RESUMO
The objective of this study was to map, through a scoping review, the evidence available in the literature on the use of platelet concentrates in compromised patients undergoing oral surgeries. Searches were performed in electronic databases for clinical studies with compromised patients undergoing oral surgery who used platelet concentrates. Only studies published in English were included. Two independent researchers carried out the selection of studies. The study design and objective, surgical procedure and platelet concentrate used, systemic involvement, analyzed outcome, and main results were extracted. A descriptive analysis of the data was performed. Twenty-two studies met the eligibility criteria and were included. Case series was the most frequent study design among the included studies (41.0%). In terms of systemic disability, 19 studies reported patients with cancer and related to surgical treatment 16 studies reported patients underwent treatment for osteonecrosis related to the use of the drug. The most used platelet concentrate was pure platelet-rich fibrin (P-PRF). In general, most studies recommend the use of platelet concentrates. Thus, the results of this study suggest that the evidence related to the use of platelet concentrates in compromised patients when undergoing oral surgeries is still initial. Also, most studies assessed the use of platelet concentrates in patients with osteonecrosis.
Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Procedimentos Cirúrgicos Bucais , Cirurgia Bucal , Humanos , Cirurgia Bucal/métodosRESUMO
Abstract The objective of this study was to map, through a scoping review, the evidence available in the literature on the use of platelet concentrates in compromised patients undergoing oral surgeries. Searches were performed in electronic databases for clinical studies with compromised patients undergoing oral surgery who used platelet concentrates. Only studies published in English were included. Two independent researchers carried out the selection of studies. The study design and objective, surgical procedure and platelet concentrate used, systemic involvement, analyzed outcome, and main results were extracted. A descriptive analysis of the data was performed. Twenty-two studies met the eligibility criteria and were included. Case series was the most frequent study design among the included studies (41.0%). In terms of systemic disability, 19 studies reported patients with cancer and related to surgical treatment 16 studies reported patients underwent treatment for osteonecrosis related to the use of the drug. The most used platelet concentrate was pure platelet-rich fibrin (P-PRF). In general, most studies recommend the use of platelet concentrates. Thus, the results of this study suggest that the evidence related to the use of platelet concentrates in compromised patients when undergoing oral surgeries is still initial. Also, most studies assessed the use of platelet concentrates in patients with osteonecrosis.
Resumo O objetivo do estudo foi mapear, através de uma revisão de escopo, as evidências disponíveis na literatura sobre o uso de agregrantes plaquetários em pacientes comprometidos e que realizaram cirurgias odontológicas. Pesquisas foram realizadas em bases de dados por estudos clínicos com pacientes comprometidos que realizaram cirurgia odontológica e usaram agragantes plaquetários. Apenas estudos em inglês foram incluídos. Dois pesquisadores independentes realizaram a seleção dos estudos. Os seguintes dados foram extraídos: desenho do estudo, objetivo, procedimento cirúrgico, agregante plaquetário usado, envolvimento sistêmico, desfecho analisado e principais resultados. Uma análise descritiva dos dados foi realizada. Vinte e dois estudos preencheram os critérios de elegibilidade e foram incluídos. Série de casos foi o desenho de estudo mais frequente entre os estudos incluídos (41,0%). Em relação ao comprometimento sistêmico, 19 estudos reportaram pacientes com câncer e em relação ao tratamento cirúrgico, 16 estudos reportaram pacientes que realizavam tratamento para osteonecrose relacionada ao uso de medicamentos. O agregante mais utilizado foi o plasma rico em fribina (P-PRF). Em geral, maioria dos estudos recomendou o uso dos agregantes plaquetários. Assim, os resultados desse estudo sugerem que a evidência relacionada ao uso de agregantes plaquetários em pacientes comprometidos que realizam cirurgia odontológica é ainda inicial. Ainda, a maioria dos estudos avaliaram o uso de agregantes plaquetários em pacientes com osteonecrose.
