Prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous populations in Brazil: a systematic review and meta-analysis.

The aim of this review was to evaluate the prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous in Brazil. A systematic review of observational studies was performed according to the PRISMA guidelines (CRD42020218704). The search strategy involved the electronic databases of Embase, LILACS, PubMed, Web of Science, Scopus, and the CAPES Theses and Dissertations for gray literature. The eligibility criteria consisted of publications that assessed the prevalence of oral conditions in indigenous populations in Brazil. Studies with indigenous people living in urban area were excluded. The risk of bias was evaluated by using JBI Critical Appraisal for prevalence studies. Thirty studies were included in the review, and the majority showed a low risk of bias. A meta-analysis of 20 studies was conducted using the random-effects model and a 95% confidence interval. Several ethnicities were studied in isolation or in groups (n = 7,627 for dental caries; n = 2,774 for periodontal disease; n = 1,067 for malocclusion; n = 150 for tooth wear). The prevalence of caries ranged from 50% among indigenous people aged 18-36 months to 100% among those aged 65-74 years. The prevalence of periodontal disease ranged from 58% to 83%. The prevalence of malocclusion was 43%. Tooth wear was assessed in only one ethnic group and showed a prevalence of 100% in indigenous people aged >18 years. The certainty of evidence assessed by the GRADE system ranged from very low to moderate. This systematic review showed significant differences in the prevalence of dental caries, periodontal disease and malocclusion between indigenous population groups and territories in which indigenous people live.

Association between the prevalence of pulp stones and calcified atherosclerotic plaques: a systematic review and meta-analysis.

OBJECTIVE: To evaluate the association between the prevalence of pulp stones (PS) in permanent teeth and calcified atherosclerotic plaques (CAP). METHODS: An electronic search was performed in 10 databases to locate observational studies that investigated the association between PS in permanent teeth and CAP, published until March 2022. Two reviewers performed the search, selection and extraction of data from eligible studies. The individual risk of bias of eligible studies was assessed using the JBI Critical Appraisal Tools. The meta-analysis was conducted using fixed and random effects and odds ratio (OR) as an effect measure with a 95% confidence interval (CI). The heterogeneity between the studies was quantified using the I² test. The certainty of evidence was evaluated using the GRADE approach. RESULTS: The electronic search resulted in 2968 records, of which only 7 studies were considered eligible. The total sample consisted of 3770 participants from 5 countries. All studies showed biases of confounding factors and exposure assessment. Based on six studies and with very low certainty of evidence, the meta-analysis showed that patients with PS were more likely to also have CAP in carotid or coronary arteries (OR: 1.70; 95% CI: 1.21; 2.38, I² = 0%). CONCLUSIONS: Limited evidence suggests that there is a positive association between the prevalence of PS in permanent teeth detected using panoramic radiography and CAP in the coronary or carotid arteries.

Critical appraisal of confounding factors of observational studies on the association between dentofacial features and dental trauma in a Brazilian population.

AIMS/OBJECTIVES: Dental trauma is a highly prevalent dental emergency. Children and adolescents without inadequate lip coverage, increased overjet, and anterior open bite are associated with the occurrence of traumatic dental injuries. Observational studies do not allow the inference of causality, one of the reasons being: the potential confounding factors. Therefore, this review aimed to critically appraise the confounding factors considered in epidemiological studies that associate dentofacial features with the occurrence of dental trauma in Brazilian children and adolescents. METHODS: Studies included in the qualitative synthesis of a recently published comprehensive systematic review and meta-analysis on the topic were screened. Studies that only mentioned the performance of bivariate analyzes or that did not mention the performance of multivariate analyzes were excluded. Evaluation of control statements for possible confounders and bias consideration was performed for each selected study. Confounding factors in these studies were also identified and categorized according to their domains. RESULTS: Fifty-five observational studies were screened, of which 11 were excluded due to the mention of only bivariate analyzes or the lack of multivariate analyses. The remaining 44 studies were critically appraised. Of these, 9 studies specifically mentioned the term confounding, and 12 studies mentioned the term bias. However, only 14 studies mentioned limitations on confounding factors in their findings. Among the 99 different variables identified, the most used were type of trauma, followed by sex and age. CONCLUSION: Most studies did not acknowledge the control for possible confounding factors and rarely stressed the need for caution in interpreting their results. Cross-sectional studies do not allow inferring a cause-and-effect relationship between dentofacial features and dental trauma.

Prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous populations in Brazil: a systematic review and meta-analysis

Abstract The aim of this review was to evaluate the prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous in Brazil. A systematic review of observational studies was performed according to the PRISMA guidelines (CRD42020218704). The search strategy involved the electronic databases of Embase, LILACS, PubMed, Web of Science, Scopus, and the CAPES Theses and Dissertations for gray literature. The eligibility criteria consisted of publications that assessed the prevalence of oral conditions in indigenous populations in Brazil. Studies with indigenous people living in urban area were excluded. The risk of bias was evaluated by using JBI Critical Appraisal for prevalence studies. Thirty studies were included in the review, and the majority showed a low risk of bias. A meta-analysis of 20 studies was conducted using the random-effects model and a 95% confidence interval. Several ethnicities were studied in isolation or in groups (n = 7,627 for dental caries; n = 2,774 for periodontal disease; n = 1,067 for malocclusion; n = 150 for tooth wear). The prevalence of caries ranged from 50% among indigenous people aged 18-36 months to 100% among those aged 65-74 years. The prevalence of periodontal disease ranged from 58% to 83%. The prevalence of malocclusion was 43%. Tooth wear was assessed in only one ethnic group and showed a prevalence of 100% in indigenous people aged >18 years. The certainty of evidence assessed by the GRADE system ranged from very low to moderate. This systematic review showed significant differences in the prevalence of dental caries, periodontal disease and malocclusion between indigenous population groups and territories in which indigenous people live.

Shaping Ability of Reciprocating and Rotary Systems After Root Canal Retreatment: a CBCT Study.

The purpose of this in vitro study was to evaluate the shaping ability of reciprocating and continuous rotary systems after root canal retreatment. After preparation and root canal filling, mesial canals of 54 mandibular molars were distributed into 3 groups (n=18), according to the filling material removal and re-instrumentation protocols: WOG group - WaveOne Gold system; PTN group - ProTaper Next system; and PTU group - ProTaper Universal system. Cone-beam computed tomographic (CBCT) images acquisition of the mesial root canals was performed at different moments: (1) before instrumentation (unprepared root canals), (2) after preparation and filling, (3) after filling material removal and (4) re-instrumentation. The apical transportation (AT), centering ability (CA) and change in root canal diameter were assessed by CBCT analysis. The remaining filling material quantification was performed by radiographic examination. The statistical analyses were performed using the 3-way ANOVA, Tukey-Kramer, Kruskal-Wallis and Dunn multiple Comparison tests (p<0.05). The tested instruments did not show full CA (=1.0). PTN group had greater AT at the 5th mm in comparison with the WOG group (p<0.05). After re-instrumentation, WOG group had greater root canal diameter change at the 1st and 5th mm than PTN and PTU groups (p<0.05). There was no significant difference among groups when comparing the amount of remaining filling material after re-instrumentation (p>0.05). The tested systems provided minimal alteration in root canal morphology at the apical portion after root canal retreatment. However, WOG promoted greater change in root canal diameter.

Shaping Ability of Reciprocating and Rotary Systems After Root Canal Retreatment: a CBCT Study

Abstract The purpose of this in vitro study was to evaluate the shaping ability of reciprocating and continuous rotary systems after root canal retreatment. After preparation and root canal filling, mesial canals of 54 mandibular molars were distributed into 3 groups (n=18), according to the filling material removal and re-instrumentation protocols: WOG group - WaveOne Gold system; PTN group - ProTaper Next system; and PTU group - ProTaper Universal system. Cone-beam computed tomographic (CBCT) images acquisition of the mesial root canals was performed at different moments: (1) before instrumentation (unprepared root canals), (2) after preparation and filling, (3) after filling material removal and (4) re-instrumentation. The apical transportation (AT), centering ability (CA) and change in root canal diameter were assessed by CBCT analysis. The remaining filling material quantification was performed by radiographic examination. The statistical analyses were performed using the 3-way ANOVA, Tukey-Kramer, Kruskal-Wallis and Dunn multiple Comparison tests (p<0.05). The tested instruments did not show full CA (=1.0). PTN group had greater AT at the 5th mm in comparison with the WOG group (p<0.05). After re-instrumentation, WOG group had greater root canal diameter change at the 1st and 5th mm than PTN and PTU groups (p<0.05). There was no significant difference among groups when comparing the amount of remaining filling material after re-instrumentation (p>0.05). The tested systems provided minimal alteration in root canal morphology at the apical portion after root canal retreatment. However, WOG promoted greater change in root canal diameter.

