Efeitos do cimento Portland modificado e MTA na viabilidade de fibroblastos e produção de citocinas

Objetivo: o objetivo desse estudo foi investigar os efeitos da nova formulação do Cimento Portland (CPM) comparando-o ao MTA Angelus na viabilidade celular e liberação de IL-1b e IL-6 em fibroblastos de rato. Métodos:tubos de polietileno preenchidos com os materiais estudados foram colocados em placas de cultura celular de 24 poços com fibroblastos de rato. Tubos vazios foram utilizados como controle. Após 24 horas, ensaio MTT foi utilizado para avaliar a viabilidade celular.Para o ensaio de citocinas, fibroblastos de ratos foram incubados em placas de fundo plano de 24 poços com discos dos materiais no fundo, ou sem material, como controle. Após 24 horas, o meio de cultura foi coletado para a avaliação das citocinas pelo ELISA. Resultados:o CPM e MTA Angelus não inibiram a viabilidade celular.Ambos os materiais induziram liberação de IL-6 eIL-1b e a quantidade foi estatisticamente significativa se comparada ao grupo controle. Conclusão: ambos os materiais não foram citotóxicos em cultura de fibroblastos e induziram a liberação de IL-6 e IL-1b.

Evaluation of tissue reaction, cell viability and cytokine production induced by Sealapex Plus

OBJECTIVE: The aim of this study was to investigate the effects of mineral trioxide aggregate (MTA), Sealapex, and a combination of Sealapex and MTA (Sealapex Plus) on the reaction of subcutaneous connective tissue of rats, and on cell viability and cytokine production in mouse fibroblasts. MATERIAL AND METHODS: The tissue reaction was carried out with dentin tubes containing the materials implanted in the dorsal connective tissue of rats. The histological analysis was performed after 7 and 30 days. Millipore culture plate inserts with polyethylene tubes filled with materials were placed into 24-well cell culture plates with mouse fibroblasts to evaluate the cell viability by MTT assay. ELISA assays were also performed after 24 h of exposure of the mouse fibroblasts to set material disks. RESULTS: Histopathologic examination showed Von Kossa-positive granules that were birefringent to polarized light for all the studied materials at the tube openings. No material inhibited the cell viability in the in vitro test. It was detected IL-6 production in all root-end filling materials. MTA and Sealapex Plus induced a slight raise of mean levels of IL-1β. CONCLUSIONS: The results suggest that Sealapex Plus is biocompatible and stimulates the mineralization of the tissue.

Evaluation of tissue reaction, cell viability and cytokine production induced by Sealapex Plus.

OBJECTIVE: The aim of this study was to investigate the effects of mineral trioxide aggregate (MTA), Sealapex, and a combination of Sealapex and MTA (Sealapex Plus) on the reaction of subcutaneous connective tissue of rats, and on cell viability and cytokine production in mouse fibroblasts. MATERIAL AND METHODS: The tissue reaction was carried out with dentin tubes containing the materials implanted in the dorsal connective tissue of rats. The histological analysis was performed after 7 and 30 days. Millipore culture plate inserts with polyethylene tubes filled with materials were placed into 24-well cell culture plates with mouse fibroblasts to evaluate the cell viability by MTT assay. ELISA assays were also performed after 24 h of exposure of the mouse fibroblasts to set material disks. RESULTS: Histopathologic examination showed Von Kossa-positive granules that were birefringent to polarized light for all the studied materials at the tube openings. No material inhibited the cell viability in the in vitro test. It was detected IL-6 production in all root-end filling materials. MTA and Sealapex Plus induced a slight raise of mean levels of IL-1ß. CONCLUSIONS: The results suggest that Sealapex Plus is biocompatible and stimulates the mineralization of the tissue.

Developmental disturbance of an unerupted permanent incisor due to trauma to its predecessor.

