Expression of OPG, RANK, and RANKL proteins in tooth repair processes after immediate and delayed tooth.

This study evaluated the immunohistochemical expression of OPG, RANK, and RANKL proteins in the repair after immediate and delayed replantation of rat teeth. Fifty-six Wistar rats (Rattus norvegicus albinus) had their maxillary right lateral incisor extracted and then replanted, according to the following conditions: group I (control; n = 8), teeth were not extracted; group II (n = 16), immediate replantation; group III (n = 16), delayed replantation without treatment; and group IV (n = 16), delayed replantation after root surface treatment (periodontal ligament removal and immersion in 2% acidulated-phosphate sodium fluoride) and calcium hydroxide intracanal dressing. Rats in group I were euthanized on the first day of the experiment, while the animals in the other groups were euthanized 10 and 60 days after replantation (n = 8/period). Hematoxylin and eosin-stained sections were obtained for histological analysis. The immunohistochemical analysis revealed expression of OPG and RANKL proteins in all groups and both postreplantation times, except for group II at 60 days. In the experimental groups, RANK expression was observed only at 10 days. In conclusion, there was strong immunostaining for the OPG-RANK-RANKL system at the earlier postreplantation time, suggesting a more effective participation of these proteins at the start of the healing process, as their expression decreased at 60 days.

A method for the geometric standardization of intraoral radiographs for long-term follow up of replanted teeth: a case report.

The interpretation of the set of radiographs taken during the follow-up period after tooth replantation might pose several difficulties, especially the inability to adequately reproduce the projection geometry of the exposures. This article describes a method for the geometric standardization of intraoral radiographs using a custom-made apparatus comprising a film-holder attached to an occlusal splint for the long-term follow up of dentoalveolar trauma. The method was applied in a patient who suffered an avulsion of the maxillary central incisors and had the teeth replanted after 4 h in saline storage. Endodontic treatment started 7 days after the trauma with changes of a calcium hydroxide intracanal medication every 15 days in the first 2 months and thereafter at 30-day intervals for 8 months. Root canal filling was carried out after this period. The radiographic exposures taken at the follow-up visits were standardized to identify the possible alterations during the repair process, such as root resorptions. A maxillary arch impression was made with alginate, and the model was cast in stone for fabrication of an acetate occlusal splint. The custom-made apparatus used for standardization of the radiographic exposures was fabricated by fixing a Rinn X-C-P film-holder and a 5-mm-long piece of 0.7-mm orthodontic wire to the occlusal splint with autopolymerized acrylic resin. Radiographs were taken at 4-month intervals, starting 10 months after replantation up to 76 months. The images were digitized and analysed using the Digora system. The length of the central incisors was determined to verify the reproduction of the projection geometry of the exposures and the orthodontic wire served to assess accuracy during length estimations in the radiographs. The method described in this article for geometric standardization of intraoral radiographs provided a consistent reproduction of the geometric exposure parameters, being indicated for use in the radiographic follow up of cases of dentoalveolar trauma.

Dragon's Blood Sap (Croton Lechleri) As Storage Medium For Avulsed Teeth: In Vitro Study Of Cell Viability.

Tooth replantation success depends on the condition of cementum periodontal ligament after tooth avulsion; which is influenced by storage medium. The dragon's blood (Croton lechleri) sap has been suggested as a promising medium because it supports collagen formation and exhibits healing, anti-inflammatory and antimicrobial properties. Thus, the aim of this study was to evaluate the efficacy of dragon's blood sap as a storage medium for avulsed teeth through evaluation of functional and metabolic cell viability. This in vitro study compared the efficacy of different storage media to maintain the viability of human peripheral blood mononuclear and periodontal ligament cells. A 10% dragon's blood sap was tested while PBS was selected as its control. Ultra pasteurized whole milk was used for comparison as a commonly used storage medium. DMEM and distilled water were the positive and negative controls, respectively. The viability was assessed through trypan blue exclusion test and colorimetric MTT assay after 1, 3, 6, 10 and 24 h of incubation. The dragon's blood sap showed promising results due to its considerable maintenance of cell viability. For trypan blue test, the dragon's blood sap was similar to milk (p<0.05) and both presented the highest viability values. For MTT, the dragon's blood sap showed better results than all storage media, even better than milk (p<0.05). It was concluded that the dragon's blood sap was as effective as milk, the gold standard for storage medium. The experimental sap preserved the membrane of all cells and the functional viability of periodontal ligament cells.

