TLR2 agonist prevents the progression of periapical lesions in mice by reducing osteoclast activity and regulating the frequency of Tregs.

AIM: To evaluate the role of regulatory T lymphocytes (Tregs) in the presence or absence of the synthetic ligand Pam3Cys during the progression of periapical lesion in wild-type (WT) and toll-like receptor 2 knockout (TLR2KO) mice. METHODOLOGY: A total of 130 C57BL/6 male WT and TLR2KO mice were allocated into control (n = 5) and experimental (periapical lesion induction) (n = 10) groups. In specific groups (WT+Pam3cys and TLR2KO+Pam3cys), the synthetic ligand Pam3cys was administered intraperitoneally every 7 days, according to the experimental period (14, 21 and 42 days). At the end of those periods, the animals were euthanized, and the mandible and the spleen were submitted to histotechnical processing. Mandible histological sections were analysed by haematoxylin and eosin, TRAP histoenzymology and immunohistochemistry (FOXP3, RANK, RANKL and OPG). Spleen sections were analysed by immunohistochemistry (FOXP3). RESULTS: The inflammatory infiltrate and bone resorption were more intense in the TLR2KO group compared to the WT group. The animals that received the Pam3cys had smaller periapical lesions when compared to the animals that did not receive the ligand (p < .05). TLR2KO animals showed a significant increase in the number of osteoclasts when compared to TLR2KO+Pam3cys group (p < .05). At 21 days, the WT+Pam3cys group had a lower number of osteoclasts when compared to the WT animals (p = .02). FOXP3 expression was more intense in the WT+Pam3cys groups when compared to the WT animals in the 42 days (p = .03). In the spleen analysis, the WT+Pam3cys group also had a higher expression of FOXP3 when compared to the WT animals at 14 and 42 days (p = .02). Concerning RANKL, there was a reduction in staining in the KOTLR2+Pam3cys groups at 21 and 42 days (p = .03) and a higher binding ratio between RANK/RANKL in animals that did not receive the ligand. CONCLUSION: Administration of the Pam3cys increased the proliferation of Tregs, showed by FOXP3 expression and prevented the progression of the periapical lesion in WT mice. On the other hand, in the TLR2KO animals, Treg expression was lower with larger areas of periapical lesions. Finally, systemic administration of the Pam3cys in KO animals was able to limit the deleterious effects of the absence of the TLR2 receptor.

Effect of systemic administration of Bifidobacterium animalis subsp. lactis HN019 on apical periodontitis.

This study aimed to evaluate the effect of Bifidobacterium animalis subsp. lactis (B. lactis) HN019 in drinking water on the development of apical periodontitis (AP) in rats. In total 60 animals were divided into a control group (sound teeth); Group I - regular water without AP; Group II - probiotic water without AP; Group III - regular water with AP; Group IV - probiotic water with AP. AP was induced after 3 days in the control groups and after 7, 21, and 42 days in groups III and IV. The animals were euthanized, and the mandibles were subjected to histotechnical processing. Samples were stained with hematoxylin & eosin (H&E) to identify root canal features, apical and periapical regions. Additionally, histoenzymology was performed to detect osteoclasts, immunohistochemistry was used to identify osteoclastogenesis markers, and the Brown & Brenn technique was applied for microbiological analysis. The data were analyzed using GraphPad Prism 8.0.1 with a significance level of 5%. Although no statistical differences were observed, the groups administered with probiotics showed better conditions in terms of histological aspects seen microscopically. Furthermore, there were no differences in the number of osteoclasts (p > 0.05). The RANKL marker was not found in the probiotic group at 42 days, unlike in group III.

Bifidobacterium animalis subsp. lactis HN019 has antimicrobial activity against endodontic pathogens in vitro.

