Papers by Fernanda Pappen
Giornale Italiano di Endodonzia, 2020
The treatment of choice for necrotic teeth with incompletely formed roots is apexification with c... more The treatment of choice for necrotic teeth with incompletely formed roots is apexification with calcium hydroxide, which induces the formation of a hard tissue barrier at the apex, however, in the long term, this medicament may increase the brittleness of dentin walls because of its hygroscopic and proteolytic properties, in addition to the disadvantage of requiring multiple appointments. A treatment option for young permanent teeth with necrotic pulps is pulp regeneration, whose advantage lies in the stimulation of new tissue formation within the root canal. Pulp revascularization is based on the disinfection of the root canal system, often performed with irrigating solutions and intracanal medicaments, accompanied by induction of periapical bleeding and formation of a blood clot that will fill the root canal. The aim of this study was to present a case of avulsion of teeth 11 and 21, both with open apices, treated with replantation associated with regenerative endodontic therapy, ...
Brazilian dental journal, 2017
This study assessed the pH, radiopacity, antimicrobial effect, cytotoxicity and biocompatibility ... more This study assessed the pH, radiopacity, antimicrobial effect, cytotoxicity and biocompatibility of endodontic filling materials for primary teeth. Zinc oxide eugenol (ZOE), Vitapex and Calen paste thickened with zinc oxide (ZO) were evaluated in comparison to an experimental MTA-based material. Radiopacity was tested using a graduated aluminum stepwedge with a digital sensor (n=5). The materials pH was recorded at 1, 4, 12 h; 1, 3, 7, 15 and 30 days (n=5). Direct contact test was used to assess the antimicrobial efficacy against Enterococcus faecalis after 1, 4, 12, 24 h (n=5). Cytotoxicity assay used MTT test for cell viability after incubation for 1, 3 and 7 days (n=5). For biocompatibility test, Wistar rats had received implants containing each material (n=5). The biopsied tissues were histologically analyzed after 15, 30 and 60 days. The results of radiopacity, pH, antimicrobial capacity and cytotoxicity were analyzed using ANOVA and Tukey tests. The histological data were subm...
Journal of Dental Research, 2003
Giornale Italiano di Endodonzia, 2019
Aim: To investigate the effects of dentinal treatment with chlorhexidine and isopropyl alcohol, a... more Aim: To investigate the effects of dentinal treatment with chlorhexidine and isopropyl alcohol, alone or associated, on the bond strength and bond stability of glass fiber posts cemented with a self-adhesive resin cement. Materials and Methods: Forty bovine teeth were endodontically treated and randomly distributed into four groups, according to the dentinal treatment after post space preparation: distilled water (Control); 2% chlorhexidine (CHX); isopropyl alcohol (ISO); 2% chlorhexidine + isopropyl alcohol (CHX+ISO). Glass fiber posts were cemented with a self-adhesive resin cement and after 24 h specimens were cut into six 1.5 mm-thick slices. One slice of each root third (i.e. apical, middle and coronal) was subjected to immediate push-out test and the other was stored in distilled water at 37 °C for six months for delayed push-out test. Bond strength was registered in megapascal (MPa). Failure mode was evaluated by a stereomicroscope, with 40x magnification. Data analysis was p...
Objective: this study evaluated the prevalence of pulp nodules in dental students from the Federa... more Objective: this study evaluated the prevalence of pulp nodules in dental students from the Federal University of Pelotas. The study also tried to establish associations between pulp nodules and elements such as caries, restorations, previous orthodontic treatment, and bruxism. Methods: an individual interview was applied to investigate the dental history and oral habits related to bruxism diagnosis. Every participant was submitted to clinical and radiographic examination. Two bitewing radiographs in the molar area were performed in each student and the frequency of pulp stones was assessed. The association between factors such as gender, age, restorations, caries, orthodontic treatment, and bruxism with the presence of nodules was assessed by the chisquare test and Spearman’s correlation coefficient (p 0.05). The results showed an association only between pulp nodules and restorative procedures (p = 0.009). Conclusions: it is possible to conclude that the prevalence of pulp nodules ...
