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The aim was to evaluate in vitro cytotoxicity and genotoxicity of Bio-C Repair (BCR), compared to Endosequence BC Root Repair (ERRM), MTA Angelus (MTA-Ang), and MTA Repair HP (MTA-HP). MC3T3 osteoblastic cells were exposed to extracts of the repairing bioceramic cements. After 1, 3, and 7 days, cytotoxicity and genotoxicity were evaluated by MTT and Micronucleus tests, respectively. Cells not exposed to biomaterials were used as a negative control. Data were compared using ANOVA two-way, followed by the Tukey Test (α=5%). MTA-Ang and MTA-HP showed no difference in relation to control regarding cytotoxicity in any experimental times. BCR and ERRM reduced cell viability after 3 and 7 days (p<0.05); however, the reduction caused by BCR was less than that caused by ERRM. Considering the micronucleus formation, all biomaterials caused an increase after 3 and 7 days (p<0.05), being greater for the BCR and ERRM groups. It can be concluded that BCR is non-cytotoxic in osteoblastic cells, as well as MTA-Ang e MTA Repair HP. BCR and ERRM showed greater genotoxicity than others tested biomaterials.

Background: This study assesses and compares the knowledge level of endodontists (ENDs) and general dental practitioners (GPs) from Brazil and United States of America (USA) in the diagnosis and treatment of internal and external inflammatory root resorptions through periapical radiographic (PA) and cone beam computed tomography (CBCT) examinations., Material and Methods: A cross-sectional online questionnaire-based survey was presented to the volunteers containing questions regarding personal and professional profile, as well as three clinical cases of internal and external inflammatory root resorption. A series of multiple-choice questions about the diagnosis and treatment options were surveyed. The data collected was analysed by the Chi-square test with Yates correction with a significance level of 5 %., Results: Most answers were considered adequate when all three questions about the diagnosis and all two questions relating to the treatment were answered accurately. A total of 374 dentists answered the survey (n: 229 from Brazil vs. 145 from USA) being 41% END and 59% GP. END presented higher level of knowledge than GP regarding to diagnosis and treatment of inflammatory root resorptions both in Brazil and USA ( p <0.05); USA presented higher level of adequate responses than Brazil ( p <0.05)., Conclusions: END achieved a level of knowledge of the diagnosis and treatment of root resorption superior to the GP. Comparing the results obtained in both countries, it was observed that the USA had a higher correct response rate than Brazil. Key words: Internal root resorption, external root resorption, management, diagnosis, treatment., Competing Interests: Conflicts of interest The authors deny any conflict of interest., (Copyright: © 2021 Medicina Oral S.L.)

