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This study evaluated the biocompatibility, bioactivity, porosity, and sealer/dentin interface of Sealer Plus BC (SP), Bio-C Sealer (BIOC), TotalFill BC Sealer (TF), and AH Plus (AHP). Dentin tubes filled with the sealers and empty tubes (control group) were implanted in the subcutaneous tissue of rats for different periods (n = 6 per group/period). Number of inflammatory cells (ICs), capsule thickness, von Kossa reaction, interleukin-6 (IL-6) and osteocalcin (OCN) were evaluated. Porosity and voids in the interface dentin/sealers were assessed by micro-computed tomography. The data were submitted to ANOVA/Tukey's tests (α = 0.05). Greater capsule thickness, ICs and IL-6 immunolabeling cells were observed in AHP. No significant difference in thickness of capsule, ICs, and IL-6- immunolabeling cells was detected between SP and TF, in all periods, and after 30 and 60 days between all groups. At 60 days all groups had reduction in capsule thickness, ICs and IL-6 immunolabeling cells. Von Kossa-positive and birefringent structures were observed in the capsules around the sealers. BIOC, SP, and TF exhibited OCN-immunolabeling cells. All sealers had porosity values below 5%, besides low and similar interface voids. BIOC, SP and TF are biocompatible, bioactive, and have low porosity and voids. The dentin-tube model used is an alternative for evaluating bioceramic materials.

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AIM: To evaluate the inflammatory reaction and the ability to induce mineralization activity of a new repair material, NeoPUTTY (NPutty; NuSmile, USA), in comparison with Bio-C Repair (BC; Angelus, Brazil) and MTA Repair HP (MTA HP; Angelus, Brazil). METHODOLOGY: Polyethylene tubes were filled with materials or kept empty (control group, CG) and implanted in subcutaneous tissue of rats for 7, 15, 30, and 60 days (n = 6/group). Capsule thickness, number of inflammatory cells (ICs), fibroblasts, collagen content, and von Kossa analysis were performed. Unstained sections were evaluated under polarized light and by immunohistochemistry for osteocalcin (OCN). Data were submitted to two-way anova followed by Tukey's test (p ≤ .05), except for OCN. OCN data were submitted to Kruskal-Wallis and Dunn and Friedman post hoc tests followed by the Nemenyi test at a significance level of 5%. RESULTS: At 7, 15, and 30 days, thick capsules containing numerous ICs were seen around the materials. At 60 days, a moderate inflammatory reaction was observed for NPutty, BC while MTA HP presented thin capsules with moderate inflammatory cells. In all periods, NPutty specimens contained the highest values of ICs (p < .05). From 7 to 60 days, the number of ICs reduced significantly while an increase in the number of fibroblasts and birefringent collagen content was observed. At 7 and 15 days, no significant difference was observed in the immunoexpression of OCN (p > .05). At 30 and 60 days, NPutty showed the lowest values of OCN (p < .05). At 60 days, a similar immunoexpression was observed for BC and MTA HP (p > .05). In all time intervals, capsules around NPutty, BC, and MTA HP showed von Kossa-positive and birefringent structures. CONCLUSIONS: Despite the greater inflammatory reaction promoted by NeoPutty than BC and MTA HP, the reduction in the thickness of capsules, the increase in the number of fibroblasts, and the reduction in the number of ICs indicate that this bioceramic material is biocompatible Furthermore, NeoPutty presents the ability to induce mineralization activity.

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OBJECTIVES: This study is to evaluate biocompatibility, bioactive potential, porosity, and dentin/material interface of Bio-C Repair (BIOC-R), MTA Repair HP (MTAHP), and Intermediate Restorative Material (IRM). MATERIALS AND METHODS: Dentin tubes were implanted into subcutaneous of rats for 7, 15, 30, and 60 days. Thickness of capsules, number of inflammatory cells (ICs), interleukin-6 (IL-6), osteocalcin (OCN), and von Kossa were evaluated. Porosity and material/dentin interface voids were also analyzed. Data were submitted to ANOVA and Tukey's tests (p < 0.05). RESULTS: IRM capsules were thicker and contained greater ICs and IL-6-immunopositive cells at 7 and 15 days. BIOC-R capsules exhibited higher thickness and ICs at 7 days and greater IL-6 at 7 and 15 days than MTAHP (p < 0.05). At 30 and 60 days, no significant difference was observed among the groups. OCN-immunopositive cells, von Kossa-positive, and birefringent structures were observed in BIOC-R and MTAHP. MTAHP exhibited higher porosity and interface voids (p < 0.05). CONCLUSIONS: BIOC-R, MTAHP, and IRM are biocompatible. Bioceramics materials demonstrate bioactive potential. MTAHP presented the highest porosity and presence of voids. CLINICAL RELEVANCE: BIOC-R and MTAHP have adequate biological properties. BIOC-R demonstrated lower porosity and presence of voids, which may represent better sealing for its clinical applications.

