Buffered 2% articaine in buccal infiltration of mandibular molars: a randomized triple-blind clinical trial.

This crossover study aimed to compare the anesthetic effects of buffered 2% articaine with 1:200,000 epinephrine with that of non-buffered 4% articaine with 1:200,000 epinephrine. Forty-seven volunteers were administered two doses of anesthesia in the buccal region of the second mandibular molars in two sessions using 1.8 mL of different local anesthetic solutions. The onset time and duration of pulp anesthesia, soft tissue pressure pain threshold, and the score of pain on puncture and burning during injection were evaluated. The operator, volunteers, and statistician were blinded. There were no significant differences in the parameters: onset of soft tissue anesthesia (p = 0.80), duration of soft tissue anesthesia (p = 0.10), onset of pulpal anesthesia in the second (p = 0.28) and first molars (p = 0.45), duration of pulp anesthesia of the second (p = 0.60) and first molars (p = 0.30), pain during puncture (p = 0.82) and injection (p = 0.80). No significant adverse events were observed. Buffered 2% articaine with 1:200,000 epinephrine did not differ from non-buffered 4% articaine with 1:200,000 epinephrine considering anesthetic success, safety, onset, duration of anesthesia, and pain on injection.

Buffered 2% articaine in buccal infiltration of mandibular molars: a randomized triple-blind clinical trial

Abstract This crossover study aimed to compare the anesthetic effects of buffered 2% articaine with 1:200,000 epinephrine with that of non-buffered 4% articaine with 1:200,000 epinephrine. Forty-seven volunteers were administered two doses of anesthesia in the buccal region of the second mandibular molars in two sessions using 1.8 mL of different local anesthetic solutions. The onset time and duration of pulp anesthesia, soft tissue pressure pain threshold, and the score of pain on puncture and burning during injection were evaluated. The operator, volunteers, and statistician were blinded. There were no significant differences in the parameters: onset of soft tissue anesthesia (p = 0.80), duration of soft tissue anesthesia (p = 0.10), onset of pulpal anesthesia in the second (p = 0.28) and first molars (p = 0.45), duration of pulp anesthesia of the second (p = 0.60) and first molars (p = 0.30), pain during puncture (p = 0.82) and injection (p = 0.80). No significant adverse events were observed. Buffered 2% articaine with 1:200,000 epinephrine did not differ from non-buffered 4% articaine with 1:200,000 epinephrine considering anesthetic success, safety, onset, duration of anesthesia, and pain on injection.

Rehabilitación de trauma facial ocasionado por fuegos artificiales utilizando triamcinolona / Aesthetic and functional rehabilitation using triamcinolone on patient suffered by facial firework injury

Introduction: Facial injuries are a common occurrence at the emergency room. Treatment for this type of trauma is complex in terms of re-establishing good oral and facial function, plus aesthetics. Objective: This paper aims to report a clinical case of aesthetic and functional rehabilitation using triamcinolone in a patient affected on the face by a fireworks explosion. Case report: A 26-year-old man was admitted to the oral and maxillofacial surgery service of the Sergipe Urgency Hospital presenting trauma after the explosion of a "Firework rocket" in his face. The patient had extensive soft tissue injury in gingival mucosa, right labial commissure, and tongue. There was also inferior incisive avulsion and dentoalveolar fracture. His clinical and tomographic evaluation presented comminuted mandibular fracture. After eighteen days he was discharged and sent to the dentistry service of the Federal University of Sergipe for aesthetic and functional rehabilitation of his facial damages. Two months later, the patient attended a University dental service to begin aesthetic and postoperative functional rehabilitation. First, the necrotic bone was removed, following intralesional infiltration of hexacetonide triamcinolone 20mg/mL into the scar of the labial region and the commissure of the lips was performed. Each application was performed after twenty days of interval. Later, lingual frenectomy and glossosplasty were done for improving his lingual mobility and then hexacetonide triamcinolone 20mg/mL infiltrations were also done in the tongue base in the following sessions. Conclusions: After five infiltrations, it was observed an improvement in the scar appearance and texture, which also had a lower contracture, as well as a lingual motricity improvement(AU)