The aim of the present study was to evaluate, in vitro, the antimicrobial activity of the probiotic Bifidobacterium animalis subsp. lactis HN019, through the well technique, against 10 microorganisms can be found involved in endodontic infections. The antimicrobial activity of the probiotic was performed on Streptococcus mutans, Streptococcus sobrinus, Lacticaseibacillus casei, Enterococcus faecalis, Staphylococcus aureus, Candida albicans, Porphyromonas gingivalis, Porphyromonas endodontalis, Fusobacterium nucleatum and Prevotella intermedia. For the control group, it was used non-pathogenic bacteria Escherichia coli, Saccharomyces cerevisiae, and Kocuria rizhopilla. After 48 to 72 h of incubation of the petri dishes containing the culture medium, the microorganism strains, and the probiotic, the plates were examined to assess the uniformity of microbial growth, presence of contaminants, and the halo of inhibition. After visual inspection, the reading of the halo of inhibition was performed with the aid of a digital caliper using a reflected light source to illuminate the inverted plate on a black, opaque background after removing the cap. Thus, 3 values were obtained from each bacterial inoculum, which were added and divided by three to obtain the average of the values. The results of the in vitro study demonstrated that the probiotic B. animalis subsp. lactis HN019 promoted the inhibition of all strains of the pathogens evaluated, with the exception of Candida albicans, demonstrating antimicrobial activity on these microorganisms.

Reparative Dentin Formation Following Dental Pulp Capping is Mediated by TNFR1 In Vivo.

INTRODUCTION: Tumor necrosis factor (TNF)-α is a pro-inflammatory cytokine that promotes biomineralization in vitro in dental pulp cells. However, the role of TNF-α-TNF receptor 1 (TNFR1) signaling in reparative dentin formation and related inflammatory pathways is not known. Therefore, the aim of this study was to evaluate the role of the TNF-α-TNFR1 axis in dental pulp repair following pulp capping in vivo. METHODS: Dental pulp repair response of genetically deficient TNF-α receptor-1 mice (TNFR1-/-; n = 20) was compared with that of C57Bl6 mice (wild type [WT]; n = 20). Pulp capping was performed with mineral trioxide aggregate on the mandibular first molars of mice. After 7 and 70 days, tissues were collected and stained with hematoxylin and eosin for histopathological and histometric evaluation, and assessed by the Brown and Brenn methods for histomicrobiological analysis and by immunohistochemistry to localize TNF-α, Runt-related transcription factor 2, Dentin Sialoprotein (DSP) and Osteopontin (OPN) expression. RESULTS: Compared with WT mice, TNFR1-/- mice showed significantly decreased reparative dentin formation with a lower mineralized tissue area (P < .0001). Unlike WT mice, TNFR1-/- mice also exhibited significant dental pulp necrosis, neutrophil recruitment, and apical periodontitis formation (P < .0001) without bacterial tissue invasion. TNFR1-/- animals further exhibited decreased TNF-α, DSP, and OPN expression (P < .0001), whereas Runt-related transcription factor 2 expression was unchanged (P > .05). CONCLUSION: The TNF-α-TNFR1 axis is involved in reparative dentin formation following dental pulp capping in vivo. Genetic ablation of TNFR1 modified the inflammatory process and inhibited the expression of the DSP and OPN mineralization proteins, which culminated in dental pulp necrosis and development of apical periodontitis.

Effect of systemic administration of Bifidobacterium animalis subsp. lactis HN019 on apical periodontitis

Abstract This study aimed to evaluate the effect of Bifidobacterium animalis subsp. lactis (B. lactis) HN019 in drinking water on the development of apical periodontitis (AP) in rats. In total 60 animals were divided into a control group (sound teeth); Group I - regular water without AP; Group II - probiotic water without AP; Group III - regular water with AP; Group IV - probiotic water with AP. AP was induced after 3 days in the control groups and after 7, 21, and 42 days in groups III and IV. The animals were euthanized, and the mandibles were subjected to histotechnical processing. Samples were stained with hematoxylin & eosin (H&E) to identify root canal features, apical and periapical regions. Additionally, histoenzymology was performed to detect osteoclasts, immunohistochemistry was used to identify osteoclastogenesis markers, and the Brown & Brenn technique was applied for microbiological analysis. The data were analyzed using GraphPad Prism 8.0.1 with a significance level of 5%. Although no statistical differences were observed, the groups administered with probiotics showed better conditions in terms of histological aspects seen microscopically. Furthermore, there were no differences in the number of osteoclasts (p > 0.05). The RANKL marker was not found in the probiotic group at 42 days, unlike in group III.

