Evaluation of Antimicrobial Properties, Cell Viability, and Metalloproteinase Activity of Bioceramic Endodontic Materials Used in Vital Pulp Therapy.

This study aimed to evaluate the antimicrobial properties, cell viability, and matrix metalloproteinase (MMP) inhibition capacity of several endodontic materials aimed at vital pulp therapy: Pro Root MTA®, EndoSequence®, Biodentine®, MTA Angelus®, TheraCal LC®, and BioC Repair®. The materials were prepared according to the manufacturer's instructions. Antimicrobial tests were conducted using a microcosm biofilm model, cell viability was assessed using murine fibroblasts (L929), and MMP activity was analyzed through electrophoresis. The results showed that BioC Repair®, Biodentine®, and EndoSequence® exhibited similar antimicrobial properties, while MTA Angelus® and ProRoot MTA® had inferior results but were comparable to each other. In terms of cell viability, no significant differences were observed among the materials. EndoSequence® demonstrated the highest MMP inhibition capacity. In conclusion, BioC Repair®, Biodentine®, EndoSequence®, and TheraCal® showed better antimicrobial properties among the tested materials. The materials did not exhibit significant differences in terms of cytotoxicity. However, EndoSequence® displayed superior MMP inhibition capacity.

Physicomechanical Properties of Tertiary Monoblock in Endodontics: A Systematic Review and Meta-analysis.

Introduction: A systematic review and meta-analysis were conducted to evaluate the physicomechanical properties of tertiary monoblock obturation with different obturation techniques. Methods and Materials: PubMed (MEDLINE), Web of Science, Scopus, the Cochrane Library, LILACS, IBECS, and BBO were searched time. PICO question was: "In extracted human teeth (Population), does tertiary monoblock obturation (Intervention) have superior physicomechanical properties (Outcome) compared to conventional obturation systems (Comparison)?". Statistical analyses for push-out bond strength were performed with RevMan software by comparing the mean differences of each study, with a 95% confidence interval. Inverse variance was used as statistical method, random-effects models as analysis model, and heterogeneity between studies was assessed by Cochran's Q test and I2 statistic (P <0.05). Results: Of 2162 studies retrieved, 31 were included in this review for "Study Characteristics". Ten studies were included in the meta-analysis. Analysis demonstrated that conventional obturation had significantly higher push-out bond strength than tertiary monoblock obturation (P <0 .01), with a mean difference of -1.00 (95% CI, -1.41 to -0.58; I2=100%). Subgroups using single-cone and cold lateral condensation techniques showed significantly lower push-out bond strength for tertiary monoblock obturation (P <0.01), respectively with a mean difference of -0.09 (95% CI, -1.13 to -0.67; I2=97%) and of -1.97 (95% CI, -3.19 to -0.75; I2=100%). The warm vertical compaction subgroup showed no statistically significant difference between tertiary monoblock and conventional systems (P =0.13), with a mean difference of 0.49 (95% CI, -0.14 to 1.12; I2=10%). Conclusion: Tertiary monoblock systems have a push-out bond strength similar to conventional systems when used with warm vertical compaction.

Effects of Brown and Green Propolis on Bond Strength of Fiberglass Posts to Root Canal Dentin.

Introduction: The purpose of this study was to evaluate the effect of brown and green propolis on bond strength of the fiberglass posts to root canal dentin, and to compare it with conventional endodontic irrigants. Methods and Materials: Sixty bovine teeth were selected, decoronated and randomly distributed into six groups (n=10), according to the irrigation solution: 0.9% saline solution (Control); 2% chlorhexidine (CHX); 5% malic acid (MA); 0.5% ethanolic extract of brown propolis (BP); 0.25% ethanolic extract of green propolis (GP); 2.5% sodium hypochlorite (NaOCl). After root canal treatment, fiber posts were cemented into prepared root canals with a self-adhesive resin cement. The roots were cross-sectioned to obtain two discs from each third and submitted to the micro push-out test. Failure patterns were evaluated under optical microscopy. The influence of irrigants agents was analyzed using one-way ANOVA followed by Games-Howell's test (α=0.05). Failure modes were analyzed using Fischer's exact test (α=0.05). Results: There were statistically significant differences among the groups (P<0.05). The control, NaOCl and BP groups showed the highest bond strength with no statistically significant difference between them (P>0.05). Adhesive failure type was the predominant in all groups. Conclusion: Based on this in vitro study, the use of 0.5% brown propolis did not influence the bond strength of fiberglass posts to root canal dentin, while the use of 0.25% green propolis did affect it negatively.

Effect of post space preparation drills on the incidence of root dentin defects.

