Use of Marsupialization as a Definitive Treatment for Large-sized Dentigerous Cysts in a Patient with Mucopolysaccharidosis Type I.

The correct diagnosis is fundamental for the appropriate treatment to be employed in a particular pathology. The best treatment is not the one that solves only local problems, fragmenting the patient, and therefore, it is necessary to integrate the entire systemic condition of the individual before initiating any local treatment. This context inevitably requires dentistry to participate in a multidisciplinary approach, where the role of the dentist is expanded in concepts that encompass ethics, human dignity, and professional valorization. This article describes a clinical case of a patient with mucopolysaccharidosis type I, whose treatment of cystic lesions present in the mandible was exclusively performed through marsupialisation. The objective of this study is to demonstrate, within the complexity of this rare syndrome, the difficulties of diagnosis and the need for evaluation of the patient beyond the limits of the oral cavity, as well as to report two cases of large dentigerous cysts, surgically treated conservatively through marsupialisation, without the need for re-approach for enucleation and without recurrences over a 20-year period.

Photobiomodulation Therapy Improves Postoperative Pain and Edema in Third Molar Surgeries: A Randomized, Comparative, Double-Blind, and Prospective Clinical Trial.

PURPOSE: Laser light has biological effects that can modulate inflammatory processes. Thus, this study aimed to evaluate the effects of photobiomodulation (PBM) therapy on pain, edema, and trismus after the extraction of retained third molars. METHODS: A split-mouth, double-blind, randomized clinical trial (RCT) was conducted in 13 patients with similar bilateral third molars who received intraoral application PBM therapy at 4 points with a diode laser at 810 nm wavelength, 6 J (100 mW, 60 seconds/point) on 1 side (the PBM side); and laser irradiation simulation on the other side (SHAM side). The pain was assessed through visual analog scale (VAS) at 0, 12, 24, 48, and 72 hours, number of analgesic-relief (NAR), and mean time of first analgesic use; edema, through VAS, and linear facial measurements at 0, 24, 48, and 72 hours; and trismus, through the mouth opening measurements at 0, 24, 48, and 72 hours. The repeated-measures analysis was applied to assess the effect of the treatment, followed by Tukey's post hoc test for multiple comparisons (P < .05). RESULTS: Thirteen patients (61.77% male and 38.63% female) with age of 24.16 ± 2.06 participated in this research. VAS showed that PBM controlled pain better (7.56 ± 6.25) than SHAM (32.25 ± 22.78) at 24 hours (P < .001) and 48 hours (19.47 ± 9.27 and 39.87 ± 4.21, respectively) (P = .011). VAS also showed that PBM controlled edema better (19.7 ± 13.27) than SHAM (32.38 ± 15.28) at 24 hours (P = .037) and 48 hours (19.47 ± 13.11 and 39.87 ± 22.77, respectively) (P = .002). CONCLUSION: The PBM therapy in this study resulted in pain and edema reduction after third molar surgery and may be considered as adjuvant therapy after the surgical procedure.

The effectiveness of hydroxyapatite-beta tricalcium phosphate incorporated into stem cells from human exfoliated deciduous teeth for reconstruction of rat calvarial bone defects.

OBJECTIVE: To investigate the effects of stem cells from the pulp of human exfoliated deciduous teeth (SHED) on biphasic calcium phosphate granules (BCP) to repair rat calvarial defects as compared to autogenous bone grafting. MATERIALS AND METHODS: A defect with a 6-mm diameter was produced on the calvaria of 50 rats. BCP granules were incorporated into SHED cultures grown for 7 days in conventional (CM) or osteogenic (OM) culture media. The animals were allocated into 5 groups of 10, namely: clot, autogenous bone, BCP, BCP+SHED in CM (BCP-CM), and BCP+SHED in OM (BCP-OM). The presence of newly formed bone and residual biomaterial particles was assessed by histometric analysis after 4 and 8 weeks. RESULTS: The autogenous group showed the largest newly formed bone area at week 8 and in the entire experimental period, with a significant difference in relation to the other groups (P < 0.05). At week 8, BCP-CM and BCP-OM groups showed homogeneous new bone formation (P = 0.13). When considering the entire experimental period, the BCP group had the highest percentage of residual particle area, with no significant difference from the BCP-CM group (P = 0.06) and with a significant difference from the BCP-OM group (P = 0.01). BCP-CM and BCP-OM groups were homogeneous throughout the experimental period (P = 0.59). CONCLUSIONS: BCP incorporated into SHED cultures showed promising outcomes, albeit less pronounced than autogenous grafting, for the repair of rat calvarial defects. CLINICAL RELEVANCE: BCP incorporated into SHED cultures showed to be an alternative in view of the disadvantages to obtain autogenous bone graft.