Introducción: Las lesiones faciales son frecuentes en el servicio de emergencia. El tratamiento para este tipo de trauma es complejo en términos de restablecer una buena función bucal y facial, además de la estética. Objetivo: Reportar un caso clínico de rehabilitación estética y funcional a través del uso de hexacetónido de triamcinolona en un paciente afectado por una explosión de fuegos artificiales en su rostro. Caso clínico: Hombre de 26 años ingresado en el servicio de cirugía oral y maxilofacial del Hospital de Urgencia de Sergipe por presentar un traumatismo después de la explosión contra su rostro de un cohete de fuegos artificiales. El paciente tenía una lesión extensa de partes blandas en la mucosa gingival, comisura labial derecha y lengua. También hubo avulsión incisiva inferior y fractura dentoalveolar. A través de la evaluación clínica y de tomografía, fue posible observar fragmentación múltiple ósea en el sitio de la fractura, compatible con fractura mandibular conminuta. Después de dieciocho días fue dado de alta y enviado al servicio de odontología de la Universidad Federal de Sergipe para la rehabilitación estética y funcional de sus daños faciales. Dos meses después, el paciente asistió al servicio dental de la universidad para comenzar la rehabilitación funcional estética y posoperatoria. Primero, se retiró el hueso necrótico, luego se realizó la infiltración intralesional de hexacetónido de triamcinolona 20 mg/mL en la cicatriz de la región labial y se realizó la comisura de los labios; con un intervalo de 20 días entre cada aplicación. Posteriormente, se realizaron frenectomía lingual y glososplastia, para mejorar su movilidad lingual, y luego se realizaron infiltraciones de 20 mg/mL de hexacetónido de triamcinolona en la base de la lengua en las sesiones siguientes. Comentarios principales: Después de cinco infiltraciones se observó una mejora en el aspecto y la textura de la cicatriz, que también tenía una contractura más baja, así como una mejora de la motricidad lingual(AU)

Avaliação do grau de ansiedade de estudantes de odontologia frente a tratamentos odontológicos / The evaluate of the anxiety of dental students' facing dental treatments

Introdução: A ansiedade, quando ocorre diante da perspectiva do tratamento odontológico, é denominada ansiedade odontológica, e esta pode estar presente em diferentes perfis de indivíduos, inclusive estudantes de odontologia. Objetivos: avaliar o grau de ansiedade e percepção de estudantes de odontologia, relacionados ao tratamento odontológico. Método: Trata-se de um estudo observacional e transversal aprovado pelo comitê de ética e pesquisa em seres humanos, envolvendo 214 alunos do curso de odontologia da Universidade Federal de Sergipe, campus Aracaju. O estudo avaliou através do questionário de Corah, o grau, o momento e o protocolo que mais causa ansiedade de estudantes de odontologia durante o atendimento odontológico. Resultados: A maioria dos entrevistados apresentou baixo nível de ansiedade independentemente da idade, do sexo, e do semestre letivo. O momento que mais causa ansiedade é no dia anterior ao procedimento odontológico e os procedimentos mais invasivos, tais como cirurgia oral e endodontia, geram maior ansiedade aos estudantes. Considerações finais: Estudantes de odontologia também podem apresentar ansiedade frente a procedimentos dos quais muitas vezes estão aptos a realizar. A auto avaliação do grau de ansiedade pode desenvolver nesses estudantes maior empatia, tranquilidade e segurança durante o atendimento odontológico... (AU)

