Periapical tissue reactions to calcium hydroxide and MTA after external root resorption as a sequela of delayed tooth replantation.

Clinical experience has shown that most avulsed teeth are replanted after a long extra-alveolar time and dry or inadequate wet storage, causing necrosis of periodontal ligament cells. This condition invariably leads to development of external root resorption, leaving the filling material in contact with the periapical connective tissues. In this study, the periapical tissue reactions to calcium hydroxide (CH) and mineral trioxide aggregate (MTA) were evaluated after occurrence of external root resorption as an expected sequela of delayed tooth replantation. Twenty male Wistar rats (Rattus norvegicus, albinus) had their right upper incisor extracted and maintained in dry storage for 60 min. Then, the dental papilla, enamel organ, pulp tissue, and periodontal ligament were removed, and the teeth were immersed in a 2% acidulated phosphate sodium fluoride solution, pH 5.5, for 10 min. The teeth were randomly assigned into two groups (n = 10), in which the canals were filled with either a CH and saline paste (CH group) or MTA (MTA group). The sockets were irrigated with saline, and the teeth were replanted. After 80 days, it was possible to observe large areas of replacement root resorption and some areas of inflammatory root resorption in both groups. More severe inflammatory tissue reaction was observed in contact with calcium hydroxide compared with the mineral trioxide aggregate. New bone formation was more intense at the bottom of the socket in the MTA group. In conclusion, as far as periapical tissue compatibility is concerned, intracanal MTA can be considered as a viable option for root canal filling in delayed tooth replantation, in which external root resorption is an expected sequela.

Oral rehabilitation after surgical removal of pleomorphic adenoma.

Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. The treatment of choice for most of maxillary tumors is surgical through either a total or partial maxillectomy. However, surgical defects caused by such type of treatment lead to both clinical and psychologic disorders for the patient. The immediate oral rehabilitation using interim palate obturator after maxillectomy provides optimization on the healing process, recovers the stomatognathic functions after surgery, and avoids psychosocial sequelae for the patients. This clinical report aimed to present the rehabilitation with immediate palate obturator of a patient who underwent a partial maxillectomy due to a hard palate pleomorphic adenoma of minor salivary glands. We report the clinical importance of the prosthetic rehabilitation and the improvements on both quality of life and stomatognathic functions of this patient. It can be concluded that the immediate rehabilitation of the patient after partial maxillectomy by using an interim palate obturator was a great option and provided clinical benefits in the immediate postoperative period, improving the patient's quality of life, allowing the patient's reinsertion into society, and reducing the surgical treatment sequelae.

Endaural access to remove the projectile from a firearm.

BACKGROUND: Surgical approaches to temporomandibular region have been the subject of numerous controversies in the literature. Pre-auricular approaches have been used with the observance of high success rate, and during surgery history, various modifications of this approach were conducted in order to reduce irreversible sequelae. Thus, given the relevance of the study, this article proposes to alert the professionals that carry out these surgical approaches in relation to the anatomical structures involved and to describe and emphasise the benefits of endaural approach. CASE REPORT: A Caucasian male patient, victim of a firearm injury, sustained a wound on the right pre-auricular region, and at the time of assessment, he complained of pain, mouth opening difficulty and dysphagia. On physical examination, there was oedema and ecchymosis in the right periorbital region. In the radiological examination, a foreign body compatible with a firearm projectile was observed in the right pre-auricular region, being in accordance with the information collected. The endaural incision and divulsion by plans was then made until the projectile. DISCUSSION: For proper exposure of the region, several studies were designed to evaluate the patterns of branching and anastomosis of the facial nerve. As for the best cosmetic result with the different pre-auricular approaches, the endaural approach was described as an approach that offers great cosmetic results because the incision design guides the surgeon in the wound closure and causes a decrease in the tension of flap, unlike that observed by some authors.

Reimplante dentário após o preenchimento do canal com pasta de B-glicerofosfato de cálcio ou pasta de hidróxido de cálcio + MTA: estudo histomorfométrico em ratos / Tooth replantation after root canal filling with paste B-glycerophosphate calcium or calcium hydroxide paste: histomorphometric study in rats

