Influence of endodontic sealers with different chemical compositions on bond strength of the resin cement/glass fiber post junction to root dentin.

OBJECTIVE: This study evaluated the influence of endodontic sealers with different chemical compositions on bond strength of resin cement/glass fiber post junction to root dentin. MATERIALS AND METHODS: Seventy-two maxillary canines roots were instrumented with Reciproc (#R50) and distributed in 6 groups (n = 12) according to endodontic sealers: G1-control (no sealer); G2-Endofill; G3-Sealapex; G4-AH Plus; G5-Sealer Plus; G6-EndoSequence BC. The glass fiber post was cemented with Panavia F in 10 of the specimens. Two specimens from each group did not receive post and were analyzed by SEM to verify presence of filling material. Three slices were obtained from each third. The first slice was subjected to push-out test and type of failure. The second slice was imaged using laser confocal microscopy for evaluation of dentin/resin cement adhesive interface. Bond strength (BS) data were analyzed using two-way ANOVA and Tukey's post hoc tests; for LCM data, we used Kruskal-Wallis and Dunn's tests. RESULTS: Endofill yielded the lowest BS values (p < 0.05). The control and AH Plus groups differed from all others (p < 0.05). In all groups, adhesive to dentin failure predominated. Most specimens of control and AH Plus groups had acceptable interfaces, while those of EndoSequence BC, Sealapex, and Sealer Plus groups ranged between acceptable and poor interfaces. Overall, few filling material remnants were observed on the dentin. CONCLUSION: EndoSequence BC, Sealapex, Sealer Plus, and Endofill negatively interfere with BS of glass fiber post/resin cement junction to root dentin. CLINICAL RELEVANCE: In cases whose restoration planning includes a post cemented with resin cement, it is recommended that endodontic sealer be based on epoxy resin.

The influence of Aloe vera with mesenchymal stem cells from dental pulp on bone regeneration: characterization and treatment of non-critical defects of the tibia in rats.

OBJECTIVE: This study aimed to evaluate the inflammatory effect and bone formation in sterile surgical failures after implantation of a collagen sponge with mesenchymal stem cells from human dental pulp (hDPSCs) and Aloe vera. MATERIAL AND METHODS: Rattus norvegicus (n=75) were divided into five experimental groups according to treatment: G1) control (blood clot); G2) Hemospon®; G3) Hemospon® in a culture medium enriched with 8% Aloe vera; G4) Hemospon® in a culture medium containing hDPSCs and G5) Hemospon® in a culture medium enriched with 8% Aloe vera and hDPSCs. On days 7, 15 and 30, the animals were euthanized, and the tibia was dissected for histological, immunohistochemistry and immunofluorescence analyses. The results were analyzed using nonparametric Kruskal-Wallis test and Dunn's post-test. RESULTS: On days 7 and 15, the groups with Aloe vera had less average acute inflammatory infiltrate compared to the control group and the group with Hemospon® (p<0.05). No statistically significant difference was found between the groups regarding bone formation at the three experimental points in time. Osteopontin expression corroborated the intensity of bone formation. Fluorescence microscopy revealed positive labeling with Q-Tracker® in hDPSCs before transplantation and tissue repair. CONCLUSION: The results suggest that the combination of Hemospon®, Aloe vera and hDPSCs is a form of clinical treatment for the repair of non-critical bone defects that reduces the inflammatory cascade's effects.

Genetic Polymorphisms in RANK and RANKL are Associated with Persistent Apical Periodontitis.