OBJECTIVES: This study investigated the incidence of root dentin defects after the use of different post space preparation (PSP) drills. MATERIALS AND METHODS: Seventy-two bovine incisors were selected and obtained 14-mm-long root sections. Twelve roots served as controls with no intervention (G1). The 60 root canals remaining were instrumented using the crown-down technique with the ProTaper Next system and obturated using the lateral condensation technique. Specimens were randomly distributed into 5 groups (n = 12) according to the operative steps performed: G2, root canal instrumentation and filling (I+F); G3, I+F and PSP with Gates-Glidden drills; G4, I+F and PSP with Largo-Peeso reamers; G5, I+F and PSP with Exacto drill; and G6, I+F and PSP with WhitePost drill. Roots were sectioned at 3, 6, 9, and 12 mm from the apex, and digital images were captured. The presence of root dentin defects was recorded. Data were analyzed by the χ2 test, with p < 0.05 considered to indicate statistical significance. RESULTS: Root dentin defects were observed in 39.6% of the root sections. No defects were observed in G1. G5 had significantly more cracks and craze lines than G1, G2, and G3 (p < 0.05), and more fractures than G1, G2, G3, and G4 (p < 0.05). When all root sections were analyzed together, significantly more defects were observed at the 12-mm level than at the 3-mm level (p < 0.05). CONCLUSIONS: PSP drills caused defects in the root dentin. Gates-Glidden drills caused fewer root defects than Largo-Peeso reamers and Exacto drills.

Influence of Parental Exposure to Risk Factors in the Occurrence of Oral Clefts.

STATEMENT OF THE PROBLEM: Non-syndromic cleft lip and palate are the most frequent craniofacial abnormalities in humans. The genetic, environmental and behavioral factors involved in this malformation must be clarified in different parts of the globe in the view of implementing preventive measures. PURPOSE: To analyze the influence of parental exposure to risk factors on the occurrence of oral clefts. MATERIALS AND METHOD: A case-control study was conducted with 150 mothers of oral cleft children paired by the children's gender to 300 mothers of children without congenital anomalies from Mato Grosso, Brazil, for the study of the variables: gender and race/color of the children; parental educational level; age; number of pregnancies; prenatal care; obesity; stress; diabetes; hypertension; use of medications, alcohol and illicit drugs; smoking and exposure to ionizing radiation during the first trimester of pregnancy. The results were analyzed in relation to the chances possibility of each variable for the occurrence of oral cleft through the bivariate and multivariate analysis by applying the model of logistic regression. RESULTS: Passive smoking, obesity, exposure to ionizing radiation and use of antibiotics were associated with the presence of clefts. The use of folic acid and analgesics were identified as preventive factors. The father's low educational level was found as a risk factor, while the black race/color was a preventive factor; nevertheless these variables were not associated in the multivariate analysis. CONCLUSION: The results reinforce the need to follow up the pregnant women, especially in the first trimester of pregnancy, in order to control the identified risk factors. Considering the factors associated with occurrence of oral clefts and those associated with its prevention, it is possible to apply specific health promotion measures during pregnancy, which can result in the reduction of oral clefts' occurrence.

Head and Neck Cancer Patients' Quality of Life: Analysis of Three Instruments.

STATEMENT OF THE PROBLEM: Head and neck cancer treatment has provided better cure and survival rates but the patient's quality of life is still an issue. PURPOSE: To verify the correlation between the three most used instruments for evaluating the quality of life of head and neck cancer patients. MATERIALS AND METHOD: This cross-sectional study evaluated patients treated for head and neck cancer at the Mato Grosso Cancer Hospital, Cuiabá, MT, Brazil. The variables age, gender, cohabitation status, education, religion, smoking, ethnicity, tumor location and histological type and treatment modality were collected. The patients quality of life was assessed by the Functional Assessment of Cancer Therapy Quality of Life Measurement System (FACT-H&N), University of Washington Quality of Life Questionnaire (UW-QOL), and EORTC QLQ-C30/EORTC QLQ-H&N35 of the European Organization for Research and Treatment of Cancer. RESULTS: The study population consisted of 33 individuals with a mean age of 63.42±11.25 years; 69.70% were males; 54.55% had no partner; 45.45% had only elementary education; 87.9% followed a religion; 84.38% were smokers and 87.50% alcoholics. Squamous cell carcinoma responded for 78.79% of the cases and palate/oropharynx and mouth floor (21.21% each) were the most affected sites. All patients underwent radiotherapy, 90.91% chemotherapy and 63.64% surgery. On the analysis of quality of life, shoulder (UW-QOL), social performance (EORTC QLQ-C30/QLQ-H&N35) and overall well-being (FACT-H&N) had the highest scores while saliva (UW-QOL), nausea and vomiting (EORTC QLQ-C30/QLQ-H&N35) and emotional well-being (FACT-H&N) had the lowest scores. A positive correlation was found between the questionnaires for the patient's overall quality of life and the domains Pain, Appearan-ce, Activity, Deglutition, Chewing, Speech, Taste, Saliva, Mood and Anxiety. CONCLUSION: Given the correlation between the questionnaires, the selection of the instrument for future research involving head and neck cancer patients' quality of life should consider the specific aspects to be evaluated.

Cytotoxicity of Chelating Agents Used In Endodontics and Their Influence on MMPs of Cell Membranes.

