RESUMO
Background and Objectives: There is still considerable controversy regarding the possibility of submitting replanted teeth to orthodontic movement (OM). The purpose of the present study was to evaluate the tissue response after orthodontic movement on replanted teeth. Materials and Methods: Sixty Wistar rats were randomly assigned to four groups (n = 15): G1, replantation without OM after 30 days; G2, replantation with OM after 30 days; G3, replantation without OM after 60 days, and G4, replantation with OM after 60 days. The maxillary left central incisors were extracted and the teeth were stored in milk media. After 30 min, the teeth were replanted and fixed with non-rigid immobilization. All specimens were observed after 30 and 60 days of replantation and then subdivided into two subgroups (with OM or without OM). The animals were euthanized after seven days of the OM started, and the maxillary bone blocks were processed for histological evaluation. Results: The histological results showed periodontal ligament repair in both periods studied without OM; however, ankylosis and root resorption was seen in all orthodontically moved teeth. Conclusions: The orthodontic movement did not favor tissue response in all replanted teeth, regardless of the experimental periods.
Assuntos
Incisivo/patologia , Incisivo/cirurgia , Ligamento Periodontal/patologia , Reabsorção da Raiz/patologia , Técnicas de Movimentação Dentária/efeitos adversos , Reimplante Dentário , Animais , Incisivo/fisiopatologia , Modelos Animais , Fotomicrografia , Complicações Pós-Operatórias/patologia , Distribuição Aleatória , Ratos , Ratos Wistar , Reabsorção da Raiz/etiologia , Avulsão Dentária/cirurgia , Raiz Dentária/patologiaRESUMO
Objetivo: Describir la importancia del reconocimiento oportuno del trauma crónico de la mucosa bucal producido por un elemento dentario que generó una lesión erróneamente diagnosticada como neoplasia maligna. Caso clínico: Una paciente de sexo femenino, de 79 años de edad, realizó una consulta estomatológica por una lesión lingual con un diagnóstico presuntivo de cáncer. Tras la inspección de la cavidad bucal y el estudio anatomopatológico se diagnosticó úlcera asociada a trauma dentario. La intervención terapéutica odontológica (eliminación del trauma) resolvió el cuadro cínico. Conclusión: El trauma crónico en la mucosa bucal puede generar lesiones sobre mucosa sana o bien complicar una patología preexistente. En el presente caso, la inspección de la cavidad bucal con la identificación y la eliminación del trauma lograron la reparación de la lesión. El estudio anatomopatológico precisó el diagnóstico de ulceración asociada a trauma dentario (AU)
Aim: The aim of this case report is to show the importance of the early diagnosis of a traumatic lesion of the oral mucosa arising from a posterior broken tooth that was initially misdiagnosed as oral cancer. Case report: A 79-year-old female attends an appointment with the oral medicine specialist for a lesion on the lateral side of the tongue with a presumptive diagnosis of oral cancer. The examination of the oral cavity and the anatomopathological diagnosis confirmed the presence of an ulcer associated with dental trauma. The lesion healed completely with the elimination of the trauma. Conclusion: Chronic trauma in the oral cavity can produce lesions in the oral mucosa or exacerbate preexisting lesions. In this case report a thorough oral examination showed a broken tooth as the cause of trauma and after its removal the lesion healed completely. The result of the biopsy confirmed the diagnosis of an oral ulcer associated with dental trauma (AU)
Assuntos
Humanos , Feminino , Idoso , Doenças da Língua/diagnóstico , Úlceras Orais/diagnóstico , Diagnóstico Diferencial , Erros de Diagnóstico , Extração Dentária , Raiz Dentária/patologia , BiópsiaRESUMO
OBJECTIVE: Maxillary impacted canines (MIC) could suffer root changes after canine traction. The aim of this study was to evaluate the 3-dimensional root changes in buccal versus palatal MIC after orthodontic traction. MATERIALS AND METHODS: This longitudinal and retrospective study included pre-treatment and after traction cone beam computed tomography scans (CBCTs) of 30 subjects with unilateral/bilateral MIC. A total of 43 MIC were divided into 2 groups: buccal (n=17) or palatal (n=26). Root changes in length and area after orthodontic traction were measured at sagittal, coronal and axial sections. Intergroup comparison was carried out by t or U Mann-Whitney tests, depending on normality. Multiple linear regression analysis was used to evaluate the influence of all predictor variables on root changes (P<0.05). RESULTS: Significant difference between groups was found for root area changes in the upper limit of the cervical third at axial section that showed greater appositional values for the palatal impacted canine group (-1.18mm2) and resorptive values for the buccal impacted canine group (0.62mm2) (P=0.024). Position of impaction palatal influenced the increase of root area in the coronal section and in the upper limit of the cervical third at axial section. Age directly influenced the decrease of total length and root area in sagittal and coronal sections, respectively. CONCLUSION: Orthodontic traction of MIC produced an important appositional root change in the palatal impaction group in the axial root area of the upper limit of the cervical third. Impaction position and age influenced the increase and decrease of root area and length of some specific radicular regions.
