Percepção de estudantes de Odontologia de uma Universidade do Estado da Paraíba sobre os impactos da pandemia de COVID-19 / Perception of dental students at an university in the state of Paraíba about the impacts of COVID-19 pandemic

Introdução: Durante a pandemia de SARS - COVID 19 os cursos de graduação em Odontologia aderiram ao método remoto de ensino, com o objetivo de diminuir o número de contaminações e mortes. Objetivo: Esse estudo objetivou avaliar a percepção dos impactos socioeconômicos, educacionais e psicológicos da pandemia, bem como a percepção da importância de aspectos de gestão para o enfrentamento da pandemia. Material e método: Esta é uma pesquisa qualitativa e quantitativa, efetuada em uma universidade pública do Nordeste brasileiro, baseada em questionário semiestruturado e com a amostra de 144 estudantes distribuídos nos 10 períodos do curso de Odontologia. Resultados: A maioria dos participantes se encontrava em alguma situação de isolamento ou autoisolamento durante a pandemia. Foi constatado que a experiência do ensino remoto não foi favorável para os discentes. Os estudantes consideram que a instituição participou parcialmente na elaboração de protocolos de biossegurança e instruções para retomada das atividades. Os estudantes relataram presença de: ansiedade, estresse, dificuldade de concentração, insegurança e exaustão emocional. Os alunos consideraram os conhecimentos de gestão e liderança como fundamentais para o enfrentamento dos desafios da pandemia. Conclusão: A presente pesquisa demonstrou que, em decorrência da pandemia por COVID-19, a maioria dos participantes teve prejuízo financeiro, bem como, um relevante prejuízo na formação acadêmica. Em relação aos quadros psicoemocionais, houve uma frequência variável relatada de diversas patologias destaque para ansiedade, estresse, insônia e baixa concentração. Por fim, a importância das competências de gestão para o enfrentamento da pandemia foi percebida pela maioria dos estudantes de Odontologia como indispensável

Introduction: During SARS - COVID 19 pandemic, undergraduate courses in Dentistry adhered to remote method of classes, with the aim of reducing the number of contaminations and deaths. Objective: This study aimed to assess the perception of socioeconomic, educational and psychological impacts of pandemic, as well as perception of the importance of management aspects for coping with the pandemic. Material and method: This is a qualitative and quantitative research, carried out at a public university of Brazilian Northeast, based on a semi-structured questionnaire and with a sample of 144 students distributed in the 10 periods of the Dentistry course. Results: Most participants were in some situation of isolation or self-isolation during the pandemic. It was found that the experience of remote teaching was not favorable for students. Students consider that university partially participated in the development of biosafety protocols and instructions for resuming activities. Students reported the presence of: anxiety, stress, difficulty concentrating, insecurity and emotional exhaustion. Students considered management and leadership knowledge as fundamental to face challenges of the pandemic period. Conclusion: The present research demonstrated that, as a result of the COVID-19 pandemic: most participants had financial losses, as well as a relevant loss in their academic training. Regarding psycho-emotional conditions, there was a variable frequency related to several pathologies, with emphasis on anxiety, stress, insomnia and low concentration. Finally, the importance of management skills for dealing with the pandemic was perceived by most of dental students as essential

The impact of the COVID-19 pandemic on dental trauma attendance: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to analyze the impact of the COVID-19 pandemic on dental trauma patient attendance. The study was registered in the PROSPERO system, using the CRD42021288398 protocol. Searching was performed in PubMed, Scopus, Web of Science, Embase, Lilacs, and OpenGrey databases, using the following keywords: "Tooth injuries," "Dental trauma," "Traumatic Dental injury," and "COVID-19". We included observational studies evaluating dental trauma in the context of the COVID-19 pandemic. Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Cross-Sectional Studies. Meta-analysis was performed in RevMan 5.4 software with Odds Ratios as a pooled measure of effect, with a 95% confidence interval, and using random-effects modeling. After applying the eligibility criteria, 32 studies were included for qualitative analysis, in which 10 were used to assess the frequency of dental trauma diagnoses in dental emergencies. Despite the decrease of visits during COVID-19, the analysis revealed no difference between the pandemic and pre-pandemic periods. Regarding the type of dental trauma, two of the studies revealed no differences for the periods before and during the pandemic. This study revealed that the COVID-19 pandemic has not impacted the frequency or type of dental trauma compared to previous periods.

