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1.
Eur Arch Paediatr Dent ; 21(5): 617-622, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31898299

RESUMEN

PURPOSE: Self-induced soft-tissue injuries (SSI) are reported as local anesthesia complications, particularly in children. The purpose of the study was to evaluate the frequency of SSI following dental anesthesia in children with and without intellectual disability. METHODS: 241 children receiving dental treatments with local anesthesia were divided into 2 groups: A, children without intellectual disability (159 individuals, 299 injections); B, children with intellectual disability (82 individuals, 165 injections). Each group was divided into subgroups according to age, injection technique and dental treatment. Two days after the dental procedure, a phone survey was conducted to determine the presence of SSI. RESULTS: The frequency of SSI in group B was 19%, with no differences in relation to gender and age. In group A the frequency of SSI was significantly lower (9%; p = 0.002; Chi-square test); the children in the ≤ 6 years-old subgroup experienced a higher frequency of SSI (p = 0.002). The lower arch was at major risk of SSI in both groups (p = 0.002). According to a multilevel approach group (p = 0.001) and injection technique (p = 0.0001) significantly influenced SSI; no influence of dental treatment is evidenced. CONCLUSIONS: SSI are common complications of local anesthesia in young children and individuals with intellectual disability.


Asunto(s)
Anestesia Dental/efectos adversos , Discapacidad Intelectual/complicaciones , Anestesia Local/efectos adversos , Niño , Preescolar , Humanos , Inyecciones , Estudios Prospectivos
2.
Int Endod J ; 51 Suppl 3: e178-e188, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28218959

RESUMEN

AIM: This retrospective study explored survival and periapical healing outcomes in teeth root filled with Thermafil obturators. METHODOLOGY: Root canals of 213 teeth (94 subjects, mean age 48 ± 13 years), instrumented with a step-down technique, irrigated with 5% NaOCl and 10% EDTA and filled with Thermafil and AH Plus sealer, were involved in a recall programme. Teeth were retrospectively re-examined after 5 ± 1 years in a controlled environment. Clinical and radiographic data that were collected included the following: preoperative Periapical Index (PAI) score and signs/symptoms, treatment type, root filling length and presence/absence of voids, restoration type, follow-up PAI score and signs/symptoms. Teeth were considered 'healthy' (PAI ≤ 2, no signs/symptoms) or 'diseased' (PAI ≥ 3, signs/symptoms present, retreated, extracted for endodontic reasons). Two PAI-calibrated examiners assessed outcomes blinded to preoperative status. Bivariate and multilevel analyses were performed at level of patient and tooth (α = 5%). RESULTS: Of 213 teeth treated, 187 (88%) survived and 26 were extracted, six (3%) for persistent endodontic infection (considered 'diseased'), and 20 (9%) for root fracture, periodontal disease or coronal fracture (excluded from analysis). Whilst survival was significantly associated with tooth type (P = 0.015), type of treatment (P = 0.012) and pulpal/periapical diagnosis (P = 0.035), none of these variables were substantiated as survival predictors by the multilevel analysis. A total of 164 of 193 teeth (85%) were assessed as 'healthy', with significantly higher (chi-square; P < 0.04) 'healthy' rates for teeth with PAI score ≤2 and root fillings of adequate length. Multilevel analysis identified PAI score ≤2 (P = 0.002) as the only predictor of periapical health. CONCLUSIONS: In this 5 ± 1 year retrospective assessment, survival and healing rates after root canal treatment with Thermafil root fillings were comparable to those previously reported for conventional root filling techniques.


Asunto(s)
Periodontitis Periapical/terapia , Materiales de Obturación del Conducto Radicular , Obturación del Conducto Radicular , Tratamiento del Conducto Radicular , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Diente no Vital/terapia , Resultado del Tratamiento
3.
Clin Oral Investig ; 21(4): 1267-1276, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-27299600

RESUMEN

OBJECTIVES: The aim of the present study is to evaluate the possible correlation between sealer penetration into dentinal tubules and sealing ability both in presence and absence of smear layer. MATERIALS AND METHODS: Fourteen maxillary central incisors were treated with 5.25 % NaOCl +10 % EDTA to remove the smear layer (SL-free group) or 5.25 % NaOCl without EDTA (SL group). Root canals were filled using #25 Thermafil Obturators with Topseal sealer labelled with 0.1 wt% rhodamine B. Sealing ability was measured as fluid filtration rate with a fluid-flow meter using water supplemented with 0.3 % calcein fluorescent dye. Specimens were sectioned, observed under confocal microscope to co-localize the presence of sealer (rhodamine B labelling) into dentinal tubules and gaps (calcein labelling) into the root canal. The depth of sealer penetration into dentinal tubules and the percentage of sealer penetration around the root canal were measured at 3, 5 and 8 mm from the apex. RESULTS: No significant differences between groups were observed in fluid filtration rate nor in depth of calcein penetration. Sealer penetration depth and percentage into dentinal tubules were not significantly different between groups, except at 8-mm level in absence of smear layer. CONCLUSION: Sealer penetration at 3- and 5-mm levels was not influenced by smear layer while it was significantly reduced at 8-mm level. Fluid filtration rate was not correlated either with depth of calcein penetration nor with sealer penetration into dentinal tubules. CLINICAL RELEVANCE: The sealing ability of Topseal sealer is not affected by presence or absence of smear layer.


