Treatment of oral myiasis in a patient with implant-supported fixed prosthesis

ABSTRACT Oral myiasis is a rare parasitic disease that requires immediate treatment once diagnosed. However, no standard treatment protocol can be found in the literature. Through a clinical-surgical report, we present the case of an 82-year-old man with lesions extending through the vestibule and alveolar ridge of the maxilla on both sides, in addition to occupying a large part of the palate, with a considerable number of larvae. The patient was initially treated with a single dose of systemic ivermectin (6 mg orally) and topical application of a tampon soaked in ether. The larvae were then surgically removed and debridement of the wound was performed. A crushed tablet of ivermectin 6 mg was applied topically for 2 days, the remaining larvae were again mechanically removed, and the patient received intravenous antimicrobial therapy. Treatment with systemic and topical ivermectin combined with antibiotic therapy and debridement proved to be effective in treating oral myiasis.

Multifocal Analysis of Acute Pain After Third Molar Removal.

Background: To analyze the pain modulation capacity profile in a Brazilian population, the relationship between opioid receptor (OPRM1) and Catechol-O-methyltransferase (COMT) 1polymorphisms and pain modulation capacity was determined through preoperative pain modulation tests and acute postoperative pain control evaluation, swelling, and trismus in 200 volunteers undergoing lower third molar removal. Methods: Psychologic and clinical parameters were measured. Patient DNA was sequenced for single nucleotide polymorphisms in OPRM1 and COMT, and the salivary concentration of interleukin (IL)-2 (IL)-6, interferon (IFN)-γ and tumor necrosis factor (TNF)-α was evaluated. Primary outcomes were the influence of all predictors on the fluctuation of pain intensity using a visual analogue scale (VAS), and swelling and trismus on the 2nd and 7th postoperative days. Preoperative pain modulation capacity (CPM), pain catastrophizing scale (PCS), body mass index (BMI), and surgery duration and difficulty were evaluated. Results: Salivary concentration of IFN-γ and IL-2 as well as the duration of surgery influenced the fluctuation of postoperative pain in the VAS, and in the sum of the differences in pain intensity test at 8, 48, and 96 h. BMI influenced swelling, while both BMI and COMT haplotype influenced trismus on the 2nd postoperative day. Conclusion: Polymorphisms in COMT, salivary concentrations of IL-2 and IFN-γ, BMI, and duration of surgery were predictors for pain fluctuation, swelling, and trismus on the 2nd day after lower third molar extraction. This therapy was effective in controlling inflammatory symptomatology after lower third molar extraction and ibuprofen was well tolerated by patients. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03169127.

Molecular response of pulp fibroblasts after stimulation with pulp capping materials

Abstract This in vitro study evaluated cell viability and metabolism, nitric oxide release and production of two chemokines and one cytokine by cultured human dental pulp fibroblasts (HDPF) in contact with two glass ionomer cements (Ketac Molar-KM and Vitrebond-VB), Single Bond (SB) and calcium hydroxide (Dycal-DY). Cultures of HDPF were established by means of an explant technique. The specimens were prepared under sterile conditions and in disks measuring 5 mm x 2 mm obtained from a prefabricated mold and placed on a permeable membrane to avoid direct contact with the cells. Cytotoxicity was assessed by Trypan Blue exclusion method and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Nitric oxide release in cell supernatant was detected by the Griess Method whereas stromal derived factor-1 alpha (SDF-1α or CXCL12), chemokine (C-X-C motif) ligand 8 [Interleukin 8 (IL-8 or CXCL8)] and interleukin-6 (IL-6) were detected by ELISA. RT-qPCR was employed for gene expression analysis. Statistical analyses were performed by One-way ANOVA followed by Tukey's post hoc test for materials independent of the time, and Two-way ANOVA followed by Bonferroni correction test for the comparisons between materials and experimental time (p<0.05). Cytotoxic tests showed significant differences only for DY. Protein levels and mRNA expression were significantly increased for IL-8 for both periods of time. IL-6 production increased when fibroblasts were stimulated by KM. SDF-1α protein production and mRNA expression were not affected by any of the materials. There was a decrease in nitrate/nitrite levels only for KM. Although DY caused intense cell death and did not stimulate the production of the inflammatory mediators evaluated in this work, it is known that this event seems to be fundamental for the process of repair of the pulp tissue and formation of mineralized barrier. KM and VB increased production of proteins related to the inflammatory process, thus favoring tissue repair. Therefore, although these glass ionomer cements did not lead to large cell death, they should be used with caution.