Improvement of bone repair with l-PRF and bovine bone in calvaria of rats. histometric and immunohistochemical study.

OBJECTIVES: The effect of leucocyte- and platelet-rich fibrin (L-PRF), associated with DBBM (deproteinized bovine bone mineral; Bio-Oss®) was investigated and compared with autogenous bone graft as a standard material for filling bone defects. MATERIAL AND METHODS: A defect of 5 mm in diameter was performed in 40 calvaria of rats. The animals were divided into 5 groups and received blood clot (CO), autogenous bone (AUT), DBBM (BIO), L-PRF, or DBBM associated with L-PRF (BIO-LPRF). After 4 and 8 weeks, bone regeneration was assessed by histometric and immunohistochemical analyses. RESULTS: The highest mean percentage of bone formation found at 4 and 8 weeks was observed for the BIO-L-PRF group (54.0% ± 2.8 and 63.6% ± 2.2). The lowest mean percentage at 4 and 8 weeks was observed for the CO group (16.7% ± 2.5 and 20.5% ± 1.0). There was statistical similarity among the AUT, BIO, and L-PRF groups. The expressions OC, RUNX 2, and VEGF showed a favorable aspect in the formation of new bone for BIO-L-PRF. VEGF was the marker with the highest expression because it was related to the initial healing process, promoting the migration and proliferation of endothelial cells in the region of the defect. Even after weeks, VEGF maintained a moderate expression. CONCLUSIONS: The association of L-PRF with DBBM improved bone repair when these biomaterials were inserted into the defects of the calvaria of rats. CLINICAL RELEVANCE: This reinforces the good performance of bovine bone and L-PRF as filler materials, especially when associated.

Doxycycline and Autogenous Bone in Repair of Critical-Size Defects.

PURPOSE: The association of doxycycline (DOX) and autogenous bone on repair of critical-size defects was evaluated. MATERIALS AND METHODS: Fifty albino rats were divided into 5 groups (n = 10). A 5-mm diameter defect was treated with: control (CO)-blood clot; DOX in Natrosol (NAT)-10% gel; NAT-gel; particulate autogenous bone (PAB); and PAB + DOX - PAB associated with 10% DOX gel. The animals were euthanized at 4 and 8 weeks postoperatively. Histomorphometric analysis was performed to assess the percentage of new bone in the defect area. Statistical analysis of the results was performed using analysis of variance and the Tukey test (P < 0.05). RESULTS: The results showed that new bone formation was limited to the margins of the defect. At 4 and 8 weeks, the group PAB + DOX showed higher bone formation (38.59% and 47.86%, respectively), with statistical difference in comparison with the CO (19.52%) at 4 weeks and CO (18.80%), DOX (22.05%), and NAT (15.89%) at 8 weeks (P < 0.05). CONCLUSIONS: The association of 10% DOX with autogenous bone significantly improved bone healing in critical-size defects.

Open Reduction in Pediatric Condylar Fracture.

Facial fractures in children are rare. Lack of pneumatization, fat pockets, mixed dentition, contribute to the elasticity and bone stability. When mandibular fractures occur in children, most often involve the condyle by indirect trauma. Such fractures are the center of discussion on the form of treatment if this should be performed conservatively, or held the reduction and fixation of the fracture with surgical exposure of the fragments. In condylar fractures in children, in most patients, the proposed treatment is closed reduction. Treatment with open reduction and fixation has its specific indications. In this case, the authors report a patient cycling accident victim, with cut-contusion injury in ment with limited mouth opening and left condylar fracture with medial rotation. The treatment was the reduction and fixation of fragments by open process.

Anterior pericranial flap for frontal sinus duct obliteration: is it a valuable resource?