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INTRODUCTION: There are no drugs specifically approved to treat cutaneous lupus. Inflammatory cells in lupus skin lesions can produce leukotrienes (LT), which promote tissue damage. In addition to hypersensitivity reactions, LT are also associated with cardiovascular diseases and elevated serum LT levels have been linked to worse atherosclerotic disease in lupus. Targeting LT could thus be an alternative to treat lupus. We present 4 cases of cutaneous lupus successfully treated with montelukast (MLK), a Cys-LT antagonist. METHODS: Four consecutive female systemic lupus erythematosus (SLE) patients with refractory skin lesions were treated with MLK (10 mg/d) in the Hospital Universitário Walter Cantídio of the Universidade Federal do Ceará. Skin lesions were scored using Revised Cutaneous LE Disease Area and Severity Index (RCLASI). Relative expression of the 5-lipoxigenase (ALOX5) and 15-lipoxigenase (ALOX15) genes was determined in peripheral blood cells (PBC) from lupus patients and 4 age-matched female controls. RESULTS: All patients experienced improvement of skin lesions measured using RCLASI scores within 2-12 weeks following initiation of MLK. The response was sustained for at least 3 months follow-up and no adverse events were recorded. ALOX5 but not ALOX15 gene expression was significantly (P = 0.0425) increased in PBC from SLE patients vs controls. CONCLUSION: This is the first report of a fast and sustained successful response of cutaneous lupus to MLK. Given its acceptable safety profile, our data encourage development of a randomized trial as an attempt to reposition MLK as a safe, affordable alternative to treat cutaneous lupus.

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A criopreservação é o melhor método de armazenamento de sêmen por período indeterminado, conferindo alta flexibilidade de uso. Além disso, é o principal meio para formação de banco de germoplasma. No entanto, congelar sêmen suíno ainda é um desafio a ser enfrentado. Isso porquê, além das características de membrana espermática que ocasionam maiores efeitos deletérios às células durante os processos de congelação e descongelação, ainda é preciso lidar com a grande variabilidade de resultados, seja entre indivíduos, ejaculados de um mesmo indivíduo ou ainda, frações de um mesmo ejaculado. Frente a isso, diferentes estratégias têm sido investigadas a fim de obter melhores resultados e assim, aumentar a aplicabilidade do sêmen congelado suíno a nível comercial. Além disso, acreditamos que haja a possibilidade de se relacionar a capacidade de criotolerância de um determinado espermatozoide a sua maior ou menor capacidade de fertilizar o oócito.(AU)

Cryopreservation is the best method of storing semen indefinitely, providing high flexibility of use. In addition, it is the primary means for forming a germplasm bank. However, freezing boar semen is still a challenge to be faced because, in addition to the characteristics of the spermatic membrane that cause deleterious effects to the cells during the freezing and thawing processes, it is still necessary to deal with the significant variability of results, whether between individuals, ejaculates from the same individual or even fractions of an even ejaculated. Because of this, different strategies have been investigated to obtain better results and thus increase the applicability of frozen boar semen at a commercial level. Furthermore, we believe it is possible to relate the cryotolerance capacity of a given sperm to its greater or lesser capacity to fertilize the oocyte.(AU)

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Ao preservar o espermatozoide suíno no estado líquido ou criopreservado, os componentes do plasma seminal (PS) contidos nos ejaculados podem alterar a capacidade de fertilização desses gametas. O PS contém substâncias essenciais para a manutenção da viabilidade e fertilidade dos espermatozoides. No entanto, esses componentes podem ser deletérios dependendo da quantidade ou duração do tempo de contato entre a ejaculação e a remoção do PS durante o processamento do sêmen para a conservação na forma refrigerada ou congelada. Foram identificadas substâncias que prejudicam (principal proteína plasmática seminal PSPI) ou melhoram (espermadesina PSP-I) a capacidade de fertilização dos espermatozoides. Dependendo dos cachaços e dos procedimentos de colheita de sêmen, a remoção do PS pode ser benéfica antes da preservação no estado líquido ou criopreservado. Em alguns casos, o PS removido antes da congelação pode ser adicionado de volta ao diluente de descongelamento, com efeitos positivos no sêmen descongelado e na viabilidade do espermatozoide no trato reprodutivo da porca. Neste texto, há um foco nos diferentes efeitos de PS em amostras de sêmen refrigerado e criopreservado de suínos com ênfase em como PS modula a função e morfologia das células espermáticas antes, durante e após a preservação de forma refrigerada ou criopreservada.(AU)