Assuntos
Maxila/patologia , Boca/patologia , Palato/patologia , Raiz Dentária/patologia , Dente Impactado/patologia , Tração/métodos , Adolescente , Criança , Tomografia Computadorizada de Feixe Cônico , Dente Canino/diagnóstico por imagem , Dente Canino/patologia , Feminino , Humanos , Incisivo/diagnóstico por imagem , Incisivo/patologia , Estudos Longitudinais , Masculino , Maxila/diagnóstico por imagem , Boca/diagnóstico por imagem , Procedimentos de Ancoragem Ortodôntica/efeitos adversos , Procedimentos de Ancoragem Ortodôntica/métodos , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva/efeitos adversos , Palato/diagnóstico por imagem , Estudos Retrospectivos , Reabsorção da Raiz , Raiz Dentária/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Adulto JovemRESUMO
ABSTRACT Objective: The objective of this study was to assess the external apical root resorption (EARR) of the maxillary posterior teeth after intrusion with miniscrews. Methods: Fifteen patients (13 females and 2 males) with age ranging from 14.5 to 22 years (mean 18.1 ±2.03 years) were selected to participate in this study. All patients presented with anterior open bite of 3 mm or more. An intrusion force of 300 g was applied on each side to intrude the maxillary posterior teeth. Cone beam computed tomography (CBCT) scans were taken pretreatment and post-intrusion and were analyzed to evaluate the EARR. Results: The maxillary posterior teeth were intruded in average 2.79 ± 0.46 mm (p< 0.001) in 5.1 ± 1.3 months, and all examined roots showed statistically significant EARR (p< 0.05) with an average of 0.55 mm, except the distobuccal root of the left first permanent molars and both the palatal and buccal roots of left first premolars, which showed no statistically significant changes. Conclusions: The evaluated teeth presented statistically significant EARR, but clinically, due to the small magnitude, it was not considered significant. Moreover, the CBCT provided a good visualization of all roots in all three planes, and it was effective in detecting minimal degrees of EARR.
RESUMO Objetivo: o objetivo desse estudo foi verificar a existência de reabsorção radicular apical externa (RRAE) em dentes posterossuperiores após intrusão ancorada em mini-implantes. Métodos: quinze pacientes (13 mulheres e 2 homens) com a idade variando entre 14,5 e 22 anos (média de 18,1 ± 2,03 anos) foram selecionados para participar desse estudo. Todos os pacientes possuíam mordida aberta anterior de 3mm ou mais. Uma força de 300 gramas foi aplicada em cada lado para intruir os dentes posterossuperiores. Tomografias computadorizadas de feixe cônico (TCFC), adquiridas antes do tratamento e após a intrusão, foram comparadas para se avaliar a RRAE. Resultados: os dentes posterossuperiores foram intruídos em média 2,70 ± 0,46 mm (p< 0,001) em 5,1 ± 1,3 meses, e todas as raízes examinadas mostraram RRAE estatisticamente significativa (p< 0,05), com média de 0,55 mm, exceto pela raiz distovestibular dos primeiros molares permanentes esquerdos, e pelas raízes palatina e vestibular dos primeiros pré-molares esquerdos, que não apresentaram mudanças estatisticamente significativas. Conclusões: os dentes avaliados apresentaram RRAE estatisticamente significativa, a qual, porém, não foi considerada clinicamente significativa, devido à sua reduzida magnitude. Além disso, a TCFC possibilitou uma boa visualização de todas as raízes nos três planos espaciais, e foi eficaz para detecção de níveis mínimos de RRAE.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Reabsorção da Raiz/diagnóstico por imagem , Parafusos Ósseos/efeitos adversos , Imageamento Tridimensional/métodos , Mordida Aberta/terapia , Maxila/patologia , Maxila/diagnóstico por imagem , Reabsorção da Raiz/patologia , Técnicas de Movimentação Dentária/efeitos adversos , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Reabsorção de Dente/patologia , Reabsorção de Dente/diagnóstico por imagem , Raiz Dentária/patologia , Raiz Dentária/diagnóstico por imagem , Dente Pré-Molar , Mordida Aberta/diagnóstico por imagem , Análise do Estresse Dentário , Procedimentos de Ancoragem Ortodôntica/efeitos adversos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Dente Molar/fisiopatologiaRESUMO
Abstract Objective: The aim of this study was to evaluate a flapless surgical technique as an alternative to traditional alveolar corticotomy used to accelerate orthodontic tooth movement (OTM). Methods: To induce OTM in Wistar rats, 40 cN of orthodontic force were applied to the maxillary left first molars. Forty rats were distributed into control groups (CG1, CG3, CG7 and CG14) and experimental groups (n= 5), in which alveolar perforations were made using a spear-shaped guide bur (EG1, EG3, EG7, EG14). Euthanasia dates were set at 1, 3, 7 and 14 days, respectively, after tooth movement began. The amount of OTM was measured with a caliper, and osteoclasts present in the periodontal ligament of the mesial root of the moved tooth were counted by means of histological evaluation (tartrate-resistant acid phosphatase staining, TRAP). Results: Although there was no difference in the amount of OTM within subgroups of corresponding experimental periods (p> 0.05), when EG14 and CG14 were compared, a larger number of osteoclasts was counted in the experimental group (p< 0.00). Conclusion: The authors concluded that flapless cortical alveolar perforations led to more intense osteoclastic activity on the fourteenth day; nevertheless, no evidence of accelerated OTM could be noted.
