Periradicular repair after single- and two-visit root canal treatments using ultrasonic irrigant activation and calcium hydroxide dressing of teeth with apical periodontitis: study protocol for randomized controlled trials.

BACKGROUND: In certain clinical situations, root canal treatment in teeth with apical periodontitis is performed in multiple visits, with the use of intracanal dressing between visits, aiming to reduce microorganisms and their by-products of the root canal system prior to filling. However, in recent years, discussions have been growing about the real need for the use of intracanal dressing in these cases. The use of ultrasonic activation of the auxiliary chemical substance has increased the potential for decontamination promoted during the chemomechanical preparation of the root canal. Thus, this study is designed to explore whether the use of intracanal dressing between visits during endodontic treatment favors periradicular repair in teeth with apical periodontitis. METHODS: This is a randomized, prospective, double-blinded, controlled clinical trial designed to evaluate 3 distinct clinical approaches used during endodontic therapy: group 1-root canal treatment in a single visit (RCT-SV); group 2-root canal treatment in two visits with intracanal dressing (RCT-TVWD); and group 3-root canal treatment in two visits without intracanal dressing (RCT-TVWOD). A total of 150 adult patients aged 18 to 60, with at least one tooth diagnosed with asymptomatic apical periodontitis and periradicular lesion (confirmed with a cone beam computed tomography (CBCT)), will be randomized and will undergo one of the types of clinical approaches during endodontic therapy. Patients' postoperative pain levels will also be recorded in periods of 24, 48, and 72 h and 7 days. Subsequently, clinical findings and long-term follow-up evaluations, with periradicular repair, will be performed at 6 and 12 months by intraoral periapical radiograph (IOPAR) and CBCT at the 24-month follow-up. DISCUSSION: This study will evaluate the periradicular repair of mandibular molar teeth with apical periodontitis, providing information about the efficacy, benefits, and safety of performing the endodontic treatment in a single and two visits, with and without the use of calcium hydroxide dressing. All endodontic therapy procedures will be performed under a dental operating microscope and using ultrasonic activation of auxiliary chemical substances. These results may contribute to changes in the clinical approaches adopted during endodontic therapy of teeth with apical periodontitis and reveal the potential of complementary approaches that aim to enhance the decontamination of the root canal system during the preparation stage. TRIAL REGISTRATION: ClinicalTrials.gov NCT05256667. Registered on 24 February 2022.

Hardness, compressive strength and resilience of complete denture lining materials: an in situ study / Dureza, resistência à compressão e resiliência de materiais de reembasamento para próteses totais: estudo in situ

ABSTRACT Objective The aim of this study was to evaluate the in situ hardness, compressive strength and resilience of soft lining materials used in total removable prostheses in different time intervals Methods total of 48 rectangular test specimens (10 x 3 x 2 mm) were fabricated of each of the polyvinylsiloxane-based soft liner (Mucopren Soft) and acrylic resin-based material (Trusoft), which were placed on total removable prostheses bases of 12 volunteers (n = 12). The hardness (Shore A), compressive strength (in MPa) and resilience (in Kgf/cm2) were evaluated in different time intervals: 0, 7, 30 and 60 days, at three different locations of the specimens surface. Results The two-way ANOVA and Tukey test showed that the polyvinylsiloxane-based soft liner presented higher hardness values (p = 0.0113) and higher compressive strength (p=0.0252) than the acrylic resin-based material at immediate and 7 days evaluations. The polyvinylsiloxane-based soft liner presented higher resilience values than the acrylic resin-based material at all times (p = 0.0133). Hardness and compressive strength were similar for both materials at 30 and 60 days evaluations. Conclusions For both materials,there was a tendency for an increase of hardness, compressive strength and resilience over time, influenced by the composition of the tissue conditioner. The polyvinylsiloxane-based soft liner presented higher hardness, compressive strength and resilience than the acrylic resin-based material, specially considering a long-term evaluation up to 60 days.