Use of Images and Clinical Experience to Calibrate Dental Surgeons for the Diagnosis of Molar Incisor Hypomineralization

ABSTRACT Objective: To evaluate an imaging protocol for use as a diagnostic and calibration tool for dentists before and after practical activity. Material and Methods: Thirty photos of children's teeth with or without changes in dental enamel were selected and evaluated by a group of experienced dentists previously calibrated to establish the diagnosis defined as the gold standard. After instructions, the images were shown to a group of postgraduate dentists for free identification of dental changes. Subsequently, a lecture on molar incisor hypomineralization (MIH) was carried out, and, at 14 days and all calibration was performed using the criteria previously. The retest was performed at 28 days. After experience in clinical activity in the following two weeks, the post-test was performed at 49 days. Data were analyzed using Cohen's kappa coefficient. Results: Theoretical learning on the subject showed low inter-examiner agreement when the diagnosis of defects was made from images obtained from intraoral photographs. After clinical practice, there was greater intra-examiner agreement. After theoretical training, dentists started to identify different types of enamel alteration, although with low agreement between them. Conclusion: Clinical experience in theoretical and imaging training favored the identification of defects. However, it is necessary to improve the protocol to establish a reliable and viable diagnostic method for calibration in MIH.

Use of the Probiotic Bifidobacterium animalis subsp. lactis HN019 in Oral Diseases.

The oral cavity is one of the environments on the human body with the highest concentrations of microorganisms that coexist harmoniously and maintain homeostasis related to oral health. Several local factors can shift the microbiome to a pathogenic state of dysbiosis. Existing treatments for infections caused by changes in the oral cavity aim to control biofilm dysbiosis and restore microbial balance. Studies have used probiotics as treatments for oral diseases, due to their ability to reduce the pathogenicity of the microbiota and immunoinflammatory changes. This review investigates the role of the probiotic Bifidobacterium animalis subsp. lactis (B. lactis) HN019 in oral health, and its mechanism of action in pre-clinical and clinical studies. This probiotic strain is a lactic acid bacterium that is safe for human consumption. It mediates bacterial co-aggregation with pathogens and modulates the immune response. Studies using B. lactis HN019 in periodontitis and peri-implant mucositis have shown it to be a potential adjuvant treatment with beneficial microbiological and immunological effects. Studies evaluating its oral effects and mechanism of action show that this probiotic strain has the potential to be used in several dental applications because of its benefit to the host.

Subcutaneous tissue reaction and gene expression of inflammatory markers after Biodentine and MTA implantation.

The aim of this study was to evaluate the subcutaneous connective tissue response of isogenic mice exposed to tricalcium silicate (Biodentine) and aggregated mineral trioxide (ProRoot MTA). A total of 120 mice were divided into 4 groups in 3 different experimental periods (7, 21 and 63 days): Biodentine; Pro-Root MTA; zinc oxide-eugenol and; Negative control - Sham. After the experimental periods microscopic descriptive, semi-quantitative and quantitative analysis of the inflammatory process were analyzed on H&E sections and evaluation of the gene expression of Il10, Infg, Il6, Il1r1 and Tnf (qRT-PCR) were performed. The data obtained were analyzed using the chi-square test and two-way analysis of variance (ANOVA) followed by the Bonferroni post-test (5% significance level). Results: In the microscopic analysis, a slight inflammatory infiltrate was observed, with a predominance of sparse macrophages and polymorphonuclear cells, slight tissue fibrosis, regular fibrous capsule and with dystrophic calcifications, in all groups that received the materials (Biodentine and Pro-Root MTA). In parallel, all materials modulated the gene expression of the different cytokines and receptors evaluated. Conclusion: Pro-Root MTA and Biodentine showed a tissue compatibility, mediated inflammation, with increased fibrous tissue and production of pro- and anti-inflammatory cytokines.