Resumo Objetivo: o objetivo do presente estudo foi avaliar a técnica cirúrgica sem retalho como alternativa à tradicional corticotomia alveolar utilizada para acelerar o movimento dentário experimental. Métodos: para induzir a movimentação dentária experimental em ratos Wistar, foram aplicados 40 cN de força ortodôntica aos primeiros molares superiores esquerdos. Quarenta ratos foram distribuídos nos grupos (n = 5) controles (GC1, GC3, GC7 e GC14) e experimentais (GE1, GE3, GE7, GE14), nos quais foram realizadas perfurações alveolares com uma ponta lança. As datas de eutanásia foram estabelecidas em 1, 3, 7 e 14 dias, respectivamente, após o início do movimento dentário. A quantidade de deslocamento dentário foi medida com um paquímetro e os osteoclastos presentes no ligamento periodontal da raiz mesial do dente movimentado foram contados por meio de avaliação histológica (coloração por fosfatase ácida resistente ao tartarato, TRAP). Resultados: embora não tenha havido diferença na quantidade de deslocamento dentário dentro dos subgrupos dos períodos experimentais correspondentes (p> 0,05), quando GC14 e GE14 foram comparados, um número maior de osteoclastos foi contado no grupo experimental (p< 0,00). Conclusão: os autores concluíram que as perfurações alveolares corticais sem retalho levaram a uma atividade osteoclástica mais intensa no décimo quarto dia; entretanto, nenhuma evidência de movimento dentário acelerado pôde ser notada.
Assuntos
Animais , Masculino , Ratos , Osteoclastos/patologia , Técnicas de Movimentação Dentária/efeitos adversos , Técnicas de Movimentação Dentária/métodos , Processo Alveolar/patologia , Aparelhos Ortodônticos , Ligamento Periodontal/patologia , Fatores de Tempo , Raiz Dentária/patologia , Reabsorção Óssea , Remodelação Óssea , Ratos Wistar , Modelos Animais , Análise do Estresse Dentário , Maxila , Dente MolarRESUMO
INTRODUCTION: The objective of this research was to evaluate the buccal bone plate and root length of maxillary permanent first molars using cone-beam computed tomography after maxillary expansion with different activation protocols. METHODS: Cone-beam computed tomography images of growing patients were obtained from the orthodontic department of Pontifical Catholic University of Rio Grande do Sul in Brazil. The groups were Haas-type 2/4 turns, Haas-type 4/4 turns, hyrax-type 2/4 turns, and hyrax-type with alternate rapid maxillary expansions and constrictions (alt-RAMEC) 4/4 turns a day. Tooth length, periodontal insertion, alveolar bone thickness, and intermolar distances were evaluated. The data at the start of treatment and 6 months later were compared using generalized linear models. The intergroup differences were determined by univariate analysis of variance with the Bonferroni adjustment. RESULTS: Tooth length was significantly shortened after expansion in all groups (-0.28 to -0.51 mm), except for the alt-RAMEC group. Bone level variables (bone level and bone level at the tooth tip) changed statistically in all groups, except for the Haas 4/4 turns group. There was significant periodontal attachment loss after rapid maxillary expansion with the hyrax/alt-RAMEC (5.09 mm). The hyrax/alt-RAMEC and hyrax groups had more dehiscences, fenestrations, and exposures of the root. CONCLUSIONS: The consequence of rapid maxillary expansion using the hyrax was alveolar bone resorption, especially in the hyrax/alt-RAMEC group, whereas the Haas expander caused mild root resorption.
Assuntos
Placas Ósseas/efeitos adversos , Tomografia Computadorizada de Feixe Cônico/métodos , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Técnica de Expansão Palatina/efeitos adversos , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Adolescente , Perda do Osso Alveolar , Processo Alveolar/diagnóstico por imagem , Análise de Variância , Brasil , Criança , Arco Dental/anatomia & histologia , Arco Dental/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional , Masculino , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Procedimentos de Ancoragem Ortodôntica/efeitos adversos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Ortodontia Corretiva/instrumentação , Ortodontia Corretiva/métodos , Técnica de Expansão Palatina/instrumentação , Dente/anatomia & histologia , Dente/diagnóstico por imagem , Raiz Dentária/patologiaRESUMO
Several uprighting mechanics and devices have been used for repositioning tipped molars. "Kissing molars" (KMs) are an uncommon tooth impaction involving 2 severely tipped mandibular molars with their occlusal surfaces positioned crown to crown, with the roots pointing in opposite directions. Orthodontic uprighting of KMs has not been a usual treatment protocol, and it can be a challenging task due to the severe tipping and double impaction, requiring efficient and well-controlled uprighting mechanics. An innovative skeletally anchored cantilever, which uses the torque principle for uprighting tipped molars, is suggested. This torqued cantilever is easy to manufacture, install, and activate; it is a well-known torque that is effective for producing root movement. A successful treatment of symptomatic KMs, involving the first and second molars, was achieved with this cantilever. Thus, clinicians should consider the suggested uprighting mechanics and orthodontic device as a more conservative alternative to extraction of KMs, depending on the patient's age, involved teeth in KMs, tipping severity, and impaction positions.
