RESUMO
AIM: To compare the intensity of postoperative pain after primary root canal treatment of asymptomatic teeth when using ultrasonically (UAI) or laser-activated irrigation (LAI). METHODOLOGY: In this superiority randomized clinical trial (ClinicalTrials.gov ID: NCT03981237) with parallel design, fifty-six patients with an asymptomatic tooth in need of primary root canal treatment were enrolled. After chemo-mechanical canal preparation using rotary instruments and NaOCl irrigation, teeth were randomly assigned to two groups and patients were blinded to the final irrigation protocol. In the UAI group (n = 28), 60s activation with an Irrisafe tip was done per canal. In the LAI group (n = 28), NaOCl was activated with a pulsed Er:YAG (2940 nm) laser, equipped with a conical tip, with settings of 50 µs, 20 mJ at 15 Hz for 60 s. Patients recorded their pain intensity 6, 24, 48 and 72 h after treatment on a 100 mm visual analogue scale (VAS), as well as their analgesic consumption. Pain levels and incidence were compared across groups using the Mann-Whitney U-test and chi-square test. RESULTS: Overall, mean postoperative pain intensity was low, with the majority of patients having no or minimal pain 24 h postoperatively. At 6 h postoperatively, pain intensity and incidence were significantly higher in the UAI group compared to the LAI group (P < 0.05). For the other time intervals, no significant differences in postoperative pain incidence or intensity were found. The frequency of analgesic intake did not differ significantly between the two groups. Neither of the activation methods resulted in any adverse effects. CONCLUSIONS: Ultrasonically and laser-activated irrigation resulted in low and comparable levels of postoperative pain in asymptomatic patients receiving primary root canal treatment.
Assuntos
Cavidade Pulpar , Tratamento do Canal Radicular , Humanos , Lasers , Dor Pós-Operatória/etiologia , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular , Tratamento do Canal Radicular/efeitos adversosRESUMO
AIM: To evaluate ex vivo the long-term sealing ability of the SE Resilon Epiphany system as an apical root-end filling material. METHODOLOGY: A total of 60 standardized horizontal bovine root sections were divided into three groups filled with either gutta-percha with AH 26, tooth-coloured mineral trioxide aggregate (MTA) or Resilon pellets with Epiphany SE, and submitted to capillary flow porometry at 48 h, 1 and 6 months to assess the minimum, mean flow and maximum pore diameters. Results of the different materials and results by material and time were analysed statistically using nonparametric tests; the level of significance was set at 0.05. RESULTS: Resilon had smaller pore diameters than gutta-percha and MTA at 48 h and smaller mean flow and maximum pore diameters than gutta-percha and MTA at 1 month. At 6 months Resilon had larger minimum pore diameters than gutta-percha. Although not always statistically significant, the minimum, mean flow and maximum pore diameters of gutta-percha and MTA diminished with time. This was not the case for Resilon, where the same parameters increased. CONCLUSIONS: All materials leaked at all times. Resilon performed better than gutta-percha and MTA in the short-term, but the seal of MTA and gutta-percha improved over time whereas the seal of Resilon deteriorated. It is critical to evaluate the performance of materials in the long-term contrary to most studies which are short-term.
Assuntos
Colagem Dentária , Cavidade Pulpar/ultraestrutura , Materiais Restauradores do Canal Radicular/química , Ápice Dentário/ultraestrutura , Compostos de Alumínio/química , Animais , Bismuto/química , Compostos de Cálcio/química , Bovinos , Infiltração Dentária/classificação , Combinação de Medicamentos , Resinas Epóxi/química , Guta-Percha/química , Teste de Materiais , Óxidos/química , Porosidade , Reologia , Silicatos/química , Prata/química , Propriedades de Superfície , Fatores de Tempo , Titânio/química , MolhabilidadeRESUMO
Piercing of the tongue and perioral regions is an increasingly popular expression of body art, with more patients coming in for a routine check-up with tongue and/or lip piercings. Several complications of oral piercing have been reported, some of which are life-threatening. In the present clinical survey the prevalence of both tongue and lip piercing complications in oral health was assessed in a group of 50 patients. The most common dental problem registered was chipping of the teeth, especially in association with tongue piercing. Gingival recession was seen as a result of lip piercing with studs. Post-procedural complications included oedema, haemorrhage and infection. Therefore, dentists and oral and maxillofacial surgeons should be given more authority to advise patients with oral and facial piercings or those who plan to acquire this type of body art.