Resumo Este estudo avalia in vitro a viabilidade e metabolismo celular, a liberação de óxido nítrico e a produção de duas quimiocinas e uma citocina por fibroblastos de polpa dentária humana em cultura (FPDH) em contato com dois cimentos de ionômero de vidro (Ketac Molar-KM e Vitrebond-VB), Single Bond (SB) e hidróxido de cálcio (Dycal-DY). As culturas de FPDH foram estabelecidas por meio de uma técnica de explante. As amostras foram preparadas em condições estéreis e em discos de 5 mm x 2 mm, obtidas de um molde pré-fabricado e colocadas em uma membrana permeável (Maxicell 24 W 0,4 µm) para evitar o contato direto com as células. A citotoxicidade foi avaliada pelo método de exclusão de Trypan Blue e pelo ensaio de MTT. A liberação de óxido nítrico no sobrenadante celular foi detectada pelo método Griess, enquanto fator 1 derivado do estroma (SDF-1α ou CXCL12), interleucina-8 (IL-8 ou CXCL8) and interleucina-6 (IL-6) foram detectados por ELISA. RT-qPCR foi empregada para análise de expressão gênica. As análises estatísticas foram realizadas por ANOVA a 1 critério, seguida pelo pós-teste de Tukey para os materiais independentes do tempo, e ANOVA a 2 critérios, seguida pelo teste de correção de Bonferroni para comparações entre materiais e tempo experimental (p<0,05). Os testes citotóxicos mostraram diferenças significativas apenas para DY. Os níveis da proteína e a expressão de RNAm para IL-8 aumentaram significativamente para ambos os tempos estudados. A produção de IL-6 aumentou quando os fibroblastos foram estimulados por KM. A produção da proteína e a expressão de RNAm para SDF-1α não foram afetadas por nenhum dos materiais. Houve uma diminuição nos níveis de nitrato/nitrito apenas para KM. Embora o DY tenha causado intensa morte celular e não tenha estimulado a produção dos mediadores inflamatórios avaliados neste trabalho, sabe-se que esse evento parece ser fundamental para o processo de reparo do tecido pulpar e formação de barreira mineralizada. Os cimentos de ionômero de vidro utilizados aumentaram a produção de proteínas relacionadas ao processo inflamatório, favorecendo a reparação tecidual e, portanto, esses materiais, embora não causem grande morte celular, devem ser utilizados com cautela.

Dental pulp fibroblasts response after stimulation with hema and adhesive system

Abstract This study evaluated in vitro cell viability and metabolism, nitric oxide release and production of chemokines by cultured human dental pulp fibroblasts (DPF) under contact with HEMA and Single Bond. Cultures of DPF were established by means of an explant technique. Once plated, cells were kept under contact with increasing concentrations of HEMA (10, 100 and 1000 nM) or Single Bond (SB) [10-fold serially diluted in culture medium (10-4, 10-3 and 10-2 v/v)] and also with polymerized SB components. Cytotoxicity was assessed by Trypan Blue exclusion method and MTT [3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay. Nitric oxide release on cell supernatant was detected by Griess Method whereas chemokines (CXCL12 and CXCL8) were detected by ELISA. RT-qPCR was employed for chemokines gene expression analysis. Cytotoxic tests showed significant differences for SB 10-2. None of the tested materials significantly altered NO levels. Protein levels of CXCL12 were significantly decreased only by HEMA. On the other hand, while CXCL12 mRNA remained unaltered, gene expression of CXCL8 had significant decrease with all materials, except for polymerized SB. In conclusion, Single Bond and HEMA at various concentrations, decreased expression and production of molecules involved in inflammatory processes and, therefore, the use of adhesive systems such as pulp capping materials must be viewed with caution due to its large cytotoxic effect when in close contact with the pulp.