Developmental disturbances of permanent teeth can result from trauma to primary teeth because of the proximity of the root of the primary teeth to their permanent successors. We describe the case of a 14-month-old boy who was referred to the baby clinic of the School of Dentistry, Universidad Estadual Paulista, Araçatuba, Brazil, after sustaining a severe trauma that led to intrusion of the right primary central incisor. Radiographic examination 4 years after the trauma showed a developing morphological change in the germ of the permanent successor. On eruption of the permanent central incisor, a crown malformation along with enamel hypoplasia was observed. We conclude that radiographic follow-up is indicated after trauma to monitor possible sequelae in the permanent successors even before their eruption

Mineral trioxide aggregate stimulates macrophages and mast cells to release neutrophil chemotactic factors: role of IL-1beta, MIP-2 and LTB(4).

OBJECTIVE: In the present study, the role of macrophages and mast cells in mineral trioxide aggregate (MTA)-induced release of neutrophil chemotactic factor was investigated. STUDY DESIGN: MTA suspension (50 mg/mL) was plated over inserts on macrophages or mast cells for 90 minutes. Untreated cells served as controls. Cells were washed and cultured for 90 minutes in RPMI without the stimuli. Macrophages and mast cell supernatants were injected intraperitoneally (0.5 mL/cavity), and neutrophil migration was assessed 6 hours later. In some experiments, cells were incubated for 30 minutes with dexamethasone (DEX, 10 muM/well), BWA4C (BW, 100 muM/well) or U75302 (U75, 10 muM/well). The concentration of Leukotriene B(4) (LTB(4)) in the cell-free supernatant from mast cells and macrophage culture was measured by ELISA. RESULTS: Supernatants from MTA-stimulated macrophages and mast cells caused neutrophil migration. The release of neutrophil chemotactic factor by macrophages and mast cells was significantly inhibited by DEX, BW, or U75. Macrophages and mast cells expressed mRNA for interleukin-1 (IL-1)beta and macrophage inflammatory protein-2 (MIP-2) and the pretreatment of macrophages and mast cells with DEX, BW, or U75 significantly altered IL-1beta and MIP-2 mRNA expression. LTB(4) was detected in the MTA-stimulated macrophage supernatant but not mast cells. CONCLUSIONS: MTA-induces the release of neutrophil chemotactic factor substances from macrophages and mast cells with participation of IL-1beta, MIP-2, and LTB(4).

Intravenous procedural sedation: an alternative in the treatment of patients with intellectual disability

Conscious sedation has become established as an important alternative to general anesthesia (GA) in dental treatment of patients with intellectual disability (ID). Aim: to investigate dental patients undergoing sedation using a mean dose of 0.6 mg/kg intravenous midazolam and the adverse events of sedation in patients with ID. Methods: This study analyzed the records of 163 dental patients with ID aged between 2 and 76 years who had undergone conscious intravenous sedation (CIV) using a mean dose of 0.61 mg/kg of midazolam at Araçatuba Dental School, São Paulo State University, Brazil. The efficacy and complications induced by CIV were evaluated in each subject. Results: CIV was effective for dental treatment in 80% of the cases. A total of 626 dental procedures were performed. The mean treatment time was 33.9 minutes. There was statistically significant difference (p<0.05) between absence and presence of adverse reactions. Adverse reactions were observed in 21.47% of the cases. Conclusions: The results of this study showed that CIV is a useful method for dental treatment of patients with ID and these patients can need higher doses of sedative to reach an adequate level of sedation.

Avaliação da capacidade de mineralização e citotoxicidade do MTA, Sealapex e Sealapex plus / Evaluation of mineralization ability and cytotoxicity of MTA, Sealapex and Sealapex plus