Replantation as treatment for extrusive luxation.

In the treatment of extrusive luxation cases, it is important that the repositioning of extruded tooth in the socket is done as soon as possible. If this does not occur, periapical clot becomes organized and makes replantation difficult reposition. In this article the patient referred to the Clinics for dental trauma sustaining extrusive luxation of the maxillary right central incisor. The patient reported having suffered a bicycle accident 12 days before, which caused traumatic tooth injuries. The repositioning was attempted without success and an alternative form of treatment was necessary to solve the case. Intentional tooth replantation, which is the deliberate extraction of the tooth and its replantation, was indicated. This technique allows clot removal and correct repositioning of the extruded tooth. Care should be taken as endodontic treatment is required for the prevention of subsequent infection-related resorption. Intracanal dressing with calcium hydroxide was used for 30 days before final root filling. Splint, systemic antibiotics and avoidance of further damage to the root surface is also important. After 49 months, showed clinical and radiographic characteristics of normality and demonstrates the availability of this technique to adversity in trauma.

Delayed tooth replantation: MTA as root canal filling.

MTA has been investigated as a root-end filling material. Its mechanism of action has some similarities to that of Ca(OH)2. The purpose of this study was to evaluate the repair process taking place in the delayed replantation of monkey teeth using calcium hydroxide and MTA as root canal filling materials. Five monkeys had their lateral incisors extracted and bench-dried for 60 minutes. After root canal preparation, the teeth were assigned to two groups according to root canal filling material: I, calcium hydroxide; and II, MTA. The same treatment sequence was followed for both groups: coronal seal, periodontal ligament removal, immersion of the tooth in 2% acidulated-phosphate sodium fluoride, irrigation of the socket with saline and replantation. Both groups exhibited replacement resorption, areas of ankylosis and absence of inflammatory root resorption. Statistically similar results (p > 0.05) were observed for both groups regarding replacement root resorption, but the groups differed significantly (p < 0.05) regarding the occurrence of ankylosis. MTA may be a viable clinical option for filling teeth submitted to delayed replantation, and is an acceptable option for treating replanted permanent teeth in order to prevent tooth resorption, particularly when dressing changes are not possible.

Uso de antibioticoterapia sistêmica após o reimplante de dentes permanentes avulsionados: uma revisão de literatura / Use of systemic antibiotic therapy after the replantation of avulsed permanent teeth: a literature review

