RESUMEN
OBJECTIVES: To investigate the presence of Streptococcus mutans in root canals of symptomatic necrotic teeth (SNT) and their associated acute apical abscesses (AAA) and in the root canals of asymptomatic necrotic teeth (ANT). It also aimed to investigate the presence of the cnm and cbm genes in specimens that harbored S. mutans. MATERIALS AND METHODS: DNA was extracted from samples collected from 10 patients presenting pulpal necrosis associated with radiographic evidence of apical periodontitis (ANT) and from 10 patients in need of endodontic therapy due to the presence of pulpal necrosis (SNT) and AAA. The control group consisted of 10 patients with teeth with normal vital pulp and requiring endodontic treatment for prosthetic reasons. The presence of S. mutans was detected by quantitative real-time-PCR (qPCR) using species-specific primers. Samples harboring S. mutans were further evaluated for the presence of CBP genes by qPCR as well. RESULTS: All studied sites showed a high prevalence of S. mutans, except the control group. Specifically, 60% of ANT and 70% of AAA/SNT paired samples were positive for S. mutans. The cnm gene was detected positive for S. mutans only in ANT samples (66.6%). The cbm gene was not detected in any of the investigated sites. CONCLUSIONS: S. mutans was found in high prevalence in both asymptomatic and symptomatic endodontic infections, including in abscesses, but it was not detected in the root canals of teeth with normal vital pulp. Interestingly, cnm+ S. mutans was only detected in asymptomatic/chronic primary endodontic infections associated with apical lesion. Therefore, it appears that cnm, and possibly other CBPs, may play an underestimated role in chronic endodontic infections. CLINICAL RELEVANCE: A high prevalence of Streptococcus mutans cnm+ gene was detected only in asymptomatic primary endodontic infections associated with apical lesion. Therefore, it appears that this collagen-binding protein gene plays an underestimated role in asymptomatic/chronic endodontic infections.
Asunto(s)
Absceso Periapical , Periodontitis Periapical , Cavidad Pulpar , Necrosis de la Pulpa Dental , Humanos , Streptococcus mutans/genéticaRESUMEN
BACKGROUND/AIMS: Among the diseases related to oral health, such as caries and oral cancer, dental trauma stands out as one of the major public health problems worldwide. The aim of this study was to verify the occurrence of factors associated with traumatic dental injuries (TDIs), including oral health-related quality of life (OHRQoL), sociodemographic characteristics, untreated caries, occlusal problems and contextual variables in 12-year-old Brazilian children. METHODS: This study assessed a complex sample of the National Research in Oral Health (SBBrasil 2010) data on 7240 12-year-old children and contextual features of the municipalities where they lived. RESULTS: TDI prevalence in 12-year-old schoolchildren was 23.96%. Being female was a protective factor for all trauma outcome variables. Non-white children were at risk of maxillary tooth fractures. Maxillary overjet greater than 3 mm was associated with all trauma outcomes. Crowding and spacing were risk factors for enamel trauma. TDI has a negative impact on OHRQoL. None of the contextual variables analysed (Gini coefficient, MHDI, family health strategy and water fluoridation) were associated with TDI in the multilevel approach. CONCLUSIONS: TDI was better explained by individual factors, related to sociodemographic conditions and occlusal problems, with a negative impact on OHRQoL, adjusted for untreated caries. Contextual variables were not associated with TDI in 12-year-old Brazilian schoolchildren. Interdisciplinary actions for preventing dental trauma, such as stimulating the use of mouthguards, have to be encouraged by the family health strategy (FHS) and school health programme (SHP).
Asunto(s)
Salud Bucal , Calidad de Vida , Traumatismos de los Dientes/epidemiología , Brasil/epidemiología , Niño , Femenino , Humanos , Masculino , Prevalencia , Factores de RiesgoRESUMEN
PURPOSE: This parallel, double-blind randomized clinical trial evaluated the 2-year bleaching efficacy and sensitivity produced by at-home (AH) and in-office (IO) bleaching therapies. METHODS: 60 participants with tooth color darker than C2, without restorations in the anterior dentition and older than 18 years old, were randomly allocated into two groups to receive either IO with 35% hydrogen peroxide or AH with 16% carbamide peroxide. Color was recorded at baseline (BA); 1-week (1W); end of the treatment (ET); and 2 years (2Y) after bleaching, using the Vita Classical shade guide. The perception of TS was recorded on a 0-4 scale during and 2Y after bleaching. The variation in shade guide units (deltaSGU) from BA vs. 1W was compared to deltaSGU from BA vs. 2Y using paired t-test. The percentage of subjects who reported TS was evaluated by Fisher's exact test. The intensity of TS was evaluated by a Mann-Whitney test (alpha=0.05). RESULTS: Both bleaching techniques demonstrated equivalent and significant tooth color shade lightening. No significant color rebound occurred after 2Y for both techniques (P= 0.77 and 0.87, for AH and IO respectively). The absolute risk of TS was similar for IO and AH (P= 0.12), however the intensity of TS was significantly higher for IO (P= 0.001). No subjects reported sensitivity after 2Y.
