Enhanced mechanical properties, anti-biofilm activity, and cytocompatibility of a methacrylate-based polymer loaded with native multiwalled carbon nanotubes.

OBJECTIVES: We aimed to optimize the mechanical and biological properties of a conventional methacrylate-based dental polymer by loading it with double- and triple-walled carbon nanotubes as growth (DTWCNTG). METHODS: A formulation of bisphenol A-glycidyl methacrylate and triethylene glycol dimethacrylate (mass ratio = 2:1) was mixed with DTWCNTG at concentrations of 0.0% (control), 0.001%, 0.005%, and 0.010%. The concentrations were physicochemical and morphologically evaluated, and antibacterial activity was assessed by seeding a Streptococcus mutans strain (ATCC 25175) on the experimental polymeric surfaces. Cellular survival and osteodifferentiation were evaluated in epithelial (HaCat) and preosteoblast cells (MC3T3-E1). RESULTS: The 0.001% DTWCNTG concentration yielded higher compressive strength, elastic modulus, flexural strength, flexural modulus, water sorption, and solubility than the control. The degree of conversion and color did not significantly change with a low amount of DTWCNTG incorporated into the polymer. Antibacterial activity significantly improved when tested on the 0.001% DTWCNTG discs. No groups showed cytotoxicity in a short-term analysis and adding DTWCNTG favored MC3T3-E1 mineralization over the control, particularly in the 0.001% formulation. SIGNIFICANCE: The micro-addition of 0.001% DTWCNTG confers mechanical resistance, antimicrobial properties, and bioactivity to methacrylate-based polymers without significantly compromising color. Incorporating DTWCNTG improved dental composite properties and could be a biomodified material for minimally invasive procedures.

Taking advantage of an unerupted third molar: a case report.

INTRODUCTION:: Treatments with dental surgery seek to displace tooth to the correct position within the dental arch. OBJECTIVE:: To report a clinical case that took advantage of an unerupted third molar. CASE HISTORY:: A male patient, 18 years of age, was referred by his dentist to evaluate the third molars. The clinical exam revealed no visible lower third molars. The computed tomography (CT) exam showed the presence of a supernumerary tooth in the region of the mandibular ramus, on the left side, and impaction of the third molar, which was causing root resorption on the second molar, thus making it impossible to remain in the buccal cavity. The preferred option, therefore, was to remove both second molar and the supernumerary tooth, in addition to attaching a device to the third molar during surgery for further traction. RESULTS:: After 12 months, the third molar reached the proper position. CONCLUSION:: When a mandibular second permanent molar shows an atypical root resorption, an impacted third molar can effectively substitute the tooth by using an appropriate orthodontic-surgical approach.

Oral myiasis: a case report.

Oral Myiasis is a rare pathology in humans and is associated with poor oral hygiene, alcoholism, senility, suppurating lesions, severe halitosis and others conditions. The treatment is a mechanical removal of the maggots one by one but a systemic treatment with Ivermectin, a semi-synthetic macrolide antibiotic, have been used for treatment for oral myiasis. We present a case report of a 32-year-old man indigent, alcohol-dependent with an extensive necrotic area and acute swelling in upper lip and fetid odor. The patient's management included topic use of gentian violet, oral therapy with ivermectin (6 mg orally), surgical exploration to remove the larvae and necrotic tissue. After the complete larvae removal the swelling and the wounds were healing normally, the patients was referred to plastic surgery to repair tissue damage. The prevention of human myiasis is by education, but unfortunately in the developing countries some people live in low social condition, predisposing the occurrence of the infestation.

Differential diagnosis of antral pseudocyst. A case report.

Antral pseudocyst (AP) is a process formed by the inflammatory exudate accumulation below the sinuses mucous membrane and causing a sessile elevation. AP is a dome-shaped, well-delineate, faintly radiopaque lesion on the intact floor of the maxillary sinus. A case of AP with an unusual location is presented. A 24-year-old male was submitted to the panoramic radiographic exam and an around, well-defined, faintly radiopaque lesion was detected in the tuberosity extension of maxillary sinus. The differential clinical-radiograph diagnoses were AP, non-odontogenic cysts, odontogenic cysts, odontogenic and non-odontogenic tumours. Fine needle aspiration demonstrated presence of viscous yellow liquid. It was performed an excisional biopsy and the histological diagnosis was AP. It is necessary biopsy when this doubt persists and also emphasize the recognition of AP in other differential diagnose and management with other lesions in region of the maxillary sinus.