Inappropriate treatments of frontal sinus fractures may lead to serious complications, such as mucopyocele, meningitis, and brain abscess. Assessment of nasofrontal duct injury is crucial, and nasofrontal duct injury requires sinus obliteration, which is often accomplished by autogenous grafts such as fat, muscle, or bone. These avascular grafts have an increased risk of resorption and infection and donor site morbidity. For these reasons, pericranial flap, which is vascular, should be used for frontal sinus obliteration. The pericranial flap presented with less morbidity procedure and has decreased infection rates, which justifies its use in frontal sinus obliteration. This study aimed to report a case of a comminuted frontal sinus fracture with a brief literature review, regarding the use of pericranial flap. The authors report a case of a 23-year-old male subject with a severely comminuted fracture of the anterior and posterior walls of the frontal sinus. The patient was successfully treated by cranialization with frontal sinus duct obliteration, using anterior pericranial flap. The patient was followed up for 16 months with no postoperative complication, such as infection. Pericranial flap is a good resource for frontal sinus duct obliteration because it is a durable and well-vascularized flap, which determines low rates of postoperative complications.

Deep impacted mandibular second molar: a case report.

Impaction of mandibular second molars is relatively rare. A case of a deep impacted mandibular right permanent second molar in a 26-year-old woman is presented. This article describes the extraction of the tooth and reports the risks of the surgical procedure. Careful manipulation of tissues and correct application of mechanical principles involved in tooth extractions allowed surgical success.

Modified coronectomy procedure for mandibular third molar: association of platelet-rich fibrin / Técnica de coronectomia de terceiro molar inferior modificada: associação de plasma rico em fibrina

ABSTRACT The present case report describes a modified technique of coronectomy for mandibular third molar with association of Platelet-Rich Fibrin Graft (PRF). The panoramic radiograph showed proximity of the roots of the vertical positioned 48 tooth with the superior wall of the mandibular canal, since the erasure of the superior cortical of the mandibular canal was observed. Due to the risk of injury to the inferior alveolar nerve, the technique of coronectomy was chosen. After the realized the coronectomy, in order to promote the regeneration of soft and hard tissues and also to prevent pulp changes that could lead to pain, pulp necrosis and infection, the PRF graft was used to fill the surgical defect formed by removal of the crown. Good healing evolution was observed and after 12 months of clinical and radiographic follow-up there was complete bone formation in the area where the crown was removed and no complications were observed.

RESUMO O presente caso clínico descreve uma técnica modificada de coronectomia de um terceiro molar inferior com a associação de Plasma Rico em Fibrina (PRF). A radiografia panorâmica mostrou proximidade das raízes do dente 48 posicionado verticalmente com a cortical superior do canal mandibular, The panoramic radiograph showed proximity of the roots of the vertical positioned 48 with the superior wall of the mandibular canal, ma vez que, observou-se o desaparecimento da cortical superior do canal. Devido ao risco de lesão ao nervo alveolar inferior, a técnica de coronectomia foi empregada. Depois de realizada a coronectomia, com o objetivo de favorecer a regeneração dos tecidos moles e duros e também de prevenir alterações pulpares que poderiam causar dor, necrose pulpar e infecção, o enxerto de PRF foi usado para preencher o defeito formado pela remoção da coroa. Boa evolução cicatricial foi observada 12 meses pós-operatórios, o acompanhamento clínico e radiográfico mostrou completa formação óssea na área onde a coroa foi removida e não foram observadas complicações.

Effect of topical application of chlorhexidine and metronidazole on the tissue repair of palatal wounds of rats: a clinical and histomorphometric study.

OBJECTIVE: This study investigated the effect of topical application of 2% chlorhexidine (GCl) and metronidazole (Gme) pastes for the repair of palatal wounds in rats. STUDY DESIGN: A 4-mm diameter wound was created on the palates of 27 rats separated randomly into 3 groups of 9 animals each, according to the treatment received: GNa (Control: natrosol), GCl, and GMe. The animals were euthanized after 3, 6, and 10 days, and wound closure was clinically and histomorphometrically assessed. RESULTS: Clinical evaluation showed a statistically significant difference in tissue repair with GCl and GMe compared with GNa. In histomorphometric analysis, the highest values in the areas of the epithelium and keratin were observed for GCl and GMe; however, compared with Gna, no statistically significant differences were observed. CONCLUSIONS: GCl and GMe pastes showed promising results with regard to tissue repair from a clinical point of view. Histologically, premature closure of wounds was noted in most specimens on day 6. Although no statistically significant differences were observed among the experimental groups with regard to histometry of the epithelium and keratin, the highest means were observed for GCl.