When preserving sperm in the liquid or cryopreserved state, seminal plasma (SP) components within ejaculates can alter fertilizing capacity of these gametes. The SP contains substances essential for maintenance of sperm viability and fertility; however, these components can be deleterious depending on quantity, or duration of time before there is removal of SP from sperm in semen processing. Substances that impair (Major seminal plasma protein PSPI - boar) or improve (e.g., spermadhesin PSP-I - boar) sper- matozoa fertilizing capacity have been identified. Depending on individual males and semen collection procedures, SP removal may be beneficial before preservation in the liquid or cryopreserved state. In some cases, SP that is removed can be added back to thawing extender with there being positive effects in thawed sperm and for sperm viability in the female reproductive tract. In this review article, there is a focus on different effects of SP in samples of cooled and cryopreserved semen from boar with there being emphasis on how SP modulates the function and morphology of sperm cells before, during, and after preservation in the refrigerated or cryopreserved state.(AU)

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OBJECTIVE: Filling materials should be restricted to the root canal space. However, sometimes it is impossible to control the apical extrusion, in this case, the fate of the filling material and the result of the treatment will depend on its physicochemical properties and biocompatibility. To evaluate the tissue response and bone repair capacity of endodontic sealers that were implanted in the calvaria of Wistar rats, forming the groups (n=16): AH Plus and Sealer Plus, compared to the clot group. METHODOLOGY: On days 30 and 60, the animals were euthanized, the calvaria was removed and processed for hematoxylin-eosin, immunohistochemistry for collagen type I, Picrosirus red and microtomographic analysis. Data were subjected to ANOVA and Tuckey tests (p<0.05). RESULTS: At 30 days, all groups showed an intense inflammatory reaction (p>0.05). At 60 days, the AH Plus and Sealer Plus maintained an intense inflammatory infiltrate compared to the clot group (p<0.05). We observed immunopositive areas for type I collagen in all groups at 30 days and 60 days (p>0.05). We observed more red collagen fibers for the Sealer Plus compared to the clot group at 30 days (p<0.05). Considering the total fibers, the clot group at 30 days compared to 60 days after surgery showed an increase in the amount of matrix (p<0.05). There were no statistical differences between groups for green and yellow fibers (p>0.05). Regarding morphometric parameters, at 30 days, the newly formed bone volume and number of bone trabeculae were higher in the groups with sealers compared to the clot group (p<0.05). At 60 days, AH Plus and Sealer Plus showed greater bone neoformation compared to the clot group (p<0.05). CONCLUSIONS: Despite AH Plus and Sealer Plus induced an intense inflammatory reaction, they can be considered biocompatible materials, since they allowed bone repair.

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BACKGROUND: Inflammatory back pain (IBP) is a major criterion in identifying axial spondyloarthritis. Whether socioeconomic issues impact prevalence of IBP assessed using standardized questionnaires has not been assessed. We determined IBP prevalence and performance of IBP questionnaires in a low-income, low-literacy population. METHODS: Individuals were interviewed in Fortaleza, Brazil, for the prevalence of IBP using Calin's, Berlin, and ASAS IBP questionnaires; monthly family income (US dollars), literacy (>/≤8 school years [SYs]), and smoking habit (present/absent) were registered. RESULTS: Two hundred nineteen individuals were included (mean age, 38.2 ± 12.9 years), 110 (50.2%) men, 58 (26.4%) White, and 38 (17.3%) smokers. Overall, 152 (69.4%) declared