Avulsão dentária é o tipo mais grave de traumatismo dentoalveolar, e o tratamento de escolha para esse tipo de lesão deve ser o reimplante do dente avulsionado. Após realizar uma revisão da literatura e promover discussões com pesquisadores experientes e especialistas clínicos de diferentes áreas, a Associação Internacional de Traumatologia Dentária (IADT) propôs um protocolo para o reimplante dentário com a recomendação de se usar a antibioticoterapia sistêmica (SAT) para reduzir o risco de ocorrência de reabsorção radicular. Diversos antibióticos foram testados, mas a tetraciclina e amoxicilina são, de longe, as drogas mais comumente usadas para lesões por avulsão. Este trabalho revisa a literatura sobre a prescrição de SAT em casos de reimplante imediato e tardio de dentes permanentes acidentalmente avulsionados, com base em uma análise crítica de artigos completos recuperados nos bancos de dados eletrônicos PubMed/Medline, Bireme e SciELO. Trabalhos de pesquisa original e revisões de literatura publicados em língua inglesa entre 1966 e 2016 e que contivessem alguma discussão sobre a relação entre antibioticoterapia e reimplante de dentes permanentes foram buscados por meio da utilização das palavras chave "avulsão dentária", "antibioticoterapia sistêmica" e "reimplante dentário". Observou-se que a prescrição de antibióticos para dentes reimplantados é um assunto controverso e que estudos clínicos randomizados são necessários para se estabelecer a real necessidade de se usarem antibióticos para o reimplante dentário. Até que os resultados desses estudos se tornem disponíveis, a recomendação é de se usar a SAT para o tratamento de dentes permanentes reimplantados após uma avulsão acidental. A melhor opção de prescrição é a tetraciclina durante 7 dias e a segunda melhor opção é a amoxicilina durante 4 a 7 dias

Dental avulsion is the most severe type of dentoalveolar trauma, and the treatment of choice for this type of injury should be the replantation of the exarticulated tooth. After conducting a review of the literature and holding discussions with experienced researchers and clinical specialists from different areas, the International Association of Dental Traumatology (IADT) proposed a protocol for tooth replantation, including a recommendation for systemic antibiotic therapy (SAT) to reduce the risk of root resorption. Several antibiotics have been tested, but tetracycline and amoxicillin are, by far, the most commonly used drugs for avulsion injuries. This paper reviews the literature on the prescription of SAT in cases of immediate and delayed replantation of accidentally avulsed permanent teeth, based on a critical analysis of full-length papers retrieved from the PubMed/Medline, Bireme and SciELO electronic databases. Original research reports and literature reviews published in English-language journals between 1966 and 2016, and directly or indirectly discussing the relation between antibiotic therapy and the replantation of permanent teeth, were searched using "tooth avulsion," "systemic antibiotic therapy" and "tooth replantation" as key words. The prescription of antibiotics for tooth replantation was found to be a controversial subject, and randomized clinical studies are needed to determine whether antibiotics for tooth replantation are actual indicated. Until the results of these studies become available, the recommendation is to use SAT for the management of permanent teeth replanted after an accidental avulsion. The best prescription option is tetracycline for 7 days, and the second best prescription option is amoxicillin for 4 to 7 days.

Dragon's Blood Sap (Croton Lechleri) As Storage Medium For Avulsed Teeth: In Vitro Study Of Cell Viability

Abstract Tooth replantation success depends on the condition of cementum periodontal ligament after tooth avulsion; which is influenced by storage medium. The dragon's blood (Croton lechleri) sap has been suggested as a promising medium because it supports collagen formation and exhibits healing, anti-inflammatory and antimicrobial properties. Thus, the aim of this study was to evaluate the efficacy of dragon's blood sap as a storage medium for avulsed teeth through evaluation of functional and metabolic cell viability. This in vitro study compared the efficacy of different storage media to maintain the viability of human peripheral blood mononuclear and periodontal ligament cells. A 10% dragon's blood sap was tested while PBS was selected as its control. Ultra pasteurized whole milk was used for comparison as a commonly used storage medium. DMEM and distilled water were the positive and negative controls, respectively. The viability was assessed through trypan blue exclusion test and colorimetric MTT assay after 1, 3, 6, 10 and 24 h of incubation. The dragon's blood sap showed promising results due to its considerable maintenance of cell viability. For trypan blue test, the dragon's blood sap was similar to milk (p<0.05) and both presented the highest viability values. For MTT, the dragon's blood sap showed better results than all storage media, even better than milk (p<0.05). It was concluded that the dragon's blood sap was as effective as milk, the gold standard for storage medium. The experimental sap preserved the membrane of all cells and the functional viability of periodontal ligament cells.