Asunto(s)
Dentina/efectos de los fármacos , Resinas Epoxi/química , Materiales de Obturación del Conducto Radicular/química , Preparación del Conducto Radicular/métodos , Ácido Edético/química , Colorantes Fluorescentes , Humanos , Técnicas In Vitro , Incisivo , Ensayo de Materiales , Microscopía Confocal , Rodaminas , Irrigantes del Conducto Radicular/química , Capa de Barro Dentinario , Hipoclorito de Sodio/química , Propiedades de Superficie
4.
Lupus ; 22(12): 1232-42, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24097995

RESUMEN

Patients with systemic lupus erythematosus (SLE) have a higher prevalence of clinical and subclinical atherosclerosis compared with age- and sex-matched controls. Atherosclerosis progression is also accelerated in SLE, and coronary heart disease (CHD) is a major cause of morbidity and mortality. Traditional cardiovascular (CV) risk factors, including hypertension, diabetes mellitus or dyslipidemia, are more prevalent in SLE patients than in the general population, but they cannot fully account for accelerated atherosclerosis in SLE. In fact, a number of nontraditional risk factors have been identified, including disease activity, damage and various treatments. Preventive strategies for CHD are mandatory in SLE patients and should include giving up smoking; performing regular physical activity; managing metabolic abnormalities such as dyslipidemia, insulin resistance, and diabetes; treating persistent disease activity; and minimizing chronic exposure to corticosteroids. Low-dose aspirin, angiotensin-converting enzyme (ACE) inhibitors, vitamin D supplementation, antimalarials and, when indicated, some immunosuppressants such as mycophenolate mofetil should also be considered.


Asunto(s)
Aterosclerosis/prevención & control , Enfermedad Coronaria/prevención & control , Lupus Eritematoso Sistémico/complicaciones , Aterosclerosis/epidemiología , Aterosclerosis/etiología , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/etiología , Progresión de la Enfermedad , Glucocorticoides/administración & dosificación , Glucocorticoides/uso terapéutico , Humanos , Estilo de Vida , Lupus Eritematoso Sistémico/terapia , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad
5.
Reumatismo ; 64(6): 380-7, 2012 Dec 20.
Artículo en Inglés | MEDLINE | ID: mdl-23285482

RESUMEN

Systemic lupus erythematosus (SLE) is an autoimmune disease involving many organ systems. Glomerulonephritis (GLN) is one of the major causes of morbidity and mortality in SLE. It has recently been demonstrated that adjuvants of vaccines could cause the so called ASIA syndrome. The study aimed to assess the effects of Complete Freund's Adjuvant (CFA) vs alum injections in NZB/NZWF1 mice. Mice (n=10 each group) were injected with a total volume of 200 µL of: CFA in PBS (group 1), alum in PBS (group 2), PBS (group 3) as controls, PTX3/CFA (group 4), PTX3/alum (group 5), 3 times, 3 weeks apart /given in each injection, three weeks apart from ten weeks of age. Urine samples were collected weekly to evaluate proteinuria. Blood samples were collected before every injection, at 21 weeks of age, and at death to evaluate levels of anti-PTX3 and anti-dsDNA. Proteinuria free survival and survival rates were analyzed by the Kaplan-Meier method using Mantel-Cox's test for comparisons. CFA-treated mice developed both anti-dsDNA antibodies and proteinuria earlier and at higher levels than alumtreated and PBS-injected mice, starting from 13 weeks of age. Proteinuria free survival rates (proteinuria ≥ 300 mg/dL) and survival rates were lower in CFA-treated mice than those treated with alum or injected with PBS (P<0.001 for all). No difference was observed between the alum-treated group and PBS-injected mice. Notably, groups 4 and 5, immunized with PTX3, developed anti-PTX3 antibodies and no significant difference was observed. Alum seems to be as effective as and safer than CFA as adjuvant, since it did not affect disease progression in immunized NZB/NZWF1 mice.


Asunto(s)
Adyuvantes Inmunológicos/administración & dosificación , Compuestos de Alumbre/administración & dosificación , Proteína C-Reactiva/inmunología , Componente Amiloide P Sérico/inmunología , Vacunación/métodos , Adyuvantes Inmunológicos/toxicidad , Compuestos de Alumbre/toxicidad , Animales , Anticuerpos Antinucleares/sangre , Autoanticuerpos/inmunología , Autoantígenos/inmunología , Proteína C-Reactiva/administración & dosificación , ADN/inmunología , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Evaluación Preclínica de Medicamentos , Adyuvante de Freund/administración & dosificación , Adyuvante de Freund/toxicidad , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/inmunología , Nefritis Lúpica/inducido químicamente , Nefritis Lúpica/inmunología , Nefritis Lúpica/orina , Ratones , Ratones Endogámicos NZB , Proteinuria/etiología , Proteínas Recombinantes/administración & dosificación , Proteínas Recombinantes/inmunología , Componente Amiloide P Sérico/administración & dosificación , Síndrome , Vacunación/efectos adversos
6.
Clin Neuropharmacol ; 13(1): 77-83, 1990 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-2306750

RESUMEN

Six males and one female with chronic tic disorders, whose ages ranged from 12 to 31 years, were evaluated before treatment, after 1 month on placebo, after a single 10 mg nifedipine dose (three patients), and monthly while on flunarizine 10-15 mg (mean dose of 13 mg). None of the patients receiving nifedipine improved, but treatment with flunarizine significantly decreased both motor and phonic tic severity and frequency in all but one patient. Side effects included mild transient headaches in one patient, depression in one, and bradykinesia in two. Although a double-blind study is essential to validate our findings, results suggest that flunarizine is a useful drug in the treatment of Gilles de la Tourette syndrome.


Asunto(s)
Bloqueadores de los Canales de Calcio/uso terapéutico , Síndrome de Tourette/tratamiento farmacológico , Adolescente , Adulto , Bloqueadores de los Canales de Calcio/efectos adversos , Femenino , Flunarizina/uso terapéutico , Humanos , Masculino , Nifedipino/uso terapéutico , Trastornos de Tic/tratamiento farmacológico , Síndrome de Tourette/psicología
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