Reestablishing blood flow and allowing the continuation of root development are some of the objectives of pulp revascularization. This procedure is currently indicated for teeth with incomplete root formation as an alternative to the traditional treatment of apecification, which consists of inserting calcium hydroxide paste into the root canal for a determined time period in order to induce the formation of a calcified barrier. Although it is considered as the most classically employed therapy, the permanence of the paste for long time periods may lead to the weakening of the root due to hygroscopic properties, as well as proteolytic activities of calcium hydroxide. Therefore, there has been a permanent search for alternatives which allow the full development of immature teeth. Revascularization has emerged as such an alternative, and a range of treatment protocols can be found in the scientific literature. The aim of this paper is to accomplish a literature review concerning this issue.

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This study evaluated the short-term response of human pulp tissue when directly capped with Portland cement. In this series of cases, twenty human third molars that were scheduled for extraction were used. After cavity preparation, pulp exposure was achieved and Portland cement pulp capping was performed. Teeth were extracted after 1, 7, 14 and 21 days following treatment and prepared for histological examination and bacterial detection. Each group had 5 teeth. The results were descriptively analysed. Dentin bridge formation was seen in two teeth with some distance from the material interface (14 and 21 days). Soft inflammatory responses were observed in most of the cases. Bacteria were not disclosed in any specimen. PC exhibited some features of biocompatibility and capability of inducing mineral pulp response in short-term evaluation. The results suggested that PC has a potential to be used as a less expensive pulp capping material in comparison to other pulp capping materials.

ResumoObjetivo: O presente estudo procurou acessar o efeito da limpeza do forame apical no reparo de lesões periapicais detectadas radiograficamente. Materiais e métodos: A amostra constituiu-se de 980 dentes selecionados de 25 de fevereiro de 1997 a 15 de março de 2005 que foram submetidos a tratamento endodôntico e exibiram lesões periapicais radiograficamente visíveis. A amostra foi então dividida em dois grupos: Grupo I, 402 tratamentos de canal em que a limpeza do forame apical não foi realizada, e Grupo II, composto pelos 578 dentes restantes onde o procedimento foi realizado. Após um ano, os dentes foram clinica e radiograficamente avaliados. Resultados: No Grupo I, 360 canais (89,55%) não tiveram evidência de lesões periapicais, versus 521 (90,13%) no Grupo II. Presença parcial dessas lesões foi observada em 23 canais (5,72%) no Grupo I versus 27 (4,67%) no Grupo II. O teste qui-quadrado de Pearson não demonstrou significância estatística entre os Grupos I e II (p=0,732). Conclusões: Estes achados sugerem que a limpeza do forame apical não é um determinante para o reparo de lesão periapical. AbstractAim: The present study sought to assess the effect of apical foramen cleaning in the repair of periapical lesions detected by radiography. Methods: The sample comprised 980 teeth collected from 25 February 1997 to 15 March 2005, which had been subjected to endodontic treatment and exhibited radiographically visible periapical lesions. The sample was then divided into two groups: Group I, 402 root canal treatments in which cleaning of the apical foramen had not been performed, and Group II, composed of the remaining 578 root canal treatments where the procedure had been performed. After one year, the teeth were clinically and radiographically evaluated. Results: In Group I, 360 canals (89.55%) had no evidence of periapical lesions, versus 521 (90.13%) in Group II. Partial presence of these lesions was observed in 23 canals (5.72%) in Group I versus 27 (4.67%) in Group II. No changes in images were observed in 19 (4.72%) canals in Group I and 30 in Group II. Pearson's chi-square test showed no statistically significant difference between the Groups I and II (p = 0.732). Conclusions: These findings suggest that foramen cleaning is not a determinant of periapical lesion repair.

PURPOSE:To evaluate the bone healing of mandibular fractures following the use of Portland cement. METHODS:Thirty-two male Wistar rats were divided into control and experimental groups. In the control group the rats were submitted to a mandibular fracture, which was reduced, and the soft tissues were sutured. In the experimental group the rats had the mandibular fracture reduced and maintained with the Portland cement. The animals were euthanized 7 and 21 days after surgery by injecting a lethal dose of anesthetic. The following variables were studied: weight of the animals, radiographic images, histopathological features and time of surgery. RESULTS: A weight loss was observed in the specimens of both groups at the different times of evaluation, a greater difference in weight before and after surgery being found in the experimental group, which was statistically significant (p <0.05, p = 0.041). From the histological point of view, with a margin of error (5.0%) the only two significant differences (p <0.05) recorded in the variables were "Material deployed" and "Bone resorption" during the evaluations at 7 and 21 days, respectively. CONCLUSION:The Portland cement served to promote bone healing. MÉTODOS: Trinta e dois ratos machos Wistar foram divididos em grupo controle e grupo experimental. No grupo controle os ratosforam submetidos à fratura, redução e manutenção dos seguimentos com sutura dos tecidos moles. No grupo experimental foram submetidos a fratura, redução e manutenção dos segmentos fraturados com CP e sutura dos tecidos. Os animais foram eutanasiados com sete e 21 dias de pós-operatório através da injeção de dose letal dos anestésicos adotados. As variáveis estudadas foram: peso dos animais, avaliação tomográfica, avaliação histológica e tempo cirúrgico. RESULTADOS:Perda de peso foi observada nos espécimes de ambos os grupos nos diferentes intervalos de tempo considerados, sendo maior a diferença de peso antes e após cirurgia para o grupo experimental, que foi estatisticamente significante (p<0,05; p=0,041). Do ponto de vista histológico para a margem de erro fixada (5,0%) as duas únicas diferenças significativas (p<0,05) foram registradas nas variáveis: "Material implantado" na avaliação com sete dias e "Reabsorção óssea" na avaliação com 21 dias. CONCLUSÃO: O cimento Portland atuou promovendo a reparação óssea.Descritores: Fraturas Mandibulares. Fixação Interna de Fraturas. Regeneração Óssea. Cimento Portland. Ratos. The use of Portland cement in the repair of mandibular fractures in ratsActa Cirúrgica 5011 -427