Subcutaneous tissue reaction and gene expression of inflammatory markers after Biodentine and MTA implantation

Abstract The aim of this study was to evaluate the subcutaneous connective tissue response of isogenic mice exposed to tricalcium silicate (Biodentine) and aggregated mineral trioxide (ProRoot MTA). A total of 120 mice were divided into 4 groups in 3 different experimental periods (7, 21 and 63 days): Biodentine; Pro-Root MTA; zinc oxide-eugenol and; Negative control - Sham. After the experimental periods microscopic descriptive, semi-quantitative and quantitative analysis of the inflammatory process were analyzed on H&E sections and evaluation of the gene expression of Il10, Infg, Il6, Il1r1 and Tnf (qRT-PCR) were performed. The data obtained were analyzed using the chi-square test and two-way analysis of variance (ANOVA) followed by the Bonferroni post-test (5% significance level). Results: In the microscopic analysis, a slight inflammatory infiltrate was observed, with a predominance of sparse macrophages and polymorphonuclear cells, slight tissue fibrosis, regular fibrous capsule and with dystrophic calcifications, in all groups that received the materials (Biodentine and Pro-Root MTA). In parallel, all materials modulated the gene expression of the different cytokines and receptors evaluated. Conclusion: Pro-Root MTA and Biodentine showed a tissue compatibility, mediated inflammation, with increased fibrous tissue and production of pro- and anti-inflammatory cytokines.

Resumo Objetivo: Avaliar a resposta do tecido conjuntivo subcutâneo de camundongos isogênicos expostos à Biodentine™ e ao Trióxido Mineral Agregado (MTA). Métodos: Um total de 120 camundongos foram divididos em 4 grupos e 3 períodos experimentais diferentes (7, 21 e 63 dias): Biodentine™ (Septodont, Saint Maur des Fosses, França); Pro-Root MTA (Dentsplay, Tulsa, EUA); óxido de zinco eugenol (Biodinâmica Química e Farmacêutica LTDA., Ibiporã, PR - Brasil); e controle negativo - Sham. Após os períodos experimentais, análises microscópicas descritivas, semiquantitativas e quantitativas do processo inflamatório foram analisadas nos cortes de H&E e ainda, foi realizada a avaliação da expressão gênica de Il10, Infg, Il6, Il1r1 e Tnf (qRT-PCR). Os dados obtidos foram analisados por meio do teste do qui-quadrado e da análise de variância (ANOVA) two-way, seguido do pós-teste de Bonferroni (nível de significância de 5%). Resultados: Na análise microscópica observou-se discreto infiltrado inflamatório, com predomínio de macrófagos esparsos e polimorfonucleares, leve fibrose tecidual, cápsula fibrosa regular e com calcificações distróficas, em todos os grupos que receberam os materiais (Biodentine ™ e Pro-Root MTA). Paralelamente, todos os materiais modulam a expressão gênica das diferentes citocinas e receptores avaliados. Conclusão: Pro-Root MTA e Biodentine™ mostraram compatibilidade tecidual, inflamação mediada, com aumento do tecido fibroso e produção de citocinas pró- e antiinflamatórias.

Múltiplas lesões dentárias em paciente com Síndrome de Lennox-Gastaut / Multiple dental lesions in a patient with Lennox-Gastaut Syndrome

Introdução: A Síndrome de Lennox-Gastaut (SLG) é uma encefalopatia epiléptica grave na infância. Seu tratamento é complexo, principalmente devido à multiplicidade das crises epilépticas, o que favorece à ocorrência de lesões dentais Objetivo: O objetivo deste relato é apresentar o manejo clínico de um paciente com SLG, vítima de traumas recorrentes, discutir os achados dentais observados e o tratamento odontológico realizado. Relato do caso: Paciente L.H.D.L., do sexo masculino, com 15 anos de idade, apresentando grande acúmulo de biofilme dental, alto risco de cárie, fluorose leve e gengivite generalizada. Clinicamente foi possível observar fratura de esmalte dos dentes 12 e 14. Os dentes 21, 22, 32 e 42 estavam ausentes clinicamente, o que se confirmou radiograficamente. Além disso, notou-se giroversão de 180 graus do dente 11, com a face palatina voltada para a vestibular. O dente apresentou-se com leve alteração de cor, mas com resposta positiva aos testes de vitalidade. Resultados: Técnicas de manejo de comportamental, foram adotadas e orientações quanto à higiene bucal e dietéticas foram fornecidas tanto ao paciente quanto ao seu cuidador. Quatro sessões de profilaxia e aplicação tópica de flúor foram realizadas semanalmente. O tratamento endodôntico foi realizado no dente 12, seguido da restauração de resina composta do dente 12 e 14 e a restauração estética do dente 11 (girovertido). Por fim, foi realizada uma prótese adesiva para restaurar a estética da região de incisivo central superior. Apesar das dificuldades para tratar pacientes com SLG, no presente caso foi possível obter resultados funcionais e estéticos satisfatórios com um diagnóstico e tratamento cuidadoso, envolvendo uma equipe multiprofissional treinada no atendimento de pacientes com necessidades especiais. Conclusão: Pode-se concluir que o cirurgião dentista deve estar familiarizado com as possíveis manifestações bucais da SLG e realizar uma pesquisa criteriosa de sinais de traumatismo dental e, sempre que possível, solicitar um exame radiográfico para que traumatismos não identificados ao exame clínico não passem desapercebidos.