Impact of the curricular component management and professional guidance on the level of knowledge about administration of dentistry students at UFPB / Impacto do componente curricular gestão e orientação profissional no nível de conhecimento sobre administração de estudantes de Odontologia na UFPB

Obtaining basic management skills and including management and leadership as essential components of the curriculum is a critical part of dental students' education. This research evaluated the understanding of management concepts of dental students at the Federal University of Paraíba (UFPB), before and after participating in a Management and Professional Guidance course. This quantitative study assessed the level of knowledge of management skills and competencies of dental students through a validated questionnaire. The data were analyzed using descriptive and inferential statistics, adopting a significance level of 5%. The sample consisted of 47 students, 18 from the 1st semester, 18 from the 7th semester and 11 from the 10th semester of the course. All students considered knowledge about management extremely important for the dentist. The level of knowledge about management skills and leadership is low among students, with no statistically significant difference between student year of training. Specifically, concerning students midway through their dental training, there was a significant increase in knowledge for all management skills after attending the Management and Professional Guidance course (p <0.05). As for Leadership Skills, there was a statistically significant difference (p <0.05) for "Legal Notions", "Self-Management" and "Management Relationship". We conclude that knowledge about management and leadership is low among undergraduate dental students at UFPB and that the "Management and Professional Guidance" course promoted a significant increase in the level of this knowledge, contributing to better professional training for students (AU).

Obter habilidades básicas de gerenciamento e incluir gerenciamento e liderança como componentes essenciais do currículo é uma parte essencial da educação dos estudantes de Odontologia. Esta pesquisa avaliou o nível de compreensão de tópicos de gestão de alunos de Odontologia da Universidade Federal da Paraíba(UFPB), antes e após a participação em um treinamento em Gestão e Orientação Profissional. Este estudo quantitativo avaliou o nível de conhecimento das habilidades e competências de gestão de estudantes de Odontologia por meio da aplicação de um questionário validado. Os dados foram analisados por meio de estatísticas descritiva e inferencial, adotando-se nível de significância de 5%. A amostra foi constituída por 47 alunos, sendo 18 do 1º semestre, 18 do 7º semestre e 11 do 10º semestre do curso. Todos consideraram o conhecimento sobre gestão extremamente importante para o cirurgião-dentista. O nível de conhecimento sobre habilidades de gestão e liderança é baixo entre os alunos, sem diferença estatisticamente significativa entre os seus anos de formação. Especificamente, em relação aos alunos na metade da formação odontológica, houve um aumento significativo do conhecimento para todas as habilidades de gestão após cursarem Gestão e Orientação Profissional (p<0,05). Quanto às Competências de Liderança, houve diferença estatisticamente significativa (p<0,05) para "Noções Jurídicas", "Autogestão" e "Relação Gerencial". Conclui-se que o conhecimento sobre gestão e liderança é baixo entre os alunos de graduação em Odontologia da UFPB e que a disciplina "Gestão e Orientação Profissional" promoveu um aumento significativo no nível desse conhecimento, contribuindo para uma melhor formação profissional dos alunos (AU).

Presence of management, entrepreneurship, leadership and marketing topics in the dental school curriculum in Brazil.

INTRODUCTION: To analyse the presence and characteristics of curricular components related to management, entrepreneurship, leadership and marketing as part of the structure and teaching methods of undergraduate courses in dentistry in Brazil. MATERIALS AND METHODS: This is an observational study that used the Ministry of Education's Undergraduate Course Accreditation Platform, which included 424 undergraduate courses in Dentistry on the last date of collection (August 31 2019). The following items were analysed as follows: the existence of curricular components in relation to the proposed themes, the most recurring denominations of curricular components, minimum and maximum workload, mandatory/optional classification, theoretical/practical teaching condition and in which year the curricular components were inserted. RESULTS: 367/424 (86.6%) of dentistry courses in Brazil included at least one of the topics: management, entrepreneurship, leadership and marketing curricular components in their curriculum, whilst 57/424 (13.4%) did not have these curricular components in their curricular structure. The most frequent names were "Management" 99 (45.21%) and "Entrepreneurship" 80 (36.5%). There was a predominance of the "theoretical method" and the number of hours varied considerably, with the most common course hours between 40 and 60 h. The majority of curricular components were inserted in the third to fifth year and offered on a compulsory basis. CONCLUSION: Most curricular matrices of dentistry courses in Brazil had components related to the topics studied. However, due to the variety of curricular components' names, hours, periods of courses and different teaching methodologies, there is a need to redesign the teaching and learning process, defining educational and evaluation models with common curricular components.

Comparative Analysis of Continuous versus Reciprocating Instruments in Retreatment of Flat-oval Root Canals.