Asunto(s)
Blanqueadores Dentales/uso terapéutico , Blanqueamiento de Dientes , Peróxido de Carbamida , Sensibilidad de la Dentina/inducido químicamente , Método Doble Ciego , Femenino , Servicios de Atención de Salud a Domicilio , Humanos , Peróxido de Hidrógeno/administración & dosificación , Peróxido de Hidrógeno/efectos adversos , Masculino , Visita a Consultorio Médico , Peróxidos/administración & dosificación , Peróxidos/efectos adversos , Estadísticas no Paramétricas , Blanqueadores Dentales/administración & dosificación , Blanqueadores Dentales/efectos adversos , Decoloración de Dientes/tratamiento farmacológico , Urea/administración & dosificación , Urea/efectos adversos , Urea/análogos & derivados , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the effect of water storage time on the cytotoxicity of soft liners. METHODS: Sample discs of soft liners Dentusoft, Dentuflex, Trusoft, Ufi-Gel-P and denture base acrylic resin Lucitone-550 were prepared and divided into four groups: GN: No treatment, G24: Stored in water at 37°C for 24 h; G48: Stored in water at 37°C for 48 h, GHW: Immersed in water at 55°C for 10 min. To analyse the cytotoxic effect, three samples of each group were placed in tubes with Dubelcco's Modified Eagle Mediums and incubated at 37°C for 24 h. During this period, the toxic substances were leached to the culture medium. The cytotoxicity was analysed quantitatively by the incorporation of radioactivity (3)H-thymidine checking the number of viable cells (synthesis of DNA). The data were statistically analysed using two-way anova and Tukey's honestly significant difference tests (α = 0.05). RESULTS: Treatments did not reduce the cytotoxicity effect of the soft liners (p > 0.05). It was found that Ufi-Gel-P had a non-cytotoxic effect, Trusoft had a slightly cytotoxic effect, Dentuflex had a moderated cytotoxic effect, Dentusoft alternated between slightly and non-cytotoxic effect, and Lucitone-550 had non-cytotoxic effect when stored in water for 48 h. CONCLUSION: The effect of water storage and the heat treatment did not reduce the cytotoxicity of the soft liners.
Asunto(s)
Materiales Dentales/toxicidad , Alineadores Dentales , Resinas Acrílicas/química , Resinas Acrílicas/toxicidad , Animales , Línea Celular , Supervivencia Celular/efectos de los fármacos , Medios de Cultivo Condicionados , Materiales Dentales/química , Dimetilpolisiloxanos/química , Dimetilpolisiloxanos/toxicidad , Fibroblastos/efectos de los fármacos , Calor , Ensayo de Materiales , Metilmetacrilatos/química , Metilmetacrilatos/toxicidad , Ratones , Radiofármacos , Elastómeros de Silicona/química , Elastómeros de Silicona/toxicidad , Temperatura , Timidina , Factores de Tiempo , Tritio , AguaRESUMEN
Evidence shows the polymicrobial etiology of endodontic infections, in which bacteria and their products are the main agents for the development, progression, and dissemination of apical periodontitis. Microbial factors in necrotic root canals (e.g., endotoxin) may spread into apical tissue, evoking and supporting a chronic inflammatory load. Thus, apical periodontitis is the result of the complex interplay between microbial factors and host defense against invasion of periradicular tissues. This review of the literature aims to discuss the complex network between endodontic infectious content and host immune response in apical periodontitis. A better understanding of the relationship of microbial factors with clinical symptomatology is important to establish appropriate therapeutic procedures for a more predictable outcome of endodontic treatment.
Asunto(s)
Cavidad Pulpar/microbiología , Enfermedades de la Pulpa Dental/complicaciones , Enfermedades de la Pulpa Dental/microbiología , Periodontitis Periapical/microbiología , Infecciones Bacterianas/complicaciones , Infecciones Bacterianas/microbiología , Citocinas/análisis , Citocinas/fisiología , Cavidad Pulpar/patología , Enfermedades de la Pulpa Dental/patología , Endotoxinas/fisiología , Humanos , Lipopolisacáridos/fisiología , Metaloproteinasas de la Matriz/análisis , Metaloproteinasas de la Matriz/fisiología , Periodontitis Periapical/patologíaRESUMEN
This study compared the effect of intermediate flush with distilled water delivered by conventional irrigation, EndoVac microcannula or Self-Adjusting File (SAF) system in the prevention of chemical smear layer (CSL) formation. Thirty human premolars were used. Canals were prepared with Reciproc system and 5.25% NaOCl. After chemomechanical preparation, samples were divided in 3 groups (n=10) according to the intermediate irrigation protocol with distilled water using: conventional irrigation, EndoVac microcannula or SAF. A final flush with 2% chlorhexidine solution was used and scanning electron microscopy was performed to assess protocol effectiveness. Two calibrated evaluators attributed scores according the presence or absence of CSL on the surface of the root canal walls at the coronal, middle and apical thirds, as follows: (1) no CSL; (2) small amounts of CSL; (3) moderate CSL; and (4) heavy CSL. Differences between protocols were analyzed with Kruskal-Wallis and Mann-Whitney U tests. Friedman and Wilcoxon signed rank tests were used for comparison between each root canal third. SAF resulted in less formation of CSL when compared with the conventional irrigation and EndoVac microcannula (p<0.05). When root canal thirds were analyzed, conventional irrigation and EndoVac groups showed less CSL formation at coronal and middle thirds in comparison to the apical third (p<0.05). In SAF group, there was no difference among the thirds (p>0.05). It may be concluded that an intermediate flush of distilled water, delivered by the SAF system resulted in a better reduction of CSL formation during chemomechanical preparation.
