Comparing the Efficiency of Single versus Dual Ultrasonic Devices for Metallic Post Removal in Endodontic Retreatment: A Clinical Study.

Introduction: Ultrasonic vibration for metallic post removal seems to be a unanimous choice between endodontists and general practitioners for providing the best results and having the highest safety. This study compared the time required by ultrasonic vibration for removing metallic post (MP) when 1 or 2 ultrasonics devices are used. Materials and Methods: One hundred and fifteen teeth with MPs from 105 patients, indicated for nonsurgical endodontic retreatment were divided into 2 groups according to the number of ultrasonic devices used (G1-1 device) and (G2-2 devices). In G1, the MP was worn with a transmetal bur, alongside the wear of the cement line (around 2 mm deep). Then, an ultrasonic tip attached to an ultrasonic unit, with a power of 100% was activated at the level of the post, with constant water spray at a level of 1 mm above the axial surface of the tooth. The position of the tip was changed between buccal and lingual surfaces every 10 seconds until the MP was removed. In G2 the same procedures were performed as described in G1, but two ultrasonic tips were activated simultaneously at buccal and lingual surfaces until the MP was removed. The vibration time necessary for removing each MP was recorded using a chronometer. Results: The mean time was 131.10±29.68 seconds (mean±standard error of the mean) for MP removal using one ultrasonic device, and 24.86±6.88 seconds for two devices. The time required for MP removal using two ultrasonic devices was significantly less than when using one ultrasonic device (P<0.001). Conclusion: The technique with 2 ultrasonic devices proved to be more efficient than the one using only 1 ultrasonic device.

Bioceramic Cements: Supporting in Remineralization of Osteolytic Lesions in Endodontic-periodontal Diseases: A Report of Two Cases.

Bioceramic cements used for filling root canals in cases of endo-perio lesion of endodontic origin seem to be promising due to having the potential of promoting faster and more predictable healing of the periapical lesion as they stimulate osteogenesis. An effective treatment plan depends on the precise diagnosis of endo-perio lesions. The origin of an infection, being exclusive to the root canal, from the periodontium, or both, is extremely important for devising the treatment plan. In both cases, no clinical evidence of periodontal disease (bleeding, calculus, etc.) was found; however, primary endodontic lesions with the possibility of drainage through the gingival crevice were present. In addition to the disinfection strategies used during the root canal treatments, the bioceramics Bio C Sealer, Bio C Repair and Bio Root RCS were used to fill in the root canals. Both cases presented an impressive bone gain within 8 months for case 1 and 5 months for case 2. Regarding case 1, in the palatal root canal an apical plug with a bioceramic repair cement was used. Based on the literature studied, it can be concluded that after adequate disinfection of the root canals, using bioceramic cements in filling the root canals shows the potential of supporting capabilities in remineralization of osteolytic lesions in endo-perio diseases.

Detecção de nódulos pulpares em incisivos por meio de radiografia digital / Detection of pulp stones in incisors by digital dental radiography

Introdução: os nódulos pulpares são calcificações de etiologia controversa, presentes no tecido pulpar com tamanho variável. Sua detecção acontece durante exames radiográficos de rotina, apresentando-se como imagens radiopacas únicas ou múltiplas, de formato circular ou ovoide. Um planejamento adequado prévio ao tratamento endodôntico é necessário, e o reconhecimento dessas alterações faz parte dessa etapa. Objetivo: o objetivo desse trabalho foi determinar a prevalência de nódulos pulpares em incisivos superiores e inferiores, por meio de radiografias digitais. Métodos: foram utilizadas 793 radiografias periapicais digitais de dentes anteriores, totalizando 2.999 dentes. Os dados foram organizados em planilhas de Excel e, então, submetidos a uma análise descritiva e ao teste qui quadrado. Resultados: os resultados demonstraram que 15% dos dentes avaliados possuíam nódulo pulpar, sendo o mais acometido o incisivo lateral direito (dente #42), com 19% do total de dentes. Houve maior prevalência em mulheres e pacientes na faixa etária de 51 a 60 anos. Conclusão: a frequência dos nódulos pulpares para dentes anteriores, quando avaliados por meio de radiografias periapicais digitais, alcança os 15%, possuindo maior prevalência no sexo feminino e apresentando relação entre o aumento da idade e a incidência de nódulos pulpares, mas não entre a presença de restaurações e as alterações.