O trauma em dentes decíduos é uma ocorrência comum na infância, sendo a reabsorção radicular patológica (RRP) uma das sequelas observadas no próprio dente traumatizado. A proposta deste estudo de coorte histórico foi avaliar a associação entre a ocorrência de reabsorção radicular externa e a perda precoce de incisivos centrais superiores decíduos traumatizados. Um examinador treinado e calibrado avaliou as fichas clínicas, fotografias e radiografias de prontuários de pacientes atendidos no Centro de Pesquisa e Atendimento de Traumatismos em Dentes Decíduos da FOUSP de 1998 a 2016. Após critérios de inclusão e exclusão, 521 prontuários foram analisados. Observou-se que 56,6% dos pacientes eram do sexo masculino, 54,7% tinham menos de 3 anos de idade e 30,7% tinham mordida aberta anterior e/ou sobressaliência no momento do trauma. A amostra deste estudo foi composta de 803 incisivos centrais superiores decíduos traumatizados, dos quais 69,2% sofreram trauma de tecido periodontal. Observou-se em 56 dentes (7%) reabsorção fisiológica, 138 (17,2%) reabsorção relacionada à reparação óssea (RRR), 163 (20,3%) reabsorção relacionada à infecção (RRI) e 446 (55,5%) reabsorção relacionada à expansão do folículo do sucessor permanente (RREXP). A ocorrência de reabsorção radicular patológica foi de 93% dos dentes incluídos neste estudo. A RREXP apresentou as maiores médias de tempo entre a ocorrência do trauma e o diagnóstico da reabsorção e entre o diagnóstico da reabsorção e a perda do dente, 32,3 meses e 24,1 meses, respectivamente. Já em contrapartida a RRI foi a que apresentou as menores médias 12,8 meses e 5 meses, respectivamente. A associação entre as variáveis independentes e os desfechos foram avaliadas usando análises de regressão de Poisson que permitiram o cálculo dos valores de risco relativo (RR) e respectivos intervalos de confiança de 95%. Em relação ao desfecho perda precoce, a análise de regressão de Poisson multivariada no modelo hierárquico pré-definido indicou como fatores de risco a presença de mordida aberta e/ou sobressaliência (RR = 1,95; 1,20 - 3,18), traumas de tecido periodontal do tipo luxação (RR = 1,84; 1,03 - 3,31) ou luxação com deslocamento (RR = 2,37; 1,36 - 4,12), reabsorção relacionada à reparação óssea (RR = 3,35; 1,17 - 9,55), reabsorção relacionada à infecção (RR = 7,55; 2,74 - 20,81) e a presença de necrose pulpar (RR = 2,35; 1,18 - 4,67). O tratamento endodôntico foi considerado fator de proteção (RR = 0,53; 0,36 - 0,77). Para o desfecho reabsorção desfavorável (RRR e RRI), a análise de regressão de Poisson multivariada indicou como fatores de risco trauma de tecido periodontal do tipo luxação (RR = 1,93; 1,20 - 3,09) e luxação com deslocamento (RR = 2,81; 1,80 - 4,38), traumas de tecido duro (RR = 1,94; 1,21 - 3,12) e ter coloração dental cinza ou marrom (RR = 1,46; 1,09 - 1,95). A calcificação pulpar foi considerada fator de proteção (RR = 0,51; 0,38 - 0,69). Conclui-se que a ocorrência de reabsorção radicular externa patológica em incisivos centrais superiores decíduos traumatizados é alta, e que as reabsorções relacionadas à reparação óssea e à infecção são desfavoráveis ao ciclo fisiológico destes dentes, porém o prognóstico melhora com o tratamento endodôntico. / Trauma in primary teeth is a common occurrence in childhood, and the pathological root resorption (PRR) is one of the sequelae, which may be observed in the traumatized tooth itself. The purpose of this historical cohort study was to evaluate the association between the occurrence of external root resorption and the premature loss of traumatized primary upper central incisors. One trained and calibrated examiner evaluated the dental records, photographs and radiographs of patients attended at the Research and Clinical Centre of Dental Trauma in Primary Teeth of FOUSP from 1998 to 2016. After inclusion and exclusion criteria, 521 dental records were evaluated. It was observed that 56.6% of the patients were males, 54.7% were less than 3 years of age and 30.7% had anterior open bite and/or overjet at the time of trauma. The study sample was composed of 803 traumatized primary upper central incisors, of which 69.2% suffered periodontal trauma. It was observed in 56 teeth (7%) physiological resorption, 138 teeth (17.2%) repair-related resorption (RRR), 163 teeth (20.3%) infection-related resorption (IRR) and 446 teeth (55.5%) expansion of dental sac-related resorption (EDSRR). The occurrence of pathological root resorption was 93% in the teeth included in this study. EDSRR presented the highest mean time between the occurrence of trauma and the diagnosis of resorption, and between the diagnosis of resorption and tooth loss, 32.3 months and 24.1 months, respectively. On the other hand, IRR presented the lowest averages 12.8 months and 5 months, respectively. The association between independent variables and outcomes was assessed after performance of Poisson regression analyses (regular or hierarchical model), which allowed the calculation of relative risk (RR) values and respective 95% confidence intervals. In relation to the premature tooth loss outcome, the multivariate Poisson regression analysis using the predefined hierarchical model indicated as risk factors: presence of anterior open bite and/or overjet (RR = 1.95; 1.20 - 3.18), periodontal trauma such as luxation (RR = 1.84; 1.03 - 3.31) or luxation with tooth displacement (RR = 2.37; 1.36 - 4.12), repairrelated resorption (RR = 3.35; 1.17 - 9.55), infection-related resorption (RR = 7.55; 2.74 - 20.81) and presence of pulp necrosis (RR = 2.35; 1.18 - 4.67). Endodontic treatment was considered a protection factor (RR = 0.53; 0.36 - 0.77). Regarding the desfavorable resorption outcome (RRR and IRR), the multivariate Poisson regression analysis indicated as risk factors periodontal trauma such as luxation (RR = 1.93; 1.20 - 3.09) and luxation with tooth displacement (RR = 2. 81; 1.80 - 4.38), hard tissue trauma (RR = 1.94; 1.21 - 3.12) and had grey or brown tooth colour (RR = 1.46; 1.09 -1.95). Pulp calcification was considered a protection factor (RR = 0.51; 0.38 -0.69). It is concluded that the occurrence of pathological external root resorption in traumatized primary upper central incisors is high, and repair-related and infection-related resorptions are unfavourable to the physiological cycle of these teeth, however the prognosis improves when endodontic treatment is performed.

No description available.

The current study investigated the distribution of periodontal epithelial cells and nerve fibres within the furcations of rat maxillary molar teeth subjected to hypothermic injury. The upper right first molars of 30 Sprague-Dawley rats were subjected to a single 20 minute application of dry ice in order to produce aseptic necrosis within the periodontal ligament, while the contralateral first molar served as an untreated control. Five animals were each sacrificed via cardiac perfusion after 7, 10, 14, 18, 21 and 28 days respectively and the maxillae were dissected out. After fixation in paraformaldehyde and processing, the tissues were embedded in paraffin wax and cut into 7µm serial coronal sections through the furcation region. Consecutive sections were then stained with H&E, cytokeratin AE1/AE3 and PGP 9.5 immunostains. Light microscopic examination of the H&E stained sections revealed that ankylosis had not developed in all of the experimental teeth, and in some of the observation groups fewer teeth were ankylosed than unaffected. The morphology of the ankylotic areas appeared to change with time, initially consisting of fine bony trabeculae, then progressing to solid bone occupying the entire furcation before becoming less solid again by the latest observation periods. Root resorption was often seen adjacent to areas of ankylosis, but the cementum of the tooth root at the point of ankylotic union was usually intact and free of resorption. Changes within the pulp chambers of the experimental teeth were also noted, with reduction in cellularity and tissue disorganisation initially, then increasing cellularity and formation of a cementum-like material on the chamber walls later. Cytokeratin AE1/AE3 immunostaining successfully identified epithelial cells within the periodontal ligament and their distribution around control teeth was similar to previous reports. Counting of these cells revealed lower numbers around experimental teeth, with the lowest counts around experimental teeth which