RESUMO
AIM: To evaluate the effects of progressive root canal enlargements on the unprepared surface area and remaining dentine thickness of three-rooted maxillary first premolars with different root configurations. METHODOLOGY: Thirty three-rooted maxillary first premolars with three root configurations (n = 10) were selected and scanned in a micro-CT device. The root canals were sequentially enlarged with rotary instruments sizes 30.02 (step 1), 30.04 (step 2) and 30.06 (step 3). After each step, a new scan was taken. Analysed parameters included morphometric measurements (length, volume and surface area), number of static voxels and minimal dentine thickness. Statistical analyses were performed with one-way anova post hoc Tukey tests and paired sample t-test at a significance level of 5%. RESULTS: No statistical differences were observed amongst groups regarding the morphometric parameters and static voxels (p > .05). The minimal dentine thickness of the distobuccal root significantly changed depending on the root configuration (p < .05), whilst no differences were observed in the other roots (p > .05). A great variation in the position of the minimal dentine thickness was observed after preparation. Overall, mean percentage reduction in dentine thickness was higher in the buccal roots than in the palatal root (p < .05). In the mesiobuccal and distobuccal root, the number of slices with minimal dentine thickness lower than 0.05 mm increases 2 to 3 times and 3 to 4 times, respectively, from steps 1 to 3. CONCLUSIONS: Instruments sizes 30.02 and 30.04 can be safely and effectively used to enlarge the buccal and palatal canals of three-rooted maxillary first premolars.
Assuntos
Cavidade Pulpar , Maxila , Dente Pré-Molar/diagnóstico por imagem , Cavidade Pulpar/diagnóstico por imagem , Dentina/diagnóstico por imagem , Maxila/diagnóstico por imagem , Preparo de Canal Radicular , Raiz Dentária/diagnóstico por imagem , Microtomografia por Raio-XRESUMO
This study evaluated the fracture strength of endodontically treated teeth submitted to reconstructive techniques through dynamic and static tests. Forty human anterior teeth were divided into 4 groups (n=10): GNW (non-weakened) - root restored with glass fiber post (GFP), GW - weakened root restored with GFP, GDA - weakened root restored with direct anatomic GFP, and GIA - weakened root restored with indirect anatomic GFP. The teeth were endodontically treated considering that experimental groups (GW, GDA and GIA) simulated weakened roots for restoration with GFP using different techniques. The GFP was luted with resin cement and the coronal portion was restored with composite resin and metallic crowns. All samples were submitted to chewing simulation at 60 cycles/min in a total of 300,000 cycles. The survival samples were further exposed to compressive loading at a crosshead speed of 1.0 mm/min in a universal testing machine. The load was applied at 135° to the long axis of the tooth until failure. Data were analyzed by ANOVA (a=0.05). After chewing simulation were observed: GNW: 100% of survival roots; GW: 70% of survival roots, and GDA and GIA: 80% of survival roots. The mean fracture strength values (N) were 280.6 (GNW), 239.0 (GW), 221.3 (GDA), and 234.1 (GIA) without significant difference among the groups (p=0.7476). The results suggested similar fracture strength in both weakened and non-weakened teeth regardless the reconstructive technique of root internal wall. Higher incidence of catastrophic fracture was observed in weakened teeth without restoration of the root internal wall.
Assuntos
Endodontia , Fraturas dos Dentes/patologia , HumanosRESUMO
Abstract This study evaluated the fracture strength of endodontically treated teeth submitted to reconstructive techniques through dynamic and static tests. Forty human anterior teeth were divided into 4 groups (n=10): GNW (non-weakened) - root restored with glass fiber post (GFP), GW - weakened root restored with GFP, GDA - weakened root restored with direct anatomic GFP, and GIA - weakened root restored with indirect anatomic GFP. The teeth were endodontically treated considering that experimental groups (GW, GDA and GIA) simulated weakened roots for restoration with GFP using different techniques. The GFP was luted with resin cement and the coronal portion was restored with composite resin and metallic crowns. All samples were submitted to chewing simulation at 60 cycles/min in a total of 300,000 cycles. The survival samples were further exposed to compressive loading at a crosshead speed of 1.0 mm/min in a universal testing machine. The load was applied at 135° to the long axis of the tooth until failure. Data were analyzed by ANOVA (a=0.05). After chewing simulation were observed: GNW: 100% of survival roots; GW: 70% of survival roots, and GDA and GIA: 80% of survival roots. The mean fracture strength values (N) were 280.6 (GNW), 239.0 (GW), 221.3 (GDA), and 234.1 (GIA) without significant difference among the groups (p=0.7476). The results suggested similar fracture strength in both weakened and non-weakened teeth regardless the reconstructive technique of root internal wall. Higher incidence of catastrophic fracture was observed in weakened teeth without restoration of the root internal wall.
