Avaliação in vitro da atividade antimicrobiana de pastas endodônticas à base de extrato glicólico de Musa paradisiaca frente a Enterococcus faecalis / In vitro evaluation of the antimicrobial activity of endodontic pastes made of Musa paradisiaca glycolic extract over Enterococcus faecalis

Os produtos de Musa paradisiaca (bananeira) são usados como sedativo para odontalgia, cicatrizante de feridas cirúrgicas de exodontia, úlcera gástrica, entre outras indicações em comunidades que têm por tradição o uso das plantas como Medicina alternativa. Na Endodontia, almeja-se uma medicação intracanal ideal contra cepas resistentes em infecções endodônticas refratárias. Por esse motivo, o objetivo desse trabalho foi testar a atividade antimicrobiana do extrato glicólico de Musa paradisiaca (Mp) sobre Enterococcus faecalis (Ef). Para realizar o experimento, o extrato glicólico de Musa paradisiaca (EGB) substituiu o Polietilenoglicol 400 (PEG), que é um veículo que compõe algumas medicações intracanal. Foi utilizado o teste de difusão em ágar, pelo método do poço, para a avaliação da atividade antimicrobiana contra a cepa de Ef, normalmente relacionada a infecções refratárias endodônticas. Experimento “A”: G1, PEG (controle negativo); G2, PEG e Ca(OH) 2 ; G3, EGB; G4, EGB e Ca(OH) 2 e G5, gel de clorexidina 2% (CHX – controle positivo). Experimento “B”: G1, PEG (controle negativo); G2, PEG e ZnO; G3, PEG, Ca(OH) 2 e ZnO; G4, EGB e ZnO; G5, EGB, Ca(OH) 2 e ZnO e G6, CHX (controle positivo). Apenas a pasta de EGB e ZnO obteve atividade antimicrobiana estatisticamente significante, podendo ser uma propriedade importante para a composição de medicação intracanal. Todo novo biomaterial baseado na etnobotânica deve ser testado criteriosamente para viabilizar sua aplicabilidade clínica, o que justificou a pertinência deste estudo preliminar. No entanto, testes físico-químicos e de biocompatibilidade são imprescindíveis para futuro emprego de fitoterápicos na Endodontia

The products of Musa paradisiaca (banana plantain) are used as a sedative for dental pain, healing of tooth extraction surgical wounds, gastric ulcer, among other indications in communities that have the tradition of using plants as alternative Medicine. Endodontics searchs for an ideal intracanal medication for resistant strains on refractory endodontic infections. Therefore, the objective of this study was to test the antimicrobial activity of Musa paradisiaca (Mp) glycolic extract over Enterococcus faecalis (Ef). To perform the experiment, the Polyethyleneglycol 400 (PEG), used to make some intracanal medication, was replaced by Musa paradisiaca glycolic extract. Agar well diffusion test was used to evaluate antimicrobial activity over Ef. Strains normally related to refractory endodontic infections. Experiment “A”: G1, PEG (negative control); G2, PEG and Ca(OH)2; G3, EGB; G4, EGB and Ca(OH)2; and G5, 2% chlorhexidine gel (CHX - positive control). Experiment “B”: G1, PEG (negative control); G2, PEG and ZnO; G3, PEG, Ca(OH)2 and ZnO; G4, ZnO and EGB; G5, EGB, Ca(OH)2 and ZnO; and G6, CHX (positive control). Only the EGB and ZnO paste has obtained statistically significant antimicrobial activity, indicating that it can be an important property for a new intracanal medication. Every new biomaterial based on ethnobotanic should be carefully tested to allow its clinical applicability reinforcing the relevance of this preliminary study. However, physicochemical and biocompatibility tests are essential to future utilization of herbal medicines in Endodontics

Management of dens invaginatus type III with large periradicular lesion.

AIM: This study describes a clinical case of type III dens invaginatus with an extensive periradicular lesion treated successfully. BACKGROUND: Dens invaginatus is a maldevelopment of the dental germ which occurs as a result of the invagination of the enamel organ. These cases may present difficulties with respect to its diagnosis and treatment because of canal morphology. The success of endodontic therapy requires a knowledge of dental anatomy and its anomalies. CASE REPORT: A 17-year-old female patient is reported presenting right maxillary lateral incisor (tooth no. 7) classified as type III dens invaginatus with necrotic pulp and presence of an extensive radiolucid lesion. Endodontic treatment was recommended for tooth. However, intracanal exudate was present, suggesting a resistant infection. Enucleation of the lesion was performed as a complementary approach. The root canal obturation was carried out by the gutta-percha thermoplastification technique with root canal sealer, followed by restoration of the tooth. Healing of the lesion with hard tissue formation was confirmed at follow-up. CONCLUSION: A combination of endodontic and surgical treatments were fundamental to the maintenance of the tooth. The treatment was considered successful. CLINICAL SIGNIFICANCE: Root canal therapy of dens invaginatus should be based on a thorough clinical and radiographic evaluation. The knowledge of classification and anatomical variations of teeth with dens invaginatus are of great importance for correct treatment.