This study evaluated the cytotoxic effect and the ability to inhibit matrix metalloproteinases (MMP-2 and MMP-9) of 0.2% chitosan (CH) and 1% acetic acid (AA) compared with 17% ethylenediaminetetraacetic acid (EDTA). Cell viability assay was performed according to ISO 10993-5 with mouse fibroblasts (L929). The culture was exposed to 0.2% CH, 1% AA, and 17% EDTA. The chelating agents were evaluated immediately after contact with the cells and after 6 h, 12 h, and 24 h of incubation. Cell viability was analyzed using the 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Inhibition of the gelatinolytic activity of MMP-2 and MMP-9 was evaluated by gelatin zymography. Different concentrations of CH were evaluated: 50 mM, 5 mM, 0.5 mM, and 0.05 mM. EDTA (0.5 mM) was used as a positive control. The results demonstrated that CH and AA had an initial cytotoxic effect, which decreased after 6 h, 12 h, and 24 h, being statistically similar to EDTA (P > 0.05). Additionally, CH at concentrations of 50 mM, 5 mM, and 0.5 mM had an inhibitory effect on MMP-2 and MMP-9, similar to that of the control with EDTA. The chelating agents had no cytotoxic effects after 24 h. MMP-2 and MMP-9 were inhibited by the experimental solutions.

Cytotoxicity of chelating agents used in endodontics and their influence on mmps of cell membranes

Abstract This study evaluated the cytotoxic effect and the ability to inhibit matrix metalloproteinases (MMP-2 and MMP-9) of 0.2% chitosan (CH) and 1% acetic acid (AA) compared with 17% ethylenediaminetetraacetic acid (EDTA). Cell viability assay was performed according to ISO 10993-5 with mouse fibroblasts (L929). The culture was exposed to 0.2% CH, 1% AA, and 17% EDTA. The chelating agents were evaluated immediately after contact with the cells and after 6 h, 12 h, and 24 h of incubation. Cell viability was analyzed using the 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Inhibition of the gelatinolytic activity of MMP-2 and MMP-9 was evaluated by gelatin zymography. Different concentrations of CH were evaluated: 50 mM, 5 mM, 0.5 mM, and 0.05 mM. EDTA (0.5 mM) was used as a positive control. The results demonstrated that CH and AA had an initial cytotoxic effect, which decreased after 6 h, 12 h, and 24 h, being statistically similar to EDTA (P > 0.05). Additionally, CH at concentrations of 50 mM, 5 mM, and 0.5 mM had an inhibitory effect on MMP-2 and MMP-9, similar to that of the control with EDTA. The chelating agents had no cytotoxic effects after 24 h. MMP-2 and MMP-9 were inhibited by the experimental solutions.

Resumo Este estudo avaliou o efeito citotóxico e a capacidade de inibição das metaloproteinases da matriz extracelular (MMP-2 e MMP-9) pela quitosana 0,2%(CH) e o ácido acético 1% (AA) em comparação com o ácido etilenodiaminotetracético 17% (EDTA). O ensaio de viabilidade celular foi realizado de acordo com a ISO 10993-5 com fibroblastos de camundongo (L929). A cultura foi exposta a CH 0,2%, AA 1% e EDTA 17%. Os agentes quelantes foram avaliados imediatamente após o contato com as células e após 6 h, 12 h e 24 h de incubação. A viabilidade celular foi analisada utilizando o ensaio de brometo de 3- (4,5-dimetitiazol-2-il) -2,5-difeniltetrazólio (MTT). A inibição da atividade gelatinolítica de MMP-2 e MMP-9 foi avaliada por zimografia de gelatina. Diferentes concentrações de CH foram avaliadas: 50 mM, 5 mM, 0,5 mM e 0,05 mM. EDTA (0,5 mM) foi usado como controlo positivo. Os resultados demonstraram que CH e AA apresentaram um efeito citotóxico inicial, que diminuiu após 6 h, 12 h e 24 h, sendo estatisticamente similar ao EDTA (P> 0,05). Adicionalmente, CH a concentrações de 50 mM, 5 mM e 0,5 mM tiveram um efeito inibidor sobre MMP-2 e MMP-9, semelhante ao controlo com EDTA. Os agentes quelantes apresentaram efeitos não citotóxicos após 24 h. MMP-2 e MMP-9 foram inibidas pelas soluções experimentais.

Taxas de prevalência de hanseníase nas macrorregiões do estado de Mato Grosso: Datasus-Brasil / Leprosy prevalence rates in Mato Grosso state macroregions: Datasus-Brazil / Tasas de prevalencia de lepra en macrorregiones del estado de Mato Grosso: Datasus-Brazil

Objetivo: analisar e comparar taxas de prevalência de hanseníase nas macrorregiões do estado de Mato Grosso a partir informações coletadas do Departamento de Informática do Sistema Único de Saúde (DATASUS) do Ministério da Saúde do Brasil. Método: estudo retrospectivo transversal onde analisou a taxa de prevalência no período de janeiro a dezembro de 2017. Os dados foram obtidos através do (DATASUS). Os valores foram comparados por análise de variância, testes de KolmogorovSmirnov e Levene, seguidos pelo teste post hoc de Tukey, com nível de significância em p<0,05. Resultados: Houve diferença estatisticamente significante entre as Macrorregiões do estado de Mato Grosso, Teles Pires, Vale do Peixoto, Vale do Arinos e Médio Araguaia, consideradas "hiperendêmicas". Conclusão: As taxas de prevalência de hanseníase encontradas neste estudo a partir da utilização da ferramenta DATASUS avaliando as macrorregiões do estado de Mato Grosso abrem perspectivas futuras para estudo epidemiológicos bem elaborados bem como a análise da qualidade dos serviços de saúde utilizados. A ferramenta DATASUS pode ser utilizada no planejamento de políticas públicas para a hanseníase.(AU)