Asunto(s)
Preparación del Conducto Radicular/instrumentación , Capa de Barro Dentinario , Irrigación Terapéutica , Clorhexidina/administración & dosificación , Humanos , Microscopía Electrónica de Rastreo , Preparación del Conducto Radicular/métodos , Hipoclorito de Sodio/administración & dosificaciónRESUMEN
The aim of this study was to analyze the antimicrobial activity and substantivity of Uncaria tomentosa Willd DC (cat's claw, CC) in root dentin contaminated with Enterococcus faecalis. Forty-eight human premolars were contaminated with E. faecalis (ATCC 29212) and randomly divided into four groups according to the irrigant used during chemomechanical preparation (CMP): CC group: 2% CC gel; CHX group: 2% chlorhexidine digluconate gel (CHX); NaOCl group: 5.25% sodium hypochlorite (NaOCl); and SS group: sterile saline (SS). Microbiological samples were collected before (S1) and after (S2) CMP and after 7 days (S3). Colony-forming units (CFU/mL) at the different sampling times and comparisons among the groups were statistically analyzed by Wilcoxon and Kruskal-Wallis tests (p < 0.05). Significant bacterial reduction was achieved in all groups after CMP (p < 0.05). Results show no significant difference between S3 and S2 (p > 0.05) in the CC and CHX groups. Bacterial load was higher in S3 than in S2 samples (p < 0.05) in the NaOCl and SS groups. Our results suggest antibacterial effect of 2% CC gel against E. faecalis in infected dentin, in addition to antibacterial substantivity of 2% CC and 2% CHX up to 7 days.
Asunto(s)
Antiinfecciosos/farmacología , Uña de Gato/química , Cavidad Pulpar/efectos de los fármacos , Cavidad Pulpar/microbiología , Dentina/efectos de los fármacos , Dentina/microbiología , Enterococcus faecalis/efectos de los fármacos , Carga Bacteriana/efectos de los fármacos , Clorhexidina/análogos & derivados , Clorhexidina/farmacología , Recuento de Colonia Microbiana , Humanos , Distribución Aleatoria , Valores de Referencia , Irrigantes del Conducto Radicular/farmacología , Hipoclorito de Sodio/farmacología , Estadísticas no Paramétricas , Factores de TiempoRESUMEN
The study aimed to evaluate the effectiveness of in-office bleaching and associated tooth sensitivity on application of nano-calcium phosphate paste as desensitizing agent. Bleaching was performed with 35% hydrogen peroxide gel in 40 patients who were randomly divided into placebo and nano-calcium phosphate paste groups. Bleaching efficacy (BE) was evaluated using a value-oriented Vita shade guide. Tooth sensitivity was recorded using a numeric rating scale (0-4) during bleaching and up to 48 h after each session. The primary outcome of absolute risk of tooth sensitivity was compared using the Fisher's exact test (α = 0.05). The intensity of tooth sensitivity and the efficacy of in-office bleaching were also statistically evaluated. No significant differences in absolute risk and intensity of tooth sensitivity were detected between the groups (p = 1.0 and p = 0.53, respectively). BE was also found to be similar between the groups (p = 0.67). Although the use of a nano-calcium phosphate paste associated with fluoride and potassium nitrate did not influence the whitening outcome, but it also did not reduce bleaching-induced tooth sensitivity.
