Evaluation of the expression of nerve fiber markers in healthy and inflamed dental pulp.

The diagnosis of irreversible pulpitis (IP) depends on clinical data, especially the chief complaint of the patient, visual inspection, response to the application of stimuli, and radiographic examination. The characterization of nerve fibers (NF) in IP may contribute to better interpret painful symptoms, but has been barely explored. This study sought to characterize the density and integrity of NF in 16 samples of IP and in five healthy pulps (HP) using S-100 and PGP 9.5 markers. Immunohistochemistry was performed to determine the density/mm2 of S-100+ and PGP 9.5+ in NF. The amount of degenerated NF was obtained by subtracting the total NF density from the amount of intact NF. Associations between NF density and integrity and symptomatology were calculated. All samples were positive for S-100 and PGP 9.5. Compared to HP samples (38.20/mm2), IP samples had a lower density of intact NF (6.24/mm2). A significantly higher density of degenerated NF was found in IP samples with spontaneous pain (39.59/mm2) compared to those with provoked pain (23.96/mm2) (p = 0.02). No association was observed between intensity of the inflammatory infiltrate and NF density and integrity (p > 0.05). The findings of this study suggest that pulpitis may involve different stages of degeneration and may be more advanced in cases with spontaneous pain. The symptoms reported by affected individuals do not appear to depend on the intensity of the inflammatory infiltrate, but rather on the integrity of NF.

Evaluation of the expression of nerve fiber markers in healthy and inflamed dental pulp

Abstract The diagnosis of irreversible pulpitis (IP) depends on clinical data, especially the chief complaint of the patient, visual inspection, response to the application of stimuli, and radiographic examination. The characterization of nerve fibers (NF) in IP may contribute to better interpret painful symptoms, but has been barely explored. This study sought to characterize the density and integrity of NF in 16 samples of IP and in five healthy pulps (HP) using S-100 and PGP 9.5 markers. Immunohistochemistry was performed to determine the density/mm2 of S-100+ and PGP 9.5+ in NF. The amount of degenerated NF was obtained by subtracting the total NF density from the amount of intact NF. Associations between NF density and integrity and symptomatology were calculated. All samples were positive for S-100 and PGP 9.5. Compared to HP samples (38.20/mm2), IP samples had a lower density of intact NF (6.24/mm2). A significantly higher density of degenerated NF was found in IP samples with spontaneous pain (39.59/mm2) compared to those with provoked pain (23.96/mm2) (p = 0.02). No association was observed between intensity of the inflammatory infiltrate and NF density and integrity (p > 0.05). The findings of this study suggest that pulpitis may involve different stages of degeneration and may be more advanced in cases with spontaneous pain. The symptoms reported by affected individuals do not appear to depend on the intensity of the inflammatory infiltrate, but rather on the integrity of NF.

Impact of Sodium Hypochlorite on Organic Tissue Dissolution in the Periapical Region of Immature Permanent Teeth: An Ex Vivo Study.

INTRODUCTION: The purpose of this study was to evaluate the impact of different sodium hypochlorite (NaOCl) irrigation protocols on organic tissue dissolution in the periapical region of simulated immature permanent teeth. METHODS: Eight single-rooted premolars and 48 samples of porcine palatal mucosa were used. Acrylic resin prototypes were constructed, placing the tissue in close contact with the dental apices. Specimens were then divided into 6 groups (n = 8): 2 control groups of normal saline irrigation with (NS/WA) or without (NS/NA) ultrasonic activation and 4 experimental groups of 1.5% and 2.5% NaOCl irrigation with (NaOCl 1.5%/WA and NaOCl 2.5%/WA) or without (NaOCl 1.5%/NA and NaOCl 2.5%/NA) activation. Root canals were irrigated with 20 mL of the solution for 5 minutes distributed over 4 irrigation cycles. In each cycle, after irrigation, the solution was either kept stagnant or activated for 30 seconds and then replaced. Specimens were weighed on a precision balance before and after the irrigation protocols. Tissue dissolution was measured by the difference between the initial and final weights. One-way analysis of variance was applied followed by the Tukey honestly significant difference test (α = 0.05). RESULTS: The NS/NA and NS/WA groups had mean weight reductions similar to the 1.5% NaOCl/NA group (P > .05) and lower than the others (P < .05). The 2.5% NaOCl/NA and 2.5% NaOCl/WA groups had the highest mean weight loss (P < .05), whereas the 1.5% NaOCl/WA group had intermediate values (P < .05). CONCLUSIONS: Periapical tissue dissolution occurred in all groups, with a greater impact observed with 2.5% NaOCl with or without ultrasonic activation.

