Root canal preparation is an important step in endodontic treatment. The anatomical complexity of the middle third of the root compromises the effective cleaning of this area. Thus, advances have been made in instrumentation techniques and instruments for this purpose. The aim of this study was to evaluate the effects of three different instrumentation systems on the enlargement of the middle thirds of root canals in mandibular incisors. The preparation methods used were the reciprocating systems Reciproc (Group I) and WaveOne (Group II) and the oscillatory system Tilos (Group III). Comparisons were made by three-dimensional image reconstruction with cone-beam computed tomography before and after instrumentation. Changes in area, perimeter, centering ability, and pattern of preparation were analyzed. The results were subjected to ANOVA complemented by the Tukey's test. Changes in area, perimeter, and tendency of transportation showed similar results among groups. The transportation index of the Tilos system was significantly lower than that of the other groups. Qualitative analysis of the preparation pattern showed that the Tilos system had a more uniform preparation, although Reciproc and WaveOne preparations appeared more rounded, incompatible with the original canal anatomy. There was similarity in the systems' performance on flattened areas, although the Tilos system presented a better pattern of root canal preparation and a lower index of transportation.
laryngeal involvement in recurrent aphthoid stomatitis is rare. Therefore, during diagnostic examination thorough clinical history and meticulous physical examination accompanied by fibroscopic examination are necessary. When atypical lesions are found, biopsies for histological evaluation and direct immunofluorescence tests are required.
Based on our results, we conclude that the patients with RAS do not show deposits of immunocomplexes in their oral cavity mucosa and immunofluorescence is useful in the differential diagnosis between this disease and bullous skin diseases.
Recurrent aphthoid stomatitis is characteristically observed in children and adolescents in the form of painful relapsing ulcers in the oral mucosa unaccompanied by evidences of systemic disease. The ulcers appear every one or two weeks for at least one entire year. Some patients suspected for recurrent aphthoid stomatitis develop lesions in atypical sites -mainly in the larynx -concurrently to the ones found in the oral mucosa. Aim: this study aims to describe a series of recurrent aphthoid stomatitis patients with atypical laryngeal injuries. Study design: this is a case series study. Materials and method: patients diagnosed with recurrent aphthoid stomatitis with oral mucosa ulcers and laryngeal symptoms without altered lab test results and no evidence of systemic disease underwent fibroscopic examination, oral and laryngeal biopsies, followed by specimen evaluation by direct immunofluorescence. Results: all six patients in this series had acute and chronic inflammatory processes according to pathology studies and negative direct immunofluorescence test results. Conclusion: laryngeal involvement in recurrent aphthoid stomatitis is rare. Therefore, during diagnostic examination thorough clinical history and meticulous physical examination accompanied by fibroscopic examination are necessary. When atypical lesions are found, biopsies for histological evaluation and direct immunofluorescence tests are required.
Recurrent aphthous stomatitis (RAS) is a diseasecharacterized by the periodic appearance of aphthous lesions on the oral mucosa, of which etiology and physiopathology are not well explained. Recent studies with direct immunofluorescence show controversial results. Some reveal that the basic disorder is associated with humoral immunity, while others point to changes in cellular immunity. Atypical forms of aphthous stomatitis may have its differential diagnosis carried out with vesicobullous diseases, such as pemphigus vulgaris. Aim: Check the presence of immunocomplexes in the mucosa of patients with aphthous stomatitis and the usefulness of the differential diagnosis method with bullous skin diseases. Materials and methods: 23 patients with aphthous stomatitis were prospectively included in the study. There were all submitted to mucosa biopsy under local anesthesia for the removal of two fragments. One of these was sent to histology and, the other to direct immunofluorescence. Results: The 23 samples from the histology exam revealed an ulcerated inflammatory process. The samples referred to immunofluorescence resulted negative and only one showed the presence of complement in the basal membrane. Conclusion: Based on our results, we conclude that the patients with RAS do not show deposits of immunocomplexes in their oral cavity mucosa and immunofluorescence is useful in the differential diagnosis between this disease and bullous skin diseases.
Allergic rhinitis (AR) and asthma represent a continuum of atopic disease and frequently occur as co-morbid conditions in the same patients. The precise mechanism underlying the inflammatory response in the lower airways of rhinitics is not fully elucidated. The primary objective of our study was to understand and to assess the inflammatory response within the upper and lower airways in patients suffering with both asthma and allergic rhinitis. METHODS: Endobronchial and nasal biopsies were obtained from atopic patients with mild asthma and persistent allergic rhinitis. Single blinded study was carried out between April 2007-July 2008. Coded biopsy specimens were embedded into glycol methacrylate resin for immunohistochemical analysis using monoclonal antibodies directed against specific cell markers including mast cells (AA1), eosinophils (EG2), neutrophils (NOE), lymphocytes (CD3ϩ, CD4ϩ, CD8ϩ). 10 analyzable biopsy specimens were studied. Cells were counted blind, as cells/mm2 both in the epithelium and the submucosal matrix. MannWhitney U-test was used for analyses. P-values of 0.05 were considered to be statistically significant. RESULTS: There was a significant increase in CD4ϩ, CD8ϩ cell counts (pϽ0.05) in lower airway. There were no differences between the two groups in the numbers of neutrophils, mast cells, eosinophils and the CD3ϩ cell counts. CONCLUSIONS: The upper airway had a similar pattern of mast cells, neutrophils and eosinophils to that in the lower airway. The increased CD4ϩ lymphocytes may be important in development and maintenance of allergic disease in the lower airway while the CD8 suggests functional diversity and protective effects in the lower airway.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.