A necessidade de melhorar a qualidade dos materiais utilizados no tratamento endodôntico tem estimulado o estudo de vários materiais buscando melhores condições de trabalho, biocompatibilidade e capacidade de estimular a mineralização dos tecidos. Este trabalho teve a finalidade de avaliar a capacidade de mineralização do MTA, Sealapex e Sealapex plus (combinação entre MTA e Sealapex) usando o implante de tubos de dentina preenchidos com os materiais em tecido subcutâneo de ratos e a citotoxicidade e a produção de citocinas (IL-1β e IL-6) por fibroblastos de camundongos estimulados por estes cimentos. Para avaliação da capacidade de mineralização foram utilizados 32 ratos, os quais receberam individualmente dois implantes de tubos de dentina contendo os cimentos ou tubos vazios que serviram de controle. Os períodos de avaliação foram 7 e 30 dias. Após cada período experimental, quatro animais foram sacrificados e os tubos de dentina juntamente com o tecido que o circunda foram removidos, fixados e processados para análise em microscopia óptica. As peças foram incluídas em uma mistura de parafina e cera de carnaúba (5%). As secções foram feitas seriadamente com 10mm de espessura e foram coradas de acordo com a técnica Von Kossa ou permaneceram sem coloração para serem visualizadas sob luz polarizada em microscópio óptico. Os critérios de avaliação foram: cápsula fibrosa fina quando < 150μm e espessa quando > 150μm. Necrose e calcificação foram registradas como presente ou ausente. Os resultados foram analisados estatisticamente pelo teste Qui-quadrado. A formação de tecido mineralizado e granulações birrefringentes à luz polarizada foram observadas em todos os materiais nos tempos de 7 e 30 dias. Para o teste de citotoxicidade foram utilizados fibroblastos de camundongos (L929) que foram incubados em placas de 24 poços e estimulados com tubos de polietileno preenchidos com os cimentos testados. Culturas de células sem os materiais foram utilizadas como...

The quality improvement of the endodontic materials is a need that has been stimulating the study of several materials aiming better work conditions, biocompatibility and mineralized tissue stimulation ability. The present work aimed to evaluate the mineralization ability of MTA, Sealapex and Sealapex plus (combination between MTA and Sealapex) using the implant of dentin tubes filled with the materials into the subcutaneous tissue of rats, the cytotoxicity, and cytokines production (IL-1β and IL-6) by fibroblasts stimulated by the materials. Thirty two rats were used for the tissue reaction test which received two implants of dentine tubes filled with the materials or empty tubes were used as control. The periods of evaluation were 7 and 30 days. After each period of evaluation, four animals were killed and the tubes and the surrounding tissue were removed, fixed and processed to be evaluated in optic microscope. The specimens were embedded in a mixture of paraffin and carnauba wax (5%). The sections were serially cut with 10mm and stained with Von Kossa or remained without staining to be evaluated under polarized light. The evaluation criteria were: fibrous capsule thin < 150 μm and thick > 150 μm. Necrosis and calcification were recorded as present or absent. The results were statistically analyzed using Qui-square test. Mineralization and birrefringent granulations to polarized light were observed with all materials and in both periods of observation. For the cytotoxicity test, fibroblasts from mice (L929) were incubated in 24 well plates and stimulated with polyethylene tubes filled with the materials. Cells cultured without the materials stimulation were used as control. After 24 hours of stimulation, the cytotoxicity was evaluated using the reduction colorimetric test (MTT). The results were analyzed using ANOVA and Bonferroni’s correction tests (p<0.05). MTA, Sealapex and Sealapex plus did not inhibited the cell viability. ELISA was used for the...

Evaluation of the effects of endodontic materials on fibroblast viability and cytokine production.

INTRODUCTION: Recently, a new sealer composed of Portland cement named Endo-CPM-Sealer was developed. The aim of this study was to investigate the effects of Endo-CPM-Sealer (EGEO SRL, Buenos Aires, Argentina), Sealapex (Sybron Endo, Glendora, CA), and Angelus MTA (Angelus, Londrina, Brazil) on cell viability and cytokine (interleukin [IL]-1beta and IL-6) production by mouse fibroblasts. METHODS: Millipore culture plate inserts with polyethylene tubes filled with materials were placed into 24-well cell culture plates with mouse fibroblasts. Cells cultured with only empty polyethylene tubes were used as the control. After 24 hours, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay was used to evaluate the cell viability. For cytokine assay, mouse fibroblasts were incubated in 24-well flat-bottom plates with set material disks at the bottom. Cells cultured without the material disks served as the negative control. After 24 hours of incubation, culture media were collected for cytokine evaluation by using an enzyme-linked immunosorbent assay. The data were statistically analyzed by analysis of variance and Bonferroni correction. RESULTS: Endo-CPM-Sealer, Sealapex, and Angelus MTA did not inhibit the cell viability. All materials induced IL-6 releasing, but the amount was not statistically significant compared with the control group. Angelus MTA induced IL-1beta releasing significantly more than the control. CONCLUSIONS: All materials were not considered cytotoxic in fibroblast culture.

