Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 184
Filtrar
1.
J Formos Med Assoc ; 120(1 Pt 2): 476-482, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32600866

RESUMO

BACKGROUND/PURPOSE: Mineral trioxide aggregate (MTA) was widely used in endodontic therapy as bioceramic material. Although MTA has high biocompatibility, it may lead to tooth discoloration. The aim of this study was to investigate the discoloration of two different bioceramic materials and the effects of internal bleaching. METHODS: Thirty single-canal mandibular premolars were extracted and randomly assigned to three groups (n = 10), white ProRoot® MTA, SavDen® MTA and a control group. Endodontic access opening, cleaning and shaping were performed, then the teeth were obturated using the two bioceramic materials. Tooth color was recorded at baseline, day 1, and 1, 2, 4, 6, 8, 12, 16, and 24 weeks after treatment. At the end of 24 weeks, sodium perborate was used to perform internal bleaching. Tooth color was recorded at 1, 2, and 6 weeks subsequently. Teeth were measured using a DeguDent® spectrophotometer, and data were transformed into Commission Internationale de l'Eclairage (CIE) L∗a∗b∗ system. RESULTS: Teeth treated with white ProRoot® MTA showed significant color change and decrease in L∗ value. Internal bleaching leaded to decrease of the ΔE∗ value for all three groups and increase in the L∗ value. There was no difference in tooth discoloration between SavDen® MTA and the control group after obturation and internal bleaching. CONCLUSION: In terms of visual perception, white ProRoot® MTA tends to cause black and blue discoloration. SavDen® MTA, formulated with calcium lactate gluconate, could be used to reduce tooth discoloration in endodontic treatment.


Assuntos
Materiais Restauradores do Canal Radicular , Descoloração de Dente , Compostos de Alumínio/efeitos adversos , Clareadores , Compostos de Cálcio/efeitos adversos , Combinação de Medicamentos , Humanos , Óxidos/efeitos adversos , Materiais Restauradores do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Descoloração de Dente/induzido quimicamente
2.
J Endod ; 46(12): 1913-1919, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32949559

RESUMO

INTRODUCTION: New tricalcium silicate cements have been shown to induce less coronal discoloration. The purpose of this in vitro study was to evaluate the degree of color change induced by various silicate materials in the presence and absence of blood. METHODS: One hundred human extracted anterior single-canal teeth were sectioned to standardized root lengths, accessed, and instrumented. Eight random experimental groups and 2 control groups were created wherein specimens were filled with experimental materials below the buccal cementoenamel junction as follows: EndoSequence RRM putty (Brasseler USA, Savannah, GA), EndoSequence RRM fast set putty (Brasseler USA), Biodentine (Septodont, Saint-Maur-des-Fossés, France), and white mineral trioxide aggregate (Dentsply Sirona, York, PA) either with the presence or absence of blood. Blood-only and saline-only samples were used for the positive and negative controls. After incubation in 100% humidity at 37°C, color changes were evaluated with a spectrophotometer (Ocean Optics, Dunedin, FL) on days 0, 30, 60, and 180 after material placement. Data were transformed into Commission International de I'Eclairage's L∗a∗b color values, and corresponding ΔE values were calculated. The 1-way analysis of variance test was performed for statistical analysis. RESULTS: Discoloration was observed in all specimens in the presence of blood. There was no statistical significance when comparing different materials in contact with blood. Intragroup observation at various time points, Biodentine, and EndoSequence RRM fast set putty showed significant difference between the presence and absence of blood at 180 days (P < .05). CONCLUSIONS: Contamination with blood of tricalcium silicate materials has the potential to cause coronal tooth discoloration.


Assuntos
Materiais Restauradores do Canal Radicular , Descoloração de Dente , Dente , Compostos de Alumínio , Compostos de Cálcio/efeitos adversos , Combinação de Medicamentos , França , Humanos , Óxidos , Materiais Restauradores do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Descoloração de Dente/induzido quimicamente
3.
BMC Oral Health ; 20(1): 163, 2020 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-32493290

RESUMO

BACKGROUND: To evaluate tooth discoloration by newly developed calcium silicate-based materials, and to examine the pre-application of dentin bonding agent (DBA) for preventing discoloration caused by mineral trioxide aggregate (MTA). METHODS: The roots of 50 premolars were randomly divided into five groups (n = 10) and cavities were prepared from resected root surfaces. MTA was placed in the cavities of teeth belonging to the ProRoot MTA (MTA) and RetroMTA (RMTA) groups. For teeth belonging to the ProRoot + DBA (MTA-B) and RetroMTA + DBA (RMTA-B) groups, DBA was first applied to the cavities prior to the addition of MTA. Teeth in the control group were restored with composite resin only (i.e., without MTA). After 12 weeks, MTA was removed from the MTA and RMTA groups and bleaching agents were applied for 3 additional weeks. Color assessments were recorded at baseline, and 1, 4, and 12 weeks, as well as after bleaching. A one-way ANOVA was performed to assess the differences between the two types of MTAs and color changes following DBA pre-application in each MTA group. A p-value of < 0.05 was considered indicative of statistical significance. RESULTS: Following 12 weeks of MTA treatment, there was a significant difference between the discoloration in the MTA and RMTA groups (p < 0.05). However, no significant difference was observed between the RMTA and RMTA-B groups (p > 0.05). Following bleaching, the color changes (ΔE values) of the MTA group were not significantly different from those of the MTA-B group (p > 0.05). The difference of ΔE between the RMTA group after internal bleaching and the RMTA-B group was also not significant (p > 0.05). CONCLUSIONS: RetroMTA caused significantly less discoloration than ProRoot MTA. Pre-application of DBA reduced discoloration caused by ProRoot MTA. MTA discoloration was improved equally well between DBA pre-application and post-bleaching.


