Conservative Treatment of a Periapical Cementoblastoma: A Case Report.

Cementoblastoma is a rare benign odontogenic neoplasm of ectomesenchymal origin, accounting for fewer than 6% of all odontogenic tumors. Although the tumor characteristics are well known, the standard practice to treat this lesion is surgical excision and extraction of the affected tooth, with few reported cases using a tooth-conservative treatment approach. This report presents the case of a 33-year-old woman with cementoblastoma who underwent conservative treatment to preserve her tooth in the oral cavity. Endodontic treatment of the tooth was performed; 30 days later, the lesion was removed with the apical third of the root of the tooth. After 7 years of follow-up, no recurrence was observed, and the tooth retains its masticatory function. In certain cases of cementoblastoma, the affected tooth can be kept in the oral cavity instead of being extracted, thereby preserving the oral health of patients.

Avaliação da eficácia de métodos de limpeza de limas endodônticas / Evaluation of the effectiveness of cleaning endodontic files methods

A reutilização de limas no tratamento endodôntico é uma realidade na rotina de grande parte dos profissionais. Alguns cuidados devem ser tomados para que a limpeza inadequada das mesmas não prejudique o processo de esterilização, aumentando o risco de infecção cruzada entre pacientes. Muitas dúvidas recaem na maneira como as limas devem ser limpas após o uso clínico e antes da esterilização. O presente trabalho avaliou a efetividade de três métodos de limpeza das limas endodônticas, foram utilizadas 18 caixas de limas da primeira série tipo Kerr, divididas em três grupos (n=6) de acordo com o tratamento endodôntico: G1- dentes com vitalidade; G2- dentes com necrose e G3- dentes com necessidade de retratamento. Terminada a instrumentação as limas foram avaliadas com microscópio óptico em um aumento de 40x, atribuindo-se valores para a presença ou ausência de detritos aderidos na superfície da parte ativa da lima. Em seguida foram submetidas a um dos processos de limpeza: torsão da lima contra gaze embebida em álcool 70%, limpeza com escova e detergente e limpeza em cuba ultrasônica e detergente e novamente avaliadas. Os resultados apresentaram diferença estatística significante entre os métodos, sendo a limpeza com a gaze o menos eficaz (p<0,05). Todos os processos de limpeza testados promoveram redução significativa nos valores de detritos, no entanto não houve nenhum método 100% efetivo em todas as situações analisadas.

The reuse of files in root canal treatment is a reality in routine of most professionals. Many questions fall on how the files should be cleaned after clinical use and before sterilization. Some care should be taken that inadequate cleaning of the files does not harm the sterilization process, increasing the risk of cross infection between patients. This study evaluated the effectiveness of three methods for cleaning of endodontic files were used 18 boxes of files from the first series Kerr, divided into 3 groups (n = 6) according to the treatment endodontic: G1-teeth with vitality; G2- teeth with necrosis and G3- teeth requiring retreatment. After instrumentation the files were evaluated with an optical microscope at a 40X magnification, assigning values to the presence or absence of debris adhered to the surface of the active part of the file. They were then subjected to one of the cleaning processes: torsion file against gauze soaked in 70% alcohol, cleaning brush with detergent and ultrasonic cleaning tank and detergent and re-evaluated. The results showed statistically significant difference between the methods, and cleaning with gauze less effective (p <0.05). All cleaning processes tested caused significant reduction in the amounts of debris; however there was no 100% effective method in the analyzed situations.

Short-term effect of COX-2 selective inhibitor as an adjunct for the treatment of periodontal disease: a clinical double-blind study in humans.