Introduction: Flat-oval root canals of incisors can be problematic in retreatments. This study assessed the efficacy of continuous and reciprocating rotation instruments in retreatment of flat-oval root canals in lower incisors via micro-computed tomography (micro-CT). File systems studied were ProTaper universal retreatment rotary system associated with ProTaper Next (PTUR+PTN), D-RaCe associated with iRaCe (DR+iR), Reciproc (REC), and WaveOne (WO). Materials and Methods: Thirty-two mandibular incisors with flat root canal were divided into 4 groups (n=8). The groups were initially prepared with PTN, iRaCe, REC, and WO, then instrumented, filled, and subjected to micro-CT analyses. All the canals were then retreated with the PTUR+PTN, DR+iR, REC, and WO, and then subjected to new micro-CT analysis which allowed quantification of residual filling material volume and change in the diameter of the root canal apical third. Endodontic retreatment time was also quantified. Data were analyzed with One-Way ANOVA and post hoc t tests. Results: None of the systems completely removed the filling material. The groups differed in terms of remnant filling material volume (PTUR+PTN=2.9±1.1 mm3; DR+iR=3.6±3.1 mm3; REC=4.9±1.9 mm3; WO=3.1±1.9 mm3) and retreatment time (PTUR+PTN=1:36±0:12 sec; DR+iR=0:57±0:13 sec; REC=2:10±0:44 sec; WO=2:03±0:31 sec), but had similar values in terms of change in apical root canal diameter (P>0.05). Conclusions: Based on this in vitro study, the type of endodontic instrument did not affect the diameter of the root canal apical third. However, PTUR with ProTaper Next had the lowest residual filling material volume and second lowest retreatment time, in flat-oval root canals in mandibular incisors.

Influence of chlorhexidine and zinc oxide in calcium hydroxide pastes on pH changes in external root surface.

The objective of this study was to assess the influence of chlorhexidine (liquid and gel) and zinc oxide in calcium hydroxide (CH) pastes on root pH in simulated external resorption. One hundred human anterior teeth with a single root canal were selected. After decoronation and root canal instrumentation, the specimens were divided into 4 experimental groups and 1 control group (without intracanal paste): CH + saline (CH+S), CH + 2% chlorhexidine liquid (CH+ CHX), CH + 2% chlorhexidine gel (CH+ CHXg), and CH + 2% chlorhexidine gel + zinc oxide (CH+ CHXg+ZnO). pH was measured using a microelectrode at 3 and 24 h, and 1, 2, 3, and 4 weeks after inserting intracanal pastes. Data were analyzed statistically using an ANOVA and Tukey's test (p < 0.05). The CH+CHXg+ZnO group had the highest pH values throughout (p<0.05). The CH+S and CH+ CHX groups had the highest pH values after 1 week and the CH+ CHXg group after 2 weeks. CH+ CHXg maintained the highest pH until the fourth week compared with CH+ CHX (p < 0.05). The control group remained at a neutral pH at all evaluated times. It can be concluded that chlorhexidine solution or gel maintained the alkaline pH of CH, and chlorhexidine gel allowed a slower decrease in pH over time. CH+ CHXg+ZnO showed the highest pH values and was an effective intracanal medication for maintaining alkaline root pH in the area of resorption.

Influence of chlorhexidine and zinc oxide in calcium hydroxide pastes on pH changes in external root surface

Abstract The objective of this study was to assess the influence of chlorhexidine (liquid and gel) and zinc oxide in calcium hydroxide (CH) pastes on root pH in simulated external resorption. One hundred human anterior teeth with a single root canal were selected. After decoronation and root canal instrumentation, the specimens were divided into 4 experimental groups and 1 control group (without intracanal paste): CH + saline (CH+S), CH + 2% chlorhexidine liquid (CH+ CHX), CH + 2% chlorhexidine gel (CH+ CHXg), and CH + 2% chlorhexidine gel + zinc oxide (CH+ CHXg+ZnO). pH was measured using a microelectrode at 3 and 24 h, and 1, 2, 3, and 4 weeks after inserting intracanal pastes. Data were analyzed statistically using an ANOVA and Tukey's test (p < 0.05). The CH+CHXg+ZnO group had the highest pH values throughout (p<0.05). The CH+S and CH+ CHX groups had the highest pH values after 1 week and the CH+ CHXg group after 2 weeks. CH+ CHXg maintained the highest pH until the fourth week compared with CH+ CHX (p < 0.05). The control group remained at a neutral pH at all evaluated times. It can be concluded that chlorhexidine solution or gel maintained the alkaline pH of CH, and chlorhexidine gel allowed a slower decrease in pH over time. CH+ CHXg+ZnO showed the highest pH values and was an effective intracanal medication for maintaining alkaline root pH in the area of resorption.