Assuntos
Compostos de Alumínio/efeitos adversos , Compostos de Cálcio/efeitos adversos , Óxidos/farmacologia , Silicatos/efeitos adversos , Descoloração de Dente/prevenção & controle , Compostos de Alumínio/farmacologia , Compostos de Cálcio/farmacologia , Dentina/efeitos dos fármacos , Adesivos Dentinários/efeitos adversos , Combinação de Medicamentos , Humanos , Óxidos/efeitos adversos , Silicatos/farmacologia , Descoloração de Dente/induzido quimicamente
4.
Sci Rep ; 10(1): 3845, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32123221

RESUMO

Plants that inhabit Antarctica have raised scientific interest due to their resilience to climate change, abiotic tolerance mechanisms and potential biological applications. In vitro propagation is useful for conservation, genetic material availability of these species and avoiding mass collection in their habitat. In vitro culture protocols for the native plants Colobanthus quitensis and Deschampsia antarctica and the non-native Juncus bufonius have been affected by endophytic microorganisms that proliferate when introduced to tissue cultures. This study evaluated the microbicidal and phytotoxic effect of calcium hypochlorite (Ca(ClO)2), silver nitrate (AgNO3) and silver nanoparticles (AgNPs), and their use at different concentrations for different time periods. The Ca(ClO)2 at 100 mg mL-1 showed the best microbial contamination control in D. antarctica (applied for 20 min) and for the three C. quitensis populations (applied for 15 min). In J. bufonius, AgNO3 at 10 mg mL-1 for 10 min reduced the microbial growth, but oxidative damage was generated. AgNPs did not prevent contamination or have adverse effects on tissues. Survival plantlets from each treatment, population or species were effectively introduced to the tissue culture and their propagation was successful. These results constitute a fundamental advance for the introduction, propagation and conservation of Antarctic species and their use in scientific research.


Assuntos
Regiões Antárticas , Anti-Infecciosos/efeitos adversos , Conservação dos Recursos Naturais/métodos , Desinfecção/métodos , Espécies Introduzidas , Compostos de Cálcio/efeitos adversos , Relação Dose-Resposta a Droga , Ecossistema , Nanopartículas Metálicas/efeitos adversos , Prata/efeitos adversos , Prata/química , Nitrato de Prata/efeitos adversos
5.
J Vet Emerg Crit Care (San Antonio) ; 30(3): 302-307, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32077228

RESUMO

OBJECTIVE: To describe a case series of systemic lime sulfur toxicosis secondary to topical administration in 2 cats. CASE SUMMARY: Two cats from the same household that were being previously treated for Microsporum canis were presented following topical administration of an incorrectly diluted lime sulfur dip. A 30% solution was used rather than the recommended 3% solution, resulting in a 10-fold concentration overdose. The cats presented to the emergency service 1 hour after dermal application of the lime sulfur product at home. The first cat, a 2-year-old female, intact Cornish Rex, had severe hypotension, bradycardia, and hypothermia. Chemical burns were also present on the ventrum and paws. Clinicopathological data revealed profound acid-base disturbances, hypercalcemia, hyperphosphatemia, and azotemia. After aggressive fluid resuscitation, electrolyte supplementation, and treatment, the patient was stabilized and discharged after 5 days of hospitalization; full recovery was later reported. The second littermate, also a 2-year-old female, intact Cornish Rex, presented the following day with similar clinical signs, physical examination findings, and clinicopathological findings. After supportive care and 2 days of hospitalization, the patient was also discharged and reported to fully recover. NEW OR UNIQUE INFORMATION PROVIDED: This case series is the first to report systemic toxicosis secondary to dermal exposure of lime sulfur. As lime sulfur is commonly used in veterinary medicine for the treatment of ectoparasites, veterinary professionals should be aware of the significant signs of poisoning that can be seen as a result of iatrogenic dosing errors by pet owners or veterinary professionals.


Assuntos
Antifúngicos/efeitos adversos , Compostos de Cálcio/efeitos adversos , Doenças do Gato/induzido quimicamente , Sulfetos/efeitos adversos , Administração Tópica , Animais , Anti-Infecciosos , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Compostos de Cálcio/administração & dosagem , Compostos de Cálcio/uso terapêutico , Doenças do Gato/tratamento farmacológico , Gatos , Feminino , Microsporum , Sulfetos/administração & dosagem , Sulfetos/uso terapêutico
6.
J Bone Miner Res ; 34(9): 1609-1618, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31063613