Comparative analysis of bond strength to root dentin and compression of bioceramic cements used in regenerative endodontic procedures.

OBJECTIVES: This study compared the Biodentine, MTA Repair HP, and Bio-C Repair bioceramics in terms of bond strength to dentin, failure mode, and compression. MATERIALS AND METHODS: Fifty-four slices obtained from the cervical third of 18 single-rooted human mandibular premolars were randomly distributed (n = 18). After insertion of the bioceramic materials, the push-out test was performed. The failure mode was analyzed using stereomicroscopy. Another set of cylindrically-shaped bioceramic samples (n = 10) was prepared for compressive strength testing. The normality of data distribution was analyzed using the Shapiro-Wilk test. The Kruskal-Wallis and Friedman tests were used for the push-out test data, while compressive strength was analyzed with analysis of variance and the Tukey test, considering a significance level of 0.05. RESULTS: Biodentine presented a higher median bond strength value (14.79 MPa) than MTA Repair HP (8.84 MPa) and Bio-C Repair (3.48 MPa), with a significant difference only between Biodentine and Bio-C Repair. In the Biodentine group, the most frequent failure mode was mixed (61%), while in the MTA Repair HP and Bio-C Repair groups, it was adhesive (94% and 72%, respectively). Biodentine showed greater resistance to compression (29.59 ± 8.47 MPa) than MTA Repair HP (18.68 ± 7.40 MPa) and Bio-C Repair (19.96 ± 3.96 MPa) (p < 0.05). CONCLUSIONS: Biodentine showed greater compressive strength than MTA Repair HP and Bio-C Repair, and greater bond strength than Bio-C Repair. The most frequent failure mode of Biodentine was mixed, while that of MTA Repair HP and Bio-C Repair was adhesive.

Proposta de termo de consentimento livre e esclarecido em endodontia regenerativa / Proposed of informed consent in regenerative endodontics

O termo de consentimento livre e esclarecido (TCLE) refere-se ao documento responsável por esclarecer ao paciente o seu diagnóstico, as modalidades de tratamento disponíveis, o prognóstico e os eventuais riscos passíveis de ocorrência em detrimento da realização de um determinado tratamento. Deve ser instituído em todas as especialidades clínicas, principalmente para casos complexos, uma vez que nestas situações busca-se manter dentes com prognósticos duvidosos na cavidade bucal. Uma situação desafiadora na Endodontia compreende o tratamento de dentes necróticos com ápices incompletamente formados. Por anos, estes casos foram tratados por meio das técnicas de apicificação, todavia, por não permitirem o desenvolvimento da raiz em espessura e comprimento, apresentavam considerável índice de fratura radicular. Diante dessas limitações, uma modalidade contemporânea de tratamento foi proposta, a Endodontia Regenerativa (ER), capaz de permitir o término do desenvolvimento radicular e fechamento apical, com resultados mais promissores. Por tratar-se de um tratamento relativamente recente, a elaboração de um termo de consentimento livre e esclarecido para estas situações clínicas faz-se necessária, com vistas a resguardar o profissional e o paciente. Assim, o presente trabalho teve como objetivos revisar a literatura quanto à importância da elaboração de um TCLE para pacientes tratados por meio da técnica de ER, bem como sugerir um modelo de documento. É relevante que o Cirurgião-dentista elabore e aplique o TCLE para pacientes que serão submetidos à ER, devendo incluir neste documento todas as informações referentes ao tratamento, para que em casos de questionamentos ético-judiciais, o mesmo o auxilie na comprovação da adequada conduta profissional

Volumetric Analysis of Irrigant Extrusion in Immature Teeth after Different Final Agitation Techniques.

INTRODUCTION: The aim of this study was to evaluate the volume of irrigant extrusion by different final agitation techniques in experimental models of immature teeth. METHODS: Fifteen single roots of mandibular premolars with a length of 14 mm and an open apex were used to form 6 groups according to the final agitation technique: group 1, positive pressure and no agitation; group 2, ultrasonic agitation with Irrisonic (Helse Dental Technology, Santa Rosa de Viterbo, Brazil); group 3, ultrasonic agitation with Irrisonic Power (Helse Dental Technology); group 4, mechanical agitation with Easy Clean (Easy Dental Equipment, Belo Horizonte, Brazil); group 5, mechanical agitation with XP-endo Finisher (FKG Dentaire, La Chaux-de-Fonds, Switzerland); and group 6, sonic agitation with Eddy (VDW, Munich, Germany). A prototype was made from an Eppendorf plastic tube filled with agar to fix the tooth and to collect the extruded irrigant. Ioditrast 76 (Justesa Imagen Mexicana, Tlalpan, Mexico) contrast solution was used to simulate the irrigant. The volume of irrigant extruded in cubic millimeters was calculated by micro-computed tomographic imaging. Data were analyzed using Kruskal-Wallis and Dunn tests with a significance level of 5%. RESULTS: The values for the volume of irrigant extruded were as follows: 0.67 (group 5), 0.76 (group 1), 2.28 (group 2), 3.14 (group 3), 3.15 (group 4), and 17.19 (group 6). There was a statistically significant difference (P < .05) when the values of group 6 were compared with those of the other groups. CONCLUSIONS: All techniques caused irrigant extrusion. The higher extrusion values occurred when sonic agitation was performed with the Eddy instrument.