Introduction: Lennox-Gastaut Syndrome (LSG) is a severe childhood epileptic encephalopathy. Its treatment is complex, mainly due to the multiplicity of epileptic crises, which in turn favors the occurrence of dental injuries. Objective: The aim of this case report is to present the clinical management of a patient with LGS, victim of recurrent trauma, discuss the observed dental findings and the dental treatment. Case report: Patient L.H.D.L., male, 15 years old presenting high quantity of oral biofilm, mild fluorosis and generalized gingivitis. Clinically, it was possible to observe enamel fractures of teeth 12 and 14. Teeth 21, 22, 32 and 42 were clinically absent, which was confirmed radiographically. In addition, a 180-degree rotation of tooth 11 was noted, with the palate facing the buccal aspect. The tooth presented a slight change in color, but with a positive response to vitality tests. Results: Behavioral management techniques were adopted and guidelines on oral hygiene and diet were provided to both the patient and their caregiver. Four sessions of prophylaxis and topical application of fluoride were performed weekly. Endodontic treatment was performed on tooth 12, followed by aesthetic restoration of teeth 12 and 14 and esthetic restoration of tooth 11 (rotated). Finally, an adhesive prosthesis was performed to restore the esthetics of the upper central incisor region. Despite the difficulties of treating patients with LGS, in the present case it was possible to obtain satisfactory functional and aesthetic results with a careful diagnosis and treatment, involving a multidisciplinary team trained in the care of patients with special needs. Conclusion: It can be concluded that the dental surgeon must be aware with the possible oral manifestations of GLS and carry out a careful search for signs of dental trauma and, whenever possible, request a radiographic examination so that unidentified traumas on clinical examination do not pass unnoticed.

Tratamento odontológico de paciente com Síndrome de Singleton-Merten / Dental treatment of a patient with Singleton-Merten Syndrome

Introdução: A Síndrome de Singleton-Merten (SMS) é uma doença autossômica dominante hereditária rara caracterizada por alterações cardiovasculares, ósseas e dentais, pouco discutida na literatura em relação ao tratamento odontológico. Objetivo: O objetivo do presente estudo foi relatar o caso de uma paciente com SMS, descrevendo seus aspectos bucais e o plano de tratamento proposto, em conjunto com uma equipe multiprofissional. Relato do caso: Durante a anamnese constatou-se que o paciente apresentava alterações cutâneas decorrentes da síndrome. Os exames clínico, radiográfico e tomográfico revelaram maxila e mandíbula parcialmente edêntulas, ampla reabsorção do osso maxilar, além da maioria dos dentes permanentes incluídos e com raízes curtas. O plano de tratamento multidisciplinar incluiu a extração de dentes com formação radicular deficiente, tração ortodôntica dos caninos superiores incluídos e a confecção de próteses parciais superiores e inferiores removíveis, para reabilitação das funções mastigatória, fonética e estética. Conclusão: É importante ressaltar que durante o atendimento odontológico de pacientes com SMS, deve-se considerar o estado geral de saúde anterior, principalmente em relação às possíveis complicações cardiovasculares existentes, e a necessidade de reabilitação destes pacientes, por apresentarem perda dentária extensa.