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Abstract Filling materials should be restricted to the root canal space. However, sometimes it is impossible to control the apical extrusion, in this case, the fate of the filling material and the result of the treatment will depend on its physicochemical properties and biocompatibility. Objective To evaluate the tissue response and bone repair capacity of endodontic sealers that were implanted in the calvaria of Wistar rats, forming the groups (n=16): AH Plus and Sealer Plus, compared to the clot group. Methodology On days 30 and 60, the animals were euthanized, the calvaria was removed and processed for hematoxylin-eosin, immunohistochemistry for collagen type I, Picrosirus red and microtomographic analysis. Data were subjected to ANOVA and Tuckey tests (p<0.05). Results At 30 days, all groups showed an intense inflammatory reaction (p>0.05). At 60 days, the AH Plus and Sealer Plus maintained an intense inflammatory infiltrate compared to the clot group (p<0.05). We observed immunopositive areas for type I collagen in all groups at 30 days and 60 days (p>0.05). We observed more red collagen fibers for the Sealer Plus compared to the clot group at 30 days (p<0.05). Considering the total fibers, the clot group at 30 days compared to 60 days after surgery showed an increase in the amount of matrix (p<0.05). There were no statistical differences between groups for green and yellow fibers (p>0.05). Regarding morphometric parameters, at 30 days, the newly formed bone volume and number of bone trabeculae were higher in the groups with sealers compared to the clot group (p<0.05). At 60 days, AH Plus and Sealer Plus showed greater bone neoformation compared to the clot group (p<0.05). Conclusions Despite AH Plus and Sealer Plus induced an intense inflammatory reaction, they can be considered biocompatible materials, since they allowed bone repair.

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OBJECTIVES: This study evaluated the biocompatibility and bioactive potential of NeoMTA Plus mixed as a root canal sealer in comparison with MTA Fillapex. MATERIALS AND METHODS: Polyethylene tubes filled with NeoMTA Plus (n = 20), MTA Fillapex (n = 20), or nothing (control group, CG; n = 20) were inserted into the connective tissue in the dorsal subcutaneous layer of rats. After 7, 15, 30 and 60 days, the specimens were processed for paraffin embedding. The capsule thickness, collagen content, and number of inflammatory cells (ICs) and interleukin-6 (IL-6) immunolabeled cells were measured. von Kossa-positive structures were evaluated and unstained sections were analyzed under polarized light. Two-way analysis of variance was performed, followed by the post hoc Tukey test (p ≤ 0.05). RESULTS: At 7 days, the capsules around NeoMTA Plus and MTA Fillapex had more ICs and IL-6-immunostained cells than the CG. However, at 60 days, there was no significant difference in the IC number between NeoMTA Plus and the CG (p = 0.1137) or the MTA Fillapex group (p = 0.4062), although a greater number of IL-6-immunostained cells was observed in the MTA Fillapex group (p = 0.0353). From 7 to 60 days, the capsule thickness of the NeoMTA Plus and MTA Fillapex specimens significantly decreased, concomitantly with an increase in the collagen content. The capsules around root canal sealers showed positivity to the von Kossa stain and birefringent structures. CONCLUSIONS: The NeoMTA Plus root canal sealer is biocompatible and exhibits bioactive potential.

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Previous studies found that physicians working in developed countries in Europe and in the USA declared insufficient knowledge concerning immune-related adverse events (irAE) following use of immune checkpoint inhibitors (ICI) in cancer treatment. We determined this knowledge gap among rheumatologists and medical students (MS) in Brazil. A web-based structured survey or a direct interview was applied to 1428 board-certified Brazilian rheumatologists and an adapted questionnaire was sent to 840 undergraduate MS attending the last 2 years of Medical Schools in Fortaleza-CE, Brazil, in September 2019. 228 (15.9%) rheumatologists and 145 (17.2%) MS answered the survey; 136 (60%) rheumatologists worked at Institutions with Oncology service. Rheumatologists had 22.6 ± 12.6 years of medical practice, most [116 (50.9%)] worked in private practice and 9 (3.9%) were on training. Fifty-three (23.4%) declared being familiar [40 (17.6%)] or very familiar [13 (5.8%)] with irAE. Almost two-thirds declared having never managed irAE and about a third (38.6%) felt confident in managing such patients. Knowledge among rheumatologists was similar regardless of having more or less than 10 years of practice (P = 0.758). Less than 5% MS declared being familiar with ICI and most have never heard of irAE. There is a large gap concerning knowledge about ICI and irAE among rheumatologists and MS in Brazil. Continuing medical education strategies are needed to improve this knowledge.