Resumo O sucesso do reimplante dentário depende da condição apresentada pelo ligamento periodontal cementário pós-avulsão que pode ser influenciado pelo meio de estocagem. O Sangue de Dragão (Croton lechleri) é sugerido como um meio promissor por auxiliar na formação de novo colágeno e apresentar propriedades cicatrizante, anti-inflamatória, antimicrobiana. Assim, o objetivo deste trabalho foi avaliar a eficácia da seiva Sangue de Dragão como meio de estocagem para dentes avulsionados por meio da aferição da viabilidade funcional e metabólica celular. Este estudo in vitro comparou a eficácia dos meios para a manutenção da viabilidade das células mononucleares de sangue periférico humano e do ligamento periodontal mantidas em cultura. Foi testada a diluição a 10% da seiva Sangue de Dragão enquanto que a PBS foi selecionada como seu controle. O leite ultrapasteurizado integral foi utilizado como meio comparativo por ser tradicionalmente utilizado como meio de estocagem. O DMEM e a água destilada foram os controles positivos e negativos, respectivamente. A avaliação da viabilidade foi feita por meio dos testes de exclusão por Azul de Tripan e colorimétrica a base de tetrazolato (MTT), após 1, 3, 6, 10 e 24 h de incubação. A seiva Sangue de Dragão apresentou resultados promissores devido à sua considerável manutenção da viabilidade celular. Para a metodologia com o Azul de Tripan, a seiva Sangue de Dragão foi semelhante ao leite.

Replantation as Treatment for Extrusive Luxation

In the treatment of extrusive luxation cases, it is important that the repositioning of extruded tooth in the socket is done as soon as possible. If this does not occur, periapical clot becomes organized and makes replantation difficult reposition. In this article the patient referred to the Clinics for dental trauma sustaining extrusive luxation of the maxillary right central incisor. The patient reported having suffered a bicycle accident 12 days before, which caused traumatic tooth injuries. The repositioning was attempted without success and an alternative form of treatment was necessary to solve the case. Intentional tooth replantation, which is the deliberate extraction of the tooth and its replantation, was indicated. This technique allows clot removal and correct repositioning of the extruded tooth. Care should be taken as endodontic treatment is required for the prevention of subsequent infection-related resorption. Intracanal dressing with calcium hydroxide was used for 30 days before final root filling. Splint, systemic antibiotics and avoidance of further damage to the root surface is also important. After 49 months, showed clinical and radiographic characteristics of normality and demonstrates the availability of this technique to adversity in trauma.

No tratamento de casos de luxação extrusiva é importante que o reposicionamento do dente extruído em seu alvéolo seja feito o mais rápido possível. Se isso não ocorrer, o coágulo periapical se torna organizado e dificulta a reposição. Neste artigo, o paciente encaminhado para a clínica de traumatismo dentário apresentava luxação extrusiva do dente 11. O paciente relatou que havia sofrido um acidente de bicicleta 12 dias antes e teve lesões dentárias. Tentou-se fazer o reposicionamento sem sucesso e uma forma alternativa de tratamento foi necessária para resolver o caso. Reimplante intencional, que é a extração do dente e seu reimplante de forma proposital, foi indicado. Esta técnica permite a remoção do coágulo e o reposicionamento correto do dente extruído. Cuidado deve ser observado quanto ao tratamento endodôntico, para a prevenção de uma reabsorção relacionada a uma infecção. Curativo de demora com hidróxido de cálcio foi realizado por 30 dias antes da obturação final. Contenção, antibióticos sistêmicos e evitar maiores danos à superfície da raiz também são importantes. O controle de 38 meses mostrou características clínicas e radiográficas de normalidade e demonstra a disponibilidade desta técnica para a adversidade no trauma.