had developed ankylosis. No change in the epithelial cell counts was detected over time, and these cells did not appear to regenerate after necrosis regardless of whether or not ankylosis developed. Statistical analysis indicated that the probability of ankylosis decreased as the number of epithelial cells increased. The PGP 9.5 immunostain identified periodontal nerve fibres, but the use of this stain was quite technique sensitive. The furcations of the molar teeth were noted to have relatively sparse innervation, with most of the visible nerve fibres being closely associated with blood vessels and located in the outer two-thirds of the ligament. Counting of the nerve fibres revealed fewer fibres around experimental teeth compared to control teeth, especially in the part of the ligament closest to the tooth root. There was no relationship detected between nerve count and time or between nerve and epithelial cell counts. Resorption was found to be more prevalent in experimental teeth, and the probability of resorption in a given tooth decreased as the epithelial cell count increased. The findings of this study suggest that the epithelial cells within the periodontal ligament have a protective function in the prevention of dentoalveolar ankylosis and resorption. Evidence of an intimate interrelationship between periodontal nerve fibre and epithelial cell numbers could not be confirmed. The null hypothesis that epithelial cell rests of Malassez do not provide a protective function against ankylosis and external root resorption was rejected, and the null hypothesis that nerve fibres and epithelial cells are not inter-dependent was retained. / http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1297409 / Thesis (D.Clin.Dent.) -- School of Dentistry, 2007

The current study investigated the distribution of periodontal epithelial cells and nerve fibres within the furcations of rat maxillary molar teeth subjected to hypothermic injury. The upper right first molars of 30 Sprague-Dawley rats were subjected to a single 20 minute application of dry ice in order to produce aseptic necrosis within the periodontal ligament, while the contralateral first molar served as an untreated control. Five animals were each sacrificed via cardiac perfusion after 7, 10, 14, 18, 21 and 28 days respectively and the maxillae were dissected out. After fixation in paraformaldehyde and processing, the tissues were embedded in paraffin wax and cut into 7µm serial coronal sections through the furcation region. Consecutive sections were then stained with H&E, cytokeratin AE1/AE3 and PGP 9.5 immunostains. Light microscopic examination of the H&E stained sections revealed that ankylosis had not developed in all of the experimental teeth, and in some of the observation groups fewer teeth were ankylosed than unaffected. The morphology of the ankylotic areas appeared to change with time, initially consisting of fine bony trabeculae, then progressing to solid bone occupying the entire furcation before becoming less solid again by the latest observation periods. Root resorption was often seen adjacent to areas of ankylosis, but the cementum of the tooth root at the point of ankylotic union was usually intact and free of resorption. Changes within the pulp chambers of the experimental teeth were also noted, with reduction in cellularity and tissue disorganisation initially, then increasing cellularity and formation of a cementum-like material on the chamber walls later. Cytokeratin AE1/AE3 immunostaining successfully identified epithelial cells within the periodontal ligament and their distribution around control teeth was similar to previous reports. Counting of these cells revealed lower numbers around experimental teeth, with the lowest counts around experimental teeth which had developed ankylosis. No change in the epithelial cell counts was detected over time, and these cells did not appear to regenerate after necrosis regardless of whether or not ankylosis developed. Statistical analysis indicated that the probability of ankylosis decreased as the number of epithelial cells increased. The PGP 9.5 immunostain identified periodontal nerve fibres, but the use of this stain was quite technique sensitive. The