INTRODUCTION: The outcome of root canal treatment has been reported as intimately related to the host response. Genetic polymorphisms might be associated with apical periodontitis repair. The aim of this study was to evaluate the association between receptor activator of nuclear factor kappa B (RANK), receptor activator of nuclear factor kappa B ligand (RANKL), and osteoprotegerin (OPG) genetic polymorphisms with persistent apical periodontitis (PAP) in Brazilian subjects. METHODS: Subjects with at least 1 year of follow-up after nonsurgical root canal therapy were recalled. Sixty-four subjects with signs/symptoms of PAP and 86 subjects with root canal-treated teeth exhibiting healthy periradicular tissues (healed) were included. Genomic DNA was extracted from saliva and used for RANK (rs3826620), RANKL (rs9594738), and OPG (rs2073618) genotyping by real-time exact tests, and odds ratio were implemented using Epi Info 3.5.2 (Centers for Disease Control and Prevention, Atlanta, GA). A logistic regression analysis was also performed using the time of follow-up as the covariate. All tests were performed with an established alpha of 0.05 (P = .05). RESULTS: An association between allele distribution and the polymorphism in RANK was observed. Subjects who carry the T allele had a lower risk of having PAP (P < .05). In RANKL polymorphism, the genotype distribution was statistically significant different between the PAP and healed groups (P = .05). The time of follow-up was associated with PAP (P < .05). In the logistic regression analysis using time as a covariant, RANK (P < .05) and RANKL (P < .05) were associated with PAP. The polymorphism rs2073618 in OPG was not associated with PAP (P > .05). CONCLUSIONS: These findings suggest that polymorphisms in RANK and RANKL genes are associated with PAP.

The influence of Aloe vera with mesenchymal stem cells from dental pulp on bone regeneration: characterization and treatment of non-critical defects of the tibia in rats

Abstract Objective This study aimed to evaluate the inflammatory effect and bone formation in sterile surgical failures after implantation of a collagen sponge with mesenchymal stem cells from human dental pulp (hDPSCs) and Aloe vera. Material and Methods Rattus norvegicus (n=75) were divided into five experimental groups according to treatment: G1) control (blood clot); G2) Hemospon®; G3) Hemospon® in a culture medium enriched with 8% Aloe vera; G4) Hemospon® in a culture medium containing hDPSCs and G5) Hemospon® in a culture medium enriched with 8% Aloe vera and hDPSCs. On days 7, 15 and 30, the animals were euthanized, and the tibia was dissected for histological, immunohistochemistry and immunofluorescence analyses. The results were analyzed using nonparametric Kruskal-Wallis test and Dunn's post-test. Results On days 7 and 15, the groups with Aloe vera had less average acute inflammatory infiltrate compared to the control group and the group with Hemospon® (p<0.05). No statistically significant difference was found between the groups regarding bone formation at the three experimental points in time. Osteopontin expression corroborated the intensity of bone formation. Fluorescence microscopy revealed positive labeling with Q-Tracker® in hDPSCs before transplantation and tissue repair. Conclusion The results suggest that the combination of Hemospon®, Aloe vera and hDPSCs is a form of clinical treatment for the repair of non-critical bone defects that reduces the inflammatory cascade's effects.

Influence Of Genetic Polymorphisms In Genes Of Bone Remodeling And Angiogenesis Process In The Apical Periodontitis.

Persistent apical periodontitis (AP) is a situation involving an inflammatory and immune response caused mainly by anaerobic polymicrobial infection of the root canal system and the outcome and follow-up of the root canal treatment has been reported as intimately related to host response. The apical periodontitis repair might be associated with genetic polymorphisms. This study aimed to evaluate the association between HIF1A genetic polymorphisms (rs2301113 and rs2057482) with PAP in Brazilian patients. Subjects with at least 1 year of follow-up after root canal therapy (RCT) were recalled. Sixty-four subjects with signs/symptoms of PAP and 84 subjects with root canal-treated teeth exhibiting healthy perirradicular tissues (healed) were included. Genomic DNA was extracted from saliva and used for HIF1A genotyping by real-time PCR. Genotype and allele frequencies were compared by c2 or Fisher's exact tests and odds ratio was implemented, using Epi Info 3.5.2. All tests were performed with an established alpha of 0.05. There was no association between allele and genotype distribution for HIF1As polymorphisms and PAP (p>0.05). The genetic polymorphisms in HIF1A were not associated with persistent apical periodontitis.