Introduction: When the anxiety occurs in the face of dental treatments it is defined as dental anxiety, which may affect different individuals' profiles, including dentistry students. Objectives: To evaluate dental students' anxiety and their perception facing dental treatment. Method: This is an observational and cross-sectional study approved by the ethics and research committee, involving 214 students from the Dentistry program at the Federal University of Sergipe, in Brazil. It was conducted using the Corah Dental Anxiety Scale questionnaire. Results: The volunteers demonstrated a lower level of anxiety regardless of age, sex, and college period. The moment that caused most anxiety in students was one day prior to the dental procedure, and invasive procedures, such as oral surgery and endodontics, caused greater anxiety for students. Final considerations: Dentistry's students may also be anxious about procedures that they are often able to perform. Self-assessment of the degree of anxiety can develop empathy, tranquility, and security during dental care... (AU)

Can local anesthesia with ropivacaine provide postoperative analgesia in extraction of impacted mandibular third molars? A randomized clinical trial.

OBJECTIVE: The aim of this study was to compare the local anesthesia efficacy of ropivacaine 0.75% compared to lidocaine 2% with 1:100,000 epinephrine for postoperative analgesia following extraction of impacted mandibular third molars. STUDY DESIGN: In this randomized, double-blind crossover clinical trial, 30 participants underwent surgical removal of bilateral impacted mandibular third molars under local anesthesia using ropivacaine 0.75% or lidocaine 2% with 1:100,000 epinephrine. The pain was recorded on a visual analog scale at 4, 8, 12, 24, and 48 h postoperatively. The use of analgesics and the presence of adverse effects were recorded. RESULTS: The duration of soft tissue anesthesia in the ropivacaine group was significantly longer than that in the lidocaine group. The lidocaine group recorded significantly higher visual analog scale scores at all postoperative time intervals, except in the final 48-h period. Analgesic use was higher in the lidocaine group. Rescue medication was used by 2 patients in each group (6.7%). Significantly more postoperative bleeding was seen in the ropivacaine group. CONCLUSION: Ropivacaine 0.75% injection before the surgical procedure may be associated with preventive analgesia for extraction of impacted mandibular third molars.

Palatal needle-free anesthesia for upper molars extraction. A randomized clinical trial.

BACKGROUND: The aim of this study was to compare the ability of liposomal and non-liposomal lidocaine and prilocaine in hydrogel formulations to promote topical anesthesia in palatal mucosa during upper molar extractions. METHODS: In this randomized, cross over, triple-blinded clinical trial, a liposomal and a non-liposomal formulation of the eutectic mixture of local anesthetics, 2.5% lidocaine and 2.5% prilocaine, were used to promote palatal anesthesia without the local anesthetic infiltration during bilateral upper molars extractions. RESULTS: From the total of 40 patients included in this study, the non-liposomal eutectic lidocaine-prilocaine formulation failed in 40% of cases, unlike the liposomal formulation, which was effective for all patients (Fisher's exact test, p < 0.0001). Furthermore, the liposomal formulation (26.75 ± 7,47 min) induced longer anesthesia duration (t-test, p < 0.0001) than the non-liposomal formulation (16.78 ± 4.75 min). No mucosal ulceration or discomfort was reported for both formulations. CONCLUSION: The liposomal formulation was able to induce adequate anesthesia in palatal mucosa during dental extraction, avoiding the local anesthetic infiltration. For the first time, a topical formulation allowed upper molars surgical removal without injection of any local anesthetic agent into palatal mucosa in adults.

Fasceíte necrotizante de origem odontogênica na região cérvico-facial: Relato de caso / Odontogenic cervico-facial necrotizing fasciitis. A case report / Fascitis necrosante cervical-facial originada por infección odontogénica. Reporte del caso

Resumo A fasceite necrotizante é caracterizada como um subconjunto das infecções agressivas da pele e tecidos moles que causam necrose da fáscia muscular e dos tecidos subcutâneos. Tem origem polimicrobiana e apresenta extensa necrose que exibe uma formação gasosa no tecido subcutâneo e fáscia superficial. É fundamental um rápido diagnóstico, seguido de intervenção cirúrgica imediata e antibioticoterapia sistêmica para que se consiga sucesso no tratamento. O objetivo desse artigo é relatar um caso de fasceíte necrotizante em região cérvico-facial com origem odontogênica, ressaltando a importância do diagnóstico e tratamento precoce.