RESUMO Objetivo O objetivo deste estudo foi avaliar in situ a dureza, resistência à compressão e resiliência de materiais para reembasamento utilizadas em próteses totais removíveis em diferentes intervalos de tempo. Métodos Um total de 48 corpos de prova retangulares (10 x 3 x 2 mm) foram confeccionados de cada uma dos reembasadores a base de polivinilsiloxano (Mucopren Soft, Kettenbach GmbH & Co) e resina acrílica (Trusoft, Bosworth), os quais foram posicionados na base de próteses totais removíveis de 12 voluntários (n = 12). A dureza (Shore A), resistência à compressão (em MPa) e resiliência (em Kgf/cm2) foram avaliadas em diferentes intervalos de tempo: 0, 7, 30 e 60 dias, em três diferentes localizações da superfície do corpo de prova. Resultados A ANOVA a dois critérios e o teste de Tukey mostraram que o reembasador a base de polivinilsiloxano apresentou maiores valores de dureza (p = 0,0113) e maior resistência à compressão (p=0,0252) do que o a base de resina acrílica nas avaliações nos tempos imediato e 7 dias. O reembasador a base de polivinilsiloxano apresentou maior resiliência que o a base de resina acrílica em todos os tempos (p = 0,0133). Dureza e resistência à compressão foram semelhantes para ambos os materiais nos tempos 30 e 60 dias de avaliação. Conclusões Para ambos os materiais, houve tendência de aumento da dureza, resistência à compressão e resiliência com o passar do tempo, influenciado pela composição dos materiais de rembasamento tecidual. O reembasador a base de polivinilsiloxano apresentou maior dureza, resistência à compressão e resiliência que o a base de resina acrílica, considerando-se especialmente o tempo de avaliação de 60 dias.

Ureterocele bilateral em adulto jovem / Bilateral ureterocele in young adult

Ureterocele é uma dilatação cística do ureter intravesical. A maioria das ureteroceles é diagnosticada no útero ou imediatamente após nascimento durante exames de ecografia na pesquisa de malformações renais. Severas infecções do trato urinário são a apresentação pós-natal mais comum das ureteroceles, mas podem, raramente, sofrer um prolapso e agudamente obstruir a saída da bexiga. Ocorre mais frequentemente em crianças, entretanto quando encontrada em adultos geralmente está associada à unilateralidade, sendo a sua bilateralidade incomum. Nós apresentamos um relato de caso de uma paciente feminina adulta com ureterocele bilateral e com histórias de infecções do trato urinário por repetição (AU)

Ureterocele is a cystic enlargement of the intravesical ureter. Most ureteroceles are diagnosed in the uterus or immediately after birth in ultrasonographic scans searching for renal malformations. Serious infections of the urinary tract are the most common post-natal presentation of ureteroceles, and they may seldom prolapse and obstruct the bladder outlet. It occurs more frequently in children, but it also appears in adults, usually unilaterally, bilaterality being uncommon. Here we describe the case of an adult female patient with bilateral ureterocele with a history of repeated urinary tract infections (AU)

Cisto pericárdico gigante em paciente octagenário / Giant pericardium cyst in octagenario patient

Os cistos pericárdicos são, essencialmente, malformações congênitas, e raramente podem ser adquiridos. Possuem uma incidência muito pequena na população, 1:100.000 nascimentos, sendo assintomáticos na maioria das vezes, mas podem se manifestar através dos sintomas de dispnéia e dor torácica. São mais comuns em adultos na quarta e quinta década de vida e sua apresentação radiológica é de uma lesão arredondada próximo à silhueta cardíaca. Apresenta paredes finas bem demarcadas com conteúdo líquido mucoso em seu interior. Neste artigo, apresentamos o caso de um paciente de 80 anos com dispnéia aos pequenos esforços e dor torácica localizada. Após raio-X e TC de tórax observou-se uma massa mediastinal sugestiva de cisto pericárdico. Encaminhado à cirurgia torácica para ressecção do cisto, houve remissão total dos sintomas (AU)

The pericardium cysts are essentially congenital malformations, and rarely can be acquired. They appear in small incidence in the population, 1:100.000 births, being asymptomatic most of the time, however they can manifest themselves through dyspnea and thoracic pain. They are more common in adults in the fourth and fifth decades of life and its radiological presentation is of a rounded lesion next to the cardiac silhouette. It presents well demarcated fine walls with a mucous liquid in its interior. In this article we present the case of an eighty years old patient with dyspnea at the small effort and with a localized thoracic pain. After X-rays and CT, a mass in the mediastinum, suggestive of a pericardium cyst was observed. The patient was directed to a thoracic surgery for cyst resection and there was a total remission of the symptoms (AU)