commonly affected teeth (50%). The frequency of traumatic injuries showed no significant correlation (p> .05) with the type of cerebral palsy or gender and they were more frequent in subjects between the ages of 0 and 12 years. Having epilepsy was not a statistically significant risk factor (p> .05) for dental trauma.

Mechanism of calcium hydroxide-induced neutrophil migration into air-pouch cavity.

The aim of this study was to investigate cellular migration induced by calcium hydroxide to air-pouch cavities in mice. The migration was more specific to neutrophil and was dose and time dependent (peaking 96 h after stimulation). This migration was inhibited by pretreatment with thalidomide, indomethacin, MK886, meloxicam, dexamethasone, MK886 associated with indomethacin, and MK886 associated with indomethacin and dexamethasone. The air-pouch exudate from animals stimulated with calcium hydroxide showed an increase of leukotriene-B(4) (LTB(4)), interleukin-1beta, tumor necrosis factor alpha (TNF-alpha), cytokine-induced neutrophil chemoattractant (KC), and macrophage inflammatory protein 2 (MIP-2) release. Pretreatment with 3% thioglycollate increased the macrophage population in the air pouch but did not change neutrophil migration. Depleting the resident mast cells through chronic pretreatment with compound 48/80 did not alter neutrophil migration in response to calcium hydroxide. It was possible to conclude that calcium hydroxide-induced neutrophil migration to the air-pouch cavity in mice is mediated by LTB(4), TNF-alpha, KC, MIP-2, and prostaglandins, but it was not dependent on macrophages or mast cells.

Comparison of the biocompatibility of different root canal irrigants

The purpose of this study was to compare the reaction of rat subcutaneous connective tissue to 0.9 percent sterile saline, 2.5 percent sodium hypochlorite (NaOCl), 5.25 percent NaOCl and 2 percent chlorhexidine gluconate solution or gel. Six circles were demarcated on the dorsal skin of 24 male Wistar rats, leaving 2 cm between each circle. Using a syringe, 0.1 mL of each root canal irrigant was injected subcutaneously into 5 circles. In the 6th circle, the needle of an empty syringe was introduced into the skin, but no irrigant was injected (control group). Evaluations were undertaken at 2 h, 48 h, 14 days and 30 days post-procedure. Tissue samples were excised, embedded in paraffin blocks and 3-µm-thick sections were obtained and stained with hematoxylin and eosin. The areas of inflammatory reaction were evaluated and analyzed statistically by ANOVA and Tukey's test. The control group showed few or no inflammatory reaction areas in the subcutaneous tissue. 0.9 percent saline solution, 2.0 percent chlorhexidine solution and 2.5 percent NaOCl showed a good biocompatibility, as very mild inflammatory reaction was detected at 14 days and tissue repair occurred at 30 days. 5.25 percent NaOCl was the most toxic irrigant, as the number of inflammatory cells remained elevated at 14 and 30 days. The group treated with 2.0 percent chlorhexidine gluconate gel presented a moderate inflammatory response at 14 days, which decreased at 30 days, being considered similar to that of the control group, 0.9 percent saline solution, 2.0 percent chlorhexidine solution and 2.5 percent NaOCl at this experimental period.

Influência da amamentação natural e artificial sobre a ocorrência de hábitos de succção não nutritivos / Breastfeeding and bottle feeding influence on non nutritive sucking habits

O objetivo deste trabalho foi investigar a influência do tempo de aleitamento natural e artificial sobre a ocorrência de hábitos de sucção não nutritivos. Para tanto, foi aplicado um questionário aos pais de 155 crianças, com idades entre três e oito anos. Pesquisou-se o período em que foram amamentadas, bem como a presença ou não de hábitos de sucção e a duração dos mesmos. Concluiu-se que a amamentação natural por um período adequado pôde prevenir a instalação destes hábitos de sucção não nutritivos, sendo a chupeta o hábito mais freqüente.

The purpose of this study was to evaluate the influence of breast-feeding and bottle-feeding period on occurring of nonnutritive sucking habits. It was applied a questionnaire to 155 parents. The children were three to eight years age. It was investigate the breast and bottle feeding period as well the presence or not of nonnutritive sucking habits and its duration. It was conc1ude that the breast-feeding for an appropriate period could prevent the development of nonnutritive sucking habits, being the pacifier the most frequent habito.

Influência do material impermeabilizante radicular na infiltração marginal com azul de metileno / The influence of the radicular impermeable material in the microleakage of the blue methylene

A obturação do canal radicular visa um perfeito selamento. Contudo, possíveis falhas podem propiciar infiltração de microrganismos e levar ao insucesso do tratamento. Com o intuito de detectar a solução de continuidade entre o material obturador e a parede do conduto, podem ser utilizados vários modelos experimentais e materiais obturadores. Um dos modelos é a microinfiltração de corantes em dentes extraídos. O objetivo deste trabalho foi avaliar a eficácia do Super-Bonder, esmalte para unha, resina epóxica de presa de 10 minutos e de 24 horas como materiais impermeabilizantes. Para tanto, foram utilizados 50 dentes bovinos unirradiculares, que tiveram suas coroas removidas e os canais preparados. Em 4 grupos de 10 elementos (um grupo para cada material), realizou-se o selamento da região coronária e apical com plug de guta-percha sem obturação dos canais. Num outro grupo, os canais foram obturados e repetiu-se a impermeabilização com esmalte de unha. Foi realizada a aplicação do impermeabilizante a ser estudado em toda superfície externa do dente e imersão dos espécimes na solução corante azul de metileno a 2% em ambiente de vácuo. Após a clivagem longitudinal, os espécimes foram examinados em uma lupa estereoscópica. Os resultados mostraram que o esmalte de unha em canal obturado exerceu uma efetiva impermeabilização, enquanto os demais grupos, os quais não receberam obturação, não diferiram entre si e mostraram-se inefetivos em todos os espécimes. Confirma-se, portanto, que o esmalte pode ser utilizado como impermeabilizante, mesmo em condições de vácuo, desde que os canais radiculares estejam obturados

The aim of the endodontic obturation is the properly sealing of the root canal system. However, some failures can occur and let microorganisms infiltrate and lead to the failure. Several methods can be used to detect failure between the obturating material and root canal walls, one of them is the microleakage of ink. The goal of this work was to evaluate the ability of Super-Bonder, nail polish, epoxi resin with 10 and 24 min of set to externally seal the root surface. It was used 50 cow’s teeth, which had their crowns removed and the root canals instrumented. In 4 groups of tem teeth each one, it was performed the coronary and apical sealing with gutta-pecha without obturation of the root canals. In other group, the root canals were filled and externally sealed with nail polish. It was performed the application of the materials on the external surface and the teeth were immersed in 2% methylene blue under vaccum. After the split, the teeth were examined in esteromicroscope. The results showed that the nail polish, when used in filled root canal , performed an effective sealing, while the other groups, which did not receive the filling, did not differ among them and they were ineffective in many cases. It was confirm that the nail polish can be used in the routine, even in vacuum condition, as long as the canals be filled