Intoduction: Singleton-Merten Syndrome (SMS) is a rare in herited autosomaldominant disorder. Characterized by cardiovascular, bone and dental alterations, little discussed in the literature regarding dental treatment. Objective: The aim of this study was to report the case of a patient with SMS, describing her oral aspects and the proposed treatment plan, together with a multidisciplinary team. Case report: During the anamnesis it was found that the patient has alterations due to the syndrome. Clinical, radiographic and tomographic examinations revealed partially edentulous maxilla and mandible, wide resorption of maxillary bone, in addition to most of the permanent teeth included and with short roots. The multidisciplinary treatment plan included the extraction of teeth with deficient root formation, orthodontic traction of the included upper canines and the making of removable upper and lower partial dentures, for rehabilitation of masticatory, phonetic and aesthetic functions. Conclusion: It is important to emphasize that during dental care of patients with SMS, the previous general state of health should be considered, especially in relation to possible existing cardiovascular complications, and the need for rehabilitation of these patients, since they will present extensive tooth loss.

Avaliação radiográfica da resposta pulpar e periapical de dentes de cães ao Emdogain® após pulpotomia / Radiographic evaluation of pulpal and periapical response of dogs teeth to Emdogain® used as pulpotomy agent

Introdução: O derivado da matriz do esmalte (Emdogain®) é um extrato de proteína usado para cicatrização periodontal. Objetivo: O objetivo desse estudo foi avaliar radiograficamente a resposta pulpar e periapical de dentes de cães após pulpotomia e uso do gel derivado da matriz do esmalte (Emdogain®). Métodos: A pulpotomia foi realizada em 30 dentes (60 raízes) de 3 cães, e o tecido pulpar remanescente foi recoberto com os seguintes materiais: Grupos 1 e 4: gel derivado da matriz do esmalte (Emdogain®); Grupos 2 e 5: hidróxido de cálcio; Grupos 3 e 6: óxido de zinco e cimento de eugenol. Após 10 dias (Grupos 1-3) e 75 dias (Grupos 4-6) foram obtidas radiografias periapicais e a avaliação radiográfica foi realizada considerando-se: a integridade da lâmina dura, presença de áreas de rarefação óssea periapical, reabsorção radicular (interna e externa) e formação de ponte de dentina. Resultados: No período de 10 dias, todos os espécimes dos Grupos 1-3 apresentaram ausência de rarefação óssea periapical, reabsorção radicular (interna e externa) e formação de ponte dentinária. No período de 75 dias, os Grupos 4-6 não apresentaram formação de ponte dentinária em nenhum espécime. Áreas de rarefação óssea periapical foram observadas em 100% das raízes no Grupo 4, 62,5% das raízes no Grupo 6 e em 25% das raízes nos Grupos 5. Conclusão: O uso do gel derivado da matriz do esmalte (Emdogain®) como material para capeamento após a pulpotomia levou à formação de lesões periapicais e não induziu a deposição de tecido mineralizado (AU).

Introduction: The enamel matrix derivative (Emdogain®) is a protein extract used for periodontal healing. The objective of this study was to evaluate radiographically the pulpal and periapical response of dogs teeth after pulpotomy and use of enamel matrix derivative gel (Emdogain®). Methods: Pulpotomy was performed in 30 teeth (60 roots) from 3 dogs and the remaining pulp tissue was capped with the following materials: Groups 1 and 4: enamel matrix derivative gel (Emdogain®); Groups 2 and 5: calcium hydroxide; Groups 3 and 6: zinc oxide and eugenol cement. After 10 days (Groups 1-3) and 75 days (Groups 4-6) periapical radiographs were obtained and the radiographic evaluation was performed considering the integrity of the lamina dura, presence of areas of periapical bone rarefaction, root resorption (internal and external) and dentin bridge formation. Results: In the 10- day period, all specimens in Groups 1-3 presented absence of periapical bone rarefaction, absence of root resorption (internal and external) and absence of dentin bridge formation. In the 75-day period, Groups 4-6 did not present dentin bridge formation in any specimen. Periapical bone rarefaction areas were observed in 100% of the roots in Group 4, 62,5% of the roots in Group 6 and in 25% of the roots in Groups 5. Conclusion: The use of enamel matrix derivative gel (Emdogain®) as a capping material after pulpotomy lead to formation of periapical lesions and did not induce deposition of mineralized tissue(AU).