Tradução e adaptação cultural de questionário sobre liderança em Odontologia / Translation and cultural adaptation of a questionnaire about leadership in Dentistry

O objetivo desse trabalho foi traduzir e adaptar para a cultura brasileira um questionário sobre habilidades de liderança de cirurgiões-dentistas. Para isso, o instrumento criado na Harvard School of Dental Medicine (HSDM) passou pelas etapas de tradução, retrotradução, adaptação transcultural a partir de uma reunião de experts no assunto e pré-teste com um grupo de cirurgiões-dentistas. Observou-se que alguns termos necessitaram ser adaptados para melhor interpretação, após o que o instrumento foi considerado de fácil compreensão por profissionais da área de interesse. O questionário necessita ainda de validação para que possa ser utilizado em pesquisas no Brasil (AU).

The aim of this study was to translate and adapt a questionnaire on dentistry leadership skills to the Brazilian culture. For this purpose, the instrument created at the Harvard School of Dental Medicine (HSDM) went through the stages of translation, back-translation and crosscultural adaptation by an expert group to be submitted afterwards to a pre-test with a group of dentists. To facilitate a clear interpretation. It was observed that some terms needed to be adapted for better interpretation, after which the instrument was considered easy to understand by professionals of the area of interest. To use the questionnaire for research in Brazil, further psychometrc validation is required (AU).

Avaliação do conhecimento sobre terapia full mouth disinfection por periodontistas da cidade de João Pessoa- PB / Evaluation of knowledge about therapy full mouth disinfection by periodontists of the city João Pessoa-PB

A terapia Full Mouth Disinfection consiste em um protocolo de tratamento periodontal em que a raspagem e o alisamento radicular são realizados dentro de um período de 24 horas com o auxílio de substâncias químicas. O objetivo deste trabalho foi avaliar o conhecimento sobre a terapia Full Mouth Disinfection por periodontistas da cidade de João Pessoa, Paraíba. O universo foi composto por todos os 57 periodontistas registrados no Conselho Regional de Odontologia da Paraíba que atuassem na cidade de João Pessoa. Houve uma perda amostral de 16 profissionais e a pesquisa foi realizada por meio de um questionário semi estruturado aplicado aos 41 periodontistas contatados. De acordo com os resultados obtidos, apenas 50% dos profissionais entrevistados conhecem a terapia Full Mouth Disinfection. E, destes que conhecem, a maioria já fez uso da terapia e acredita em vantagens desta técnica em relação ao tratamento convencional por quadrantes. As curetas manuais foram os instrumentais de escolha relatados pelos profissionais que já haviam utilizado a Full Mouth Disinfection, assim como a clorexidina foi a substância química mais citada para execução deste protocolo. Dessa forma, concluiu-se que a Full Mouth Disinfection é uma técnica conhecida pela metade dos periodontistas entrevistados, mas ainda é pouco utilizada na Paraíba...

Full Mouth Disinfection therapy consists in a periodontal treatment’s protocol that scaling and root planning are performed within a period of 24 hours with the aid of chemicals. The aim of this study was to evaluate the knowledge of periodontists in the city of João Pessoa, Paraíba about Full Mouth Disinfection therapy. The universe was composed of all 57 periodontists registered in the Regional Council of Dentistry of Paraíba who acted in the city of João Pessoa. As there was a sample loss of 16 professionals, the survey was conducted using a semi-structured questionnaire administered to 41 periodontists contacted. According to results, only 50% of the interviewed professionals know Full Mouth Disinfection therapy, among those who know, most have already made use of it and believe in advantages of this technique compared to quadrants conventional treatment. It was also observed that hand instruments are the most widely used in this this procedure and chlorhexidine was the most often chemical substance cited for implementation of this protocol. Thus, it was concluded that Full Mouth Disinfection is a technique known by half of respondents periodontists, but is still not widely utilized in Paraiba...

Knowledge of leadership and management: pilot study of students perceptions of a dentistry course at a university in Brazil / Conhecimento de liderança e de gestão: Estudo piloto das percepções dos estudantes de um curso de odontologia em uma universidade no Brasil

The Dentistry Course at UFPB was created in 1955. Although the course is recognized for its high-quality technical education in dentistry, through 2014, it has had no leadership and management subject, even though it is known that these skills are critical to the dentist. The aim of this research was therefore to evaluate the perceptions of knowledge about leadership and management of students in the fifth year of the UFPB dentistry course. Students answered a questionnaire and evaluated their current leadership skills on a scale from one (very poor) to five (excellent). On average, they rated themselves best on "Integrity" (4.42 points) and worst on "Advocacy skills" (2.38 points). The "ability to build others' trust" was the aspect considered most beneficial for an oral surgeon, representing 23.08% of responses, while "compassion" was the ability deemed least beneficial, with 34.62% of the responses. All students questioned agreed that it is important to create leadership and management subject in the UFPB dentistry course. Little knowledge of leadership and management has been demonstrated, as well as a great need for creating a leadership course at UFPB (AU).