Resumo O objetivo deste estudo in vitro foi avaliar a capacidade de modelagem de sistemas rotatórios e reciprocantes após o retratamento do canal radicular. Após o preparo e obturação do canal radicular, os canais mesiais de 54 molares inferiores foram distribuídos em 3 grupos, de acordo com os protocolos de remoção do material obturador e re-instrumentação: (n=18): grupo WOG - sistema WaveOne Gold; Grupo PTN - sistema ProTaper Next; e grupo PTU - sistema ProTaper Universal. A análise das imagens de tomografia computadorizada de feixe cônico foi realizada em diferentes momentos: (1) antes da instrumentação (canais radiculares não preparados), (2) após o preparo e obturação, (3) após a remoção do material obturador e (4) re-instrumentação. O transporte apical (TA), a capacidade de centralização (CC) e a mudança no diâmetro do canal radicular foram avaliados por análise tomográfica. A quantificação do restante do material obturador foi realizada por exame radiográfico. As análises estatísticas foram realizadas utilizando os testes de ANOVA de 3 fatores, Tukey-Kramer, Kruskal-Wallis e Comparações Múltiplas de Dunn (p<0,05). Os instrumentos não apresentaram CC perfeita (=1,0). PTN apresentou maior TA no 5º mm em comparação ao grupo WOG (p<0,05). Após a re-instrumentação, o grupo WOG apresentou maior aumento no diâmetro do canal radicular no 1° e 5° mm do que os grupos PTN e PTU. Não houve diferença significativa entre os grupos em relação à remoção do material obturador (p>0,05). Os sistemas testados proporcionaram alteração mínima na morfologia do canal radicular na porção apical após o retratamento do canal radicular. No entanto, WOG promoveu maior alteração no diâmetro do canal radicular.

CONSORT Compliance in Randomized Clinical Trials of Regenerative Endodontic Treatments of Necrotic Immature Teeth: A Scoping Review.

INTRODUCTION: This study aimed to investigate methodological quality of clinical trials in regenerative endodontics and its compliance with the CONSORT statement. METHODS: An electronic search was performed in 8 electronic databases. Only clinical trials whose participants underwent regenerative endodontic treatment on necrotic permanent immature teeth were included. Quality assessment was performed using the Cochrane Collaboration's Risk of Bias Tool (RoB, version 2.0). Compliance of articles with the CONSORT guidelines was assessed by a tool with scales: 0 = no description, 1 = deficient, and 2 = adequate description, totaling a maximum score of 32 points. The Mann-Whitney and Kruskal-Wallis tests were used to compare the scores among journals, studies, country, income levels, and publication periods. Spearman correlation analyses were performed between CONSORT compliance scores and 2019 journal CiteScore values, publication year, and quality assessment. RESULTS: Twenty studies were included. The average CONSORT compliance score was 20.95 (±6.19). The better reported items were the description of the interventions performed in the trials (100%), followed by the description of the number of patients analyzed, losses and exclusions (90%), and the hypothesis tested (85%). Within the 20 studies, 3 articles were classified as "low risk of bias," 8 studies were classified as "some concerns," and 9 studies were considered "high risk of bias." Studies carried out in countries with higher income levels presented higher CONSORT scores. Significant moderate correlations were found between the CONSORT score and the percentage of risk of bias in low-risk domains (rs = 0.63; 95% CI, 0.31-0.94; P = .003) and the overall risk of bias categories (rs = 0.76; 95% CI, 0.54-0.98; P = .001). CONCLUSIONS: The adequacy of reporting based on the CONSORT checklist items of regenerative endodontic trials was low with a moderate to high risk of bias.

Calcium Silicate-Based Sealers Do Not Reduce the Risk and Intensity of Postoperative Pain after Root Canal Treatment when Compared with Epoxy Resin-Based Sealers: A Systematic Review and Meta-Analysis.

This review aims to evaluate whether root canal obturation with calcium silicate-based (CSB) sealers reduces the risk and intensity of endodontic postoperative pain when compared to epoxy resin-based (ERB) sealers. The review was registered at PROSPERO (CRD42020169255). Two independent reviewers conducted an electronic search in PubMed, Scopus, EMBASE, Web of Science, Cochrane Library and LILACS until November 2020 and included only randomized clinical trials with adult health participants undergoing root canal treatment. After selection, the JBI Critical Appraisal tool was used to assess the risk of bias. A fixed-effect meta-analysis was performed to summarize the results of pain risk and pain intensity at time intervals of 24 and 48 hours. Finally, the certainty of evidence was assessed using the GRADE approach. The search resulted in 1,206 records, of which five studies (n = 421 patients) met the eligibility criteria and presented moderate to low risk of bias. There was no significant difference between groups in the risk of pain in the first 24 hours (relative risk or RR = 0.83, 95% confidence interval or CI: 0.60, 1.16, I 2 =) or 48 hours (RR = 0.56, 95% CI: 0.26, 1.21, I 2 =). Silicate-based sealers led to lower pain intensity only at 48 hours (mean and standard deviation = 0.37, 95% CI: 0.69, 0.05). All analyses revealed low heterogeneity (I 2 < 25%). The evidence presented moderate level of certainty. Currently available evidence has shown that there is no difference between CSB and ERB sealers in the risk or intensity of postoperative pain.