Resumo Este estudo avaliou a resistência à fratura de dentes tratados endodonticamente submetidos a diferentes técnicas de reconstrução por meio de testes dinâmico e estático. Quarenta dentes humanos anteriores foram divididos em 4 grupos (n=10): GNW (não fragilizado): raiz restaurada com pino de fibra de vidro (PFV), GW: raiz fragilizada restaurada com PFV, GDA: raiz fragilizada restaurada com PFV anatômico direto, e GIA: raiz fragilizada restaurada com PFV anatômico indireto. Os dentes foram tratados endodonticamente considerando que nos grupos experimentais (GW, GDA e GIA) simulou-se fragilização radicular das raízes para restauração com PFV utilizando diferentes técnicas. Os PFV foi cimentados com cimento resinoso e a porção coronária foi restaurada com resina composta e coroa metálica. Todas as amostras foram submetidas a simulação de mastigação em 60 ciclos/min totalizando 300,000 ciclos. As amostras sobreviventes foram submetidas a teste de compressão com velocidade de 1,0 mm/min em máquina universal de ensaio. A carga foi aplicada a 135° em relação ao longo eixo do dente até a falha do dente. Os dados foram analisados por ANOVA (a=0,05). Após a simulação da mastigação foi observado: GNW: 100% de sobrevivência das raízes; GW: 70% de sobrevivência das raízes, e GDA e GIA: 80% de sobrevivência das raízes. O valor médio de resistência à fratura (N) foi de 280,6 (GNW), 239,0 (GW), 221,3 (GDA) e 234,1 (GIA) sem diferença significante entre os grupos (p=0,7476). Os resultados sugerem similar resistência à fratura em ambos os dentes fragilizados ou não-fragilizados em relação à técnica de reconstrução das paredes radiculares internas. Elevada incidência de fraturas catastróficas foram observadas nos dentes fragilizados sem a restauração das paredes radiculares internas.
Assuntos
Humanos , Endodontia , Fraturas dos Dentes/patologiaRESUMO
Scanning electron microscopy (SEM) can be used to analyze the presence of debris and smear layer on the internal walls of root canal. This study evaluated the debris and smear removal in flattened root canals using SEM after use of different irrigant agitation protocols. Fifty mandibular incisors were distributed into five groups (n = 10) according to the irrigant agitation protocol used during chemomechanical preparation: conventional syringe irrigation with NaviTip needle (no activation), active scrubbing of irrigant with brush-covered NaviTip FX needle, manual dynamic irrigation, continuous passive ultrasonic irrigation, and apical negative pressure irrigation (EndoVac system). Canals were irrigated with 5 mL of 2.5% NaOCl at each change of instrument and received a final flush with 17% EDTA for 1 min. After instrumentation, the roots were split longitudinally and SEM micrographs at ×100 and ×1,000 were taken to evaluate the amount of debris and smear layer, respectively, in each third. Data were analyzed by Kruskal-Wallis and Dunn's post-hoc tests (α = 5%). Manual dynamic activation left significantly (p < 0.05) more debris inside the canals than the other protocols, while ultrasonic irrigation and EndoVac were the most effective (p < 0.05) for debris removal. Regarding the removal of smear layer, there was no statistically significant difference (p > 0.05) either among the irrigant agitation protocols or between the protocol-canal third interactions. Although none of the irrigant agitation protocols completely removed debris and smear layer from flattened root canals, the machine-assisted agitation systems (ultrasound and EndoVac) removed more debris than the manual techniques.