Aim: The most common anatomical configuration of the mandibular molar is to present two roots and... more Aim: The most common anatomical configuration of the mandibular molar is to present two roots and three or four canals, but it’s possible to find many different configurations. A case of unusual mandibular molar is presented to illustrate the anatomic root canal variation. Summary: Endodontic treatment was performed in a mandibular third molar with five roots, four in the mesial portion and one in the distal portion. The x-ray examination showed an abnormal root canal anatomy, suggesting the presence of extra mesial roots. Cone-beam computed tomography (CBCT) imaging revealed five roots and five root canals, with four independent roots in the mesial portion and one in the distal portion, indicating a rare anatomic configuration. This case report presents the importance of searching for extra canals and the unusual canal morphology, because the knowledge of the most common anatomic characteristics and their possible variations is fundamental to the endodontic treatment success. Key l...
Purpose: Calcium hydroxide [Ca(OH)2] interaction with the immune system to destroy or neutralize ... more Purpose: Calcium hydroxide [Ca(OH)2] interaction with the immune system to destroy or neutralize bacteria and their by-products is not completely understood. This study evaluated the calcium hydroxide ability to neutralize Pseudomonas aeruginosa lipopolysaccharides (LPS) using two different methods: nitric oxide (NO) stimulation and Tumoral Necrosis Factoralpha (TNF-alpha) release in mice macrophage culture. Methods: For the NO assay, peritoneal exudate cells (PECs) were placed in contact with 25μg/mL and 50μg/mL LPS and LPS/Ca(OH)2 suspensions (50μg/25mg and 25μg/25mg). After incubation for 8h, Griess reagent was used, and the NO release was quantified. In the TNF-alpha assay the LPS solution was tested in 25μg/mL, and the LPS/Ca(OH)2 suspension was tested in 25μg/25mg concentration. After incubation for 24 hours, cells were fixed and stained with crystal violet. Absorbance values were obtained. Results were expressed in micromols. All tests were performed in triplicate. Results: T...
This study evaluated in vitro the cytotoxicity of four root canal sealers (Topseal, EndoRez, Tubl... more This study evaluated in vitro the cytotoxicity of four root canal sealers (Topseal, EndoRez, TubliSeal and Kerr Pulp Canal Sealer E.W.T.) and their effects on reactive oxygen/nitrogen intermediate induction by mouse peritoneal macrophages. Thioglycollate-induced cells were obtained from Swiss mice by peritoneal lavage with 5 mL 10 mM phosphate-buffered saline, washed twice and resuspended (10(6) cells/mL) in appropriate medium for each test. Cytotoxicity was determined by the presence of hydrogen peroxide (H2O2) and nitric oxide (NO) by the peroxidase-dependent oxidation of phenol red and Griess reaction, respectively. Sealer suspensions were obtained in two different concentrations from each material: 18 mg/mL and 9 mg/mL, established according to compatibility parameters following MTT assay. Comparing the sealers, H2O2 release at concentrations of 9 mg/mL and 18 mg/mL was similar: Topseal > positive control (medium + cells + 5 mg/mL zimozan solution) > EndoRez > TubliSeal...
Aim: This study evaluated, by the application of questionnaires, the impact of the COVID-19 pande... more Aim: This study evaluated, by the application of questionnaires, the impact of the COVID-19 pandemic on the clinical routine and inspection by the competent authorities, on the flow of patients in the office, as well as on possible changes in Endodontic treatment costs and the amounts charged to patients. Methods: This cross-sectional study was conducted from May 2nd, 2020 to May 6th, 2020, using an online questionnaire with a convenience sample. The inclusion criterion was professionals who perform endodontic treatments in daily clinical practice and who professional setting is private practice. The questionnaire brought questions about the impact on costs and the amount charged to the patient. Results: A total of 1042 questionnaires were answered from all the different states of Brazil, by professional who usually perform Endodontic treatment, and who is working in private practice. A total of 1010 (96.9%) respondents affirm it was necessary to modify the protective equipment in e...