Asunto(s)
Fosfatos de Calcio/administración & dosificación , Desensibilizantes Dentinarios/administración & dosificación , Sensibilidad de la Dentina/inducido químicamente , Peróxido de Hidrógeno/administración & dosificación , Nitratos/administración & dosificación , Compuestos de Potasio/administración & dosificación , Blanqueadores Dentales/administración & dosificación , Blanqueamiento de Dientes/efectos adversos , Adulto , Fosfatos de Calcio/efectos adversos , Método Doble Ciego , Femenino , Humanos , Peróxido de Hidrógeno/efectos adversos , Masculino , Nitratos/efectos adversos , Compuestos de Potasio/efectos adversos , Blanqueamiento de Dientes/métodos , Blanqueadores Dentales/efectos adversos , Decoloración de Dientes/tratamiento farmacológico , Adulto JovenRESUMEN
The purpose of this study was to compare the efficacy of reciprocating and rotary techniques for removing gutta-percha and sealer from root canals. Forty straight and oval single-rooted premolars were prepared up to size 30, filled with gutta-percha and sealer, and then randomly allocated to two experimental retreatment groups: ProTaper Retreatment System (PTRS) and WaveOne System (WS). Procedural errors, time of retreatment and apically extruded material were recorded for all the roots. The roots were radiographed after retreatment. The percentage of residual material was calculated using image analysis software. The data were analyzed by Kolmogorov-Smirnov and t tests, with a significance level set at 5%. No system completely removed the root filling material from the root canal. No significant differences were observed between the systems, in terms of residual filling material in any tested third (p > 0.05). WS was faster in removing filling material than PTRS (p < 0.05). Extrusion was observed in 4 cases in PTRS and in 5 cases in WS. No procedural errors were observed in either group. It can be concluded that although no differences were observed in the efficacy of PTRS and WS for removing root filling material, WS was faster than PTRS.
Asunto(s)
Instrumentos Dentales , Gutapercha/química , Materiales de Obturación del Conducto Radicular/química , Tratamiento del Conducto Radicular/instrumentación , Ápice del Diente/diagnóstico por imagen , Diseño de Equipo , Humanos , Níquel/química , Radiografía , Reproducibilidad de los Resultados , Retratamiento , Tratamiento del Conducto Radicular/métodos , Estadísticas no Paramétricas , Factores de Tiempo , Titanio/química , Fracturas de los DientesRESUMEN
OBJECTIVE: The aim of this clinical study was to determine the efficacy of Uncaria tomentosa (cat's claw) against denture stomatitis (DS). STUDY DESIGN: Fifty patients with DS were randomly assigned into 3 groups to receive 2% miconazole, placebo, or 2% U tomentosa gel. DS level was recorded immediately, after 1 week of treatment, and 1 week after treatment. The clinical effectiveness of each treatment was measured using Newton's criteria. Mycologic samples from palatal mucosa and prosthesis were obtained to determinate colony forming units per milliliter (CFU/mL) and fungal identification at each evaluation period. RESULTS: Candida species were identified with HiCrome Candida and API 20C AUX biochemical test. DS severity decreased in all groups (P < .05). A significant reduction in number of CFU/mL after 1 week (P < .05) was observed for all groups and remained after 14 days (P > .05). C albicans was the most prevalent microorganism before treatment, followed by C tropicalis, C glabrata, and C krusei, regardless of the group and time evaluated. U tomentosa gel had the same effect as 2% miconazole gel. CONCLUSIONS: U tomentosa gel is an effective topical adjuvant treatment for denture stomatitis.
Asunto(s)
Antifúngicos/uso terapéutico , Candidiasis Bucal/tratamiento farmacológico , Candidiasis Bucal/microbiología , Uña de Gato , Miconazol/uso terapéutico , Fitoterapia/métodos , Estomatitis Subprotética/tratamiento farmacológico , Estomatitis Subprotética/microbiología , Administración Tópica , Anciano , Anciano de 80 o más Años , Antifúngicos/administración & dosificación , Candida/efectos de los fármacos , Método Doble Ciego , Femenino , Geles , Humanos , Masculino , Miconazol/administración & dosificación , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Introdução: um dos objetivos da terapia endodôntica é a redução dos fatores microbianos no interior dos canais radiculares, o que pode ser conseguido por meio do preparo químico-mecânico (PQM). O PQM tem como finalidade criar um ambiente propício à condição de reparo, por meio da limpeza e modelagem do sistema de canais radiculares (SCR), que associa a ação mecânica dos instrumentos ao uso de substâncias químicas auxiliares. Em relação ao limite apical desse preparo e ao diâmetro apical final da instrumentação, podemos observar que não há consenso entre os profissionais. Introdução: o objetivo do presente estudo foi avaliar, por meio de uma revisão de literatura, a eficiência de duas técnicas no preparo e desinfecção do terço apical do SCR: a técnica de ampliação foraminal e a técnica de batente apical com manutenção da patência foraminal. Métodos: foi realizada uma busca nas bases de dados PubMed, Medline, BBO, Lilacs e SciELO, usando os seguintes termos: canal radicular, forame apical, endodontia, lima de patência, tamanho apical, lima apical final, preparo biomecânico, ampliação foraminal, comprimento de trabalho, anatomia dental, tratamento endodôntico, patência foraminal, preparo do canal radicular e batente apical. Cada um desses termos foi combinado utilizando os operadores booleanos E/OU. Após leitura dos resumos, 65 artigos foram selecionados e incluídos nessa revisão. Resultados: os resultados demonstraram que o alargamento do terço apical, seja com ou sem ampliação foraminal, parece favorecer o prognóstico do tratamento endodôntico, devido à redução do conteúdo infeccioso em toda a extensão do SCR. A manutenção da patência foraminal é um fator essencial para um PQM adequado quando a técnica de batente apical é realizada. Conclusão: conclui-se que preparos apicais mais amplos promovem resultados mais previsíveis, e que a ampliação foraminal possibilita o melhor debridamento e desinfeção do SCR (AU).