Objective: The purpose of this study was to evaluate influence of topical sodium alendronate (ALN), photodynamic therapy (aPDT), or a combination thereof as adjuvant to scaling and root planing (SRP) in the treatment of experimental periodontitis in rats., Background: Therapeutic protocols to control periodontitis progression that aim to equalize bacterial action and load with tissue immune response are well addressed in current scientific research., Methods: Experimental periodontitis was induced in 96 rats with a ligature around the mandibular left first molar. After 7 days, ligature was removed and animals were treated according to the following experimental groups (n = 8): control-SRP plus saline solution; ALN-SRP plus ALN; aPDT-SRP plus methylene blue irrigation, followed by low-level laser therapy (LLLT); and ALN/aPDT-SRP plus ALN and methylene blue irrigation followed by LLLT. The animals were euthanized at 7, 15, and 30 days after treatments. Collagen maturation (picrosirius red staining) and immunohistochemical analyses (TRAP, RANKL and osteoprotegerin [OPG]) were performed. Data were submitted to statistical analysis (P < .05)., Results: At 7 days, group ALN presented a significantly higher number of TRAP-positive cells and percentage of immature collagen fibers than group ALN/aPDT, while group ALN/aPDT presented a significantly higher percentage of mature collagen fibers than group ALN. At 30 days, group ALN presented significantly lower percentage of immature collagen fibers and higher percentage of mature collagen fibers than control., Conclusion: It can be concluded that topical use of ALN coadjutant to SRP, alone or combined with aPDT, enhanced collagen maturation and reduced osteoclastogenesis during the healing of experimental periodontitis., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To evaluate the antimicrobial action of NeoMTA Plus on mono- and dual-species biofilms of Enterococcus faecalis and Candida albicans., Material and Methods: A total of 171 sterile dentin blocks, measuring 4 mm × 4 mm × 1 mm, were incubated in media containing E. faecalis (3.1 × 10 8 cells/mL) and/or C. albicans (1 × 10 7 cells/mL) for 2 d. These blocks were randomly divided into three groups: the control (no treatment with biomaterials), MTA (treated with an MTA sample with width and thickness same as those of the dentin block after the material was set), and NeoMTA Plus (treated with NeoMTA Plus in a fashion similar to the treatment of the MTA group) groups. The biomaterials remained in contact with the biofilms for 24 h. Quantitative analyses of the number of colony-forming units (CFUs) and metabolic activity (XTT), were performed. Furthermore, qualitative analysis of biofilm structure was performed by scanning electron microscopy. Data were statistically analyzed considering a significance level of 5%., Results: XTT and the number of CFUs were similar among the groups (p > 0.05). The type of biofilm (mono- or dual-species) or the biomaterial used (MTA or NeoMTA Plus) did not affect the results. Biofilm structure exhibited a robust architecture composed of yeast and bacterial cell multilayers and was homogeneous among the groups., Conclusion: NeoMTA Plus was not effective against mono- and dual-species biofilms of E. faecalis and C. albicans. Further research investigating biofilm removal methods including those involving the use of biomaterials with antiseptics and other supporting therapies is warranted., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Context: Is it possible that the irrigating solutions can have the potential to cause post-operative pain? Unfortunately, the current literature does not provide clear guidance., Aim: The purpose of this systematic review and meta-analysis was to comprehensively review two different irrigation solutions (sodium hypochlorite and chlorhexidine) regarding the post-operative pain after endodontic treatment., Settings and Design: This study was prepared according to the Cochrane criteria for creating a systematic review and meta-analysis and confirms the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement., Material and Methods: This search was conducted in the PubMed/MEDLINE, SCOPUS and Cochrane Library databases until February 2018 to answer the In [(Population) what is the effect of (Intervention) on (Outcome), compared with (Comparison) Intervention] (PICO) question: could sodium hypochlorite cause more post-operative pain than chlorhexidine in teeth subjected to endodontic treatment? The primary outcome was overall post-operative pain after 24 h., Results: After applying the inclusion and exclusion criteria, three randomized clinical trials fulfilled the eligibility criteria, and two were subjected to the meta-analysis. There was no difference in post-operative pain between the tested irrigating solutions., Conclusions: There are few studies published in the current literature; therefore, additional randomized clinical studies are required to on this topic to help clinicians make the best decision concerning treatment., Competing Interests: None

Background/aim: Anti-allergic drugs can inhibit the hard tissue resorption process, and due to similarities between root resorption and bone mechanisms, it can be inferred that these drugs may also control root resorption. The aim of this study was to analyze the effects of anti-allergic drugs used systemically on the process of root resorption following delayed tooth replantation., Materials and Methods: Thirty-two maxillary right incisors of rats were extracted and subsequently replanted. Rats were divided into four groups according to the anti-allergic drug administered: the rats in groups DEX, Q, and MO were treated systemically with dexamethasone phosphate, quercetin, and montelukast, respectively, and no systemic medication was administered to rats in group C. After 60 days, the animals were euthanized, and the specimens were processed for histomorphometric and immunohistochemical analyses. Statistical significance was set at P < .05., Results: There were no significant differences between the groups in terms of inflammatory resorption, replacement resorption, or presence of tartrate-resistant acid phosphatase. In terms of events occurring in the periodontal ligament space, there was a difference between groups Q and MO due to the presence of dental ankylosis and inflammatory connective tissue (P < .05). A difference in inflammatory cells was also observed through CD45 immunolabeling between the DEX and Q groups when compared to the C group (P < .05)., Conclusion: The systemic administration of anti-allergic drugs did not have an effect on the process of root resorption following delayed tooth replantation., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported., (Copyright © 2020. The Korean Academy of Conservative Dentistry.)

