RESUMO
PURPOSE: To compare, both qualitatively and quantitatively, the inflammatory cells, vascular density and IL-6 immunolabeled cells present in the pulp after pulpotomy with white MTA versus 15.5% ferric sulfate (FS). METHODOLOGY: Forty-eight mandibular first molars from 24 Wistar rats were divided into MTA or FS groups and subdivided according to the period after pulpotomy procedure (24, 48 and 72 hours). Four teeth (sound and untreated) were used as controls. Histological sections were obtained and assessed through the descriptive analysis of morphological aspects of pulp tissue and the quantification of inflammatory cells, vascular density and interleukin-6 (IL-6) expression. Data were statistically analyzed (p<0.05). RESULTS: The number of inflammatory cells was similar in both groups, being predominantly localized at the cervical radicular third. In the MTA group, increased inflammation was observed at 48 hours. Vascular density was similar in both groups and over time, being predominant in the medium radicular third. No correlation was found between the number of inflammatory cells and the vascular density. Pulp tissue was more organized in MTA-treated teeth. In both groups, a weak to moderate IL-6 expression was detected in odontoblasts and inflammatory cells. Comparing both groups, there was a greater IL-6 expression in the cervical radicular third of teeth treated with MTA at 24 hours and in the medium and apical thirds at 72 hours, while in the FS group a greater IL-6 expression was found in the apical third at 24 hours. CONCLUSION: The MTA group presented better histological features and greater IL-6 expression than the FS group. However, no difference was observed between the groups regarding the inflammatory status and vascularization, suggesting the usefulness of FS as a low-cost alternative to MTA.
Assuntos
Compostos de Alumínio/farmacologia , Compostos de Cálcio/farmacologia , Compostos Férricos/farmacologia , Inflamação/imunologia , Interleucina-6/análise , Óxidos/farmacologia , Pulpotomia/efeitos adversos , Silicatos/farmacologia , Animais , Polpa Dentária/efeitos dos fármacos , Polpa Dentária/patologia , Combinação de Medicamentos , Masculino , Ratos Wistar , Estatísticas não Paramétricas , Fatores de TempoRESUMO
Abstract Purpose To compare, both qualitatively and quantitatively, the inflammatory cells, vascular density and IL-6 immunolabeled cells present in the pulp after pulpotomy with white MTA versus 15.5% ferric sulfate (FS). Methodology Forty-eight mandibular first molars from 24 Wistar rats were divided into MTA or FS groups and subdivided according to the period after pulpotomy procedure (24, 48 and 72 hours). Four teeth (sound and untreated) were used as controls. Histological sections were obtained and assessed through the descriptive analysis of morphological aspects of pulp tissue and the quantification of inflammatory cells, vascular density and interleukin-6 (IL-6) expression. Data were statistically analyzed (p<0.05). Results The number of inflammatory cells was similar in both groups, being predominantly localized at the cervical radicular third. In the MTA group, increased inflammation was observed at 48 hours. Vascular density was similar in both groups and over time, being predominant in the medium radicular third. No correlation was found between the number of inflammatory cells and the vascular density. Pulp tissue was more organized in MTA-treated teeth. In both groups, a weak to moderate IL-6 expression was detected in odontoblasts and inflammatory cells. Comparing both groups, there was a greater IL-6 expression in the cervical radicular third of teeth treated with MTA at 24 hours and in the medium and apical thirds at 72 hours, while in the FS group a greater IL-6 expression was found in the apical third at 24 hours. Conclusion The MTA group presented better histological features and greater IL-6 expression than the FS group. However, no difference was observed between the groups regarding the inflammatory status and vascularization, suggesting the usefulness of FS as a low-cost alternative to MTA.