Assuntos
Dente Molar/patologia , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico/métodos , Técnicas de Movimentação Dentária/métodos , Dente Impactado/terapia , Torque , Brasil , Cefalometria , Criança , Implantes Dentários , Análise do Estresse Dentário , Feminino , Humanos , Má Oclusão Classe II de Angle/terapia , Mandíbula/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Níquel/química , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico/instrumentação , Aparelhos Ortodônticos , Braquetes Ortodônticos , Fios Ortodônticos , Planejamento de Assistência ao Paciente , Radiografia Panorâmica , Estresse Mecânico , Titânio/química , Coroa do Dente , Erupção Dentária , Técnicas de Movimentação Dentária/instrumentação , Raiz Dentária/anatomia & histologia , Raiz Dentária/patologia , Dente Impactado/complicações , Dente Impactado/diagnóstico por imagem , Resultado do TratamentoRESUMO
The aim of this study is to evaluate the action of paramonochlorophenol associated with Furacin followed by calcium hydroxide (CH) dressing in the control of inflammatory root resorption in cases of immediate tooth replantation with delayed endodontic treatment. A total of 28 incisors of 3 male dogs were extracted and replanted after 15 minutes, and randomly divided into 3 groups: Group I (n = 8) - endodontic treatment was performed before the extraction and replantation; Group II (n = 10) - endodontic treatment was performed 30 days after replantation and the root canal was filled with CH dressing; Group III (n = 10) - endodontic treatment was performed 30 days after replantation and root canals received temporary medication of paramonochlorophenol-Furacin followed by CH dressing. The animals were euthanized 90 days after replantation. The histomorphological events analyzed at the epithelial reattachment site were the intensity and extent of acute and chronic inflammatory processes, periodontal ligament (PDL) organization, the intensity and extent of acute and chronic inflammatory processes in the PDL space, root resorption, bone tissue, and ankylosis. Data were submitted to the Wilcoxon Signed Ranks Test for group comparison (α = 5%). In Groups I, II and III the periodontal ligament was regenerated and most of the resorption areas were repaired by newly formed cementum. The depth and extent of root resorption were significantly higher in Group II than in Group III. The use of paramonochlorophenol-furacin followed by CH dressing was more effective in controlling inflammatory root resorption after immediate tooth replantation.
Assuntos
Anti-Infecciosos Locais/farmacologia , Clorofenóis/farmacologia , Nitrofurazona/farmacologia , Reabsorção da Raiz/prevenção & controle , Reimplante Dentário/métodos , Dente não Vital/tratamento farmacológico , Animais , Hidróxido de Cálcio/farmacologia , Cães , Masculino , Ilustração Médica , Ligamento Periodontal/efeitos dos fármacos , Ligamento Periodontal/patologia , Distribuição Aleatória , Reprodutibilidade dos Testes , Materiais Restauradores do Canal Radicular/farmacologia , Tratamento do Canal Radicular/métodos , Reabsorção da Raiz/patologia , Fatores de Tempo , Raiz Dentária/efeitos dos fármacos , Raiz Dentária/patologia , Dente não Vital/patologia , Resultado do TratamentoRESUMO
OBJECTIVE: The objective of this study was to assess the external apical root resorption (EARR) of the maxillary posterior teeth after intrusion with miniscrews. METHODS: Fifteen patients (13 females and 2 males) with age ranging from 14.5 to 22 years (mean 18.1 ±2.03 years) were selected to participate in this study. All patients presented with anterior open bite of 3 mm or more. An intrusion force of 300 g was applied on each side to intrude the maxillary posterior teeth. Cone beam computed tomography (CBCT) scans were taken pretreatment and post-intrusion and were analyzed to evaluate the EARR. RESULTS: The maxillary posterior teeth were intruded in average 2.79 ± 0.46 mm (p< 0.001) in 5.1 ± 1.3 months, and all examined roots showed statistically significant EARR (p< 0.05) with an average of 0.55 mm, except the distobuccal root of the left first permanent molars and both the palatal and buccal roots of left first premolars, which showed no statistically significant changes. CONCLUSIONS: The evaluated teeth presented statistically significant EARR, but clinically, due to the small magnitude, it was not considered significant. Moreover, the CBCT provided a good visualization of all roots in all three planes, and it was effective in detecting minimal degrees of EARR.
Assuntos
Parafusos Ósseos/efeitos adversos , Imageamento Tridimensional/métodos , Maxila/diagnóstico por imagem , Maxila/patologia , Mordida Aberta/terapia , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/patologia , Técnicas de Movimentação Dentária/efeitos adversos , Adolescente , Adulto , Dente Pré-Molar , Tomografia Computadorizada de Feixe Cônico/métodos , Análise do Estresse Dentário , Feminino , Humanos , Masculino , Dente Molar/fisiopatologia , Mordida Aberta/diagnóstico por imagem , Procedimentos de Ancoragem Ortodôntica/efeitos adversos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Reabsorção de Dente/diagnóstico por imagem , Reabsorção de Dente/patologia , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/patologia , Adulto JovemRESUMO
OBJECTIVE: The aim of this study was to evaluate a flapless surgical technique as an alternative to traditional alveolar corticotomy used to accelerate orthodontic tooth movement (OTM). METHODS: To induce OTM in Wistar rats, 40 cN of orthodontic force were applied to the maxillary left first molars. Forty rats were distributed into control groups (CG1, CG3, CG7 and CG14) and experimental groups (n= 5), in which alveolar perforations were made using a spear-shaped guide bur (EG1, EG3, EG7, EG14). Euthanasia dates were set at 1, 3, 7 and 14 days, respectively, after tooth movement began. The amount of OTM was measured with a caliper, and osteoclasts present in the periodontal ligament of the mesial root of the moved tooth were counted by means of histological evaluation (tartrate-resistant acid phosphatase staining, TRAP). RESULTS: Although there was no difference in the amount of OTM within subgroups of corresponding experimental periods (p> 0.05), when EG14 and CG14 were compared, a larger number of osteoclasts was counted in the experimental group (p< 0.00). CONCLUSION: The authors concluded that flapless cortical alveolar perforations led to more intense osteoclastic activity on the fourteenth day; nevertheless, no evidence of accelerated OTM could be noted.