Background: Objective: To analyze and compare leprosy prevalence rates in the macroregions of the state of Mato Grosso from information collected from the Department of Informatics of the Unified Health System (DATASUS) of the Brazilian Ministry of Health. Method: a retrospective cross-sectional study analyzing the prevalence rate from January to December 2017. Data were obtained through (DATASUS). The values were compared by analysis of variance, Kolmogorov-Smirnov and Levene tests, followed by Tukey post hoc test, with significance level of p <0.05. Results: There was a statistically significant difference between the macroregions of the state of Mato Grosso, TelesPires, Peixoto Valley, Arinos Valley and Middle Araguaia, considered "hyperendemic". Conclusion: The prevalence rates of leprosy found in this study from the use of the DATASUS tool evaluating the macro-regions of the state of Mato Grosso open future perspectives for well-prepared epidemiological studies as well as the analysis of the quality of the health services used. DATASUS tool can be used in the planning of public policies for leprosy.(AU)

Objetivo: analizar y comparar las tasas de prevalencia de lepra en los macrorregiones del estado de Mato Grosso a partir de la información recopilada del Departamento de Informática del Sistema Único de Salud (DATASUS) del Ministerio de Salud de Brasil. Método: estudio retrospectivo transversal que analiza la tasa de prevalencia de enero a diciembre de 2017. Los datos se obtuvieron a través de (DATASUS). Los valores se compararon mediante análisis de varianza, pruebas de KolmogorovSmirnov y Levene, seguidas de la prueba post hoc de Tukey, con un nivel de significación de p <0,05. Resultados: Hubo una diferencia estadísticamente significativa entre los macrorregiones del estado de Mato Grosso, Teles Pires, Peixoto Valley, Arinos Valley y medio Araguaia, consideradas "hiperendémicas". Conclusión: Las tasas de prevalencia de lepra encontradas en este estudio a partir del uso de la herramienta DATASUS que evalúa las macro regiones del estado de Mato Grosso abren perspectivas futuras para estudios epidemiológicos bien preparados, así como el análisis de la calidad de los servicios de salud utilizados. La herramienta DATASUS se puede utilizar en la planificación de políticas públicas.(AU)

Experimental Resin-Based Monoblock Endodontic Obturation System.

OBJECTIVE: The aim of the present study was to characterize a novel resin-based monoblock endodontic obturation system consisting of a polymeric cone and a resin-based endodontic sealer. METHODS: The preliminary tests performed for the experimental cone were as follows: cohesive strength, dimensional stability, standardization of the diameter and taper, calcium ion release, and radiopacity, for the characterization of the experimental sealer, film thickness and flow tests were performed. Tests were performed according to the American National Standards Institute/American Dental Association (ANSI/ADA) Standards Nos. 57 and 78. The experimental cone was compared to gutta-percha, whereas the experimental sealer was compared to AH Plus. Data were analyzed by Student's t-test (α = 0.05). RESULTS: The experimental cone had superior values for cohesive strength and dimensional stability compared to gutta-percha. Regarding calcium ion release, the experimental system continued to release calcium ions after 30 days. Film thickness was similar for both endodontic sealers; conversely, the experimental resin-based sealer achieved higher values for flow compared to AH Plus. CONCLUSION: The experimental resin-based monoblock obturation system fully met the requirements of the ANSI/ADA Standard No. 78 and the ANSI/ADA Standard No. 57, except for radiopacity. Considering this, further studies are still needed to evaluate other radiopacifiers and the effect of their incorporation on the physicochemical properties of this novel resin-based monoblock endodontic obturation system.

The Influence of Vasoconstritor Use in Local Anesthesia in Individuals with Chronic Renal Failure / A Influência do Uso de Vasoconstritor na Anestesia Local em Indivíduos com Insuficiência Renal Crônica

Individuals with chronic renal failure (CRD) undergo hemodialysis to compensate for systemic-based disease and often develop systemic arterial hypertension (SAH). Such individuals, when needing dental treatment, carry with them the consideration of which type of anesthetic to be used in clinical and surgical interventions. The objective of this study was to evaluate the action of anesthetics with vasoconstrictor (AwV) and without vasoconstrictor (AoV) in individuals with chronic renal failure. Research subjects needed dental treatment, with dental restorations, on the right and left lower dental arch in premolars and / or molars, thus receiving the model of a split-mouth clinical study. In a randomized study, each side of the mandible was subjected to an anesthetic infiltration with only one 1.8 mL tube in two different moments with a minimum interval of 7 days (for one moment with AwV and another AoV moment). The parameters of oxygen saturation (SaO2), heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured 5 minutes before anesthesia, 5, 15 and 30 minutes after anesthesia. The results found in this study showed statistical difference only in SaO2 in the time of 5 minutes after the anesthesia in comparison of the AwV and AoV group, this same result was obtained when only those individuals who, besides nephropathies, had a diagnosis of SAH, were evaluated. The findings of this study highlight the safety of the use of anesthetics, with or without vasoconstrictors since in small amounts, in individuals with CRF with or without associated SAH. (AU)

