This paper describes the clinical courses of three cases with extra-oral sinus tract formation, from diagnosis and treatment to short-term follow-up and evaluation. All teeth involved had periradicular radiolucent areas noted on radiographic examination and extra-oral sinus tracts appearing on the chin with exudation and unpleasant aesthetic appearance. The adopted treatment protocol included treating the sinus tract surface simultaneously with the root canal therapy. After root canal shaping using 5.25% sodium hypochlorite solution, calcium hydroxide-based pastes associated with different vehicles were inserted into the root canal for 4 months, and were changed monthly. All the sinus tracts healed in 7 to 10 days. The apical lesions were completely repaired in a maximum period of 24 months. The treatment adopted provided a complete healing of the periapical lesions in a short follow-up period. Surgical repair of the cutaneous sinus tract was therefore unnecessary.

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Oral mucositis is a harmful side effect of radiotherapy (RT) on the head and neck region. There are encouraging reports on the beneficial aspects of the use of laser light on the treatment of oral mucositis. This paper reports the efficacy of laser phototherapy (LPT) on the treatment of oral mucositis in a patient undergoing RT after surgical removal of a squamous cell carcinoma with osseous invasion of the maxilla. Palatal and commissural lesions were treated with l660 nm, 40 mW, ∅=4 mm 2 , in contact mode, 5 x 2.4 J/cm 2 per point, 14.4 J/cm 2 per session. For treating the lesion on the patient's nasal mucosa, LPT (∅=4 mm 2 , l780 nm, 70 mW, 3 x 2.1 J/cm 2 per point, 6.3 J/cm 2 per session, contact mode) was used on the external area of the nose. A single dose (2.4 J/cm 2 ) with the l660 nm laser, as described before, was applied on the entrance of each nostril. LPT was used 3 times/week during 4 weeks. Treatment results indicate that the use of LPT on oral mucositis was effective and allowed the patient to carry on the RT without interruption. However, long-term and controlled clinical trials are necessary to establish both preventive and curative protocols using LPT.

The aim of this work was to verify the existence of correlation between Raman spectroscopy readings of phosphate apatite (~960 cm -1 ), fluoridated apatite (~575 cm -1 ) and organic matrix (~1450 cm -1 ) levels and Diagnodent ® readings at different stages of dental caries in extracted human teeth. The mean peak value of fluorescence in the carious area was recorded and teeth were divided in enamel caries, dentin caries and sound dental structure. After fluorescence readings, Raman spectroscopy was carried out on the same sites. The results showed significant difference (ANOVA, p<0.05) between the fluorescence readings for enamel (16.4 ± 2.3) and dentin (57.6 ± 23.7) on carious teeth. Raman peaks of enamel and dentin revealed that ~575 and ~960 cm -1 peaks were more intense in enamel caries. There was significant negative correlation (p<0.05) between the ~575 and ~960 cm -1 peaks and dentin caries. It may be concluded that the higher the fluorescence detected by Diagnodent the lower the peaks of phosphate apatite and fluoridated apatite. As the early diagnosis of caries is directly related to the identification of changes in the inorganic tooth components, Raman spectroscopy was more sensitive to variations of these components than Diagnodent.

Objective:The aim of this study was to evaluate the biomechanical preparation of flattened root canals using the following systems: Endo-Eze AET stainless steel oscillatory instruments (Ultradent) and RaCe rotary NiTi instruments (FKG Dentaire).Materials and Methods:Twenty extracted human mandibular incisors were randomly assigned to two groups: Group 1 - Instrumentation with oscillatory Endo-Eze AET files (oscillatory technique); Group 2 - Instrumentation with rotary NiTi RaCe files (rotary technique). The teeth were decoronated, had their apices and coronal openingssealed with sticky wax and were embedded in crystal-clear orthophtalic polyester resin. The roots were sectioned transversally with diamond discs at 10 mm (middle third) and 5 mm (apical third) from the apex and the segments were reassembled for instrumentation. The sections were photographed before and after root canal instrumentation and evaluated with respect to whether the original root canal shape was modified by instrumentation. To evaluate the differences in the root canal shape before and after biomechanical preparation, scores were given regarding the instruments touch on the intracanal walls.Results:In middle third of the root canals instrumented with the rotary system, there was a change in the original canal anatomy (p<0.05), with formation of a protuberance in the mesiodistal direction. This protuberance did not occur when the oscillatory instrumentation was used. The oscillatory system had better results in the middle and apical thirds as evaluated by Dunn’s multiple-comparison test (p>0.05).Conclusion:Under the tested conditions, Endo-Eze oscillatory system yielded the instrumentation of all flattened root canal walls, maintaining the canal original shape throughout the biomechanical preparation, and was more effective than RaCe rotary system.