Effect of Occlusal Adjustment on Postoperative Pain after Root Canal Treatment: A Randomized Clinical Trial.

The aim of this prospective, randomized, clinical study was to analyze the influence of occlusal adjustment on the prevalence of postoperative pain after endodontic treatment. Seventy-eight patients, diagnosed with symptomatic irreversible pulpitis with indication for endodontic treatment, were selected to participate in the study. The participants were randomized and divided into two groups: in the occlusal adjustment group (OAG), endodontic treatment was performed with subsequent occlusal adjustment. In the control group (CG), endodontic treatment was performed without occlusal adjustment. Treatments were performed by the same operator. Pain occurrence and intensity were recorded on two scales: the verbal rating scale (VRS) and numerical rating scale (NRS). Pain assessment was carried out by a second examiner, blinded to the experiment, 6, 24 and 72 h after endodontic treatment. Data were analyzed using Mann-Whitney, chi-squared, and Fisher's exact tests. In the occlusal adjustment group, 71.1% reported postoperative pain and 67.5% reported pain in the control group. At the 6-hour assessment, 21 individuals reported pain in the occlusal adjustment group and 24 in the control group (p=0.672). At the 24-hour assessment, 18 and 19 individuals reported pain (p=0.991) and at the 72-hour assessment, 8 and 4 reported pain (p=0.219), respectively. Occlusal adjustment did not influence the prevalence of postoperative pain of endodontically treated teeth with symptomatic irreversible pulpitis.

Effect of occlusal adjustment on postoperative pain after root canal treatment: a randomized clinical trial

Abstract The aim of this prospective, randomized, clinical study was to analyze the influence of occlusal adjustment on the prevalence of postoperative pain after endodontic treatment. Seventy-eight patients, diagnosed with symptomatic irreversible pulpitis with indication for endodontic treatment, were selected to participate in the study. The participants were randomized and divided into two groups: in the occlusal adjustment group (OAG), endodontic treatment was performed with subsequent occlusal adjustment. In the control group (CG), endodontic treatment was performed without occlusal adjustment. Treatments were performed by the same operator. Pain occurrence and intensity were recorded on two scales: the verbal rating scale (VRS) and numerical rating scale (NRS). Pain assessment was carried out by a second examiner, blinded to the experiment, 6, 24 and 72 h after endodontic treatment. Data were analyzed using Mann-Whitney, chi-squared, and Fisher's exact tests. In the occlusal adjustment group, 71.1% reported postoperative pain and 67.5% reported pain in the control group. At the 6-hour assessment, 21 individuals reported pain in the occlusal adjustment group and 24 in the control group (p=0.672). At the 24-hour assessment, 18 and 19 individuals reported pain (p=0.991) and at the 72-hour assessment, 8 and 4 reported pain (p=0.219), respectively. Occlusal adjustment did not influence the prevalence of postoperative pain of endodontically treated teeth with symptomatic irreversible pulpitis.

Resumo O objetivo deste estudo prospectivo, randomizado e clínico foi analisar a influência do ajuste oclusal na prevalência de dor pós-operatória após o tratamento endodôntico. Setenta e oito pacientes, diagnosticados com pulpite irreversível sintomática com indicação de tratamento endodôntico, foram selecionados para participar do estudo. Os participantes foram randomizados e divididos em dois grupos: no grupo de ajuste oclusal (GAO), foi realizado tratamento endodôntico com posterior ajuste oclusal. No grupo controle (GC), o tratamento endodôntico foi realizado sem ajuste oclusal. Os tratamentos foram realizados pelo mesmo operador. A ocorrência e a intensidade da dor foram registradas em duas escalas: a escala de classificação verbal (VRS) e a escala de classificação numérica (NRS). A avaliação da dor foi realizada por um segundo examinador, cego para o experimento, 6, 24 e 72 horas após o tratamento endodôntico. Os dados foram analisados utilizando testes de Mann-Whitney, qui-quadrado e exato de Fisher. No grupo de ajuste oclusal, 71,1% relataram dor pós-operatória e 67,5% relataram dor no grupo controle. Na avaliação de 6 horas, 21 indivíduos relataram dor no grupo de ajuste oclusal e 24 no grupo controle (p=0,672). Na avaliação de 24 horas, 18 e 19 indivíduos relataram dor (p=0,991) e, na avaliação de 72 horas, 8 e 4 relataram dor (p=0,219), respectivamente. O ajuste oclusal não influenciou a prevalência de dor pós-operatória após o tratamento endodôntico em dentes com pulpite irreversível sintomática.