Assuntos
Desbridamento/métodos , Cavidade Pulpar/patologia , Cavidade Pulpar/cirurgia , Irrigantes do Canal Radicular/administração & dosagem , Microscopia Eletrônica de Varredura , Resultado do TratamentoRESUMO
BACKGROUND: It remains unclear as to whether or not dental bleaching affects the bond strength of dentin/resin restoration. PURPOSE: To evaluated the bond strength of adhesive systems to dentin submitted to bleaching with 38% hydrogen peroxide (HP) activated by LED-laser and to assess the adhesive/dentin interfaces by means of SEM. STUDY DESIGN: Sixty fragments of dentin (25 mm²) were included and divided into two groups: bleached and unbleached. HP was applied for 20 s and photoactivated for 45 s. Groups were subdivided according to the adhesive systems (n = 10): (1) two-steps conventional system (Adper Single Bond), (2) two-steps self-etching system (Clearfil standard error (SE) Bond), and (3) one-step self-etching system (Prompt L-Pop). The specimens received the Z250 resin and, after 24 h, were submitted to the bond strength test. Additional 30 dentin fragments (n = 5) received the same surface treatments and were prepared for SEM. Data were analyzed by ANOVA and Tukey's test (α = 0.05). RESULTS: There was significant strength reduction in bleached group when compared to unbleached group (P < 0.05). Higher bond strength was observed for Prompt. Single Bond and Clearfil presented the smallest values when used in bleached dentin. SEM analysis of the unbleached specimens revealed long tags and uniform hybrid layer for all adhesives. In bleached dentin, Single Bond provided open tubules and with few tags, Clearfil determined the absence of tags and hybrid layer, and Prompt promoted a regular hybrid layer with some tags. CONCLUSIONS: Prompt promoted higher shear bond strength, regardless of the bleaching treatment and allowed the formation of a regular and fine hybrid layer with less deep tags, when compared to Single Bond and Clearfil.
Assuntos
Resinas Compostas/química , Cimentos Dentários/química , Dentina/química , Peróxido de Hidrogênio/farmacologia , Clareamento Dental/efeitos adversos , Adesividade/efeitos dos fármacos , Resinas Compostas/análise , Colagem Dentária , Restauração Dentária Permanente , Análise do Estresse Dentário , Dentina/fisiologia , Dentina/ultraestrutura , Humanos , Peróxido de Hidrogênio/química , Microscopia Eletrônica de Varredura/métodos , Dente/efeitos dos fármacos , Clareamento Dental/métodosRESUMO
OBJECTIVE: To evaluate the adhesion of the endodontic sealers Epiphany, Apexit Plus, and AH Plus to root canal dentin submitted to different surface treatments, by using the push-out test. METHODS: One hundred twenty-eight root cylinders obtained from maxillary canines were embedded in acrylic resin, had the canals prepared, and were randomly assigned to four groups (n = 32), according to root dentin treatment: (I) distilled water (control), (II) 17% EDTAC, (III) 1% NaOCl and (IV) Er:YAG laser with 16-Hz, 400-mJ input (240-mJ output) and 0.32-J/cm(2) energy density. Each group was divided into four subgroups (n = 8) filled with Epiphany (either dispensed from the automix syringe supplied by the manufacturer or prepared by hand mixing), Apexit Plus, or AH Plus. Data (MPa) were analyzed by ANOVA and Tukey's test. RESULTS: A statistically significant difference (p < 0.01) was found among the root-canal sealers, except for the Epiphany subgroups, which had statistically similar results to each other (p > 0.01): AH Plus (4.77 +/- 0.85), Epiphany/hand mixed (3.06 +/- 1.34), Epiphany/automix syringe (2.68 +/- 1.35), and Apexit Plus (1.22 +/- 0.33). A significant difference (p < 0.01) was found among the dentin surface treatments. The highest adhesion values were obtained with AH Plus when root dentin was treated with Er:YAG laser and 17% EDTAC. Epiphany sealer presented the lowest adhesion values to root dentin treated with 17% EDTAC. CONCLUSIONS: The resin-based sealers had different adhesive behaviors, depending on the treatment of root canal walls. The mode of preparation of Epiphany (automix syringe or hand mixing) did not influence sealer adhesion to root dentin.
