In Vivo study of an intracanal dressing of calcium hydroxide/chlorhexidine in necrotic primary teeth

AIM: To evaluate the clinical and radiographic success of endodontic treatment in human primary teeth with necrotic pulp with and without radiographically visible furcal/periapical lesion treated with a calcium hydroxide (CH) and chlorhexidine (CHX) intracanal dressing. The tested hypothesis was that there is no difference in the clinical and radiographic success in primary teeth medicated with CH pastes prepared with polyethylene glycol (PEG) or CHX. METHODS: Thirty-two teeth with necrotic pulp were used in this randomized clinical study: 12 without and 20 with lesion. Canals were prepared and medicated with CH pastes with polyethylene glycol (CH/PEG) (n=16) or 2% CHX gel (CH/CHX) (n=16). Definitive filling was done after 30 days. The teeth were clinically and radiographically examined during 12 months to determine the success of the endodontic therapy. Data from clinical and radiographic examination of the initial condition and 12 months after treatment were compared using the Z test (α = 0.05). RESULTS: There was no significant difference (p>0.05) in the success rate of teeth with and without lesion medicated with CH/PEG or CH/CHX. No significant difference (p>0.05) was found between the pastes regardless of the presence of lesion. CONCLUSIONS: Combination of CHX and CH was not more effective than the CH/PEG paste, as similar clinical and radiographic success rate was observed in teeth medicated with either type of intracanal dressing.

Effect of induced diabetes mellitus on alveolar bone loss after 30 days of ligature-induced periodontal disease.

Several studies have shown that diabetics are more susceptible to the development of severe periodontal disease. Currently, the use of animal models can be considered a feasible alternative in radiographic assessments of these two pathologies. The purpose of this radiographic study was to evaluate the effect of induced diabetes mellitus on alveolar bone loss after 30 days of ligature-induced periodontal disease. Sixty-four Wistar rats were randomly distributed into four experimental groups. Diabetes was induced in Groups II and IV, while periodontal disease was induced in Groups III and IV; Group I was used as control. In order to perform the radiographic assessment of the specimens, the rats were killed on the 3rd and 30th days of the study. Radiographic measurements were assessed with ANOVA and Tukey's test to determine statistically significant differences (p < 0.05). It was observed that Groups III and IV featured greater bone loss when compared to Groups I and II. Only the diabetic group with periodontal disease (Group IV) featured statistically significant greater bone loss when compared to the other groups. These results suggested that the alveolar bone loss resulting from the periodontal disease installation is greater when associated to the diabetes mellitus.

Efeito do L-Name na expressão de iNOS, MPO e na perda óssea alveolar em ratos diabéticos com periodontite experimental / Effect of L-NAME on iNOS, MPO expression and alveolar bone loss in diabetic rats with experimental periodontitis

Mediadores inflamatórios como mieloperoxidase (MPO) e óxido nítrico (NO) participam do processo inflamatório da doença periodontal e na associação ao diabetes. Inibidores da Óxido Nítrico Sintase (NOS), como o L-NAME têm sido administrados na tentativa de minimizar danos teciduais decorrentes da inflamação. O objetivo deste estudo foi avaliar o efeito do L-NAME sobre os níveis da isoforma induzível de óxido nítrico (iNOS), sobre a perda óssea alveolar e sobre os níveis de mieloperoxidase (MPO) em ratos diabéticos com periodontite induzida. Foram utilizados 192 ratos divididos em grupos de 24 animais cada: grupo C: Controle com ingestão de água; grupo C-L: Controle com ingestão de LNAME; grupo D: Ratos diabéticos com ingestão de água; grupo D-L: Ratos diabéticos com ingestão de L-NAME; grupo P: Ratos com periodontite experimental e ingestão de água; grupo P-L: Ratos com periodontite experimental e ingestão de L-NAME; grupo DP: Ratos diabéticos com periodontite experimental e ingestão de água; e grupo DP-L: Ratos diabéticos com periodontite experimental e ingestão de L-NAME. O sacrifício dos animais foram realizados aos 3,7,15,e 30 dias após a indução da periodontite experimental. Foram realizadas análises da taxa glicêmica, da perda óssea alveolar, da atividade de mieloperoxidase e da expressão de iNOS. Os grupos com D, P e DP mostraram níveis de iNOS estatisticamente mais altos quando comparados aos grupos D-L, P-L e DP-L que ingeriram L-NAME em todos os períodos. (p < 0.05). Os grupos que ingeriram L-NAME mostraram perda óssea estatisticamente menor quando comparados aos grupos que ingeriram água (p < 0.05). A alta expressão de MPO foi observada nos grupos com periodontite P e DP que ingeriram água. Foi verificado um pico nos níveis de MPO aos 7 dias em todos os grupos experimentais que ingeriram água...