furcations of the molar teeth were noted to have relatively sparse innervation, with most of the visible nerve fibres being closely associated with blood vessels and located in the outer two-thirds of the ligament. Counting of the nerve fibres revealed fewer fibres around experimental teeth compared to control teeth, especially in the part of the ligament closest to the tooth root. There was no relationship detected between nerve count and time or between nerve and epithelial cell counts. Resorption was found to be more prevalent in experimental teeth, and the probability of resorption in a given tooth decreased as the epithelial cell count increased. The findings of this study suggest that the epithelial cells within the periodontal ligament have a protective function in the prevention of dentoalveolar ankylosis and resorption. Evidence of an intimate interrelationship between periodontal nerve fibre and epithelial cell numbers could not be confirmed. The null hypothesis that epithelial cell rests of Malassez do not provide a protective function against ankylosis and external root resorption was rejected, and the null hypothesis that nerve fibres and epithelial cells are not inter-dependent was retained. / http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1297409 / Thesis (D.Clin.Dent.) -- School of Dentistry, 2007

No description available.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-06-14T19:54:45Z No. of bitstreams: 1 marciojosedasilvacampos.pdf: 1176643 bytes, checksum: 1457c82026f6f668987773e0e28443e4 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-06-29T12:17:33Z (GMT) No. of bitstreams: 1 marciojosedasilvacampos.pdf: 1176643 bytes, checksum: 1457c82026f6f668987773e0e28443e4 (MD5) / Made available in DSpace on 2017-06-29T12:17:33Z (GMT). No. of bitstreams: 1 marciojosedasilvacampos.pdf: 1176643 bytes, checksum: 1457c82026f6f668987773e0e28443e4 (MD5) Previous issue date: 2012-08-03 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Durante o tratamento ortodôntico, a densidade mineral (DM) óssea aumentada é considerada fator de risco para a reabsorção radicular apical (RRA) enquanto a DM do cemento é associada à proteção da raiz contra essa lesão. Nosso objetivo foi avaliar a DM da estrutura dentária do terço radicular apical e do osso alveolar adjacente de incisivos superiores com e sem RRA associada ao tratamento ortodôntico. Foram selecionados e submetidos ao exame de tomografia computadorizada de feixe cônico (TCFC) 21 pacientes em tratamento que apresentavam um incisivo com RRA e o seu correspondente contralateral sem RRA. A DM foi avaliada nas imagens obtidas em quatro áreas no terço apical radicular e em quatro áreas no osso alveolar adjacente. Os incisivos com RRA apresentaram DM radicular maior do que os incisivos sem RRA, porém essa diferença não foi significante. O osso alveolar supra-apical foi mais denso nos incisivos sem RRA (p<0,05). A DM radicular não foi associada com a proteção da raiz contra a reabsorção. A menor DM do osso supra-apical foi associada à presença da RRA nos incisivos superiores. / During orthodontic treatment, increased bone mineral density (BMD) is considered a risk factor for apical root resorption (ARR), whereas the cementum mineral density has been associated to the protection of the root against this lesion. Our objective was to evaluate the mineral density (MD) of the apical third of the root and adjacent alveolar bone of maxillary incisors with and without ARR associated to orthodontic treatment. Twenty one patients under treatment with one incisor with ARR and its contralateral counterpart without ARR were selected and submitted to cone beam computed tomography (CBCT). Mineral density was assessed in the images obtained from 4 areas of the apical third of the root and 4 areas of adjacent alveolar bone. Incisors with ARR showed greater root mineral density than incisors without ARR, however the difference was not significant. The supra-apical alveolar bone showed high density in the incisors without ARR (p<0.05). Root mineral density was not associated with root protection against resorption. The lower MD of the supra-apical bone was associated with the presence of ARR in the maxillary incisors.

Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-03-23T12:12:30Z No. of bitstreams: 1 paulamoraeslupatini.pdf: 2954241 bytes, checksum: 79130d300f2b4037e5c633836842bf06 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-03-23T12:20:52Z (GMT) No. of bitstreams: 1 paulamoraeslupatini.pdf: 2954241 bytes, checksum: 79130d300f2b4037e5c633836842bf06 (MD5) / Made available in DSpace on 2018-03-23T12:20:52Z (GMT). No. of bitstreams: 1 paulamoraeslupatini.pdf: 2954241 bytes, checksum: 79130d300f2b4037e5c633836842bf06 (MD5) Previous issue date: 2017-12-13 / Introdução: A reabsorção radicular apical (RRA) é uma conseqüência comum do tratamento ortodôntico. Sua etiologia é multifatorial, mas ainda não foi totalmente esclarecida. A análise da dimensão fractal é um método quantitativo que descreve e caracteriza a complexidade das imagens ou, mais precisamente, sua composição textural. Objetivo: O objetivo deste estudo transversal observacional foi avaliar a qualidade do tecido dentário e do osso adjacente ao terço apical radicular dos incisivos maxilares com RRA em pacientes sob tratamento ortodôntico, determinando a dimensão fractal nas imagens de tomografia computadorizada de feixe cônico e compará-las com as imagens dos dentes contralaterais correspondentes, sem RRA, no mesmo indivíduo. Metodologia: A amostra consistiu em 20 pacientes sob tratamento ortodôntico com aparelho edgewise, que apresentaram RRA em um incisivo maxilar (grupo experimental) e ausência de reabsorção no incisivo contralateral correspondente (grupo controle), identificado através de radiografias periapicais de rotina . A dimensão fractal de duas regiões no terço apical da raiz e de quatro no osso alveolar adjacente aos incisivos com RRA e seus dentes contralaterais sem RRA foi determinada e comparada. Resultados: Em todas as regiões ósseas e dentárias avaliadas, exceto no terço apical da raiz no corte coronal, os incisivos sem RRA apresentaram valores de DF maiores do que os incisivos com RRA, mas não houve diferença significativa. Conclusão: Não foi encontrada diferença estatística entre a qualidade dos tecidos radiculares e ósseos da região apical dos incisivos maxilares com e sem reabsorção apical radicular do mesmo paciente ortodôntico. / Introduction: Apical root resorption (ARR) is a common consequence of the orthodontic treatment. Its etiology is multifactorial but has not yet been entirely clarified. The fractal dimension analysis is a quantitative method that describes and caracterizes the complexity of images or, more precisely, their textural composition. Objective: The aim of this observational cross-sectional study was to assess the quality of the dental tissue and the adjacent bone of the root apical third of maxillary incisors with ARR in patients under orthodontic treatment by determining the fractal dimension in cone beam computed tomography images and compare them with the images of the corresponding contralateral teeth without ARR in the same individual. Methodology: The study sample consisted of 20 patients under orthodontic treatment with edgewise appliance, who presented apical root resorption in a maxillary incisor (experimental group) and absence of root resorption in the corresponding contralateral incisor (control group), identified through routine periapical dental radiographs. The fractal dimension of two regions in the apical third of the root and four in the adjacent alveolar bone of incisors with ARR and their contralateral teeth without ARR was determined and compared. Results: In all bone and dental regions evaluated, except the coronal slice of the apical third of the root, the incisors without ARR had higher FD values than incisors with ARR, but there was no significant difference. Conclusion: No statistical difference was found between the quality of the radicular and bone tissues of the apical region of the maxillary incisors with and without apical root resorption of the same orthodontic patient.