Evaluation of the Degradation of a Resin Composed by the Metabolites Produced by Streptococcus Mutans: in vitro Study / Avaliação da Degradação de uma Resina Composta pelos Metabólitos Produzidos por Streptococcus Mutans: Estudo in vitro

Os Streptococcus mutans são microrganismos constituintes do biofilme oral, onde seus metabólitos podem promover alterações superficiais e microestruturais dos compósitos comprometendo suas propriedades. O objetivo deste estudo foi avaliar, in vitro, o efeito dos metabólitos produzidos por essa bactéria por meio de um meio de cultivo à base de sacarose 5% sobre a superfície e microestrutura de uma resina composta. Foram confeccionados 32 corpos de prova em resina composta, os quais foram divididos em quatro grupos (N=8): o grupo controle externo (G1), grupo controle interno imerso em caldo BHI (G2), no grupo G3 foi inoculado o Streptococcus mutans ATCC® 25175™ e no grupo G4 foi inserido o mesmo microrganismo associado à sacarose 5%. Após o período laboratorial, correspondente a 42 dias, as amostras foram submetidas à análise da superfície através dos testes de microrrugosidade, micrografia e microdureza superficial obtida por meio de ensaio Vickers. Os resultados obtidos foram submetidos ao teste Anova One-Way, onde se verificou que os grupos G3 e G4 apresentaram maior rugosidade superficial e menor dureza quando comparados com os grupos controle G1 e G2. Concluiu-se que os metabólitos produzidos pelos Streptococcus mutans são capazes de alterar a superfície e a microestrutura do compósito avaliado in vitro e em boca, pode comprometer a longevidade das restaurações confeccionadas com este tipo de material. (AU)

Streptococcus mutans are microorganisms constituent of the oral biofilm, where their metabolites can promote superficial and microstructural alterations of the composites compromising their properties. The objective of this study was to evaluate, in vitro, the effect of the metabolites produced by this bacterium by means of 5% sucrose based culture medium on the surface and microstructure of a composite resin (Charisma®, Heraeus Kulzer®, Hanau, Germany). The samples were divided into four groups (N = 8): the external control group (G1), the internal control group immersed in BHI broth (G2), the G3 group was inoculated with Streptococcus mutans ATCC® 25175™ and in group G4 the same 5% sucrose associated microorganism was inserted. After the laboratory period, corresponding to 42 days, the samples were subjected to the surface analysis through the tests of microroughness, micrograph and surface microhardness obtained by means of Vickers assay. The results were submitted to One-Way Anova test, where it was verified that the G3 and G4 groups presented higher surface roughness and lower hardness when compared to the G1 and G2 control groups. It was concluded that the metabolites produced by Streptococcus mutans are capable of altering the surface and the microstructure of the composite evaluated in vitro, and in the mouth it could compromise the restorations longevity made with this type of material.(AU)

Asynchronous idiopathic bone cavity: a case report.

Idiopathic bone cavity (IBC) is a non-odontogenic intra-osseous lesion that affects the jaws and others bones. The aetiology of IBC remains unknown. IBC is frequently observed as a single radiolucent area with a corticated, well-defined border, a scalloped shape and a minimal effect on the surrounding structures. A case report of asynchronous IBC in a 17-year-old woman is presented. The first lesion occurred in the mandibular symphysis region, and the second IBC occurred in the right mandibular ramus. Both lesions were surgically treated, and the patient has been disease-free for 5 years.

Taking advantage of an unerupted third molar: a case report

ABSTRACT Introduction: Treatments with dental surgery seek to displace tooth to the correct position within the dental arch. Objective: To report a clinical case that took advantage of an unerupted third molar. Case history: A male patient, 18 years of age, was referred by his dentist to evaluate the third molars. The clinical exam revealed no visible lower third molars. The computed tomography (CT) exam showed the presence of a supernumerary tooth in the region of the mandibular ramus, on the left side, and impaction of the third molar, which was causing root resorption on the second molar, thus making it impossible to remain in the buccal cavity. The preferred option, therefore, was to remove both second molar and the supernumerary tooth, in addition to attaching a device to the third molar during surgery for further traction. Results: After 12 months, the third molar reached the proper position. Conclusion: When a mandibular second permanent molar shows an atypical root resorption, an impacted third molar can effectively substitute the tooth by using an appropriate orthodontic-surgical approach.