Understanding facial trauma behaviors in different populations can help enhance effective prevention and efficient management of public resources in order to offer better treatment in large health systems. The aim of this study was to assess the epidemiology of maxillofacial trauma treated by a public health emergency care service. A cross-sectional study was conducted to assess maxillofacial trauma in patients treated by a public health service of emergency care at a midsize city in southern Brazil. Facial trauma records were retrieved directly from medical records from January 2010 to April 2014. The following variables were collected: patient age, sex, destination of patient after initial treatment, cause of trauma, and type of injury. Statistical analyses were performed using G tests with Williams' corrections (p < .05). The most frequent cause was road traffic collision (39.6%), followed by falls (33.6%) and interpersonal violence (22.0%). The prevalence of falls was higher in older adults. A statistically significant association was observed between age and causes (p < .05). After the initial care provided by the prehospital service, 44.1% of the patients were referred to secondary care centers and 40.1% to hospitals. Traffic accidents were the most common cause of facial trauma in Brazil, with a higher prevalence in young men. Falls were also a big concern for facial injuries, especially among older adults. Although most lesions could be classified as minor trauma, many patients are being treated at hospitals, which may increase the costs to the public health system.

Background: Extrusion of infected debris into the periapical tissue has been cited as the major cause of postoperative pain, regardless of instrumentation technique., Aim: Comprehensively review two different kinematics of instrumentation (reciprocating and rotary) and association to the postoperative pain after endodontic treatment., Methods: Two investigators performed a systematic review with meta-analysis. MEDLINE/PubMed, Cochrane Library, and Scopus supplied relevant data from studies published until February 2018 to answer the PICO question. Primary outcome was overall postoperative pain, and the secondary outcomes were nature of the pain (mild, moderate, and severe) at 12, 24, and 48 h., Results: Ten randomized clinical trials fulfilled eligibility criteria, and five of them were submitted in the meta-analysis. Primary outcome indicated that reciprocating system results in less postoperative pain compared to rotary system ( P < 0.05). As a secondary outcome, there was no statistical difference for mild, moderate, and severe pain after 12 and 24 h using reciprocating or rotary systems ( P > 0.05). However, the reciprocation system showed less severe pain after 48 h ( P < 0.05)., Conclusion: Rotary motion had a negative impact on postoperative pain after endodontic treatment. Furthermore, after 48 h, more patients presented severe pain under rotary motion. More randomized clinical studies would be helpful., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Journal of Conservative Dentistry.)

Background: Endodontic infections require the use of root canal dressings to reduce microorganisms, and studies of new intracanal medications are common. Two experimental intracanal medications that contain antibiotics and chlorhexidine have been proposed. However, given the composition of these medications, tooth discoloration with subsequent impacts on aesthetic parameters is a concern. The objective of this study is to evaluate tooth discoloration after the use of experimental intracanal medications for up to 180 days., Methods: Thirty extracted bovine teeth were divided into 3 groups according to intracanal medication as follows: group I: experimental intracanal medication 1; group II: experimental intracanal medication 2; and group III: no medication (negative control). Color change was assessed using a spectrophotometer on day 0 (before the placement of the material); daily until the seventh day; and 8, 15, 60 and 180 days after removal of the medications. The values obtained were compared using ANOVA and Tukey's tests at a significance level of 5% (P<0.05)., Results: Up to 60 days after the removal of the medication, the teeth did not exhibit color changes. However, at 180 days, compared with the other medications, experimental intracanal medication 2 significantly promoted tooth staining (P<0.05)., Conclusions: In contrast to experimental intracanal medication 2, intracanal medication 1 did not promote tooth discoloration.

Introduction: Sports' practitioners are vulnerable to dental trauma; if this occurs, the emergency treatment should be fast and efficient. This may be performed by any person at the site of the accident, not only by dental professionals. Physical educators may face dental trauma and should be able to provide proper care. This study had the objective evaluated the knowledge of physical education graduates on dental trauma., Materials and Methods: A questionnaire containing questions on dental trauma was applied to 199 physical education students; after collection of the questionnaires, data were tabulated and processed on the software Epi Info 2000 (Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA). As a result, only 36.7% of participants would take the individual suffering trauma to the dental professional, 56.8% believe that the avulsed tooth should be replanted, and 42.2% would replant it. Only 7.5% would store the avulsed tooth in an ideal storage medium for transportation., Conclusion: It was concluded that there is a lack of knowledge on dental trauma among physical education graduates, evidencing the need of public policies to allow education on this issue., Competing Interests: There are no conflicts of interest.