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O objetivo do presenteestudo foi avaliar a atividade antibacteriana dos cimentos endodôn-ticos MTA Fillapex, Sealapex, Sealer 26 e Endofill puros e acrescidos de amoxicilina e ci-profloxacina frente a duas linhagens ATCC de Enterococcus faecalis (ATCC 29212 e ATCC 4083). Os testes foram realizados pela técnica de difusão radial dos cimentos aplicados di-retamente no ágar e impregnados em discos de papel e pelo teste de contato direto. Para a análise estatística, utilizaram-se os testes de ANOVA e Tukey com nível de significância de 5%. Os resultados mostraram que pela técnica da difusão radial, considerando os cimentos puros, o Sealapex foi o único que apresentou halos de inibição frente às duas linhagens. Já quando da associação de amoxicilina e ciprofloxacina, o MTA Fillapex revelou os melhores halos de inibição para as duas linhagens. Todos os cimentos tiveram a ação potencializada pela adição dos antibióticos (p<0,05). Pela técnica de difusão dos cimentos impregnados em discos de papel, o cimento Sealapex puro fresco demonstrou atividade antimicrobiana em todas as variáveis de tempo. Quando acrescidos dos antibióticos, todos os cimentos ti-veram a ação antimicrobiana potencializada pelas drogas, em todas as variáveis de tempo. Esse mesmo resultado foi observado na técnica do contato direto dos cimentos com ambas as linhagens. A atividade antibacteriana, frente ao E. faecalis, dos cimentos MTA Fillapex, Endofill, Sealer e Sealapex, acrescidos dos antibióticos amoxicilina e ciprofloxacina, foi potencializada mesmo após um longo período da presa dos cimentos.

The objective of this study was to evaluate the antibacterial activity of different endodon-tic cements (MTA Fillapex, Sealapex, Sealer 26, and Endofill), both pure and mixed with 5% of amoxicillin or ciprofloxacin, against two strains of Enterococcus faecalis (ATCC 29212 and ATCC 4083). Bacterial susceptibility testing was conducted by radial diffusion methods and direct contact test after different periods. Data were subjected to ANO-VA and Tukey test with a significance level of 5%. Sealapex was the only pure sealer to promote the inhibition of bacterial growth against both strains in different experimental periods. However, all cements present an increase in antibacterial activity by the addition of antibiotics (p<0.05). MTA Fillapex and Sealapex associated with amoxicillin promoted increased values for bacterial growth against ATCC 29212 and ATCC 4083 in comparison to other groups (p<0.001), including extended periods after setting time. The association of antibiotic agents increased the antibacterial effect of the evaluated sealers against the strains of E. faecalis.

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INTRODUCTION: Bio-C Sealer (BC; Angelus, Londrina, PR, Brazil) and Sealer Plus BC (SPBC; MK Life, Porto Alegre, Brazil) are new ready-to-use bioceramic endodontic sealers. The aim of this study was to evaluate the biocompatibility and bioactive potential of BC and SPBC sealers in comparison with AH Plus (AHP; Dentsply DeTrey Gmbh, Konstanz, Germany) in subcutaneous tissue of rats. METHODS: Polyethylene tubes filled with materials and empty tubes, serving as the control group, were implanted in the subcutaneous tissues of rats. After 7, 15, 30, and 60 days, the tubes with connective tissue were removed, and inflammatory cells (ICs)/mm2 and immunolabeled cells for interleukin (IL)-6 were evaluated. Osteocalcin and von Kossa analysis were also performed. Data were submitted to analysis of variance and Tukey tests, with a significance level of 5%. RESULTS: At 7 days, SPBC showed lower ICs than BC (P < .05). AHP exhibited greater immunolabeled cells for IL-6 (P < .05). After 15 days, BC showed lower ICs and IL-6 compared with other materials. At 30 days, SPBC and AHP showed higher values for ICs (P < .05). After 60 days, calcium silicate sealers did not show statistical difference (P > .05) for ICs and IL-6, with values lower than AHP (P < .05). The materials showed positive structures to von Kossa staining. BC exhibited osteocalcin labeling in all periods. SPBC showed osteocalcin labeling from 15-60 days. AHP and the control group did not exhibit osteocalcin labeling. CONCLUSIONS: BC and SPBC sealers are biocompatible and present bioactive potential.