Abstract Necrotizing fasciitis is characterized as a subset of aggressive infections of the skin and soft tissues that cause necrosis of the muscular fascia and subcutaneous tissues. It has a polymicrobial origin and presents an extensive necrosis that exhibits gas formation in the subcutaneous tissue and superficial fascia. The management of infected tissues requires rapid diagnosis, immediate surgical intervention accompanied by extensive debridement and systemic antibiotic therapy. The aim of this paper is to relate a case of an odontogenic necrotizing fasciitis of the cervico-facial region emphasizing the importance of early diagnosis and treatment.

Resumen La fascitis necrotizante es una infección rara y de tejidos blandos caracterizada por una infección de rápida propagación del tejido subcutáneo y, en particular, de la fascia. La fascitis necrotizante tiene un origen polimicrobiano y una necrosis extensa que exhibe formación gaseosa en el tejido subcutáneo y la fascia superficial. El manejo de los tejidos infectados requiere un diagnóstico rápido, una intervención quirúrgica inmediata acompañada de un desbridamiento prolongado y una terapia antibiótica sistémica. El objetivo de este trabajo es relatar un caso raro de fascitis necrotizante de la región cervical-fascial, haciendo hincapié en la importancia del diagnóstico y el tratamiento temprano.

Assessment of anesthetic properties and pain during needleless jet injection anesthesia: a randomized clinical trial.

OBJECTIVE: Pain due to administration of local anesthetics is the primary reason for patients' fear and anxiety, and various methods are used to minimize it. This study aimed to measure the degree of pain during administration of anesthesia and determine the latency time and duration of pulpal anesthesia using two anesthetic methods in the maxilla. MATERIALS AND METHODS: A randomized, single-blind, split-mouth clinical trial was conducted with 41 volunteers who required class I restorations in the maxillary first molars. Local anesthesia was administered with a needleless jet injection system (experimental group) or with a carpule syringe (control) using a 30-gauge short needle. The method of anesthesia and laterality of the maxilla were randomized. A pulp electric tester measured the latency time and duration of anesthesia in the second molar. Visual analogue scale (VAS) was used to measure the degree of pain during the anesthetic method. Data were tabulated and then analyzed by a statistician. The t-test was used to analyze the differences between the groups for basal electrical stimulation. Duration of anesthesia and degree of pain were compared using the Mann-Whitney test. A 5% significance level was considered. RESULTS: There was no statistical difference in the basal electrical stimulation threshold (mA) and degree of pain between the two methods of anesthesia (p>0.05). Latency time was 2 minutes for all subjects. The duration of pulpal anesthesia showed no statistical difference (minutes) between the two methods (p<0.001), with a longer duration for the traditional method of anesthesia (median of 40 minutes). CONCLUSIONS: The two anesthetics methods did not differ concerning the pain experienced during anesthesia. Latency lasted 2 minutes for all subjects; the traditional infiltration anesthesia resulted in a longer anesthetic duration compared with the needleless jet injection.

Comparação das propriedades anestésicas em duas técnicas anestésicas distintas para molares inferiores / Comparison of anesthesic properties in two distincts anestehesic techniques for inferior molars