Remoção de terceiro molar superior deslocado para o espaço bucal / Removal of upper third molar displaced to the buccal space

Os autores descrevem um caso clínico de deslocamento de germe dentário de terceiro molar superior esquerdo para o espaço bucal em um paciente de 13 anos de idade. A localização do dente em posição profunda com envolvimento do corpo adiposo do bucinador dificultou a sua localização, ainda não descrita, nas condições em questão, na literatura. Com a Tomografia Computadorizada de Feixe Cônico (TCFC), foi possível localizar o dente deslocado e planejar a sua remoção. Os riscos e benefícios das extrações de germes de terceiros molares precisam ser avaliados devido ao grande risco de deslocamentos... (AU)

The authors describe a case of displacement of left upper third molar tooth germ to the buccal space in a patient 13 years old. The deep position of the tooth with involvement of the fat body of the buccinator made it difficult its location, still not described, under the concerned conditions, in the literature. With the cone beam computed tomography (CBCT), it was possible determine the location of the tooth and plan his removal. The risks and benefits of third molar tooth germ extraction should be evaluated because there is a greater chance of displacement... (AU)

Papillary mucinous cystadenocarcinoma: rare malignant tumor in minor salivary gland / Cistadenocarcinoma papilar mucinoso: tumor maligno raro em glândula salivar menor

ABSTRACT Clinical case description of a papillary mucinous cystadenocarcinoma, extremely rare malignant tumor in the salivary gland and difficult to diagnose, in geriatric patient. Patient with 86 years old was referred for treatment with nodular lesion on the inner side of left lower lip extending to the bucal mucosa, without any clinical appearances of malignancy. The lesion was asymptomatic, had flabby consistency and slow growth. Despite the favorable clinical features, after surgical removal, was diagnosed as papillary mucinous papillary mucinous cystadenocarcinoma. Nonetheless, the cellular atypia found was considered to be mild and immunohistochemical evaluation the reaction to Ki-67 was low, indicating a low rate of proliferation of the tumor. Medical evaluation confirmed the absence of systemic disorders or distant metastases. Although it is a malignant lesion, due to low degree of proliferation of lesion and the careful follow-up carried out, there was a favorable evolution after conservative treatment in a follow-up period of 11 years and six months.

RESUMO Descrição do caso clínico de um cistadenocarcinoma papilar mucinoso, tumor maligno extremamente raro em glândula salivar e de difícil diagnóstico, em um paciente geriátrico. Paciente com 86 anos foi encaminhado para tratamento com lesão nodular na parte interna do lábio inferior do lado esquerdo estendendo-se para a mucosa jugal sem qualquer aspecto clínico de malignidade. A lesão era assintomática, apresentava consistência flácida e crescimento lento. Apesar das características clínicas favoráveis, após a remoção cirúrgica, o diagnóstico foi de cistadenocarcinoma papilar mucinoso. Entretanto, a atipia celular encontrada foi considerada leve e a reação imunohistoquímica para o Ki67 baixa, indicando uma baixa taxa de proliferação do tumor. A avaliação médica confirmou a ausência de transtornos sistêmicos e de metástases a distância. Apesar de se tratar de uma lesão maligna, devido ao baixo grau de proliferação do tumor e o acompanhamento cuidadosos realizado houve uma evolução favorável após o tratamento conservador após um período de acompanhamento de 11 anos e 6 meses.

Explorando o volume 3D em TCFC frente aos elementos dentais ectópicos. Relato de casos / Exploring the 3D volume CBCT face of ectopic teeth. Case reports

Os exames por Tomografia de Feixes Cônicos proporcionam inovadoras perspectivas de avaliação de todo o volume adquirido, aumentando assim a previsibilidade da localização exata de elementos dentais ectópicos, através da compreensão dos planos tomográficos em terceira dimensão. Os autores relatam casos de dentes supranumerários ectópicos encontrados incidentalmente em exames tomográficos para planejamento de reabilitação com implantes dentários e salientam a importância da tomografia computadorizada como método de diagnóstico por imagens mais preciso na Odontologia, permitindo conseguir um plano de tratamento mais completo para os pacientes.

Cone Beam Tomography assessments provide innovative perspectives on the evaluation of the entire acquired volume, thereby increasing the predictability of the exact location of ectopic teeth, through understanding of tomographic planes in three dimensions. The authors report cases of ectopic supernumerary teeth found incidentally in CT scans for planning dental implants. They stress the importance of computed tomography as a diagnostic method for more accurate images in dentistry, allowing to achieve a more full treatment plan for patients.