Assuntos
Animais , Masculino , Óxidos/farmacologia , Pulpotomia/efeitos adversos , Compostos Férricos/farmacologia , Interleucina-6/análise , Silicatos/farmacologia , Compostos de Cálcio/farmacologia , Compostos de Alumínio/farmacologia , Inflamação/imunologia , Fatores de Tempo , Ratos Wistar , Estatísticas não Paramétricas , Polpa Dentária/efeitos dos fármacos , Polpa Dentária/patologia , Combinação de MedicamentosRESUMO
BACKGROUND: Furcal perforation consists of a communication between the pulp cavity and the periodontal tissues that can occur accidentally during cavity preparation or root canal instrumentation. This complication may lead to inflammatory reactions and compromise adjacent tissues irreversibly, resulting in the early loss of primary teeth. Perforation sealing with a biocompatible material is necessary to ensure a favourable prognosis. Among different materials, MTA has been employed due to its excellent healing and physical properties. CASE REPORT: The purpose of these case reports was to describe immediate and mediate cases of furcal perforation treatment using MTA in primary molars. In both the cases, after accidental perforation detection, the pulp chamber was cleaned with saline solution to clear off the debris. The wound surface was continuously irrigated with saline solution and a dry sterile cotton pellet was placed on the radicular pulp stumps and perforation area with slight pressure until the bleeding was controlled. The MTA was applied into the perforation and pulp chamber area with the aid of a sterile amalgam carrier. The teeth were restored with resin-modified glass ionomer cement. FOLLOW-UP: Clinical and radiographic follow-up examinations were carried out at 3, 6, 12, 18, and 24 months after perforation sealing. Both the cases remained asymptomatic, presenting no discomfort, mobility, swelling, or fistula after 24-months follow-up. Radiographically, the radiolucent area disappeared as a result of bone formation in the inter-radicular space, showing adjacent tissue preservation. CONCLUSION: Thus, MTA may be considered as an ideal option for conservative treatment of immediate and mediate furcal perforation in primary teeth, once it promoted repair with tooth maintenance in both the cases.
Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Cavidade Pulpar/lesões , Dente Molar/lesões , Óxidos/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Silicatos/uso terapêutico , Dente Decíduo/lesões , Criança , Polpa Dentária/efeitos dos fármacos , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/patologia , Combinação de Medicamentos , Seguimentos , Cimentos de Ionômeros de Vidro/uso terapêutico , Humanos , Masculino , Dente Molar/diagnóstico por imagem , Dente Molar/patologia , Osteogênese , Doenças Periapicais/etiologia , Pulpotomia/efeitos adversos , Tratamento do Canal Radicular/efeitos adversos , Cloreto de Sódio/uso terapêutico , Raiz Dentária/efeitos dos fármacos , Raiz Dentária/lesões , Dente Decíduo/diagnóstico por imagem , Dente Decíduo/patologia , CicatrizaçãoRESUMO
En 11 pacientes se realizaron 7 pulpotomías con agregado trióxido mineral (MTA) y 6 con Sulfato Férrico (SF). Se incluyeron pacientes que presentaron dientes primarios con exposición accidental de la pulpa durante la remoción de caries en ausencia de signos y síntomas clínicos y/o radiográficos de patología pulpar. Las piezas tratadas fueron restauradas con coronas preformadas de acero inoxidable y controladas clínica y radiográficamente cada 6 meses. El seguimiento promedio fue de 15,6 meses para ambos grupos, con éxito clínico de un 100 por ciento para ambos medicamentos. El éxito radiográfico fue de 85,71 por ciento para el MTA y de 83,33 por ciento para el SF. Si bien ambos medicamentos presentaron un buen desempeño clínico y radiográfico durante el periodo de seguimiento, el SF fue más económico y necesitó un menor tiempo de trabajo, característica deseable en odontopediatría.
In eleven patients 7 pulpotomies were performed with Mineral Trioxide Aggregate (MTA) and 6 with ferric sulphate (FS). We included patients who had primary teeth with accidental exposure of the pulp during caries removal in the absence of clinical signs and symptoms and / or radiographic evidence of pulpal pathology. The treated pieces were restored with preformed stainless steel crowns and controlled clinically and radiographically every 6 months. The average follow-up was 15.6 months for both groups, with clinical success of 100 percent for both treatments. Radiographic success was 85.71 percent for the MTA and 83.33 percent for SF.ÊAlthough both procedures showed good performance during the clinical and radiographic follow-up period, the SF was cheaper and required less working time, a desirable characteristic in pediatric dentistry.
