Materiales bioactivos para restauraciones directas en dientes posteriores / Bioactive materials for direct restorations in posterior teeth

Se trata de paciente femenino de 22 años de edad, en quien se realizó una restauración en un molar siguiendo la filosofía de mínima intervención desde el diagnóstico hasta la obturación con un material bioactivo. Los objetivos del tratamiento fueron devolver la funcionalidad y estética de dicho molar, pero sobre todo brindar una protección a largo plazo mediante la liberación y recarga de iones de calcio, fosfato y flúor proporcionado por el material bioactivo (AU)

t is about a female patient of twenty-two years, in which a restoration was made in a molar following the philosophy of minimal intervention from diagnosis to filling with a bioactive material. The objectives of the treatment were to restore the functionality and aesthetics, but mainly to provide long-term protection through the release and recharge of calcium, phosphate and fluoride ions provided by the bioactive material used (AU)

Lesiones perirradiculares asociadas a primeros molares superiores tratados endodónticamente: estudio a través de tomografías computadas / Periradicular lesions associated with endodontically treated maxillary first molars: study through computed tomography

Objetivos: Estudiar con tomografías computadas de haz cónico (CBCT) las lesiones perirradiculares de primeros molares superiores tratados endodónticamente; evaluar la lo- calización y, en los que tenían lesión en la raíz mesiovestibu- lar (MV), evaluar la frecuencia del conducto MV2. Materiales y métodos: A partir de una muestra de 179 tomografías, que incluían primeros molares superiores, se seleccionaron y analizaron aquellas en las cuales estos ha- bían recibido un tratamiento endodóntico previo, presentaban lesiones perirradiculares y conservaban una restauración co- ronaria. Las variables analizadas fueron: la localización de áreas radiolúcidas compatibles con lesiones perirradiculares de origen endodóntico y la correlación entre diferentes loca- lizaciones y la calidad del tratamiento realizado (adecuado, defectuoso o sin tratamiento). Los datos fueron analizados mediante la prueba de chi-cuadrado y la prueba de Spearman. Resultados: De las 179 CBCT que incluían primeros molares superiores, 90 reunían las condiciones requeridas. La frecuencia de las lesiones perirradiculares fue significativa- mente mayor en la raíz MV al compararla con las raíces disto- vestibular y palatina (p<0,05). El conducto MV1 presentó un tratamiento adecuado en todos los casos. El conducto MV2 recibió un tratamiento adecuado en 4 casos (4,44%), defec- tuoso en 4 casos (4,44%) y no tratado en 82 casos (91,1%); con una diferencia estadísticamente significativa (p<0,05). Conclusiones: En la muestra analizada, la localización de lesiones perirradiculares postratamiento endodóntico en primeros molares superiores se encontró con mayor frecuencia asociada a la raíz mesiovestibular, donde en la mayoría de los casos el con- ducto MB2 no fue tratado o presentó un tratamiento defectuoso (AU)

Aim: To study with cone-beam computed tomography (CBCT) the periradicular lesions of maxillary first molars with endodontical treatment; to evaluate its localization and, in those with a mesiobuccal root (MB) injury, assess the fre- quency of the MB2 root canal. Materials and methods: From a sample of 179 tomog- raphies (CBCT) that included maxillary first molars, those in which they had received previous endodontic treatment, pre- sented periradicular lesions and had a coronary restoration were selected and analyzed. The analyzed variables were: localization of radiolucent areas compatible with periradic- ular lesions of endodontic origin and the correlation between different localizations and quality of the performed treatment (adequate, defective, or untreated). Data were analyzed by the chi-square test and the Spearman test. Results: Of the 179 CBCT that included maxillary first molars, 90 met the required conditions. The frequency of periradicular lesions was significantly higher in the MB root when compared with distobuccal and palatal roots (P<0,05). The MB1 canal presented an adequate treatment in all cas- es. The MB2 canal received adequate treatment in 4 cases (4.44%), a defective one in 4 cases (4.44%) and was untreated in 82 cases (91.1%). The differences among these frequencies were statistically significant (P<0.05). Conclusions: In the analyzed sample, the localization of periradicular lesions after endodontic treatment in maxillary first molars was associated more frequently with the mesio- buccal root in which in the majority of cases the MB2 canal was untreated or presented a defective treatment

Caries en primeros molares permanentes y factores asociados a esta en escolares de Acapulco / Caries in permanent first molars and associated factors with its in schoolchildren from Acapulco

Introducción: La caries es una de las enfermedades bucodentales más frecuentes y, por ser las primeras en emerger, los primeros molares permanentes son las piezas más susceptibles a esta afección. Objetivo: Estimar la prevalencia de caries y factores asociados a esta en los primeros molares permanentes en escolares de segundo grado de primaria. Métodos: Estudio transversal, en estudiantes de segundo grado en 17 de 67 escuelas públicas de Acapulco, Guerrero. Un cuestionario autoadministrado se utilizó para obtener datos sociodemográficos y hábitos de higiene dental. La caries y la presencia de placa dentobacteriana se midieron a través de índices epidemiológicos, el CPOD (diente cariado, obturado y perdido) y el O'Leary. Se estimó la razón de momios e intervalo de confianza de 95 por ciento, ajustada por conglomerado, como medida de la fuerza de asociación mediante análisis multivariado. Resultados: Se revisaron 3332 primeros molares permanentes, el 21 por ciento tuvo caries, el 6 por ciento tuvo obturaciones y el 1 por ciento ya se había extraído. El índice CPOD de caries grupal fue 0,27. Cinco factores estuvieron asociados a la caries de los primeros molares permanentes: higiene dental deficiente (RMa = 2,87), técnica de cepillado dental inadecuada (RMa = 1,70), tomar alguna bebida dulce antes de ir a dormir (RMa = 1,68), visitar al dentista (RMa = 0,67) y aplicación de flúor (RMa = 0,61). Conclusiones: La prevalencia de caries en los primeros molares permanentes fue 21 por ciento dentro del rango reportado en otros estudios. Fueron identificados cinco factores asociados a la caries: higiene dental deficiente, técnica de cepillado inadecuado, consumo de azúcares antes de dormir, visitas al dentista y aplicación de flúor. Estos factores orientan sobre qué medidas preventivas se deben promover en los escolares para la preservación de sus piezas dentales(AU)