Pulpal and periapical response of dogs' teeth after pulpotomy and use of enamel matrix derivative as a capping agent

Objective: To evaluate the pulpal and periapical response of dogs' teeth after pulpotomy and use of Enamel Matrix Derivative (EMD) as capping agent. Methods: Pulpotomy was performed in 40 teeth from 4 dogs and the remaining pulp tissue was recovered with the following materials: Groups I and IV: EMD (Emdogain®); Groups II and V: calcium hydroxide; Groups III and VI: zinc oxide and eugenol cement. After 7 days (Groups I, II, and III) and 70 days (Groups IV, V, and VI), the animals were euthanized and the teeth were removed and processed for histological analysis; were analyzed using Kruskal-Wallis test followed by Dunn test or Mann Whitney test ( =0.05). Results: 7-day period: in Group I, it was observed a mild to moderate inflammatory infiltrate and intense vascular proliferation while Group II presented a mild inflammatory infiltrate and an intact pulp tissue (p < 0.05). Group III presented a moderate to severe inflammatory infiltrate. 70- day period: Groups IV and VI showed no dentin bridge formation, the remaining pulp tissue presented necrotic areas with inflammatory cells in the periapical region and bone and cementum resorption (p > 0.05). In Group V, there was dentin bridge formation, absence of inflammation and absence of mineralized tissue resorption (p < 0.05). Conclusion: EMD as a capping material after pulpotomy did not show either satisfactory tissue response or capacity of inducing deposition of mineralized tissue in dental pulp.

Objetivo: Avaliar a resposta pulpar e periapical de dentes de cães após pulpotomia e uso de Derivados de Matriz de Esmalte (EMD) como agente de capeamento. Métodos: A pulpotomia foi realizada em 40 dentes de 4 cães e o tecido pulpar remanescente foi recuperado com os seguintes materiais: Grupos I e IV: EMD (Emdogain®); Grupos II e V: hidróxido de cálcio; Grupos III e VI: cimento de óxido de zinco e eugenol. Após 7 dias (Grupos I, II e III) e 70 dias (Grupos IV, V e VI), os animais foram eutanásiados e os dentes foram removidos e processados para análise histológica; foram analisados pelo teste de Kruskal-Wallis, seguido pelo teste de Dunn ou Mann Whitney ( = 0,05). Resultados: Período de 7 dias: no Grupo I, observou-se infiltrado inflamatório leve a moderado e intensa proliferação vascular, enquanto o Grupo II apresentou infiltrado inflamatório leve e tecido pulpar intacto (p <0,05). O grupo III apresentou infiltrado inflamatório moderado a grave. Período de 70 dias: os grupos IV e VI mostraram, na formação da ponte de dentina, que o tecido pulpar remanescente apresentava áreas necróticas com células inflamatórias na região periapical, reabsorção óssea e de cemento (p> 0,05). No Grupo V, houve formação de ponte de dentina, ausência de inflamação e ausência de reabsorção tecidual mineralizada (p <0,05). Conclusão: O EMD como material de cobertura após pulpotomia não mostrou resposta tecidual satisfatória ou capacidade de induzir deposição de tecido mineralizado na polpa dentária.

Development of odontoma in the permanent dentition after intrusion of primary incisors: case report

Introduction: Dental trauma in childhood is a serious and high incidence complication, mostly due to the discovery phase. This is when the first steps begin, without adequate motor coordination, making children more prone to falls. Trauma to a deciduous tooth can leave sequelae owing to the anatomical proximity to the permanent successor tooth germ. Objective: This study aimed to report a case of severe intrusion in a 10-month-old baby with the emergence of odontoma after dental trauma. Case Report: A 9-year-old patient, accompanied by the guardian, sought attendance for delayed primary teeth exfoliation. During anamnesis, the trauma to the deciduous dentition was found in a 10-month old child, followed by clinical and radiographic examination, showing the presence of odontoma in teeth 11 and 21. The multidisciplinary treatment plan included surgery to remove the odontoma, with subsequent rehabilitation. Conclusion: Trauma to primary dentition can have several consequences for permanent dentition. Thus, dental care is required soon after the incident, besides careful follow-up to evaluate possible sequelae.