Fístula oronasal após palatoplastia em pacientes fissurados / Oronasal fistula after palatoplasty in cleft patients

A fístula oronasal (FON) consiste na principal sequela pós-cirúrgica da palatoplastia podendo levar a problemas funcionais, como a fala hipernasal e regurgitação de alimentos pelo nariz. Essa condição compromete o resultado do tratamento da fissura labiopalatina, e seu reparo torna-se um desafio para a equipe multidisciplinar. Este trabalho relata três casos de pacientes com fissura lábio-palatina que apresentaram FON após palatoplastia. Nos casos, foram diagnosticadas FON tipo VII (alveolar na região labial), provocadas pela tensão muscular excessiva sobre a sutura após palatoplastia. O tratamento consistiu em uma cirurgia para fechamento da fístula através da técnica de retalho mucoperiosteal, realizada por um cirurgião bucomaxilofacial. É essencial um planejamento cirúrgico adequado a fim de promover o melhor prognóstico para o paciente, visando a uma melhor qualidade de vida... (AU)

The oronasal fistula (ONF) is the main postoperative sequel of palatoplasty and can leads to functional problems such as hypernasality of voice and regurgitation of food through the nose. This condition affects the outcome of treatment of cleft palate and is challenging for the multidisciplinary team. This paper reports three cases of patients with cleft lip and palate who presented ONF after palatoplasty. In these cases, type VII ONF (alveolar in the labial region) were diagnosed, and were caused by excessive muscle tension on the suture after palatoplasty. The treatment consisted of a surgery for closure of the fistula through the mucoperiosteal flap, which was carried out performed by a maxillofacial surgeon. It is essential an appropriate surgical planning in order to promote better prognosis for the patient aiming better quality of life... (AU)

Avaliação morfométrica da região apical após a utilização de sistemas oscilatório e rotatório / Morphometric evaluation of the apical region after the use of oscillatory and rotary syeterns

Objetivo: este trabalho avalia comparativamente os sistemas oscilatório e contínuo de preparo de canais, a partir da análise morfométrica, da região apical de molares preparadas com limas manuais flexofile acionadas a motores pneumático (oscilatório) e elétrico (rotatório), acopladas ao sistema ProTaper Universal. Materiais e métodos: vinte raízes de molares inferiores humanos extraídos com curvaturas aproximadas de 30 graus foram selecionadas e inicialmente submetidas a radiografias. As imagens radiográficas foram digitalizadas e por meio do Software Image tool determinados a área e o perímetro da região apical. Em seguida, as raízes foram divididas aleatoriamente em dois grupos: no grupo I, as raízes foram instrumentadas pelo sistema oscilatório e, no grupo II, pelo sistema rotatório. Os terços cervical e médio foram preparados com Gates Glidden 1 e 2. Após o preparo químico-mecânico, novas radiografias foram realizadas para a determinação da nova área e do novo perímetro. Os resultados foram analisados estatisticamente no programa Statistical Package for the Social Sciences (SPSS) da versão 20.0, com nível de significância de 5% (p<0,05). Resultados: o sistema rotatório apresentou diferença estatisticamente significativa quanto à área antes e após o preparo químico mecânico (p<0,05) e não ocorreu diferença quanto ao perímetro. Não foram observados desvios apicais atribuídos à maior proporcionalidade entre o preparo apical e a dilatação dos terços médio e cervical realizado previamente. Conclusão: ambos os sistemas apresentaram um preparo apical aceitável, porém o sistema oscilatório, empregando limas flexofile desgastou menor espessura dentinária quando comparadas ao sistema ProTaper Universal.