The aim of the present study was to evaluate the cytotoxicity of root canal sealers under conditions closely resembling a clinical reality. A primary human fibroblast cell line was seeded in 24-well acrylic plates with Dulbecco's modified Eagle's medium supplemented with 10% serum fetal bovine (SFB) and incubated for 24 h. Root canals from premolars were filled and individually attached to nylon devices to be stabilized in the wells with the already seeded cells. Specimens were divided into groups as follows: Control: gutta-percha cones (GPC); AH Plus+GPC; Sealapex+GPC; MTA Fillapex+GPC and Endofill+GPC. After 24 and 48 h, cell viability and morphology were evaluated by MTT assay and scanning electron microscopy (SEM), respectively. Statistical analysis was performed by Mann-Whitney test, complemented by Kruskal Wallis test (p<0.05). Only Endofill presented cytotoxicity after 24 h. MTA Fillapex and Endofill reduced the production of succinic desidrogenase after 48 h. AH Plus was non-toxic at any time point. SEM showed that the AH Plus and MTA Fillapex groups presented fibroblasts with morphology close to the control group, while the Endofill group presented few cells with thin extensions cells. The present study showed that good results were present in AH Plus and Sealapex, but not the Endofill group after 48 h. The method used enabled evaluation of the cytotoxicity of the studied sealers that diffused through the root apex.

Ca3SiO5 is new cement based on the composition of Portland that has been developed to have superior physicochemical and biological properties. In a clinical evaluation, the cement did not appear to have cytotoxic properties and allowed for the proliferation of pulp cells and gingival fibroblasts. However, no previous studies have evaluated the genotoxicity or the mutagenicity of Ca3SiO5in vivo. Therefore, the goal of this study is to evaluate the genotoxic and mutagenic potential of Ca3SiO5-based cement in vivo. Twenty-four male Wistar rats were divided into 3 groups (n = 8). Group A rats received subcutaneous implantation of Ca3SiO5 in the dorsum. Group B rats received a single dose of cyclophosphamide (positive control). Group C rats received subcutaneous implantation of empty tubes in the dorsum (negative control). After 24 hours, all animals were euthanized and the bone marrow of the femurs was collected for use in the comet assay and the micronucleus test. The comet assay revealed that the Ca3SiO5 group had a tail intensity of 23.57 ± 7.70%, the cyclophosphamide group had a tail intensity of 27.43 ± 7.40%, and the negative control group had a tail intensity of 24.75 ± 5.55%. The average number of micronuclei was 6.25 (standard deviation, SD = 3.53) in the Ca3SiO5 group, 9.75 (SD = 2.49) in the cyclophosphamide group, and 0.75 (SD = 1.03) in the negative control group. There was an increase in the micronuclei frequency in the Ca3SiO5 group compared to that of the negative control group (p < 0.05). Our data showed that exposure to the Ca3SiO5-based cement resulted in an increase in the frequency of micronuclei, but no genotoxicity was detected according to the comet assay.

Introduction: Biodentine (Septodont, St-Maur-des-Fossés, France) is a new material suitable for various clinical situations in endodontics, such as perforation repair, retrograde filling, pulp capping, and others. Because it is a new material, its properties should be analyzed before routine clinical use. Thus, this study evaluated the biocompatibility of Biodentine in the subcutaneous tissue of rats., Methods: This study was conducted on 15 male rats. Two incisions were made on the dorsal region of each animal for the introduction of 4 tubes. One tube was empty, 1 was filled with zinc oxide-eugenol cement, 1 was filled with mineral trioxide aggregate, and the last tube was filled with Biodentine. After 7, 14, and 30 days, the animals were sacrificed, and the specimens were submitted to histotechnical preparation. The histologic sections were stained with hematoxylin-eosin and analyzed using light microscopy. Scores were established according to the inflammatory process and were statistically compared using the Kruskal-Wallis test (P < .05)., Results: The analysis of the histologic sections evidenced a nonsignificant or mild presence of inflammatory reaction in the connective tissue in contact with the empty tube and the tube containing MTA, which was different from the tube containing zinc oxide eugenol. The connective tissue was moderately inflamed at 7 days when in contact with Biodentine; however, at 14 and 30 days, the inflammatory process was mild or nonsignificant., Conclusions: Biodentine was biocompatible with tissue after the 14th day., (Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Intracanal medications are fundamental for disinfection of the root canal system and participate in periapical repair, so their biocompatibility is of utmost importance to avoid tissue damage. This study evaluated the biocompatibility of a experimental paste of calcium hydroxide and propolis in the subcutaneous tissue of rats. The study was conducted on 15 male Wistar rats. Two incisions were made on the dorsal region of each animal for introduction of 4 tubes: one tube was empty; one contained zinc oxide-eugenol cement, and the two other tubes were filled with experimental paste. After 7, 14 and 30 days, the animals were euthanized and the specimens were subjected to histotechnical preparation. The hematoxylin and eosin-stained histological sections were analyzed by light microscopy. Scores were established according to the inflammatory process and statistically compared by the Tukey test (α = 5%). The analysis of histological sections showed non-significant or mild inflammatory reaction in the connective tissue in contact with the empty tubes in all study periods while the contact of subcutaneous tissue with zinc oxide-eugenol elicited moderate or severe inflammation similarly without significant difference among the study periods. The connective tissue was moderately inflamed at 7 days when contacting the experimental paste, but the inflammatory process was non-significant or mild at 14 and 30 days. The experimental paste was biocompatible with the tissues after 14 days of subcutaneous implantation.