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We investigated the physical properties, antimicrobial activity, and tissue reaction to Apexit Plus in comparison to Sealapex. Flow, radiopacity, setting time, and solubility were evaluated in each material. The antimicrobial activity against Enterococcus faecalis was performed. Polyethylene tubes containing Apexit Plus or Sealapex, and without material (control group) were implanted into the subcutaneous tissue of rats. At 7, 15, 30, and 60 days of implantation, the specimens were paraffin-embedded and the number of inflammatory cells (ICs) and the amount of birefringent collagen (BC) were quantified. The von Kossa reaction followed by immunohistochemistry for detection of alkaline phosphatase (ALP) was also performed. Statistical analysis was performed with ANOVA and Tukey test (p ≤ 0.05). The flow value of Apexit Plus was greater than Sealapex, whereas the radiopacity (3.44 mm Al) was lower than Sealapex (6.82 mm Al). Apexit Plus showed lower solubility and shorter initial and final setting (p 0.0001), whereas the antimicrobial activity was significantly greater than Sealapex. Although the number of ICs was higher in Apexit Plus (p = 0.0009) at 7 days, no significant difference was detected between Apexit Plus and Sealapex at 15, 30, and 60 days. All groups showed higher values for BC in the capsules over time. ALP-immunolabelled cells were observed, mainly around von Kossa-positive structures, either in the capsules of Apexit Plus or Sealapex. Therefore, our results revealed that Apexit Plus exhibited a greater effectiveness against Enterococcus faecalis and better physical properties than Sealapex, except for the radiopacity. In vivo findings indicate that Apexit Plus is biocompatible and presents potential bioactivity in the subcutaneous tissue.

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OBJECTIVES: Evaluate the cytotoxicity and biocompatibility of calcium hydroxide paste [Ca (OH)2] associated with 5% diclofenac sodium, ibuprofen, or amoxicillin. MATERIALS AND METHODS: Pre-osteoblast-like cells were cultivated and the MTT test was used to determine the cytotoxicity of the paste extracts after time intervals of 24, 48, 72 h, and 7 days. Tubes containing Ca (OH)2 pastes associated with the drugs and empty tubes were implanted in subcutaneous tissue of 30 rats. After 7 and 30 days, the specimens were removed and submitted to histological analysis. The data obtained were submitted to Kruskal-Wallis and Dunn tests (p ≤ 0.05). RESULTS: All the Ca (OH)2 pastes promoted cell viability after all periods. At 7 days, there was greater inflammatory tissue reaction adjacent to the implants. At 30 days, there was a significant reduction in the number of inflammatory cells, and increase in fibroblasts in all groups. In this period, a lower number of inflammatory cells and a higher number of fibroblasts were observed in the capsules adjacent to the association with diclofenac, when compared with the other mixtures (p ≤ 0.05); the capsule thickness was greater at 7 days than at 30 days. CONCLUSIONS: The Ca (OH)2 pastes associated with the drugs were not cytotoxic and presented biocompatibility after implantation in rat subcutaneous tissues. CLINICAL RELEVANCE: Ca (OH)2 pastes with anti-inflammatory or antibiotic may be clinical alternatives as intracanal medication to reduce resistant microorganisms in root canal system.

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Objetivo: o objetivo do presente relato de caso foi demonstrar o emprego do ultrassom em diversas etapas do tratamento endodôntico de um segundo molar inferior com anatomia em forma de C, possibilitando um aumento na previsibilidade no tratamento em dentes com complexidades anatômicas. Relato de caso: paciente do sexo masculino, relatou sensibilidade dolorosa no lado direito inferior da face. O exame clínico mostrou ausência de vitalidade pulpar, e o exame radiográfico detectou a presença de lesão cariosa no dente #47, lesão periapical e uma anatomia em forma de C. Assim, o tratamento de escolha foi a necropulpectomia. Após abertura coronária, foi realizado o refinamento da câmara pulpar e das embocaduras dos canais, com ponta de ultrassom. O preparo biomecânico foi realizado com instrumento Reciproc 25.08 e Mtwo 40.04, sendo a agitação final do hipoclorito de sódio e do EDTA realizada com a ponta ultrassônica Irrisonic. A medicação intracanal empregada foi a pasta de hidróxido de cálcio. Após 15 dias, a medicação foi removida por meio de irrigação ultrassônica passiva, e os canais foram secos com pontas de papel absorvente esterilizadas. A obturação dos canais foi realizada com o cimento AH Plus, o qual foi inserido com espiral de Lentulo #40 e, em seguida, agitado por 1 minuto com ultrassom. Então, a técnica de obturação híbrida de Tagger foi realizada. Conclusão: o controle radiográfico após 1 ano e 8 meses mostrou o reparo total da lesão periapical, demonstrando que uso o ultrassom nas diversas etapas da terapia endodôntica pode contribuir para uma maior previsibilidade do tratamento (AU).