Introduction: Caries is the most frequent oral disease and the first permanent molars are very susceptible to this condition because they are the first teeth to emerge. Objective: To estimate the prevalence of caries its associated factors in the first permanent molars in second grade primary school children. Methods: A cross-sectional study was carried out in second grade students in 17 out of 67primary public schools in Acapulco, Guerrero. We applied a self-administered questionnaire to obtain sociodemographic data and dental hygiene habits. Caries and the presence of dentobacterial plaque were measured through epidemiological indices, CPOD (decayed, blocked and lost tooth) and O'Leary index. The odds ratio and 95 percent confidence interval, adjusted by cluster, were estimated as a measure of strength of association through multivariate analysis. Results: We reviewed 3 332 permanent first molars, 21 percent had cavities, 6 percent had seals and 1 percent had already been removed. The CPOD index of group caries was 0,27. We found five factors associated with caries of the first permanent molars: deficient dental hygiene (RMa=2,87), inadequate tooth brushing technique (RMa=1,70), drinking a sweet drink before bedtime (RMa=1,68), visiting the dentist (RMa=0,67) and fluoride application (RMa=0,61). Conclusions: Prevalence of caries in the first permanent molars was 21 percent, within the range reported in other studies. Five factors associated with caries were identified: poor dental hygiene, inadequate brushing technique, consumption of sugars before going to sleep, visits to the dentist and application of fluoride. These factors guide what preventive measures should be promoted in schoolchildren for the preservation of their teeth(AU)

Quiste bucal mandibular infectado bilateral: reporte de caso estudiado con CBCT / Bilateral mandibular infected buccal cyst: report of a case studied by CBCT

El quiste bucal mandibular infectado (QBMI), también conocido como quiste de bifurcación, es un quiste odontogénico inflamatorio poco frecuente y descripto por primera vez por Stoneman y Worth. Ha sido incluido en la clasificación de la OMS de quistes y tumores odontogénicos en 1992. Este quiste suele darse, específicamente, en pacientes entre 6 y 13 años, y su localización más frecuente son el primer y segundo molar permanente y, eventualmente, segundo premolar. Su fisiopatología sigue sin estar clara y se han propuesto múltiples teorías. Este quiste se observa como una inflamación en el vestíbulo del molar afectado. Los síntomas frecuentes son dolor en el área afectada y supuración, pero también muchos casos permanecen asintomáticos. Radiográficamente se describe como un área radiolúcida circunferencial. El quiste está revestido con un epitelio escamoso no queratinizado con infiltrado inflamatorio de células en el tejido conectivo. La mayoría de las características clínicas e histológicas son similares a las reportadas para los quistes paradentales, de ahí la importancia de un buen diagnóstico radiográfico complementario en base a tomografía computada de haz cónico. Los enfoques conservadores suelen ser el tratamiento de elección, con la enucleación del quiste y el seguimiento del diente afectado (AU)

Mandibular infected buccal cyst (MIBC), also known as bifurcation cyst; it is a rare inflammatory odontogenic cyst first described by Stoneman and Worth. It was included in the WHO classification of cysts and odontogenic tumours in 1992. It usually occurs, specifically, in patients between 6 and 10 years of age and its most frequent location is the first and second permanent molars, and eventually the second premolar. Its pathophysiology remains unclear and multiple theories have been proposed. This cyst is seen as an inflammation in the vestibule of the affected molar. Frequent symptoms are pain in the affected area and suppuration, but many cases remain asymptomatic. Radiographically it is described as a circumferential radiolucent area. The cyst is lined with a nonkeratinized squamous epithelium with an inflammatory cell infiltrate in the connective tissue. Most of clinical and histological characteristics are like those reported for paradental cysts, hence the importance of a good complementary radiographic diagnosis based on cone beam computed tomography. Conservative approaches are usually the treatment of choice, with enucleation of the cyst and monitoring of the affected tooth (AU)

Experimental furcal perforation treated with mineral trioxide aggregate plus selenium: immune response

Abstract The aim of this study is to evaluate the expression of cytokines in response to mineral trioxide aggregate (MTA) plus selenium in germ-free mice with experimental furcal perforation. The first left maxillary molar was opened, and the furcal area was perforated and treated with post-MTA-Se (experimental group). The same surgical intervention was performed for the maxillary right first molar, which was treated with MTA (control group). Fifteen mice were sacrificed 7, 14, and 21 days after furcal perforation, and periapical tissue samples were collected. The mRNA expression levels of the cytokines TGF-β, TNF-α, IFN-γ, HPRT, IL-10, IL-4, RANK, RANKL, IL-1, and IL-17 were assessed by using real-time polymerase chain reaction. In the experimental group, at 21-days post-MTA-Se sealing, the mRNA levels of TNF-α and IL-10 were upregulated compared with those in the control group (p < 0.05). Futher assessment revealed basal mRNA expression levels of IL-1α, IFN-γ, RANK, RANKL, IL-17A, IL-4, and TGF-β, over long experimental times, in both the experimental and control groups (p > 0.05). In conclusion, MTA+Se sealing favoured increased expression of IL-10 and TNF-α at later time points (day 21).