Comparison of the effect of photobiomodulation therapy and Ibuprofen on postoperative pain after endodontic treatment: randomized, controlled, clinical study.

The aim of the study was to compare the effect of Ibuprofen and the application of photobiomodulation therapy protocol on the reduction of postoperative pain in endodontically treated teeth using a randomized clinical trial design. Seventy patients, diagnosed with symptomatic irreversible pulpitis, were selected. Treatment was performed by a single operator; a reciprocal system was used to prepare the canals; they were obturated using the Tagger's hybrid technique and coronally sealed with glass-ionomer cement. After treatment, patients were randomly divided into 2 groups. In the active control group, two Ibuprofen 600 mg tablets were administered within a 12-h interval. In the photobiomodulation therapy group, the irradiation was applied after treatment. The evaluation of postoperative pain was performed by another researcher blinded to the groups at 6, 12, 24, and 72 h intervals after treatment. To measure the outcome, two pain scales were used: numerical rate scale (NRS) and verbal rate scale (VRS). Data were analyzed using the chi-square, Mann-Whitney, and Wilcoxon paired tests. Outcome was superior with photobiomodulation therapy at 6 h (p < 0.001), 12 h (p = 0.005), and 24 h (p < 0.001) intervals compared with Ibuprofen. The results for the 72 h (p = 0.317) interval were similar, both in the VRS and NRS scales. It may be concluded that the use of photobiomodulation therapy was effective in reducing pain within the first 24 h when compared with the administration of Ibuprofen 600 mg.

Endodontic Surgery Associated with Guided Tissue Regeneration Technique: Case Report / Cirurgia Parendodôntica Associada à Técnica de Regeneração Tecidual Guiada: Relato de Caso

Non-surgical endodontic retreatment should always be the first option for reintervention when the initial endodontic treatment fails. The surgical treatment, called periradicular surgery, will be the procedure of choice when there is no success after the conventional endodontic retreatment. The purpose of this article is to describe clinical case of endodontic surgery, associated with guided tissue regeneration (GTR). A male patient, 24 years old, was referred for endodontic surgery on tooth 12 after two unsuccessful endodontic interventions. During the surgery, osteotomy, lesion curettage, apicectomy, retrograde obturation with Mineral Trioxide Aggregate (MTA), and filling of the bone failure with lyophilized bone and reabsorbable collagen membrane were performed. After six months of follow-up, the patient did not present any type of painful symptomatology. The endodontic surgery, associated with a technique of guided tissue regeneration, was efficient to solve this clinical case. (AU)

O retratamento endodôntico não cirúrgico deve sempre ser a primeira opção de reintervenção quando o tratamento endodôntico inicial falha. Já o tratamento cirúrgico, ou cirurgia parendodôntica, será o procedimento de escolha quando não há sucesso após o retratamento endodôntico convencional. O objetivo deste artigo é descrever um caso clínico de cirurgia parendodôntica, associada à regeneração tecidual guiada (RTG). O paciente, gênero masculino, 24 anos, foi encaminhado para cirurgia parendodôntica no dente 12 após duas intervenções endodônticas sem sucesso. Durante a cirurgia foram realizadas manobras de osteotomia, curetagem da lesão, apicectomia, obturação retrógrada com Mineral Trióxido Agregado (MTA), além de preenchimento da falha óssea com osso liofilizado e membrana de colágeno reabsorvível. Após seis meses de acompanhamento do caso, o paciente não apresentou nenhum tipo de sintomatologia dolorosa. A cirurgia parendodôntica, associada à técnica de regeneração tecidual guiada, foi eficiente para solucionar este caso clínico. (AU).

Effect of photobiomodulation therapy on postoperative pain after endodontic treatment: a randomized, controlled, clinical study.