Assuntos
Processo Alveolar/patologia , Osteoclastos/patologia , Técnicas de Movimentação Dentária/efeitos adversos , Técnicas de Movimentação Dentária/métodos , Animais , Remodelação Óssea , Reabsorção Óssea , Análise do Estresse Dentário , Masculino , Maxila , Modelos Animais , Dente Molar , Aparelhos Ortodônticos , Ligamento Periodontal/patologia , Ratos , Ratos Wistar , Fatores de Tempo , Raiz Dentária/patologiaRESUMO
BACKGROUND/AIM: The aim of this study was to test and validate a new model of extrusive luxation trauma on maxillary first molars of rats. MATERIAL AND METHODS: Forty adult male rats (Rattus norvegicus albinus, Wistar; weight = 230-250 g), 45 days old, were divided into eight groups (n = 5): control groups, in which animals were not subjected to any procedure and waited 1 day (GC1D) or 3 days (GC3D) for euthanasia, and experimental groups, in which animals were subjected to forces of 1100cN, 1300cN, or 1500cN and waited 1 or 3 days for euthanasia (GT1100/1D, GT1100/3D, GT1300/1D, GT1300/3D, GT1500/1D, GT1500/3D). In animals of the experimental groups, trauma was produced by an extrusive force in maxillary first right molars. Four-micrometer serial cuts stained with hematoxylin and eosin (HE) were made. Descriptive microscopic analysis of first upper right molar and semi-quantitative analysis (scores 1 to 4) of intensity of acute and chronic inflammation and vascular changes in the periodontal ligament and active and inactive external root resorption were conducted. The distribution of scores in the groups was compared using the Freeman-Halton extension of Fisher's exact test. The significance level was 5%. RESULTS: It was observed that vascular disorders (bleeding) on the periodontal ligament became more evident with increasing extrusive force. CONCLUSIONS: This new method was capable of generating histological changes, proving its secure application in this research area. The 1500cN force produced more damage on the periodontal ligament. CLINICAL RELEVANCE: The validation of a new experimental method can produce more reliable evidence in further research.
Assuntos
Modelos Animais de Doenças , Dente Molar/lesões , Avulsão Dentária/patologia , Animais , Tecido Conjuntivo/lesões , Tecido Conjuntivo/patologia , Ligadura , Masculino , Maxila , Ligamento Periodontal/lesões , Ligamento Periodontal/patologia , Ratos , Ratos Wistar , Raiz Dentária/lesões , Raiz Dentária/patologiaRESUMO
Abstract The aim of this study is to evaluate the action of paramonochlorophenol associated with Furacin followed by calcium hydroxide (CH) dressing in the control of inflammatory root resorption in cases of immediate tooth replantation with delayed endodontic treatment. A total of 28 incisors of 3 male dogs were extracted and replanted after 15 minutes, and randomly divided into 3 groups: Group I (n = 8) - endodontic treatment was performed before the extraction and replantation; Group II (n = 10) - endodontic treatment was performed 30 days after replantation and the root canal was filled with CH dressing; Group III (n = 10) - endodontic treatment was performed 30 days after replantation and root canals received temporary medication of paramonochlorophenol-Furacin followed by CH dressing. The animals were euthanized 90 days after replantation. The histomorphological events analyzed at the epithelial reattachment site were the intensity and extent of acute and chronic inflammatory processes, periodontal ligament (PDL) organization, the intensity and extent of acute and chronic inflammatory processes in the PDL space, root resorption, bone tissue, and ankylosis. Data were submitted to the Wilcoxon Signed Ranks Test for group comparison (α = 5%). In Groups I, II and III the periodontal ligament was regenerated and most of the resorption areas were repaired by newly formed cementum. The depth and extent of root resorption were significantly higher in Group II than in Group III. The use of paramonochlorophenol-furacin followed by CH dressing was more effective in controlling inflammatory root resorption after immediate tooth replantation.