The aim of this case report was to describe the use of ultrasonic in several endodontics steps during root canal treatment of second C-shaped mandibular molar, favoring more predictable outcome of endodontic treatment of teeth with complex anatomy. A male patient reported painful symptoms on the right and lower side of the face. Clinical examination revealed absence of pulp vitality of tooth 47 and the radiographic examination showed carious lesion, apical periodontitis and C-shaped anatomy. Therefore, the necropulpectomy treatment was selected. After the coronal access, an ultrasonic tip was used to remove the irregularities of the pulp chamber. The root canal preparation was performed using Reciproc 25.08 and Mtwo 40.04 and a final passive ultrasonic irrigation of the sodium hypochlorite and EDTA was performed with Irrisonic tip. Calcium hydroxide paste was used as intracanal dressing, which was introduced by Lentulo #40 and ultrasonic agitated. After 15 days, a passive ultrasonic irrigation was performed to remove the intracanal dressing and the canals were dried with sterilized paper points. The root filling was performed with AH Plus sealer, which was introduced by Lentulo #40 in a electric motor at 350 rpm and ultrasonic agitated during 1 minute. Then, the hybrid Tagger technique was performed to root canal filling. The radiographic examination showed the suitable isthmus and lateral canals filling. After 1 year and 8 months, the radiographic examination revealed complete apical healing, showing that the use of ultrasonic in several steps of endodontic treatment can favor a more predictable outcomes (AU).

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Introdução: a frequência de micoses invasivas causadas por patógenos fúngicos oportunistas tem aumentado significativamente nas últimas décadas. Entre os principais agentes etiológicos de micoses oportunistas está a Candida albicans. Essa levedura apresenta vários fatores de virulência importantes para produção de doença. Alguns estudos têm demonstrado que C. albicans coloniza canais radiculares e túbulos dentinários. O espectro de atividade antimicrobiana do curativo de hidróxido de cálcio deve incluir essa levedura. Objetivos: o objetivo da presente pesquisa foi determinar a suscetibilidade in vitro de quatro linhagens de C. albicans coletadas da cavidade oral e uma estirpe padrão ATCC 10231 a pastas de hidróxido de cálcio associadas a drogas antifúngicas, antibióticas e anti-inflamatórias. A eficiência das pastas de Ca(OH)2 associadas às drogas sobre as leveduras foram analisadas pelo método da difusão radial e, também, pela técnica do contato direto com os medicamentos. Os dados foram analisados pelo teste de Kruskal-Wallis e o pós-teste de Dunn, para indicar as diferenças entres os grupos, com um nível de significância de 5%. Resultados: todas as medicações antifúngicas potencializaram a ação das pastas de hidróxido de cálcio contra a Candida albicans. Conclusões: a associação de medicações antifúngicas às pastas de Ca(OH)2 pode ser uma alternativa como medicação intracanal. (AU)

Introduction: the frequency of invasive mycoses caused by opportunistic fungal pathogens has increased significantly in the last decades. Among the main etiological agents of opportunistic mycoses is Candida albicans. This yeast has several important virulence factors for producing disease. Some studies have demonstrated that C. albicans colonized root canals and dentinal tubules. The spectrum of antimicrobial activity of calcium hydroxide dressing should include this yeast. Objectives: the aim of the present study was to determine the in vitro susceptibility of four C. albicans strains collected from the oral cavity and a standard strain ATCC 10231 to calcium hydroxide paste associated with antifungal, antibiotic and anti-inflammatory drugs. The efficiency of the Ca(OH)2 paste associated with the drugs on the yeasts was analyzed by the radial diffusion method and also by the direct contact method. Data were analyzed by Kruskal Wallis test and the Dunn post-test were used to indicate the differences between the groups with a significance level of 5%. Results: all antifungal drugs increased the action of the calcium hydroxide pastes against Candida albicans. Conclusions: the association of antifungals with Ca(OH)2 may be considered for use as intracanal medicaments (AU).