Adjunctive therapeutic strategies that modulate the inflammatory mediators can play a significant role in periodontal therapy. In this double-blind, placebo-controlled study, 60 subjects diagnosed as periodontitis patients were evaluated for 28 days after periodontal treatment combined with selective cyclooxygenase-2 (COX-2) inhibitor. The experimental group received scaling and root planning (SRP) combined with the Loxoprofen antiinflammatory drug (SRP+Loxoprofen). The control group received SRP combined with placebo (SRP+placebo). Plaque index (PI), probing pocket depth (PD) and bleeding on probing (BOP) were monitored with an electronic probe at baseline and after 14 and 28 days. Both groups displayed clinical improvement in PD, PI and BOP. They also showed statistically similar values (p>0.05) of PD reduction on day 14 (0.4 mm) and on day 28 (0.6 mm). At the baseline, few deeper sites (>or=7 mm) from SRP+Loxoprofen group were responsible and most PD reduction was observed after 14 days (p<0.05). The percentage of remaining deep pockets (>or=7 mm) after 14 days in the SRP+Loxoprofen group was significantly lower (p<0.05) than in the SRP+placebo group. Loxoprofen presents potential effect as an adjunct of periodontal disease treatment, but long-term clinical trials are necessary to confirm its efficacy.

Short-term effect of COX-2 selective inhibitor as an adjunct for the treatment of periodontal disease: a clinical double-blind study in humans

Adjunctive therapeutic strategies that modulate the inflammatory mediators can play a significant role in periodontal therapy. In this double-blind, placebo-controlled study, 60 subjects diagnosed as periodontitis patients were evaluated for 28 days after periodontal treatment combined with selective cyclooxygenase-2 (COX-2) inhibitor. The experimental group received scaling and root planning (SRP) combined with the Loxoprofen antiinflammatory drug (SRP+Loxoprofen). The control group received SRP combined with placebo (SRP+placebo). Plaque index (PI), probing pocket depth (PD) and bleeding on probing (BOP) were monitored with an electronic probe at baseline and after 14 and 28 days. Both groups displayed clinical improvement in PD, PI and BOP. They also showed statistically similar values (p>0.05) of PD reduction on day 14 (0.4 mm) and on day 28 (0.6 mm). At the baseline, few deeper sites (>7 mm) from SRP+Loxoprofen group were responsible and most PD reduction was observed after 14 days (p<0.05). The percentage of remaining deep pockets (>7 mm) after 14 days in the SRP+Loxoprofen group was significantly lower (p<0.05) than in the SRP+placebo group. Loxoprofen presents potential effect as an adjunct of periodontal disease treatment, but long-term clinical trials are necessary to confirm its efficacy.

Estratégias terapêuticas adjuvantes que modulam os mediadores inflamatórios podem ter função significante na terapia periodontal. Neste estudo duplo-cego controlado com placebo, 60 indivíduos diagnosticados com periodontite foram avaliados por 28 dias após tratamento periodontal combinado com inibidor seletivo de COX-2. O grupo experimental foi tratado com raspagem e alisamento radicular combinado com medicação anti-inflamatória Loxoprofeno (RAR+Loxoprofen). O grupo controle foi tratado com raspagem e alisamento radicular combinado com medicação placebo (Raspagem e alisamento radicular - RAR+placebo). Presença de placa (PI), profundidade de sondagem (PS) e sangramento à sondagem (SS) foram monitoradas com auxílio de uma sonda computadorizada no início do estudo e após 14 e 28 dias. Os dois grupos demonstraram melhora clínica em relação a PS, PI e SS. Também foi observado valores semelhantes (p>0,05) de redução da PS nos períodos de 14 dias (0,4 mm) e 28 dias (0,6 mm). No início do estudo, alguns sítios profundos (>7 mm) do grupo RAR+Loxoprofen foram os responsáveis pela maior redução da PS depois de 14 dias (p<0,05). A porcentagem de bolsas periodontais profundas >7 mm após 14 dias no grupo RAR+Loxoprofen foi significativamente inferior do que o grupo RAR+placebo (p<0.05). A medicação Loxoprofen apresenta potencial efeito adjuvante à terapia periodontal, mas estudos de longo prazo são necessários para confirmar sua eficácia.