RSBO
A blindagem coronária, também conhecida como barreira intraorifício, é definida como a colocação ... more A blindagem coronária, também conhecida como barreira intraorifício, é definida como a colocação de um material restaurador na entrada do orifício do canal radicular imediatamente após a remoção de 3 mm de guta-percha e cimento e tem como finalidade aumentar a resistência do dente à fratura, além de prevenir a infiltração coronária. Objetivo: Relatar e discutir os dados existentes na literatura odontológica a respeito dos materiais disponíveis para realização da barreira intraorifício em dentes tratados endodonticamente e apontar se a desejada blindagem coronária é realmente possível de ser alcançada. Revisão de literatura: Os materiais analisados foram resina composta, cimento de ionômero de vidro (CIV), materiais à base de óxido de zinco, amálgama de prata e agregado de trióxido mineral (MTA). Resultados: Resina composta e bulk-fill flow mostraram melhores resultados em comparação com outros materiais, como MTA. O amálgama de prata, os materiais à base de óxido de zinco e o CIV nã...
Brazilian Dental Journal
This case report discusses the endodontic treatment of a 7-year-old girl who suffered trauma (int... more This case report discusses the endodontic treatment of a 7-year-old girl who suffered trauma (intrusion) to the immature upper central incisors secondary to a fall from a bicycle. Thirty days after the accident the patient was brought by her mother for clinical and radiographic assessment with a chief complaint of swelling and tenderness to percussion and palpation. Acute apical abscess associated with immature teeth were diagnosed. A decision was made to perform regenerative endodontic treatment. Access cavities were made and the root canals were disinfected by irrigation with 2.5% sodium hypochlorite. Final irrigation was performed with 17% EDTA. Due to pain and presence of secretions, 2% chlorhexidine gel was applied as an intracanal medicament. Seven days later, at the second visit, the root canals were once again disinfected and the canals of the right and left permanent upper central incisors were filled with double antibiotic paste (metronidazole/ciprofloxacin) and calcium hy...
Revista da ABENO
O objetivo do presente estudo foi determinar a frequência e/ou intensidade de dor pós-operatória ... more O objetivo do presente estudo foi determinar a frequência e/ou intensidade de dor pós-operatória e os fatores associados a esta ocorrência em tratamentos e retratamentos endodônticos realizados pelas técnicas de instrumentação manual e reciprocante, por estudantes de graduação em Odontologia da Universidade Federal de Pelotas. Para tal, utilizou-se informações dos prontuários de pacientes atendidos por estudantes do último ano de graduação, no período compreendido entre janeiro de 2017 e julho de 2019, totalizando 182 tratamentos. A dor foi registrada por meio da Escala de Avaliação Numérica da Dor (EAND). Considerou-se como variáveis preditivas no desfecho de dor pós-operatória: dente, número de canais, sintomas, coroa dentária, tratamento indicado e índice periapical radiográfico. Como variáveis relativas aos tratamentos, técnica de instrumentação, número de sessões e limite apical de instrumentação. Havia relato de dor no momento do tratamento em 28% dos prontuários, enquanto 11...
RSBO
Introduction: Pregnancy and early childhood are the most critical phases with regard to biologica... more Introduction: Pregnancy and early childhood are the most critical phases with regard to biological, cognitive, emotional, and social development. Adverse events in these periods of life may be related to alterations in dental development, including alterations in size, shape and mineralization. Objective: To evaluate the frequency of dental abnormalities and the factors associated with the developmental defects of the enamel in primary teeth. Material and methods: Information about family income, maternal education level, pretermbirth, and hospitalization history up to 11 months of age were collected from the dental records of 544 children. Clinical examination of the children was performed to investigate abnormalities of tooth number, form, size, and developmental defects of the enamel (DDE). Data were analyzed using χ2 test and Poisson regression. Results: In all, 544 children were evaluated. Sixty children (11.0%) presented some alterations in the primary teeth; and 7.5% showed D...
RSBO
Introduction: The coronary shield, known as the intra-orifice barrier, is defined as a placement ... more Introduction: The coronary shield, known as the intra-orifice barrier, is defined as a placement of a restorative material at the entrance of the root canal orifice after 3mm of gutta-percha and aiming to increase the resistance of the tooth to the fracture in addition to preventing coronary infiltration. Objective: to report and discuss the existing data in the dental literature regarding the materials available to perform the intra-orifice barrier in endodontically treated teethand to indicate if the desired coronary shield is really achievable. Literature review: The materials analyzed were composite resin, glass ionomer cement (CIV), zinc oxide based materials, silver amalgam and mineral trioxide aggregate (MTA). Results: composites of resin and bulkfill / flow in their results when compared with other materials like MTA. Silver amalgam, zinc oxide-based materials, and CIV do not result in terms of intra-orifice barrier. MTA was favorable in relation to microleakage, but did not...