Orientador: Francisco Haiter Neto / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T04:13:50Z (GMT). No. of bitstreams: 1 Oenning_AnneCarolineCosta_D.pdf: 1767252 bytes, checksum: 12c4bdabb358d47c201b7c1f01f1cf57 (MD5) Previous issue date: 2014 / Resumo: O presente estudo propôs-se a comparar um método radiográfico bidimensional, a radiografia panorâmica, com uma modalidade de imagem tridimensional, a tomografia computadorizada de feixe cônico (TCFC), no diagnóstico da reabsorção radicular externa (RRE) nos segundos molares relacionada à impactação dos terceiros molares. Buscou-se também relacionar a inclinação do terceiro molar, de acordo com a classificação proposta por Winter, com a presença da RRE no segundo molar. Primeiramente, a amostra foi composta por 188 terceiros molares impactados (66 indivíduos) observados na radiografia panorâmica (Orthopantomograph OP100 D) e nas imagens de TCFC obtidas no equipamento i-CAT Classic. Dois cirurgiões-dentistas, especialistas em Radiologia Odontológica, registraram a presença da RRE no segundo molar e a inclinação do terceiro molar impactado. Os dados foram tabulados e submetidos à análise estatística por meio dos testes de qui-quadrado, teste exato de Fisher, teste Z para duas proporções e regressão logística simples (nível de significância de 5%). Um número significativamente maior de casos de RRE foi diagnosticado na TCFC (n=43) quando comparada à radiografia panorâmica (n=10) (P=0,0001). Além disso, a concordância entre os métodos para o diagnóstico da RRE foi de apenas 4,3% (n=8). Terceiros molares inferiores e nas posições mesioangular e horizontal foram mais relacionados à presença da RRE nos segundos molares. Por esse motivo, 174 terceiros molares inferiores nessas duas inclinações foram avaliados em uma segunda amostra formada por 116 imagens de TCFC obtidas em dois diferentes equipamentos: i-CAT Classic e Picasso Trio. Além da presença da RRE, informações acerca da idade, sexo dos indivíduos e profundidade de terceiros molares (análise subjetiva e classificação de Pell & Gregory) foram registradas pelos dois avaliadores. Os dados numéricos foram submetidos aos testes ANOVA e Mann-Whitney, e os dados categóricos, aos testes do qui-quadrado para análises de contingência e qui-quadrado de aderência. Não houve diferenças estatisticamente significantes na detecção da RRE nos dois equipamentos e entre as inclinações mesioangular e horizontal (p>0,05). A prevalência da condição na amostra total de dentes foi de 49,43%. Os terceiros molares pertencentes a pacientes de maior idade e posicionados mais superiormente (classes A e B de Pell & Gregory) estiveram mais associados à presença da RRE nos dentes adjacentes. Concluiu-se que a TCFC deve ser indicada quando for observado um contato direto entre o segundo e o terceiro molar inferiores na radiografia panorâmica, principalmente nos casos de impactações mesioangulares e horizontais, em classes A e B de Pell & Gregory e de pacientes com idade superior a 24 anos. / Abstract: The aim of this study was to compare a two-dimensional method - panoramic radiography - and a three-dimensional modality - cone beam computed tomography (CBCT) - on the assessment of external root resorption (ERR) of second molars associated with impacted third molars. In addition, we aimed to relate the third molar inclination (Winter's classification) with the detection of ERR on the second molar. First, the sample was consisted of 188 impacted third molars (66 individuals). Panoramic radiography (Orthopantomograph OP100 D) and CBCT imaging (i-CAT Classic) were obtained of all patients. Two oral radiologists investigated the presence of ERR on the adjacent second molar and the inclination of the third molar. Statistical analysis was performed using chi-square test, Fisher exact test, two-proportion Z test and simple logistic regression (significance level was set at 5%). A significantly higher number of ERR was diagnosed on CBCT images (n=43) than on panoramic radiographs (n=10) (P=0.0001). The agreement between panoramic radiographs and CBCT for diagnosing ERR was 4.3% (n=8). The mandibular third molars on mesioangular and horizontal inclinations were more related to ERR lesions on the second molars. Therefore, 174 mandibular third molars on these two inclinations were evaluated in a second sample comprising of 116 CBCT images acquired in two units: i-CAT Classic e Picasso Trio. Age and sex of individuals and depth of third molars (subjective analysis and Pell and Gregory classification) were also recorded. Statistical analysis was performed using ANOVA and Mann-Whitney tests (numerical data) and chi-square test (qualitative data). There were no statistically significant differences in the detection of ERR in images from both devices (p>0.05). Therefore, subsequent analyzes were performed on the total sample. The prevalence of ERR on this sample was 49.43%. There was no difference between mesioangular and horizontal inclination in the detection of ERR. Third molars of older patients (over 24 y-o) and in Pell and Gregory Class A and Class B were more associated with the presence of ERR. The results showed that CBCT should be indicated when a direct contact between the mandibular second and third molars is observed on panoramic radiography, especially in patients aged over 24 presenting with mesioangular or horizontal impactions, and Class A or Class B of Pell & Gregory. / Doutorado / Radiologia Odontologica / Doutora em Radiologia Odontológica