Assuntos
Hidróxido de Cálcio/química , Dentina/química , Resinas Epóxi/química , Materiais Restauradores do Canal Radicular/química , Preparo de Canal Radicular/métodos , Adesividade , Colagem Dentária , Dentina/efeitos da radiação , Ácido Edético/química , Humanos , Lasers de Estado Sólido , Materiais Restauradores do Canal Radicular/efeitos da radiação , Hipoclorito de Sódio/químicaRESUMO
OBJECTIVE: This study evaluated ultra-structural dentine changes at the apical stop after CO(2) laser irradiation used during biomechanical preparation. BACKGROUND: Most studies evaluating the sealing efficiency of CO(2) lasers have been carried out after apical root canal resections and retro-filling procedures. METHODS: Sixty human canines were prepared with #1 to #6 Largo burs. The apical stops were established at 1 mm (n = 30) and 2 mm (n = 30) from the apex. Final irrigation was performed with 1% NaOCl and 15% EDTA followed by 20 ml of distilled and deionized water. Specimens were subdivided into three subgroups (n = 10 for each stop distance): GI- no radiation (n = 20); GII- 3W potency (n = 20), GIII- 5W potency (n = 20). After preparation, specimens were evaluated by scanning electron microscopy, with ultra-structural changes classified according to a scoring system based on six qualitatively different outcomes. RESULTS: Statistical analysis using the Mann-Whitney test confirmed more intense results for the specimens irradiated at 5 W potency than at 3 W (p < 0.0001). The Kruskal-Wallis test indicated that when using the same potencies (3 or 5 W) at 1 and 2 mm from the apex, there were no statistically significant differences in ultra-structural changes. CONCLUSIONS: Our results showed that ultra-structural changes ranged from smear layer removal to dentine fusion. As laser potency was increased from 3 to 5 W, ultra-structural changes included extensive fused lava-like areas sealing the apical foramen.
Assuntos
Dentina/efeitos da radiação , Dentina/ultraestrutura , Lasers , Preparo de Canal Radicular/métodos , Dióxido de Carbono , Relação Dose-Resposta à Radiação , Humanos , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular/farmacologia , Camada de Esfregaço , Raiz Dentária/efeitos da radiaçãoRESUMO
BACKGROUND: The topographical features of intraradicular dentine pretreated with sodium hypochlorite (NaOCl) or ethylenediamine tetraacetic acid (EDTA) followed by diode laser irradiation have not yet been determined. PURPOSE: To evaluate the alterations of dentine irradiated with 980-nm diode laser at different parameters after the surface treatment with NaOCl and EDTA. STUDY DESIGN: Roots of 60 canines were biomechanically prepared and irrigated with NaOCl or EDTA. Groups were divided according to the laser parameters: 1.5 W/CW; 1.5 W/100 Hz; 3.0 W/CW; 3.0 W/100 Hz and no irradiation (control). The roots were splited longitudinally and analyzed by scanning electron microscopy (SEM) in a quali-quatitative way. The scores were submitted to two-way Kruskal-Wallis and Dunn's tests. RESULTS: The statistical analysis demonstrated that the specimens treated only with NaOCl or EDTA (control groups) were statistically different (P < 0.05) from the laser-irradiated specimens, regardless of the parameter setting. The specimens treated with NaOCl showed a laser-modified surface with smear layer, fissures, and no visible tubules. Those treated with EDTA and irradiated by laser presented absence of smear layer, tubules partially exposed and melting areas. CONCLUSIONS: The tested parameters of 980-nm diode laser promoted similar alterations on dentine morphology, dependent to the type of surface pretreatment.
Assuntos
Dentina/efeitos da radiação , Dentina/ultraestrutura , Lasers Semicondutores , Preparo de Canal Radicular/métodos , Dentina/efeitos dos fármacos , Ácido Edético/farmacologia , Humanos , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular/farmacologia , Hipoclorito de Sódio/farmacologia , Raiz Dentária/efeitos dos fármacos , Raiz Dentária/efeitos da radiação , Raiz Dentária/ultraestruturaRESUMO
This study evaluated comparatively the adhesion of Epiphany and AH Plus endodontic sealers to human root dentin treated with 1% NaOCl and 1% NaOCl+17% EDTA, using the push-out test. Sixty root cylinders obtained from maxillary canines had the canals prepared and were randomly assigned to 3 groups (n=20), according to root dentin treatment: GI - distilled water (control), GII - 1% NaOCl and GIII - 1% NaOCl+17% EDTA. Each group was divided into 2 subgroups (n=10) filled with either Epiphany or AH Plus. Bond strength push-out test data (kN) were obtained and analyzed statistically by ANOVA and Tukey's post-hoc test. There was statistically significant difference between sealers (AH Plus: 0.78 +/- 0.13; Epiphany: 0.61 +/- 0.19; p<0.01) and among root dentin treatments (distilled water: 0.58 +/- 0.19; 1% NaOCl: 0.71 +/- 0.12; 1% NaOCl+17% EDTA: 0.80 +/- 0.17; p<0.05). In conclusion, AH Plus sealer presented greater adhesion to dentin than Epiphany, regardless of the treatment of root canal walls.
