Técnica intralesional en endodoncia con injerto aloplástico transforamen apical / Intralesional endodontic technique with apical transforaminal alloplastic graft

La endodoncia es preventiva cuando sacrifica la totalidad o parte del tejido pulpar vital para evitar una posible invasión microbiana a los tejidos de so- porte del diente. Esta endodoncia pasa a ser curativa cuando se instala en ellos la noxa bacteriana, donde la farmacoterapéutica local alcanza una relevancia significativa. Cuando se realiza la obturación del conducto radicu- lar con un biomaterial no reabsorbible y se invade el periodonto, la posterior reparación posendodóntica solo se realiza a expensas del hueso medular y se impide el cierre de la trayectoria final del conducto radicular con tejido mineralizado de origen perio- dontal (cemento secundario). Aplicando una técnica intralesional, ya sea transfo- ramen apical o utilizando como vector un trayecto fistuloso, se viabiliza una terapia intralesional con biomateriales biodegradables y bioactivos. Se obtiene así, mayor calidad y rapidez en la regeneración ad integrum de los tejidos lesionados, por medio de la activación de la fase defensiva-constructiva y el cierre del foramen apical con tejido mineralizado. Los tejidos afectados curan con una cinética significativamente más rápida, sin recurrir a la cirugía complementaria de la endodoncia, procedimiento invasivo asociado con ciertos efectos adversos (AU)

Endodontics is preventive when it sacrifices all or part of the vital pulp tissue to avoid possible microbial invasion of the supporting tissues of the tooth. This endodontics becomes curative when bacterial noxa settles in them, where local pharmacotherapeutics reaches significant relevance. When root canal obturation is performed with a non-resorbable biomaterial and the periodontium is invaded, the subsequent postendodontic repair is only performed at the expense of the medullary bone and the closure of the final trajectory of the root canal with mineralized tissue of periodontal origin is prevented. (Secondary cement). Applying an intralesional technique, be it apical transformation or using a fistulous tract as a vector, intralesional therapy with biodegradable and bioactive biomaterials becomes viable. In this way, greater quality and speed is obtained in the ad integrum regeneration of injured tissues, through the activation of the defensive-constructive phase and the closure of the apical foramen with mineralized tissue. Affected tissues heal with significantly faster kinetics, without resorting to complementary endodontic surgery, an invasive procedure associated with certain adverse effects (AU)

Tissue repair after orbital reconstruction using polypropylene mesh implants: A histological study in dogs / Reparo tecidual após reconstrução de órbita com implante de malha de polipropileno: um estudo histológico em cães

Purpose: This experimental study aimed to assess the histological outcomes of orbit reconstruction with a polypropylene mesh implant in an animal model using dogs. Methods: The right and left orbits of 12 dogs were fractured in order to simulate orbital fractures similar to those occurring in humans as a result of trauma. The orbits were reconstructed with a polypropylene mesh positioned approximately 10 mm beyond the bone defect borders. The 24 orbits were divided into four groups of six: one group was given one polypropylene mesh layer; another group received two layers; a third group was given three polypropylene mesh layers; and the fourth group did not receive any implant (control group). The dogs were divided into clusters of four animals and were euthanized 15, 30, or 60 days after the surgery. The orbit medial wall was removed, and samples were subjected to histological polypropylene mesh analysis by optical microscopy. Data were analyzed using a non-parametric test with a 5% level of significance. Results: It was found that the polypropylene mesh caused a mild to moderate tissular reaction. Conclusion: The implant was well tolerated even with two or three overlapping layers.

Objetivo: Trata-se de estudo experimental em que se reconstruíram os continentes orbitais de 12 cães com implante de tela de polipropileno. Metodologia: Os continentes orbitais foram fraturados simulando as fraturas orbitais que ocorrem em humanos devido ao trauma e reconstruídas com tela de polipropileno cortadas com extensão de cerca de 10mm além da margem do defeito ósseo. Utilizaram-se uma, duas ou três camadas de tela de polipropileno nas órbitas teste e algumas órbitas, somente fraturadas, serviram como controle. Os cães foram sacrificados nos tempos de 15, 30 e 60 dias de pós-operatório; os tecidos das órbitas teste e controle foram removidos e preparados para análise histológica em microscopia óptica. Os resultados obtidos pela análise histológica foram submetidos a análise estatística não paramétrica com 5% de significância. Resultados: A tela de polipropileno causou reação tecidual de leve a moderada nos tecidos. Conclusão: O implante foi bem tolerado, mesmo quando a tela foi superposta em duas ou três camadas.