Multidisciplinary approach for crown-root fracture treatment after trauma: case report / Abordagem multidisciplinar para tratamento de fratura corono-radicular pós-traumatismo: relato de caso

The development of an accurate diagnosis and appropriate treatment plan can be a complex task, especially in cases of dentoalveolar trauma. The authors present a case report of crown-root fracture caused by trauma and highlight the importance of a multidisciplinary approach for the treatment. An eighteen year-old boy had a bicycle accident resulting in dental trauma. The upper right first molar showed a complicated crownroot fracture and the lower left second pre-molar showed an uncomplicated crown-root fracture. Endodontic treatment, controlled tooth extrusion, periodontal surgery for recovery of biological width, and porcelain crown and onlay restorations were performed. Esthetic and functional results were achieved. At the two-year follow-up it was observed that the tooth/onlay interface of the upper right first molar was stained and the onlay of the left lower second pre-molar was fractured. Therefore, the interface stained was repaired and a porcelain crown was made for the lower second premolar. The clinical case presented herein leads to the conclusion that a multidisciplinary treatment plan is extremely important for a proper resolution in cases of dentoalveolar trauma

A elaboração de um diagnóstico preciso e de um plano de tratamento adequado pode constituir uma tarefa bastante complexa, especialmente nos casos de traumatismos dentoalveolares. O relato de caso teve por finalidade demonstrar a importância da abordagem multidisciplinar para o tratamento de fratura corono-radicular pós traumatismo. Paciente de 18 anos de idade, gênero masculino, sofreu uma queda de bicicleta resultando em traumatismos dentários. O 16 sofreu fratura corono-radicular complicada e o 35 fratura corono-radicular não-complicada. Foi realizado tratamento endodôntico, extrusão dentária controlada, cirurgia periodontal para recuperação do espaço biológico, coroa de porcelana e restauração tipo onlay. O resultado estético e funcional foi alcançado. O paciente foi acompanhado por 2 anos onde foi observado um manchamento na interface dente/onlay do 16 e fratura da onlay do 35. Foi realizado um reparo na interface do 16 e confeccionada uma coroa de porcelana para o 35. Foi possível concluir que a multidisciplinaridade do plano de tratamento é de extrema importância para uma adequada resolução dos casos de traumatismos dentoalveolares

Resveratrol como meio de estocagem para dentes avulsionados: estudo in vitro da viabilidade celular / Resveratrol as storage media for avulsed teeth: an in vitro study of cell viability

A manutenção dos dentes avulsionados em meios de estocagem adequados para a preservação da viabilidade celular é de extrema importância para o reparo do ligamento periodontal e prevenção do aparecimento das reabsorções radiculares, maior causa de perda dos dentes reimplantados. Recentemente, o resveratrol tem sido bastante estudado, em razão das suas propriedades antioxidante, anti-inflamatória, antimicrobiana e da sua capacidade de prolongar a vida de diversos organismos desde as leveduras até os mamíferos. Nesse contexto, o objetivo deste trabalho é analisar a eficácia do resveratrol como meio de estocagem para dentes avulsionados por meio da aferição da viabilidade estrutural e funcional celular, pelo método de exclusão pelo corante Azul de Tripan e metodologia colorimétrica a base de tetrazolato. Foi testado o resveratrol dissolvido em propilenoglicol + solução tampão salina-fosfato (PBS), o qual serviu de controle da solução. O leite ultrapasteurizado integral foi utilizado como meio comparativo por ser tradicionalmente utilizado e indicado para esse fim. Os controles positivos utilizados foram Meio Modificado Dulbecco Eagle (DMEM) e PBS, e o controle negativo, a água destilada. Foram utilizados dois tipos celulares: mononucleares de sangue periférico humano e fibroblastos do ligamento periodontal humano mantidos em cultura e a avaliação da viabilidade celular in vitro foi feita por meio dos testes de exclusão pelo corante Azul de Tripan e colorimétrica a base de tetrazolato (MTT), sendo determinada nos tempos 1, 3, 6, 10 e 24 horas de incubação. Os ensaios foram realizados em triplicata e com 4 repetições. O resveratrol apresentou bons resultados com ambos os tipos celulares quando analisado pelo teste de exclusão por Azul de Tripan. Não houve diferenças entre o resveratrol e o leite ao longo do tempo. Quando analisado pela metodologia MTT, o resveratrol apresentou resultados inferiores ao leite e ao controle positivo DMEM (p<0,05). Baseado nesses...