Assessment of oxygen saturation in dental pulp of permanent teeth with periodontal disease.

INTRODUCTION: In individuals with periodontal disease, dental pulp status should be determined before a treatment plan is made. Pulse oximeters are promising diagnostic tools to evaluate pulp vascularization. This study used pulse oximetry to determine the level of oxygen saturation in dental pulp of intact permanent teeth with periodontal attachment loss (PAL) and gingival recession (GR) and to evaluate the correlation between periodontal disease and level of oxygen saturation in the pulp. METHODS: This study included 67 anterior teeth of 35 patients; all teeth showed intact crowns, PAL, a periodontal pocket (PP), and GR. The teeth underwent periodontal examination, cold and electric pulp testing, and pulse oximetry measurements. The Pearson correlation coefficient and a linear regression coefficient were calculated to evaluate the degree of correlation between periodontal disease markers (PAL, PP, and GR) and the level of oxygen saturation in dental pulp. These tests also evaluated possible associations between oxygen saturation and cold and electric pulp testing. RESULTS: PAL, PP, and GR had negative correlations with oxygen saturation in dental pulp. Conversely, no statistically significant association was found between oxygen saturation in dental pulp and the response to electric sensibility testing. CONCLUSIONS: Oxygen saturation was lower in the pulp of permanent teeth with PAL, PP, and GR, indicating that periodontal disease correlates with the level of oxygen saturation in the pulp.

Oxygen saturation in the dental pulp of permanent teeth: a critical review.

INTRODUCTION: Pulse oximetry is a noninvasive method for assessing vascular health based on oxygen saturation level. The method has recently also been used to assess dental pulp vitality, but a median oxygen saturation level suggestive of normal pulp physiology has not been determined. The objective of this study was to make a critical analysis of the published research to establish the median oxygen saturation for the diagnosis of normal dental pulps in maxillary anterior permanent teeth using pulse oximetry. METHODS: Studies reporting on the use of pulse oximeters to determine oxygen saturation in dental pulps were retrieved using the MEDLINE, Scientific Electronic Library Online, and Cochrane Central Register of Controlled Trials databases plus a manual search of relevant references cited by selected articles. Different combinations of the terms "oximetry," "oximeter," "pulp," "dental," and "dentistry" were used in the search. Statistical analysis was performed for each group of teeth (central incisors, lateral incisors, and canines) using R statistical software (US EPA ORD NHEERL, Corvallis, OR) and a random effects model (P < .0001) with an I(2) of 99%. RESULTS: Of the 295 articles found, only 6 met the inclusion criteria (472 teeth). Of these, the number of articles included in each analysis (according to tooth group) was as follows: all 6 studies (288 teeth) for central incisors at a median oxygen saturation of 87.73%, 3 studies (90 teeth) for lateral incisors at a median oxygen saturation of 87.24%, and 4 studies (94 teeth) for canines at a median oxygen saturation of 87.26%. CONCLUSIONS: The median oxygen saturation in normal dental pulps of permanent central incisors, lateral incisors, and canines was higher than 87%.

Temperature and curing time affect composite sorption and solubility.