Introduction: Endodontic therapy should reduce the microbial load within the root canals, which can be achieved during chemomechanical preparation (CMP). The purpose of CMP of the root canal system (RCS) is to create a favorable environment for healing. CMP associates the mechanical action of instruments with the use of auxiliary chemical substances. There is no consensus among professionals about what should be the diameter of the apical foramen after CMP. This literature review evaluated the efficiency of two apical preparation techniques: foraminal enlargement and apical stop with maintenance of foraminal patency. Material and methods: A literature search was conducted in PubMed, Medline, BBO, Lilacs and Scielo using the following terms: root canal, apical foramen, endodontics, patency file, apical size, master apical file, biomechanical preparation, foraminal enlargement, working length, dental anatomy, endodontic treatment, foraminal patency, root canal preparation, and apical stop. All terms were combined using the Boolean operators AND/OR. After the abstracts were analyzed, 65 full texts were selected and included in this review. Results: The enlargement of the apical third, with or without foraminal enlargement, seems to improve endodontic treatment prognosis due to the reduction of infectious contents throughout the RCS. Foraminal patency is essential for adequateCMP when the apical stop technique is performed. Conclusion: Apical preparations with a greater diameter have more predictable results, and foraminal enlargement ensures better debridement and disinfection of the RCS (AU).
Asunto(s)
Tratamiento del Conducto Radicular , Preparación del Conducto Radicular , Enfermedades Periapicales , Ápice del DienteRESUMEN
UNLABELLED: A calcium aluminate-based endodontic material, EndoBinder, has been developed in order to reduce MTA negative characteristics, preserving its biological properties and clinical applications. OBJECTIVES: The aim of this study was to evaluate the cytotoxicity, antimicrobial activity, pH, solubility and water sorption of EndoBinder and to compare them with those of white MTA (WMTA). MATERIAL AND METHODS: Cytotoxicity was assessed through a multiparametric analysis employing 3T3 cells. Antimicrobial activity against Enterococcus faecalis (ATCC 29212), Staphylococcus aureus. (ATCC 25923) and Candida albicans (ATCC 10556) was determined by the agar diffusion method. pH was measured at periods of 3, 24, 72 and 168 hours. Solubility and water sorption evaluation were performed following ISO requirements. Data were statistically analyzed by ANOVA and Tukey`s test with a significance level of 5%. RESULTS: EndoBinder and WMTA were non-cytotoxic in all tested periods and with the different cell viability parameters. There was no statistical differences between both materials (P>.05). All tested materials were inhibitory by direct contact against all microbial strains tested. EndoBinder and WMTA presented alkaline pH in all tested times with higher values of pH for WMTA (P<.05). Both materials showed values complying with the solubility minimum requirements. However, EndoBinder showed lower solubility than WMTA (P<.05). No statistical differences were observed regarding water sorption (P>.05). CONCLUSION: Under these experimental conditions, we concluded that the calcium aluminate-based endodontic material EndoBinder demonstrated suitable biological and physicochemical properties, so it can be suggested as a material of choice in root resorption, perforations and root-end filling.
Asunto(s)
Compuestos de Aluminio/toxicidad , Compuestos de Calcio/toxicidad , Óxidos/toxicidad , Materiales de Obturación del Conducto Radicular/toxicidad , Silicatos/toxicidad , Células 3T3 , Compuestos de Aluminio/química , Animales , Compuestos de Calcio/química , Candida albicans/efectos de los fármacos , Candida albicans/aislamiento & purificación , Combinación de Medicamentos , Enterococcus faecalis/efectos de los fármacos , Enterococcus faecalis/aislamiento & purificación , Concentración de Iones de Hidrógeno , Ensayo de Materiales , Ratones , Óxidos/química , Reproducibilidad de los Resultados , Materiales de Obturación del Conducto Radicular/química , Silicatos/química , Solubilidad , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación , Factores de Tiempo , Agua/químicaRESUMEN
Furcal perforations are significant iatrogenic complications of endodontic treatment and could lead to endodontic failure. Mineral trioxide aggregate (MTA) has been regarded as an ideal material for perforation repair, retrograde filling, pulp capping, and apexification. This case report describes a furcal perforation in a maxillary first molar, which was repaired using MTA. The tooth was endodontically treated and coronally restored with resin composite. After 2 years, the absence of periradicular radiolucent lesions, pain, and swelling along with functional tooth stability indicated a successful outcome of sealing the perforation using MTA.