The maintenance of avulsed teeth in appropriate storage media for the preservation of cell viability is very important for the repair of the periodontal ligament and to prevent the development of root resorption, which is the main cause of loss of replanted teeth. Recently, resveratrol has been extensively studied due to its antioxidant, anti-inflammatory and antimicrobial properties and ability to prolong the lives of several organisms since yeast to mammals. Thus, the aim of this study is to evaluate the effectiveness of resveratrol as storage media for avulsed teeth by measuring the structural and functional cell viability. The resveratrol dissolved in propylene glycol + phosphate-buffered saline (PBS), which was control of the solution, was tested. UHT milk was used as a comparative storage medium because it is traditionally used and indicated to this purpose. The positive controls used were Dulbecco’s Modified Eagle’s Medium (DMEM) and PBS, and the water as negative control. Two cell types were used: human peripheral blood mononuclear cells and human periodontal ligament fibroblasts maintained in culture and the cell viability was analyzed by Trypan Blue exclusion test and the tetrazolium salt-based colorimetric assay (MTT) and determined at 1, 3, 6, 10 and 24 h of incubation. The tests were performed in triplicate and with 4 replications. The resveratrol presented good results with both cell types when analysed by Trypan Blue exclusion test. There were no differences between milk and resveratrol over time. When analysed by MTT assay, resveratrol presented inferior results than milk and positive control DMEM (p<0,05). Based on these results, it may be concluded that resveratrol was able to maintain the structural cell viability of the human peripheral blood mononuclear cells and periodontal ligament fibroblasts by Trypan Blue exclusion test. However, resveratrol not showed good performance while maintaining the functional viability of periodontal...

Resveratrol como meio de estocagem para dentes avulsionados: estudo in vitro da viabilidade celular / Resveratrol as storage media for avulsed teeth: an in vitro study of cell viability

A manutenção dos dentes avulsionados em meios de estocagem adequados para a preservação da viabilidade celular é de extrema importância para o reparo do ligamento periodontal e prevenção do aparecimento das reabsorções radiculares, maior causa de perda dos dentes reimplantados. Recentemente, o resveratrol tem sido bastante estudado, em razão das suas propriedades antioxidante, anti-inflamatória, antimicrobiana e da sua capacidade de prolongar a vida de diversos organismos desde as leveduras até os mamíferos. Nesse contexto, o objetivo deste trabalho é analisar a eficácia do resveratrol como meio de estocagem para dentes avulsionados por meio da aferição da viabilidade estrutural e funcional celular, pelo método de exclusão pelo corante Azul de Tripan e metodologia colorimétrica a base de tetrazolato. Foi testado o resveratrol dissolvido em propilenoglicol + solução tampão salina-fosfato (PBS), o qual serviu de controle da solução. O leite ultrapasteurizado integral foi utilizado como meio comparativo por ser tradicionalmente utilizado e indicado para esse fim. Os controles positivos utilizados foram Meio Modificado Dulbecco Eagle (DMEM) e PBS, e o controle negativo, a água destilada. Foram utilizados dois tipos celulares: mononucleares de sangue periférico humano e fibroblastos do ligamento periodontal humano mantidos em cultura e a avaliação da viabilidade celular in vitro foi feita por meio dos testes de exclusão pelo corante Azul de Tripan e colorimétrica a base de tetrazolato (MTT), sendo determinada nos tempos 1, 3, 6, 10 e 24 horas de incubação. Os ensaios foram realizados em triplicata e com 4 repetições. O resveratrol apresentou bons resultados com ambos os tipos celulares quando analisado pelo teste de exclusão por Azul de Tripan. Não houve diferenças entre o resveratrol e o leite ao longo do tempo. Quando analisado pela metodologia MTT, o resveratrol apresentou resultados inferiores ao leite e ao controle positivo DMEM (p<0,05). Baseado nesses...

