ABSTRACT
Introdução: A periodontite apical assintomática (PAA) é caracterizada pela inflamação e destruição dos tecidos periapicais, e sua progressão promove reabsorção óssea, podendo ser agravada pelo uso contínuo de isotretinoína. Objetivo: O objetivo do presente estudo foi relatar a resolução de uma PAA com rompimento de cortical óssea mandibular em um paciente sob tratamento contínuo com isotretinoína (Roacutan®), por meio de procedimentos químicos-mecânicos convencionais e controle com tomografia computadorizada de feixe cônico (TCFC). Descrição: Um paciente com 21 anos de idade, ASA I, em tratamento contínuo com isotretinoína, procurou atendimento odontológico com moderada dor na região do elemento dental #38. Após exames clínicos, radiográficos e tomográficos, verificou-se a necessidade de tratamento endodôntico do dente #36. A TCFC mostrou uma imagem apical extensa e hipodensa entre os dentes #36 e #37, compatível com lesão cística óssea, com dimensões de 25,59 mm (largura) x 14,37 mm (altura) x 8,40 mm (profundidade). Também foram observados reabsorção apical da raiz distal, halo hipodenso sob a restauração coronal do #36 e ruptura da cortical externa vestibular e lingual. O tratamento endodôntico foi realizado em três sessões, com auxílio de um microscópio operatório e protocolos químicos-mecânicos, como Easy Clean e terapia fotodinâmica. Resultado: A resolução da PAA foi observada após acompanhamento por três anos. Conclusão: O tratamento endodôntico permitiu o reparo de uma lesão periapical extensa, evitando a cirurgia parendodôntica imediata, e o uso contínuo de isotretinoína não afetou a resolução da PAA(AU).
Introduction: Asymptomatic apical periodontitis (AAP) is characterized by inflammation and destruction of the periapical tissues and its progression leads to bone resorption, which may be aggravated by continuous use of Isotretinoin. The objective of this study was to report the resolution of AAP with mandibular cortical disruption in a patient under continuous treatment with isotretinoin (Roacutan®) and kickboxing practitioner, by conventional chemical-mechanical procedures and cone-bean computed tomography (CBCT) follow-up. Description: A 21-year-old Caucasoid individual, ASA I, under continuous use of isotretinoin and kickboxing practitioner sought dental care with moderate pain at the region of tooth #38. After clinical, radiographic and tomographic examination, the need for endodontic treatment of tooth #36 was verified. The CBCT showed an extensive and hypodense apical image between teeth #36 and #37, compatible with cystic bone lesion, with dimensions of 25.59 mm wide x 14.37 mm high x 8.40 mm deep. Apical resorption of the distal root, hypodense halo under a coronal restoration at #36, and rupture of the external buccal and lingual cortical bone were also observed. The endodontic treatment was performed in three sessions with the aid of a microscope and chemical-mechanical protocols, such as Easy Clean and photodynamic therapy. Result: Resolution of AAP was observed after follow-up for three years. Conclusion: Endodontic treatment allowed healing of an extensive periapical lesion, avoiding immediate parendodontic surgery and the continuous use of isotretinoin did not affect the AAP resolution. (AU).
Subject(s)
Humans , Periapical Periodontitis , Isotretinoin , Cone-Beam Computed Tomography , Cortical Bone , Research ReportABSTRACT
To overcome the challenge imposed by the presence of biofilm and reach significant bacterial reduction of the root canals, many irrigants have been indicated during endodontic treatment, among them nanoparticles solutions. Aims: This study aims to evaluate the effectiveness of experimental solutions containing silver and zinc oxide nanoparticles (ZnO Np) and conventional endodontic irrigants against Enterococcus faecalis biofilm, in root canals. Methods: Seventy-six extracted human teeth were biomechanically prepared and sterilized. The root canal surface was exposed to E. faecalis suspension to form a 7-day-old biofilm. Four teeth were analyzed by scanning electron microscopy (SEM) to confirm the presence of biofilm. The remaining teeth were randomly divided into 6 groups (n = 12) and treated with passive ultrasonic irrigation and different solutions: G1 – 0.85% saline (control); G2 – 2% chlorhexidine gluconate (CHX); G3 – 5% sodium hypochlorite (NaOCl); G4 – 1% NaOCl; G5 – 1% silver nanoparticles (Ag Np) solution; and G6 – 26% ZnO Np solution. The susceptibility of E. faecalis biofilms to disinfecting solutions (n = 10) was determined by quantification of colony-forming units. SEM analysis was also carried out to examine the biofilm structure after treatments (n = 2). Data were analyzed by Kruskal–Wallis and Dunn post hoc tests (P < 0.05). Results: All tested solutions showed superior effectiveness compared to 0.85% saline (P < 0.05). Overall, 2% CHX presented the most effective action against E. faecalis biofilm, followed by 5% NaOCl, 1% Ag Np, 26% ZnO Np, and 1% NaOCl. Conclusions: 1% Ag Np and 26% ZnO Np were effective against E. faecalis biofilm similarly to conventional endodontic irrigants.
ABSTRACT
O objetivo deste estudo foi avaliar a atuação do odontolegista no processo de identificação post mortem do Instituto Médico Legal da cidade de Florianópolis, SC. Para tanto, foi realizada uma análise retrospectiva dos casos de identificação post mortem registrados no Instituto Médico Legal no período de 2005 a 2014. Destes, foram selecionados apenas os laudos periciais de identificação post mortem odontológicos. Foram avaliados 6.511 laudos: os quais 26 foram laudos de identificação post mortem realizados pelo odontolegista. Dentre os 26 laudos, 13 casos foram identificados, sendo que 7 (53,84%) por meio do prontuário odontológico da vítima, 4 (30,76%) por prontuário e exame radiográfico, 1 (7,1%) por prontuário/registro de mordida e placa de acrílico e 1 (7,1%) por foto extrabucal. Os outros 13 casos resultaram em não identificação, pois 12 (46,2%) casos não apresentaram prontuário e em 1 (3,8%) caso houve o incompleto preenchimento do prontuário odontológico, resultando na impossibilidade de identificação dos cadáveres. Conclui-se que a atuação do odontolegista no processo de identificação post mortem no IML Florianópolis forneceu informações eficazes para a identificação de 13 casos em 9 anos e que o método de comparação de prontuário odontológico ante e post mortem foi o mais utilizado nas identificações
The purpose of this study is to evaluate the acting of the forensic dentist in the process of the post mortem iden-tification in the National Legal Medicine Institute of Florianópolis, SC. For this matter, a retrospective analysis of post mortem cases identification registered in the National Legal Medicine Institute of Florianópolis, in the period of 2005 to 2014, was done. From these, were selected only the expert reports of odontological post mortem identification. 6.511 expert report were evaluated, though 26 was post mortem identification reports made by the forensic dentist. Among the 26 reports, 13 cases were identified of which 7 (53,84%) through dental records of the victim, 4 (30,76%) mecial record and radiographic examination, 1 (7,1%) record/bite registration material and acrylic plate, and 1 (7,1%) by extraoral photo. The other 13 cases were resulted in no identification, for 12 (46,2%) cases did not present records and in 1 (3,8%) case there was the incomplete filling of the odontological record, resulting in the impossibility of the identification of the corpses. In conclu¬sion, the acting of the forensic dentist in the process of the post mortem identification in the National Legal Medicine Institute of Florianópolis provided effective informations to an identification of 13 cases in 9 years that the method of comparison of the ondontological record ante mortem and post mortem was the most used in the identifications