RESUMO

Autosomal dominant hypocalcemia type 1 (ADH1) is a rare form of hypoparathyroidism caused by heterozygous, gain-of-function mutations of the calcium-sensing receptor gene (CAR). Individuals are hypocalcemic with inappropriately low parathyroid hormone (PTH) secretion and relative hypercalciuria. Calcilytics are negative allosteric modulators of the extracellular calcium receptor (CaR) and therefore may have therapeutic benefits in ADH1. Five adults with ADH1 due to four distinct CAR mutations received escalating doses of the calcilytic compound NPSP795 (SHP635) on 3 consecutive days. Pharmacokinetics, pharmacodynamics, efficacy, and safety were assessed. Parallel in vitro testing with subject CaR mutations assessed the effects of NPSP795 on cytoplasmic calcium concentrations (Ca2+ i ), and ERK and p38MAPK phosphorylation. These effects were correlated with clinical responses to administration of NPSP795. NPSP795 increased plasma PTH levels in a concentration-dependent manner up to 129% above baseline (p = 0.013) at the highest exposure levels. Fractional excretion of calcium (FECa) trended down but not significantly so. Blood ionized calcium levels remained stable during NPSP795 infusion despite fasting, no calcitriol supplementation, and little calcium supplementation. NPSP795 was generally safe and well-tolerated. There was significant variability in response clinically across genotypes. In vitro, all mutant CaRs were half-maximally activated (EC50 ) at lower concentrations of extracellular calcium (Ca2+ o ) compared to wild-type (WT) CaR; NPSP795 exposure increased the EC50 for all CaR activity readouts. However, the in vitro responses to NPSP795 did not correlate with any clinical parameters. NPSP795 increased plasma PTH levels in subjects with ADH1 in a dose-dependent manner, and thus, serves as proof-of-concept that calcilytics could be an effective treatment for ADH1. Albeit all mutations appear to be activating at the CaR, in vitro observations were not predictive of the in vivo phenotype or the response to calcilytics, suggesting that other parameters impact the response to the drug. © 2019 American Society for Bone and Mineral Research.


Assuntos
Compostos de Cálcio/uso terapêutico , Hipercalciúria/tratamento farmacológico , Hipocalcemia/tratamento farmacológico , Hipoparatireoidismo/congênito , Adulto , Área Sob a Curva , Compostos de Cálcio/efeitos adversos , Compostos de Cálcio/farmacocinética , Linhagem Celular , Feminino , Genótipo , Humanos , Hipercalciúria/genética , Hipocalcemia/genética , Hipoparatireoidismo/tratamento farmacológico , Hipoparatireoidismo/genética , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
7.
Fish Shellfish Immunol ; 86: 169-178, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30453045

RESUMO

The aquaculture industry has developed rapidly in recent years, and in China Crayfish Procambarus clarkii represent an important aquaculture fishery. However, bacterial and viral diseases are becoming an increasingly serious threat, causing considerable economic losses. Farmers use a large number of drugs and chemicals to destroy pathogenic microorganisms and to purify aquaculture water. The purpose of this study was to assess the effects of such drugs on crayfish immune systems. Five of the most commonly used fishery drugs and water treatment chemicals were analyzed: norfloxacin, calcium hypochlorite, quick lime, povidone iodine and copper sulfate. Crayfish immune activity tests revealed that total hemocytes counts, as well as the activities of phenoloxidase and superoxide dismutase, decreased following exposure to all five treatments. These treatments, especially calcium hypochlorite and norfloxacin, significantly enhanced hemocyte apoptosis in crayfish, regardless of disease status. Calcium hypochlorite, in particular, led to a significant decrease in the survival rates of crayfish infected with white spot syndrome virus or Vibrio alginolyticus. Our results indicate that water treatment and disease control compounds commonly used in aquaculture can reduce the innate immunity and therefore disease resistance of crayfish.


Assuntos
Anti-Infecciosos/efeitos adversos , Astacoidea/imunologia , Imunidade Inata/efeitos dos fármacos , Vibrio alginolyticus/fisiologia , Vírus da Síndrome da Mancha Branca 1/fisiologia , Animais , Apoptose , Compostos de Cálcio/efeitos adversos , Sulfato de Cobre/efeitos adversos , Hemócitos/efeitos dos fármacos , Interações Hospedeiro-Patógeno/efeitos dos fármacos , Interações Hospedeiro-Patógeno/imunologia , Óxidos/efeitos adversos , Povidona-Iodo/efeitos adversos
8.
Braz Dent J ; 29(5): 409-418, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30517438

RESUMO

This systematic review aimed to evaluate whether alternative materials to conventional triple antibiotic paste (TAP - metronidazole, ciprofloxacin, and minocycline) and grey mineral trioxide aggregate (GMTA) could avoid tooth discoloration in teeth submitted to Regenerative Endodontic Procedure (REP). It was also investigated if dental bleaching is able to reverse the color of darkened teeth due to REP. The search was conducted in four databases (Medline via PubMed, Scopus, ISI Web of Science and BVS - Virtual health library), following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The retrieved papers were uploaded in the software EndNoteTM and two reviewers independently selected the studies and extracted the data. Only studies in humans (case reports, case series, clinical trials) were included in the review. From 1,122 potentially eligible studies, 83 were selected for full-text analysis, and 38 were included in the review. The included studies were mainly case reports (76.3 %). The studies described a total of 189 teeth submitted to REP. From these, about 54% of teeth presented some degree of discoloration. Most teeth presenting color alteration were treated with TAP, especially when combined with GMTA. Only three studies performed dental bleaching to restore the color of teeth and neither bleaching technique was able to restore the original color of the crowns. The use of alternative materials to TAP and GMTA, such as double antibiotic paste or Ca(OH)2 pastes and white mineral trioxide aggregate or BiodentineTM, reduces the occurrence of tooth discoloration.