The maintenance of avulsed teeth in appropriate storage media for the preservation of cell viability is very important for the repair of the periodontal ligament and to prevent the development of root resorption, which is the main cause of loss of replanted teeth. Recently, resveratrol has been extensively studied due to its antioxidant, anti-inflammatory and antimicrobial properties and ability to prolong the lives of several organisms since yeast to mammals. Thus, the aim of this study is to evaluate the effectiveness of resveratrol as storage media for avulsed teeth by measuring the structural and functional cell viability. The resveratrol dissolved in propylene glycol + phosphate-buffered saline (PBS), which was control of the solution, was tested. UHT milk was used as a comparative storage medium because it is traditionally used and indicated to this purpose. The positive controls used were Dulbecco’s Modified Eagle’s Medium (DMEM) and PBS, and the water as negative control. Two cell types were used: human peripheral blood mononuclear cells and human periodontal ligament fibroblasts maintained in culture and the cell viability was analyzed by Trypan Blue exclusion test and the tetrazolium salt-based colorimetric assay (MTT) and determined at 1, 3, 6, 10 and 24 h of incubation. The tests were performed in triplicate and with 4 replications. The resveratrol presented good results with both cell types when analysed by Trypan Blue exclusion test. There were no differences between milk and resveratrol over time. When analysed by MTT assay, resveratrol presented inferior results than milk and positive control DMEM (p<0,05). Based on these results, it may be concluded that resveratrol was able to maintain the structural cell viability of the human peripheral blood mononuclear cells and periodontal ligament fibroblasts by Trypan Blue exclusion test. However, resveratrol not showed good performance while maintaining the functional viability of periodontal...

Plano de tratamento em odontologia: análise dos planos propostos por alunos de graduação / Dentistry treatment planning: analysis of treatment planning developed by undergraduate students

Objetivo: Avaliar a habilidade dos alunos do último ano degraduação da Faculdade de Odontologia de Araçatuba - UNESPpara a elaboração de planos de tratamento para um mesmo casoclínico.Método: Para a realização do presente estudo foi selecionado umcaso clínico envolvendo várias especialidades. Após a realizaçãodo exame do paciente os achados foram anotados na ficha utilizadapela disciplina de Clínica Integrada. Acrescentaram-se, também,fotografias, radiografias periapicais e fotografias dos modelos deestudo de maneira a permitir uma ilustração adequada do casoclínico. A documentação obtida foi entregue aos alunos do últimoano do curso de Odontologia. Foi solicitado, sob a forma de avaliaçãocurricular, que elaborassem planos de tratamento e enumerassemquais os fatores considerados para a elaboração dos mesmos. Amesma avaliação foi aplicada no início e final do ano letivo, duranteos anos de 2004 e 2005, com amostra de 200 indivíduos. Os dadosforam coletados e submetidos à análise descritiva, incluindo adistribuição de freqüências calculadas pelo software Epi Infoversão 3.2.Resultados: Os fatores mais citados para a elaboração dos planosforam: condição sócio-econômica, necessidades e expectativasdos pacientes, fatores sistêmicos, higiene e oclusão. A forma deapresentação do plano por especialidade foi escolhida por 90,61 por centodos alunos e mais de 78 por cento deles elaboraram mais de um plano.Conclusão: Os alunos são capazes de elaborar vários planos detratamento para um mesmo caso clínico, demonstrando capacidadepara oferecer diferentes opções de tratamento ao paciente.