Introdução: O traumatismo dentário na infância é uma intercorrência grave, de incidência alta devido principalmente a fase de descobertas, com o início dos primeiros passos, sem ter coordenação motora adequada, tornando as crianças mais propensas a quedas. Um trauma em um dente decíduo pode deixar sequelas em razão da proximidade anatômica ao germe do dente sucessor permanente. Objetivo: O objetivo deste trabalho foi relatar um caso de intrusão grave em bebê de 10 meses, com surgimento de Odontoma após trauma dentário. Relatode Caso: Paciente de 9 anos de idade, acompanhada pela responsável, procurou atendimento pelo atraso na esfoliação dos dentes decíduos. Durante a anamneses foi constatado traumatismo na dentição decídua aos 10 meses de idade, e em seguida realizado o exame clínico e radiográfico, demostrando a presença de odontoma nos dentes 11 e 21. O plano de tratamento multidisciplinar compreedeu a cirurgia para remoção do odontoma, com posterior tratamento ortodôntico reabilitador. Conclusão: O trauma na dentição decídua pode gerar diversas consequências para a dentição permanente. Desse modo é necessário um atendimento odontológico logo após o incidente e um proservação do caso, para avaliar possíveis sequelas.

Ameloblastic fibrodentinoma in a baby maxilla: case report

Introduction: Ameloblastic fibrodentinoma (AFD) is a rare, asymptomatic, slow-growing mixed odontogenic tumor, usually affecting children and young peoplein their first or second decade of life. This lesion usually causes bone expansion ofthe involved region and makes tooth eruption difficult. Objective: the aim of thisstudy is to report a case of AFD in the anterior maxilla of a 3-year-old baby and itstreatment, highlighting the importance of early dental care and treatment forthis type of injury. Casereport: A 3-year-old female patient attended the dentalcare clinic at Cesmac University Center (Maceió- AL, Brazil), accompanied by hermother, reporting a swollen gum for approximately 6 months. Clinical examinationrevealed an increase in volume in the right central and lateral incisor region,discreetly reddish in color, smooth surface, spherical shape, sessile insertion, nomobility and firm consistency. Radiographic examination revealed a mixed lesionwith radiolucent area compatible with bone resorption and radiopaque areascompatible with calcified material within the lesion. An incisional biopsy wasperformed, confirming the diagnosis of Ameloblastic Fibrodentinoma. Conclusion:Treating this anomaly requires an early approach to improve the quality of life ofthese patients. Parents or guardians should be advised of the need for periodicfollow-up after treatment.

Introdução: O Fibrodentinoma Ameloblástico (FDA) é um tumor odontogênicomisto, raro, assintomático e de crescimento lento, acometendo normalmentecrianças e jovens em sua primeira ou segunda década de vida. Essa lesãogeralmente provoca expansão óssea da região envolvida e dificulta a erupçãodentária. Objetivo: O objetivo deste trabalho é relatar um caso de FDA em maxilaanterior de bebê de 3 anos de idade e seu tratamento, ressaltando a importânciado atendimento odontológico precoce e o tratamento para este tipo de lesão.Relatodecaso: Paciente do gênero feminino, 3 anos, compareceu à clínicaodontológica de atendimento a bebês do Centro Universitário Cesmac (Maceió ­AL, Brasil), acompanhada de sua mãe, relatando uma gengiva inchada háaproximadamente 6 meses. Ao exame clínico, observou-se um aumento de volumena região do incisivo central e lateral direito, com coloração discretamenteavermelhada, superfície lisa, formato esférico, com inserção séssil, sem mobilidadee de consistência firme. Ao exame radiográfico constatou-se uma lesão mistacom área radiolúcida compatível com reabsorção óssea e áreas radiopacascompatíveis com material calcificado no interior da lesão. Foi realizado umabiopsia incisional, confirmando o diagnóstico de Fibrodentinoma Ameloblástico.Conclusão: O tratamento desta anomalia requer uma abordagem precoce como objetivo de melhorar a qualidade de vida desses pacientes, devendo-se aconselharos pais ou responsáveis quanto à necessidade do acompanhamento periódicoapós a realização do tratamento.