Characterization of consultations for odontogenic abscesses in a major Chilean hospital

OBJECTIVES: To characterize consultations for odontogenic abscesses at the dental and maxillofacial unit of the public emergency hospital in Santiago, Chile. METHODOLOGY: descriptive study, involving consecutive sampling of patients with diagnosis of odontogenic abscess, conducted between august and september 2016. descriptive statistics were performed to determine the frequency of diagnosis, affected tooth, sex and need for hospitalization. RESULTS: odontogenic abscesses accounted for 6.3 percent (n=414) of a total of 6,535 consultations. males represented 59 percent; 42 percent of odontogenic abscesses presented in molars and maxillary premolars. the vestibular space was the most frequently affected anatomical space (50 percent), associated in 53 percent of the cases to submucosal abscesses. ninety-eight per cent of patients were successfully treated on an outpatient basis, 2 percent required hospitalization, mainly associated to abscesses involving the deep submandibular space. CONCLUSION: odontogenic abscesses account for a low percentage of dental emergencies at the public emergency hospital in Santiago, Chile. most cases receive outpatient treatment.

Prevalencia y algunos factores de riesgo de caries dental en el primer molar permanente en una población escolar de 6 a 12 años de edad / Incidence and risk factors of tooth decay on the first permanent molar in a schoolchildren population aged 6 to 12 years old

Introducción: La Organización Mundial de la Salud reporta que la caries en México afecta a 48 por ciento de los menores de 5 años y que 93 por ciento de los niños de 15 años la padecen. En conjunto se estima que 99 por ciento de la población ha tenido caries y que esta enfermedad es la causa más importante de la pérdida de dientes antes de los 35 años de edad. La pérdida principal la constituyen los primeros molares permanentes, estos órganos dentales acompañan a la dentición primaria en la boca de un niño transformando la oclusión de la primera dentición a la dentición mixta. El propósito de este trabajo fue identifi car la prevalencia y algunos factores de riesgo de caries en el primer molar permanente en una comunidad escolar del municipio de Tultitlán, Estado de México. Métodos: Estudio observacional, prolectivo, transversal y descriptivo en una población de 560 escolares con una media de edad de 9.0 (± 2.0), mediana de 9.0 (6-12 años). Se valoró la presencia de placa dentobacteriana con el índice O’Leary y la experiencia de caries con los índices CPOD y CPOS. Resultados: La prevalencia de caries en el primer molar permanente en la población de estudio fue de 25.6 por ciento, el valordel índice CPOS fue de 1.6 ± 2.7; CPOD de 1.0 ± 1.4; los más afectados son los molares inferiores en 30.6 por ciento (n = 343) con un CPOS 1.0 (± 1.7) vs. los superiores 20.5 por ciento (n = 226) con un CPOS de 0.6 (± 1.4). De los riesgos analizados, el factor tiempo de exposición a la PDB medido a través de la edad mostró que los escolares ≥ 8 años tienen 7.1 veces más riesgo de presentar caries en el PMP que los menores de esa edad, siendo esta diferencia clínica estadísticamente significativa (RM = 8.1; IC95 por ciento 4.4-14.7, p < 0.0001). Conclusiones: Nuestra población de estudio muestra una similitud en los índices de caries en la dentición permanente con la literatura científica.

Introduction: The World Health Organization reports that tooth decay inMexico aff ects 48% of children under 5 years of age and 93% of childrenunder 15. Overall it is estimated that 99% of the population has hadtooth decay and that this disease is the most important cause of tooth lossbefore age 35. The greatest loss is of the fi rst permanent molars, thesedental organs represent the primary dentition in the mouth of a child,transforming with its presence the primary occlusion in mixed. Therefore,the purpose of this study was to identify the prevalence and some risk factorsfor tooth decay in the fi rst permanent molar in a school community in themunicipality of Tultitlan, State of Mexico. Methods: An observational,prolective, transverse and descriptive study in a population of 560 studentswith a mean age of 9.0 (± 2.0), median of 9.0 (6-12 years), the presenceof dental plaque (biofi lm) was assessed with the O’Leary index and theexperience of tooth decay with the DMFT and DMF indexes. Results:The prevalence of tooth decay in the fi rst permanent molar in the studypopulation was 25.6%, the value of the DMF index was 1.6 ± 2.7; DMFTof 1.0 ± 1.4; the most aff ected were the lower molars with 30.6% (n = 343)with a DMF 1.0 (± 1.7) vs. the upper ones with 20.5% (n = 226) with aDMF of 0.6 (± 1.4). Of the risks analyzed, the factor «time of exposure toPDB¼ measured through age showed that, schoolchildren ≥ 8 years of ageare 7.1 times more likely to have tooth decay in the fi rst molar than childrenunder that age, this diff erence is clinically and statistically signifi cant (RM= 8.1, IC95% 4.4-14.7, p < 0.0001). Conclusions: Our study populationshows a similarity in the tooth decay indexes in permanent dentitionwith the one indicated in the scientifi c literature; of the risks analyzed,the exposure time to dental plaque (biofi lm) was the one that showed astatistically signifi cant diff erence.

