Epidemiology and severity of traumatic dental injuries in permanent teeth: A 20-year retrospective study

This study aimed to assess the traumatic dental injuries (TDIs) in permanent dentition among patients who attended at the outpatient clinic of a Brazilian dental school, during the last 20 years, and to investigate factors associated with the severity of these injuries. Clinical records of patients who attended a specialized center for dental trauma care in Brazil presenting at least one TDI in a permanent tooth, between the years 2000 and 2019, were reviewed. The data recorded were sex, age, affected arch, etiology, number, and type of the teeth affected, and classification and severity of the TDIs. The diagnosis and classification of the TDIs were based on the guidelines of the International Association of Dental Traumatology (IADT). The severity of each patient's injuries was defined as mild, moderate, or severe. Descriptive statistics, chi-square and multinomial regression analyses were used to evaluate the results. The significance level was set at 5%. A total of 837 clinical records were included, totaling 2357 teeth. Males were more prevalent than females. The patients' age ranged from 5 to 71 years. The most common traumas were avulsion (n=512) and uncomplicated enamel-dentin fracture (n=488). Univariate analyses showed that there was a statistically significant association between age group (p=0.004), etiology (p=0.000) and number of teeth affected (p=0.000) with severity of dental trauma. In conclusion, TDIs that occurred in Piracicaba and region are epidemiologically similar to those found worldwide, and that more severe injuries are related to age range, etiology and number of teeth affected.

Death occurred due to undiagnosed systemic amyloidosis: a case report

Amyloidosis is a disorder related to errors in protein folding. We present a clinical case of systemic amyloidosis manifesting as hypotension, tachycardia, pain, weight loss, asthenia, anorexia, dysphagia, and mood deflection in a 49-year-old-year-old woman with a previous clinical history of articular and muscular pain, correlated to suspected seronegative arthritis. The blood test revealed kidney insufficiency, an electrocardiogram identified low voltages of the peripheral leads and T waves anomalies. A serum protein electrophoresis revealed the presence of high levels of monoclonal kappa free chains. The woman started to have a sense of suffocation, and after one week she was found dead in her bed. After the autopsy, the results of Congo red staining of the myocardium were characteristic of amyloid. According to the autoptic and the histological examination, death occurred due to acute cardiac and respiratory arrest secondary to amyloid cardiomyopathy in a patient with undiagnosed systemic amyloidosis.

The evolution of the autopsy over the years

Autopsy has played an extremely important role in both the forensic and clinical fields for many years. In recent years, clinical autopsy has become less important, but today, thanks to the pandemic, this importance has been rediscovered. Conversely, forensic autopsy has never lost its importance, but it would need to be updated.

Spectrophotometric analysis of internal bleaching of traumatized teeth with coronal discoloration following regenerative endodontic procedures

Aim: The objective of this study was to describe a case series concerning internal bleaching of anterior traumatized teeth that underwent regenerative endodontic procedures (REP). Methods: Seven non-vital maxillary anterior teeth discolored after regenerative endodontic procedures were included and divided into two groups according to the medication protocol used in the REP: (1) Triple antibiotic paste (TAP) group (n=4); (2) Calcium hydroxide and 2% chlorhexidine gel (HC+CHX) (n=3). The bleaching technique used was walking bleach, where sodium perborate associated with distilled water was used. Bleaching agent was replaced weekly until the darkened tooth was slightly lighter than the adjacent tooth. The color was recorded with the aid of a digital spectrophotometer in two moments (T1: prior the first session of bleaching, T2: fourteen days after the last session of bleaching). The change in color after the procedure (ΔE) was calculated and reported in a descriptive analysis. Results: The ΔE for all teeth showed color differences exceeding the perceptibility threshold (ΔE > 3.7). Both groups showed similar ΔE (TAP: 18.3 ± 11.5; HC+CHX: 14 ± 11.2) at the end of the treatment. The average number of sessions needed to achieve satisfactory results was 1.7 ± 0.6 for HC+CHX group and 2.3 ± 0.5 for TAP group. Conclusion: Internal bleaching with sodium perborate associated with distilled water is effective in treating discolored teeth after regenerative endodontic procedures.

Effects of veratrine on repolarization in the canine right bundle branch

Superfusion of Purkinje fibers in the canine right bundle branch with Tyrode solution containing veratrine, less than or equal to 1 mug/ml, prolonged repolarization phases 2 and 3 and induced a long-lasting negative after-potential that ended in some experiments with a slightly hyperpolarized resting transmembrane potential. The alterations in repolarization time were reversed by washout with veratrine-free Tyrode solution or by adding tetrodotoxin to the veratrine-containing Tyrode solution to a concentration of 0.1 and 1 mug/ml. The effect of veratrine on the repolarization time was more prominent at slower driving rates. Its effect on repolarization of ventricular muscle cells was smaller than that on the repolarization of Purkinje fibers. In the concentrations used, veratrine did not induce multiple responses.