Journal of Oral Investigations
Objetivos: O condicionamento da superfície dos tecidos dentários duros com ácido fosfórico 35% é ... more Objetivos: O condicionamento da superfície dos tecidos dentários duros com ácido fosfórico 35% é normalmente utilizado para fornecer retenção micromecânica para adesivos odontológicos. Quando lavado da superfície, o ácido pode gerar gosto amargo e desagradável ao paladar do paciente. O objetivo deste estudo foi analisar o efeito da adição de um agente aromatizante à composição do gel de ácido fosfórico 35% e investigar se existe alteração de características fundamentais deste material, como sua capacidade de desmineralizar a superfície dentária. Métodos: Além de um grupo controle (sem flavorizante), foram testados grupos de ácido fosfórico 35% com a adição de 0,5% ou 3% do aromatizante (Aroma Abacaxi Pó; Bio Green Ingredients). Foram realizadas análises de viscosidade, estabilidade do pH e de desmineralização da superfície de esmalte condicionada por microscopia eletrônica de varredura, além de teste de resistência de união ao esmalte por microcisalhamento. Resultados: Apesar dos gr...
International Endodontic Journal
AIM To evaluate bone tissue reactions in rats to an MTA-based endodontic sealer with and without ... more AIM To evaluate bone tissue reactions in rats to an MTA-based endodontic sealer with and without the addition of various concentrations of C3A or C3A + Ag. METHODOLOGY Bone tissue reactions were evaluated in 45 Wistar rats after 7, 30 and 90 days (n = 5 per period). Three surgical cavities were prepared on the right femur and filled with 0.2 mL MTA Fillapex, MTA Fillapex + C3A and C3A + Ag at various concentrations: AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany), EndoSequence BC (Brasseler USA, Savannah, GA, USA) or no sealer (negative control). By the end of each experimental period, animals were randomly euthanized. The samples were histologically processed and analysed using a light microscope. The presence of inflammatory cells, fibres and hard tissue barrier formation was evaluated. Data were analysed statistically using nonparametric tests to compare the differences between groups. Multiple groups were compared using the Kruskal-Wallis and Mann-Whitney U-tests with a Bonferroni correction at P = 0.05. RESULTS The inflammatory response significantly decreased from 30 to 90 days (P < 0.05). Fibre condensation was similar amongst the groups at 07 and 30 days after intervention (P > 0.05). At 90 days, however, fibres were absent in most specimens of EndoSequence BC Sealer, AH Plus, MTA Fillapex and the control group, whilst they were still observed in samples of the modified sealers (P < 0.05). At 90 days, all specimens of AH Plus, EndoSequence BC Sealer and control group had complete formation of hard tissue barrier. In the MTA Fillapex group, as well as in the modified sealers groups, partial deposition of mineralized tissue was noticed. CONCLUSION The hypothesis tested that the incorporation of C3A and C3A + Ag particles to MTA Fillapex would improve bone tissue repair was partially accepted, since modified MTA Fillapex did not have the same repair potential as the commercial bioceramic material.
Brazilian Dental Journal
The purpose of this study was to evaluate the inflammatory process following direct pulp capping ... more The purpose of this study was to evaluate the inflammatory process following direct pulp capping during pregnancy. This experimental study involved 48 maxillary first molars of female Wistar rats. The procedures were performed in pregnant and non-pregnant animals (n =20 each). Direct pulp capping with mineral trioxide aggregate (MTA) and restoration with a light-cured resin composite was performed in half of exposed pulp specimens. In the other half of specimens, light-cured composite was placed directly on the exposed pulp. In the control groups (n=4 each), no intervention was performed. Animals were euthanized at 3 and 7 days. All sections (three per slide) were viewed under an optical microscope. One previously calibrated pathologist performed descriptive analysis and assigned scores for inflammatory response and tissue organization adjacent to the pulp exposure. The Kappa value for intra-examiner variability was 0.91. At 3 days, in animals treated with MTA, inflammatory infiltra...
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Papers by Fernanda Pappen