OBJECTIVE: This study evaluated the effect of temperature and curing time on composite sorption and solubility. MATERIAL AND METHODS: Seventy five specimens (8×2 mm) were prepared using a commercial composite resin (ICE, SDI). Three temperatures (10°C, 25°C and 60°C) and five curing times (5 s, 10 s, 20 s, 40 s and 60 s) were evaluated. The specimens were weighed on an analytical balance three times: A: before storage (M1); B: 7 days after storage (M2); C: 7 days after storage plus 1 day of drying (M3). The storage solution consisted of 75% alcohol/25% water. Sorption and solubility were calculated using these three weights and specimen dimensions. The data were analyzed using the Kruskal-Wallis and Mann-Whitney U Tests (α=5%). RESULTS: The results showed that time, temperature and their interaction influenced the sorption and solubility of the composite (p<0.05). At 60°C, the composite sorption showed an inverse relationship with the curing time (p<0.05). The composite cured for 5 s showed higher sorption for the 40 s or 60 s curing times when compared with all temperatures (p<0.05). Curing times of 20 s and 40 s showed similar sorption data for all temperatures (p>0.05). The 60°C composite temperature led to lower values of sorption for all curing times when compared with the 10°C temperature (p<0.05). The same results were found when comparing 10°C and 25°C (p<0.05), except that the 20 s and 40 s curing times behaved similarly (p>0.05). Solubility was similar at 40 s and 60 s for all temperatures (p>0.05), but was higher at 10°C than at 60°C for all curing times (p<0.05). When the composite was cured at 25°C, similar solubility values were found when comparing the 5 s and 10 s or 20 s and 40 s curing times (p>0.05). CONCLUSION: In conclusion, higher temperatures or longer curing times led to lower sorption and solubility values for the composite tested; however, this trend was only significant in specific combinations of temperature and curing times.

Temperature and curing time affect composite sorption and solubility

Objective: This study evaluated the effect of temperature and curing time on composite sorption and solubility. Material and Methods: Seventy five specimens (8×2 mm) were prepared using a commercial composite resin (ICE, SDI). Three temperatures (10°C, 25°C and 60°C) and five curing times (5 s, 10 s, 20 s, 40 s and 60 s) were evaluated. The specimens were weighed on an analytical balance three times: A: before storage (M1); B: 7 days after storage (M2); C: 7 days after storage plus 1 day of drying (M3). The storage solution consisted of 75% alcohol/25% water. Sorption and solubility were calculated using these three weights and specimen dimensions. The data were analyzed using the Kruskal-Wallis and Mann-Whitney U Tests (α=5%). Results: The results showed that time, temperature and their interaction influenced the sorption and solubility of the composite (p<0.05). At 60°C, the composite sorption showed an inverse relationship with the curing time (p<0.05). The composite cured for 5 s showed higher sorption for the 40 s or 60 s curing times when compared with all temperatures (p<0.05). Curing times of 20 s and 40 s showed similar sorption data for all temperatures (p>0.05). The 60°C composite temperature led to lower values of sorption for all curing times when compared with the 10°C temperature (p<0.05). The same results were found when comparing 10°C and 25°C (p<0.05), except that the 20 s and 40 s curing times behaved similarly (p>0.05). Solubility was similar at 40 s and 60 s for all temperatures (p>0.05), but was higher at 10°C than at 60°C for all curing times (p<0.05). When the composite was cured at 25°C, similar solubility values were found when comparing the 5 s and 10 s or 20 s and 40 s curing times (p>0.05). Conclusion: In conclusion, higher temperatures or longer curing times led to lower sorption and solubility values for the composite tested; however, this trend was only significant in specific combinations of temperature and curing times.

Conhecimento de profissionais de Educação Física frente ao tratamento emergencial de dentes permanentes avulsionados / Knowledge of physical education professionals regarding emergency treatment for avulsed permanent teeth

Introdução: O prognóstico do dente traumatizado depende de pronto e apropriado atendimento de emergência, no qual os profissionais de Educação Física ocupam papel de destaque, uma vez que lidam com a prática esportiva diária e podem estar presentes nos locais em que esses acidentes ocorrem. Objetivo: Investigar o conhecimento de profissionais de Educação Física, atuantes em academias na cidade de Goiânia-GO, frente ao tratamento emergencial de dentes permanentes avulsionados. Material e método: Foi aplicado questionário sobre o perfil do público avaliado e o seu conhecimento sobre o tratamento emergencial da avulsão dentária. Os dados foram apresentados por meio de estatística descritiva e o teste Qui-quadrado (a = 5%) foi utilizado para avaliar a relação entre a frequência de profissionais com pós-graduação e se estes sabiam ou não como proceder frente à avulsão e ao reimplante dentários. Resultado: Dos 94 respondentes, sendo a maioria do gênero masculino, com idade entre 20 e 29 anos, com tempo de experiência profissional de 1 a 5 anos e pós-graduação na área de formação acadêmica, apenas 28,7% consideravam-se preparados para a realização do tratamento emergencial da avulsão dentária. Dentre os pós-graduados, não foi encontrada associação entre ter o título da pós-graduação e o nível de conhecimento dos mesmos (p > 0,05); segundo esse parâmetro, 69,2% desconheciam os procedimentos necessários para o atendimento de uma avulsão dentária, 48,1% não realizariam o reimplante nesta situação e 37,0% da amostra avaliada não sabia qual o meio de acondicionamento utilizaria para transporte do dente avulsionado. Conclusão: Os profissionais de Educação Física apresentaram conhecimento insuficiente sobre o tratamento emergencial de dentes permanentes avulsionados e mostraram-se inaptos para a realização de atendimento nesta situação.