As alterações pulpares e periapicais decorrentes de sobrecarga oclusal são problemas que acometem considerável parcela da população. Geralmente causadas por contato prematuro de restaurações com material em excesso, provocam um trauma de baixa intensidade, porém de alta frequência. Objetivo: Avaliar as alterações pulpares e periapicais, induzidas por esta sobrecarga oclusal associada ou não à doença periodontal induzida em dentes de ratas. Método: Foram utilizadas vinte ratas (Wistar) com noventa dias de idade e peso aproximado de 250g divididas em quatro grupos (n=5): GC (controle), GT (trauma), GL (ligadura) e GLT (ligadura e trauma), com sobrecarga oclusal e periodontite induzida restritas aos primeiros molares inferiores, que receberam a ligadura. As superfícies oclusais dos segundos e terceiros molares superiores receberam desgastes, sem que houvesse exposição pulpar e os animais foram observados por um período de quatro semanas. Depois de anestesiados, estes foram decapitados com uma guilhotina e, após a eutanásia, as hemi-mandíbulas foram enviadas para a análise histológica do tecido pulpar e periapical, com coloração por hematoxicilina-eosina, para avaliação da presença de nódulos pulpares, lacunas de reabsorção e células inflamatórias, além de submetidos à análise histoquímica pela Fosfatase Ácida Tartarato Resistente (TRAP) para avaliação da presença de células clásticas e pré-clásticas. Resultados: Histologicamente, os dentes submetidos à ligadura apresentaram presença moderada de fibras e vasos, enquanto os submetidos ao trauma e ao conjunto trauma-ligadura apresentaram grande aumento de vasos e fibras além de infiltrado neutrofílico e, por vezes, nódulos. Histoquimicamente, notou-se certa normalidade no GC, uma irregularidade na região cervical externa no GL e maior presença de lacunas dentinárias e células multinucleadas no GT e GLT. Conclusão: A sobrecarga oclusal provoca alterações pulpares e periapicais assim como a doença periodontal induzida. Mas a associação da doença periodontal e da sobrecarga é mais lesiva aos tecidos pulpares e radiculares. / Pulp and periapical changes resulting from occlusal overload are problems that affect a considerable portion of the population. Generally caused by premature contact of restorations with material in excess, cause a trauma of low intensity, however high frequency. Objective: To evaluate the changes of pulpal and periapical induced by this overload occlusal associated or not to the induced periodontal disease in teeth of rats. Method: Used twenty rats (Wistar) with ninety days old and weighing approximately 250g divided into four groups (n = 5): GC (control), GT (overload), GL (ligature) and GLT (ligature and overload) with occlusal overload and induced periodontitis restricted to lower first molars, which received the ligature. The occlusal surfaces of upper second and third molars were worn away, with no pulp exposure and the animals were observed for a period of four weeks. Once anesthetized, they were beheaded with a guillotine and, after euthanasia, the hemi-mandibles were sent for histological analysis of pulp and periapical with hematoxylin-eosin staining for evaluation of nodules pulp, resorption gaps and inflammatory cells, and analyzed by immunohistochemistry Tartrate Resistant Acid Phosphatase (TRAP) for assessing the presence of clastic cells and pre-clastic. Results: Histologically, the teeth underwent to ligature showed the presence of fibers and vessels, while the other submitted to overload and overload-ligature group showed a large increase in vessels and fibers as well as neutrophil infiltration and sometimes nodules. Histochemically, it was noted some degree of normality in the GC, an irregularity in the external cervical region in the GL and greater presence of dentinal gaps and multinucleated cells in the GT and GLT. Conclusion: The occlusal overload causes changes pulp and periapical as well as induced periodontal disease. But the association between periodontal disease and the overload occusal is more damage to pulp and root tissues.

