André Luis Shinohara

Efficacy of NiTi rotary instruments in removing calcium hydroxide dressing residues from root canal walls

THE AIM OF THIS STUDY was to evaluate the efficacy of three rotary instrument systems (K3, ProTaper and Twisted File) in removing calcium hydroxide residues from root canal walls. Thirty-four human mandibular incisors were instrumented with the ProTaper System up to the F2 instrument, irrigated with 2.5% NaOCl followed by 17% EDTA, and filled with a calcium hydroxide intracanal dressing. After 7 days, the calcium hydroxide dressing was removed using the following rotary instruments: G1 - NiTi size 25, 0.06 taper, of the K3 System; G2 - NiTi F2, of the ProTaper System; or G3 - NiTi size 25, 0.06 taper, of the Twisted File System. The teeth were longitudinally grooved on the buccal and lingual root surfaces, split along their long axis, and their apical and cervical canal thirds were evaluated by SEM (×1000). The images were scored and the data were statistically analyzed using the Kruskall Wallis test. None of the instruments removed the calcium hydroxide dressing completely, either in the apical or cervical thirds, and no significant differences were observed among the rotary instruments tested (p > 0.05).

Evaluation of the interaction between sodium hypochlorite and several formulations containing chlorhexidine and its effect on the radicular dentin—SEM and push‐out bond strength analysis

The aim of the current study was to evaluate the presence of debris and smear layer after endodontic irrigation with different formulations of 2% chlorhexidine gluconate (CHX) and its effects on the push‐out bond strength of an epoxy‐based sealer on the radicular dentin. One hundred extracted human canines were prepared to F5 instrument and irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Fifty teeth were divided into five groups (n = 10), according to the final irrigation protocol with different 2% CHX formulations: G1 (control, no final rinse irrigation), G2 (CHX solution), G3 (CHX gel), G4 (Concepsis), and G5 (CHX Plus). In sequence, the specimens were submitted to scanning electron microscopy (SEM) analysis, in the cervical‐medium and medium‐apical segments, to evaluate the presence of debris and smear layer. The other 50 teeth were treated equally to a SEM study, but with the root canals filled with an epoxy‐based endodontic sealer and submitted to a push‐out bond strength test, in the cervical, middle, and apical thirds. G2, G3, G4, and G5 provided higher precipitation of the debris and smear layer than G1 (P < 0.05), but these groups were similar to each other (P > 0.05), in both segments. The values obtained in the push out test did not differ between groups, independent of the radicular third (P > 0.05). The CHXs formulations caused precipitation of the debris and smear layer on the radicular dentin, but these residues did not interfere in the push‐out bond strength of the epoxy‐based sealer. Microsc. Res. Tech. 77:17–22, 2014.

Comparison of results obtained with standard and inside out vein graft techniques and their implication on neurotrophin expression in repair of nerve defect: An experimental study

Standard vein graft (SVG) and inside out vein graft (IOVG) techniques to promote peripheral nerve regeneration have been widely studied since last two decades. In this experimental study, we attempted to compare these two techniques and analyze the differences in the expression of the neurotrophins during peripheral nerve regeneration. Thirty‐six male Wistar rats were used in this sciatic nerve transection model and were divided into two experimental groups (SVG and IOVG) and one sham operated control group. An overall defect of 10 mm was made in the sciatic nerve of the animals in the experimental groups. Each group consisted of two time intervals of 6 and 12 weeks (n = 6). After each experimental interval, sciatic functional index (SFI) along with area and diameter of the axons and fibers of each group were calculated. Muscle mass measurements were also evaluated to see any functional recovery in the groups. Expression of neurotrophins in the graft and distal stump were analyzed with the help of RT‐PCR. SFI obtained from walking track analysis showed poor motor recovery in the experimental groups during both time intervals. No significant differences in the histological, morphometric (P > 0.05), and muscle mass measurements (P > 0.05) between the two experimental groups were observed. Analysis of RT‐PCR data exhibited an increase in the expression of NT‐3 with time in both the grafts (6 weeks 0.428 ± 0.392, 12 weeks 1.089 ± 0.455, P < 0.05) and distal stump (6 weeks 0.411 ± 0.306, 12 weeks 0.807 ± 0.303, P < 0.05) of the SVG group. The study concludes that there is no substantial difference in the nerve regeneration ability between both the techniques. Also, the difference in the level of NT‐3 between SVG and IOVG suggests a distinct regulation of NT‐3 in peripheral nerve regeneration.

Visible epiglottis in children.

ABSTRACT% Visible epiglottis is a rare anatomical variant which is usually asymptomatic without the need of any medical or surgical intervention. It is most commonly seen in children but there are some reports of its prevalence in adults too. Cases of visible epiglottis seem to be unfamiliar among dental professionals. In this report, we have attempted to present this anatomical variant of epiglottis in the feld of dentistry by describing a case of an 8-year-old girl who presented to the department of pediatric dentistry for normal dental check-up unaware of the existence of the visible epiglottis. How to cite this article: Ahmed FJ, Shinohara AL, da Silva SMB, Andreo JC, de Castro Rodrigues A. Visible Epiglottis in Children. Int J Clin Pediatr Dent 2014;7(3):223-224.

Surgical anatomy of the human middle ear: an insight into cochlear implant surgery.