Assuntos
Endodontia Regenerativa , Descoloração de Dente/induzido quimicamente , Descoloração de Dente/prevenção & controle , Compostos de Alumínio/efeitos adversos , Antibacterianos/efeitos adversos , Compostos de Cálcio/efeitos adversos , Combinação de Medicamentos , Humanos , Óxidos/efeitos adversos , Materiais Restauradores do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Clareamento Dental
9.
J Endod ; 44(11): 1692-1696, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30241682

RESUMO

INTRODUCTION: A lack of information exists regarding the efficacy of RetroMTA (BioMTA, Seoul, Korea) directly applied on the pulp in vital pulp therapy. This study was designed to examine the clinical efficacy of RetroMTA compared with ProRoot mineral trioxide aggregate (MTA) (Dentsply Tulsa Dental, Tulsa, OK) for partial pulpotomy. METHODS: Partial pulpotomy was performed in 22 healthy human maxillary and mandibular third molars planned for extraction. The teeth were randomly divided into 2 groups (n = 11) and underwent partial pulpotomy with RetroMTA and ProRoot MTA as the control. The teeth were then restored with glass ionomer cement. Clinical and electric pulp tests were performed after 1 and 8 weeks. The teeth were radiographed and extracted at 8 weeks. Histologic sections were prepared and analyzed for pulp inflammation and dentinal bridge formation. Data were analyzed using the Mann-Whitney U test. RESULTS: Clinical examination after 1 and 8 weeks showed no sensitivity to heat, cold, or palpation in the ProRoot MTA and RetroMTA groups. Periapical radiographs taken before the extraction of teeth showed no evidence of periapical pathology. Electric pulp testing revealed no sensitivity. Data comparisons using the Mann-Whitney U test showed no significant difference between the materials with regard to the pulp inflammation type, intensity and extension (P = .3), or bridge continuity (P = .12). However, these data revealed a significant difference between the 2 materials in pulp morphology (P < .05) and bridge thickness (P < .01). CONCLUSIONS: This is the first work to evaluate a RetroMTA histologic outcome in partial pulpotomy in human permanent teeth. It shows pulp disorganization, an absence of inflammation, and discontinuous mineralization, which may represent a potential drawback with RetroMTA in this indication.


Assuntos
Compostos de Alumínio/efeitos adversos , Compostos de Cálcio/efeitos adversos , Polpa Dentária/efeitos dos fármacos , Polpa Dentária/patologia , Dentição Permanente , Dente Serotino , Óxidos/efeitos adversos , Pulpotomia/métodos , Silicatos/efeitos adversos , Adolescente , Adulto , Combinação de Medicamentos , Feminino , Cimentos de Ionômeros de Vidro , Humanos , Masculino , Materiais Restauradores do Canal Radicular , Fatores de Tempo , Extração Dentária , Adulto Jovem
10.
Cochrane Database Syst Rev ; 8: CD006023, 2018 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-30132304