Pérdida prematura del primer molar permanente en niños de la escuela primaria "Antonio López". México. 2016 / First permanent molar premature lost in children of the "Antonio López" primary school. México. 2016

Introducción: el primer molar permanente es un diente fundamental al determinar el patrón de masticación durante toda la vida y desempeñar un papel primordial para desarrollar y mantener una oclusión apropiada. Objetivo: describir la pérdida prematura del primer molar permanente. Materiales y Métodos: se realizó estudio observacional, descriptivo, transversal en la escuela primaria "Antonio López Coloma" del Consejo popular México, del municipio Colón, provincia Matanzas, en el periodo comprendido de enero a marzo del 2015 en 169 niños las edades 6 a 11 años. Se estudiaron variables como: edad sexo, y localización del molar ausente. Resultados: el 3% de los estudiados perdió el primer molar permanente, el 40 % de niños con 11 años tuvo pérdida de este diente, las féminas representaron el 60 % de los estudiados. Conclusiones: los estudiados en la edad de 11 años con predominio del sexo femenino presentaron pérdida prematura del primer molar permanente, en los que resaltó el primer molar inferior izquierdo (AU).

Introduction: The first permanent molar is a fundamental tooth to determine the mastication pattern during the whole life, it is vital to develop and maintain a proper occlusion. Objective: describing the premature loss of the first permanent molar. Materials and Methods: an observational, descriptive and transversal study was carried out in the primary school Antonio López Coloma in the area of Mexico neighborhood in Colon municipality, Matanzas province, in the period from January to March 2015, in 169 children 6 to 11 years old. They were study variable, age, sex and the location of the missing tooth. Results: the 3 % of the students lost the first permanent molar, the 40 % of 11 years old boys loss this tooth. The girls represented the 60 % of the studied. Conclusions: The investigated mainly the female sex in the age of 11 lost the first permanent molar very early. The left lower first molar had the highest incidence (AU).

Influencia del tutor en la educación en el trabajo / Tutor's influence in education at work

El método de tutoría actúa de forma flexible y se acomoda a cada uno de los estudiantes, de acuerdo con su personalidad, intereses, conocimientos, capacidades, nivel de dificultades y avances. Actúa dentro de un sistema de enseñanza aprendizaje colectivo. En este proceso juegan un papel importante los factores que influyen en la formación de la personalidad, y dentro de ellos la escuela; que como institución está llamada a cumplir el rol de mayor responsabilidad en la formación de las nuevas generaciones, pero para cumplir con este papel, requiere de un trabajo conjunto con el tutor del área práctica, ya que este resulta un eje fundamental para el desempeño del futuro profesional. En Cuba, en las condiciones de la formación profesionallos tutoresson docentes en ejercicio. Dada la importancia que tiene el tutor y el papel que debe jugar en la práctica profesional, para una correcta contribución a la preparación y formación de los futuros tecnólogos, este artículo se propuso fundamentar el valor que tiene este durante la educación en el trabajo. Se abordan aspectos de gran interés para su desempeño, relacionados con su labor desde el área práctica, incluyendo la formación en valores (AU).

The tutoring method works in a flexible way and is able to accommodate to every of the students according to their personality, interests, knowledge, capacity, difficulties level and advances. It functions as a part of a collective teaching-learning process. The factors influencing in personality's formation play an important role in this process, especially the school. As an institution, the school should play a role of higher importance in forming new generations, but to play this role a combined work with the tutor of the practical area is needed because the tutor is a main piece in the performance of the future professional. In Cuba, in the conditions of the professional training, tutors are pedagogues in exercise of their profession. Due to the importance of the tutor and the role he/she should play in the professional practice for a correct contribution to the training of future health technologists, this article had the purpose of explaining the importance they have in the education at work. Several aspects are approached that are of great interest for the sake of tutors´ performance, related with their practical work including values formation (AU).

Influencia de los determinantes sociales en la salud del primer molar permanente / Influence of the social determinants in the first permanent molar health

Introducción: el proceso salud enfermedad depende de múltiples y complejas condiciones y no se rige solamente por las leyes conocidas de las ciencias naturales, sino que abarca también influencias psicológicas, socioeconómicas y ambientales. Estas son consideradas determinantes sociales de salud. Los factores causales que clínicamente producen la caries están bien identificados, pero no los determinantes socialesos a su prevalencia y menos asociados al primer molar permanente, considerado por diferentes autores como llave de la oclusión. Objetivo: determinar la salud del primer molar permanente, relacionado con algunos determinantes sociales de la salud en escolares de 11 a 16 años de edad. Materiales y métodos: para ello se decidió realizar una investigación observacional descriptiva prospectiva y transversal con el objetivo de determinar la salud del primer molar permanente, relacionado con algunos determinantes sociales de la salud en escolares de 11 a 16 años de la Escuela Secundaria Básica “Fermín y Yolanda” del municipio Unión de Reyes de septiembre 2014 de a abril de 2015. Resultados: se encontró que la mayoría de los adolescentes eran del sexo femenino, y tenían entre 13 y 14 años de edad. La mayoría de las familias de los adolescentes eran disfuncionales. De las barreras para conductas saludables estudiadas, la que más incidió fue la ingestión de alimentos que expenden alrededor de la escuela con el 95,3%. Conclusiones: a pesar de estos resultados el 60,7% de los molares permanentes eran saludables(AU).

