Effect of systemic antibiotic therapy on pulp repair following extrusive luxation and avulsion in a murine model: A histomorphological study.

BACKGROUND/AIM: The evidence for any benefit of systemic antibiotic therapy on pulp survival following extrusive luxation and avulsion is inconclusive. The aim of this study was to evaluate the effect of systemic antibiotic therapy with amoxycillin and tetracycline for 7 days on different aspects of dental pulp repair in a murine model. MATERIAL AND METHODS: The right maxillary incisor of 180 4 to 8-week-old male Wistar rats underwent extrusive luxation or avulsion. The animals were then treated with saline solution (control), tetracycline, or amoxicillin administered intra-gastrically for 7 days, and euthanized at 7, 15, and 30 days post-operatively. The layer of odontoblast cells, reparative dentin deposition, Hertwig's epithelial root sheath, pulp necrosis, and periapical inflammatory infiltrate were histomorphologically analyzed and scored. Mann-Whitney, Kruskal-Wallis, and Dunn tests were used to compare mean scores for the different procedures, treatments, and times (p ≤ .05). RESULTS: Significant differences were observed between luxated and avulsed teeth (p < .05). In luxated teeth, no differences were observed among treatments and times, except for more tertiary dentin deposition in the coronal third with the use of tetracycline compared with amoxicillin at 15 days (p < .05). In avulsed teeth, higher scores for the layer of odontoblast cells and lower scores for periapical inflammatory infiltrate at 7 days and pulp necrosis at 7 and 15 days were observed in the amoxicillin group compared to the saline and tetracycline groups (p < .05). At 30 days, however, no differences were observed among treatments. CONCLUSIONS: The use of systemic antibiotic therapy with tetracycline or amoxicillin for 7 days did not contribute to pulp repair following extrusive luxation or avulsion in rats. However, the results warrant further research into the use of amoxicillin for a more extended period of time in cases of avulsion.

Calcific metamorphosis of pulp after extrusive luxation.

BACKGROUND/AIM: The literature on the pathogenesis of extrusive dental luxation has been focused on periodontal tissue responses, with little attention given to the pulp. The aim of this study was to evaluate the response of dental pulp of teeth following extrusive luxation in a rat model. MATERIAL AND METHODS: The maxillary right central incisors of 30 rats were extrusively luxated and repositioned after 5 minutes. The animals were euthanized after 7, 15, and 30 days to provide three groups: I, II, and III, respectively (n = 10). Histological sections were stained with H and E for histomorphometric analysis of the odontoblast layer, reparative dentin deposition, Hertwig's epithelial root sheath, pulp necrosis, and periapical inflammatory infiltrate. RESULTS: In most cases, new vascular formation occured in association with reparative dentin deposition on the root walls and within the pulp. In some cases, dentin deposition occupied the entire pulp space over time, with no other types of non-odontogenic hard tissues being observed. Pulp necrosis with the presence of periapical inflammatory infiltrate was also observed in a few cases. No statistical differences were observed among the studied groups. CONCLUSIONS: Following extrusive luxation, calcific metamorphosis of the pulp is very likely to occur.

Estratégia de educação dos orientadores educacionais para atuarem em casos de traumatismos dentários / Educational strategy of educational mentors to act in cases of dental trauma