RESUMO

BACKGROUND: Phosphate binders are used to reduce positive phosphate balance and to lower serum phosphate levels for people with chronic kidney disease (CKD) with the aim to prevent progression of chronic kidney disease-mineral and bone disorder (CKD-MBD). This is an update of a review first published in 2011. OBJECTIVES: The aim of this review was to assess the benefits and harms of phosphate binders for people with CKD with particular reference to relevant biochemical end-points, musculoskeletal and cardiovascular morbidity, hospitalisation, and death. SEARCH METHODS: We searched the Cochrane Kidney and Transplant Register of Studies up to 12 July 2018 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. SELECTION CRITERIA: We included randomised controlled trials (RCTs) or quasi-RCTs of adults with CKD of any GFR category comparing a phosphate binder to another phosphate binder, placebo or usual care to lower serum phosphate. Outcomes included all-cause and cardiovascular death, myocardial infarction, stroke, adverse events, vascular calcification and bone fracture, and surrogates for such outcomes including serum phosphate, parathyroid hormone (PTH), and FGF23. DATA COLLECTION AND ANALYSIS: Two authors independently selected studies for inclusion and extracted study data. We applied the Cochrane 'Risk of Bias' tool and used the GRADE process to assess evidence certainty. We estimated treatment effects using random-effects meta-analysis. Results were expressed as risk ratios (RR) for dichotomous outcomes together with 95% confidence intervals (CI) or mean differences (MD) or standardised MD (SMD) for continuous outcomes. MAIN RESULTS: We included 104 studies involving 13,744 adults. Sixty-nine new studies were added to this 2018 update.Most placebo or usual care controlled studies were among participants with CKD G2 to G5 not requiring dialysis (15/25 studies involving 1467 participants) while most head to head studies involved participants with CKD G5D treated with dialysis (74/81 studies involving 10,364 participants). Overall, seven studies compared sevelamer with placebo or usual care (667 participants), seven compared lanthanum to placebo or usual care (515 participants), three compared iron to placebo or usual care (422 participants), and four compared calcium to placebo or usual care (278 participants). Thirty studies compared sevelamer to calcium (5424 participants), and fourteen studies compared lanthanum to calcium (1690 participants). No study compared iron-based binders to calcium. The remaining studies evaluated comparisons between sevelamer (hydrochloride or carbonate), sevelamer plus calcium, lanthanum, iron (ferric citrate, sucroferric oxyhydroxide, stabilised polynuclear iron(III)-oxyhydroxide), calcium (acetate, ketoglutarate, carbonate), bixalomer, colestilan, magnesium (carbonate), magnesium plus calcium, aluminium hydroxide, sucralfate, the inhibitor of phosphate absorption nicotinamide, placebo, or usual care without binder. In 82 studies, treatment was evaluated among adults with CKD G5D treated with haemodialysis or peritoneal dialysis, while in 22 studies, treatment was evaluated among participants with CKD G2 to G5. The duration of study follow-up ranged from 8 weeks to 36 months (median 3.7 months). The sample size ranged from 8 to 2103 participants (median 69). The mean age ranged between 42.6 and 68.9 years.Random sequence generation and allocation concealment were low risk in 25 and 15 studies, respectively. Twenty-seven studies reported low risk methods for blinding of participants, investigators, and outcome assessors. Thirty-one studies were at low risk of attrition bias and 69 studies were at low risk of selective reporting bias.In CKD G2 to G5, compared with placebo or usual care, sevelamer, lanthanum, iron and calcium-based phosphate binders had uncertain or inestimable effects on death (all causes), cardiovascular death, myocardial infarction, stroke, fracture, or coronary artery calcification. Sevelamer may lead to constipation (RR 6.92, CI 2.24 to 21.4; low certainty) and lanthanum (RR 2.98, CI 1.21 to 7.30, moderate certainty) and iron-based binders (RR 2.66, CI 1.15 to 6.12, moderate certainty) probably increased constipation compared with placebo or usual care. Lanthanum may result in vomiting (RR 3.72, CI 1.36 to 10.18, low certainty). Iron-based binders probably result in diarrhoea (RR 2.81, CI 1.18 to 6.68, high certainty), while the risks of other adverse events for all binders were uncertain.In CKD G5D sevelamer may lead to lower death (all causes) (RR 0.53, CI 0.30 to 0.91, low certainty) and induce less hypercalcaemia (RR 0.30, CI 0.20 to 0.43, low certainty) when compared with calcium-based binders, and has uncertain or inestimable effects on cardiovascular death, myocardial infarction, stroke, fracture, or coronary artery calcification. The finding of lower death with sevelamer compared with calcium was present when the analysis was restricted to studies at low risk of bias (RR 0.50, CI 0.32 to 0.77). In absolute terms, sevelamer may lower risk of death (all causes) from 210 per 1000 to 105 per 1000 over a follow-up of up to 36 months, compared to calcium-based binders. Compared with calcium-based binders, lanthanum had uncertain effects with respect to all-cause or cardiovascular death, myocardial infarction, stroke, fracture, or coronary artery calcification and probably had reduced risks of treatment-related hypercalcaemia (RR 0.16, CI 0.06 to 0.43, low certainty). There were no head-to-head studies of iron-based binders compared with calcium. The paucity of placebo-controlled studies in CKD G5D has led to uncertainty about the effects of phosphate binders on patient-important outcomes compared with placebo.It is uncertain whether the effects of binders on clinically-relevant outcomes were different for patients who were and were not treated with dialysis in subgroup analyses. AUTHORS' CONCLUSIONS: In studies of adults with CKD G5D treated with dialysis, sevelamer may lower death (all causes) compared to calcium-based binders and incur less treatment-related hypercalcaemia, while we found no clinically important benefits of any phosphate binder on cardiovascular death, myocardial infarction, stroke, fracture or coronary artery calcification. The effects of binders on patient-important outcomes compared to placebo are uncertain. In patients with CKD G2 to G5, the effects of sevelamer, lanthanum, and iron-based phosphate binders on cardiovascular, vascular calcification, and bone outcomes compared to placebo or usual care, are also uncertain and they may incur constipation, while iron-based binders may lead to diarrhoea.


Assuntos
Compostos de Cálcio/uso terapêutico , Quelantes/uso terapêutico , Distúrbio Mineral e Ósseo na Doença Renal Crônica/tratamento farmacológico , Distúrbio Mineral e Ósseo na Doença Renal Crônica/prevenção & controle , Fósforo/sangue , Poliaminas/uso terapêutico , Adulto , Idoso , Cálcio/sangue , Compostos de Cálcio/efeitos adversos , Causas de Morte , Quelantes/efeitos adversos , Doença Crônica , Distúrbio Mineral e Ósseo na Doença Renal Crônica/sangue , Progressão da Doença , Humanos , Hipercalcemia/induzido quimicamente , Compostos de Ferro/efeitos adversos , Compostos de Ferro/uso terapêutico , Lantânio/efeitos adversos , Lantânio/uso terapêutico , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue , Poliaminas/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Diálise Renal/estatística & dados numéricos , Sevelamer/uso terapêutico
11.
Gen Dent ; 66(3): 64-67, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29714703

