RESUMO
BACKGROUND: Vital pulp therapy aims at maintaining the pulp tissue injured but vital. Thus, the use of capping materials that induce tissue regeneration is a great current trend. This study aims to evaluate clinically and radiographically the pulp repair after the use of dentin-pulp biostimulation membrane in primary teeth. METHODS: Four hundred and sixty-eight teeth from children aged between 5 and 9 years old, both genders, with deep caries lesion with pulp involvement, but no furcal impairment and any sign of necrosis will be selected. The vital pulp therapy will be performed with mineral trioxide aggregate (control group) and dentin-pulp biostimulation chitosan membrane (BBio group). The clinical and radiographic outcomes will be assessed at 12 and 24 months after treatment. The thickness of the dentin barrier will be verified through Image J2 software. The Wilcoxon signed rank test and Mann-Whitney test will respectively compare the intra- and intergroup clinical and radiographic outcomes. Paired t test and independent t test will respectively compare the intra- and intergroup radiographic measurements. The logistic regression will be applied, and the degrees of this association will be measured using odds ratio (OR) and 95% confidence interval (95% CI). DISCUSSION: Therefore, this study protocol aims at new perspectives of vital pulp therapy of primary teeth by employing new easy-handling, low-cost material to keep viable the pulp tissue capable of regenerating and maintain the physiological process of deciduous tooth exfoliation. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials RBR-6vr58b . Registered on 17 February 2019.
Assuntos
Cárie Dentária , Pulpotomia , Brasil , Criança , Pré-Escolar , Cárie Dentária/diagnóstico por imagem , Cárie Dentária/terapia , Dentina/diagnóstico por imagem , Combinação de Medicamentos , Feminino , Humanos , Masculino , Óxidos , Ensaios Clínicos Controlados Aleatórios como Assunto , Dente Decíduo , Resultado do TratamentoRESUMO
PURPOSE: The aim of this study was to evaluate the readability and the quality of toothache-related information found in Brazilian websites. MATERIALS AND METHODS: Fifty-five websites retrieved from Google Search, Baidu, Yahoo! and Bing were evaluated by two independent examiners using the DISCERN questionnaire, the Journal of American Medical Association (JAMA) benchmark criteria and the Flesch Reading Ease adapted to Brazilian Portuguese (FRE-BP). Additionally, the websites were categorised according to their information, adopting four criteria related to: (i) endodontic pain, (ii) toothache relief or treatment, (iii) the self-resolution of pain, and (iv) the promotion of home remedies usage. The statistical analysis was performed using Spearman's rank correlation coefficient, Mann-Whitney U test, hierarchical clustering analysis by Ward's minimum variance method, Kruskal-Wallis test, post-hoc Dunn's test and Chisquare test. P < 0.05 was considered statistically significant. RESULTS: The overall means (± SD) of DISCERN and FRE-BP were, respectively, 31.02 (± 5.56) and 61.20 (± 11.79), without quality-based differences between the websites with health- and non-health-related authors, and distinct clusters. CONCLUSION: Therefore, the quality of toothache-related information found in this sample of Brazilian websites was classified as simple, accessible and of poor quality, which can hamper the personal decision-making process of seeking dental treatment, leading to damages caused by the non-effective self-management of toothache.
Assuntos
Informação de Saúde ao Consumidor , Odontalgia , Brasil , Compreensão , Humanos , Internet , Inquéritos e QuestionáriosRESUMO
This study aimed to compare the effects of photobiomodulation (PBM) in different energy densities and irradiances on maintaining cell viability, and proliferation of pulp fibroblasts from human primary teeth (HPF) were cultured in DMEM and used between the fourth and eighth passages. Then, HPF were irradiated with the following different energy densities: 1.25 J/cm2 (a), 2.50 J/cm2 (b), 3.75 J/cm2 (c), 5.00 J/cm2 (d), and 6.25 J/cm2 (e); but varying either the time of irradiation (groups 1a-1e) or the output power (groups 2a-2e). Positive (groups 1f and 2f) and negative controls (groups 1g and 2g), respectively, comprised non-irradiated cells grown in regular nutritional conditions (10% fetal bovine serum [FBS]) and under nutritional deficit (1% FBS). Cell viability and proliferation were respectively assessed through MTT and crystal violet (CV) assays at 24, 48, and 72 h after irradiation. Statistical analysis was performed by two-way ANOVA, followed by Tukey test (P < 0.05). The negative controls showed significantly lower viability in relation to most of the corresponding subgroups, both for MTT and CV assays. For both assays, the intragroup comparison showed that the periods of 24 h exhibited lower viability than the periods of 48 and 72 h for most of the subgroups, except the negative controls with lower viability. The different irradiation protocols (equal energy densities applied with different irradiances) showed no statistically significant differences on cell viability and proliferation at the evaluated periods. The proposed PBM in different energy densities and irradiance did not affect the viability and proliferation of pulp fibroblasts from human primary teeth.