Introduction: The prognosis of traumatized teeth depends on how prone and proper emergency care is done. Physical Education professionals frequently are present in places where accidents occur, becoming the key of the success for such treatment. Objective: The aim of this study was to investigate the physical education professional?s knowledge about emergency treatment of avulsed permanent teeth. Material and method: Professionals working in gym academies in the city of Goiania - GO where the target population. A questionnaire accessed the profile of each subject evaluated as well their knowledge about emergency treatment of dental avulsion. Data was presented using descriptive statistics and the chi-square test (a = 5%) was used to evaluate the relationship between the frequencies of post-graduated professionals who knew and who not knew how to proceed when facing tooth avulsion. Result: From the 94 respondents, most were male, aged 20 to 29 years, with professional experience within 1-5 years and with post-graduation degree. Only 28.7% considered themselves prepared for the emergency treatment of dental avulsion. No association was found between post-graduation degree and tooth avulsion knowledge (p > 0.05). Sixty-nine point two percent of the post-graduated professionals were unaware about procedures necessary for tooth avulsion care and 48 1% of them would not perform the tooth replantation. Moreover, 37.0% of the analyzed sample did not know which solution should be used to store the avulsed tooth. Conclusion: The physical education professionals evaluated had insufficient knowledge about the emergency treatment of avulsed permanent teeth, thus being unable to perform the proper emergency care in this situation.

Conhecimento e atitudes de acadêmicos de Educação Física frente aos traumatismos dentários

Introdução: os traumatismos dentários resultam em danos pulpares e periodontais, traduzidos em um impacto negativo na qualidade de vida, tendo prognóstico altamente influenciado pelo atendimento emergencial. Objetivo: investigar a autoavaliação do conhecimento e atitudes de acadêmicos de Educação Física frente aos traumatismos dentários. Métodos:estudo transversal junto a acadêmicos do primeiro ao último período, de quatro universidades de Goiânia, Goiás.Foi utilizado questionário para coleta dos dados referentes ao perfil do estudante, seu conhecimento e atitude frente ao atendimento emergencial às vítimas de traumatismo dentário.Resultados: dos 392 respondentes, a maioria foi do sexo masculino (54,3%), com idade entre 20 e 29 anos (59,2%) e do segundo período de graduação (27,0%); 46,5% dos mesmos tiveram treinamento em primeiros socorros durante a formação escolar e apenas 4,4% desses revelaram ter recebido informações sobre traumatismo dentário. Em relação à satisfação com o conhecimento sobre traumatismo dentário,74,1% dos acadêmicos afirmaram não ter conhecimento do assunto e dentre os que afirmaram ter, 95,6% mostraram-se insatisfeitos com o próprio conhecimento e não sentiam-se preparados para socorrer vítimas desse acometimento; e 95,7% dos acadêmicos que estavam insatisfeitos com o conhecimento sobre traumatismo dentário gostariam de receber informações sobre o assunto. Conclusão: os acadêmicos relataram conhecimento insuficiente sobre traumatismo dentário e mostraram-se inaptos para realização de atendimento emergencial dessa situação, o que remete à necessidade de elaboração de estratégias de conscientização e divulgação de conhecimento para habilitação dos mesmos na prevenção e promoção de saúde bucal em traumatologia dentária

Relação entre a microbiota do canal radicular de dentes humanos permanentes traumatizados com coroa intacta e o teste de percussão vertical / The relation between the microbiota of the root canals in traumatized human permanent teeth with intact crown and the vertical percussion test

O presente estudo teve como objetivos avaliar a microbiota do canal radicular de 20 dentes humanos permanentes traumatizados com coroa intacta e diagnóstico clínico de necrose pulpar e relacionar a resposta ao teste de percussão vertical com a presença de microrganismos nesses dentes. A coleta microbiológica foi realizada com cones de papel absorvente autoclavados e a determinação do número de unidades formadoras de colônias (ufc) de bactérias foi efetuada pela semeadura do material coletado em ágar chocolate (contagem de bactérias totais), ágar mitis salivarius (contagem de estreptococos bucais) e ágar SB20 (contagem de estreptococos do grupo mutans). O Teste de Regressão Linear e Análise de Diagnóstico revelaram que: em apenas 15% das amostras não foi detectado o desenvolvimento microbiano. O tempo decorrido do traumatismo dentário até a intervenção endodôntica variou de 15 dias a 31 meses, sendo que o transcurso desse tempo só foi estatisticamente significante (p = 0,047) em relação ao número de estreptococos bucais isolados no canal radicular. Verificou-se um aumento desse número à medida que o tempo também era maior. O teste de percussão vertical apresentou alta sensibilidade (80%) na detecção de microrganismos no canal radicular de dentes traumatizados. Diante dos resultados, as seguintes conclusões podem ser destacadas: 85% dos dentes apresentaram microrganismos no canal radicular, com coroa intacta; o diagnóstico clínico da necrose pulpar foi realizado, em 70% dos dentes, em até 3 meses e a resposta positiva ao teste de percussão vertical esteve associada à necrose pulpar com presença de microrganismos.