Assuntos
Animais , Masculino , Cães , Reabsorção da Raiz/prevenção & controle , Reimplante Dentário/métodos , Clorofenóis/farmacologia , Dente não Vital/tratamento farmacológico , Anti-Infecciosos Locais/farmacologia , Nitrofurazona/farmacologia , Ligamento Periodontal/efeitos dos fármacos , Ligamento Periodontal/patologia , Materiais Restauradores do Canal Radicular/farmacologia , Tratamento do Canal Radicular/métodos , Reabsorção da Raiz/patologia , Fatores de Tempo , Raiz Dentária/efeitos dos fármacos , Raiz Dentária/patologia , Hidróxido de Cálcio/farmacologia , Distribuição Aleatória , Reprodutibilidade dos Testes , Resultado do Tratamento , Dente não Vital/patologia , Ilustração MédicaRESUMO
INTRODUCTION: In this study, we investigated if apical periodontitis (AP) associated with diabetes influenced the levels of endogenous antioxidants, the total antioxidant capacity (TAC), and the oxidant parameter in the serum of Wistar rats. METHODS: Forty male rats were divided into 4 equal groups: normal rats (N), rats with AP (AP), diabetic rats (D), and diabetic rats with AP (D + AP). Diabetes was induced by alloxan (150 mg/kg). AP was induced by exposing the pulpal tissue to the oral environment. After 36 days, blood and maxillae were collected. Albumin, bilirubin, uric acid, TAC, and malondialdehyde (MDA) levels were measured, and histologic analysis of the maxillae was performed. P < .05 was set as the threshold for statistical significance. RESULTS: Uric acid levels were higher in the D + AP group when compared with that of the N, D, and AP groups (P < .05). The MDA concentration was higher in the D and D + AP groups when compared with the N and AP groups (P < .05). The level of albumin was lower in the D + AP group when compared with the N, AP, and D groups. Inflammatory infiltration was more intense in the periapical region in the D + AP group compared with that in the AP group (P < .05). CONCLUSIONS: Our findings indicate that diabetes may change the antioxidant status, increase the concentration of MDA and uric acid, and decrease albumin levels in the serum. In addition, AP can potentiate the effects of diabetes by reducing the levels of albumin and increasing the levels of uric acid.
Assuntos
Diabetes Mellitus Experimental/metabolismo , Estresse Oxidativo , Periodontite Periapical/metabolismo , Animais , Polpa Dentária/patologia , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/complicações , Masculino , Periodontite Periapical/complicações , Periodontite Periapical/patologia , Ratos , Ratos Wistar , Raiz Dentária/patologiaRESUMO
Radicular cyst is the most common inflammatory jaw cystic lesion that occurs in necrotic teeth. They account for more than 50 % of all odontogenic cysts. Radicular cysts cause slowly progressive painless swelling and there are no symptoms until they become large. Enucleating the cyst with endodontic therapy of the affected tooth is recommended as the primary treatment. Here we describe a patient with a large recurrent radicular cyst with maxillary sinus involvement who underwent a midfacial degloving approach for complete enucleation. In conclusion, radicular cyst should be considered in the differential diagnosis of large maxillary sinus lesions and never be discarded until histopathology is available.
El quiste radicular es la lesión inflamatoria quística más común que ocurre en los dientes necróticos. Su presentación abarca más del 50 % de los quistes odontogénicos. Los quistes radiculares se presentan como una inflamación indolora de crecimiento lento y progresivo y se hacen sintomáticas una vez que alcanzan un gran tamaño. El tratamiento primario recomendado para este quiste es la enucleación junto al tratamiento endodóntico de los dientes afectados. Presentamos un reporte de caso de un paciente que presentaba un gran quiste radicular recurrente con envolvimiento de todo el seno maxilar y que fue tratado con un acceso intraoral extendido para lograr la completa enucleación de la lesión. En conclusión, el quiste radicular debe ser siempre considerado en el diagnóstico diferencial de lesiones de gran tamaño que involucren el seno maxilar y nunca ser descartado hasta tener el resultado de histopatología.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Doenças Maxilares/cirurgia , Cisto Radicular/diagnóstico por imagem , Cisto Radicular/cirurgia , Diagnóstico Diferencial , Radiografia Panorâmica , Recidiva , Tomografia Computadorizada por Raios X , Raiz Dentária/patologiaRESUMO
Objetivo: describir, mediante un caso clínico, una técnica quirúrgica para la optimización del injerto conectivo libre subepitelial en la cobertura de recesiones gingivales contiguas múltiples. Caso clínico: Una paciente de sexo femenino, de 57 años de edad, concurrió a la consulta con recesiones clase III de Miller, abfracciones, erosiones y malposición. El procedimiento quirúrgico elegido fue la técnica de desplazado coronal con incisiones oblicuas. Se realizó la toma de un injerto conectivo subepitelial y se lo optimizó en seis porciones trian-gulares, de manera tal que cada una abarcara una recesión desde el 13 hasta el 23. Se efectuó el seguimiento de la cicatrización y de la estabilidad de la cobertura radicular a los 90 días.Conclusión: Este nuevo abordaje quirúrgico es una alternativa válida para cubrir recesiones gingivales múltiples en un solo procedimiento, al poder aprovechar al máximo la utilización de un injerto conectivo libre subepitelial.