Indivíduos com insuficiência renal crônica (IRC) em geral são submetidos à hemodiálise para compensação da doença de base sistêmica e frequentemente desenvolvem a hipertensão arterial sistêmica (HAS). Tais indivíduos, ao necessitarem de tratamento odontológico, levam consigo a ponderação de qual tipo de anestésico a ser utilizado em intervenções clínicas e cirúrgicas. O objetivo deste estudo foi avaliar a ação de anestésicos com vasoconstritor (ACV) e sem vasoconstritor (ASV) em indivíduos com insuficiência renal crônica. Os indivíduos da pesquisa tinham necessidade de tratamento odontológico, com restaurações dentárias, no arco dentário inferior direito e esquerdo em pré-molares e/ou molares, recebendo assim o modelo de estudo clínico de boca dividida. De forma aleatória, os hemiarcos inferiores foram submetidos, em dois diferentes momentos com intervalo mínimo de 7 dias, a infiltração anestésica com apenas um tubete de 1,8 mL (para um momento com ACV e outro momento ASV). Foi feita aferição dos parâmetros de saturação de oxigênio (SaO2), frequência cardíaca (FC), pressão arterial sistólica (PAS) e diastólicas (PAD), 5 minutos antes da anestesia, 5, 15 e 30 minutos após a anestesia. Os resultados encontrados neste estudo demonstraram diferença estatística apenas na SaO2 no tempo de 5 minutos após a anestesia em comparação do grupo ACV e ASV, esse mesmo resultado foi obtido quando avaliados apenas os indivíduos que, além de nefropatas, apresentavam diagnóstico de HAS. Os achados deste estudo ressaltam a segurança do uso de anestésicos, com ou sem vasoconstritores desde que em pequenas quantidades, em indivíduos com IRC com ou sem HAS associada. (AU)

Correlation of periodontal and microbiological evaluations, with serum levels of estradiol and progesterone, during different trimesters of gestation.

Our purpouse was to identify quantitatively and qualitatively the subgingival flora in different gestational trimesters, compared to non-pregnant women; evaluating the correlations between epidemiological characteristics, clinical diagnosis, microbiological findings and levels of estradiol and progesterone. 52 pregnant women divided into 3 groups, according to the gestational trimester and 15 non-pregnant patients, without hormonal contraceptives, were evaluated. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) were evaluated. Subgingival biofilm samples were processed by the qPCR technique and the serum levels of estradiol and progesterone quantified by chemiluminescence. Clinical diagnosis during gestation was correlated with the total bacterial count. A higher prevalence of Tannerella forsythia (Tf) was identified in first trimester of pregnancy and this periodontopathogen was correlated with the diagnosis of gingivitis among pregnant women. Porphyromonas gingivalis (Pg) showed a positive correlation with progesterone levels in the first trimester. High prevalence of periodontopathogens was noticed in this population. Clinical diagnosis in gestation was positively correlated with the total amount of bacteria, without influence of the hormonal levels or the epidemiological factors evaluated. The presence of Tf favored occurrence of gingivitis during pregnancy and the progesterone levels in the first trimester enhanced the growth of Pg.

Immediate Insertion of Dental Implants Immediate Insertion in Bilateral Traumatic Bone Cysts With or Without a Bone Grafting Material: A 5-Year Follow-Up Case Report.

This case report describes the rehabilitation of a patient who received dental implants in traumatic bone cyst areas (TBC). A 24-year-old male patient sought dental treatment for the bilateral absence of the mandibular second premolars. Radiographic examination revealed bilateral large radiolucent images in the mandible body. Surgical exploration confirmed the diagnosis of TBC. Rehabilitation with dental implants was performed using different approaches on each side. One cystic cavity was filled with blood clot and allogenic bone graft; the other was filled only with blood clot. After 5 years, the implants are osseointegrated and functioning. The filling of the traumatic bone cyst cavity with local blood clot in contact with the implant presented clinical and radiographic success similar to that obtained with filling with bone graft in the same patient. Thus, in this patient, the blood clot-only approach can be considered as a viable, safe-low cost alternative to blood clot and grafting material.