This study aimed to evaluate the microbiota of root canals of 20 human permanent traumatized teeth with crown intact and clinical diagnosis of pulpal necrosis and relate the response to vertical percussion test with the presence of microorganisms in these teeth. The microbiological sampling was performed with autoclaved absorbent paper cones and determining the number of colony-forming units (cfu) of bacteria was performed by seeding the material collected on chocolate Agar (count of total bacteria), mitis salivarius agar (count of buccal streptococcus) and agar SB20 (counts of mutans streptococcus of the group). The Linear Regression test and Diagnostics Analysis revealed that in only 15% of the samples was not detected the microbial development. The time of dental trauma to the endodontic intervention ranged from 15 days to 31 months, with the passage of time only was statistically significant (p = 0.047) on the number of buccal streptococcus isolated in the root canal. There is an increase that number as time was also higher. The vertical percussion test showed high sensitivity (80%) in the detection of microorganisms in root canals of traumatized teeth. Basing on these results we can conclude that: 85% of teeth showed microorganisms in root canal with crown intact, the clinical diagnosis of pulpal necrosis was achieved in 70% of the teeth, up to 3 months and the positive response to the vertical percussion test was associated with pulpal necrosis with the presence of microorganisms.

Microbiological and microscopic analysis of the pulp of non-vital traumatized teeth with intact crowns.

OBJECTIVE: This study evaluated the presence of microorganisms and analyzed microscopically the pulp of 20 traumatized human teeth with intact crowns and clinical diagnosis of pulp necrosis, based on the association of at least three of the clinical criteria: crown discoloration, negative response to thermal and electric pulp vitality tests, positive response to vertical and horizontal percussion, pain on palpation or mobility. MATERIAL AND METHODS: Microbiological collection was performed from the root canals to evaluate the presence of microorganisms. The pulp samples were stained with hematoxylin and eosin (H.E.) for histological evaluation of possible morphological alterations. RESULTS: Analysis of results was performed by statistical tests (linear regression test and diagnostic analysis) and subjective analysis of the sections stained with H.E. and revealed that only 15% of the sample did not exhibit microbial development. The time elapsed between dental trauma and onset of endodontic intervention ranged from 15 days to 31 months; the percussion test presented high sensitivity (80%) for detection of microorganisms in the root canal of traumatized teeth; 3 teeth (15%) did not present pulp tissue, being characterized as complete autolysis; analysis of pulp samples was performed on the other 17 cases, among which 3 (15%) exhibited partial necrosis without possibility of repair and 14 presented complete necrosis; none of the clinical criteria employed for the diagnosis of pulp necrosis in traumatized teeth was pathognomonic. CONCLUSIONS: The present results allowed the following conclusions: with regard to microbiological findings, 85% of teeth presented microorganisms in the root canal, despite the presence of an intact crown. Concerning the microscopic findings, 100% of traumatized teeth presented pulp necrosis; the pulp vitality tests based on pulp response to heat, cold and vertical percussion were the most reliable to diagnose pulp necrosis in traumatized teeth.

Microbiological and microscopic analysis of the pulp of non-vital traumatized teeth with intact crowns

OBJECTIVE: This study evaluated the presence of microorganisms and analyzed microscopically the pulp of 20 traumatized human teeth with intact crowns and clinical diagnosis of pulp necrosis, based on the association of at least three of the clinical criteria: crown discoloration, negative response to thermal and electric pulp vitality tests, positive response to vertical and horizontal percussion, pain on palpation or mobility. MATERIAL AND METHODS: Microbiological collection was performed from the root canals to evaluate the presence of microorganisms. The pulp samples were stained with hematoxylin and eosin (H.E.) for histological evaluation of possible morphological alterations. RESULTS: Analysis of results was performed by statistical tests (linear regression test and diagnostic analysis) and subjective analysis of the sections stained with H.E. and revealed that only 15 percent of the sample did not exhibit microbial development. The time elapsed between dental trauma and onset of endodontic intervention ranged from 15 days to 31 months; the percussion test presented high sensitivity (80 percent) for detection of microorganisms in the root canal of traumatized teeth; 3 teeth (15 percent) did not present pulp tissue, being characterized as complete autolysis; analysis of pulp samples was performed on the other 17 cases, among which 3 (15 percent) exhibited partial necrosis without possibility of repair and 14 presented complete necrosis; none of the clinical criteria employed for the diagnosis of pulp necrosis in traumatized teeth was pathognomonic. CONCLUSIONS: The present results allowed the following conclusions: with regard to microbiological findings, 85 percent of teeth presented microorganisms in the root canal, despite the presence of an intact crown. Concerning the microscopic findings, 100 percent of traumatized teeth presented pulp necrosis; the pulp vitality tests based on pulp response to heat, cold and vertical percussion ...