Assuntos
Colagem Dentária , Cavidade Pulpar/ultraestrutura , Dentina/ultraestrutura , Resinas Epóxi/química , Materiais Restauradores do Canal Radicular/química , Adesividade , Quelantes/química , Ácido Edético/química , Humanos , Teste de Materiais , Irrigantes do Canal Radicular/química , Preparo de Canal Radicular/métodos , Hipoclorito de Sódio/química , Estresse Mecânico , Propriedades de Superfície , Água/químicaRESUMO
This study evaluated comparatively the adhesion of Epiphany and AH Plus endodontic sealers to human root dentin treated with 1 percent NaOCl and 1 percent NaOCl+17 percent EDTA, using the push-out test. Sixty root cylinders obtained from maxillary canines had the canals prepared and were randomly assigned to 3 groups (n=20), according to root dentin treatment: GI - distilled water (control), GII - 1 percent NaOCl and GIII - 1 percent NaOCl+17 percent EDTA. Each group was divided into 2 subgroups (n=10) filled with either Epiphany or AH Plus. Bond strength push-out test data (kN) were obtained and analyzed statistically by ANOVA and Tukey's post-hoc test. There was statistically significant difference between sealers (AH Plus: 0.78 ± 0.13; Epiphany: 0.61 ± 0.19; p<0.01) and among root dentin treatments (distilled water: 0.58 ± 0.19; 1 percent NaOCl: 0.71 ± 0.12; 1 percent NaOCl+17 percent EDTA: 0.80 ± 0.17; p<0.05). In conclusion, AH Plus sealer presented greater adhesion to dentin than Epiphany, regardless of the treatment of root canal walls.
O objetivo do presente estudo foi avaliar a adesividade do cimento Epiphany à dentina radicular previamente tratada com hipoclorito de sódio a 1 por cento e EDTA a 17 por cento, em comparação ao cimento AH Plus, pelo método do "push-out". Foram preparados sessenta cilindros de raízes de caninos superiores humanos que foram distribuídos em 3 grupos (n=20) de acordo com o tratamento da dentina: GI água destilada (controle), GII hipoclorito de sódio 1 por cento e GIII EDTA 17 por cento. Esses grupos de corpos-de-prova foram distribuídos em 2 subgrupos para receber os cimentos obturadores a serem testados: Ephiphany e AH Plus. Foi realizado o teste do "push-out" e os resultados (em kN) foram analisados estatisticamente por ANOVA e o teste "post-hoc" de Tukey. A análise demonstrou diferença estatisticamente significativa entre os cimentos (AH Plus: 0,78 ± 0,13; Epiphany: 0,61 ± 0,19; p < 0,01) e entre as soluções testadas (água destilada: 0,58 ± 0,19; NaOCl: 0,71 ± 0,12; EDTA: 0,80 ± 0,17; p<0,05). Conclui-se que o cimento AH Plus apresentou valores de adesividade superiores aos obtidos pelo cimento Epiphany, independente do tratamento realizado nas paredes dos canais radiculares.
Assuntos
Humanos , Colagem Dentária , Cavidade Pulpar/ultraestrutura , Dentina/ultraestrutura , Resinas Epóxi/química , Materiais Restauradores do Canal Radicular/química , Adesividade , Quelantes/química , Ácido Edético/química , Teste de Materiais , Irrigantes do Canal Radicular/química , Preparo de Canal Radicular/métodos , Estresse Mecânico , Propriedades de Superfície , Hipoclorito de Sódio/química , Água/químicaRESUMO
BACKGROUND: Nerve sheath myxoma (NSM) is an extremely rare benign neoplasm in the oral cavity. This paper describes the first case, to our knowledge, of NSM in the gingival mucosa of an 84-year-old female patient. METHODS: Intraoral examination revealed a painless and well-defined nodule in the lingual gingival mucosa of the right mandibular lateral incisor, which measured approximately 1.0 cm in diameter. The lesion was fully excised under local anesthesia, without intercurrences. Hematoxylin and eosin staining was performed in 5-microm sections for histopathologic analysis. Immunohistochemical reactions against vimentin and S-100 protein were carried out in 3-microm histologic sections in accordance with manufacturers' instructions. RESULTS: The patient's medical history and an extraoral exam did not reveal other abnormalities. The patient wore a removable partial denture in the affected area. A trauma-induced gingival hyperplasia was the main diagnostic hypothesis. Microscopically, the lesion was composed of an abundant myxoid matrix and stellated and spindle-shaped cells arranged in lobules separated by fine fibrous septa. The cells presented strong positivity for vimentin and S-100 protein. According to the histopathologic and immunohistochemical features, the diagnosis of NSM was established. After 9 months of treatment, no signs or symptoms of recurrences have been observed. CONCLUSION: Although NSM is an extremely rare oral tumor, it should be considered in the clinical differential diagnosis of gingival nodules.