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Considering that endodontic sealers release some components which may promote delay in the repair process, our purpose was to evaluate the tissue reaction promoted by MTA Plus and MTA Fillapex in comparison with AH Plus (standard control) and Endofill, which has a long clinical track record. One hundred rats were distributed into five groups: MTA Plus (Avalon Biom Inc., Bradenton, FL, USA), MTA Fillapex (Angelus, Londrina, PR, Brazil), AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany), Endofill (Dentsply, Petrópolis, RJ, Brazil) and CG (control group, empty polyethylene tubes). The polyethylene tubes filled with sealers or empty (CG) were implanted into subcutaneous. After 7, 15, 30 and 60 days, the tubes surrounded by capsules were paraffin-embedded. In HE-stained sections, the volume density of inflammatory cells (VvIC) was estimated in the capsules. The number of interleukin-6-immunolabelled cells (IL-6), a pro-inflammatory cytokine, was also computed in the capsules. The birefringent collagen content was quantified in picrosirius-stained sections. Data were analysed by ANOVA and Tukey tests (p ≤ 0.05). At 7 days, the capsules showed moderate inflammatory reaction. In all groups, VvIC and IL-6-immunostained cells reduced significantly from 7 to 60 days. At 60 days, IL-6 immunoexpression was reduced significantly in MTA Plus and MTA Fillapex in comparison with AH Plus; no difference was found in the VvIC among MTA Plus, MTA Fillapex, AH Plus and CG whereas Endofill exhibited the highest VvIC. The reduction in VvIC was parallel to an increase in the collagen in all the groups, except Endofill. MTA Plus, MTA Fillapex and AH Plus induce a response that culminates in the regression of inflammation and formation of a fibrous capsule over time. The lower IL-6 immunoexpression in the capsules of MTA Plus and MTA Fillapex than AH Plus suggests that the immune response is suppressed more rapidly in the MTA-based sealers.

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Introdução: a substituição do MTA pelo cimento Portland tem sido recomendada pela semelhança em suas composições e propriedades físicas e biológicas. A adição de um antibiótico ao cimento promoveria vantagens clínicas, desde que esse fosse liberado antes e após a presa do cimento. Objetivo: avaliar a atividade antimicrobiana, pelos métodos da difusão e concentração inibitória mínima (CIM), do cimento Portland puro e acrescido de radiopacificador, adicionado de amoxicilina e ciprofloxacina, frente a cinco microrganismos: S. aureus, P. aeruginosa, E. coli, E. faecalis e C. albicans. Métodos: no teste de difusão, foram utilizadas 30 placas de Petri com ágar, escavadas com poços onde foram introduzidos os cimentos imediatamente após a manipulação e após presa de 24h. Para o teste de CIM, foram preparados 120 tubos de ensaio, contendo 10mL de caldo BHI, divididos em quatro grupos. Cada grupo foi semeado com um inóculo fresco de cada microrganismo, separadamente. Os tubos foram incubados em estufa a 37°C e a turbidez foi avaliada após 24h. Os resultados foram avaliados pela análise de variância ANOVA e a comparação dos grupos, pelo teste de Tukey, com significância de 5%. Resultados: o cimento Portland apresentou atividade antimicrobiana apenas contra C. albicans. A amoxicilina apresentou um tênue efeito antibacteriano, enquanto a ciprofloxacina inibiu o crescimento bacteriano em todas as concentrações testadas. Conclusão: a adição da ciprofloxacina ao cimento Portland a fim de incrementar a atividade antimicrobiana parece segura; entretanto, os resultados não sustentam sua aplicação clínica, sendo necessários novos estudos.

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The aim of this study was to evaluate the ability of gutta-percha and a thermoplastic synthetic polymer (Resilon) to fill simulated lateral canals, using warm vertical compaction. Forty-five single-rooted human teeth were prepared using the rotary crown-down technique. Artificial lateral canals were made at 2, 5, and 8 mm from the working length (WL) in each root. The specimens were divided into three groups (n = 15), according to the filling material: Dentsply gutta-percha (GD), Odous gutta-percha (GO), and Resilon cones (RE). The root canals were obturated using warm vertical compaction, without endodontic sealer. The specimens were subjected to a tooth decalcification and clearing procedure. Filling of the lateral canals was analyzed by digital radiography and digital photographs, using the Image Tool software. The data were subjected to the Kruskal-Wallis and Dunn tests at 5% significance. RE had the best filling ability in all root thirds (p < 0.05), with similar results for GO in the coronal third. In the middle and apical thirds, GD and GO had similar results (p > 0.05). Resilon may be used as an alternative to gutta-percha as a solid core filling material for use with the warm vertical compaction technique. The study findings point to the potential benefit of the warm vertical compaction technique for filling lateral canals, and the study provides further information about using Resilon and gutta-percha as materials for the warm vertical compaction technique.

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