Comparison of the anesthetic efficacy between bupivacaine and lidocaine in patients with irreversible pulpitis of mandibular molar.

INTRODUCTION: The purpose of this study was to compare the anesthetic efficacy of 0.5% bupivacaine with 1:200,000 epinephrine with that of 2% lidocaine with 1:100,000 epinephrine during pulpectomy in patients with irreversible pulpitis in mandibular posterior teeth. METHODS: Seventy volunteers, patients with irreversible pulpitis admitted to the Emergency Center of the School of Dentistry at the University of São Paulo, randomly received a conventional inferior alveolar nerve block containing 3.6 mL of either 0.5% bupivacaine with 1:200,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine. During the subsequent pulpectomy, we recorded the patients' subjective assessments of lip anesthesia, the absence/presence of pulpal anesthesia through electric pulp stimulation, and the absence/presence of pain through a verbal analog scale. RESULTS: All patients reported lip anesthesia after the application of either inferior alveolar nerve block. By measuring pulpal anesthesia success with the pulp tester, lidocaine had a higher success rate (42.9%) than bupivacaine (20%). For patients reporting none or mild pain during pulpectomy, the success rate of bupivacaine was 80% and lidocaine was 62.9%. There were only statistically significant differences to the success of pulpal anesthesia. CONCLUSIONS: Neither of the solutions resulted in an effective pain control during irreversible pulpitis treatments of mandibular molars.

Análise in vitro da ação antibacteriana de filme nanoestruturado contendo partículas de prata aplicado em superfície de titânio / Analysis in vitro of antibacterial effect of nanostructured film with silver particles applied to titanium surface

Apesar do alto e significativo índice de sucesso dos implantes osseointegráveis, fracassos podem ser acarretados por diversos fatores, tais como falhas cirúrgicas, protéticas, trauma oclusal e por infecções nos tecidos ao redor do implante. As lesões inflamatórias desenvolvidas ao redor de implantes são conhecidas coletivamente como doença peri-implantar, que possui um papel muito importante na falência de implantes, sendo considerada uma das principais causas. O objetivo deste trabalho foi analisar a ação antibacteriana de filme nanoestruturado com partículas de prata aplicado em superfície de titânio de componentes protéticos conectados a implantes, em relação às bactérias predominantes na infecção peri-implantar. Para avaliar a ação antibacteriana do filme nanoestruturado com partículas de prata foi realizado teste microbiológico com cepas de Aggregatibacter actinomycetemcomitans (ATCC 43719), Fusobacterium nucleatum (ATCC 25586) e Porphyromonas gingivalis (ATCC 33277). Discos de titânio sem tratamento formaram o grupo controle (Ti) e discos com filme nanoestruturado com partículas de prata, o grupo teste (NT-Ag). Cada teste foi realizado em triplicata e repetido por três ocasiões separadas. Após 48 horas de incubação dos discos em caldo de infusão de cérebro e coração (BHI), previamente inoculado com as cepas, a 37 °C, em anaerobiose, os discos foram então retirados e colocados em um tubo contendo solução tampão fosfato-salina (PBS) e centrifugados por 1 minuto em aparelho tipo vortex.

O PBS foi diluído em série até 1:100.000, distribuído em placas de ágar sangue e essas foram incubadas por 48 horas, a 37ºC, em anaerobiose e então foi feita a contagem de colônias sobre as placas para posterior calculo das unidades formadoras de colônia (UFC). A análise da adesão bacteriana foi realizada com cepas de Aggregatibacter actinomycetemcomitans (ATCC 43719), Fusobacterium nucleatum (ATCC 25586) e Porphyromonas gingivalis (ATCC 33277), através da leitura dos discos em microscópio eletrônico de varredura Leo 43, após imersão dos discos em BHI inoculado. O teste antibacteriano, realizado com Aggregatibacter actinomycetemcomitans, apresentou valor médio de UFC/mL do grupo teste (NT-Ag) semelhante ao obtido do grupo controle (Ti), não havendo diferença estatística (p<0,01) entre eles. Os testes realizados com Fusobacterium nucleatum e Porphyromonas gingivalis não apresentaram crescimento bacteriano, na etapa de leitura das placas, para os dois grupos, controle (Ti) e teste (NT-Ag). As imagens obtidas, através do microscópio eletrônico de varredura (MEV), demonstraram uma notável redução da adesão bacteriana, nos discos com filme nanoestruturado com partículas de prata (NT-Ag), em comparação com as imagens do grupo controle (Ti), para todas as cepas, porém não são conclusivas. O filme nanoestruturado com partículas de prata não foi efetivo na redução da adesão de A. actinomycetemcomitans.

Despite the high and significant success rate of dental implants, failures can be posed by various factors such as surgical and prosthetic failures, oclusal trauma and infections in the tissues around the implant. The inflammatory lesions developed around implants are collectively known as peri-implant disease, which has a very important role in implant failure and is considered one of the main causes. The aim of this study was to evaluate the antibacterial activity of nanostructured film with silver particles, applied on abutments connected to implants, in relation to the predominant bacteria in peri-implant infection. To evaluate the antibacterial activity of the nanostructured film, microbiological tests were performed with strains of Aggregatibacter actinomycetemcomitans (ATCC 43719), Fusobacterium nucleatum (ATCC 25586) and Porphyromonas gingivalis (ATCC 33277). Untreated titanium discs were the control group (Ti) and discs with the nanostructured film with silver particles formed the test group (NT-Ag). Each test was run in triplicate and repeated on three separate occasions. After 48 hours of discs incubation in brain heart infusion broth (BHI), previously inoculated with the strains, at 37 °C, under anaerobic conditions, the discs were then removed and placed in a tube containing phosphate buffered saline solution (PBS) and vortexed for 1 minute. The PBS was serially diluted up to 1:100,000, distributed in blood agar plates and incubated for 48 hours, at 37 ° C in anaerobiosis and then colonies were counted for subsequent calculation of colony forming units (CFU).

The analysis of bacterial adhesion was performed with strains of Aggregatibacter actinomycetemcomitans (ATCC 43719), Fusobacterium nucleatum (ATCC 25586) and Porphyromonas gingivalis (ATCC 33277) by reading the discs surface in a scanning electron microscope Leo 43, after immersion of the discs on inoculated BHI. The antibacterial test, performed with Aggregatibacter actinomycetemcomitans, obtained CFU/mL medium value from the test group (NT-Ag) similar to the obtained in the control group (Ti), showing no statistical difference (p <0.01) between them. The tests performed with Fusobacterium nucleatum and Porphyromonas gingivalis showed no bacterial growth, in plates reading step, for both groups, control (Ti) and test (NT-Ag). The images obtained by scanning electron microscopy showed a remarkable reduction of bacterial adhesion, on discs with nanostructured film with silver particles (NT-Ag), when compared to the images of the control group (Ti), for all strains, but they were not conclusive. The nanostructured film with silver particles was not effective in reducing bacterial adhesion of A. actinomycetemcomitans.