O Curso de Odontologia na Universidade Federal da Paraíba (UFPB), Brasil, foi criado em 1955. Embora seja um curso reconhecido pela sua alta qualidade no ensino técnico da odontologia, até 2014 não possuía nenhuma disciplina de liderança e gestão mesmo entendendo-se que essas habilidades precisam ser alimentadas e desenvolvidas ao longo da vida. O objetivo do presente trabalho foi avaliar a percepção do conhecimento sobre liderança e gestão dos estudantes do quinto ano do curso de odontologia da UFPB. Os alunos responderam a um questionário e avaliaram suas habilidades de liderança atuais em uma escala de um (muito insuficiente) a cinco (excelente), em média, eles avaliaram a si mesmos melhores em "Integridade" (4,42 pontos) e o pior em "Habilidades em advocacia" (2,38 pontos). A "Capacidade de construir a confiança dos outros" foi o aspecto considerado mais benéfico para um cirurgião-dentista, representando 23,08% das respostas, enquanto "compaixão" foi a habilidade considerada menos benéfica, com 34,62% das respostas. Todos os alunos questionados acharam que é importante criar uma disciplina de liderança e gestão no curso de odontologia da UFPB. Esse artigo avaliou a percepção de liderança e gestão dos alunos de odontologia da UFPB e a necessidade de instruir aos alunos sobre o assunto. Comprovou-se que houve pouco conhecimento sobre liderança e há uma grande necessidade de criação do curso de liderança na UFPB (AU).

Accuracy and repeatability of 3 apex locators in locating root canal perforations: an ex vivo study.

INTRODUCTION: This study was an ex vivo evaluation of the accuracy and repeatability of 3 electronic apex locators (EALs) in locating simulated root canal perforations. METHODS: Thirty-five human teeth were used. Perforations were placed 5 mm from the apex of each specimen. A #15 K-file was attached to a micrometer, and the specimens were fixed in a mounting model. The EALs were connected to the files, and electronic measurements of the simulated perforations were obtained. This procedure was repeated, the files were cemented in place, and x-rays were obtained to evaluate the distances between the measurement files and the simulated perforations. The obtained results were compared with the corresponding control lengths. Three investigators evaluated the distance of the file position in relation to the perforation for each specimen. The 3 investigators reached consensus regarding these measurements. RESULTS: Statistical analyses of the results revealed that the EAL reliabilities in the exact detections of the root canal perforations were 97.1% for the Mini Apex Locator, 100% for the Root SW, and 91.4% for the Root ZX II. Analysis of variance revealed that the accuracies of the 3 devices were not different (P > .05). The results also indicated high levels of repeatability for each of the 3 EALs (intraclass correlation coefficients: 0998, 0.999, and 0.999 for the Mini Apex Locator, Root SW, and Root ZX II, respectively). CONCLUSIONS: It was concluded that each of these 3 EALs provided excellent ex vivo accuracy in locating root perforations and that all tested devices possess excellent ex vivo repeatability.

Tratamento de uma perfuração complexa de furca: relato de caso / Treatment of a large furcal perforation: Case Report

Introdução: Comunicações endo-periodontais podem ocorrer a partir de reabsorções, cárie ou eventos iatrogênicos durante o tratamento endodôntico. Perfurações de furca podem ter um impacto negativo no prognóstico por comprometer o aparelho de fixação. Este estudo relata o tratamento de perfuração de furca do primeiro molar inferior direito (46) resultando na manutenção de dente severamente comprometido. Relato do caso: Clinicamente o paciente apresentava fístula ativa, tecido de granulação na área da perfuração e ausência de mobilidade patológica. Na radiografia inicial foi observada área radiolúcida extensa na região de furca e o tratamento endodôntico previamente realizado apresentava-se dentro das condições de normalidade. Através das inspeções visual e radiográfica foi diagnosticada a perfuração complexa de furca. O tratamento foi realizado com MTA branco e o paciente foi proservado. Após um ano de acompanhamento, observaram-se condições de normalidade, após reabilitação protética, sugestiva de saúde, bem como, um quadro clínico revelando o restabelecimento da saúde periodontal. Conclusão: O tamanho da perfuração levaria a um prognóstico sombrio, porém nesta situação de paciente jovem e perfuração severa, torna-se muito importante a adoção de procedimento mais conservador para manutenção do elemento dental

Introduction: Endo-periodontal communications can happens from reabsorption, carie or iatrogenic during endodontic treatment. Furcation perforation may have a negative impact on prognosis because compromising the periodontal attachment. The aim of this study was to report the treatment of furcation perforation of right mandibular first molar (46) resulting in the maintenance of teeth severely compromised. Case Report: Clinically, the patient had active fistula, granulation tissue in the area of drilling and absence of pathological mobility. In the initial radiographic was observed extensive radiolucent area in the furcation area and a previo endodontic treatment in conditions of normality. Through visual and radiographic inspection was diagnosed drilling large furcation perforation. The treatment was performed with white MTA and the case was followed. After a year of monitoring, observed normality conditions, after prosthetic restoration, suggestive of health, as well as, a clinical situation revealing the restoration of periodontal health. Conclusion: The perforation size would lead to a poor prognosis, but in this situation the young patient and severe drilling, it becomes very important to adopt more conservative procedure for maintenance of the dental element. as well as a clinical revealing the restoration of periodontal health.