Resumo Este estudo avaliou in vitro a viabilidade e metabolismo celular, liberação de óxido nítrico e produção de quimiocinas em cultura de fibroblastos de polpa dental humana (DPF) em contato com HEMA e Single Bond. Culturas de DPF foram estabelecidas por meio de uma técnica de explante. Uma vez plaqueadas, as células foram mantidas em contato com concentrações crescentes de HEMA (10, 100 e 1000 nM) ou Single Bond (SB) [10 vezes diluídas em série em meio de cultura (10-4, 10-3 e 10-2 v/v)] e também com SB polimerizado. A citotoxicidade foi avaliada pelo método de exclusão de Trypan Blue e pelo ensaio de 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazólio brometo (MTT). A liberação de óxido nítrico no sobrenadante celular foi detectada pelo método de Griess, enquanto as quimiocinas (CXCL12 e CXCL8) foram detectadas por ELISA. RT-qPCR foi empregada para análise de expressão gênica de quimiocinas. Testes citotóxicos mostraram diferenças significativas para SB 10-2. Nenhum dos materiais testados alterou significativamente os níveis de NO. Os níveis de proteína de CXCL12 foram significativamente diminuídos apenas pelo HEMA. Por outro lado, enquanto o RNAm de CXCL12 permaneceu inalterado, a expressão gênica de CXCL8 teve redução significativa com todos os materiais, com exceção do SB polimerizado. Em conclusão, Single Bond e HEMA, em várias concentrações, diminuíram a expressão e produção de moléculas envolvidas em processos inflamatórios e, portanto, o uso de sistemas adesivos, como o material protetor da polpa, deve ser visto com cautela devido ao seu grande efeito citotóxico quando em contato com a polpa.

Ideal Versus Late Secondary Alveolar Bone Graft Surgery: A Bone-Thickness Cone-Beam Computed Tomographic Assessment.

OBJECTIVE: To compare the bone morphology after secondary alveolar bone graft surgery (SABG) performed before and after permanent canine eruption. DESIGN: Cross-sectional study. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil. PATIENTS: 25 cone-beam computed tomography (CBCT) scans of complete unilateral cleft lip and palate (CLP) individuals who underwent SABG before or after eruption of the permanent canine taken 2 and 6 months (T1 and T2) after SAGB, resulting in 50 CBCT scans. Two groups were assessed, Ideal Group (IG; n = 10) and Late Group (LG; n = 15), according to the time of the SABG. INTERVENTIONS: SABG buccal-palatal thicknesses were measured in 3 different root levels: cement-enamel junction (cervical slice), middle point of the root (intermediate slice), and apex of the central incisor (apical slice). Thickness measurements were assessed in the mesial, distal, and intermediate aspects of the alveolar bone graft. Clinical long-term follow-up was also done. RESULTS: The IG showed significantly greater bone thickness, especially in the intermediate and apical slices, when compared to LG, in T1 and T2. Bone thickness was maintained over time. Clinically, all the IG individuals completed orthodontics, and no major complications were observed. In contrast, 27% of the LG individuals had failures, and rehabilitation was achieved through prosthesis. CONCLUSION: Ideal SABG presents with better results compared with late ABG. When it is not possible to perform SABG at the ideal time, acceptable outcomes still can be expected for late bone grafting.

Efficacy of piroxicam for postoperative pain after lower third molar surgery associated with CYP2C8*3 and CYP2C9.

OBJECTIVE: Nonsteroidal anti-inflammatory drugs (NSAIDs) are metabolized by the cytochrome P450 enzymes (CYPs), predominantly CYP2C8 and CYP2C9. The aim of this study was to evaluate the possible association of polymorphisms in the CYP2C8*3 and CYP2C9 genes with the clinical efficacy of oral piroxicam (20 mg daily for 4 days) after lower third molar surgeries with regard to postoperative pain, swelling, trismus, adverse reactions, need for rescue medication and the volunteer's overall satisfaction. MATERIALS AND METHODS: For this purpose, 102 volunteers were genotyped for CYP2C8*3 and CYP2C9 polymorphisms. Briefly, genomic DNA was isolated from saliva collected from volunteers subjected to invasive lower third molar surgeries, and the preoperative, intraoperative and postoperative parameters were collected and analyzed. RESULTS: An equal amount of piroxicam sufficiently managed postoperative pain and inflammatory symptoms, with visual analog pain scores typically <40 mm for all genotypes investigated. Furthermore, only two out of 102 volunteers heterozygous for CYP2C8*3 and CYP2C9*3 reported adverse side effects. CONCLUSION: In general, slow metabolizers of piroxicam, who were volunteers with mutant alleles, were indifferent from normal metabolizers with the wild-type alleles and therefore did not require specialized piroxicam doses to manage postoperative pain and inflammation.