Aim: to present the surgical resolution of a clinical caseof multiple gingival recessions treated with a novel approach.Case report: A 57 year-old non-smoking female patientwith Miller Class III gingival recessions abfractions, erosionsand tooth malposition came to the consultation. The treatmentthat was chosen consisted in covering the gingival recessionswith a coronal advanced flap with oblique incisions. A subephitelialgingival graft was harvested from the palate andan optimization in triangular portions was made, in order touse one portion for each recession. Healing and stability wererecorded for a 90 days follow-up period.Conclusion: This new surgical approach could be analternative for the treatment of multiple gingival recessionsin a single procedure, as the use of the ILS could be maximized.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Raiz Dentária/patologia , Retração Gengival/cirurgia , Tecido Conjuntivo/transplante , Transplante de Tecidos/métodos , Argentina , Cicatrização/fisiologia , Retalhos Cirúrgicos/métodos , Procedimentos Cirúrgicos Bucais/métodos , Faculdades de Odontologia , Técnicas de SuturaRESUMO
OBJECTIVE: The aim of this retrospective study was to evaluate the long-term effects of orthodontic traction on root length and alveolar bone level in impacted canines and adjacent teeth. MATERIAL AND METHODS: Sample consisted of 16 patients (nine males and seven females), mean initial age 11 years and 8 months presenting with unilaterally maxillary impacted canines, palatally displaced, treated with the same surgical and orthodontic approach. Teeth from the impacted-canine side were assigned as Group I (GI), and contralateral teeth as control, Group II (GII). The mean age of patients at the end of orthodontic treatment was 14 years and 2 months and the mean post-treatment time was 5 years and 11 months. Both contralateral erupted maxillary canines and adjacent teeth served as control. Root length and alveolar bone level (buccal and palatal) were evaluated on cone-beam computed tomography (CBCT) images. The comparison of root length and alveolar bone level changes between groups were assessed by applying paired t-test, at a significance level of 5% (p<0.05). RESULTS: There were no statistically significant differences in root length and buccal and palatal bone levels of canines and adjacent teeth among groups. CONCLUSIONS: Impacted canine treatment by closed-eruption technique associated with canine crown perforation, has a minimal effect on root length and buccal and palatal alveolar bone level in both canine and adjacent teeth, demonstrating that this treatment protocol has a good long-term prognosis.
Assuntos
Processo Alveolar/patologia , Dente Canino/patologia , Extrusão Ortodôntica/efeitos adversos , Técnicas de Movimentação Dentária/efeitos adversos , Raiz Dentária/patologia , Dente Impactado/terapia , Perda do Osso Alveolar/etiologia , Processo Alveolar/diagnóstico por imagem , Criança , Tomografia Computadorizada de Feixe Cônico , Dente Canino/diagnóstico por imagem , Feminino , Humanos , Masculino , Extrusão Ortodôntica/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Reabsorção da Raiz/etiologia , Estatísticas não Paramétricas , Fatores de Tempo , Erupção Ectópica de Dente/etiologia , Técnicas de Movimentação Dentária/métodos , Raiz Dentária/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Resultado do TratamentoRESUMO
Abstract Objective The aim of this retrospective study was to evaluate the long-term effects of orthodontic traction on root length and alveolar bone level in impacted canines and adjacent teeth. Material and Methods Sample consisted of 16 patients (nine males and seven females), mean initial age 11 years and 8 months presenting with unilaterally maxillary impacted canines, palatally displaced, treated with the same surgical and orthodontic approach. Teeth from the impacted-canine side were assigned as Group I (GI), and contralateral teeth as control, Group II (GII). The mean age of patients at the end of orthodontic treatment was 14 years and 2 months and the mean post-treatment time was 5 years and 11 months. Both contralateral erupted maxillary canines and adjacent teeth served as control. Root length and alveolar bone level (buccal and palatal) were evaluated on cone-beam computed tomography (CBCT) images. The comparison of root length and alveolar bone level changes between groups were assessed by applying paired t-test, at a significance level of 5% (p<0.05). Results There were no statistically significant differences in root length and buccal and palatal bone levels of canines and adjacent teeth among groups. Conclusions Impacted canine treatment by closed-eruption technique associated with canine crown perforation, has a minimal effect on root length and buccal and palatal alveolar bone level in both canine and adjacent teeth, demonstrating that this treatment protocol has a good long-term prognosis.
Assuntos
Humanos , Masculino , Feminino , Criança , Dente Impactado/terapia , Técnicas de Movimentação Dentária/efeitos adversos , Raiz Dentária/patologia , Dente Canino/patologia , Extrusão Ortodôntica/efeitos adversos , Processo Alveolar/patologia , Reabsorção da Raiz/etiologia , Fatores de Tempo , Erupção Ectópica de Dente/etiologia , Dente Impactado/diagnóstico por imagem , Técnicas de Movimentação Dentária/métodos , Raiz Dentária/diagnóstico por imagem , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Perda do Osso Alveolar/etiologia , Resultado do Tratamento , Estatísticas não Paramétricas , Dente Canino/diagnóstico por imagem , Extrusão Ortodôntica/métodos , Tomografia Computadorizada de Feixe Cônico , Processo Alveolar/diagnóstico por imagemRESUMO
AIM: To evaluate the immunoexpression of tryptase, MMP-9 and MMP-13 in periapical lesions, correlating them with the type of lesion, intensity of the inflammatory infiltrate and thickness of the epithelial lining. METHODOLOGY: Twenty periapical granulomas (PGs), twenty radicular cysts (RCs) and twenty residual radicular cysts (RRCs) were submitted to immunohistochemical analysis using antitryptase, anti-MMP-9 and anti-MMP-13 antibodies. Immunoexpression of MMP-9 and MMP-13 was quantitatively evaluated both in the connective tissue of all lesions and in the epithelial lining of RCs and RRCs. Tryptase-positive mast cells were counted only in the connective tissue. The data were analysed using Kruskal-Wallis and Fisher's exact tests, as well as Spearman's correlation test (P < 0.05). RESULTS: In comparison with RCs and RRCs, PGs exhibited higher immunoexpression of tryptase, MMP-9 and MMP-13 (P = 0.002, P = < 0.001 and P < 0.001, respectively). In comparison with lesions with inflammatory infiltrates grades I and II, lesions with inflammatory infiltrate grade III had higher median percentages of MMP-13-positive cells (P = 0.003) and a tendency for higher expression of MMP-9 (P = 0.059). No significant difference was observed between the expression of the studied markers and epithelial thickness (P > 0.05). There were positive correlations between the number of tryptase-positive mast cells and the immunoexpression of MMP-9, as well as between the immunoexpression of MMP-9 and MMP-13. CONCLUSION: A larger number of tryptase-positive mast cells and greater enzymatic activity of MMP-9 and MMP-13 were found in PGs compared to RCs and RRCs. These findings are a characteristic of the dynamics of periapical diseases.
