Fábio André dos Santos

Effect of Pretreatment Prednisolone on Postendodontic Pain: A Double-blind Parallel-randomized Clinical Trial

INTRODUCTION Effective management of endodontic pain represents a continuing challenge. This study evaluates the use of a preoperative, single oral dose of prednisolone for the prevention and control of postendodontic pain. METHODS Forty patients were randomly assigned to 2 groups, placebo and prednisolone (30 mg). The medications were administered 30 minutes before the start of standard endodontic treatment. Postoperative pain was assessed after 6, 12, and 24 hours by using a visual analogue scale. RESULTS The outcome showed that prednisolone resulted in a statistically significant reduction in postendodontic pain at 6, 12, and 24 hours (P < .0001). No side effects were reported for any of the medications used. CONCLUSIONS This study suggests that a preoperative, single oral dose of prednisolone substantially reduced postendodontic pain. Further studies are needed to evaluate the applicability of these findings to other clinical conditions, single- versus multiple-visit endodontic treatment, and drug regimens.

Comparison of Biomaterial Implants in the Dental Socket: Histological Analysis in Dogs

BACKGROUND Bone graft procedures have been used commonly in buco-maxillo-facial surgery. For this reason, many researchers have evaluated the bone substitutes. PURPOSE The present study evaluated soft and hard tissue reactions to two different hydroxyapatites HAs (synthetic HA and natural HA) and bioactive glass implanted into the sockets immediately after extraction. MATERIALS AND METHODS First and third upper and lower premolars, on both sides, were extracted from six female dogs. The alveolar sockets were randomly assigned to four groups: Group 1 - control (unfilled), Group 2 - filled with synthetic hydroxyapatite, Group 3 - filled with bovine bone mineral (natural HA), and Group 4 - filled with bioactive glass. The animals were euthanized at 4 weeks (n = 2), 8 weeks (n = 2), and 28 weeks (n = 2) after extraction. The mandible and maxilla of each animal were removed for histological analysis to determine soft tissue reactions, newly formed bone, bone characteristics, and presence or absence of implanted materials. RESULTS Most particles of synthetic hydroxyapatite had bone formation on their surface, although some particles showed a layer of fibrous connective tissue. The bovine bone mineral group exhibited particles partially replaced with bone formation. The bioactive glass group showed particles with a thin layer of calcified tissue, but was absent in some specimens, suggesting complete resorption. CONCLUSION All biomaterials had similar behavior. Bovine bone mineral, compared to synthetic hydroxyapatite and bioactive glass, showed a larger number of particles covered with osseous tissue. All biomaterials interfered with the socket repair process.

Effect of pretreatment dexamethasone on postendodontic pain

OBJECTIVE This study evaluates the use of a preoperative single oral dose of dexamethasone for the prevention and control of postendodontic pain. STUDY DESIGN Forty-seven patients were randomly assigned to 2 groups: placebo and dexamethasone (4 mg). The medications were administered 1 hour before the start of endodontic treatment. Postoperative pain was assessed after 4, 12, 24, and 48 hours. RESULTS Dexamethasone resulted in a statistically significant reduction in postendodontic pain at 4 and 12 hours (P < .05). However, no statistical difference (P > .05) was observed at 24 and 48 hours (Mann-Whitney test). The placebo group exhibited higher rescue medication intake (P < .05; Student t test). No side effects were reported for any of the medications used. CONCLUSION Preoperative single oral dose of dexamethasone substantially reduced postendodontic pain. Further studies are needed to evaluate the applicability of these findings to other clinical conditions and drug regimens.

Pre-clinical anti-inflammatory aspects of a cuisine and medicinal millennial herb: Malva sylvestris L.

Malva sylvestris has been used since ancient times for its emollient, laxative and anti-inflammatory properties, being extensively used as salads, soups and teas. The preset study evaluated the topical anti-inflammatory action of M. sylvestris hydroalcoholic extract (HE) and its compounds in mice ear inflammation caused by 12-O-tetradecanoylphorbol-acetate in mice. The LC-MS analysis of the HE confirmed the presence of scopoletin, quercetin and malvidin 3-glucoside compounds in the HE of M. sylvestris. Topical application of the HE reduced ear oedema, polymorphonuclear cells influx (myeloperoxydase activity and histological analysis) and interleukin-1β levels in the tissue. The topical application of the compound present in the HE, malvidin 3-glucoside was also able to inhibit ear oedema and leukocytes migration. The other tested compounds, scopoletin, quercetin and malvidin 3,5-glucoside were able to prevent the formation of oedema and cell infiltration, but with less effectiveness when compared to HE and malvidin 3-glucoside. Therefore, these results consistently support the notion that M. sylvestris leaves possesses topical anti-inflammatory activity, the compound malvidin 3-glucoside seems to be major responsible for this effect, with the participation of other anti-inflammatory compounds in the extract. Thus, as recommended by population, M. sylvestris can be used as a future treatment to skin disorders.