Comparative study of rules employed for calculation of pediatric drug dosage.

The present study was conducted to evaluate the utilization of Clark's, Salisbury and Penna's rules and the Body Surface Area (BSA) formula for calculation of pediatric drug dosage, as well as their reliability and viability in the clinical use. These rules are frequently cited in the literature, but much controversy still exists with regards to their use. The pediatric drug dosage was calculated by utilization of the aforementioned rules and using the drugs Paracetamol, Dipyrone, Diclofenac Potassium, Nimesulide, Amoxicillin and Erythromycin, widely employed in Pediatric Dentistry. Weight and body surface areas were considered of children with ages between 1 and 12 years old as well as the dosage for the adult. The pediatric dosages achieved were compared to the predetermined dosages in mg kg-1 herein-named standard dosages. The results were submitted to the parametric test ANOVA and to the Tukey test (p<0,05). The antibiotics and Diclofenac provides acceptable utilization of the rules in pediatric dentistry, however for the Dipyrone, the dosages obtained by the rules suggest their clinical ineffectiveness. For the Paracetamol, the Penna's rule and the BSA formula should not be clinically employed, especially for children between 1 and 5 years old, once such dosages were much close to the hepatotoxic dosage of the drug. It can be concluded that the use of the rules for safe calculation of the pediatric drug dosage is possible and it depends on the used drug and age group.

Introdução acidental de terceiro molar superior em seio maxilar / Accidental introduction of upper third molar into maxillary sinus

Introdução: O deslocamento de dentes ou raízes dentárias para espaços anatômicos é uma complicação associada com forças inadequadas durante movimentos de luxação aplicados aos fórceps e extratores para extrações dentárias próximas de cavidades aéreas. Os autores descrevem o deslocamento acidental de terceiro molar superior não irrompido para dentro do seio maxilar. Método: Após 18 dias foi realizada a osteotomia da parede lateral do seio maxilar para remoção do dente deslocado. No pós-operatório de 7 dias foi removida a sutura e não foi observado qualquer sinal de infecção. Resultado e conclusão: Após 12 meses de acompanhamento, o paciente não relatou queixas de dor nem de infecção sinusal.

Introduction: The displacement of the teeth or dental roots into anatomic spaces is a complication associated with inadequate forces during surgical movements applied by forceps and elevators, and proximity with air-filled cavities. The authors describe the accidental displacement of an unerupted maxillar third molar into maxillary sinus. Method: After 18 days, it was realized the osteotomy of lateral wall of the maxillary sinus to removal of the dislocated tooth. On seventh day postoperatively, the suture was removed and any signal of infection was not observed. Result and conclusion: After 12 months of accompaniment, the patient did not tell complaints of pain and nor of sinusal infection.

Comparative study of rules employed for calculation of pediatric drug dosage

O presente estudo foi realizado com a finalidade de avaliar as fórmulas de Clark, Salisbury, Área da Superfície Corpórea (ASC) e Penna, quanto a sua confiabilidade e viabilidade de uso clínico para o cálculo de doses medicamentosas infantis, uma vez que tais fórmulas são freqüentemente citadas na literatura, mas muita controvérsia ainda existe com relação ao seu uso. As doses infantis foram calculadas utilizando as fórmulas descritas e os medicamentos Paracetamol, Dipirona, Diclofenaco de Potássio, Nimesulida, Amoxicilina e Eritromicina, largamente usados na clínica odontopediátrica. Foram considerados parâmetros como o peso e área da superfície corpórea de crianças com idades entre 1 e 12 anos e a dose para o adulto. As doses obtidas foram comparadas às doses em mg/kg consideradas como padrão de referência para os medicamentos. Os resultados foram submetidos ao teste paramétrico ANOVA e de Tukey (P<0,05). Os antibióticos e o Diclofenaco propiciam utilização aceitável das fórmulas na Odontopediatria, porém para a Dipirona, as doses obtidas pelas fórmulas sugerem ineficácia clínica. Para o Paracetamol, o uso clínico das fórmulas de Penna e da ASC para crianças entre 1 a 5 anos é contra-indicado, uma vez que as doses obtidas com tais fórmulas aproximaram-se muito das doses hepatotóxicas do medicamento. Pode-se concluir que o uso das fórmulas para o cálculo seguro de doses infantis é viável, dependendo do medicamento utilizado e da faixa etária.