Assuntos
Mastócitos/patologia , Metaloproteinase 13 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Granuloma Periapical/patologia , Cisto Radicular/patologia , Triptases/metabolismo , Tecido Conjuntivo/patologia , Epitélio/patologia , Humanos , Técnicas Imunoenzimáticas , Estatísticas não Paramétricas , Raiz Dentária/patologiaRESUMO
AIM: To analyse the immunoreactivity of IL-1α, TNF-α and IL-10 in odontogenic cysts and tumours and to investigate possible associations with established biological behaviours of these different lesions. METHODOLOGY: Immunohistochemical expression of anti-IL-1α, anti-TNF-α and anti-IL-10 antibodies was assessed on epithelium and mesenchyme of 20 radicular cysts (RCs), 20 residual cysts (RECs), 20 dentigerous cysts (DCs), 18 solid ameloblastomas (SAs), 20 keratocystic odontogenic tumours (KCOTs) and 15 dental follicles (DFs). Comparative analysis of data was performed using the nonparametric Wilcoxon signed-rank test and Kruskal-Wallis's test. RESULTS: Significantly greater expression of IL-1α in the epithelium was noted in RC, KCOT and SA (P = 0.01), whilst IL-10 and TNF-α was in the epithelium of RC, DC and KCOT (P < 0.01). In the mesenchyme, significantly greater immunopositivity was observed for IL-1α, IL-10 and TNF-α in KCOT, DC and RC (P < 0.01). In epithelial and mesenchymal tissues, there were a significant number of cases of RC and DC with IL-1α < IL-10 ratio (P < 0.01), whilst SA and KCOT showed IL-1α > IL-10 (P < 0.01). There was a significantly greater percentage of DF, DC and KCOT with TNF-α > IL10 ratio (P < 0.01). CONCLUSION: These results suggest involvement of the proteins in the pathogenesis of odontogenic cysts and tumours, with emphasis on the highest immunoreactivity of osteolysis stimulating factors in tumours with aggressive biological behaviour, such as SA and KCOT.
Assuntos
Cistos Odontogênicos/imunologia , Tumores Odontogênicos/imunologia , Cisto Radicular/imunologia , Saco Dentário/imunologia , Saco Dentário/patologia , Epitélio/imunologia , Epitélio/patologia , Humanos , Técnicas Imunoenzimáticas , Mesoderma/imunologia , Mesoderma/patologia , Cistos Odontogênicos/patologia , Tumores Odontogênicos/patologia , Cisto Radicular/patologia , Raiz Dentária/imunologia , Raiz Dentária/patologia , Fator de Necrose Tumoral alfaRESUMO
BACKGROUND: Aim of this study was to investigate the influence of gutta-percha and metallic posts on the efficiency of Cone Beam Computed Tomography (CBCT) in diagnosing Vertical Root Fracture (VRF). METHODS: Forty-eight teeth were divided into 3 experimental and 3 control groups. The teeth of the first experimental group and the first control group received neither gutta-percha nor metal posts. The teeth of the second experimental group and the second control group were filled with gutta-percha, and the teeth of the third experimental group and the third control group were filled with the metal posts. The teeth of the experimental groups were artificially fractured. The teeth were evaluated through images taken by a Prexion scanner with a 0.1 mm resolution. Fisher's exact test was used to measure the following values: sensitivity, false negative, specificity, false positive and accuracy for the VRF detection through the scanner. Three observers calibrated and blinded to the protocol evaluated the images. RESULTS: The inter-observer Kappa coefficient was 0.83. The presence of posts and gutta-percha reduced the sensitivity and the accuracy in detecting the VRF. Regarding to the sensitivity (p = 0.837, p = 0.304, p = 0.837 for evaluator 1, 2 and 3, respectively) and specificity (p = 0.162, p = 0.056, p = 0.062 for evaluator 1, 2 and 3, respectively), Fisher's exact test showed no statistically significant difference among the evaluated groups. However, a significant difference was observed in relation to the accuracy in the results of evaluator 2 (p = 0.03), which showed a much lower accuracy for the post group (50 %) than for the Nonfilled group (93.8 %). CONCLUSIONS: The Prexion tomograph was precise in detecting vertical root fractures and the CBCT diagnostic ability was not influenced by the presence of posts or gutta-percha.