Assuntos
Polpa Dentária/citologia , Fibroblastos/efeitos da radiação , Terapia com Luz de Baixa Intensidade , Dente Decíduo/citologia , Animais , Contagem de Células , Proliferação de Células/efeitos da radiação , Forma Celular/efeitos da radiação , Sobrevivência Celular/efeitos da radiação , Células Cultivadas , Criança , Pré-Escolar , Humanos , Mitocôndrias/efeitos da radiaçãoRESUMO
The current study developed through layer-by-layer deposition a multilayer membrane for intraoral drug delivery and analyzed the biochemical, functional, and biological properties of this membrane. For that purpose, we designed a three-layer chlorhexidine-incorporated membrane composed by pure chitosan and alginate. The biochemical, functional, and biological properties were analyzed by the following tests: degradation in saliva medium; controlled drug release; water absorption, mass loss; pH analysis; and biocompatibility through fibroblast cell viability by MTT assay. All tests were conducted at three different periods (24, 48 and 72hours). The results demonstrated that hybrid membranes composed by alginate and chitosan with glycerol had greater water absorption and mass loss in buffer solution and in artificial saliva. The controlled drug release test revealed that the hybrid membrane exhibited greater drug release (0.075%). All chlorhexidine-incorporated membranes reduced the cell viability, and chitosan membranes with and without glycerol did not interfere with fibroblast viability. The biochemical and biophysical characteristics of the designed membranes and the findings of cell viability tests indicate great potential for application in Dentistry.
Assuntos
Alginatos , Quitosana , Clorexidina , Portadores de Fármacos , Membranas Artificiais , Alginatos/química , Alginatos/farmacocinética , Alginatos/farmacologia , Animais , Quitosana/química , Quitosana/farmacocinética , Quitosana/farmacologia , Clorexidina/química , Clorexidina/farmacocinética , Clorexidina/farmacologia , Preparações de Ação Retardada/química , Preparações de Ação Retardada/farmacocinética , Preparações de Ação Retardada/farmacologia , Odontologia , Portadores de Fármacos/química , Portadores de Fármacos/farmacocinética , Portadores de Fármacos/farmacologia , Ácido Glucurônico/química , Ácido Glucurônico/farmacocinética , Ácido Glucurônico/farmacologia , Ácidos Hexurônicos/química , Ácidos Hexurônicos/farmacocinética , Ácidos Hexurônicos/farmacologia , Camundongos , Células NIH 3T3RESUMO
Epidermolysis bullosa comprises a group of uncommon skin-related diseases, characterized by the formation of blisters on mucocutaneous regions occurring spontaneously, following a trauma, exposure to heat, or as a result of minimal mechanical trauma. The dental treatment of the patient with epidermolysis bullosa raises many questions and discussions, due to the difficulty of carrying out the procedures. This report aimed to detail the clinical considerations of the treatment under general anesthesia of a patient with epidermolysis bullosa. The extraction of all deciduous teeth under general anesthesia was recommended based on the clinical and radiographic examinations. At 24-month follow-up, the patient had great improvement in oral hygiene without new caries lesions. The patient has been followed-up at every month for caries lesion prevention and permanent tooth development. The treatment under general anesthesia provided the ideal safe conditions and was beneficial for the patient.
Assuntos
Anestesia Geral , Assistência Odontológica para Crianças , Assistência Odontológica para Doentes Crônicos , Epidermólise Bolhosa/complicações , Pré-Escolar , Humanos , MasculinoRESUMO
This study aimed to evaluate the effects of low-level laser therapy (LLLT) on pulpal response of primary teeth. Twenty mandibular primary molars were randomly divided into the following groups: group I Buckley's formocresol (diluted at 1:5), group II calcium hydroxide, group III LLLT + zinc oxide/eugenol, and group IV LLLT + calcium hydroxide. LLLT parameters were set at 660-nm wavelength, 10-mW power output, and 2.5 J/cm(2) energy density for 10 s in continuous mode (InGaAlP laser, Twin Laser®, MMOptics, Sao Carlos, Sao Paulo, Brazil). The teeth were extracted at the regular exfoliation period. The dentin-pulp complex was graded by an established histopathological score system. Statistical analysis was performed by Kruskal-Wallis and chi-square test. The histopathological assessment revealed statistically significant differences among groups (P < 0.05). The lowest degree of pulpal inflammation was present in LLLT + calcium hydroxide (P = 0.0296). Calcium hydroxide showed the highest rate of hard tissue barrier (P = 0.0033), odontoblastic layer (P = 0.0033), and dense collagen fibers (P = 0.0095). On the other hand, formocresol showed the highest incidence of internal resorption (P = 0.0142). Based on this study, low-level laser therapy preceding the use of calcium hydroxide exhibited satisfactory results on pulp tissue healing. However, further clinical studies on human teeth with long-term follow-up are needed to test the low-level laser therapy efficacy.