Comportamentos dos pais frente ao uso de medicamentos infantis / Parents´ behavior and the use of medication in children

O objetivo deste estudo foi avaliar o comportamento dos pais frente à administração de medicamentos a seus filhos, uma vez que a utilização de medicamentos pelas crianças fica restrita a iniciativa dos adultos. Um número de 116 pais/responsáveis selecionados foi submetido a uma entrevista na qual foram empregados questionários individuais, visando a obtenção de informações pessoais, além de dados relacionados à farmacoterapia infantil. Os resultados encontrados denotam que, em geral, pais com escolaridade fundamental apresentam menor nível de conhecimento a respeito do uso de medicamentos infantis, do que aqueles com escolaridade superior. Com relação a doses, intervalos entre doses e duração do tratamento, as respostas obtidas foram satisfatórias. Entretando, foi observado um grande número de pais que normalmente apresentam dúvidas quanto à prescrição e automedicam seus filhos. Acredita-se que os vários níveis de conhecimento, opinião e comportamentos expressos pelos pais entrevistados, sejam indicativos da necessidade constante de esclarecimento dos mesmo sobre os cuidados no uso de medicamentos por crianças.

Estudo comparativo de fórmulas disponíveis para o cálculo de doses medicamentosas infantis / Comparative study of available formulas for the calculation of drugs dosage in children

Este estudo avaliou as fórmulas de Bastedo, Young e Dilling, sua confiabilidade e viabilidade de uso na prática clínica. Cento e dezesseis crianças participaram do experimento que propôs o cálculo de doses infantis utilizando as fórmulas descritas e alguns medicamentos largamente usados na clínica odontopediátrica. As doses obtidas através das fórmulas foram comparadas às doses definidas em "mg/kg", consideradas atualmente como padrão de referência para a medição de crianças. Os resultados encontrados sugerem que tais fórmulas não devem ser utilizadas para o cálculo de doses infantis, uma vez que não mostraram coerência na obtenção das doses que permita aplicá-las clinicamente com segurança

Estudo comparativo entre duas formas de tratamento de alveolite: rifamicina em pasta e líquida / Comparative study between two forms of treatmente of dry socket: rifamycin in paste and liquid

A alveolite, complicação mais freqüente no pós-operatório das exodontias, apresenta diversas modalidades de tratamento. Este estudo compara o efeito da Rifamicina B dietilamina nas formas pastosa e líquida no combate da sintomatologia desta patologia. Doze voluntários, portadores de alveolite, foram divididos em dois grupos e tratados com uma das formulações. A avaliação da dor mostrou redução significativa desta a partir da primeira sessão de tratamento em ambos os grupos. Não foram observadas diferenças estatísticas entre as formas de tratamento. A pasta rifocinada mostrou-se adequada no controle da alveolite de forma similar à formulação líquida da Rifamicina B dietilamina

Análise comparativa do efeito anestésico da lidocaína 2 por cento e da prilocaína 3 por cento / Comparative analysis of the anesthetic of the boty lidocaine 2 per cents and prilocaine 3 per cents

Uma análise comparativa das soluçöes anestésicas prilocaína a 3 por cento com felipressina 0,03 UI/ml e lidocaína a 2 por cento com noradrenalina 1:50.000 foi realizada com o objetivo de identificar variaçöes do período de latência, duraçäo da anestesia e quantidade de anestésico necessária para a extraçäo de terceiros molares inferiores em inclusäo bilateral semelhante, bem como o comportamento destas soluçöes anestésicas no controle da dor trans e pós-operatória, associada a analgésicos e antiinflamatórios. 20 pacientes jovens, de ambos os sexos, portadores de terceiros molares inferiores retidos foram submetidos a exodontias. Os resultados mostraram semelhança estatística entre as duas soluçöes anestésicas e garantiram eficácia no controle da dor trans-operatória com quantidades mínimas de soluçäo anestésica (médias de 2,125 e 2,025 tubetes para a prilocaína e lidocaína respectivamente). Portanto, a escolha da soluçäo anestésica deve näo estar relacionada à duraçäo do efeito e período de latência e sim aos aspectos sistêmicos do paciente portador de inclusäo dentária, limitantes do uso de sais anestésicos e vasoconstritores