Objetivo: avaliar o efeito da educação continuada na aquisição e consolidação de conhecimento sobre avulsão dentária dos Orientadores Educacionais do Ensino Fundamental de escolas públicas do município de Maringá-PR, em relação aos corretos procedimentos a serem adotados imediatamente após a ocorrência de uma avulsão dentária. Material e Métodos: Trata-se de um estudo de campo, descritivo-exploratório, de abordagem quantitativa desenvolvido com os Orientadores Educacionais do Ensino Fundamental da rede pública do Município de Maringá, PR. Consideraram-se dois grupos de profissionais entrevistados: submetido à intervenção oral e visual e submetido à intervenção oral e visual, reforçada por outros meios visuais, e o grupo controle, anterior à intervenção. Aplicou-se um questionário dividido em três partes: dados demográficos, conhecimento/domínio sobre traumatismos dentários em geral e a avulsão, em especial, sendo a terceira o conhecimento/domínio sobre as atitudes a serem adotadas em relação ao manejo imediato dos dentes avulsionados .No questionário,utilizou-se uma escala indireta para medir as atitudes dos participantes, a escala de Likert e para interpretação das respostas aplicou-se uma escala de escores de 0 a 4. A intervenção propriamente dita foi a instituição de um Programa de Educação Continuada para capacitação dos envolvidos. A consistência interna do instrumento foi medida por meio do coeficiente Alfa de Cronbach. Para medir a diferença entre os escores atribuídos, utilizou-se o teste de Kruskal-Wallis, seguido do teste de comparações múltiplas de Dunn. Resultados: Foram observadas diferenças estatisticamente significativas para ambos os domínios, Conhecimento e Atitude, quando se comparou o conhecimento prévio e após a realização da capacitação, seja por meio da comunicação oral e visual ou quando houve reforço visual. No entanto, não houve diferenças entre o conhecimento adquirido entre esses dois grupos. Conclusão: A educação continuada, por meio da comunicação oral e visual foi eficaz na aquisição e consolidação de conhecimento dos Orientadores Educacionais do Ensino Fundamental de escolas públicas do município de Maringá-PR sobre avulsão dentária e os corretos procedimentos a serem adotados imediatamente após a sua ocorrência(AU)

Aim: To evaluate the effect of continuing education on the acquisition and consolidation of knowledge about dental avulsion of Primary School Education Mentors of public schools in the city of Maringá-PR, in relation to the correct procedures to be adopted immediately after the occurrence of a dental avulsion. Materials and methods: This is a field-based, descriptive-exploratory, quantitative approach developed with the Educational Mentors of Elementary School of the public network of the city of Maringá, PR. Two groups of professionals were interviewed: submitted to oral and visual intervention; and submitted to oral and visual intervention, reinforced by other visual means, and the control group, prior to the intervention. A questionnaire was applied divided into three parts: demographic data, knowledge / domain on dental trauma in general, and avulsion in particular; and the third, knowledge / domain about the attitudes to be adopted in relation to the immediate management of avulsed teeth. In the questionnaire, an indirect scale was used to measure the participants' attitudes, the Likert scale and for the interpretation of the answers a score scale of 0 to 4 was used. The intervention it self was the institution of a Continuing Education Program to empower those involved. The internal consistency of the instrument was measured by Cronbach's alpha coefficient. To measure the difference between the assigned scores, the KruskalWallis test was used, followed by Dunn's multiple comparison test. Results: Statistically significant differences were observed for both domains, Knowledge and Attitude, when comparing the previous knowledge and after the realization of the training, either through oral and visual communication or when there was visual reinforcement. However, there was no difference between the knowledge acquired between these two groups Conclusion: Continuing education through oral and visual communication was effective in acquiring and consolidating the knowledge of Primary School Education Advisors of public schools in the municipality of Maringá-PR on dental avulsion and the correct procedures to be adopted immediately after its occurrence(AU)

Eficácia dos solventes no retratamento endodôntico de obturações realizadas com resilon/epiphany / Efficacy of solvents in the endodontic retreatmet of obturation performed with resilon/epiphany