RESUMO Introdução: o objetivo do tratamento odontológico cirúrgico é deslocar os dentes para a posição correta na arcada dentária. Objetivo: relatar um caso clínico de aproveitamento de terceiro molar não irrompido. Histórico do caso: paciente do sexo masculino, com 18 anos de idade, foi encaminhado, pelo dentista responsável pelo caso, para avaliação dos terceiros molares. Ao exame clínico, os terceiros molares inferiores não eram visíveis. Com a tomografia computadorizada (TC), foi possível identificar a presença de um dente supranumerário na região do lado esquerdo do ramo da mandíbula, além de impacção do terceiro molar, causadora de reabsorção radicular no segundo molar, tornando impossível a permanência desse dente na cavidade bucal. Logo, optou-se pela remoção tanto do segundo molar quanto do dente supranumerário, além da instalação de um aparelho no terceiro molar, durante o procedimento cirúrgico, para posterior tracionamento. Resultados: após 12 meses, o terceiro molar alcançou a posição adequada. Conclusão: nos casos em que o segundo molar inferior permanente apresenta reabsorção radicular atípica, um terceiro molar impactado pode substituir o dente reabsorvido, de maneira eficaz, através de uma abordagem ortocirúrgica apropriada.

Tratamento cirúrgico e conservador de cisto periapical de grande proporção: relato de caso / Surgical and conservative treatment of large periapical cyst: case report

O objetivo deste estudo foi descrever uma técnica de tratamento conservadora, cuja conduta preconizada foi a realização da descompressão seguida pela enucleação cística através do relato de um caso de cisto periapical de grande extensão. Paciente de 50 anos de idade, melanoderma, apresentando cisto periapical com aproximadamente 4,5 cm em seu maior diâmetro associado ao incisivo central inferior esquerdo. Na primeira etapa do tratamento, foi realizada descompressão cística e biopsia incisional, cujo exame histopatológico confirmou o diagnóstico clínico. Após 25 semanas de acompanhamento, houve uma considerável regressão do tamanho da lesão e a mesma foi enucleada sem comprometimento dos elementos dentários envolvidos e dos tecidos adjacentes. O relato de caso evidenciou que o tratamento cirúrgico e conservador pode ser um recurso em cistos periapicais de maior dimensão, sendo importante a cooperação do paciente no acompanhamento pós-operatório.

The aim of this study was to describe a conservative treatment technique, the recommended therapeutic of which was performed decompression and followed by cystic enucleation through the report of a large periapical cyst case. A 50-year-old melanoderma patient presented a periapical cyst with approximately 4,5 cm in its largest diameter associated with the left lower central incisor. In the first stage of the treatment, cystic decompression and incisional biopsy were performed; whose histopathological examination confirmed the clinical diagnosis. After follow-up, there was a considerable regression of the size of the lesion and it could be enucleated without compromising the dental elements involved and adjacent tissues. The case report showed that surgical and conservative treatment may be a resource in larger periapical cysts, and patient cooperation in postoperative follow-up is very important.

The histopathological examination of the dental follicleof asymptomatic impacted tooth: is it necessary? / Exame histopatológico do folículo dental de denteimpactado assintomático: é necessário?

Introduction: During the development of a tooth, the pericoronal tissue may develop pathological changes.The clinical dilemma occurs in the early diagnostic of the tissue around the crown of an uneruptedtooth. Objective: The purpose of this paper is to present a clinical case with different diagnoses of a smallradiolucency area around the crown of impacted teeth on the same patient. The histological diagnosis ofthe follicle related to tooth 48 was of dentigerous cyst and the histological finding of follicular tissue associatedto tooth 38 showed some features of unicystic ameloblastoma. The follicles of teeth 18 and 28 didnot present histopathological changes. Conclusion: The radiographic appearance may not be a reliableindicator of the absence of disease in pericoronal tissues. We recommend histopathological analysis onall surgically extracted follicle tissue, even when radiographic and clinical findings are not indicative ofpathological alterations.

Introdução: Durante o desenvolvimento dental, o tecido pericoronário pode sofrer alterações patológicas.O dilema clínico está no diagnóstico precoce dos tecidos em torno da coroa de um dente retido. Objetivo: O objetivodeste trabalho é apresentar um caso clínico em que houve diferentes diagnósticos histológicos relacionadosaos tecidos pericoronários em um mesmo paciente sem a presença de alteração radiográfica característica.Os diagnósticos histológicos dos folículos dos terceiros molares sugeriram cisto dentígero relacionado ao dente48, características de ameloblastoma unicístico ao dente 38, e os tecidos dos dentes 18 e 28 não apresentaramalterações histopatológicas. Conclusão: O aspecto radiográfico neste caso não foi um indicador confiável daausência de doença em tecidos pericoronários. Logo, recomendamos que todos os tecidos pericoronários sejamencaminhados para o exame histopatológico mesmo que os achados radiológicos e clínicos não mostrem alteraçõespatológicas.