Surgical Treatment of Odontogenic Keratocyst with Application of Carnoy's Solution: Case Report / Tratamento Cirúrgico de Queratocisto Odontogênico com Aplicação de Solução de Carnoy: Relato de Caso

Odontogenic cysts are benign non-neoplastic lesions that originate from epithelial cells Arachnida-Araneae) community in the process of the teeth development. Among them, the odontogenic keratocyst is a developmental cyst characterized by its epithelium of parakeratinized stratified and aggressive squamous cells as well as infiltrative behavior. Thus, the objective of this study was to describe a clinical case of surgical treatment of odontogenic keratocysts in a 52-year-old female patient, who presented for the treatment of a large lesion in a region of the left mandibular body and angle. After incisional biopsy and installation of a decompression device, the histopathological diagnosis of odontogenic keratocyst was obtained. Subsequently to a period of 9 months with the decompression device in place, a decrease of the lesion was noticed, thus allowing intervention to be performed the excision of the lesion. Thus, the patient was subjected, under general anesthesia, to enucleation of the lesion as the main treatment, with complementary maneuvers of peripheral ostectomy and application of Carnoy solution over the remaining bone bed. After an outpatient follow-up of 16 months, no signs of recurrence of the lesion were observed. The proposed treatment was efficient in removing the keratocyst with minimal surgical morbidities. In conclusion, the treatment protocol was effective and conservative in the surgical management of the lesion, allowing rapid recovery and return of the function.(AU).

Cistos odontogênicos são lesões benignas não-neoplásicas que tem por origem células remanescentes epiteliais do processo de formação do órgão dental. Dentre elas, o queratocisto odontogênico é um cisto de desenvolvimento caracterizado por seu epitélio de células escamosas estratificadas paraqueratinizadas, pelo comportamento agressivo e infiltrativo. Sendo assim, o objetivo desse estudo foi descrever um caso clínico de tratamento cirúrgico do queratocisto odontogênico em uma paciente do gênero feminino de 52 anos de idade, que compareceu para o tratamento de uma lesão de grande porte em região de corpo e ângulo mandibulares à esquerda. Após biópsia incisional e instalação de um dispositivo descompressivo, obteve-se o diagnóstico histopatológico de queratocisto odontogênico. Posteriormente a um período de 9 meses com o dispositivo de descompressão em posição, notou-se uma diminuição da lesão, permitindo assim a execução de intervenção para exérese da lesão. Assim, a paciente foi submetida, sob anestesia geral, à enucleação da lesão como tratamento principal, com manobras complementares de ostectomia periférica e aplicação de solução de Carnoy sobre o leito ósseo remanescente. Após um acompanhamento ambulatorial de 16 meses, não foi observado nenhum sinal de recorrência da lesão. O tratamento proposto foi eficiente em remover o queratocisto com as mínimas morbidades cirúrgicas. Concluindo, o protocolo de tratamento foi efetivo e conservador no manejo cirúrgico da lesão, permitindo rápida recuperação e retorno da função. (AU).

Maxillofacial Fractures in a University Hospital in Central Brazil / Fraturas Oralmaxilofaciais em um Hospital Universitário do Brasil Central

The objective of this study was to evaluate epidemiological aspects of maxillofacial fractures in 346 hospitalized patients treated at the Department of Oral and Maxillofacial Surgery of the University General Hospital, Mato Grosso, Brazil. The following information was collected from the patients' medical records: gender, age, etiologic factor, type of injury, patient origin, seasonal distribution and hospital stay period. The statistical treatment analyzed data from frequency distribution and chi-squared test. The level of significance was set at 5% for all analyses. The highest incidence of maxillofacial fractures was found among males (n=290; 83.8%), with 21-30 years-old (n=120; 34.5%) and from inner cities of Mato Grosso (n=169; 48.9%). The main etiologic factor were vehicle traffic accidents (n=169; 48.9%), violence (n=65; 18.8%) and falls (n=25; 7.2%). The seasonal distribution showed that most of the cases occurred in the fall (n=89; 25.8%), winter and spring (n=77; 22.2% each). The lower third of the face was the most commonly involved region (n=276; 54.3%). The most frequently observed fracture involved the zygomatic complex (n=146; 28.7%), followed by the mandible body (n=99; 19.4%). The epidemiological aspects of maxillofacial fractures in this study were similar to those observed in other studies, regarding the prevalence of the male, age group and traffic accidents as the main etiological factor. (AU).

Avaliou-se os aspectos epidemiológicos das fraturas oralmaxilofaciais em prontuários de pacientes atendidos em um Hospital Universitário do Brasil central. A amostra do estudo foi proveniente da revisão de prontuários de 346 pacientes atendidos no Serviço de Cirurgia e Traumatologia Oralmaxilofacial do Hospital Geral Universitário na cidade de Cuiabá, Mato Grosso, Brasil. Os seguintes dados foram coletados dos registros hospitalares de cada paciente: sexo, idade, fator etiológico, região anatômica afetada, procedência, distribuição sazonal e período de internação. O tratamento estatístico analisou os dados frente à distribuição de frequência e qui-quadrado. O nível de significância foi de p<0,05. Observouse elevada frequência de fraturas oralmaxilofaciais em indivíduos do sexo masculino (n=290; 83,8%), com idade variando entre 21-30 anos (n=120; 34,5%) e provenientes de cidades do interior do estado do Mato Grosso (n=169; 48,8%). Os principais fatores etiológicos foram os acidentes de trânsito motorizados (n=169; 48,9%), violência (n=65; 18,8%) e quedas (n=25; 7,2%). A distribuição sazonal evidenciou elevado número de lesões no outono (n=89; 25,8%), inverno e primavera (n=77; 22,2%, cada um). O terço inferior da face foi a região mais comumente envolvida (n=276; 54,3%). A injúria mais comum foi a fratura do complexo zigomático (n=146; 28,7%), seguida da fratura do corpo da mandíbula (n=99; 19,4%). Os dados obtidos se assemelham aos encontrados na literatura, no que diz respeito à prevalência do sexo masculino, da faixa etária e dos acidentes de trânsito como principal agente etiológico. (AU).