Comparative study on the effect of ultrasonic instruments on the root surface in vivo

The present study was designed to investigate the effectiveness of different ultrasonic instruments on the root surface. Fourteen patients with 35 single root teeth designated for extraction were recruited to the present study. Teeth were assigned to four experimental groups: group 1, piezoelectric ultrasonic device; group 2, magnetostrictive ultrasonic device; group 3, hand instrumentation; and group 4, untreated teeth (control). After instrumentation, the teeth were extracted and the presence of residual deposits (roughness and root surfaces characteristics) were analyzed. The results showed that residual deposits were similar in all tested groups: piezoelectric, 8.7%; magnetostrictive, 9.7%; hand instrumentation, 11.1% and control, 76.4%. There were statistically significant differences between control and all the experimental groups (p < 0.0001). With respect to roughness parameters evaluation, Ra and Rz of the roots treated with the different instruments showed a similar pattern (p > 0.05), but for Rt and Ry, a significant difference was observed (p < 0.05) among hand instrumentation and ultrasonic devices. SEM analysis revealed a similar root surface pattern for the ultrasonic devices, but curettes showed many instrumental scratches, deep gouges, and a relatively large amount of dentin was removed. Within the limits of the study, although the instruments produced similar results, root surfaces instrumentated with curettes were rougher and had more root surface tissue removed than with the ultrasonic device.

Physical-chemical characteristics of whitening toothpaste and evaluation of its effects on enamel roughness

This in vitro study evaluated the physical-chemical characteristics of whitening toothpastes and their effect on bovine enamel after application of a bleaching agent (16% carbamide peroxide). Physical-chemical analysis was made considering mass loss by desiccation, ash content and pH of the toothpastes. Thirty bovine dental enamel fragments were prepared for roughness measurements. The samples were subjected to bleaching treatments and simulated brushing: G1. Sorriso Dentes Brancos (Conventional toothpaste), G2. Close-UP Whitening (Whitening toothpaste), and G3. Sensodyne Branqueador (Whitening toothpaste). The average roughness (Ra) was evaluated prior to the bleaching treatment and after brushing. The results revealed differences in the physical-chemical characteristics of the toothpastes (p < 0.0001). The final Ra had higher values (p < 0.05) following the procedures. The mean of the Ra did not show significant differences, considering toothpaste groups and bleaching treatment. Interaction (toothpaste and bleaching treatment) showed significant difference (p < 0.0001). The whitening toothpastes showed differences in their physical-chemical properties. All toothpastes promoted changes to the enamel surface, probably by the use of a bleaching agent.

Phytochemical screening, antioxidant, and antimicrobial activities of the crude leaves' extract from Ipomoea batatas (L.) Lam.

Background: Ipomoea batatas (L.) Lam., popularly known as sweet potato (SP), has played an important role as an energy and a phytochemical source in human nutrition and animal feeding. Ethnopharmacological data show that SP leaves have been effectively used in herbal medicine to treat inflammatory and/or infectious oral diseases in Brazil. The aim of this research was to evaluate the phytochemical, antioxidant, and antimicrobial activities of the crude leaves’ extract of SP leaves. Materials and Methods: The screening was performed for triterpenes/steroids, alkaloids, anthraquinones, coumarins, flavonoids, saponins, tannins, and phenolic acids. The color intensity or the precipitate formation was used as analytical responses to these tests. The total antioxidant capacity was evaluated by the phosphomolybdenum complex method. Antimicrobial activity was made by agar disk and agar well diffusion tests. Results: The phytochemical screening showed positive results for triterpenes/steroids, alkaloids, anthraquinones, coumarins, flavonoids, saponins, tannins, and phenolic acids. Total contents of 345.65, 328.44, and 662.02 mg were respectively obtained for alkaloids, anthraquinones, and phenolic compounds in 100 g of the dry sample. The total antioxidant capacity was 42.94% as compared to ascorbic acid. For antimicrobial studies, no concentration of the SP freeze dried extract was able to inhibit the growth of Streptococcus mutans, S. mitis, Staphylococcus aureus, and Candida albicans in both agar disk and agar well diffusion tests. Conclusions: SP leaves demonstrated the presence of secondary metabolites with potential biological activities. No antimicrobial activity was observed.