Introduction: the health-disease process depends on multiple and complex conditions and it is not only ruled by the acknowledged laws of the natural sciences. It also includes psychological, socioeconomic and environmental influences. These are considered health social determinants. The causal factors clinically producing caries are well identified, but the social determinants related with its prevalence are not, less those associated to the first permanent molar considered by several authors as the key of the occlusion. Aim: to determine first permanent molar health related with several health social determinants in students aged 11-16 years. Materials and methods: a cross-sectional, prospective, descriptive and observational research was carry out with the aim of determining the health of the first permanent molar that is related with several health social determinants in students aged 11-16 years of the Basic Secondary School (Junior High School in the United States) “Fermin y Yolanda”, of the municipality Unión de Reyes from September 2014 to April 2015. Outcomes: most of the teenagers were females ones, aged 13-14 years. Most of their families were dysfunctional. From the studied barriers for healthy behaviour, the one with more incidences was the intake of food sold near the school with 95.3 %. Conclusions: in spite of these results, 60.7 % of the permanent molars were healthy (AU).

Restauración de molares endodonciados, con resina híbrida sobre muñón de amalgama: a propósito de un caso / Restoration of endodontic molars with hybrid resin over amalgam stump: about a case

Introducción: En la actualidad la restauración funcional y estética de dientes endodonciados con gran pérdida de tejido dentario, es efectuada a través del método indirecto; sin embargo, la construcción de muñones de amalgama como elemento de sustitución de metal es una opción terapéutica viable. Objetivo: Mostrar la viabilidad de la restauración estética y funcional de molares endodonciados y con gran pérdida de tejido dentario, por vía directa mediante resina híbrida sobre muñón de amalgama. Presentación del caso: Tratamiento impuesto a un paciente de 35 años con antecedentes de traumatismo dentario condicionantes de fracturas complicadas de corona en 36 y 37, tratados con endodoncias radicales de 2 años de evolución. Acudió a la consulta presentando pérdidas de más de dos tercios del tejido coronal en ambos casos. Luego de comprobar que ambos molares cumplían con los requerimientos, se realizó la preparación de las cavidades, seguida de la confección de muñones de amalgama, sobre los cuales pasadas las 48 horas, se realizó la restauración definitiva con resina híbrida nano composite. Conclusiones: El tratamiento cosmético con nano composite sobre muñón de amalgama, resulta una alternativa terapéutica viable en la restauración estética y funcional por vía directa, aun en molares con gran pérdida de tejido dentario y tratamiento pulporadicular radica(AU)

Introduction: Nowadays functional and aesthetic restoration of endodontic teeth with a great loss of dental tissue, is performed by means of an indirect method, however the construction of amalgams stumps as an element for the metal substitution is a viable therapeutic option. Objective: To show the viability of endodontic molars aesthetic and functional restoration with a great loss of dental tissue, through direct method with resin on amalgam stump. Case Presentation: Treatment applied to a 35-year-old patient with antecedents of traumatism conditioning complicated fractures of crown in 36 and 37, treated with radical endodontic therapy 2 years ago. Arrived to the consulting room presenting losses of more than two thirds of the coronal tissues in both cases. After verifying that both molars met the requirements, the cavities were prepared, followed by the conformation of amalgams stumps over which after 48h, was applied a nano hybrid resin for the definitive restoration. Conclusions: The cosmetic treatment with Nano composite resin over the amalgam stump is an alternative and viable therapy for the functional and aesthetic restoration by means of a direct procedure, even in molars with great loss of dental tissue and subjected to radical endodontic therapy(AU)

Reparación de una lesión endoperiodontal mediante tratamiento endodóntico no quirúrgico: reporte de un caso / Repair of an endo-periodontal lesion using a non-surgical endodontic treatment approach: report of a case

El tratamiento y pronóstico de las lesiones endoperiodontales depende del diagnóstico oportuno y preciso de la enfermedad endodóntica y/o periodontal. Cuando se trata de lesiones endodónticas primarias con involucración periodontal secundaria, la estrategia de tratamiento debe ser primeramente enfocada a la infección pulpar, al debridamiento y desinfección de los conductos radiculares. El objetivo de este estudio es demostrar la capacidad de reparación de una lesión endoperiodontal mediante terapia endodóntica no quirúrgica, sin posterior terapia periodontal. El caso es un paciente masculino de 10 años con necrosis pulpar del órgano dentario 46 con involucración periodontal mediante lesión en furca, la cual reparó completamente en tres meses tras el tratamiento endodóntico. Estos hallazgos se confirman radiográficamente y por la disminución de la profundidad sondeable en la zona de la lesión. Se concluye que en este tipo de casos, con involucración endodóntica primaria, la necesidad del tratamiento periodontal quirúrgico o no quirúrgico será determinada exclusivamente por la falta de reparación de la lesión por largos periodos de tiempo.

he treatment and prognosis of endo-periodontal lesions depend on the timely and accurate diagnosis of the endodontic and/or periodontal disease. In the case of primary endodontic lesions with secondary peri-odontal involvement, the treatment strategy should be focused primarily on the pulp infection and the debridement and disinfection of root canals. The aim of this study is to demonstrate the repair capacity of an endo-periodontal lesion treated with nonsurgical endodontic root therapy and no subsequent periodontal treatment. The case involves a 10-year-old male patient with pulpal necrosis and apical periodontitis of tooth 46; periodontal furcation involvement was also evident. The diagnosis was a primary endodontic lesion with secondary periodontal involvement. The furcation defect healed completely within three months of non-surgical root canal treatment, a fact confi rmed by X-rays and by the reduction in the probing depth in the area of the lesion. We conclude that in cases such as this, where there is primary endodontic involvement, surgical or non-surgical periodontal treatment should be considered exclusively if the periodontal lesion persists for long periods of time.