Análise microscópica de polpas de dentes humanos permanentes traumatizados / Microscopic analysis of the human pulp of permanent traumatized teeth

O presente estudo tem como objetivos analisar microscopicamente a polpa de 20 dentes humanos permanentes traumatizados com coroa intacta e diagnóstico clínico de necrose pulpar, e avaliar a confiabilidade desse diagnóstico mediante os achados histopatológicos. As amostras depolpas removidas foram coradas pelas técnicas de Hematoxilina e Eosina, para avaliar possíveis alterações morfológicas, e pelo método de Brown e Brenn, para verificação de microrganismos. As análises - subjetiva geral e estatística (análise de diagnóstico) - revelaram que 3 dentes (15%) nãoapresentaram tecido pulpar, sendo caracterizados como autólise total, e 17 (85%) tiveram suas amostras de polpas analisadas à microscopia, sendo que 3 (15%) apresentaram necrose parcial sem condições de reparo e 14 (70%), necrose total; em 12 (65%) das 17 amostras de polpas, pôde ser verificada, pelo método de Brown e Brenn, a presença de microrganismos e nenhum dos critérios clínicos empregados no diagnóstico de necrose pulpar em dentes traumatizados foi patognomônico. Diante dos resultados, as seguintes conclusões podem ser destacadas: a) mediante os achados microscópicos, 100% dos dentes traumatizados estavam necróticos e em 65% destes,constatou-se presença de microrganismos; b) os testes de vitalidade pulpar ao calor, ao frio e o teste de percussão vertical foram os mais confiáveis para o diagnóstico de necrose pulpar nos dentes traumatizados.

This study microscopically analyzed the pulp of 20 human permanent traumatized teeth with intact crowns and clinical diagnosis of pulp necrosis, and evaluated this diagnosis concerning histopatologic findings. The removed pulp specimens were stained with hematoxylin and eosin, for evaluation of possible morphological alterations, and Brown e Brenn method, to verify microorganisms. General subjective analysis and statistical analyses (diagnostic analysis) revealed that 3 teeth (15%) did not present pulp tissue, being characterized as complete autolysis; analysis of pulp samples was performed on the other 17 (85%) cases, among which 3 (15%) exhibited partial necrosis without possibility of repair and 14 (70%) presented complete necrosis; in 12 (65%) outof 17 pulps the presence of microorganisms could be conformed by Brown and Brenn method and none of the clinical criteria employed for the diagnosis of pulp necrosis in traumatized teeth was pathognomonic. The present results allowed the following conclusions: concerning the microscopic findings, 100% of traumatized teeth presented pulp necrosis and 65% of them with microorganisms; the pulp vitality tests to heat, cold and vertical percussion test were the most reliable to diagnose pulp necrosis in traumatized teeth.

Microscopic evaluation of the effect of different storage media on the periodontal ligament of surgically extracted human teeth.

The objective of this study was to microscopically evaluate the human periodontal ligament adhered to extracted teeth, after extra-alveolar period of 1 h using, as storage media, pasteurized milk (group I), chicken egg white (group II) and artificial saliva (group III). Forty intact premolars were selected, with indication of tooth extraction for orthodontic reasons. After the extraction of 30 teeth, they were maintained dried on a gauze at room temperature for 10 min, and then immersed in the selected storage media. After the established time, the teeth were washed with saline solution and placed in 10.0% buffered formalin. Ten teeth were extracted and immediately immersed in 10.0% neutral formalin (group IV). Thereafter, they were submitted to histological processing. After fixation and decalcification, the specimens were cut at the cervical, medium and apical thirds, inserted in paraffin and serially sectioned, with 6-mum thickness. They were stained by hematoxylin-eosin and analyzed under light microscopy. According to the results of quantitative analysis, there was no statistically significant difference in the number of cells per mm(2) between groups I, II and III. The qualitative analysis showed similar results in relation to the organization of collagen fibers and the number of cells in groups I and II, but group III displayed a higher disorganization of the collagen fibers and also a higher reduction in the number of cells. Based on these results, it was concluded that the quality of periodontal ligament was affected by the storage media, when compared with the control group. There was a statistically significant difference in the number of cells per mm(2) between the control group and groups I, II and III. There was no significant statistical difference in the number of cells per mm(2) between groups I, II and III.