Objetivo: Avaliar por meio de análises radiográfica e histológica os efeitos da associação do laser de diodo e do fator de crescimento de fibroblastos no tratamento de dentes de ratos reimplantados tardiamente. Método: Cinquenta ratos (Rattus norvegicus albinus, Wistar) tiveram seus incisivos superiores direitos extraídos, a papila dental removida, e por via retrógrada, o preparo e preenchimento dos canais radiculares com pasta de hidróxido de cálcio. Em seguida, os espécimes foram aleatoriamente divididos em cinco grupos: C+ (controle positivo)- reimplante imediato; C- (controle negativo)- reimplante tardio, mantidos em meio ambiente seco por sessenta minutos, sem tratamento adicional; LA (laser de alta potência)-reimplante tardio associado ao tratamento prévio da superfície radicular com irradiação por varredura com laser diodo de alta potência (810nm, modo contínuo, fibra óptica de 600&#956;m, 1,5W input, 30s); FGF (Fator de crescimento de fibroblastos)- reimplante tardio associado à aplicação do fator de crescimento de fibroblastos 50 &#956;g na concentração de 0,2% FGF-2 em gel de hidroxipropilmetilcelulose (HPMC) a 3% sobre a superfície radicular lingual e no interior do alvéolo dental de cada espécime; LA+FGF (Laser de alta potência e FGF)- reimplante tardio, com tratamento prévio da superfície radicular com laser diodo nos mesmos parâmetros do grupo LA, associado à aplicação do FGF-2 da mesma forma que no grupo FGF. A eutanásia dos animais ocorreu após sessenta dias. Os espécimes foram radiografados digitalmente e processados para análise descritiva dos eventos histológicos e análise da porcentagem de fibras colágenas do tipo I por meio do método Picrosirius Red. Resultados: Na análise radiográfica, o grupo LA+FGF apresentou o menor número e porcentagem de áreas reabsorvidas (p<0,05). Com a análise dos eventos histológicos por meio de escores, o grupo LA apresentou as menores médias de reabsorção substitutiva e inflamatória e anquilose, seguido pelo grupo LA+FGF e não diferindo estatisticamente do grupo controle positivo. O grupo LA+FGF apresentou o melhor reparo periodontal entre os grupos experimentais, com a maior quantidade de fibras colágenas espessas, (p<0,05). Conclusões: A irradiação da superfície radicular com laser de diodo de alta potência associada ou não ao FGF-2 reduziu a incidência de reabsorções radiculares externas e anquilose. A aplicação do FGF-2 favoreceu o reparo do ligamento periodontal, embora a reinserção das fibras não tenha ocorrido em todos os espécimes. / Aim: The aim of this study was to evaluate, by radiographic and histological analyses, the effects of high-power diode laser irradiation and fibroblast growth factor (FGF) in the treatment of delayed replanted rat teeth. Methods: Fifty rats ratos (Rattus norvegicus albinus, Wistar) had their maxillary right incisors extracted, the dental papilla removed, and by a retrograde way, the root canals were prepared and filled with calcium hydroxide paste. Subsequently, the specimens were randomly assigned to five groups: C+ (positive control)- immediate replantation; C- (negative control)- delayed replantation, left on the bench for sixty minutes, without additional treatment; LA (Diode laser high potency)- delayed replantation and root surface treatment scanning irradiation with a high-power diode laser (810nm, continuous mode, optic fiber 600&#956;m, 1.5W input, 30s); FGF (Fibroblast Growth Factor) - delayed replantation and topical application of 50&#956;g 0,2% FGF-2 gel in 3% hydroxylpropyl methylcellulose matrix (HPMC) over the lingual root surface and into dental alveolus of each specimen; LA+FGF (Diode laser high potency + Fibroblast Growth Factor)- delayed replantation and root surface treatment irradiation with a diode laser using the same parameters as those used for LA group, associated to topical application of FGF-2 in the same way as FGF group. The rats were euthanized after sixty days of replantation. The specimens were digitally radiographed and processed for descriptive histological events analysis and percentage analysis of type I collagen fibers by the Picrosírius red method. Results: By radiographic analysis, the minnor number and percentage of resorpted areas were seen in LA+FGF group (p<0.05). In the histological analysis through scores, the LA group showed lower means of replacement and inflammatory resorption and ankylosis and followed by LA+FGF group and they were not statistically different of positive control group. The LA+FGF group showed the best periodontal healing of all experimental groups, with the greater number of thick collagen fibers stained (p<0,05). Conclusions: The irradiation of root surface treatment with high-power diode laser associated or not to FGF-2 reduced the occurrence of external root resorption and ankylosis. The FGF-2 application favored the periodontal ligament healing, but the fibers reinsertion not occurred in all the specimens.