A avulsão dentária acomete principalmente pacientes jovens e que possuem dentes com rizogênese incompleta, sendo frequente a necrose pulpar e a apicificação que é prejudicada. O amplo forame dificulta a inserção de curativos de demora. Assim é importante o uso de um curativo de demora a favorecer o controle da reabsorção radicular e a formação de uma barreira de tecido mineralizado permitindo o selamento apical. O hidróxido de cálcio tem sido o material mais utilizado para esse fim. O objetivo deste trabalho foi estudar o processo de reparo de incisivos de ratos com elementos dentais reimplantados tardiamente após a obturação do canal radicular com pasta de β-glicerofosfato de cálcio ou pasta de hidróxido de cálcio. Foram empregados 30 ratos machos divididos em 3 grupos de 10 animais. Os elementos dentais foram extraídos e mantidos em meio seco por 60 minutos. Após esse período os elementos dentais sofreram um preparo especifico descrito a seguir. No Grupo I os dentes foram preenchidos com soro fisiológico. No Grupo II, utilizou-se a pasta de hidróxido de cálcio no interior do conduto e plug apical de cimento MTA. E, no grupo III utilizou-se a pasta de β-glicerofosfato de cálcio. Os dentes foram reimplantados e a eutanásia dos animais foi realizada 60 dias após para a avaliação histomorfométrica em H.E (Hematoxicilina-Eosina). Os resultados demonstraram que os grupos I e III foram mais comprometidos pela reabsorção radicular inflamatória do que o grupo II. O grupo II apresentou menor comprometimento pela reabsorção total do que o grupo II (p<0,05). Nos grupos I e III a região periapical apresentou a maior extensão de tecido conjuntivo fibroso com a presença de infiltrado inflamatório. Conclui-se que o β-glicerofosfato de cálcio não foi mais eficiente do que o hidróxido de cálcio no controle da reabsorção radicular e no reparo da região periapical por tecido mineralizado...

Thooth avulsion mainly affects young patients who have incomplete root formation, with frequent necrotic pulp and apexification impaired. The large foramen hinders the insertion of dressings delay. The use of a long time fill to facilitate control of formation and resorption of mineralized tissue barrier permitting the apical seal. Calcium hydroxide and MTA has been the most widely used material for this purpose. The objective of this work is to study the repair process of rat incisors with dental elements reimplanted late after root canal filling with paste β-glycerophosphate calcium or calcium hydroxide paste. Were used 30 male rats were divided into 3 groups of 10 animals. All the teeth were extracted and kept in dry for 60 minutes. In Group I, the root canals were filled with saline. Group II used the paste of calcium hydroxide and finished with a MTA plug and Group III were used β-glycerophosphate calcium paste. The teeth were reimplanted and euthanasia was performed 60 days later for histomorfometric analyse with HE(Hematoxiciline-Eosine). Results showed that the groups I and III were more impaired by inflammatory root resorption than group II. Group II had less involvement by total reabsorption of the group II (p <0,05). In groups I and III, the periapical region showed the greatest extent of fibrous connective tissue with inflammatory infiltrate. It is concluded that β-glycerophosphate calcium were less effective than calcium hydroxide in the control of root resorption and repair of the periapical area of mineralized tissue...

Reimplante dentário após o preenchimento do canal com pasta de B-glicerofosfato de cálcio ou pasta de hidróxido de cálcio + MTA: estudo histomorfométrico em ratos / Tooth replantation after root canal filling with paste B-glycerophosphate calcium or calcium hydroxide paste: histomorphometric study in rats

A avulsão dentária acomete principalmente pacientes jovens e que possuem dentes com rizogênese incompleta, sendo frequente a necrose pulpar e a apicificação que é prejudicada. O amplo forame dificulta a inserção de curativos de demora. Assim é importante o uso de um curativo de demora a favorecer o controle da reabsorção radicular e a formação de uma barreira de tecido mineralizado permitindo o selamento apical. O hidróxido de cálcio tem sido o material mais utilizado para esse fim. O objetivo deste trabalho foi estudar o processo de reparo de incisivos de ratos com elementos dentais reimplantados tardiamente após a obturação do canal radicular com pasta de β-glicerofosfato de cálcio ou pasta de hidróxido de cálcio. Foram empregados 30 ratos machos divididos em 3 grupos de 10 animais. Os elementos dentais foram extraídos e mantidos em meio seco por 60 minutos. Após esse período os elementos dentais sofreram um preparo especifico descrito a seguir. No Grupo I os dentes foram preenchidos com soro fisiológico. No Grupo II, utilizou-se a pasta de hidróxido de cálcio no interior do conduto e plug apical de cimento MTA. E, no grupo III utilizou-se a pasta de β-glicerofosfato de cálcio. Os dentes foram reimplantados e a eutanásia dos animais foi realizada 60 dias após para a avaliação histomorfométrica em H.E (Hematoxicilina-Eosina). Os resultados demonstraram que os grupos I e III foram mais comprometidos pela reabsorção radicular inflamatória do que o grupo II. O grupo II apresentou menor comprometimento pela reabsorção total do que o grupo II (p<0,05). Nos grupos I e III a região periapical apresentou a maior extensão de tecido conjuntivo fibroso com a presença de infiltrado inflamatório. Conclui-se que o β-glicerofosfato de cálcio não foi mais eficiente do que o hidróxido de cálcio no controle da reabsorção radicular e no reparo da região periapical por tecido mineralizado