OBJECTIVE: The aim of this prospective, randomized, clinical study was to assess the effect of photobiomodulation therapy (PBM) with low-level laser irradiation (LLLI) on postoperative pain after endodontic treatment. MATERIALS AND METHODS: Sixty patients, diagnosed with irreversible pulpitis in lower molar teeth, participated in the study. All treatments were performed by a single operator. Participants were randomly divided into two groups: in the experimental group (EG), endodontic treatment was performed with a reciprocating system, immediately followed by PBM with LLLI; and only endodontic treatment was performed in the control group (CG). Postoperative pain was assessed by a second examiner, who was blinded, using two scales: verbal rating scale (VRS) and numerical rating scale (NRS). Assessment was carried out at 6, 12, and 24 h after treatment. Data were analyzed using chi-squared, Fisher's exact, Mann-Whitney tests, ordinal, and non-parametric regression analyses. RESULTS: For the prevalence of pain, the difference between the groups was significant for the evaluations performed after 6 h (p = 0.04) and 24 h (p = 0.02). The difference after 24 h remained significant after stratification by sex and extrusion of filling material. Increased pain intensity was associated with extrusion of root canal filling material to the periapical region in the two scales used. CONCLUSION: The effect of PBM therapy after endodontic treatment showed a significant decreasein prevalence of postoperative pain. CLINICAL RELEVANCE: The PBM reduces the prevalence of postoperative pain and may benefit patients who need endodontic treatment.

Apical Transportation and Centering Ability After Root Canal Filling Removal Using Reciprocating and Continuous Rotary Systems: A CBCT Study.

OBJECTIVE: To evaluate the apical transportation and centering ability promoted by reciprocating and continuous rotary systems after root canal filling removal. MATERIALS AND METHODS: After obturation, 40 mesial root canals of mandibular molars were distributed into four groups (n = 20) for filling material removal: PTU group-F2 instrument (25.08) of ProTaper Universal system; R25 group-R25 instrument (25.08) of Reciproc system; X2 group-X2 instrument (25.06) of ProTaper Next system and X3 group-X2 instrument (25.06) of ProTaper Next system, followed by X3 instrument (30.07). Cone-beam computed tomographic analysis was performed before and after filling material removal for acquisition of apical images. Apical transportation (AT) and its direction, and centering ability (CA), were assessed using the equations AT = (X1-X2)-(Y1-Y2) and CA = (X1-X2/Y1-Y2 or Y1-Y2/X1-X2), respectively. Data were submitted to the nonparametric Kruskal-Wallis and Dunn multiple comparison tests (p < 0.05) for statistical analysis. RESULTS: There was no statistically significant difference among groups for AT (p > 0.05), with a tendency toward transportation in the distal direction. Also, there was no statistically significant difference among groups regarding CA (p > 0.05). CONCLUSIONS: The different systems, including ProTaper Next, caused AT within the acceptable clinical limit after filling removal. In addition, none of the tested systems presented adequate CA.

Desvio apical promovido por sistemas rotatórios e reciprocantes: estudo piloto em canais simulados / Apical deviation promoted by rotary and reciprocating systems: pilot study in simulated canals

Objetivo: Instrumentos endodônticos de movimentos reciprocante estão entre as últimas inovações para o preparo do sistema de canais radiculares. O objetivo desse estudo piloto foi comparar o desvio apical promovido por sistemas reciprocantes e rotatório em canais simulados. Material e método: Quarenta e cinco canais simulados foram distribuídos aleatoriamente em três grupos experimentais (n=15), de acordo com o sistema utilizado para realização do preparo: Grupo PT - sistema ProTaper; Grupo RP - sistema Reciproc e Grupo WO - sistema WaveOne. O desvio apical foi avaliado por meio da análise de imagens obtidas pré e pós-instrumentação de cada canal simulado, com auxílio do programa ImageJ. Resultados: Todos os grupos apresentaram algum nível de desvio apical. O grupo PT apresentou maior desvio aos 2 mm, com diferença estatisticamente significante em relação aos demais grupos (p<0,05). Quando comparada a média dos 3 mm apicais, somente houve diferença significativa entre os grupos PT e RP (p<0,05). Conclusão: Nenhum dos sistemas testados, reciprocante ou rotatório, foi capaz de manter a posição original do forame apical após o preparo do canal simulado.

Objective: Endodontic instruments of reciprocating motion are among the latest innovations for root canal system preparation. The aim of this pilot study was to compare the apical deviation promoted by reciprocating and rotary systems in simulated canals. Methods: Forty-five simulated canals were randomly distributed into three experimental groups (n=15), according to the system used for preparation: PT group - ProTaper system; RP group - Reciproc and WO group - WaveOne system. The apical deviation was assessed by analysis of pre- and post-instrumentation images of each simulated canal, with the aid of the ImageJ software. Results: All groups presented some level of apical deviation. The PT group presented greater deviation at 2 mm, with statistically significant difference in comparison with the other groups (p<0.05). When compared the average of the final apical 3 mm, there was significant difference only between PT and RP groups (p<0.05). Conclusion: None of the tested systems, reciprocating or rotary, were able to maintain the original position of the apical foramen after preparation of the simulated canal.