Evaluation of the tissue reaction to fast endodontic cement (CER) and Angelus MTA.

INTRODUCTION: A new cement (CER; Cimento Endodôntico Rápido or fast endodontic cement) has been developed to improve handling properties. It is a formulation that has Portland cement in gel. However, there had not yet been any study evaluating its biologic properties. The purpose of this study was to evaluate the rat subcutaneous tissue response to CER and Angelus MTA. METHODS: The materials were placed in polyethylene tubes and implanted into dorsal connective tissue of Wistar rats for 7, 30, and 60 days. The specimens were prepared to be stained with hematoxylin-eosin or von Kossa or not stained for polarized light. The presence of inflammation, predominant cell type, calcification, and thickness of fibrous connective tissue were recorded. Scores were defined as follows: 0, none or few inflammatory cells, no reaction; 1, <25 cells, mild reaction; 2, 25-125 cells, moderate reaction; 3, >125 cells, severe reaction. Fibrous capsule was categorized as thin when thickness was <150 mum and thick at >150 mum. Necrosis and formation of calcification were both recorded. RESULTS: Both materials Angelus MTA and CER caused moderate reactions at 7 days, which decreased with time. The response was similar to the control at 30 and 60 days with Angelus MTA and CER, characterized by organized connective tissue and presence of some chronic inflammatory cells. Mineralization and granulations birefringent to polarized light were observed with both materials. CONCLUSIONS: It was possible to conclude that CER was biocompatible and stimulated mineralization.

Enamel defects in maxillary central incisors of infants with unilateral cleft lip.

OBJECTIVE: To evaluate the presence of enamel alterations in deciduous maxillary central incisors of infants with unilateral cleft lip and alveolar ridge, with or without cleft palate, and to compare the occurrence and location of these alterations between the central incisor adjacent to the cleft and the contralateral incisor. DESIGN: Intraoral clinical examination was performed after tooth cleaning and drying by a single examiner with the aid of a dental mirror, dental probe, and artificial light, with the child positioned on a dental chair. The defects were recorded in a standardized manner according to the criteria of the Modified Developmental Defects of Enamel Index. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies (HRAC) at Bauru, São Paulo, Brazil. PATIENTS: One hundred one infants were evaluated. All were white, of both genders, aged 12 to 36 months and had at least two thirds of the crowns of maxillary incisors erupted. RESULTS: Demarcated opacity was the most common defect at both cleft and noncleft sides, followed by diffuse opacity. The occurrence of hypoplasia at the cleft side was 11.8%. Most defects affected less than one third of the crown. CONCLUSION: The occurrence of enamel defects in deciduous maxillary central incisors of patients with unilateral cleft lip was 42.6%, mainly affecting the cleft side as to both number and severity.

Reaction of rat connective tissue to a new calcium hydroxide-based sealer.

The aim of this study was to histopathologically examine the reaction of the connective tissue of rats to 2 calcium hydroxide-based sealers, Acroseal and Sealapex. Dentin tubes containing the materials and empty control tubes were implanted into the dorsal connective tissue of 36 Wistar albino rats. The animals were killed after 7 or 30 days, and the specimens were prepared for histologic analysis with hematoxylin and eosin, Von Kossa technique, and polarized light. Results were statistically analyzed using Kruskal-Wallis test. Both materials caused mild or moderate inflammatory reactions on the 7th day, but these reactions decreased by the 30th day with no significant difference at any time (P > .05). Mineralization of the subcutaneous tissue of the rats was observed only with Sealapex.

MTA-induced neutrophil recruitment: a mechanism dependent on IL-1beta, MIP-2, and LTB4.