This study evaluated the diffusion through the dentinal tubules of hydroxyl ions from different calcium hydroxide (CH) pastes containing Aloe vera. Sixty single-rooted bovine teeth were used. The tooth crowns were removed, the root canals were instrumented and the specimens were assigned to 4 groups (n=15) according to the intracanal medication: Group CH/S - CH powder and saline paste; Group CH/P - CH powder and propylene glycol paste; Group CH/A - calcium hydroxide powder and Aloe vera gel paste; Group CH/A/P - CH powder, Aloe vera powder and propylene glycol paste. After placement of the root canal dressings, the teeth were sealed coronally and apically with a two-step epoxy adhesive. The teeth were placed in identified flasks containing deionized water and stored in an oven with 100% humidity at 37 °C. After 3 h, 24 h, 72 h, 7 days, 15 days and 30 days, the deionized water in the flasks was collected and its pH was measured by a pH meter. The obtained data were subjected to statistical analysis at a significance level of 5%. The results demonstrated that all pastes provided diffusion of hydroxyl ions through the dentinal tubules. The combination of Aloe vera and CH (group CH/A) provided a constant release of calcium ions. Group CH/A/P showed the highest pH at 24 and 72 h. In conclusion, the experimental pastes containing Aloe vera were able to enable the diffusion of hydroxyl ions through the dentinal tubules.

When late replantation is performed, the root surface and root canal should be treated. Notwithstanding failures still occur, because of the high rates of root resorption, evidencing the need to search for substances that may inhibit root resorption. The acetazolamide is a known anti-resorptive agent, and its use as root canal dressing may increase the success rates in the treatment of root resorption. Therefore, this study evaluated the effect of an acetazolamide paste used as root canal dressing in late replanted teeth. The study was conducted on 24 maxillary right incisors of rats, which were avulsed and divided in two groups. In group I, the teeth were kept dry for 30 min, had their root surfaces rubbed with a blade, and were treated with 2% sodium fluoride at pH 5.5 for 20 min; the root canals were instrumented and filled with acetazolamide paste; and then the teeth were replanted. In group II, the treatment was similar to group I, except for the root canal dressing, with utilization of calcium hydroxide in group II. At 15 and 60 days after replantation, the animals were killed and the specimens were processed in a histotechnical laboratory for microscopic and morphometric analysis. The results demonstrated the ability of both intracanal substances to limit root resorption, yet they were unable to completely inhibit the root resorption. Replacement resorption lacunae were present in greater proportion in group II, at 60 days. It was concluded that the acetazolamide paste was effective to limit the root resorption, being more effective in limiting the replacement resorption compared with calcium hydroxide., (© 2012 John Wiley & Sons A/S.)

This study evaluated the ability of ions from a non-alcoholic calcium hydroxide-propolis paste to diffuse through dentinal tubules. Thirty-six single-rooted bovine teeth were used. The tooth crowns were removed, and the root canals were instrumented and divided into 3 groups: Group 1 - calcium hydroxide-propylene glycol paste; Group 2 - calcium hydroxide-saline solution paste; Group 3 - calcium hydroxide-propolis paste. After the root canal dressings were applied, the teeth were sealed and placed in containers with deionized water. The pH of the water was measured after 3, 24, 72 and 168 hours to determine the diffusion of calcium hydroxide ions through the dentinal tubules. All of the pastes studied promoted the diffusion of calcium hydroxide ions through the dentinal tubules. Associating propolis to calcium hydroxide resulted in a pH increase, which occurred with greater intensity after 72 hours. The calcium hydroxide-propolis paste was able to diffuse in dentin.