Asunto(s)
Compuestos de Aluminio/uso terapéutico , Compuestos de Calcio/uso terapéutico , Cementos Dentales/uso terapéutico , Diente Molar/lesiones , Óxidos/uso terapéutico , Preparación del Conducto Radicular/efectos adversos , Silicatos/uso terapéutico , Raíz del Diente/lesiones , Adulto , Resinas Compuestas/química , Materiales Dentales/química , Restauración Dental Permanente/métodos , Combinación de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Enfermedad Iatrogénica , Obturación del Conducto Radicular/métodos , Preparación del Conducto Radicular/métodos , Diente no Vital/terapia , Resultado del TratamientoRESUMEN
Abstract This study compared the effect of intermediate flush with distilled water delivered by conventional irrigation, EndoVac microcannula or Self-Adjusting File (SAF) system in the prevention of chemical smear layer (CSL) formation. Thirty human premolars were used. Canals were prepared with Reciproc system and 5.25% NaOCl. After chemomechanical preparation, samples were divided in 3 groups (n=10) according to the intermediate irrigation protocol with distilled water using: conventional irrigation, EndoVac microcannula or SAF. A final flush with 2% chlorhexidine solution was used and scanning electron microscopy was performed to assess protocol effectiveness. Two calibrated evaluators attributed scores according the presence or absence of CSL on the surface of the root canal walls at the coronal, middle and apical thirds, as follows: (1) no CSL; (2) small amounts of CSL; (3) moderate CSL; and (4) heavy CSL. Differences between protocols were analyzed with Kruskal-Wallis and Mann-Whitney U tests. Friedman and Wilcoxon signed rank tests were used for comparison between each root canal third. SAF resulted in less formation of CSL when compared with the conventional irrigation and EndoVac microcannula (p<0.05). When root canal thirds were analyzed, conventional irrigation and EndoVac groups showed less CSL formation at coronal and middle thirds in comparison to the apical third (p<0.05). In SAF group, there was no difference among the thirds (p>0.05). It may be concluded that an intermediate flush of distilled water, delivered by the SAF system resulted in a better reduction of CSL formation during chemomechanical preparation.
Resumo O presente estudo comparou o efeito da utilização de uma irrigação intermediária com água destilada usando a irrigação convencional, a microcânula EndoVac ou o sistema Self-Adjusting File (SAF) na prevenção de formação da smear-layer química (SLQ). Trinta pré-molares humanos foram utilizados. Os canais foram preparados com sistema Reciproc e irrigados com NaOCl a 5,25%. Após o preparo químico mecânico, as amostras foram divididas em 3 grupos (n=10) de acordo com o protocolo de irrigação intermediária com água destilada utilizado: irrigação convencional, a microcânula EndoVac ou SAF. Utilizou-se uma lavagem final com solução de clorexidina a 2% e a microscopia electrónica de varredura foi utilizada para avaliar a eficácia dos protocolos. Dois avaliadores calibrados atribuíram escores de acordo com a presença ou ausência de SLQ nas paredes do canal radicular nos terços coronal, médio e apical, como a seguir: (1) sem SLQ; (2) pequenas quantidades de SLQ; (3) SLQ moderada e (4) muita SLQ. As diferenças entre protocolos foram analisadas com testes de Kruskal-Wallis e Mann-Whitney U. Os testes Friedman e Wilcoxon foram utilizados para comparação entre cada terço do canal radicular. SAF resultou em menor formação de SLQ quando comparado com a irrigação convencional e a microcânula EndoVac (p<0,05). Quando os terços dos canais radiculares foram analisados, os grupos irrigação convencional e microcânula EndoVac apresentaram menor formação de SLQ nos terços coronal e médio em relação ao terço apical (p<0,05). No grupo SAF, não houve diferença entre os terços (p>0,05). Dentro dos resultados do presente estudo, pode-se concluir que um fluxo intermediário de água destilada, administrado pelo sistema SAF resultou em melhor redução da formação de SLQ durante o preparo químico mecânico.
Asunto(s)
Humanos , Preparación del Conducto Radicular/instrumentación , Capa de Barro Dentinario , Irrigación Terapéutica , Clorhexidina/administración & dosificación , Microscopía Electrónica de Rastreo , Preparación del Conducto Radicular/métodos , Hipoclorito de Sodio/administración & dosificaciónRESUMEN
Abstract The aim of this study was to analyze the antimicrobial activity and substantivity of Uncaria tomentosa Willd DC (cat's claw, CC) in root dentin contaminated with Enterococcus faecalis. Forty-eight human premolars were contaminated with E. faecalis (ATCC 29212) and randomly divided into four groups according to the irrigant used during chemomechanical preparation (CMP): CC group: 2% CC gel; CHX group: 2% chlorhexidine digluconate gel (CHX); NaOCl group: 5.25% sodium hypochlorite (NaOCl); and SS group: sterile saline (SS). Microbiological samples were collected before (S1) and after (S2) CMP and after 7 days (S3). Colony-forming units (CFU/mL) at the different sampling times and comparisons among the groups were statistically analyzed by Wilcoxon and Kruskal-Wallis tests (p < 0.05). Significant bacterial reduction was achieved in all groups after CMP (p < 0.05). Results show no significant difference between S3 and S2 (p > 0.05) in the CC and CHX groups. Bacterial load was higher in S3 than in S2 samples (p < 0.05) in the NaOCl and SS groups. Our results suggest antibacterial effect of 2% CC gel against E. faecalis in infected dentin, in addition to antibacterial substantivity of 2% CC and 2% CHX up to 7 days.