Effective method for the detection of piroxicam in human plasma using HPLC

Abstract Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used by the general population to alleviate inflammation and pain after oral surgeries. Piroxicam is among the most commonly used NSAIDs and excels in controlling pain, swelling, trismus and other common symptoms of inflammation. This study aimed to evaluate different concentrations of piroxicam and its major metabolite, 5'-hydroxypiroxicam, in human plasma samples over time using high performance liquid chromatography (HPLC) after liquid-liquid extraction. Briefly, 10 volunteers participated in this study after approval by the Ethics Committee of Bauru School of Dentistry, Universidade de São Paulo - USP, Brazil. Volunteers received a single dose oral of piroxicam (20 mg) and had blood collected at various times following an established protocol. The methodology of liquid-liquid extraction was effective for determining concentrations of piroxicam in plasma using HPLC in 10 out of 10 volunteers while 5'-hydroxypiroxicam was only detected in 2 out of 10 volunteers.

Evolution of Postoperative Edema in Alveolar Graft Performed With Bone Morphogenetic Protein (rhBMP-2).

OBJECTIVE: To evaluate the evolution of facial edema in the postoperative period after alveolar graft surgeries performed with collagen membrane soaked with recombinant human bone morphogenetic protein-2 (rhBMP-2) in individuals with cleft lip and palate. DESIGN: Longitudinal prospective. SETTING: Tertiary craniofacial center. PARTICIPANTS: One hundred fifty individuals submitted to alveolar graft. INTERVENTIONS: In the preoperative consultation and 4 days after surgery, the individuals were assessed as to age, professional performing the surgery, duration of the procedure, type of cleft, measurement of facial edema, mouth opening, and global evaluation of the postoperative period. MAIN OUTCOME MEASURES: Statistical analysis was performed to compare the facial edema and different variables, at a significance level of .05. RESULTS: The maximum facial edema occurred between 3 and 4 days postoperatively, was inversely proportional to age and mouth opening, greater for female patients compared with male patients, for incomplete unilateral cleft lip and palate compared with other types of clefts, and for surgeon 1 compared with the other surgeons at some moment postoperatively. The surgeries were longer for complete unilateral and bilateral clefts. The difference was statistically significant for these variables. CONCLUSIONS: The facial edema was influenced by the rhBMP-2 used in alveolar graft, and trismus was proportional to the intensity of facial edema.

Increase in age is associated with worse outcomes in alveolar bone grafting in patients with bilateral complete cleft palate.

This prospective study aimed at evaluating the surgical outcomes of alveolar bone grafting (ABG) in subjects with bilateral cleft lip and palate treated at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil, by means of cone-beam computed tomography. Twenty-five patients with bilateral complete cleft lip and palate, resulting in 50 clefts, were analyzed. Subjects were divided into 2 groups according to the dentition status at the time of surgery: (1) SABG group: subjects with mixed dentition operated on before or immediately after eruption of the permanent canine (10-13 years); (2) TABG group: subjects with permanent dentition (15-23 years). Cone-beam computed tomography analysis was performed in the buccal, intermediate, and palatal views, 2 and 6 to 12 months postoperatively. In the SABG group, 96% of the grafts were classified as successful, and no failure cases were observed. In the TABG group, successful cases decreased to 65%, and failures were seen in 27% of the cleft sites. In both postoperative periods, significantly better outcomes (lower mean scores) were observed for the SABG group in all the cone-beam computed tomography views (P < 0.05). Results show that the timing of surgery is an important factor in determining the outcomes of ABG in patients with bilateral cleft lip and palate, with increasing age being associated with the worse outcomes.

Timing of alveolar bone grafting determines different outcomes in patients with unilateral cleft palate.

The objective of the current study was to assess the outcome of the alveolar bone grafting (ABG) in patients with cleft palate. Thirty-one patients with complete unilateral cleft lip and palate were prospectively divided into 2 groups according to the timing of surgery: (1) secondary ABG (SABG), undertaken during mixed dentition (n = 16); and (2) tertiary ABG (TABG), undertaken during permanent dentition (n = 15). Septum height was assessed using cone beam computed tomography in 3 views (buccal, intermediate, palatal) and classified according to the modified Bergland Index, which scores the results into 5 types according to the height of the neoformed bone septum (excellent: septum with a normal height; good: septum with minor deficiency; regular: marginal defect of >25% of the root length; bad: bone deficiency on the nasal aspect; and failure). In the SABG group, 6 to 12 months postoperatively, 75% of the patients were classified as having excellent/good conditions and 25% as having regular/bad conditions. No patients were observed as having failure conditions. In the TABG group, 53% of the patients were classified as having excellent/good, 21% were classified as having regular/bad conditions, and 26% were classified as having failure conditions. Significantly better outcomes were observed for the SABG group when compared with the TABG group. In conclusion, the age at which ABG is performed is a factor that impacts on the surgical outcome. Specifically, increasing age is associated with worse outcomes.