A subjetividade do diagnóstico em Endodontia - relato de caso / The subjectivity of diagnosis in Endodontics - case report

Na Endodontia, em algumas situações, o diagnóstico é bastante subjetivo. Apesar dos fenômenos necróticos e degenerativos estarem presentes na necrose parcial pulpar, ainda podem ser observados filetes nervosos em algumas partes do tecido pulpar. Embora seja necessário o acompanhamento da vitalidade pulpar dos dentes submetidos ao tratamento ortodôntico, deve-se considerar a subjetividade do teste de vitalidade e o diagnóstico só será concluído quando do acesso a câmara pulpar. O objetivo deste estudo é relatar um caso de necrose pulpar parcial ocasionada por uma cárie profunda associada ao emprego de forças excessivas durante o tratamento ortodôntico.

In some situations diagnosis in Endodontic is a very subjective procedure. Despite the presence of necrosis and degenerative phenomena are present in partial pulp necrosis, nerve fibers can still be observed in some parts of the pulp tissue. While it is necessary to monitor the pulp vitality of the teeth subjected to orthodontic treatment, one should take into account the subjectivity of the vitality test and the diagnosis must be completed only when the pulp chamber is opened. The objective of this study was to report a case of partial pulp necrosis caused by deep tooth decay associated to excessive force during orthodontic treatment.

Variações anatômicas que interferem no tratamento endodôntico - revisão da literatura / Anatomic variations affecting endodontic treatment – a review of the literature

O tratamento endodôntico visa restaurar a função e forma próprias do dente além de manter uma condição perirradicular saudável. No entanto, a ocorrência de variações na anatomia dental pode dificultar e/ou comprometer a eficácia do tratamento. Este estudo objetivou realizar uma revisão da literatura acerca das variações anatômicas que podem interferir no tratamento endodôntico. Foram encontrados diversos estudos contendo informações sobre variações anatômicas nos diferentes grupos de dentes e métodos auxiliares para diagnóstico. Desta maneira, se faz evidente a importância da detenção desse conhecimento para o sucesso da terapêutica endodôntica.

Endodontic treatment aims to restore tooth’s function and shape as well as maintaining a healthy periradicular condition. However, the occurrence of dental anatomy variations may difficult and/or compromise the efficacy of the treatment. The present study aimed toundertake a review of the literature on the anatomical variations, which may interfere with endodontic treatment. It was found several studies containing information about anatomical variations affecting different groups of teeth and auxiliary diagnostic methods. Thus, itbecomes evident the importance of such knowledge to endodontic treatment success.

Tratamento endodôntico de molar com instrumento de NiTi fraturado / Endodontic treatment of molar with fractured NiTi instrument

Diversas técnicas de instrumentação têm sido propostas com a finalidade deagilizar o processo de limpeza e modelagem do canal radicular, para que o canal esteja em condições de receber o material obturador de modo rápido e ao mesmo tempo eficaz. Apesar de confirmada a eficiência clínica dos instrumentos de NiTi, fratura inesperada pode ocorrer, sem quaisquer sinais visíveis de deformação em suas lâminas de corte. Atenção deve ser dada ao fato de que, durante o preparo químico-mecânico, quer seja ele manual ou rotatório, o instrumento endodôntico está constantemente submetido a uma série de forças que podem propiciar falhas. Portanto, durante o preparo químico-mecânico um dos maiores obstáculos ao uso desses sistemas são as fraturas dentro do canal radicular, sendo que o profissional deve estar apto a minimizar os efeitos desse acidente. Este relato de caso teve por objetivos descrever e discutir um caso clínico de uma paciente, gênero feminino, 45anos, que procurou atendimento na Clínica de Endodontia do Centro Odontológico de Estudos e Pesquisas (Coesp), João Pessoa (PB), Brasil, para o tratamento endodôntico do elemento dental com periodontite apical crônica, que possuía um instrumento F2, NiTi do sistema Protaper Universal rotatório (Dentsply Ballaiges, Maillefer, Suíça) fraturado no canal mesio-vestibular da raiz mesial do elemento 36 com periodontite apical crônica. Foram utilizadas limas C+, tipo K e Flexofile(Dentsply Ballaiges, Maillefer, Suíça) para ultrapassar o instrumento F2 Protaper Universal rotatório fraturado e em seguida foi concluído o preparo químico mecânico pela técnica escalonada com recuo anatômico.

