Treatment of an Acute Apical Abscess in a Patient With Autoimmune Hepatitis Taking Alendronate: A Case Report.

INTRODUCTION: The aim of this study was to report a patient's clinical case who was diagnosed with severe apical abscess and with autoimmune hepatitis (AIH) using immunosuppressive drugs and bisphosphonate. METHODS: A 32-year-old man of black African descent urgently sought dental surgery because of an increase in volume in the right genic region and a nuisance in the region of the lower right second premolar when chewing. After intraoral and radiographic clinical examination, the patient was diagnosed with pulp necrosis and an acute apical abscess. Because he had AIH and was taking corticosteroids and bisphosphonate (alendronate), he was submitted to endodontic therapy as a minimally invasive treatment, considering his systemic state. RESULTS: After 3 years of follow-up treatment with periapical and tomographic radiographic control, bone repair of the periapical region of the tooth was observed. CONCLUSIONS: Through this report, we can infer that it is possible to reverse the condition of a periapical lesion in a tooth with an acute apical abscess and necrotic pulp in an AIH patient who is using alendronate without the need for more invasive procedures and that would put at risk the patient's general and oral condition in the postoperative period.

Can universal adhesive systems bond to zirconia?

OBJECTIVE: To measure the bond strength to zirconia subjected to different surface treatments of universal bonding agents. MATERIALS AND METHODS: Eighty blocks of zirconia were obtained by CAD/CAM milling. The blocks were embedded into PVC tubes, polished sequentially with increasing granulation sandpapers and divided into two groups according to surface treatment: polished or grit-blasted with alumina particles. Each group was then subdivided by bonding agent employed: Z-Prime Plus (control); Scotchbond Universal; All Bond Universal; and Z-Prime Plus + All Bond Universal. Cylindrical composite resin build-ups were constructed atop the blocks using a two-part metal die. Specimens were stored for 24 hours and subjected to microshear bond strength testing. Statistical analyses were performed by means of the F-test (ANOVA), Student's t and Tukey's test. After sputter coating, zirconia surfaces and adhesive interfaces were analyzed by scanning electron microscopy (SEM). RESULTS: Bond strength was superior for grit-blasted zirconia. In specimens with this surface treatment, there were no significant differences between experimental groups. On SEM, blasted surfaces exhibited areas of micromechanical retention and adhesive interfaces exhibited areas of zirconia-adhesive interlocking. CONCLUSION: Universal adhesive systems were able to bond to zirconia. The interlocking promoted by grit-blasting enhanced bond strength. CLINICAL SIGNIFICANCE: Universal adhesive systems simplify bonding to zirconia and enable intraoral repair of fractures.

Pulp Revascularization: A Literature Review.

Reestablishing blood flow and allowing the continuation of root development are some of the objectives of pulp revascularization. This procedure is currently indicated for teeth with incomplete root formation as an alternative to the traditional treatment of apecification, which consists of inserting calcium hydroxide paste into the root canal for a determined time period in order to induce the formation of a calcified barrier. Although it is considered as the most classically employed therapy, the permanence of the paste for long time periods may lead to the weakening of the root due to hygroscopic properties, as well as proteolytic activities of calcium hydroxide. Therefore, there has been a permanent search for alternatives which allow the full development of immature teeth. Revascularization has emerged as such an alternative, and a range of treatment protocols can be found in the scientific literature. The aim of this paper is to accomplish a literature review concerning this issue.

Rehabilitación estética por medio de facetas directas-presentación de casos clínicos / Aesthetic rehabilitation through direct facets - report of cases

En la actualidad, la sociedad prácticamente exige una uniformidad de las características relacionadas con la apariencia física de las personas, lo que hace aumentar la búsqueda por los tratamientos que proporcionen un aspecto más agradable, vinculado a técnicas eficientes y seguras. Las alteraciones dentarias de color, de forma, textura y/o posición contribuyen de modo desfavorable, principalmente en los dientes anteriores, para una armonía facial. El uso de las facetas estéticas, directamente en la boca, es cada vez más enfatizado debido a evolución de los materiales restauradores y de la técnica adhesiva, ofreciendo una mejor relación costo/beneficio para el paciente. El objetivo del presente artículo es presentar casos clínicos en los cuales el tratamiento con facetas directas es una alternativa de tratamiento eficaz, reversible y de fácil realización.

At present, society practically demands uniformity of features in relation to physical appearance, resulting in an increasing number of persons seeking treatment that will provide them with a more pleasant visual appearance, linked to efficient and safe techniques. Alterations in tooth shade, shape, texture and/or position, particularly of anterior teeth, contribute unfavorably to facial harmony. Aesthetic facets placed directly in the mouth have been increasingly emphasized, due to the development of restorative materials and adhesive techniques, offering the patient an even better cost/benefit ratio. The aim of this article is to present clinical cases in which the direct facet was shown to be an efficient, reversible and easy to perform alternative treatment.

Durabilidad de la línea de unión de restauraciones adhesivas

La durabilidad de las restauraciones adhesivas representa un punto crítico en el campo de la restauración dentaria, ya que la biodegradación es un factor decisivo para el fracaso de dichas restauraciones, a lo largo del tiempo. Este artículo busca esclarecer los mecanismos envueltos en el deterioro de la línea de unión, así como apuntar nuevos caminos o desafíos para la obtención de restauraciones adhesivas cada vez más durables.

The durability of adhesive procedures represents a critical point in function of the biodegradation to represent a decisive factor for the failure of the restorations. This aim of this study was to carry through a revision of literature with the purpose to clarify the involved mechanisms in the degradation of the bonding interface, as well as pointing new ways or challenges with respect to the attainment of more durable adhesive restorations.