Assuntos
Neoplasias Gengivais/diagnóstico , Mixoma/diagnóstico , Neoplasias de Bainha Neural/diagnóstico , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Seguimentos , Hiperplasia Gengival/diagnóstico , Neoplasias Gengivais/patologia , Humanos , Incisivo/patologia , Mandíbula/patologia , Mixoma/patologia , Neoplasias de Bainha Neural/patologia , Proteínas S100/análise , Vimentina/análiseRESUMO
This laboratory study evaluated Er:YAG laser antibacterial action in infected root canals. Forty-eight maxillary central incisors were used. After canal preparation, the teeth were autoclaved and divided into four groups: (1) non-treated teeth (control group); (2) teeth treated with NaOCl; (3) teeth irradiated with Er:YAG laser (7 Hz, 100 mJ, 80 pulses/canal, 11 sec) to the working length; (4) teeth irradiated similarly to, but 3 mm short, of the apex. The root canals from Groups 2, 3 and 4 were inoculated with 4 bacteria: Bacillus subtillus, Enterococcus faecalis, Pseudomonas aeruginosa, and Staphylococcus aureus, together with Candida albicans, and maintained for 24 h at 37 degrees C. All suspensions were adjusted to tube 2 of the MacFarland scale. The intracanal material was then collected with sterile paper points, which were placed in the canals for 5 min and then immersed in 5 ml of BHI medium. This was then seeded onto agar and stained by Gram's method. The NaOCl solutions and the Er:YAG laser irradiation to working length were effective against all five micro-organisms; however, 70% of the specimens irradiated 3 mm short of the apex remained infected.
Assuntos
Cavidade Pulpar/microbiologia , Desinfecção/métodos , Terapia a Laser , Irrigantes do Canal Radicular/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Silicatos de Alumínio , Bacillus subtilis/efeitos dos fármacos , Bacillus subtilis/efeitos da radiação , Candida albicans/efeitos dos fármacos , Candida albicans/efeitos da radiação , Contagem de Colônia Microbiana , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/efeitos da radiação , Érbio , Humanos , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/efeitos da radiação , Preparo de Canal Radicular , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/efeitos da radiação , Ápice Dentário/microbiologia , ÍtrioRESUMO
This in vitro study evaluated the effect of Er:YAG laser on adhesion to human dentin of Grossman, Endomethasone, N-Rickert, and Sealer 26 root canal sealers. The crowns of 40 human molars were cut on the occlusal side until a flat dentin surface was obtained. The teeth were divided into two groups: group 1, no laser application; and group 2, irradiation with Er:YAG laser (KaVo Key Laser 2; 11 mm focal distance, perpendicular to the dentin surface, 4 Hz frequency, 200 mJ energy, 62 J total energy and 313 pulses, 1-min application time, and 2.25 W power). Five samples were tested for each sealer and each group. An Instron universal testing machine was used for the adhesion test. Sealer 26 showed the best adhesion both with and without laser application (p < 0.01). Grossman and N-Rickert sealers had intermediate values, and Endomethasone had the worst adhesion. Application of Er:YAG laser did not alter the adhesion of Grossman, N-Rickert, or Endomethasone sealers. However, laser application increased the adhesion of Sealer 26. The epoxy resin-based root canal sealer (Sealer 26) adhered better to dentin prepared with and without Er:YAG laser than the zinc oxide/eugenol-based sealers (Endomethasone, N-Rickert, and Grossman).