Various root canal preparation techniques have been proposed in order to improve the process of cleaning and shaping of the root canal system, leading the root canal to be able to receive the filling material. Although confirmed the clinical efficiency of NiTi instruments, unexpected fractures may occur without any visible signs of strain in their blades. Attention should be given to the fact that during the root canal preparation, the endodontic instrument is constantly subjected to a series of forces that can provide failures. Therefore, during the root canal preparation, an important obstacle of the use of these systems is the file fracture into the root canal, and the professional must beable to minimize the effects of this accident. The aim of the present study was describe and discuss a clinical case of patient, female, 45, who requested endodontic treatment at the Endodontic Clinic of the Post- graduation course at COESP – dental center of studies and researches, João Pessoa (PB), Brazil. During the endodontic treatment of a lower, right molar (36) with apical periodontitis, a F2 Protaper Niti Instrument (Dentsply Ballaiges, Maillefer, Suíça), has been fractured into the mesio-bucal root canal system. There were used, in sequence: C + files, K files and Flexofile instruments (Dentsply Ballaiges, Maillefer, Suisse) to surpass the instrument. After that, the root canal preparation was finish by step-back preparation and the root canal was filled.

Avaliação da percepção dos alunos da disciplina de endodontia sobre o uso do Ambiente Virtual de Aprendizagem (Moodle). Uso do questionário de auto-avaliação COLLES / Assessing how endodontics students perceive the Virtual Learning Environment (Moodle) with the COLLES self-assessment questionnaire

A Disciplina de Endodontia I da Universidade Federal da Paraíba (UFPB) implantou a partir da turma 2008.1, o sistema de gerenciamento de cursos, mediante Plataforma Moodle. Ao final do período é empregado um questionário de avaliação disponível no ambiente Moodle. O objetivo deste trabalho foi analisar os resultados do questionário COLLES do tipo "experiência efetiva", aplicados aos 57 alunos das turmas 2008.2 e 2009.1 da disciplina de Endodontia I. O questionário COLLES permite avaliar os quesitos: Relevância, Reflexão Crítica, Interação, Apoio dos Tutores, Apoio dos Colegas e Compreensão. A partir das respostas obtidas foram gerados gráficos com resultados numéricos que posteriormente foram analisados quantitativamente. Os resultados revelaram excelente relevância em que 73,6% dos alunos relatam a importância do aprendizado para prática da profissão e 68,4% demonstraram a melhora no seu desempenho. Já em relação à reflexão crítica, 41% refletem criticamente com frequência sobre os conteúdos do curso e 43,8% refletem sobre como está sendo o seu aprendizado. A interatividade entre os alunos apresenta-se deficiente, pois uma pequena parcela (21%) se dispõe a explicar suas ideias aos outros participantes. No apoio dos tutores, apresentou frequente estímulo a reflexão e encorajamento à participação; já no apoio entre os colegas, houve baixa frequência de elogio e estima as contribuições. Os alunos também apresentaram frequente compreensão das mensagens dos participantes (50,8%) e dos tutores (57,8%). Conclui-se que existe necessidade de estimular o apoio entre os alunos e interação de suas ideias para que haja um melhor aproveitamento dentro do meio de ensino à distância (AU).

The discipline of Endodontics I taught at the Federal University of Paraíba (UFPB) introduced the Learning Management System by Virtual Learning Environment (Moodle) as of the class of 2008 (1st sem.). When students finish the course, they are required to answer to a self-assessment questionnaire available in the Moodle environment. The aim of this study was to analyze the results of the COLLES (Constructivist On-Line Learning Environment Survey) questionnaire­an "effective experience" type questionnaire­applied to the 57 students from the classes of 2008 (2nd sem.) and 2009 (1st sem.) of the discipline of Endodontics I. COLLES evaluates the quality of the learning process in the virtual environment, according to the following perceptions: Professional Relevance, Reflective Thinking, Interactivity, Cognitive Demand, Affective Support and Interpretation of Meaning. Based on the answers, tables were constructed with results in numbers that were later analyzed quantitatively. The results indicated a high relevance rate, in that 73.6% of the students reported that what they learned was important to professional practice, and 68.4% reported having improved their own performance. In relation to Reflective Thinking, 41% of the subjects frequently reflect critically on the subject content, and 43.8% reflect on how their learning process is developing. The interactivity among the students was considered poor, because only a small proportion (21%) was willing to explain their ideas to other participants. As for Cognitive Demand, students were often encouraged to reflect and engage in participation. In relation to Affective Support, there was a low frequency of acknowledgment and valuation of the contributions offered. The students were frequently found to understand the messages of participants (50.8%) and tutors (57.8%). Based on the results of the present research, it was concluded that, for the Virtual Learning Environment to be best taken advantage of, it is necessary to encourage support among students and interaction of their ideas (AU).