A experiência do cirurgião-dentista tem efeito sobre a ocorrência de infecções após exodontias de terceiros molares inferiores inclusos e/ou impactados? / Does the surgeons experience affect the occurrence of infections after removal of impacted or intrabony lower third molar?

A antibioticoterapia em cirurgias de terceiros molares inferiores inclusos e/ou impactados é um assunto controverso no meio odontológico. O objetivo do presente estudo foi elucidar a real necessidade de prescrição de antibióticos nestes tipos de cirurgias realizadas por três operadores com experiências clínicas distintas. Um especialista, uma doutoranda e um aluno do último ano da graduação realizaram 50 cirurgias cada um, todas com remoção de osso e alto grau de dificuldade. Antibióticos não foram prescritos nos períodos pré e pós-operatório. No período préoperatório, 2o e 7o dias pós-operatórios foram analisados os seguintes parâmetros: dor, edema, trismo, temperatura corpórea, níveis de proteína C-reativa e contagem de neutrófilos salivares. Durante a cirurgia foram analisados: pressão arterial sistólica, diastólica e média, oximetria, freqüência cardíaca, qualidade da anestesia, quantidade de anestésico local, sangramento, dificuldade e tempo de duração da cirurgia. No dia da retirada de pontos, 7o dia pós-cirúrgico, foi avaliada a qualidade de cicatrização e os voluntários relataram a avaliação global do período póscirúrgico. Não houve nenhum caso comprovado de alveolite ou outro tipo de infecção no local operado. O tempo de cirurgia do graduando e da doutoranda mostraram valores médios maiores que os do especialista (p<0,05). Houve diferença estatisticamente significativa entre o graduando e os outros dois operadores nos seguintes parâmetros: qualidade da anestesia, quantidade de tubetes utilizados, sangramento no momento da incisão, trismo e dor em vários momentos pósoperatórios (p<0,05). Não houve mudanças significativas nos parâmetros hemodinâmicos durante as cirurgias. Os voluntários operados pela doutoranda tiveram uma recuperação da abertura de boca melhor que os operados pelos outros dois operadores (95,88±1,67% para a doutoranda, 86,87±2,05% para o especialista e 79,51±3,05% para o graduando, p<0,05). Houve diferença estatisticamente...

The use of antibiotics in lower third molar surgeries with necessity of boné removal is controversial. The aim of this study was to elucidate the real necessity of antibiotics prescription in such types of surgeries performed by three different surgeons with distinct clinical experiences. A specialist, a PhD student and a senior dental student performed 50 surgeries each, all with osteotomy and high degree of difficulty. Antibiotics were not prescribed either before or after surgeries. In the preoperatory period and on the second and seventh postoperative days, the following parameters were analyzed: pain, swelling, trismus, body temperature, C-reactive protein levels and salivary neutrophil count. During the surgeries the following parameters were analyzed: systolic, diastolic and mean arterial pressure, oxymetry, heart rate, quality of anesthesia, amount of local anesthetic, bleeding, surgery difficulty and duration of surgery. At the suture removal, seventh postoperative day, quality of wound healing and global evaluation performed by the patient were recorded. There was no confirmed case of dry socket or another type of local infection in the study. The duration of surgeries performed by the senior student and the PhD student showed higher values as compared to the specialist (p<.05). There was statistically significant difference between the senior student compared to both surgeons in the following parameters: quality of anesthesia, amount of local anesthetic, bleeding at incision time, trismus and pain at several postoperative times (p<.05). There were no significant changes in hemodynamic parameters during the surgeries. The PhD students volunteers had better recovery of mouth opening in comparison with the volunteers of the other surgeons (95.88±1.67% for the PhD student, 86.87±2.05% for the specialist, and 79.51±3.05% for the senior student, p<.05). There was significant statistically difference in C-reactive protein levels between the senior student...