Introdução: O medo de sentir dor é um dos principais motivos pelos quais muitos pacientes evitam submeter-se a tratamento dentário. Em vários procedimentos odontológicos, o uso de anestésicos locais se faz necessário. O aparelho Morpheus® propõe a introdução da agulha sem dor e anestesia satisfatória, com uso de menor volume de anestésico local. Quando há necessidade de intervenção em molares e pré-molares inferiores, é preconizado o uso deste aparelho para técnica intrasseptal CaZOE, substituindo o bloqueio do nervo alveolar inferior tradicional (BNAI). Objetivo: O presente trabalho de pesquisa configurou-se como um estudo randomizado, duplo cego e cruzado, cujo objetivo foi avaliar as propriedades anestésicas através da técnica intrasseptal CaZOE e da técnica convencional do bloqueio do nervo alveolar inferior (BNAI). Material e método: Os procedimentos anestésicos foram realizados em duas sessões, por um único operador previamente treinado. Assim, foram avaliados parâmetros físicos, saturação periférica de O2, ansiedade, sensibilidade dolorosa, eficácia, tempo de latência e duração da anestesia em cada uma das técnicas, sendo então os respectivos dados comparados. Resultado: Não houve diferenças significativas quanto aos parâmetros físicos e à saturação periférica de O2. A técnica intrasseptal CaZOE apresentou maior taxa de sucesso anestésico, menor tempo de latência, menor tempo de duração e menor desconforto na execução, quando comparada ao BNAI. Conclusão: Inserir a injeção eletrônica na rotina da clínica odontológica pode proporcionar maior conforto aos pacientes submetidos à anestesia local e diminuir o abandono dos tratamentos odontológicos por medo e ansiedade associados à anestesia local.

Introduction: The fear of pain is one of the main reasons why many patients avoid undergoing dental treatment. In many dental procedures, the use of local anesthetics is necessary. Morpheus® system, which began to be marketed in Brazil in 2005, provides insertion of the needle painlessly and satisfactory anesthesia with lower volume of local anesthetic. When there is need for intervention in molars and premolars, advocated the use of this device to intrasseptal CaZOE technical replacing traditional inferior alveolar nerve block (IANB). Objective: This research work treated in a randomized duble-blind, and crossover, whose objective was to evaluate the anesthetic properties by intrasseptal CaZOE technical and traditional inferior alveolar nerve block (IANB). Material and method: The study was be conducted in two sessions. The procedures were be performed by a single operator previously trained. Physical parameters were evaluated, O2 saturation, anxiety, pain sensitivity, efficiency, latency and duration of anesthesia as compared to each of the techniques. Result: There were no significant differences in the physical parameters and the O2 saturation, the intrasseptal technical CaZOE showed greater success, shorter latency and shorter duration compared to IANB, and shorter perception painful at execution when compared to IANB. Conclusion: Inserting the electronic injection in routine dental clinic provide greater comfort to patients undergoing local anesthesia and decrease the abandonment of dental treatments for fear and anxiety associated with local anesthesia.

Avaliação da eficácia anestésica do Morpheus® através da técnica intrasseptal CaZOE na pulpotomia de dentes decíduos: estudo-piloto / Anesthetic effectiveness evaluation of Morpheus® through intrasseptal technical CaZOE in pulpotomy of deciduous teeth: pilot study

Introdução: O medo de sentir dor é um dos principais motivos pelos quais muitos pacientes evitam submeter-se a tratamento dentário, principalmente as crianças. Em vários procedimentos odontopediátricos, o uso de anestésicos locais se faz necessário. O aparelho Morpheus® se propõe a uma introdução da agulha sem dor e anestesia satisfatória com uso de menor volume de anestésico local. Associando-o à técnica CaZOE, o paciente perceberia a pressão antes da dor, podendo assim evitá-la. Objetivo: Avaliar a eficácia anestésica do Morpheus® através da técnica intrasseptal CaZOE na pulpotomia de molares inferiores decíduos. Material e método: Dezenove voluntários foram selecionados de acordo com os critérios de inclusão e exclusão. O procedimento foi realizado em sessão única, utilizando 0,9 mL de Articaína 4% com epinefrina 1:100.000, através da técnica anestésica CaZOE, empregando o injetor de anestésicos Morpheus®. Esta foi realizada por um único operador, não envolvido na avaliação dos parâmetros da anestesia, e seguiu as recomendações do fabricante. Para a análise dos dados, foi realizada estatística descritiva. Resultado: Dos 19 voluntários, 63% foram do sexo feminino e 37%, do masculino. Em pouco mais da metade da amostra (63%), houve sucesso na realização do procedimento. Os casos de insucesso (37%) ocorreram durante a abertura coronária e a amputação da polpa. Conclusão: A eficácia anestésica do Morpheus® através da técnica intrasseptal CaZOE na pulpotomia de molares inferiores decíduos foi constatada em 63% da amostra. Para que possa ser comprovada a eficácia desse sistema, são necessários mais estudos.