Revisão sistemática sobre a capacidade de selamento apical do Resilon/Epiphany® e da guta-percha/cimento / Systematic review about capacity of Resilon/Epiphany® and gutta-percha/cement to seal the apex of the root canal

Ao se obturar o sistema de canais radiculares, deseja-se que o material obturador apresente, entre suas propriedades, biocompatibilidade, selamento e que seja estável dimensionalmente. Sabe-se que, tanto da região apical como da coronária, fluidos e micro-organismos fluem, o que pode ocasionar uma contaminação do canal radicular ou então servir de nutriente para as bactérias que possam ter ficado após o preparo químico-mecânico, levando-se, assim, ao insucesso do tratamento endodôntico. Os materiais e métodos usados para execução da obturação têm sido amplamente estudados a fim de se conseguirem os melhores resultados, o que ainda representa um grande desafio na Endodontia. O objetivo desta revisão sistemática foi avaliar os estudos comparativos entre o sistema obturador de canais radiculares Resilon/Epiphany® e a guta-percha/cimento, apontando qual deles apresentou melhor capacidade seladora. Os resultados mostraram que, em se tratando de selamento apical, o Resilon/Epiphany® pode substituir a associação guta-percha/cimento. Contudo, estudos comparativos das outras propriedades desse sistema obturador são imprescindíveis.

During the obturation procedure of the root canals system is important that the filling substance presents among its qualities biocompatibility, sealing and that it can be dimensionally stable. There is a flow of fluids and microorganisms in the apical and coronary area, that can cause the contamination of the root canal or serve as nutriment to bacteria that can have remains after chemical and mechanical preparation, this situation will lead to failure to the endodontic treatment. The materials and methods used to the execution of obturation have been largely studied in order to get better results, what still representing a great challenge in Endodontics. The main purpose of this research was to evaluate the comparative studies between the obturator system of root canals Resilon/Epiphany® and the gutta-percha/cement, pointing which of them presents best sealing capacity. The results showed that, concerning to apical sealing, Resilon/Epiphany® can substitute the association of gutta/percha convention, however comparative studies of other qualities of the system filled are indispensable.

Estudo "in vitro" da acurácia e da repetibilidade de odontometrias realizadas com três localizadores apicais eletrônicos / Study in vitro accuracy and repeatability odontometric conducted with three electronic apex locators

Este estudo avaliou, in vitro, a acurácia e a reprodutividade das odontometrias eletrônicas realizadas por três localizadores apicais eletrônicos (EALS): Root ZX-II, Mini Apex Locator e Novapex...

This study evaluated, in vitro, the accuracy and the repeatability of the electronic working length obtained by: Root ZX-II, Mini Apex Locator and Novapex...

Estudo "in vitro" da acurácia e da repetibilidade de odontometrias realizadas com três localizadores apicais eletrônicos / Study in vitro accuracy and repeatability odontometric conducted with three electronic apex locators

Este estudo avaliou, in vitro, a acurácia e a reprodutividade das odontometrias eletrônicas realizadas por três localizadores apicais eletrônicos (EALS): Root ZX-II, Mini Apex Locator e Novapex...

This study evaluated, in vitro, the accuracy and the repeatability of the electronic working length obtained by: Root ZX-II, Mini Apex Locator and Novapex...

The accuracy of root canal measurements using the Mini Apex Locator and Root ZX-II: an evaluation in vitro.

OBJECTIVE: The aim of this in vitro study was to compare the capacity of the Root ZX-II and Mini Apex Locator, electronic apex locators (EALS), to prevent overestimated working length. STUDY DESIGN: Forty extracted human teeth were used for the study. The cervical portion of each canal was flared using Gates Glidden drills and the teeth were embedded in an alginate model. Canals were irrigated with 2.5% sodium hypochlorite. The actual length (AL) and electronic length (EL) measurements were made on each specimen separately with both devices with the aid of a k-type file. RESULTS: The results obtained with each EAL were compared with the corresponding actual length. The statistical analysis of the results showed EAL reliability to prevent overestimated working length to be 100% for the Mini Apex Locator and 97.44% for the Root ZX-II, within a tolerance of +/-0.5 mm into account. A paired sample t test showed that there was no statistically significant difference between the accuracy of the devices (P = .5841). CONCLUSION: The results of this study indicate that the Root ZX-II and Mini Apex Locator are accurate devices to prevent overestimated working length.