The maintenance of the avulsed teeth in appropriate media for preserving the cellular viability has been important for repairing the periodontal ligament and preventing the root resorption after tooth reimplantation. Propolis is a substance capable of preserving cellular viability. This study aimed to analyze the propolis substance as a storage media for maintaining the avulsed teeth, besides to determine the ideal time period for keeping the tooth inside it. Thus, 60 maxillary right central incisors of rats were extracted and divided into five groups. In groups I and II, teeth were kept in propolis for 60 min and 6 h, respectively; in group III, teeth were kept in milk for 6 h; in group IV, teeth were kept dry for 60 min; and in group V, they were immediately reimplanted. All teeth had their root canals filled with calcium hydroxide paste. Following, teeth were reimplanted in their sockets. After 15 and 60 days, animals were killed and the obtained samples were processed in laboratory for microscopic and morphometric analyzing. The results showed that the occurrence of inflammatory resorption, dental ankylosis and the formation of the connective tissue parallel to the root surface were similar among groups. It could be verified a greater occurrence of replacement resorption in group IV when comparing to other groups. In groups I and IV, the presence of periodontal ligament-like connective tissue was substantially smaller than the other groups. Regarding to the cementum amount over the root, it could be observed that this was present in smaller amount in groups I and IV. Group II was similar to groups III and IV. Therefore, according to the results of this study, the use of propolis as a storage media for maintaining avulsed teeth could be highlighted, and the 6-h period was more appropriate than the 60-min period.

This study evaluated the use of zoledronic acid, a resorption inhibitor, as a medication for root resorption treatment of late replanted teeth. Twenty-four maxillary right central incisors of rats were avulsed and kept dry for 30 min. Then, the teeth were divided into 2 groups. In group I, root surface was treated with 2% sodium fluoride for 20 min; in group II, 10-6M zoledronic acid solution was used for 20 min. All root canals were filled with calcium hydroxide. Next, teeth were replanted in their respective sockets. After 15 and 60 days post-replantation, the animals were killed and the anatomic pieces were obtained and prepared for microscopic and morphometric analyses. The results showed that zoledronic acid was capable of limiting the occurrence of root resorption and preserving cementum resorption. Further research must be performed to confirm the use of zoledronic acid in root surface treatment of late replanted teeth.

Dental trauma is a common consequence of sports practice to which emergency treatment is critical. The purpose of this study was to evaluate the knowledge of sports participants about dental trauma procedures, particularly tooth avulsion. A specific questionnaire concerning concepts, experiences and behaviors after dental trauma and the use of mouthguard was standardized and validated with 80 people. The validated questionnaire was then distributed to 310 sports participants. The results showed that 28.4% had experienced a kind of dental trauma; 42.6% would look for a dentist for treatment; 51.7% reimplanted or would reimplant the avulsed tooth; 6.5% would maintain the avulsed tooth in milk. Although 47.4% of the participants were aware of the possibility of accidents during sports practice, only 13.9% reported to use a mouthguard. This study showed an overall lack of knowledge of sportsmen and sportswomen with regards to tooth avulsion, thus reinforcing the need for educational campaigns to improve the immediate emergency treatment of tooth avulsion.

This study aimed to evaluate the diffusion capacity of calcium hydroxide pastes with different vehicles through dentinal tubules. The study was conducted on 60 extracted single-rooted human teeth whose crowns had been removed. The root canals were instrumented and divided into 4 groups according to the vehicle of the calcium hydroxide paste: Group I - distilled water; Group II - propylene glycol; Group III - 0.2% chlorhexidine; Group IV - 2% chlorhexidine. After placement of the root canal dressings, the teeth were sealed and placed in flasks containing deionized water. After 1, 2, 7, 15, 30, 45 and 60 days, the pH of the water was measured to determine the diffusion of calcium hydroxide through the dentinal tubules. The data were recorded and statistically compared by the Tukey test. The results showed that all pastes presented a similar diffusion capacity through dentin. Group IV did not present difference compared to group I. Group II presented difference compared to the other groups, as did Group III. In conclusion, groups I and IV presented a better diffusion capacity through dentin than groups II and III; 2% chlorhexidine can be used as a vehicle in calcium hydroxide pastes.