RESUMO

This study evaluated the effect of 3 commercially available calcium silicate materials (CSMs) on pH changes in simulated root resorption defects. Simulated root resorption defects were prepared on the facial root surface of 40 mandibular premolars. The depth of each defect was individually calculated to standardize the remaining dentin thickness to 1 mm. Prepared canals were obturated with the 3 CSMs. Ten specimens were kept as controls, filled with unbuffered normal saline. The pH measurements were taken at 1 hour, 6 hours, 1 day, 1 week, 2 weeks, 3 weeks, 1 month, and 2 months. All CSM groups exhibited an initial alkaline pH of 9.0-9.7. The pH decreased to 8.0-8.5 after 2 months of storage. There were no significant differences between pH measurements at other time intervals. The CSM groups exhibited higher pH levels than the control group. The results showed that intracanal placement of the CSMs maintained initial pH levels of 9.0-9.7 inside the simulated resorption defects; these measurements gradually decreased to 8.0-8.5 over the span of 2 months.


Assuntos
Compostos de Cálcio/uso terapêutico , Obturação do Canal Radicular/efeitos adversos , Reabsorção da Raiz/etiologia , Silicatos/uso terapêutico , Compostos de Cálcio/efeitos adversos , Preparo da Cavidade Dentária , Humanos , Concentração de Íons de Hidrogênio , Técnicas In Vitro , Obturação do Canal Radicular/métodos , Silicatos/efeitos adversos
12.
Int J Pediatr Otorhinolaryngol ; 108: 91-94, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29605374

RESUMO

INTRODUCTION: Augmentation pharyngoplasty (AP) is a technique that may effectively treat velopharyngeal insufficiency (VPI), while avoiding typical short and long term surgical risks. This study seeks to determine if children with VPI treated by AP with calcium hydoxylapatite (CaHa) demonstrate clinically significant improvement in speech outcomes. METHODS: Retrospective review (2012-2016) of prospectively collected database of children with VPI, cared for at a single tertiary children's hospital. Preoperative speech assessment, nasometry, and video nasendoscopy were used to identify patients with VPI treated by AP with CaHa. Demographics, surgical/speech outcomes, complications, novel surgical technique and follow-up were recorded. Main outcome measures included pre and postoperative nasality and perceptual speech assessments, based on the Pittsburgh Weighted Values for Speech (PWS). RESULTS: 17 patients treated with AP with CaHa, as initial primary treatment for VPI, were identified. 8 patients had cleft palate, 9 patients had isolated VPI. Mean age at treatment was 6.6 years, with no operative complications. Mean nasality scores before and after surgery were 3.2 vs. 0.5 (p < 0.001). Mean PWS before and after surgery were 9.7 vs. 2.1 (p < 0.001). Based on the PWS scoring, 4/8 of cleft patients (50%) and 8/9 of isolated patients (89%) achieved a competent/borderline competent nasopharyngeal valve. 17/17 of patients (100%) had improvement in nasality. Mean length of follow-up was 32.8 months (range 10-64 months). CONCLUSION: In this largest series of patients to date, AP with CaHa is a safe, minimally invasive, enduring treatment for VPI in properly selected patients. Nasality and speech scores significantly improved, especially in patients with isolated VPI.


Assuntos
Compostos de Cálcio/uso terapêutico , Faringe/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Insuficiência Velofaríngea/cirurgia , Adolescente , Compostos de Cálcio/efeitos adversos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Cirurgia Endoscópica por Orifício Natural/métodos , Complicações Pós-Operatórias/epidemiologia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Estudos Retrospectivos , Fala/fisiologia , Distúrbios da Fala/etiologia , Resultado do Tratamento
14.
Int Endod J ; 51(3): 284-317, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28846134

RESUMO

Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.


Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Cimentos Dentários/uso terapêutico , Óxidos/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Silicatos/uso terapêutico , Compostos de Alumínio/efeitos adversos , Animais , Compostos de Cálcio/efeitos adversos , Cimentos Dentários/efeitos adversos , Combinação de Medicamentos , Humanos , Óxidos/efeitos adversos , Materiais Restauradores do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos
15.
J Endod ; 43(10): 1593-1601, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28864217

RESUMO

INTRODUCTION: On the basis of many clinical observations, some calcium silicate-based cements have a high potential for staining tooth tissue. This feature greatly limits the use of those cements, particularly for anterior teeth. This review aimed to provide a systematic evaluation of published in vitro studies to determine the effect of different calcium silicate-based cements on dental tissue discoloration. METHODS: This literature review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The literature search was based on all publications without a year limit. The last search was performed on October 22, 2016. An electronic search was performed on MEDLINE (PubMed), Cochrane, and Scopus. The articles were selected to address the following research question: Which materials based on calcium silicate-based cements have hard tissue staining potential? The necessary information was extracted by 2 authors independently using a standardized form. RESULTS: The search resulted in 390 titles from all databases. Twenty-three studies met the inclusion criteria. Most of the studies exhibited a moderate risk of bias. The results indicated that some materials showed a strong potential for staining, including gray and white MTA Angelus (Londrina, PR, Brazil), gray and white ProRoot MTA (Dentsply, Tulsa, OK), and Ortho MTA (BioMTA, Seoul, Korea). Individual study results showed that Biodentine (Septodont, Saint Maur des Fosses, France), Retro MTA (BioMTA), Portland cement, EndoSequence Root Repair Material (Brasseler USA, Savannah, GA), Odontocem (Australian Dental Manufacturing, Brisbane, Australia), MM-MTA (Micro Mega, Besancon Cedex, France), and MTA Ledermix (Riemser Pharma GmbH, Greiswald-Insel Riems, Germany) were materials with the smallest staining potential. CONCLUSIONS: This review clearly showed that some calcium silicate-based cements have a high potential for staining hard tissue. On the other hand, some showed only a small change in color, which was nearly invisible to the human eye (ΔE <3.3). However, more long-term clinical studies are needed.