Evaluation of Selective Physicochemical and Biological Properties of Different Root Canal Sealers.

Introduction: This in vitro study aimed to evaluate the chemical composition, water solubility, radiopacity, pH, electrical conductivity and cytotoxicity of four different root canal sealers. Methods and Materials: Four materials were tested including an epoxy resin-based sealer (AH-Plus), a calcium silicate-based sealer (MTA Fillapex), a calcium hydroxide-based sealer (Sealapex) and a zinc-oxide-eugenol-based sealer (Endofill). The materials were submitted to energy-dispersive x-ray microanalysis for elemental chemical composition. Solubility and radiopacity were evaluated according to ANSI/ADA. The pH and electrical conductivity were measured at different periods of time. L929 immortalized mouse fibroblast line were used for cytotoxicity evaluation. Statistical analyses were carried out using the ANOVA and Tukey's test. Results: The main elements were found to be silicon and calcium in MTA Fillapex, calcium and bismuth in Sealapex, zirconium and tungsten in AH-Plus and zinc and bismuth in Endofill. Sealapex had the highest value for solubility (P<0.05), AH-Plus showed the highest radiopacity value (P<0.05) while MTA Fillapex had the highest pH and electrical conductivity values (P<0.05). AH-Plus showed the highest rate of cell viability (P<0.05). Conclusion: Based on the results of this in vitro study, it was possible to conclude that Endofill and Sealpex did not meet the requirements for water solubility. The tested sealers were alkaline and showed radiopacity in accordance with ANSI/ADA standards. AH-Plus showed to be less cytotoxic than other tested root canal sealers.

Epidemiological Profile of Patients with Hematological Neoplasms in an Oncological Hospital of Mato Grosso / Perfil Epidemiológico de Pacientes com Neoplasia Hematológica em um Hospital Oncológico de Mato Grosso

O objetivo do estudo foi analisar os aspectos epidemiológicos de pacientes adultos com diagnóstico de neoplasia hematológica, no período de 2004 a 2014, em um Hospital Oncológico em Mato Grosso. A coleta de dados foi realizada através de busca e análise de 590 prontuários. Entre os pacientes, 335 (56,8%) eram do sexo masculino (p<0,05). A maioria possuía mais de 50 anos (p<0,05), com idade média de 53,97±16,55 anos. Quanto ao local de procedência, 257 pacientes eram provenientes da região metropolitana de Cuiabá (43,6%) e 333 (56,4%) de outros locais (p<0,05). A maioria eram pacientes não brancos (p<0,05) e solteiros 342 (58%) (p<0,05). Em relação ao tratamento, 537 (91%) pacientes utilizavam quimioterapia (p<0,05), 57 (9,7%) fizeram uso da radioterapia (p<0,05). Cinquenta e quatro (9,2%) pacientes fizeram uso de ambas as terapias de forma associada (p<0,05) e 50 pacientes (8,4%) não fizeram uso de radioterapia e nem de quimioterapia. Referente aos tipos de neoplasia, os diagnósticos mais encontrados na análise foram de: leucemia mielóide crônica 131 (22,2%); linfoma não Hodking 119 (20,2%); mieloma múltiplo 93 (15,8%); trombocitemia essencial 49 (8,3%); linfoma de Hodking 39 (6,6%); leucemia linfocítica crônica 38 (6,4%); policetemia vera 34 (5,8%); leucemia mielóide aguda 27 (4,6%); síndrome mielodisplasica 21 (3,6); leucemia linfocítica aguda 13 (2,2%) e síndrome mieloproliferativa 10 (1,7%) (p<0,05). A partir dos resultados deste estudo, pode-se concluir que, em geral, os pacientes mais acometidos pelas neoplasias hematológicas tinham mais de 50 anos, eram homens, provenientes do interior do Estado, não brancos e solteiros.(AU).

The objective of this study was to analyze the epidemiological aspects of adult patients diagnosed with hematologic neoplasia, from 2004 to 2014, at a Cancer Hospital in Mato Grosso. Data collection was performed through the search and analysis of 590 patient records. Among the patients, 335 (56.8%) were male (p <0.05). The majority was older than 50 years (p <0.05), with a mean age of 53.97 ± 14.95 years. Regarding origin, 257 patients came from the metropolitan region of Cuiabá (43.6%) and 333 (56.4%) from other sites (p <0.05). The majority was non-white patients (p <0.05) and unmarried 342 (58%) (p <0.05). About treatment, 537 (91%) patients used chemotherapy (p <0.05), 57 (9.7%) used radiotherapy (p <0.05). Fifty-four (9.2%) patients used both therapies in an associated way (p <0.05) and 50 patients (8.4%) did not use either radiotherapy or chemotherapy at any time of their treatment. Regarding the types of neoplasia, the diagnoses most found in the analysis were: chronic myelogenous leukemia 131 (22.2%); non Hodking lymphoma 119 (20.2%); multiple myeloma 93 (15.8%); essential thrombocythemia 49 (8.3%); Hodgkin's lymphoma 39 (6.6%); chronic lymphocytic leukemia 38 (6.4%); policetemia vera 34 (5.8%); acute myeloid leukemia 27 (4.6%); myelodysplastic syndrome 21 (3,6); acute lymphocytic leukemia 13 (2.2%) and myeloproliferative syndrome 10 (1.7%) (p <0.05). From the results of this study, it can be concluded that, in general, the most affected patients by hematological malignancies were older than 50 years, were men from the interior of the State, non-white and unmarried.(AU)

Root perforations: a review of diagnosis, prognosis and materials.