O objetivo deste estudo foi a comparação in vitro da efetividade de três diferentes solventes: xilol, eucaliptol e Óleo de Laranja, usados durante o retratamento endodôntico de canais obturados com o sistema Resilon/Epiphany. Para cada grupo experimental constituído por 15 dentes foram analisados: o tempo, em minutos, requerido para a remoção do material obturador; e a análise comparativa nos terços cervical, médio e apical da ação dos solventes quanto ao grau de limpeza proporcionado, avaliando radiográfica e macroscopicamente os espécimes com atribuição de escores. Todos os solventes mostraram-se potencialmente aceitos, sendo o Xilol e o Óleo de Laranja mais rápidos que o Eucaliptol (p>0.05); o terço cervical e médio das amostras examinadas não apresentaram diferença estatisticamente significante [ps 0.05); os grupos onde se usou os solventes Xilol e Eucaliptol tiveram uma tendência a apresentar maior quantidade de resíduos de material obturador no terço apical das amostras. Dentre os solventes avaliados, maior rapidez de ação foi observada para o óleo de laranja e o xilol, e menor quantidade de resíduos no terço apical para o óleo de laranja.

The aim of this study was to compare the "in vitro" effectiveness of three different solvents, xylol, eucalyptol and orange oil, in the endodontic retreatment of channels filled with Resilonl Epiphany system. For each experimental group of 15 teeth it was evaluated: time in minutes required to remove the filling material, comparative evaluation of cervical, middle and apical thirds, the action of solvents according with the levei of cleaning obtained, by radiographic and macroscopic analysis using scores. Ali of the solvents were potentially accepted, but the xylol and the orange oil were faster than eucalyptol (p>0.05); the cervical and middle thirds of the sample did not show significant statistic differences (p~0.05); the groups that used xylol and eucalyptol showed a tendency of leaving more filling material in the apical third of the samples; Among the solvents tested, the faster action was observed for orange oil and xylol and smaller amount of filling material in the apical third for orange oil.

Capacidade de limpeza de alguns agentes auxiliares do preparo biomecânico em dentes portadores de canais laterais (Estudo em microscopia eletrônica de varredura) / Cleaning efficiency assessment of some auxiliary substances during the preparation of teeth with lateral canals (a SEM study)

O objetivo deste trabalho foi avaliar a eficiência de limpeza de diferentes substâncias irrigadoras auxiliares durante o preparo biomecânico em dentes portadores de canais laterais. Foram utilizados 40 dentes pré-molares inferiores humanos recém-extraídos, com canal único. Confeccionou-se em cada dente, três canais laterais (terços cervical, médio e apical). Os dentes foram divididos em quatro grupos, em função das substâncias utilizadas: Grupo I-Hipoclorito de sódio a 1% + EDTA; Grupo II-Endo-PTC + hipoclorito de sódio a 0,5%; Grupo III-File-Eze; Grupo IV-Clorexidina a 2%, em forma de gel. O preparo biomecânico dos canais radiculares foi realizado utilizando o sistema de instrumentação rotatória, Profile 0.04, técnica “crown-down”. Apos o preparo dos canais as raízes foram seccionadas longitudinalmente e então preparadas para análise das paredes dos canais em microscopia eletrônica de varredura, a qual se analisou a obstrução ou não dos canais laterais.O hipoclorito de sódio associado ao EDTA propiciou menor obstrução dos canais laterais; mais obstruções ocorreram no terço apical.

The aim of this work was to assess the cleaning efficiency of different auxiliary substances during the biomechanical preparation of teeth with lateral canals. 40 human lower pre-molar teeth with just one canal were used; three lateral canals (cervical, mid and apical thirds) were made in each tooth. The teeth were divided into 4 groups of 10 specimens each according to the substance used: Group I-1% sodium hypochlorite + EDTA; Group II-Endo-PTC + 0,5% sodium hypochlorite; Group III-File-Eze; Group IV-2% Chlorexidine gel. The root canal biomechanical preparation was carried out using rotating instrumentation, Profile 04 with “crown-down” technique.The teeth were split along their long axis in a buccolingual direction and prepared for scanning electron microscopic analysis. The results concluded that the sodium 1% sodium hypochlorite + EDTA showed best cleaning of lateral canal; apical third showed most obstruction of lateral canal.