PurposeThis research was designed to aid practical otologic studies of the human middle ear. The topographic anatomy access of the middle ear was described with special focus to the cochlear implant procedure. It was conducted in an attempt to elucidate factors that would ultimately determine the ease of insertion of an electrode array.MethodsFifteen right and 12 left temporal bones were dissected under the surgical microscope. After performing appropriate incisions, the distances between the stapedius muscle tendon, incus long crus and the cochleostomy were measured with the help of a digital microscope (Dino-Lite plus®).ResultsAfter performing statistical analysis, we found that strong relationship exists in the distances between the measured anatomical landmarks.ConclusionMicroscopic anatomical studies of the temporal bone are essential to safely perform surgical intervention within the middle ear. The results shows that morphometric data concerning different anatomical structures inside the middle ear, particularly distances, is an important contribution towards the planning of safe surgical procedures.

Identification of the bony canal of the posterior superior alveolar nerve and artery in the maxillary sinus: tomographic, radiographic, and macroscopic analyses.

The aim of this study was to identify the shape and route of the bony canal of the posterior superior alveolar artery (PSAA) and posterior superior alveolar nerve (PSAN) using different identification methods, including computed tomography (CT), panoramic radiograph, and macroscopic evaluation (corpse and dry skull). Twenty-four patients were analyzed by CT and panoramic and posterior anterior (PA) radiographs; additionally, 90 dry skulls and 21 dissected anatomical specimens were examined. Three-dimensional-CT revealed that the lateral wall of the maxillary sinus resembled a tunnel format in 60% of the treated patients. Out of all 24 patients, the panoramic radiograph identified the bony canal in only one patient; whereas the PA radiograph identified it in 80% of the patients. The dry skulls showed tunnellike routes of the PSAA and PSAN in 65% of the cases. Moreover, the pathway was also visibly observed in the dissected anatomical specimens as a straight shape in 85% of the cases. Thus, our results demonstrated that the most common shape of the bony canal of the PSAA and PSAN is the tunnel format with a straight route by 3D-CT, posterior anterior radiography, and macroscopic evaluation. However, in the panoramic radiographs, it was difficult to identify this canal.

Anatomical, clinical and radiographic characteristics of styloid syndrome (Eagle syndrome): a case report

El sindrome estilode (Sindrome de Eagle) se caracteriza por un proceso estiloides alargado o calcificacion de los ligamentos estilohioideo y estilomandibular. Este estudio describe el caso de una mujer de 65 anos de edad que concurrio a la Clinica Estomatologica de la Universidad de Marilia con dolor de la articulacion temporomandibular, zumbido en los oidos y una disminucion de la capacidad de abrir la boca. Las radiografias digitales panoramica y posteroanterior mostraron alargamiento bilateral de los procesos estiloides, especialmente del lado derecho, cuya longitud se extendio mas alla del angulo de la mandibula. El diagnostico se confirmo con la asociacion de los datos clinicos y los examenes de imagen. Las opciones de tratamiento para el sindrome estiloide incluyen el seguimiento clinico, la extirpacion quirurgica del proceso estiloides o la fractura del proceso alargado. El caso fue tratado con rehabilitacion protesica y seguimiento clinico, observando el nivel de molestia y el beneficio que se podria lograr mediante la terapia, evitando la intervencion quirurgica.

Ipsilateral supplementary lateral incisors: a case report

Supernumerary teeth are one of the dental anomalies which occur due to the developmental disturbances in teeth. They can be seen in various shape and form. They can occur in both the deciduous and permanent dentition and can impose aesthetic and occlusion problems. Morphologically the supernumerary teeth exhibit various forms ranging from conical to tuberculate and supplemental types. Supplemental teeth as the name suggests are similar in shape to that of the normal prototype. In this particular case, we are reporting a case of ipsilateral supplemental permanent lateral incisors and the treatment approach which would subsequently facilitate the patient to undergo orthodontic treatment.

Morphological Study of Myoneural Interaction between the Levator Labii Superioris Muscle and its Motor Nerve in Rats

El progreso de la ciencia en busca de nuevas tecnicas para la regeneracion neural y la recuperacion funcional de los musculos reinervados, ha atraido el interes de muchos investigadores en todo el mundo. En consecuencia, los musculos y los nervios merecen mas aclaraciones sobre su morfologia, relaciones anatomicas y particularidades. Entre las areas que merecen estudios mas profundos y detallados, esta la region de cabeza y cuello, que es a menudo afectada por enfermedades graves. Con el proposito de ofrecer a la comunidad cientifica un modelo morfologico de interaccion mioneural, se eligio el musculo elevador del labio superior y su nervio motor, la rama bucal del nervio facial (VII par craneal), por sus especiales caracteristicas y su importancia en la expresion facial. En esta investigacion se opto por la rata, por las facilidades de obtencion, de manejo y para comparar los datos obtenidos con estudios previos. Se utilizaron tecnicas mesoscopicas de diseccion, histoenzimologicas y morfometricas. Los resultados mostraron un musculo con predominio de fibras de contraccion rapida (FG y FOG), ubicacion superficial, insercion proximal osea e insercion distal en la piel. Su nervio motor, la rama bucal del nervio facial, ingresa en el vientre muscular en la cara profunda, y esta compuesto por un grupo heterogeneo de fibras nerviosas mielinicas dispuestas de forma regular por todo el fasciculo nervioso cerca del punto motor. El nervio es formado por dos fasciculos de diferentes tamanos. Debido a las pequenas dimensiones en la rata, el diametro de las fibras nerviosas presenta valores reducidos, en comparacion con el nervio motor del musculo pectineo en el gato, por ejemplo. Los datos aportados podran ser usados como referencia en estudios de regeneracion en nervios y musculos. Otros estudios con marcadores neuronales se iniciaron para aclarar la distribucion y la estructura de las fibras mencionadas.