OBJECTIVE: The objective of this study was to investigate the mediators and the resident peritoneal cells involved in the neutrophil migration (NM) induced by mineral trioxide aggregate (MTA) in mice. STUDY DESIGN: MTA (25 mg/cavity) was injected into normal and pretreated peritoneal cavities (PC) with indomethacin (IND), dexamethasone (DEX), BWA4C, U75302, antimacrophage inflammatory protein-2 (MIP-2), and anti-interleukin-1beta (IL-1beta) antibodies and the NM was determined. The role of macrophage (MO) and mast cells (MAST) was determined by administration of thioglycollate 3% or 48/80 compound, respectively. The concentration of IL-1beta and MIP-2 exudates was measured by ELISA. RESULTS: MTA induced dose- and time-dependent NM into mice PC, with the participation of MO and MAST. NM was inhibited by DEX, BWA4C, and U75302, as well as anti-MIP-2 and anti-IL-1beta antibodies. In the exudates, IL-1beta and MIP-2 were detected. CONCLUSIONS: This study suggests that MTA induces NM via a mechanism dependent on MAST and MO mediated by IL-1beta, MIP-2, and LTB(4).

Manejo do comportamento infantil no consultório odontológico - relato de caso clínico / Child behavior management in the dental office - case report

Para realização de um tratamento odontológico adequado e seguro, é fundamental o controle do comportamento do paciente infantil. Na maioria dos casos, é possível conduzir crianças apreensivas e medrosas sem o uso de medicação. Para isso, é imprescindível que o profissional que atende crianças conheça o desenvolvimento psicológico infantil e seu contexto familiar, e que também tenha o domínio das técnicas de manejo de comportamento, aplicando-as adequadamente durante o atendimento. As técnicas não-farmacológicas de controle de comportamento mais utilizadas são: falar-mostrar-fazer, reforço positivo, controle de voz, distração, comunicação não-verbal, contenção física e técnica da mão-sobre-a-boca. O objetivo deste trabalho é descrever estas técnicas e suas indicações, bem como sua aplicação em um caso clínico

O tratamento restaurador atraumático (TRA) como alternativa de tratamento em bebês portadores de fissura: relato de caso clínico / The atraumatic restorative treatment (ART) as an alternative for treatment of abies with cleft: a case report

A técnica da restauração atraumática (TRA), consiste na remoção de tecido cariado com auxílio de instrumentos manuais e posterior selamento das cavidades com um material adesivo (cimento de ionômero de vidro). Devido à facilidade da técnica pode ser empregada em pacientes especiais, crianças de baixa idade e ainda em crianças que não podem submeter-se ao tratamento convencional. O objetivo desse trabalho é descrever a técnica TRA modificada como alternativa de tratamento para um bebê portador de fissura labiopalatal com lesão de cárie no dente adjacente a essa área

Síndrome EEC: relato de caso clínico / EEC syndrome: a clinical case report

A síndrome EEC é definida como uma anomalia congênita múltipla caracterizada por displasia ectodérmica, ectrodactilia e fissura labiopalatal. Neste artigo, os autores relatam um caso clínico de uma criança portadora desta síndrome, que apresenta sinais clássicos de displasia ectodérmica, incluindo anomalias dentárias, associadas a alterações de extremidades e fissura labiopalatal bilateral. O objetivo do trabalho é discutir uma opção de abordagem odontológica para esses casos

Doenças sexualmente transmissíveis / Sexually transmitted diseases

O presente trabalho foi desenvolvido durante a participaçäo no Projeto Especial do Ensino-PEEPIN no ano de 1993, no posto de saúde do Jardim Marabá-PR, observa-se que o nível sócioeconômico da populaçäo estudada é diversificado, variando de classe média a baixa. O tema escolhido foi Doenças Sexualmente Transmissíveis(DST), devido a sua alta incidência na regiäo, constatado no levantamento dos prontuários dos pacientes no período de janeiro a agosto de 1993. Estudou-se uma amostra de 111 pacientes, dos quais obteve-se os seguintes resultados: 60 por cento dos pacientes estudados apresentaram flora mista, 26 por cento Gardnerella vaginallis, 6 por cento Trichomonas vaginallis