Comparasion of the efficacy of etoricoxib and ibuprofen in pain and trismus control after lower third molar removal / Comparação da eficácia de etoricoxib e ibuprofeno no controle da dor e do trismo após exodontia de terceiros molares inferiores

Introduction: This work compares the efficacy of two different non-steroidal anti-inflammatory drugs (NSAIDS), etoricoxib (COX-2 selective inhibitor) and ibuprofen (non-selective COX inhibitor), in a double blind, randomized and crossed study, in 16 patients aged 18 years or over who needed the removal of both symmetrically positioned lower third molars. Methods: The following parameters were assessed: 1) subjective postoperative pain evaluation with the aid of a visual analogue scale; 2) mouth opening before the surgery and at the suture removal; 3) incidence, type and severity of adverse reactions, and 4) total amount of rescue medication taken by the patients (paracetamol). Data were analyzed by paired t test and Wilcoxon test. Results: The results revealed that: 1) both NSAIDS were efficient for postoperative pain relief (p>0.05); 2) there was a similar reduction in mouth opening at suture removal compared to the measure in the preoperative period for both NSAIDS (85.34 ± 19.82% and 82.43 ± 15.07% of initial measures for ibuprofen and etoricoxib, respectively, p>0.05); 3) discrete eyelid edema was observed in only one patient medicated with ibuprofen, and 4) there was no statistically significant difference regarding the total amount of rescue medication taken by the patients treated with ibuprofen or etoricoxib (843.75 ± 1189.80 mg and 515.63 ± 808.64 mg, respectively, p>0.05). Conclusion: These data, therefore, suggest that there is no advantage in the prescription of etoricoxib in relation to ibuprofen for pain and trismus reduction after lower third molar removal.

Introdução: Comparar a eficácia de dois antiinflamatórios não-esteroidais (AINES), etoricoxib (inibidor seletivo da cicloxigenase-2) e ibuprofeno (inibidor não seletivo das cicloxigenase-1 e 2), num estudo duplo-cego e cruzado, em 16 pacientes com idade igual ou superior a 18 anos necessitando de exodontia dos dois terceiros molares inferiores (com posições muito semelhantes). Métodos: Avaliaram-se os seguintes parâmetros: 1) avaliação subjetiva da dor pós-operatória com o auxílio de uma escala analógica visual; 2) abertura de boca antes da cirurgia e no momento da retirada de pontos; 3) incidência, tipo e gravidade das reações adversas e 4) quantidade total de medicação de socorro (paracetamol). Os dados foram analisados pelos testes t pareado e de Wilcoxon. Resultados: Os resultados revelaram que: 1) ambos os AINES se mostraram eficazes para o alívio da dor pós-operatória (p>0,05); 2) houve igual redução da abertura de boca na retirada de pontos em comparação com a medida no período pré-operatório para ambos os AINES (85,34 ± 19,82% e 82,43 ± 15,07% da medida inicial para ibuprofeno e etoricoxib, respectivamente, p>0,05); 3) em relação às reações adversas, apenas 1 paciente medicado com ibuprofeno apresentou edema de pálpebra discreto e 4) não houve diferença significativa com relação à quantidade total de medicação de socorro ingerida pelos pacientes tratados com ibuprofeno ou etoricoxib (843,75 ± 1189,80 mg e 515,63 ± 808,64 mg, respectivamente, p>0,05). Conclusão: Estes dados, portanto, sugerem que não existe vantagem na prescrição do etoricoxib em relação ao ibuprofeno para redução da dor e trismo após extração de terceiros molares inferiores.

Efectos de la Hindarina sobre las aurículas aisladas / Effects on hindarine on the isolated atria

Se presentan los efectos de la hindarina y de la clorpromacina sobre la amplitud y la frecuencia de las contracciones espontáneas de la aurículas aisladas de rata. La hindarina produjo bradicardia moderada y aumento discreto de la amplitud de las contracciones en forma dosis-dependiente, en tanto que la clorpromacina deprimió más intensamente tanto la frecuencia como la amplitud de dichas contracciones. Se descartó una acción colinérgica o beta-bloqueadora en la producción de la bradicardia por la hindarina. Se descartó también una acción cardiotónica de la hindarina en las aurículas aisladas de cobayo deprimidas por solución hipocálcica o por hipoxia. Se sugiere su estudio como antiarrítmico