Introduction: The fear of pain is one of the main reasons why many patients avoid dental treatment, especially children. In several pediatric dentistry procedures, the use of local anesthetic is necessary. Morpheus® system proposes an insertion of the needle painlessly and satisfactory anesthesia with lower volume of local anesthetic. With the CaZOE technique, the patient realizes the pressure before the pain, thus being able to avoid it. Objective: To evaluate the anesthetic efficacy of Morpheus® through intrasseptal technical CaZOE in pulpotomy of mandibular's primary molars. Material and method: Nineteen volunteers were selected according to the inclusion and exclusion criteria. The study was conducted in a single session using 0.9 mL of Articaine 4% with epinephrine 1: 100,000 through anesthetic CaZOE technique, using the Morpheus®. This was carried out by a single operator not involved in the evaluation of anesthesia parameters and followed the manufacturer's recommendations. For data analysis, descriptive statistics was performed. Result: Of the 19 volunteers, 63% were female and 37% male. In just over half of the sample (63%), was successful in performing the procedure. Cases of failure (37%) occurred during coronary opening and removal of pulp. Conclusion: The efficacy of Morpheus® through intrasseptal technical CaZOE in pulpotomy of mandibular's primary molars was noted in 63% of the sample. Further studies should be carried out to prove this efficacy.

Comparação do nível álgico no bloqueio do nervo alveolar inferior através de duas técnicas distintas / Comparison of pain level in the inferior alveolar nerve block through two different techniques

Introdução: O bloqueio do nervo alveolar inferior está entre as anestesias mais utilizadas e importantes da Odontologia; porém, não há estudos que comparem a anestesia eletrônica (Morpheus) e a anestesia tradicional manual, utilizando a seringa Carpule. Objetivo: Avaliar comparativamente dois sistemas de anestesia com relação à sensibilidade dolorosa durante e após a anestesia, com a administração de lidocaína 2% associada à epinefrina 1:100.000, na técnica anestésica para o nervo alveolar inferior. Material e método: Este ensaio clínico foi executado de modo randomizado, cruzado e duplamente cego, envolvendo 30 voluntários, que necessitavam de tratamento odontológico e que se submeteram ao bloqueio do nervo alveolar inferior, utilizando a seringa tipo Carpule na primeira sessão e o injetor de velocidade controlada Morpheus, o qual foi realizado em duas sessões, com intervalo de pelo menos duas semanas entre cada sessão. Ao final de cada sessão, foi aplicada a Escala Visual Analógica (EAV), para avaliação da sensibilidade dolorosa à injeção. Resultado: A comparação entre os métodos revelou que o convencional mostrou induzir maiores valores na EAV do que o Morpheus. O teste do Qui-Quadrado, para proporções esperadas iguais, mostrou que a técnica com Morpheus obteve maior (p=0,0062) preferência do que a convencional. Conclusão: No conjunto, os dados revelam que a técnica empregando o Morpheus foi superior à convencional nos três momentos. A execução da anestesia realizada com Morpheus mostrou ser mais confortável e ter aceitação e maior preferência dos voluntários.