Topographic and Chemical Analysis of Reciprocating and Rotary Instruments Surface after Continuous Use

Abstract This study aimed at evaluating the changes in surface characteristics and NiTi content of reciprocating and rotary instruments after continuous use. Thirty brand-new instruments were assigned to 3 groups (n=10): PNX1 Group - ProTaper Next system - instrument X1; PNX2 Group - ProTaper Next system - instrument X2 and WO Group - WaveOne system - Primary instrument 25.08. The instruments were used to prepare 60 simulated root canals. Analysis of surface characteristics by scanning electron microscopy (SEM) and chemical analysis of Ni and Ti content by energy-dispersive spectroscopy (EDS) were performed before and after the first and third use of the instruments. Only WO Group had significant increase in the quantity of defects and deformations after the third use (p<0.05). PNX1 Group had significant decrease in Ni content after the third use, in comparison with the unused instruments (p<0.05). PNX1 Group had no decrease in Ti content throughout the time of use (p>0.05), however, in PNX2 Group, there was significant decrease in the different time interval of analysis (p<0.05). Continuous use promoted increase in defects and deformations only for WaveOne instruments. Chemical composition presented significant changes according to the time of instruments use.

Resumo Este estudo teve como objetivo avaliar as alterações nas características de superfície e teor de NiTi de instrumentos reciprocantes e rotatórios após uso contínuo. Trinta instrumentos novos foram separados em três grupos (n=10): Grupo PNX1 - ProTaper Next system - instrumento X1; Grupo PNX2 - ProTaper Next system - instrumento X2 e Grupo WO - WaveOne system - instrumento Primary 25.08. Os instrumentos foram utilizados para o preparo de 60 canais radiculares simulados. Análise por microscopia eletronica de varredura (MEV), a análise química do conteúdo de Ni e Ti por espectroscopia de energia dispersiva (EED) foram realizadas antes e após o primeiro e terceiro uso dos instrumentos. Apenas o Grupo WO apresentou aumento significativo na quantidade de defeitos e deformações após o terceiro uso (p<0,05). O grupo PNX1 teve diminuição significativa no teor de Ni após o terceiro uso, em comparação aos instrumentos não utilizados (p<0,05). O grupo PNX1 não apresentou diminuição do teor de Ti ao longo do tempo de uso (p>0,05), no entanto, no Grupo PNX2, houve diminuição significativa nos diferentes intervalos de tempo de análise (p<0,05). O uso contínuo promoveu aumento nos defeitos e deformações somente para os instrumentos WaveOne. A composição química apresentou alterações significativas de acordo com o tempo de uso dos instrumentos.

Assessment of a Cavity to Optimize Ultrasonic Efficiency to Remove Intraradicular Posts.

INTRODUCTION: The study assessed an in vitro protocol for the removal of cast metal posts using ultrasonic vibration in multirooted teeth by drilling a cavity in the coronal portion of the post followed by ultrasound application in the cavity. METHOD: Forty endodontically treated molars received intraradicular cast posts and were divided into 4 groups according to the removal protocol: the control group, no cavity and no ultrasonic vibration; the ultrasonic group, no cavity and ultrasonic vibration in the coronal portion of the core; the cavity group, a cavity in the core and no ultrasonic vibration; and the cavity ultrasonic group, a cavity in the core and ultrasonic vibration inside the cavity. The traction test was performed on all samples using a universal testing machine (EMIC DL-2000; EMIC Equipamentos e Sistemas de Ensaio LTDA, São José dos Pinhais, PR, Brazil) at a speed of 1 mm/min, obtaining values in Newtons. The data were statistically analyzed using analysis of variance and the Tukey-Kramer test (P < .05). RESULTS: The results showed statistically significant differences between the tested groups (control group = 322.74 N, ultrasonic group = 283.09 N, cavity group = 244.00 N, and cavity ultrasonic group = 237.69 N). The lowest mean strength was found in the group that received ultrasonic vibration inside the cavity. CONCLUSIONS: Preparing a cavity in the coronal core followed by ultrasonic vibration reduces the traction force required for removal. The removal protocol was effective for removing posts in multirooted teeth cemented with zinc phosphate.

Technological advances in endodontics: treatment of a mandibular molar with internal root resorption using a reciprocating single-file system.