Thooth avulsion mainly affects young patients who have incomplete root formation, with frequent necrotic pulp and apexification impaired. The large foramen hinders the insertion of dressings delay. The use of a long time fill to facilitate control of formation and resorption of mineralized tissue barrier permitting the apical seal. Calcium hydroxide and MTA has been the most widely used material for this purpose. The objective of this work is to study the repair process of rat incisors with dental elements reimplanted late after root canal filling with paste β-glycerophosphate calcium or calcium hydroxide paste. Were used 30 male rats were divided into 3 groups of 10 animals. All the teeth were extracted and kept in dry for 60 minutes. In Group I, the root canals were filled with saline. Group II used the paste of calcium hydroxide and finished with a MTA plug and Group III were used β-glycerophosphate calcium paste. The teeth were reimplanted and euthanasia was performed 60 days later for histomorfometric analyse with HE(Hematoxiciline-Eosine). Results showed that the groups I and III were more impaired by inflammatory root resorption than group II. Group II had less involvement by total reabsorption of the group II (p <0,05). In groups I and III, the periapical region showed the greatest extent of fibrous connective tissue with inflammatory infiltrate. It is concluded that β-glycerophosphate calcium were less effective than calcium hydroxide in the control of root resorption and repair of the periapical area of mineralized tissue

Estudo histomorfométrico de incisivos de ratos submetidos a diferentes níveis de luxação extrusiva e subluxação / Histomorphometric study of incisors of rats after extrusive luxation and subluxation

Este estudo avaliou as consequências de níveis diferentes de luxação e subluxação de dentes anteriores de ratos sem reposicionamento e o processo de reparo do tecido pulpar e do periodonto adjacentes. Realizou-se avaliação histológica descritiva e histomorfométrica. Utilizou-se 39 ratos divididos em 3 grupos sendo esses: GI: realizou-se a subluxação dos incisivos superiores. GII: realizou-se luxação extrusiva dos referidos dentes em 1 mm e GIII: luxação em 2 mm dos dentes acima citados. A avaliação qualitativa histológica das laminas foi realizada, utilizando tabela de scores previamente desenvolvida e descrita no texto. Foi utilizado também o programa imagelab 2000 para a quantificação da área compreendida pela superfície da câmara pulpar após esses movimentos traumáticos nos elementos dentais estudados. Observou-se como resultado qualitativo, que dentro desses limites previamente estabelecidos de luxação, ocorreu pouca, e em alguns casos nenhum, processo de reabsorção da estrutura dentinária. Agora, com relação ao comprometimento pulpar, observou-se que, quanto maior o trauma sofrido pelo dente, maior foi o processo degenerativo do conteúdo pulpar, apresentando em alguns casos, áreas de abscesso instaladas, concorrendo também com a revascularização do referido dente.

This study evaluated the consequences of different levels of dislocation and subluxation of the anterior teeth of rats without repositioning and repair process of the pulp tissue and periodontal healing. Carried out histological description and histomorphometry. We used 39 rats divided into 3 groups and these: GI: it was a subluxation of the upper incisors. GII: held extrusive luxation of those teeth in 1 mm and GIII: dislocation of 2 mm above the teeth. The qualitative assessment of histological slides was performed using table scores previously developed and described in the text. We also used ImageLab 2000 software to quantify the area including the surface of the pulp chamber after these movements in traumatic dental elements studied. Observed as a result qualitatively, that within those limits previously established dislocation, there was little, and in some cases non-existent, resorption of the dentin structure. Now, with respect to pulp involvement, it was observed that the greater trauma suffered by the tooth, greater degeneration of the pulp content, presenting in some cases, areas of abscess installed, also competing with revascularization of that tooth.

Avaliação clinica de enxertos ósseos autógenos de crista ilíaca em maxilas atróficas para instalação de implantes osseointegráveis / Clinical evaluation of bone autogenous bone graft from iliac crest in a atrophic maxillae to perform ossointegrated implants

A falta de estrutura óssea influência diretamente no resultado protético, quando se utiliza implantes osseointegrados. Os enxertos ósseos para reconstrução total de maxilas atróficas anterior aos implantes, tornam-se, muitas vezes, um procedimento indispensável. O osso ilíaco é uma área doadora muito utilizada para enxertos ósseos. Avaliou-se clinicamente 12 pacientes com atrofias totais de maxila, que foram submetidos a enxertos retirados da crista ilíaca. Encontrou-se uma melhora do perfil externo, bem como no posicionamento labial dos pacientes após o enxerto ósseo. Em todos os casos houve aumento do rebordo alveolar. Concluiu-se também, que é possível utilizar enxertos ósseos da crista do ilíaco para reconstruções de maxila atróficas, para instalação de implantes osseointegrados.

The lack of bone structure direct influences prosthethic results, when there is a need for the use of osseointegrated implants. The bone graft for the reconstruction of atrophic total maxillae before the implants has become, in many cases. Was analyzed 12 patients with total maxillae atrophy who where undergone to bone graft surgery from the iliac crest. Was found an improvement of the external profile, as well as, in the patients in the patients lip positioning after bone graft. In all cases there was an increase of bone in alveolar crest. Also in conclusion, it is possible the use iliac bone graft to reconstructed atrophic total maxillae in order to perform osseointegrated implants.