Inflammatory mediators such as myeloperoxidase (MPO) and nitric oxide (NO) play a role in inflammatory processes related to periodontal disease and diabetes. NO-Synthase (NOS) inhibitors as L-NAME have been administered in attempts to reduce tissue damage resulting from such inflammation. The aim of this study was to evaluate the effects of L-NAME on alveolar bone loss, NO and MPO levels in diabetic rats with experimental periodontitis. A hundred ninety-two rats were divided into one of the following groups with 24 animals each: group C-W: control group with water intake; group C-L: control group with L-NAME intake; group D-W: diabetic rats with water intake; group D-L: diabetic rats with LNAME intake; group P-W: chronic periodontitis rats with water intake; group PL: chronic periodontitis rats with L-NAME intake; group DP-W: diabetic chronic periodontitis rats with water intake, and group DP-L: diabetic chronic periodontitis rats with L-NAME intake. The killing was performed at 3, 7, 15 and 30 days after ligature-periodontitis induction to obtain gingival specimens and to evaluate MPO and NO activity and radiographic bone loss. Groups with D-W or P-W and DP-W showed statistically higher iNOS expression compared to LNAME groups in all periods (p < 0.05). L-NAME treatment (L) statistically decreased iNOS expression in all groups with inflammatory pathological conditions, such as D, P and DP. In general, groups with L-NAME intake showed lower bone loss compared to water intake groups. In addition, P-L or DP-L rats demonstrated statistically lower bone loss compared to diabetics and controls at 30 days (p < 0.05). The highest MPO expression was verified in periodontitis groups with water intake (P-W e DP-W). There was a peak in MPO levels at 7 days in all experimental groups with water intake during experimental evolution. The L-NAME statistically decreased MPO levels from all groups...

Prevalence and features of palato-radicular grooves: an in-vitro study.

The presence of a morphological defect called a palato-radicular groove (PRG) is considered to be an important contributing factor to the development of localized chronic periodontitis, for it favors the accumulation and proliferation of bacterial plaque deep into the periodontium. This anomaly affects maxillary incisors, especially lateral incisors. The prevalence and different morphologic conditions of the PRG were evaluated in 376 maxillary lateral and central incisors. The teeth were evaluated by a single examiner, considering their presence, localization, origin of formation, extension and depth in millimeters, using a magnifying glass, a precision pachymeter and a millimeter-scaled periodontal probe. Results showed a higher prevalence in lateral incisors (11.1%), with higher prevalence in proximal localization (62.8%), origination from central fossa (57.1%) and predominance in oblique trajectory (62.8%). Of all these teeth, only 8.6% of PRGs reached the root apex, while 97.1% were considered as flat (< 1 mm). Thus, in the presence of a PRG, periodontal pathologic conditions could be more severe in proximal faces, reaching in a few cases the tooth apex and the pulp canal.

Prevalência de canais acessórios na região de furca de molares decíduos: revisão de literatura / Prevalence of accessory canais in the furcation área of the primary molars: literatura review

O forame apical é a principal via de comunicação entre polpa e períodonto, por conectar os tecidos sem interrupções, mas canais acessórios também podem ser observados no sistema de canais radiculares. Há na literatura grande variabilidade na frequência de canais acessórios na região de furca de molares decíduos, variação esta que talvez possa ser explicada por diferenças metodológicas e tipos de dentes avaliados.Diante de tais considerações, propusemo-nos neste estudo revisar os diferentes trabalhos descritos na literatura, para mostrar os diferentes métodos empregados na detecção de canais acessórios na área de furca de molares decíduos, bem como mostrar sua prevalência

Sharpening of periodontal instruments with different sharpening stones and its influence upon root debridement--scanning electronic microscopy assessment.

The objective of this study was to evaluate, through scanning electronic microscopy, the effect of sharpening with different sharpening stones on the cutting angle of periodontal curettes (Gracey 5-6), and the influence on root surfaces after debridement and planing. The experimental model consisted of two different phases. In the first, the cutting angles of fifteen stainless steel Gracey 5-6 curettes were analyzed under a scanning electronic microscope after being sharpened with different types of stones. In the second phase, the root surfaces of 25 newly extracted teeth were evaluated with a scanning electronic microscope after being debrided with curettes sharpened with different stones. Analysis of the results showed that the synthetic stones (aluminum oxide and carborundum) are more abrasive and produce more irregular cutting angles, whereas Arkansas stones are less abrasive and produce smoother and more defined cutting angles. There was no significant statistical differences among the five groups tested with regard to the degree of irregularity of the root surfaces after instrumentation.

Influência de leucemias agudas em pacientes portadores de doença periodontal: Revisão de literatura / Acute leukemias influence in patients with periodontal disease: literature review

A medicina periodontal é uma área que vem recebendo importância atualmente, por relacionar doenças sistêmicas a patologias periodontais. Estudos têm sido realizados com o propósito de se verificar esta relação, e por isso, a literatura vem enfocando a cavidade bucal como um importante instrumento no diagnóstico precoce de alterações de patologias sistêmicas, como no caso de leucemias agudas. Sinais clínicos como crescimento gengival, sangramento espontâneo e periodontite de progressão rápida devem ser observados pelos cirurgiões-dentistas, para a suspeita de um quadro leucêmico. Desta forma, é importante que o profissional esteja devidamente informado para diagnosticar precocemente esta condição. Diante de tais considerações, o objetivo do nosso trabalho é verificar a influência da condição sistêmica de pacientes leucêmicos no curso da doença periodontal.