Resveratrol como meio de conservação para dentes avulsionados: análise histomorfológica e imunoistoquímica / Resveratrol as storage media for avulsed teeth: histomorphological and immunohistochemical

A manutenção da vitalidade do ligamento periodontal cementário é de extrema importância para o sucesso do reimplante dentário. Minimizar o período de exposição do dente avulsionado ao meio seco ou mantê-lo em meio úmido, se constitui em importante conduta para o tratamento. Recentemente, o resveratrol tem sido bastante estudado, em razão das suas propriedades antioxidantes e da sua capacidade de prolongar a vida de diversos organismos desde as leveduras até os mamíferos. Portanto, o objetivo deste trabalho é avaliar a manutenção da vitalidade do ligamento periodontal cementário armazenado em resveratrol. Para isso foram empregados incisivos superiores e inferiores de sete macacos, totalizando 56 dentes. No grupo I os dentes foram extraídos e imediatamente imersos em solução fixadora. Nos grupos II a VI os dentes foram imersos em 50mL de solução de resveratrol em propilenoglicol (5 μM/L) durante 1, 2, 6, 12 e 24 horas, respectivamente. No grupo VII os dentes foram mantidos em meio seco por 6 horas. Parte dos cortes obtidos foi corada em H.E. para estudo histomorfológico e outra parte para análise imunoistoquímica utilizando anticorpos primários contra osteopontina e caspase. Os resultados demonstraram que nos grupos imediato e resveratrol 12 horas houve presença de moderado número de fibroblastos, alguns macrófagos e linfócitos. Nos grupos resveratrol 1, 2, 6 e 24 horas houve presença de pequeno número de fibroblastos e discreta vascularização. O grupo seco apresentou ausência de vasos sanguíneos e fibroblastos em degeneração. Houve imunomarcação moderada de osteopontina nos grupos imediato, resveratrol 12 e 24 horas. Nos demais grupos a imunomarcação variou de ausente a leve. Quanto à caspase, foi observada imunomarcação moderada nos grupos resveratrol 1, 2, 6 e 24 horas. No restante dos grupos a imunomarcação variou de ausente a leve. Foi possível concluir que o resveratrol parece ser um bom meio de conservação da vitalidade das células do ligamento...

The maintenance of vitality of the cement periodontal ligament is important for success of tooth reimplantation. It has been suggested to minimize the period of exposure of the avulsed tooth to dry environment or keep it in wet storage. Recently, resveratrol has been extensively studied due to its antioxidant properties and ability to prolong the lives of several organisms since yeast to mammals. The aim of this study is to evaluate the maintenance of vitality of the cement periodontal ligament stored in resveratrol. The analysis was conducted using maxillary and mandibular incisors of seven monkeys, total of 56 teeth. In group I, the teeth were extracted and immediately immersed in fixative solution. In groups II to VI, the teeth were immersed in 50ml of solution of resveratrol in propylene glycol (5 μM/L) for 1, 2, 6, 12 and 24 hours; respectively. In group VII, the teeth were maintained in dry environment for 6 hours. Some cuts were stained with HE for histomorphological analysis while some cuts were submitted to immunohistochemical analysis using primary antibody against osteopontin and caspase. The results demonstrated that in the groups immediate and resveratrol 12 hours showed presence of a moderate number of fibroblasts, some macrophages and lymphocytes. In the groups resveratrol 1, 2, 6 and 24 hours showed presence of small numbers of fibroblasts and mild vascularization. The dry group showed absence of blood vessels and fibroblasts in degeneration. There was moderate immunomarcation of osteopontin in the groups immediate, and resveratrol 12 and 24 hours. In the other groups, immunomarcation ranged from absent to light. Considering the caspase, it was observed moderate immunomarcation in the groups resveratrol 1, 2, 6 and 24 hours. In the remaining groups, immunomarcation ranged from absent to light. It was concluded that the resveratrol may be adequate for maintenance of vitality of cells of periodontal ligament until 12 hours