Avaliacão clínica de restauracões de resina composta em molares decíduos estudo piloto / A clinical evaluation of composite restorations in primary molars - an interim study

As restaurações de resina composta têm sido amplamente utilizadas na Clínica Infantil, pois além de preservarem a estrutura dental sadia são mais estéticas e o seu desgaste é semelhante ao desgaste fisiológico do dente decíduo. Objetivos: avaliar o comportamento e a longevidade das restaurações realizadas com resina composta em dentes decíduos posteriores utilizando os métodos USPHS e FDI. Materiais e Métodos: foram selecionadas 09 crianças que possuíam 34 restaurações eclusas ou ocluso-proximal em molares decíduos, realizadas no curso de graduação da Universidade Luterana do Brasil Cachoeira do Sul/RS com as resinas Charisma®, Filtekl P60, Filtekl Z250 XT. As restaurações foram avaliadas por um examinador cego para os objetivos do estudo, segundo critérios dos métodos USPHS e FOI. A análise estatística foi realizada com o teste Kruskal-Wallis, com nível de significãncia 5%. Resultados: as 34 restaurações feitas com as três resinas compostas não apresentaram diferenças em relação à maioria dos critérios nos dois métodos empregados. Apenas para o critério manchamento superficial houve diferença entre as resinas compostas (p=0,006), sendo que a resina Filtek P60 demonstrou maior manchamento superficial do que as resinas Charisma e Filtek Z250. Conclusões: as três resinas compostas mostraram-se satisfatórias durante o período de tempo avaliado, confirmando a sua indicação para tratamentos restauradores dos dentes decíduos. As resinas Charisma e Filtek Z250 apresentaram melhor desempenho em relação ao manchamento superficial do que a Filtek P60. Os dois métodos de avaliação clínica podem ser utilizados para avaliação de restaurações em dentes decíduos, sendo o método FDI mais completo e promissor.

The composite resins have been widely used in Pediatric Dentistry, because they preserve the health dental structure, are more esthetics and their abrasion levei is similar that of the deciduous teeth. Objectives: to evaluate the behavior and the longevity of the composite resins fillings in posterior deciduous teeth using the USPHS and FDI methods. Materiais and methods: 09 children were selected who had 34 restorations (occlusal and occlusoproximal) in primary molars performed by undergraduate students of Lutheran University of Brazil Cachoeira do Sul/RS with Charisma®, Filtekl P60, Filtekl Z250 XT composite resins). The restorations were evaluated by an examiner blinded to the study objectives, through USPHS and FDI methods criteria. Statistical analysis was performed by the Kruskal-Wallis test, with the significance level set at 5%. Results: the 3 composite resins did not show any difference regarding to majority of criteria employed in the two methods. For the superficial staining criterion there was statistically significant difference among the composite resins (p=0,OO6), being Filtek P60 the resin that showed worst superficial staining than Charisma and Filtek Z250. Conclusions: the composite resins evaluated were satisfactory and available to fill deciduous teeth. lhe composite resins Charisma and Filtek Z250 showed better performance than Filtek P60 in relation to superficial staining criterion. The two evaluation methods can be used to evaluate restorative procedures in deciduous teeth, being FOI method the most complete and promising though.

Microscopic evaluation of induced tooth movement after subluxation trauma: an experimental study in rats

OBJECTIVE: The objective of this study was to assess the histological alterations that occurred in the periodontal area of rat molars submitted to induced tooth movement (ITM) right after an intentional trauma (subluxation). METHODS: Forty adult male Wistar rats (Rattus norvegicus albinus) were selected. The animals were divided into eight groups (n = 5), according to the combination of variables: Group 1 - control (neither trauma nor ITM); Group 2 - ITM; Groups 3, 4, 5 and 6 - dentoalveolar trauma groups corresponding, respectively, to 1, 3, 8 and 10 days after trauma; Groups 7 and 8 - the animals' molars were subjected to a 900 cN impact and, one and three days after the trauma event, tooth movement was induced. The rats' maxillary first molars were mesially moved during seven days with a closed coil (50 cN). After the experimental period of each group, the animals were sacrificed by anesthetic overdose and the right maxillas were removed and processed for histological analysis under light microscopy. RESULTS: In the animals of group 3, 4, 5 and 6, the histological alterations were not very significant. Consequently, the effect of induced tooth movement right after a subluxation event (groups 7 and 8) was very similar to those described for Group 2. CONCLUSION: There was no difference in the quality of periodontal repair when ITM was applied to teeth that had suffered a subluxation trauma. .

OBJETIVO: avaliar as alterações histológicas ocorridas na área periodontal de molares de ratos submetidos à movimentação dentária induzida (MDI), logo após um trauma intencional (subluxação). MÉTODOS: quarenta ratos Wistar machos adultos (Rattus norvegicus albinus) foram selecionados. Os animais foram divididos em oito grupos (n = 5), de acordo com a combinação das variáveis: Grupo 1 - controle (sem trauma e sem MDI); Grupo 2 - MDI; Grupos 3, 4, 5 e 6 - grupos de trauma dentoalveolar correspondendo, respectivamente, para 1, 3, 8 e 10 dias após o trauma; Grupos 7 e 8 - os molares murinos foram submetidos a um impacto de 900cN e, de um e três dias após o evento trauma, o movimento do dente foi induzido. Os primeiros molares superiores dos animais foram movidos mesialmente durante sete dias, com uma mola fechada (50cN). Após período experimental de cada grupo, os animais foram sacrificados por overdose anestésica e as maxilas direitas foram removidas e processadas para análise histológica qualitativa. RESULTADOS: nos animais dos grupos 3, 4, 5 e 6, as alterações histológicas não foram muito significativas. Consequentemente, o efeito do movimento dentário induzido logo após um evento de subluxação (grupos 7 e 8) foi muito semelhante ao descrito para o grupo 2. CONCLUSÃO: não houve diferença na qualidade do reparo periodontal quando a MDI foi aplicada aos dentes que sofreram um trauma de subluxação. .