This aim of this study was to investigate the biocompatibility of two experimental acetazolamide (AZ)-based pastes in the subcutaneous tissue of rats. Both pastes contained AZ as the main component in similar concentration. The vehicle in experimental paste 1 was saline, while experimental paste 2 was prepared with propylene glycol. Sixty polyethylene tubes were sealed at one end with gutta-percha (GP), which served as a control. Half of the tubes were filled with paste 1 and half with paste 2. The tubes were implanted in the subcutaneous tissue of 15 rats, being 4 tubes for each animal. The animals were killed 7, 15 and 45 days after surgery and the specimens were processed in laboratory. The histological sections were stained with hematoxylin and eosin and were analyzed by light microscopy. Scores were assigned to level of inflammatory process: 1- none; 2- mild; 3- moderate; 4- severe. The data were analyzed statistically by the Kruskal-Wallis test (p< or =0.05). Paste 1 produced an inflammatory process at 7 days. However, the intensity of this inflammation decreased with time and was nearly absent at 45 days. No statistically significant difference (p>0.05) was observed between the control (GP) and paste 1. However, paste 2 produced inflammatory response at all study periods and differed significantly (p<0.05) from the control. In conclusion, in the present study, the experimental AZ-based paste 1 was considered as biocompatible as the control matrial (GP), while experimental paste 2 was irritating to rat subcutaneous tissue.

Tooth avulsion is a very common event in children and emergency care procedures are crucial for case prognosis. As anyone at the moment of accident can provide first-aid measures, knowledge of school professionals dealing with children is of paramount importance. An informative campaign about dental trauma was performed in urban schools in the city of Adamantina, São Paulo state, Brazil, in an attempt to educate school professionals about emergency procedures in cases of tooth avulsion. A questionnaire arguing on personal information, tooth avulsion knowledge and personal impressions of the campaign was handed out for evaluation of the informative campaign. Eighty school professionals participated in the survey. Most participants were females (93.75%) aged 41-60 years old (53.75%) with a college degree (77.5%). Time at work ranged from 1-5 years (22.5%). The efficacy of the campaign was considered positive, as 100% of the interviewees replied to the importance of emergency procedures in case of tooth avulsion. In addition, 81.25% of the respondents answered that they would store the avulsed tooth in some storage medium, of which milk was the most frequently mentioned (84.61%). The participants considered the campaign as satisfactory and a region-wide campaign will be accomplished at other schools.

The use of substances that inhibit root resorption may be an alternative for cases of unsuccessful reimplants. Hence, the purpose of this study was to test a solution of alendronate, a resorption inhibitor, as an intracanal therapeutic agent for teeth submitted to late reimplantation. Thirty rat maxillary right central incisors were avulsed and kept dry for 30 min. The teeth were instrumented, and the root surfaces treated with 1% hypochlorite solution followed by application of 2% sodium fluoride. Thereafter, the teeth were divided in two groups according to the intracanal dressing: (i) group I, solution of alendronate and (ii) group II, calcium hydroxide paste. Teeth were then reimplanted in their respective sockets. The animals were killed at 15, 30 and 60 days after reimplantation and the samples processed for morphometric and microscopic analysis. The results demonstrated that the solution of alendronate and the calcium hydroxide paste limited the root resorption, yet did not impair its occurrence. It may be concluded that alendronate and calcium hydroxide paste demonstrated similar behavior.

Tooth avulsion is common in children, and emergency management in these cases is critical. This management can be made, not only by a dentist but by people who are present where the accident occurs. Consequently, knowledge of tooth avulsion is fundamental for school professionals working with children. The purpose of the present study was to evaluate the knowledge of tooth avulsion of school professionals from Adamantina, São Paulo, Brazil. For that purpose a questionnaire, including questions regarding emergency procedures for tooth avulsion, was answered by 117 teachers. The results demonstrated that 75.2% of school professionals knew the importance of emergency management and 60.6% would look for a dentist for treatment of the cases; 18.8% would reimplant the tooth and 7.6% would keep it in milk. This study showed the lack of knowledge of teachers on tooth avulsion; educational campaigns are necessary to improve the emergency management of tooth avulsion.