Asunto(s)
Humanos , Enterococcus faecalis/efectos de los fármacos , Uña de Gato/química , Cavidad Pulpar/efectos de los fármacos , Cavidad Pulpar/microbiología , Dentina/efectos de los fármacos , Dentina/microbiología , Antiinfecciosos/farmacología , Valores de Referencia , Irrigantes del Conducto Radicular/farmacología , Hipoclorito de Sodio/farmacología , Factores de Tiempo , Recuento de Colonia Microbiana , Distribución Aleatoria , Clorhexidina/análogos & derivados , Clorhexidina/farmacología , Estadísticas no Paramétricas , Carga Bacteriana/efectos de los fármacosRESUMEN
The study aimed to evaluate the effectiveness of in-office bleaching and associated tooth sensitivity on application of nano-calcium phosphate paste as desensitizing agent. Bleaching was performed with 35% hydrogen peroxide gel in 40 patients who were randomly divided into placebo and nano-calcium phosphate paste groups. Bleaching efficacy (BE) was evaluated using a value-oriented Vita shade guide. Tooth sensitivity was recorded using a numeric rating scale (0–4) during bleaching and up to 48 h after each session. The primary outcome of absolute risk of tooth sensitivity was compared using the Fisher’s exact test (α = 0.05). The intensity of tooth sensitivity and the efficacy of in-office bleaching were also statistically evaluated. No significant differences in absolute risk and intensity of tooth sensitivity were detected between the groups (p = 1.0 and p = 0.53, respectively). BE was also found to be similar between the groups (p = 0.67). Although the use of a nano-calcium phosphate paste associated with fluoride and potassium nitrate did not influence the whitening outcome, but it also did not reduce bleaching-induced tooth sensitivity.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Adulto Joven , Fosfatos de Calcio/administración & dosificación , Desensibilizantes Dentinarios/administración & dosificación , Sensibilidad de la Dentina/inducido químicamente , Peróxido de Hidrógeno/administración & dosificación , Nitratos/administración & dosificación , Compuestos de Potasio/administración & dosificación , Blanqueadores Dentales/administración & dosificación , Blanqueamiento de Dientes/efectos adversos , Fosfatos de Calcio/efectos adversos , Método Doble Ciego , Peróxido de Hidrógeno/efectos adversos , Nitratos/efectos adversos , Compuestos de Potasio/efectos adversos , Blanqueadores Dentales/efectos adversos , Blanqueamiento de Dientes/métodos , Decoloración de Dientes/tratamiento farmacológicoRESUMEN
The purpose of this study was to compare the efficacy of reciprocating and rotary techniques for removing gutta-percha and sealer from root canals. Forty straight and oval single-rooted premolars were prepared up to size 30, filled with gutta-percha and sealer, and then randomly allocated to two experimental retreatment groups: ProTaper Retreatment System (PTRS) and WaveOne System (WS). Procedural errors, time of retreatment and apically extruded material were recorded for all the roots. The roots were radiographed after retreatment. The percentage of residual material was calculated using image analysis software. The data were analyzed by Kolmogorov-Smirnov and t tests, with a significance level set at 5%. No system completely removed the root filling material from the root canal. No significant differences were observed between the systems, in terms of residual filling material in any tested third (p > 0.05). WS was faster in removing filling material than PTRS (p< 0.05). Extrusion was observed in 4 cases in PTRS and in 5 cases in WS. No procedural errors were observed in either group. It can be concluded that although no differences were observed in the efficacy of PTRS and WS for removing root filling material, WS was faster than PTRS.
Asunto(s)
Humanos , Instrumentos Dentales , Gutapercha/química , Materiales de Obturación del Conducto Radicular/química , Tratamiento del Conducto Radicular/instrumentación , Ápice del Diente , Diseño de Equipo , Níquel/química , Reproducibilidad de los Resultados , Retratamiento , Tratamiento del Conducto Radicular/métodos , Estadísticas no Paramétricas , Factores de Tiempo , Fracturas de los Dientes , Titanio/químicaRESUMEN
A calcium aluminate-based endodontic material, EndoBinder, has been developed in order to reduce MTA negative characteristics, preserving its biological properties and clinical applications. Objectives: The aim of this study was to evaluate the cytotoxicity, antimicrobial activity, pH, solubility and water sorption of EndoBinder and to compare them with those of white MTA (WMTA). Material and Methods: Cytotoxicity was assessed through a multiparametric analysis employing 3T3 cells. Antimicrobial activity against Enterococcus faecalis (ATCC 29212), Staphylococcus aureus. (ATCC 25923) and Candida albicans (ATCC 10556) was determined by the agar diffusion method. pH was measured at periods of 3, 24, 72 and 168 hours. Solubility and water sorption evaluation were performed following ISO requirements. Data were statistically analyzed by ANOVA and Tukey`s test with a significance level of 5%. Results: EndoBinder and WMTA were non-cytotoxic in all tested periods and with the different cell viability parameters. There was no statistical differences between both materials (P>.05). All tested materials were inhibitory by direct contact against all microbial strains tested. EndoBinder and WMTA presented alkaline pH in all tested times with higher values of pH for WMTA (P<.05). Both materials showed values complying with the solubility minimum requirements. However, EndoBinder showed lower solubility than WMTA (P<.05). No statistical differences were observed regarding water sorption (P>.05). Conclusion: Under these experimental conditions, we concluded that the calcium aluminate-based endodontic material EndoBinder demonstrated suitable biological and physicochemical properties, so it can be suggested as a material of choice in root resorption, perforations and root-end filling. .