The field of endodontics has become increasingly successful due to technological advances that allow clinicians to solve clinical cases that would have been problematic a few years ago. Despite such advances, endodontic treatment of teeth with internal root resorption remains challenging. This article presents a clinical case in which a reciprocating single-file system was used for endodontic treatment of a mandibular molar with internal root resorption. Radiographic examination revealed the presence of internal root resorption in the distobuccal root canal of the mandibular right first molar. A reciprocating single-file system was used for root canal instrumentation and final preparation, and filling was obtained through a thermal compaction technique. No painful symptoms or periapical lesions were observed in 12 months of follow-up. The results indicate that a reciprocating single-file system is an adequate alternative for root canal instrumentation, particularly in teeth with internal root resorption.

Endodontic treatment of maxillary lateral incisor with internalroot resorption using a hybrid instrumentation technique -case report / Tratamento endodôntico de incisivo lateral superior com reabsorção radicular interna utilizando uma técnica de instrumentaçãohíbrida - relato de caso

Several factors influence the cleaning and shaping capacity of instrumentation techniques, such as internal resorption areas. Internal root resorption contributes to failure of endodontic treatment, since debris may remain attached to dentine walls, and the instruments are not able to completely remove them. This paper reports a clinical case of endodontic treatment of a tooth with internal root resorption using a hybrid instrumentation technique. After clinical and radiographic examinations, pulp necrosis with periapical lesion, and the presence of an internalroot resorption were diagnosed. Biomechanical preparation began with glide path creation with sizes15 and 20 K-type files. Apical third instrumentation was performed with rotary ProFile files #25.04 upto #35.04, followed by root canal filling. The casewas followed-up for twelve months. Progressive bone repair was observed radiographically. Despitethe presence of internal root resorption, theresults achieved with the hybrid technique suggest effectiveness in this clinical case solution...

Diversos fatores influenciam a capacidade de limpezae modelagem das técnicas de instrumentação, como áreas de reabsorção interna. A reabsorção radicular interna contribue para falhas no tratamento endodôntico, uma vez que detritos podem permanecer aderidos as paredes dentinárias, e os instrumentos não são capazes de removê-los completamente. O objetivo deste estudo foi relatar um caso clínico de tratamento endodôntico de incisivo lateral superior com reabsorção interna empregando uma técnica híbrida de instrumentação. Após exames clínico e radiográfico, o diagnóstico foi de necrose pulpar com lesão periapical, além da presença de reabsorção radicular interna. O preparo biomecânico teve início com exploração inicial com limas tipo K #15 e #20. O preparo do terço apical foi realizado com instrumentos rotatórios Pro File #25.04 à #35.04,seguido de obturação. O acompanhamento do caso foi realizado por doze meses. Radiograficamente foi possível observar progressiva reparação óssea.Apesar da presença de reabsorção radicular interna,a técnica de instrumentação híbrida foi eficaz na resolução do caso...

Apical Transportation, Centering Ability, and Cleaning Effectiveness of Reciprocating Single-file System Associated with Different Glide Path Techniques.

INTRODUCTION: The aim of this study was to evaluate the apical transportation, the centering ability, and the cleaning effectiveness of a reciprocating single-file system associated to different glide path techniques. METHODS: The mesial root canals of 52 mandibular molars were randomly distributed into 4 groups (n = 13) according to the different glide path techniques used before biomechanical preparation with Reciproc System (RS): KF/RS (sizes 10 and 15 K-files), NGP/RS (no glide path, only reciprocating system), PF/RS (sizes 13, 16, and 19 PathFile instruments), and NP (no preparation). Cone-beam computed tomography analysis was performed before and after instrumentation for apical third images acquisition. Apical transportation and its direction were evaluated by using the formula D = (X1 - X2) - (Y1 - Y2), and the centering ability was analyzed by the formula CC = (X1 - X2/Y1 - Y2 or Y1 - Y2/X1 - X2). The samples were submitted to histologic processing and analyzed under a digital microscope for debris quantification. The values were statistically analyzed (Kruskal-Wallis, the Dunn multiple comparisons test, P < .05). RESULTS: All groups had similar apical transportation values, with no significant difference among them (P > .05). Groups had a tendency toward transportation in the mesial direction. No technique had perfect centering ability (=1.0), with no significant difference among them. KF/RS had larger amount of debris, with statistically significant difference in comparison with NGP/RS (P > .05). CONCLUSIONS: The different glide path techniques promoted minimal apical transportation, and the reciprocating single-file system tested remained relatively centralized within the root canal. Also, the different techniques interfered in the cleaning effectiveness of the reciprocating system.