Introduction: Blockade of the inferior alveolar nerve is among the most used and important anesthesia in dentistry, but there are no studies that compare the electronic anesthesia (Morpheus) and traditional manual anesthesia, using a syringe Carpule. Objective: To evaluate and compare two anesthesia systems with respect to pain sensitivity during and after anesthesia with lidocaine 2% associated with epinephrine 1: 100,000 in anesthetic techniques for inferior alveolar nerve. Material and method: This clinical trial was performed in a randomized, crossover, double-blind, involving 30 volunteers, who required dental treatment and who underwent blockade of the lower alveolar nerve, using the syringe type Carpule in the first session and the gun controlled speed Morpheus, where it was held in two sessions, with an interval of at least two weeks between each session. At the end of each session was applied to Visual Analogue Scale (VAS) to assess pain sensitivity to injection. Result: A comparison between the conventional methods revealed that induce showed higher values ​​than the EVA Morpheus. The chi -square for expected equal proportions showed that the technique with Morpheus had a higher (p = 0.0062) preference than conventional. Conclusion: Taken together, the data show that the technique employing the Morpheus was superior to conventional in 3 times. The implementation of anesthesia performed with Morpheus proved to be more comfortable, have greater acceptance and preference for volunteers.

Removal of an upper third molar from the maxillary sinus.

The maxillary sinus or antrum is the largest of the paranasal sinuses. It is located in the maxillary bone and has a proximity to the apexes of upper molars and premolars, which allows it to form a direct link between the sinus and the oral cavity. Dislocation of a foreign body or tooth to the interior of a paranasal sinus is a situation that can occur as a result of car accidents, firearm attacks, or iatrogenic in surgical procedures. Therefore, it is necessary to know how to treat this kind of situation. This study's objective is to report the case of a 23-year-old female patient, leucoderma, who sought treatment from the Surgical Unit at the Dental Faculty of the Federal University of Sergipe. She had a history of pain and edema in the right side of the genian region and two failed attempts at removing dental unit (DU) 18. The extraoral clinical exam revealed intense edema of the left hemiface with signs of infection, excoriation of the labial commissure, hematoma, a body temperature of 39°C, and a limited ability to open her mouth. The patient was medicated and treated surgically. The tooth was removed from the maxillary sinus with caution, as should have been done initially.

Relação entre presença de fendas de cristais de colesterol em lesão periapical e nível de colesterol sérico / Relationship between the presence of clefts of cholesterol crystals in periapical lesion and serum cholesterol level

Introdução: Uma infecção crônica nos tecidos periapicais pode desencadear uma lesão periapical em função da estimulação e da proliferação dos restos epiteliais de Malassez. Ao estudo microscópico, é possível detectar a presença de fendas de cristais de colesterol no interior de cistos e granulomas. De acordo com alguns estudos, a origem do colesterol no interior de lesões no periápice pode ser, parcialmente, por causa da condensação e da cristalização de colesterol dentro da parede do cisto. Outros estudos afirmam que a presença de colesterol pode ser derivada de produtos metabólicos locais ou da circulação vascular. Objetivo: O presente estudo teve por objetivo analisar a relação entre as fendas de cristais de colesterol encontradas nas lesões periapicais e os níveis de colesterol sérico. Material e Método: Estudo observacional de natureza descritiva, que incluiu 70 pacientes portadores de lesões periapicais, de acordo com exame radiográfico, atendidos no Departamento de Odontologia da Universidade Federal de Sergipe. Esses pacientes foram submetidos à exodontia da unidade dentária acometida e à remoção da lesão periapical, sendo esta peça encaminhada para exame anatomopatológico. Na mesma consulta, era solicitado um lipidograma para avaliação das taxas de colesterol sérico dos pacientes. Resultado: Fendas de cristais de colesterol estavam presentes apenas em cistos grandes (maiores que 1,5 cm de diâmetro, aproximadamente) e, portanto, mais antigos. Conclusão: A presença de cristais de colesterol é rara nas lesões periapicais. O estudo sugere uma relação entre a presença dos cristais de colesterol e o índice de colesterol sérico elevado, em lesões grandes e antigas.