Assuntos
Compostos de Cálcio/efeitos adversos , Cimentos Dentários/efeitos adversos , Silicatos/efeitos adversos , Descoloração de Dente/induzido quimicamente , Animais , Bovinos , Humanos , Técnicas In Vitro
16.
J Biol Regul Homeost Agents ; 31(2 Suppl 1): 1-9, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28691448

RESUMO

TheraCal LC (TLC, Bisco Inc., Schaumburg, IL, USA) is a light-cured, resin-modified, calcium silicate-filled base/liner material designed for direct and indirect pulp-capping. In this study the result of the evaluation in vitro of the biocompatibility and chemical-physical properties of TLC are reported. TLC specimens were prepared under aseptic conditions in strict compliance with the manufacturer’s instructions and sterilized. Osteoblast-like cells (MG63) were used. For different time points, solubility, water uptake, alkalinizing activity and cytotoxicity were evaluated. In ddH20 and in DMEM+FBS, TLC showed a loss of material increasing simultaneously with the absorption capacity. The increase of water uptake of the material promoting the solubilization of mineral ions in medium is a requisite for a bioactive material. The alkalinizing activity is correlated to antimicrobial/bacteriostatic activity and to the ability to favor the formation of apatite deposits. The pH values for water absorption after immersion of the disks ranged between 8 and 9 at each times of evaluation. Cytotoxicity was not observed in MG63 cells treated with TLC and after 5 days, the cells were organized to form a confluent monolayer as demonstrated by fluorescence microscopy observation. TLC showed biocompatibility on MG63 cells allowing a physiologic cell growth and differentiation. The chemical-physical properties and biocompatibility of TLC observed in vitro in the present study, allows considering this cement as an innovative pulp-capping material for the vital pulp therapy.


Assuntos
Compostos de Alumínio/química , Compostos de Alumínio/farmacologia , Compostos de Cálcio/química , Compostos de Cálcio/farmacologia , Teste de Materiais , Óxidos/química , Óxidos/farmacologia , Agentes de Capeamento da Polpa Dentária e Pulpectomia/química , Agentes de Capeamento da Polpa Dentária e Pulpectomia/farmacologia , Silicatos/química , Silicatos/farmacologia , Compostos de Alumínio/efeitos adversos , Compostos de Cálcio/efeitos adversos , Combinação de Medicamentos , Humanos , Testes de Sensibilidade Microbiana , Osteoblastos/efeitos dos fármacos , Óxidos/efeitos adversos , Agentes de Capeamento da Polpa Dentária e Pulpectomia/efeitos adversos , Silicatos/efeitos adversos
17.
Indian J Dent Res ; 28(3): 341-343, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28722003

RESUMO

The aim of this report was to present the long-term clinical and radiographic outcomes of a case including severe unintentional extrusion of mineral trioxide aggregate (MTA). An 11-year-old boy was referred with a previously traumatized permanent central incisor which was temporarily treated by using calcium hydroxide root canal filling material. Since having an open apex and a large periapical lesion, root canal treatment with MTA apexification was planned. During the apexification process, a huge amount of MTA was unintentionally extruded into periapical tissues. The parents were informed about the complication, and the obturation of the remaining root canal was completed. Clinical and radiographic follow-up was performed for 4 years. Complete healing of periapical lesion was confirmed by the radiographic follow-up at the 48th month. Patients should be followed-up for giving a chance to observe periapical healing without any surgical removal if the MTA is unintentionally extruded.


Assuntos
Compostos de Alumínio/efeitos adversos , Apexificação/efeitos adversos , Compostos de Cálcio/efeitos adversos , Óxidos/efeitos adversos , Silicatos/efeitos adversos , Compostos de Alumínio/uso terapêutico , Apexificação/métodos , Compostos de Cálcio/uso terapêutico , Criança , Coroas , Combinação de Medicamentos , Humanos , Incisivo/diagnóstico por imagem , Incisivo/lesões , Incisivo/cirurgia , Masculino , Óxidos/uso terapêutico , Radiografia Dentária , Silicatos/uso terapêutico
18.
Drugs ; 77(11): 1155-1186, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28584909