Tratamento endodôntico transcirúrgico: uma opção para casos especiais / Trans-surgical endodontic treatment: an option for special cases

A cirurgia endodôntica é indicada quando perfurações, instrumentos fraturados, calcificações e anormalidades anatômicas são responsáveis pelo insucesso do tratamento endodôntico convencional. Dentre as modalidades cirúrgicas, a obturação do canal radicular simultânea ao ato cirúrgico é indicada, quando não se consegue conter o exsudato persistente por meio de medicação intracanal e medicação sistêmica. O propósito deste trabalho é o de descrever a técnica cirúrgica utilizada e apresentar três casos clínicos de apicectomia com tratamento endodôntico trans-cirúrgico, promovendo uma discussão sobre suas indicações dentro da moderna clínica odontológica.

Endodontic surgery is indicated when perforations, broken instruments, calcifications and anatomical abnormalities are responsible for the failure of conventional endodontic treatment. Among the surgical modalities the obturation of the root canal concomitantly with the surgical procedure is indicated when it is not possible to contain the persistent exsudate by means of intracanal medication and systemic medication. The purpose of this paper is to describe the surgical technique used and to present three clinical cases of apicectomy with trans-surgical endodontic treatment, discussing its indications in modern clinical dentistry.

Tratamento endodôntico transcirúrgico: uma opção para casos especiais / Trans-surgical endodontic treatment: an option for special cases

A cirurgia endodôntica é indicada quando perfurações, instrumentos fraturados, calcificações e anormalidades anatômicas são responsáveis pelo insucesso do tratamento endodôntico convencional. Dentre as modalidades cirúrgicas, a obturação do canal radicular simultânea ao ato cirúrgico é indicada quando não se consegue conter o exsudato persistente por meio de medicação intracanal e medicação sistêmica. O propósito deste trabalho é o de descrever a técnica cirúrgica utilizada e apresentar três casos clínicos de apicectomia com tratamento endodôntico transcirúrgico, promovendo uma discussão sobre suas indicações dentro da moderna clínica odontológica.

The endodontic surgery is indicated when perforations, instruments broken, anatomical calcification and abnormalities are responsible for the failure of the conventional endodontic treatment. Among the surgical modalities the obturation of the canal to radicular simultaneous to the surgical act is indicated when it is not obtained to contain the persistent exsudate by means of intracanal medication and systemic medication. The intention of this work is to describe the surgical technique used and to present three clinical cases of apicectomy with trans-surgical endodontic treatment, making a discussion on its indications in of the clinical modern.

Cisto dentígero seqüencial: relato de caso / Sequential dentigerous cyst: case report

O cisto dentígero (CD) é definido como um cisto que se origina pela separação do folículo pericoronáriode um dente incluso devendo estar associado à coroa do mesmo e unido à junção cemento-esmalte.CD seqüencial (CDS) pode ser definido como o desenvolvimento de maneira seqüencial de mais de um cistodentígero em diferentes momentos da vida do paciente. Paciente de 16 anos, sexo masculino, queixando-sede aumento de volume do lado esquerdo da mandíbula com evolução lenta. Após exame físico, radiográficoe histopatológico, foi diagnosticado cisto dentígero. Após 12 anos de controle do paciente, houve aparecimentode imagem radiolucida associada ao dente 48, que teve o diagnóstico de cisto dentígero. Esta descriçãorepresenta um caso raro de CDS. O paciente encontra-se em acompanhamento e após de 16 anos daprimeira ocorrência do CD, não apresenta sinais clínicos e radiográficos de recidivas.

Dentigerous cyst (DC) is originate from separation of dental follicle of the crown of an enclosed tooth,must be associated to the crown of exactly joined to the cementoenamel junction. Sequential DC (SDC)represents the development of DC in sequential way at different moments of one determined period of life ofthe patient. Patient of 16 years, male, complaining of increase of volume of the left side of the jaw with slowevolution. After clinical, radiographic and histopathology exam, the diagnosis of DC was performed. After 12-years follow-up, it was observed a radioluscence, well-defined area associated to the 48 tooth. Also, it wasdiagnosed as DC. This case report represents a rare case of SDC. The patient is free-disease after 16 yearsof follow-up.