Caries dental aguda del primer molar permanente en niños de 12 años / Acute dental caries of the first permanent molar in children younger than 12 years

El primer molar permanente es considerado la llave de la oclusión dentaria, la presencia de caries en éste es elevada, lo que dificulta el logro de las metas trazadas por organizaciones de salud a nivel mundial en este grupo de edad. Objetivo: determinar el comportamiento de la caries dental aguda en primer molar permanente en una población de 12 años de edad atendida en la Clínica Estomatológica Santa Cruz de la Parroquia Goaigoaza. Métodos: se realizó un estudio descriptivo transversal en la Clínica Estomatológica Santa Cruz. Parroquia Goaigoaza, municipio Puerto Cabello, estado Carabobo, en el período comprendido entre abril del 2009 a abril 2010. Se seleccionaron 97 pacientes de 12 años de edad los que constituyeron el universo y la muestra. Acudieron a la consulta por dolor debido a la presencia de caries dental aguda. Se registraron las variables: edad, sexo, grado clínico de la caries dental, estímulos externos que provocaron dolor, la cara dental y la arcada dentaria más afectadas. La información fue recogida mediante interrogatorio y examen clínico. Resultados: el sexo masculino representó el 63,9 por ciento. La caries dental de 3er grado estuvo presente en un 68 por ciento. Los estímulos externos que provocaron dolor fueron: el frío presente en 75,2 por ciento y los alimentos dulces en 69,1 por ciento en ambos sexos. El primer molar inferior derecho resultó más afectado (46,4 por ciento) que el izquierdo (36,1 por ciento), así como la arcada dentaria inferior (25,8 por ciento) y la cara oclusal (64,9 por ciento). Conclusiones: predominaron el sexo masculino y la caries dental aguda de 3er grado. El frío y los alimentos dulces fueron los estímulos externos más frecuentes. Los más afectados resultaron el primer molar inferior derecho, la cara oclusal y la arcada dentaria inferior(AU)

The first permanent molar is considered the dental key to occlusion. The presence of caries here is high, hindering the achievement of goals set by various health organizations worldwide in this age group. Objetive: to determine acute dental caries behavior in the first permanent molar within a 12 year-aged population, assisted at The Dental Clinic of Santa Cruz in Goaigoaza Parish. Method: a descriptive cross-sectional study was conducted in The Dental Clinic of Santa Cruz in Goaigoaza Parish, Puerto Cabello, Carabobo, from April 2009 to April 2010. 97 patients (12 year-aged) were selected to form the universe and sample. These patients came to consultation in pain due to the presence of acute dental caries. Variables were recorded such as: age, sex, clinical grade of dental caries, external stimuli causing pain, dental face and the most affected dental arch: the variables were. The information was collected by interview and clinical examination. Results: the males accounted for 63.9 percent. 3rd grade dental caries were present in 68.0 percent. External stimuli causing pain were cold (75.2 percent) and sweet foods (69.1 percent) in both genders. The lower right first molar was the more affected (46.4 percent) than the left one (36.1 percent), as well as the lower dental arch (25.8 percent) and the occlusal face (64.9 percent). Conclusions: acute 3rd grade dental caries and males patients predominated. Cold and sweet foods were the most frequent external stimuli, The lower right first molar, the occlusal face and lower dental arch were the most affected(AU)

Effects of Gates-Glidden, LA Axxess and orifice shaper burs on the cervical dentin thickness and root canal area of mandibular molars

This study evaluated the increase of the instrumented area and dentin thickness in the mesial and distal aspects of mesial canals of mandibular molars after the use of Gates Glidden (GG), LA Axxess (LA) and Orifice Shaper (OS) instruments. A total of 53 canals from 27 mandibular molars were embedded in resin and divided into 3 groups. The roots were sectioned 3 mm below the cementoenamel junction and the images were captured before and after instrumentation. The increase of the instrumented area in terms of percentages and the remaining dentin thickness, in mm, at the mesial and furcal aspects were calculated using the Image tools software. Data were analyzed using the Kruskal-Wallis and Dunn's test. The significance level was set at 5 percent. All instruments promoted cervical flaring with different amounts of dentin removal at the mesial and distal aspects of the root canals. Statistically significant difference (p<0.05) was found between LA and all other instruments after using the first instrument. Regarding dentin thickness, no significant difference (p>0.05) was found between the mesial and distal walls in all groups. It may be concluded that LA 35.06 and GG 3 burs produced the thinnest dentin walls, and thus their use in mesial canals of mandibular molars should be done with caution.

Este estudo avaliou o aumento da área do canal e a espessura de dentina na parede mesial e distal dos canais mesiais de molares inferiores após o uso de Gates Glidden (GG), La Axxess (LA), Orifice Shaper (OS). Um total de 53 canais mesiais de 27 molares inferiores foram incluídos em resina e divididos em 3 grupos. As raízes foram seccionados 3 mm abaixo da junção cemento-esmalte e as imagens foram capturadas antes e depois da instrumentação. O aumento da área do canal em percentagem e a espessura da dentina remanescente nas paredes mesial e furca foram calculados utilizando o software Image Tools. Os dados foram analisados utilizando o Kruskal-Wallis e teste de Dunn. O Nível de significância foi de 5 por cento. Todos os instrumentos promoveram o aumento da área cervical, com diferentes quantidades de remoção da dentina nas paredes mesial e distal do canal radicular. Diferença estatística (p<0,05) foi encontrada entre LA e todos os outros instrumentos após o uso do primeiro instrumento. Quanto à espessura da dentina, não houve diferença significativa (p>0,05) entre as paredes mesial e distal de todos os instrumentos analisados. O LA 35.06 e GG 3 mostraram a menor espessura da parede e sua utilização em canais mesiais de molares inferiores deve ser feito com cuidado.