RESUMO

As kidney disease progresses, phosphorus retention also increases, and phosphate binders are used to treat hyperphosphatemia. Clinicians prescribe phosphate binders thinking that reducing total body burden of phosphorus may decrease risks of mineral and bone disorder, fractures, cardiovascular disease, progression of kidney disease, and mortality. Recent meta-analyses suggest that sevelamer use results in lower mortality than use of calcium-containing phosphate binders. However, studies included in meta-analyses show significant heterogeneity, and exclusion or inclusion of specific studies alters results. Since no long-term studies have been conducted to determine whether treatment with any phosphate binder is better than placebo on any hard clinical endpoint (including mortality), it is unclear whether possible benefit with sevelamer represents net benefit of sevelamer, net harm with calcium-containing phosphate binders, or both. Although one meta-analysis suggested that calcium acetate may be more efficacious gram for gram than calcium carbonate as a binder, calcium acetate did not reduce hypercalcemia, and gastrointestinal intolerance was higher. Data are insufficient to determine whether calcium acetate provides lower risk of vascular calcification than calcium carbonate. Fears of lanthanum accumulation in the central nervous system or bone with long-term treatment do not appear to be warranted. Newer iron-containing phosphate binders have potential benefits, such as lower pill burden (sucroferric oxyhydroxide) and improved iron parameters (ferric citrate). The biggest challenge to phosphate binder efficacy is non-adherence. This article reviews the current knowledge regarding safety, effectiveness, and adherence with currently marketed phosphate binders and those in development.


Assuntos
Quelantes/uso terapêutico , Hiperfosfatemia/tratamento farmacológico , Lantânio/uso terapêutico , Fosfatos/metabolismo , Insuficiência Renal Crônica/tratamento farmacológico , Compostos de Cálcio/efeitos adversos , Compostos de Cálcio/metabolismo , Compostos de Cálcio/uso terapêutico , Quelantes/efeitos adversos , Quelantes/economia , Quelantes/farmacologia , Custos de Medicamentos , Compostos Férricos/efeitos adversos , Compostos Férricos/metabolismo , Compostos Férricos/uso terapêutico , Humanos , Hiperfosfatemia/etiologia , Lantânio/metabolismo , Lantânio/farmacologia , Metanálise como Assunto , Fosfatos/sangue , Insuficiência Renal Crônica/complicações , Sevelamer/uso terapêutico
19.
Medwave ; 17(Suppl2): e6942, 2017 May 12.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-28525528

RESUMO

Chronic kidney disease-mineral and bone disorder is prevalent. There is controversy regarding whether calcium-based phosphate binders or sevelamer - a non-calcium phosphate binder – constitute a better therapeutic alternative. Searching in Epistemonikos database, which is maintained by screening multiple information sources, we identified 12 systematic reviews comprising 61 studies of which 41 correspond to randomized trials addressing the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded sevelamer may decrease hypercalcemia, but with a higher incidence of gastrointestinal effects than calcium based phosphate binders. It is unclear if there are differences in mortality because the certainty of the evidence is very low.


Assuntos
Quelantes/uso terapêutico , Distúrbio Mineral e Ósseo na Doença Renal Crônica/tratamento farmacológico , Sevelamer/uso terapêutico , Compostos de Cálcio/efeitos adversos , Compostos de Cálcio/uso terapêutico , Quelantes/efeitos adversos , Distúrbio Mineral e Ósseo na Doença Renal Crônica/fisiopatologia , Bases de Dados Factuais , Humanos , Hipercalcemia/epidemiologia , Hipercalcemia/prevenção & controle , Fosfatos/metabolismo , Ensaios Clínicos Controlados Aleatórios como Assunto , Sevelamer/efeitos adversos
20.
J Appl Biomater Funct Mater ; 15(4): e382-e386, 2017 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-28525679

RESUMO

BACKGROUND: During the apexification procedure for teeth with open apices, mineral trioxide aggregate (MTA) may be unintentionally extruded. The aim of the present study was the retrospective evaluation of the healing of periapical lesions in permanent incisor teeth with open apices after the unintentional extrusion of MTA. METHODS: The clinical and radiographic records of 55 maxillary permanent central teeth treated by MTA apexification were evaluated. Filled teeth with unintentionally extruded MTA were selected as group 1 (n = 21), whereas the teeth with no MTA extrusion were selected as group 2 (n = 34). For each tooth, the clinical and radiographic records from a 3-year follow-up were investigated. RESULTS: Complete healing (CH) was observed in 19 teeth (90.4%) in group 1, whereas the same type of healing was observed in all 34 teeth (100%) in group 2 (p>0.05). At the 6-month follow-up appointment, 25 teeth (73.5%) showed CH in group 2, whereas 15 teeth (71.4%) showed CH at the 1-year follow-up in group 1 (p<0.001). At the end of the 3-year follow-up period, the amount of MTA extrusion was reduced in 17 teeth (85%) (p<0.05), whereas it was almost absent in 2 teeth (10%). CONCLUSIONS: The unintentional extrusion of MTA does not prevent the healing of periapical lesions, but may be a delaying factor for periapical healing.


Assuntos
Compostos de Alumínio/efeitos adversos , Apexificação/efeitos adversos , Compostos de Cálcio/efeitos adversos , Óxidos/efeitos adversos , Doenças Periapicais/etiologia , Doenças Periapicais/reabilitação , Materiais Restauradores do Canal Radicular/efeitos adversos , Obturação do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Cicatrização/fisiologia , Apexificação/métodos , Criança , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Doença Iatrogênica , Masculino , Doenças Periapicais/cirurgia , Estudos Retrospectivos , Materiais Restauradores do Canal Radicular/química , Materiais Restauradores do Canal Radicular/uso terapêutico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...