Short-term vs long-term calcium hydroxide therapy after immediate tooth replantation: a histomorphometric study in monkey's teeth.

Endodontic treatment is an important step of tooth replantation protocols, but the ideal moment for definitive obturation of replanted teeth has not yet been established. In this study, a histomorphometric analysis was undertaken to evaluate the repair process on immediate replantation of monkey's teeth after calcium hydroxide (CH) therapy for 1 and 6 months followed by root canal filling with a CH-based sealer (Sealapex(®) ). The maxillary and mandibular lateral incisors of five female Cebus apella monkeys were extracted, kept in sterile saline for 15 min, replanted and splinted with stainless steel orthodontic wire and composite resin for 10 days. In Group I (control), definitive root canal filling was performed before tooth extraction. In Groups II and III, CH therapy started after removal of splint, and definitive root canal filling was performed 1 and 6 months later, respectively. The animals were euthanized 9 months after replantation, and specimens were processed for histomorphometric analysis. In all groups, epithelial attachment occurred at the cementoenamel junction or very close to this region; the areas of resorption on root surface had small extension and depth and were repaired by newly formed cementum; and the periodontal ligament was organized. Statistical analysis of the scores obtained for the histomorphometric parameters did not show any statistically significant difference (P = 0.1221) among the groups. The results suggests that when endodontic treatment is initiated 10 days after immediate replantation and an antibiotic regimen is associated, definitive root canal filling can be performed after a short-term CH therapy.

Treatment of traumatic dental intrusion by surgical repositioning.

The prevalence of dental trauma and its consequences are challenging. This article presents a clinical case of a 9-year-old female who was in a bicycling accident and had a dental intrusion of the left maxillary lateral incisor with extensive dislocation. In the emergency department, surgical repositioning of the intruded tooth and a splinting with steel wire and composite resin was performed and the soft-tissue lesions were sutured. Two weeks after the first visit, pulp necrosis was found and endodontic treatment of the intruded tooth was started with a calcium hydroxide dressing. Despite the traumatic nature of the dental injury, the result of treatment was favorable. After 3 years of follow-up, repair of the resorptions and no signs of ankylosis of the teeth involved were evident. Considering the patient's age and the extent of intrusion, it was concluded that surgical repositioning associated with adequate endodontic therapy was an effective alternative treatment for this case.

Uprighting impacted mandibular second molars with orthodontic elastic separating rings.

A 16-year-old girl presented with complaints of recurrent spontaneous pain in the mandibular second molar region. Treatment favored use of a simple uprighting technique involving orthodontic elastic separating rings.

Influência do emprego dos cimentos obturadores à base de CA(OH)² no PH do ambiente periapical da raiz do dente e do sistema de canal radicular / Influence of calcium hydroxide cements in the PH of apical environment and the root canal system

Dentes humanos extraídos foram preparados biomecanicamente e impermeabilizados com Araldite, exceção feita à abertura coronária e forâme apical. A seguir, os canais foram obturados com pasta de hidróxido de cálcio em água destilada. Sealapex, Apexit, CRCS, Sealer 26, e as aberturas coronárias seladas. Os espécimes foram mergulhados em frascos contendo 20 ml de água destilada e o pH da água avaliado de 0 a 30 dias. Isso feito, os dentes foram partidos ao meio, mergulhados em nova água destilada, sendo o pH novamente avaliado no tempo de 0 a 30 dias. Os resultados mostraram que os cimentos estudados determinaram, através de forâme apical, pH ao redor de 8, fato também observado com a pasta de hidróxido de cálcio. Por outro lado, quando os dentes foram partidos ao meio, apenas o Sealapex exibiu pH (12,30) próximo ao da pasta de hidróxido de cálcio (pH 12,65). Concluiu-se que, dentre os cimentos obturadores estudados, o Sealapex teria melhores condições de manter o pH do sistema de canal próximo ao obtido com o hidróxido de cálcio