Assuntos
Humanos , Pré-Escolar , Criança , Alumínio/uso terapêutico , Compostos Férricos/uso terapêutico , Compostos de Cálcio/uso terapêutico , Dente Decíduo , Exposição da Polpa Dentária/terapia , Pulpotomia/métodos , Silicatos/uso terapêutico , Combinação de Medicamentos , Exposição da Polpa Dentária , Seguimentos , Óxidos/uso terapêutico , Pulpotomia/efeitos adversos , Análise de Sobrevida , Resultado do TratamentoRESUMO
PURPOSE: This study's purpose was to histologically evaluate the repair of rat tissue after pulpotomy and covering the pulp tissue with Copaifera langsdorffi oil resin, green propolis extract, fibrin sponge and iodoform-based paste. METHODS: Pulpotomies were performed in the maxillary and mandibular first molars of 21 Wistar rats (84 total teeth). The access cavities were sealed with Coltosol, and histological evaluations were performed at 24 hours, 15 days, and 30 days postoperatively. RESULTS: For all experimental periods and materials, an inflammatory response constituted predominantly by neutrophils was observed, being of milder intensity for the Copaifera langsdorffii oil-resin group and more severe for the fibrin sponge group, which exhibited periapical microabscesses. Necrosis was observed in all groups, and its extension increased with time, except for teeth protected with Copaifera langsdorffii oil-resin. Formation of a mineralized tissue barrier in the pulp exposure area occurred only in the Copaifera langsdorffii oil-resin group. Other findings, such as vascular congestion, edema, and hemorrhage, were observed in all cases. CONCLUSIONS: The inflammatory response was less severe, the area of pulp necrosis was smaller, and more frequent formation of a mineralized tissue barrier was noted after pulpotomy was performed with Copaifera langsdorffii oil-resin compared to the other materials tested.
Assuntos
Polpa Dentária/fisiologia , Fabaceae , Fitoterapia , Extratos Vegetais/uso terapêutico , Óleos de Plantas/uso terapêutico , Agentes de Capeamento da Polpa Dentária e Pulpectomia/uso terapêutico , Animais , Necrose da Polpa Dentária/etiologia , Dentina Secundária/metabolismo , Feminino , Adesivo Tecidual de Fibrina/uso terapêutico , Hidrocarbonetos Iodados/uso terapêutico , Abscesso Periapical/etiologia , Própole/uso terapêutico , Pulpite/etiologia , Pulpotomia/efeitos adversos , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
OBJECTIVE: The main goal of this work is to compare the In vitro toxicity of MTA with other primary teeth pulpotomy agents. STUDY DESIGN: The In vitro toxicity of MTA, calcium hydroxide, ferric sulphate solution, diluted formocresol and Buckley's formocresol were tested using MTT and Neutral Red Uptake cell viability assays. The results for MTA were compared to those obtained for the other substances using ANOVA and Tukey statistical tests (p < 0.05). RESULTS: MTA had the lower in vitro toxicity and Buckley's formocresol, the higher, with statically significant difference. CONCLUSION: Among the primary teeth pulpotomy agents tested, MTA showed the lower In vitro toxicity, standing as the most promising substitute to formocresol.
Assuntos
Compostos de Alumínio/toxicidade , Compostos de Cálcio/toxicidade , Óxidos/toxicidade , Materiais Restauradores do Canal Radicular/toxicidade , Silicatos/toxicidade , Células 3T3 , Animais , Hidróxido de Cálcio/toxicidade , Membrana Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Corantes , Combinação de Medicamentos , Compostos Férricos/toxicidade , Formocresóis/toxicidade , Dose Letal Mediana , Camundongos , Mitocôndrias/efeitos dos fármacos , Vermelho Neutro , Pulpotomia/efeitos adversos , Sais de Tetrazólio , TiazóisRESUMO
Furcal perforations may occur during access opening of the pulp chamber or cavity preparation. The perforation can cause an inflammatory reaction in the periodontal ligament. Management of these iatrogenic accidents can pose a significant clinical challenge, mainly when they occur in primary teeth. Current developments in the techniques and materials utilized for root perforation repair have enhanced this procedure's prognosis. Recently, mineral trioxide aggregate (MTA) has been used for several dental purposes. This biocompatible material promotes bone healing and elimination of clinical symptoms. The purpose of this case report was to describe the treatment of a furcal perforation using mineral trioxide aggregate (MTA) in a primary molar tooth. After 20 months, the tooth was asymptomatic. The radiolucent image had disappeared and bone formation at the furcation area had been observed, suggesting healing of the underlying periodontal tissues. Therefore, MTA may be considered an alternative option for the repair of furcal perforation in primary teeth, prolonging the longevity of these dental elements.
Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Cavidade Pulpar/lesões , Dente Molar/lesões , Óxidos/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Silicatos/uso terapêutico , Raiz Dentária/lesões , Dente Decíduo/lesões , Criança , Cavidade Pulpar/patologia , Combinação de Medicamentos , Seguimentos , Cimentos de Ionômeros de Vidro/uso terapêutico , Humanos , Doença Iatrogênica , Masculino , Dente Molar/patologia , Doenças Periapicais/etiologia , Pulpotomia/efeitos adversos , Retratamento , Raiz Dentária/patologia , Dente Decíduo/patologia , CicatrizaçãoRESUMO
AIM: To compare the effectiveness of mineral trioxide aggregate (MTA), calcium hydroxide (CH) and formocresol (FC) as pulp dressing agents in carious primary teeth. METHODOLOGY: Forty-five primary mandibular molars with dental caries in 23 children [AUTHOR QUERY: How many children?] between 5 and 9 years old were treated by a conventional pulpotomy technique. The teeth were randomly assigned to the experimental (CH or MTA) or control (FC) groups. After coronal pulp removal and haemostasis, remaining pulp tissue was covered with MTA paste or CH powder in the experimental groups. In the control group, diluted FC was placed with a cotton pellet over the pulp tissue for 5 min and removed; the pulp tissue was then covered with zinc oxide-eugenol (ZOE) paste. All teeth were restored with reinforced ZOE base and resin modified glass-ionomer cement. Clinical and radiographic successes and failures were recorded at 3, 6, 12, 18 and 24 month follow-up. RESULTS: Forty-three teeth were available for follow-up. In the FC and MTA groups, 100% of the available teeth were clinically and radiographically successful at all follow-up appointments; dentine bridge formation could be detected in 29% of the teeth treated with MTA. In the CH group, 64% of the teeth presented clinical and radiographic failures detected throughout the follow-up period, and internal resorption was a frequent radiographic finding. CONCLUSIONS: Mineral trioxide aggregate was superior to CH and equally as effective as FC as a pulpotomy dressing in primary mandibular molars. Internal resorption was the most common radiographic finding up to 24 month after pulpotomies performed with CH.
Assuntos
Compostos de Alumínio/farmacologia , Compostos de Cálcio/farmacologia , Óxidos/farmacologia , Pulpotomia/métodos , Materiais Restauradores do Canal Radicular/farmacologia , Silicatos/farmacologia , Hidróxido de Cálcio/farmacologia , Criança , Pré-Escolar , Polpa Dentária/efeitos dos fármacos , Dentina Secundária/metabolismo , Combinação de Medicamentos , Feminino , Formocresóis/farmacologia , Humanos , Masculino , Pulpotomia/efeitos adversos , Reabsorção da Raiz/etiologia , Dente DecíduoRESUMO
Taking into consideration genetic damage plays an important role in carcinogenesis, the purpose of this paper is to provide an overview on the genotoxic potential of some endodontic compounds currently used in dentistry, such as formocresol, paramonochlorophenol, calcium hydroxide, resin-based sealers, phenolic compounds, chlorhexidine, mineral trioxide aggregate, and others. Some of these compounds appear capable of exerting noxious activity on the genetic material. The action mechanisms are discussed. Therefore, this is an area that warrants investigation since the estimation of risk of these substances with respect to genotoxicity will be added to those used for regulatory purposes in improving oral health and preventing oral carcinogenesis.
Assuntos
Dano ao DNA , Materiais Dentários/toxicidade , Pulpectomia/efeitos adversos , Pulpotomia/efeitos adversos , Tratamento do Canal Radicular/efeitos adversos , Animais , Anti-Infecciosos Locais/toxicidade , Clorexidina/toxicidade , Humanos , Testes de MutagenicidadeRESUMO
O material MTA (Agregado de Trióxido Mineral) foi inicialmente desenvolvido para selar comunicações entre o dente e a superfície externa periodontal. Foram encontradas no MTA propriedades como a alta alcalinidade, baixa solubilidade, excelente selamento marginal, capacidade antimicrobiana, radiopacidade, estabilidade dimensional, resistência à compressão e elvada biocompatibilidade, com formação de barreira de tecido mineralizado pela polpa dentária em maior quantidade e qualidade que o hidróxido de cálcio. Diante destas características, o MTA passou a ser credenciado com um material promissor para uso em procedimentos conservadores com pulpotomias de dentes decíduos e capeamento pulpar direto e pulpotomias em dentes permanentes jovens, procedimentos usuais na odontologia infanto-juvenil. Este trabalho tem como objetivo, através de revisão da literatura, demonstrar a viabilidade da utilização do matrial MTA para os procedimentos realizados em odontopediatria e seu potencial futuro de vir a ser o material de eleição para esses procedimentos