Aloe vera as vehicle to mineral trioxide aggregate: study in bone repair / Aloe vera como veículo ao mineral trióxido agregado: estudo em reparo ósseo

Aim: Mineral trioxide aggregate (MTA) was associated to Aloe vera to verify the coadjutant action of that medicinal plant in the bone neoformation process in tibia of rats. Material and Method: 36 male rats (Rattus norvegicus) were used, divided into two groups of 18 rats each. Two circumferential bone defects with approximately 5 mm in diameter were made on the right tibia of each animal: the upper defect was filled with blood coagulates in both groups to serve as experimental control and the lower defect was filled with MTA and Aloe vera in experimental (group E1) and MTA and distilled water in experimental (group E2). Seven, 15 and 30 days after surgery, six animals from each group were euthanized and the right tibia of each animal was removed for histological analysis. Result: Histologically, experimental group E1 presented better results for the two variables, inflammation [at seven days (p=0.045)] and bone formation [at seven days (p=0.018) and 30 days (p=0.034)], compared to the E2 group. Conclusion: The association of MTA and Aloe vera showed potential to reduce the effects of the inflammatory cascade and promote bone neoformation making it to a promising proposal for future use in endodontic therapy. .

Objetivo: Mineral trióxido agregado (MTA) foi associado a Aloe vera para se verificar a ação coadjuvante desta planta medicinal no processo de neoformação óssea em tíbia de ratos. Material e Método: 36 ratos machos (Rattus norvegicus) foram utilizados, divididos em dois grupos com 18 animais em cada. Dois defeitos ósseos circunferenciais com aproximadamente 5 mm de diâmetro foram feitos na tíbia direita de cada animal: o defeito superior foi preenchido com coágulo sanguíneo em ambos os grupos para servir como controle e o defeito inferior foi preenchido com MTA e Aloe vera (grupo E1) e MTA e água destilada (grupo E2). Sete, 15 e 30 dias após a cirurgia, seis animais de cada grupo foram submetidos à eutanásia e a tíbia direita de cada animal foi retirada para análise histológica. Resultado: Histologicamente, o grupo experimental E1 apresentou melhores resultados para as duas variáveis, inflamação [em sete dias (p = 0,045)] e formação óssea [em sete dias (p = 0,018) e 30 dias (p = 0,034)], em comparação com os resultados do grupo E2. Conclusão: A associação entre o MTA e Aloe vera demonstrou potencial para reduzir os efeitos da cascata inflamatória e promover a neoformação óssea, tornando-a uma proposta promissora para uso futuro no tratamento endodôntico. .

Conduct of pediatricians in relation to the oral health of children / Conduta de pediatras em relação à saúde bucal de crianças

Objective: Pediatricians are health professionals who treat the child during the first years of their life. The purpose of this study was to evaluate the conduct adopted by pediatricians regarding the oral health of children. Method: This was a descriptive cross-sectional observational study with a sample of 100 physicians specialized in pediatrics, working in the public and private sectors. A questionnaire was used for data collection, and the pediatricians were approached in their workplaces. Result: Most pediatricians (69%) belong to the female gender, with an average age of 48 years, and work in both the public and private sectors of health and have over 20 years of professional experience. Regarding their level of knowledge on oral health, 59% consider it to be good and 59% said that they had not been approached about this issue during their training in pediatrics. Ninety-two percent routinely examine the oral cavity of the baby; 64% recommend the use of fluoridated toothpaste, and 66.7% direct patients to a dental appointment in the first year of life. Regarding breastfeeding at night, 55.6% do not make the association between breastfeeding and the onset of early childhood caries. Furthermore, 74.7% do not justify the associations between the eruption of the first primary teeth and systemic manifestations, and 93% contraindicate the use of a dummy. Conclusion: It was concluded that pediatricians have proactive attitudes with regards to oral health. However, they need more information on the importance of fluoride for the control of dental caries.