Asunto(s)
Animales , Ratones , Compuestos de Aluminio/toxicidad , Compuestos de Calcio/toxicidad , Óxidos/toxicidad , Materiales de Obturación del Conducto Radicular/toxicidad , Silicatos/toxicidad , Compuestos de Aluminio/química , Compuestos de Calcio/química , Candida albicans/efectos de los fármacos , Candida albicans/aislamiento & purificación , Combinación de Medicamentos , Enterococcus faecalis/efectos de los fármacos , Enterococcus faecalis/aislamiento & purificación , Concentración de Iones de Hidrógeno , Ensayo de Materiales , Óxidos/química , Reproducibilidad de los Resultados , Materiales de Obturación del Conducto Radicular/química , Silicatos/química , Solubilidad , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación , Factores de Tiempo , Agua/químicaRESUMEN
O objetivo deste relato de caso clínico é apresentar a utilização da fita de politetrafluoretileno (PTFE) para facilitar a técnica de reprodução anatômica durante a restauração de incisivos centrais superiores. Paciente do sexo feminino, 10 anos de idade, apresentou-se na Clínica de Dentística Operatória e Estética da Universidade Peruana Cayetano Heredia - UPCH, para a realização de restaurações nos dentes 21 e 11. Os dentes foram preparados, de acordo com as técnicas convencionais. Em seguida, os dentes adjacentes foram secos e recobertos com um pedaço de fita de PTFE. Os dentes foram, então, restaurados, utilizando-se uma resina composta de nanopartículas, por meio das técnicas da matriz de silicone e da técnica incremental. No final da restauração, a fita de PTFE foi removida e procederam-se o acabamento e o polimento das restaurações. Após o término da restauração, uma aparência estética e natural do dente fraturado foi conseguida, satisfazendo as expectativas funcionais e estéticas do paciente.
The aim of this case report is to present the use of PTFE tape to make easier the copy of anatomic details, during the restoration of maxillary central incisors. A 10-year-old girl attended the Dental Clinic of the Universidad Peruana Cayetano Heredia - UPCH with fracture in the teeth 21 and 11. The teeth were prepared, in according to conventional techniques. Next, the adjacent teeth were dry and covered with a piece of tape of PTFE. The teeth were restored using a composite resin of nanoparticles, through the techniques of the silicon matrix and composite stratification. When the restoration was finished, the tape of PTFE was removed and the finishing and polishing of the restorations were made. After the restoration, an aesthetic and natural appearance of toothfracture was achieved, satisfying the expectations and functions of the patient.
Asunto(s)
Humanos , Femenino , Niño , Politetrafluoroetileno , Fracturas de los Dientes , Resinas Compuestas , Cementos Dentales , Estética Dental , IncisivoRESUMEN
Objetivo: avaliar in vitro a eficiência do localizador apical eletrônico (LAE) Root ZX II em determinar o comprimento de trabalho, utilizando limas manuais de aço inoxidável,limas manuais de níquel-titânio e limas rotatórias de níquel-titânio. Métodos: foram utilizados 20 dentes humanos unirradiculares (incisivos centrais retos). O comprimento real do dente (CRD) foi determinado através da inserção de um lima #15 até que a sua ponta fosse visível no forame apical, utilizando uma ampliação de 4x. A lima foi removida do canal e seu comprimento foi medido com um paquímetro digital. Para as medições eletrônicas,as amostras foram fixadas em uma embalagem de vidro com cobertura plástica, contendo solução salina a 0,9%. As medições foram realizadas utilizando-se o Root ZX II, com lima #15 de aço inoxidável, lima manual de níquel-titânio e lima rotatória Mtwo. As limas foram acopladas ao LAE e as medições foram monitoradas até que o LAE indicasse o valor zero. Os valores correspondentes à diferença entre o CRD e a medição eletrônica foram gravados e submetidos à análise de variância(ANOVA) e o teste Tukey (α=0,05). Resultados: não houve diferença estatisticamente significativa (p<0,05)entre as limas testadas. Conclusão: a partir do presente estudo, constatou-se que o LAE Root ZX II foi eficaz,mostrando-se um método confiável, e que nenhuma interferência significativa na sua leitura foi detectada ao se utilizar as diferentes limas