ResumoDiabetes melito (DM) abrange um grupo de distúrbios metabólicos que têm em comum a presença de hiperglicemia. Além das manifestações sistêmicas, o DM mal controlado apresenta importantes repercussões sobre a saúde oral (e.g., doença periodontal, xerostomia, hiposalivação, susceptibilidade a infecções, dificuldade de cicatrização). Este trabalho tem por objetivo destacar a importância do conhecimento básico do odontologista sobre DM e propor um protocolo de atendimento dentário para esses pacientes. A revisão bibliográfica foi realizada nos bancos de dados MEDLINE e LILACS, com pesquisa em artigos publicados nos últimos dez anos, a partir das palavras-chave: diabetes mellitus, dentistry, oral health e periodontal disease. Os resultados são estruturados em tópicos. Na primeira parte, são atualizadas informações sobre diagnóstico, manifestações clínicas, repercussões orais e tratamento do DM. Na segunda parte, propomos um protocolo de atendimento, no qual são discutidas, de modo didático (e.g., anamnese, exame físico, exames complementares, conduta), as dúvidas mais comuns em relação à consulta odontológica do diabético (e.g., profilaxia antibiótica em procedimentos com risco de bacteremia, uso de antiinflamatórios, sedativos e anestésicos com vasoconstrictores, tratamento paliativo versus definitivo, como proceder em casos de hipoglicemia e hiperglicemia, quando suspeitar de um DM não diagnosticado). Ao final, uma ficha clínica sumariza os principais aspectos da consulta odontológica do paciente diabético. Conclui-se que diabéticos bem controlados e sem complicações podem ser tratados de modo similar a não-diabéticos, para a maioria dos procedimentos de rotina. O cirurgião-dentista, em comunicação com o médico assistente, desempenha um importante papel na promoção e manutenção do bem-estar e qualidade de vida do paciente diabético.

The aim of this study was to evaluate, clinically and histologically, the influence of laser and LED photobiomodulation in the healing of formocresol-induced oral mucosa ulcers of rats. We used 60 Wistar rats in which oral ulcers were induced on the gingiva of the lower incisors. Forty-eight hours after inducing the ulcers, the animals were divided into three groups: laser, LED, and untreated. Animals from the laser group received irradiation with GaAlAs, 660 nm, CW, 40 mW, φ 4 mm(2), 4.8 J/cm(2). Animals from the LED group received irradiation with InGaAIP, 630 nm, 150 mW, 4.8 J/cm(2), 0.8 cm spot. Forty-eight hours after oral ulcer induction, both irradiations were applied in a punctuate manner in the center of the ulcer at 48-h interval until the end of the experimental period. The animals were killed at 3, 5, 7, and 11 days after day 0. The results of the clinical evaluation showed that the laser and LED phototherapies were able to accelerate the healing of formocresol-induced oral ulcers, which occurred first in the laser group (ANOVA, p < 0.05). Histologically, there was a slight variation between LED and laser therapy; therefore, the laser group proved to be effective in accelerating wound healing, especially at 5 days, whereas the LED group was more effective at the end of the experimental period. It was concluded that laser and LED photobiomodulation were effective in accelerating the healing of formocresol-induced oral ulcers in both clinical and histological aspects.

The use of laser phototherapy on the root surface and at the entrance of the alveolus prior to replantation had a positive biomodulative effect on alveolar repair after tooth replantation in rats.