Objetivo: Os médicos pediatras são os profissionais de saúde que acompanham a criança ao longo dos primeiros anos de vida. O objetivo deste estudo foi avaliar condutas adotadas por pediatras em relação à saúde bucal de crianças. Método: Trata-se de um estudo observacional transversal descritivo, com amostra constituída por 100 médicos especialistas em pediatria, atuantes em serviços público e privado. Foi utilizado questionário como instrumento de coleta de dados e os pediatras foram abordados em seus locais de trabalho. Resultado: A maioria dos pediatras (69%) pertence ao gênero feminino, com idade média de 48 anos, trabalham simultaneamente nos serviços de saúde público e privado, com mais de 20 anos de experiência profissional. Com relação ao nível de conhecimento em relação à saúde bucal, 59% consideraram como bom e 59% afirmaram não ter sido abordado o tema sobre saúde bucal durante a formação em pediatria. Noventa e dois por cento realizam exame da cavidade bucal do bebê como procedimento de rotina; 64% recomendam o uso de dentifrício fluoretado; 66,7% encaminham os pacientes à consulta odontológica no primeiro ano de vida. Com relação à amamentação noturna, 55,6% não fazem associação entre aleitamento materno e a instalação de cárie precoce na infância. Além disso, 74,7% não justificam associações entre irrompimento dos primeiros dentes decíduos e manifestações sistêmicas e 93% contraindicam uso de chupetas. Conclusão: Conclui-se que os pediatras apresentam atitudes pró-ativas em relação à saúde bucal, apesar de necessitarem de maiores esclarecimentos quanto à importância dos fluoretos no controle da cárie dentária.

Microbiological assessment of the effectiveness of chlorhexidine mouthrinse before taking impressions of the oral cavity / Avaliação microbiológica da eficácia do bochecho de clorexidina prévio à moldagem da cavidade bucal

PURPOSE: The aim of this study is to assess the reduction of microbial load that adhered to irreversible hydrocolloid impressions obtained after rinsing with 0.12% and 0.2% chlorhexidine solutions. METHODS: The study consisted of 24 participants (48 dental arch impressions) equally divided into two groups: Group 1 (0.12% chlorhexidine) and Group 2 (0.2% chlorhexidine). The impressions were taken using Hydrogun® irreversible hydrocolloid before (control) and after (experimental) a single 10 mL mouthrinse of chlorhexidine for 1 minute. Each impression was placed in a sterile beaker containing 250 ml of saline. The microbiological analysis of the storage solution was carried out using BHI Agar culture medium. The plates were incubated for 24 hours, followed by a CFU (Colony Forming Units) count. The data were analyzed using the Wilcoxon's t test. RESULTS: There was a reduction in the degree of contamination of the impressions after rinsing with the antimicrobial mouth rinses at both concentrations when compared with the control group. There was a statistically significant difference when the effectiveness of the two concentrations used was compared. CONCLUSION: Therefore, using a chlorhexidine rinse prior to obtaining irreversible hydrocolloid impressions reduces contamination and is more efficient at the 0.2% concentration.

OBJETIVO: O objetivo deste estudo é avaliar a redução da carga microbiana aderida nos moldes de hidrocolóide irreversível obtidos após bochecho com clorexidina nas concentrações 0,12% e 0,2%. METODOLOGIA: O estudo incluiu 24 participantes (48 moldes de arcadas dentárias) divididos igualmente em dois grupos: Grupo 1 ( clorexidina 0,12%) e Grupo 2 (clorexidina 0,2%). As arcadas foram moldadas com hidrocolóide irreversível Hydrogun® antes (controle) e após (experimental) bochecho único com 10 mL de clorexidina nas concentrações específicas de cada grupo durante 1 minuto. Cada molde foi acomodado em bécker estéril contendo 250 mL de soro fisiológico. A partir dessa solução, realizou-se análise microbiológica em meio de cultura BHI Ágar. As placas foram submetidas a um período de incubação de 24 h oras, seguida de contagem das UFC (Unidades Formadoras de Colônias). Os dados foram submetidos à análise estatística aplicando o teste t de Wilcoxon. RESULTADOS: Observou-se redução do grau de contaminação dos moldes obtidos após bochecho com o antimicrobiano nas duas concentrações, em relação ao grupo controle e, também, diferença estatística significativa quando comparadas a eficácia das duas concentrações utilizadas. CONCLUSÃO: O bochecho de clorexidina prévio à obtenção de moldes de hidrocolóide irreversível reduz a contaminação e com melhor eficácia na concentração 0,2%.