Root perforation results in the communication between root canal walls and periodontal space (external tooth surface). It is commonly caused by an operative procedural accident or pathological alteration (such as extensive dental caries, and external or internal inflammatory root resorption). Different factors may predispose to this communication, such as the presence of pulp stones, calcification, resorptions, tooth malposition (unusual inclination in the arch, tipping or rotation), an extra-coronal restoration or intracanal posts. The diagnosis of dental pulp and/or periapical tissue previous to root perforation is an important predictor of prognosis (including such issues as clinically healthy pulp, inflamed or infected pulp, primary or secondary infection, and presence or absence of intracanal post). Clinical and imaging exams are necessary to identify root perforation. Cone-beam computed tomography constitutes an important resource for the diagnosis and prognosis of this clinical condition. Clinical factors influencing the prognosis and healing of root perforations include its treatment timeline, extent and location. A small root perforation, sealed immediately and apical to the crest bone and epithelial attachment, presents with a better prognosis. The three most widely recommended materials to seal root perforations have been calcium hydroxide, mineral trioxide aggregate and calcium silicate cements. This review aimed to discuss contemporary therapeutic alternatives to treat root canal perforations. Accordingly, the essential aspects for repairing this deleterious tissue injury will be addressed, including its diagnosis, prognosis, and a discussion about the materials actually suggested to seal root canal perforation.

Immediate Rehabilitation of Elderly Patient with Large Proportion Residual Cyst / Reabilitação Imediata de Paciente Idoso com Cisto Residual de Grande Proporção

Residual cyst is consequence of a radicular cyst incomplete removal. This paper presents the case of a patient with residual cyst of unusual size located in the pre-maxilla causing large bone defect rehabilitated by titanium mesh. A 78-year-old male patient with good general health sought treatment reporting maladjustment of the upper dental prosthesis due to a volumetric increase with one year of evolution. Patient history and clinical and complementary exams led to diagnosis of residual cyst. Due to the cyst size and bone resorption, after the lesionremoval, a titanium mesh was fixed and a membrane positioned, in an attempt to reduce bone deformity and induce tissue repair to avoid functional and aesthetic sequelae. The treatment restored maxillary sinus health and provided satisfactory aesthetic contours to the patient's face, enabling a proper prosthetic rehabilitation and proved to be a viable alternative for the treatment of similar cases. (AU).

O cisto residual é consequência da remoção incompleta de um cisto radicular. Este artigo apresenta o caso de um paciente com cisto residual de tamanho incomum localizado na região pré-maxilar causando grande defeito ósseo reabilitado com uso de tela de titânio. Paciente do sexo masculino, 78 anos, com boa saúde geral procurou tratamento com desajuste da prótese dentária superior, devido a um aumento volumétrico com um ano de evolução. A história do paciente e exames clínicos e complementares levaram ao diagnóstico de cisto residual. Devido ao tamanho do cisto e à reabsorção óssea, após a remoção da lesão, uma tela de titânio foi fixada e uma membrana posicionada, na tentativa de reduzir a deformidade óssea e induzir a reparação tecidual para evitar sequelas funcionais e estéticas. O tratamento restaurou a saúde do seio maxilar e forneceu contornos estéticos satisfatórios para a face do paciente, permitindo uma reabilitação protética adequada e provou ser uma alternativa viável para o tratamento de casos semelhantes. (AU).

Effectiveness of different endodontic irrigants against Enterococcus faecalis: an ex vivo study

Aim: To evaluate the effectiveness of different endodontic irrigants against Enterococcus faecalis (ATCC 29212). Methods: Seventy bovine mandibular incisors were prepared, inoculated with a bacterial strain for 60 days and divided into the following groups: positive control; negative control; 2.5% NaOCl; 17% EDTA; 0.2% chitosan; 2.5% NaOCl + 0.2% chitosan; and 2.5% NaOCl + 17% EDTA. The irrigation protocol was performed using an experimental peristaltic pump device, with the irrigating solutions circulating within the apparatus at a constant flow for 10 min. Paper-point samples were then collected from the root canals and immersed in 7 mL of brain heart infusion broth, followed by incubation at 37°C for 48 h. Bacterial growth was assessed by turbidity of the culture medium. Results: E. faecalis was present in all samples after the use of different irrigants. Conclusion: The different irrigants tested were not effective in completely eliminating dentin bacterial contamination with E. faecalis.