Root perforations treatment using mineral trioxide aggregate and Portland cements / Cimentos de agregado trióxido mineral e Portland no tratamento de perfurações radiculares

PURPOSE: Clinical, radiological and histological evaluation of root perforations treated with mineral trioxide aggregate (MTA) or Portland cements, and calcium sulfate barrier. METHODS: One molar and 11 premolar teeth of a male mongrel dog received endodontic treatment and furcations were perforated with a high-speed round bur and treated with a calcium sulfate barrier. MTA, Portland cement type II (PCII) and type V (PCV), and white Portland cement (WPC) were used as obturation materials. The teeth were restored with composite resin and periapical radiographs were taken. The animal was euthanized 120 days post-surgery for treatment evaluation. RESULTS: Right lower first premolar (MTA), right lower third premolar (PCV), left lower second premolar (MTA), and right lower second premolar (WPC): clinically normal, slightly radio-transparent area on the furcation, little inflammatory infiltrate, and new-bone formation. Left lower third premolar (PCII), right upper first premolar (WPC), right upper third premolar (PCII), and left upper first molar (PCV): clinically normal, radiopaque area on the furcation, and new-bone formation. Right upper second premolar (MTA), left upper second premolar (WPC), left upper third premolar (PCII): presence of furcation lesion, large radiolucent area, and intense inflammatory infiltrate. CONCLUSION: All obturation materials used in this study induced new-bone formation.

OBJETIVO: Avaliar clínica, radiológica e histologicamente perfurações radiculares tratadas com MTA e cimentos Portland, com barreira de sulfato de cálcio. MÉTODOS: A amostra foi constituída por 11 dentes pré-molares e um molar de cão macho, sem raça definida. Após tratamento endodôntico realizaram-se perfurações nas furcas com broca esférica de alta rotação e barreira de sulfato de cálcio. Foram utiliados os cimentos MTA, Portland tipo II (CPII), Portland tipo V (CPV) e Portland branco estrutural (CPB). Os dentes foram restaurados com resina composta e submetidos a radiografias periapicais. O animal foi confinado por 120 dias e submetido à eutanásia para avaliações. RESULTADOS: Primeiro pré-molar inferior direito (MTA), terceiro pré-molar inferior direito (CPV), segundo pré-molar inferior esquerdo (MTA) e segundo pré-molar inferior direito (CPB): clinicamente normal; leve área radiotransparente na furca; pequeno infiltrado inflamatório e neoformação óssea. Terceiro pré-molar inferior esquerdo (CPII), primeiro pré-molar superior direito (CPB), terceiro pré-molar superior direito (CPII) e primeiro molar superior esquerdo (CPV): clinicamente normal; área radiopaca na furca; neoformação óssea. Segundo pré-molar superior direito (MTA), segundo pré-molar superior esquerdo (CPB) e terceiro pré-molar superior esquerdo (CPII): clinicamente com lesão na furca; intensa área radiolucida; infiltrado inflamatório intenso. CONCLUSÃO: Todos os cimentos induziram a neoformação óssea.

Reprodutibilidade in vitro dos métodos visual e de fluorescência a laser na detecção de lesões de cárie oclusais em dentes decíduos / In vitro reproducibility of the visual and laser fluorescence methods for the detection of occlusal caries in primary molars

O objetivo deste trabalho foi avaliar a reprodutibilidade dos métodos visuais e de fluorescência a laser na detecção de lesões oclusais de cárie não-cavitadas em molares decíduos. Utilizaram-se 57 dentes com sítios suspeitos de lesão oclusal provenientes do Banco de Dentes Humanos da Faculdade de Odontologia da Universidade de São Paulo (FOUSP/SP). Dois examinadores, previamente treinados, atribuíram escores visuais e médias de fluorescência a laser com o aparelho DIAGNOdent® (KaVo, Biberach, Alemanha) a cada dente selecionado; os exames foram repetidos após uma semana. O teste Kappa e a correlação de Pearson foram calculados para determinação da concordância intra e interexaminadores e da reprodutibilidade do aparelho de fluorescência a laser, respectivamente. Os resultados obtidos para os índices visuais demonstraram concordância intraexaminador de substancial a quase perfeita e moderada. Quanto à reprodutibilidade das médias de fluorescência a laser, os valores de correlação de Pearson foram positivos e altamente significativos para ambos os avaliadores. Concluiu-se que a inspeção visual e a fluorescência a laser são métodos confiáveis para a detecção de lesões de cárie na superfície oclusal de molares decíduos.

Quiste bucal mandibular infectado: presentación de un caso clínico / Mandibular infected buccal cyst: report of a clinical case

El quiste bucal mandibular infectado es un quiste inflamatorio que se presenta en niños entre 6 y 10 años de edad. Es una patología poco frecuente que afecta a los primeros o segundos molares inferiores semierupcionados. El objetivo del presente trabajo es presentar uncaso de quiste bucal mandibular infectado que a pesar de ser una entidad que presenta un comportamiento biológico benigno, pueden alcanzar grandes proporciones si no se diagnostican en forma temprana ni se tratan apropiadamente.