An innovative quaternary ammonium methacrylate polymer can provide improved antimicrobial properties for a dental adhesive system.

A quaternary ammonium methacrylate polymer (QAMP) with antimicrobial potential was synthesized. The resulting product (QAMP) was characterized by FTIR spectroscopy, NMR spectroscopy, visible spectrophotometry, XRPD and TGA. The in vitro susceptibility tests against Streptococcus mutans of QAMP were investigated prior and after incorporation into a commercial adhesive system (Clearfil™ SE Bond). The release of quaternary ammonium compounds from the experimental adhesive system (Clearfil™ SE Bond + 5% QAMP) was performed during 1, 7, 14, 21 and 30 days. Spectroscopic data confirmed that QAMP was successfully obtained. Thermogravimetric analysis indicated that QAMP was heat stable. Prior incorporation into the adhesive system, QAMP revealed an inhibition halo of 18.33 ± 0.6 mm. By agar disk diffusion test, Clearfil™ SE Bond containing 5% QAMP presented an inhibition halo (16.67 ± 1.5 mm) similar to Clearfil™ Protect Bond (positive control, 17.00 ± 1.7, p = 0.815) and significantly higher than Clearfil™ SE Bond (negative control, 11.00 ± 1.0, p = 0.006). The minimum inhibitory/bactericidal concentrations for Clearfil™ SE Bond containing 5% QAMP were 20 μL mL−1. The release of quaternary ammonium compounds from the experimental adhesive containing QAMP was very low (5.1%) when compared to Clearfil™ Protect Bond that released 47.2% of its quaternary ammonium monomer (MDPB) after 30 days. The QAMP can offer enhanced antimicrobial properties for self-etching adhesive systems.

Biocompatibility of four root canal sealers: a histopathological evaluation in rat subcutaneous connective tissue

The aim of this study was to evaluate the subcutaneous biocompatibility of: Epiphany, AH Plus, Pulp Canal Sealer and Sealapex root canal sealers. Sixty rats were randomly assigned to 4 groups, according to the sealer. Polyethylene tubes containing the tested materials were inserted into the connective tissue. The implants were removed after 7, 15 and 30 days, and the tissue samples were processed, stained and examined by light microscopy. The descriptive analysis considered: thickness of the fibrous capsule, severity of the inflammatory reaction, and presence of giant cells. After 7 days, all sealers induced moderate to severe inflammatory reaction. After 15 days, Epiphany and AH Plus sealers showed a moderate inflammatory reaction, while Pulp Canal Sealer and Sealapex induced severe and mild inflammatory reactions, respectively. After 30 days, mild inflammatory reactions were observed for Epiphany, Sealapex and AH Plus. Sealapex induced the lowest inflammatory response at all evaluation periods, and only Pulp Canal Sealer did not show a decreased in the inflammatory reaction over time.

Hardness of a bleaching-shade resin composite polymerized with different light-curing sources

The microhardness of a bleaching-shade resin composite polymerized with different light-curing units was evaluated. Composite samples (3M ESPE Filtek Supreme) were applied to brass rings (2 mm in thickness, 5 mm in diameter). Three commercial LED lights were used to polymerize the specimens and the results were compared to those of a conventional halogen light. The light sources used in the present study were: Demetron Optilux 401 (QTH), 3M ESPE Elipar FreeLight (LED 1); Kerr L.E. Demetron I (LED 2), and ColtoluxLED lights (LED 3). The microhardness of the top and bottom surfaces was assessed with a digital Vickers hardness-measuring instrument, under load. At the bottom surface, no significant difference among the light sources was observed (two-way ANOVA). At the top surface, the QTH light source presented significantly higher hardness values compared to the values observed when LED 1 and LED 3 were used. There were no significant differences between the QTH and LED 2 light sources. Significantly higher hardness values were also found at the top surface when compared to the values observed at the bottom surface. The power density of the polymerization light sources seemed to be responsible for the observed resin composite hardness, not their irradiance.