Avaliação da padronização e da precisão de réguas endodônticas milimetradas utilizadas para odontometria em endodontia / Standardization and accuracy of endodontic milimetered rulers used for endodontic odontometry

A régua endodôntica milimetrada é necessária para a transferência do comprimentode trabalho ao instrumento endodôntico, devendo ser padronizada e precisa a fim de se evitar errosde interpretação e mensuração que comprometam o êxito da terapia endodôntica. Assim, esteestudo teve por objetivo avaliar a padronização e a precisão de quatro marcas diferentes de réguasmilimetradas utilizadas para odontometria em endodontia. Oitenta réguas foram selecionadas eincluídas em 4 grupos de 20, de acordo com a marca comercial: 1. Malleifer; 2. Jon; 3. sem marcae 4. Imagem. Estas foram submetidas à análise de medição em projetor de perfil, realizando-setrês ciclos para cada posição, tendo como referências os pontos de 15 mm à 25 mm, à temperaturade 19,9 ºC controlada por termohigrômetro. Após análise estatística utilizando-se os testes deFriedman e Regressão Linear, concluiu-se que: não houve padronização entre as quatro marcasde réguas endodônticas analisadas; todas as réguas endodônticas, independente da marca, nãoforam precisas em suas medidas; analisando-se todas conjuntamente, as réguas sem marca foramas mais precisas, seguidas das réguas das marcas Imagem, Jon e Malleifer.

The endodontic millimetered ruler is necessary to transfer working length to theendodontic instrument. It must be standardized and accurate to avoid mistakes in interpretationor measurement which may compromise the success of endodontic therapy. The purpose of thisstudy was thus to evaluate the standardization and accuracy of four different brands of millimeteredrulers used for endodontic odontometry. Eighty rulers were selected and included in four groups oftwenty each, according to brand: 1. Malleifer; 2. Jon; 3. no brand name; and 4. Imagem. They weremeasured with a profile projector. Three cycles were carried out for each position with referencepoints from 15 to 25 mm at a temperature of 19.9 ºC. as measured by a thermohygrometer. Afterstatistical analysis using Friedman and linear regression tests, it was concluded that there was nostandardization among the four brands of endodontic rulers tested. All of the endodontic rulers,whatever the brand, were imprecise in their measurements. Of the four groups, the no-brand rulerswere the most accurate, followed by Imagem, Jon and Malleifer.

Determinação dos microrganismos no canal radicular, antes do preparo biomecânico e após a utilização da medicação intracanal, em dentes com necrose pulpar e reação periapical crônica / Determination of the microorganisms in the root canal before biomechanical preparation and after using intracanal medication in teeth with pulpal necrosis and chronic periapical reaction

O objetivo do presente trabalho foi determinar, em dentes humanos com necrose pulpar e reação periapical crônica, microrganismos no canal radicular antes do preparo biomecânico e após a utilização da medicação intracanal. Foram selecionados 45 dentes anteriores superiores com necrose pulpar e reação periapical crônica visível radiograficamente. Antes do preparo biomecânico foi realizada a primeira coleta do material para detecção e contagem microbiana. Após o preparo, os canais radiculares receberam a medicação intracanal de Calen + paramonoclorefenol canforado. Decorridos os períodos de tempo de 7, 14 e 30 dias, a medicação intracanal foi removida e os canais radiculares permaneceram selados e vazios por sete dias, quando então, foi realizada a segunda coleta microbiológica e obturação final. Os resultados mostraram que todos os canais radiculares apresentaram, antes do preparo biomecânico, cultura positiva para anaeróbios facultativos e 35 para estreptococos. Após o preparo biomecânico e medicação intracanal por 7, 14 e 30 dias, houve uma redução no número de microrganismos anaeróbios de 97,8 por cento, 98,5 por cento e 99,7 por cento e de estreptococos de 98,8 por cento, 99,5 por cento e 99,5 por cento respectivamente. Conclui-se que os dentes com necrose pulpar e reação periapical crônica apresentaram elevado número de microrganismos, predominantemente anaeróbios, e que com a utilização da associação Calen + paramonoclorofenol canforado houve uma redução de no mínimo 97,0 por cento da microbiota do canal radicular