Introduction: A chronic infection in periapical tissue can trigger a periapical lesion due to stimulation and proliferation of epithelial rests of Malassez. On microscopic study, it is possible to detect the presence of clefts of cholesterol crystals within cysts and granulomas. According to some studies, the source of cholesterol inside the periapice lesions may be partially due to the condensation and crystallization of cholesterol in the cyst wall. Yet another part, can be derived metabolic products local or vascular circulation. Objective: This study aimed to analyze the relationship between the clefts of cholesterol crystals found in periapical lesions and cholesterol levels in the blood circulation. Material and Method: An observational study of a descriptive nature that included 70 patients with periapical lesions (according to radiographic examination) at the Department of Dentistry, Federal University of Sergipe. These patients underwent extraction of the affected tooth unit and removal of the periapical lesion, and this number sent for pathological examination. At the same query was asked a lipid profile to assess rates of serum cholesterol of patients. Result: Clefts of cholesterol crystals were present only in cysts (larger than 1.5 cm in diameter, approximately), and therefore older. Conclusion: The presence of cholesterol crystals is rare in periapical lesions. The study suggests a relationship between the presence of cholesterol crystals and the rate of cholesterol serum levels in large and old injuries.

Efeito comparativo entre clonixinato de lisina e paracetamol no controle da dor pós-exodontia / Comparison between lysine and paracetamol for post tooth extraction pain control

JUSTIFICATIVA E OBJETIVOS: A exodontia é praticada desde os primórdios da humanidade como forma de resolver cirurgicamente os problemas dentários. Porém, como todo procedimento cirúrgico, ela promove um processo inflamatório reacional que se apresenta clinicamente com dor. Muitos fármacos têm sido usados no intuito de minimizar o desconforto pós-operatório, porém um protocolo para o seu controle ainda não está estabelecido. Este estudo teve como objetivo avaliar o efeito analgésico do clonixinato de lisina e paracetamol no controle de dor pós-exodontia. MÉTODO: Estudo duplamente encoberto e randomizado com 40 pacientes atendidos no Ambulatório de Cirurgia I no Departamento de Odontologia da Universidade Federal de Sergipe (DOD/UFS) que necessitaram de extrações por via alveolar em hemiarcadas diferentes utilizando clonixinato de lisina (125 mg) três vezes ao dia ou paracetamol (750 mg) quatro vezes ao dia, ambos por três dias no pós-operatório. A dor foi avaliada nas primeiras 24 e 48h com o uso da escala analógica visual. Os dados foram submetidos aos testes estatísticos t de Student e de Friedman. RESULTADOS: Não houve diferenças estatisticamente significantes entre idade, em relação aos gêneros e em relação à intensidade da dor. CONCLUSÃO: Tanto o clonixinato de lisina como o paracetamol foi eficaz para o controle da dor pós-exodontia.

BACKGROUND AND OBJECTIVES: Tooth extraction is practiced since the early days of mankind to surgically solve dental problems. However, as any surgical procedure, it promotes an inflammatory reaction with clinical presentation of pain. Several drugs have been used to minimize postoperative discomfort; however there is still no established protocol for its control. This study aimed at evaluating the analgesic effect of lysine and paracetamol to control post tooth extraction pain. METHOD: Double blind randomized study with 40 patients seen by the Surgical Outpatient Setting I, Dentistry Department, Federal University of Sergipe (DOD/UFS), who needed alveolar extractions in different hemiarcades using lysine (125 mg) three times a day or paracetamol (750 mg) four times a day, both during three postoperative days. Pain was evaluated at 24 and 48 hours with the visual analog scale. Data were submitted to Student's t and Friedman statistical tests. RESULTS: There have been no statistically significant differences in age, gender and pain intensity. CONCLUSION: Both lysine and paracetamol were effective to control post tooth extraction pain.