Assuntos
Piercing Corporal/efeitos adversos , Retração Gengival/etiologia , Fraturas dos Dentes/etiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Lábio/lesões , Masculino , Língua/lesõesRESUMO
AIM: To evaluate the long-term sealing ability of a variety of materials when used as root-end fillings. METHODOLOGY: A total of 140 standardized horizontal bovine root sections (external diameter: 7 mm, height: 3 mm; internal diameter: 2.5 mm) were divided into seven groups, filled with either gutta-percha with AH26, Ketac Fil, Fuji IX, Tooth-Colored MTA, IRM, Ketac Fil with conditioner or Fuji IX with conditioner and submitted to capillary flow porometry at 1 and 6 months to assess minimum, mean flow and maximum pore diameters. Results of the different materials and results by material were analysed statistically using non-parametric tests; the level of significance was set at 0.05. RESULTS: There were no significant differences between the minimum pore diameters associated with the materials at each time. At 1 month the mean flow pore diameters of Ketac Fil were significantly larger than those of gutta-percha, Ketac Fil with conditioner, Fuji IX with conditioner and IRM. There were significant differences between the maximum pore diameters at 1 month (all>IRM; Fuji IX>gutta-percha, Ketac Fil with conditioner, Fuji IX with conditioner) and 6 months (Fuji IX>gutta-percha, IRM; Ketac Fil>gutta-percha, IRM). There were significant differences in the minimum pore diameters between the different points in time for each material except IRM, in the mean flow pore diameters for each material and in the maximum pore diameters for each material except MTA. CONCLUSIONS: All materials were associated with capillary flow. IRM root-end fillings had through pores that were smaller than those associated with other materials. Conventionally setting glass-ionomer cements had the largest pores, although dentine conditioning improved their performance. The seal of all materials improved after 6 months.
Assuntos
Colagem Dentária , Obturação Retrógrada , Materiais Restauradores do Canal Radicular/química , Resinas Acrílicas/química , Compostos de Alumínio/química , Animais , Bismuto/química , Compostos de Cálcio/química , Bovinos , Infiltração Dentária/classificação , Adesivos Dentinários/química , Combinação de Medicamentos , Resinas Epóxi/química , Cimentos de Ionômeros de Vidro/química , Guta-Percha/química , Maleatos/química , Metilmetacrilatos/química , Microfluídica/métodos , Óxidos/química , Porosidade , Silicatos/química , Prata/química , Fatores de Tempo , Titânio/química , Cimento de Óxido de Zinco e Eugenol/químicaRESUMO
AIM: To evaluate ex vivo the effect of Nd:YAG laser irradiation with and without black ink on instrumented root canal walls, and the degree of both coronal and apical microleakage of filled root canals. METHODOLOGY: Seventy-two single-rooted teeth were instrumented up to a size 40 K-file, and then divided into six groups of 10 teeth: groups 1 and 4 remained unlased and acted as control groups, groups 2 and 5 were treated with a Nd:YAG laser (Fidelis Plus, Herzele, Belgium), groups 3 and 6 were treated with a laser and black ink; the remaining 12 teeth served as positive and negative controls. The laser was operated at 1.5 W, 15 Hz, four times for 5 s with a 20-s interval. Groups 4-6 were filled using cold lateral condensation of gutta-percha and AH26. After storage in water for 48 h at 37 degrees C, through-and-through leakage (L in microL day-1) was measured for 48 h under a pressure of 1.2 atm using a fluid transport model and recorded as L=0 (L1), 0
Assuntos
Colagem Dentária , Cavidade Pulpar/ultraestrutura , Resinas Epóxi/química , Terapia a Laser , Materiais Restauradores do Canal Radicular/química , Silicatos de Alumínio , Bismuto/química , Infiltração Dentária/classificação , Cavidade Pulpar/efeitos da radiação , Dentina/efeitos da radiação , Dentina/ultraestrutura , Combinação de Medicamentos , Corantes Fluorescentes , Guta-Percha/química , Humanos , Microscopia Eletrônica de Varredura , Neodímio , Pressão , Rodaminas , Prata/química , Camada de Esfregaço , Titânio/química , ÍtrioRESUMO
AIM: To compare the integrity of root apices of cadaver and extracted teeth after resection, ultrasonic root-end cavity preparation at medium and low ultrasonic power settings and retrieval. METHODOLOGY: Root canal treatment, perpendicular root-end resection and root-end preparation were performed on single-rooted anterior and premolar teeth (49 teeth in situ in maxillary and mandibular jaws from cadavers and 45 extracted teeth). Apical root-end cavities were prepared with the S12/90 degrees D tip and the Suni-Max ultrasonic unit (Satelec, Merignac, France) at the intensity prescribed by the manufacturer (power 7 at power mode S) (34 cadaver teeth, 30 extracted teeth) and at a lower intensity (power 4 at power mode S) (15 cadaver teeth, 15 extracted teeth). After ultrasonic preparation the cadaver teeth were retrieved from the jaws. Exaflex impressions (GC Corporation, Tokyo, Japan) were made of the root apices after resection, root-end preparation and retrieval. These impressions were processed for SEM analysis, and the recordings evaluated for cracks and marginal chipping. RESULTS: In general, extracted teeth showed significantly more cracks and chipping than cadaver teeth. Lowering the ultrasonic power from medium to low intensity resulted in equal scores for cracks on extracted teeth and for chipping on cadaver teeth, in higher scores for cracks on cadavers and in lower scores for chipping on extracted teeth. Complete cracks and cracks originating from the root surface occurred only in extracted teeth. CONCLUSIONS: The number of cracks and degree of chipping caused by ultrasonic root-end preparation was higher on extracted teeth than on cadaver teeth. Lowering the ultrasonic power from medium to low intensity cannot be recommended as it resulted in more cracks and equal chipping on cadaver teeth. Investigation of techniques and materials should be conducted in situ and not on extracted teeth.