The aim of this study was to investigate the effect of gallium nitrate solution, an anti-resorption substance, when applied for root surface treatment in rat teeth submitted to delayed replantation, in order to inhibit the root resorption process and enhance repair. For such purpose, 20 maxillary right central incisors of rats were randomly assigned to 2 groups (n=10). In group I, root surface was treated with 10-4M gallium nitrate solution for 20 min, while in group II root surface was treated with 2% sodium fluoride for 20 min. All root canals were filled with a calcium hydroxide-based paste. At 15 and 60 days after replantation, the animals were killed and the specimens were processed in laboratory for light transmission microscopy. In both groups, there was mild occurrence of ankylosis and root resorption. The connective tissue formed at the periodontal ligament area was arranged parallel to the root in most specimens in both groups and presented signs of inflammation. In group I, there was periodontal pocket formation in all specimens at 60 days, revealing lack of repair. These findings contraindicate the use of gallium nitrate for root surface treatment of teeth submitted to late replantation.

The purpose of this study was to test a gallium nitrate solution, a resorption inhibitor, employed as a root canal dressing in teeth submitted to late replantation. Thirty maxillary right central incisors of rats were avulsed and kept dry for thirty minutes. The teeth were instrumented and the root surfaces were treated with 1% hypochlorite solution followed by application of 2% sodium fluoride. Thereafter, the teeth were divided into two groups according to the root canal dressing: Group I, solution of gallium nitrate; and Group II, calcium hydroxide paste. The teeth were then replanted in their respective sockets. The animals were killed at 15, 30 and 60 days after replantation and the samples were processed for morphometric and microscopic analysis. The results demonstrated that the gallium nitrate solution and the calcium hydroxide paste limited the root resorption, yet they did not impair its occurrence. It may be concluded that gallium nitrate solution and calcium hydroxide paste demonstrated similar performance.

The use of substances that inhibit root resorption may be an alternative for cases of unsuccessful reimplants. Hence, the purpose of this study was to test a solution of acetazolamide, a resorption inhibitor, as an intracanal therapeutic agent for late reimplanted teeth. Thirty rat maxillary right central incisors were avulsed and kept dry for 30 min. The teeth were instrumented, and the root surfaces treated with 1% hypochlorite solution followed by application of 2% sodium fluoride. Thereafter, the teeth were divided into two groups according to the intracanal dressing: Group I, solution of acetazolamide and Group II, calcium hydroxide paste. Teeth were then reimplanted in their respective sockets. The animals were killed at 15, 30, and 60 days after reimplantation and the samples processed for morphometric and microscopic analysis. The results showed that calcium hydroxide paste limited root resorption, even though not avoiding it. In contrast, no root resorption was observed after 60 days in the acetazolamide group, confirming the efficacy of the substance in inhibiting root resorption.

The objective of this study was to evaluate the influence of calcium hydroxide in intracanal dressing on the ability of the dyes rhodamine B and methylene blue to label the dentine. Forty extracted human mandibular premolars had their canals instrumented and were divided into four groups: in two groups, the canals were filled with a calcium hydroxide paste and the others remained in distilled water. After 15 days, in two groups (with and without dressing), the canals were obturated with sealer containing methylene blue, whereas the others contained rhodamine B. For analysis, the roots were transversally sectioned in their cervical, medium and apical thirds, and the labeling was analyzed. The Mann-Whitney test showed statistically significant difference between the dressing/methylene blue group and the others. Based on these results, it was concluded that calcium hydroxide in intracanal dressing negatively interferes with the labeling ability of methylene blue.

Glass ionomer cements are important options in restorative and preventive dentistry due to their adhesion to the tooth surface and to fluoride release, which can decrease the risk of recurrent caries. The topical use of acidulated and neutral fluoride gels has been frequent in dentistry. However, this procedure can adversely affect the surface of restorative materials, increasing their roughness and the retention of dental plaque. Thus, this study evaluated the period in which Vitremer glass ionomer cement maintains its antimicrobial activity over Streptococcus mutans ATCC 25175, as well as the effects of topical application of acidulated and neutral fluoride gels on these microbiological parameters and on the superficial characteristics of the restorative material. It was verified that the antimicrobial activity of Vitremer is very transient, decreasing to an undetectable level after four days, and the topical application of fluoride gel did not restore this activity. It was observed that S. mutans ATCC 25175 adheres to this restorative material, and the topical fluorides did not affect this event. The surface of Vitremer was not altered by the application of fluoride gels.