Assuntos
Apicectomia , Preparo de Canal Radicular/métodos , Ápice Dentário/ultraestrutura , Terapia por Ultrassom/métodos , Apicectomia/efeitos adversos , Dente Pré-Molar , Cadáver , Dente Canino , Dentina/lesões , Dentina/ultraestrutura , Humanos , Incisivo , Mandíbula , Maxila , Microscopia Eletrônica de Varredura , Técnicas de Réplica , Obturação Retrógrada , Preparo de Canal Radicular/efeitos adversos , Camada de Esfregaço , Ápice Dentário/lesões , Extração Dentária , Terapia por Ultrassom/efeitos adversosRESUMO
AIM: (i) To compare the root-end sealing ability of IRM Caps (IRM), Fuji IX Capsules (Fuji IX) and Pro Root MTA Tooth-Coloured Formula (MTA) in teeth obtained from cadavers. (ii) Further research on leakage study methodology by means of comparison of the fluid transport method (FTM) and capillary flow porometry (CFP). METHODOLOGY: Root canal treatment was performed on 33 cadaver teeth in situ 2 weeks prior to root resection and ultrasonic retropreparation (S12/90 degrees D-tip on Suni-Max), after which the teeth were retrieved from the cadavers. Two teeth were kept as positive and negative controls. The other teeth were divided in three different groups at random, with each group receiving one of the retrofill materials. Retrofills were exposed to water 5 min after placement. The teeth were stored at 37 degrees C for 12 h after which the root filling was removed. Microleakage (L in microL day(-1)) was measured for 24 h under a pressure of 1.2 atm using FTM and recorded as L = 0, 0 < L < or = 10, L > 10. The measurements were repeated after 1 and 6 months. After 6 months, leakage was also assessed by CFP in order to measure through pores and their diameters. Results were analysed statistically using nonparametric Kruskal-Wallis and Mann-Whitney U-tests, and Spearman correlation coefficients between the results of both methods were calculated. The level of significance was set at 0.05. RESULTS: (i) A statistically significant difference could be demonstrated between Fuji IX and IRM at 1 month with FTM. FTM revealed a significant difference between Fuji IX and the other materials at 6 months, whereas CFP did not. However, using both methods, Fuji IX showed the best result. (ii) When comparing both techniques, CFP demonstrated through pores in all teeth, whereas with FTM in only 14 of the 31 teeth could through pores be demonstrated. A positive correlation between both methods was demonstrated. CONCLUSIONS: Under the conditions of this study (i) the conventionally setting glass-ionomer cement Fuji IX showed the best results when used as a root-end material and (ii) CFP appeared to be a useful method for leakage evaluation of through pores in endodontics.
Assuntos
Infiltração Dentária/diagnóstico , Infiltração Dentária/etiologia , Obturação Retrógrada/efeitos adversos , Materiais Restauradores do Canal Radicular , Compostos de Alumínio , Compostos de Cálcio , Combinação de Medicamentos , Cimentos de Ionômeros de Vidro , Humanos , Estudos Longitudinais , Metilmetacrilatos , Microcirculação , Óxidos , Porosidade , Reologia , Silicatos , Estatísticas não Paramétricas , Cimento de Óxido de Zinco e EugenolRESUMO
The capacity to bond to dental tissues, especially to dentine, their long-term fluoride release and their biocompatibility make glass ionomer cements (GICs) advantageous for use in endodontics, as well as in restorative dentistry. This review provides information on the basic properties of GICs, such as adhesion, antimicrobial effects and biocompatibility, particularly as they relate to use in endodontics. Indications for the use of GICs in endodontics are orthograde root canal sealing, root-end filling, repair of perforations and root resorption defects, treatment of vertical fractures and maintenance of the coronal seal. The paper includes a review on each of these indications. It is concluded that in spite of the critical handling characteristics and the inconclusive findings regarding sealing ability and antimicrobial activity, there is substantial evidence to confirm their satisfactory clinical performance. Both soft tissue and bone compatibility make them suitable for use during endodontic surgery.