RESUMO
Abstract: This study investigated the effectiveness of XP-Endo Finisher (XPF) associated with XP-Endo Shaper (XPS) or Reciproc Blue (RB) files in reducing bacterial load in oval-shaped root canals (RC) during chemomechanical preparation (CMP) using 0.9% saline solution (NaCl) or 2.5% sodium hypochlorite (NaOCl). Eighty mandibular incisors with single oval-shaped RC were contaminated with Enterococcus faecalis. The teeth were randomly assigned to eight experimental groups (n = 10) according to the CMP, as follows: G1: XPS, G2: XPS + XPF, G3: RB, and G4: RB + XPF. CMP was performed with NaCl or NaOCl. The reduction of bacterial load was assessed by colony-forming unit count before (S1) and after (S2) CMP. Data normality was verified by using Shapiro-Wilk test. ANOVA, Tukey's test, and Bonferroni post-hoc test were used at a 5% significance level. Culturable bacteria were present in all S1 samples (p>0.05). All instrumentation techniques were effective in reducing bacterial load, irrespective of the irrigating solution (p < 0.05). With the use of NaCl, RB was more effective than XPS (p = 0.035). With the use of NaOCl, XPS and RB presented similar effectiveness (p = 0.779). XPF enhanced the bacterial reduction of both systems tested (p < 0.05). The use of NaOCl improved the CMP, irrespective of the instrumentation technique used (p < 0.05). In conclusion, XPS and RB files are effective in reducing bacterial levels in oval-shaped RC. The use of XPF as a method of agitation of the irrigating solution improved the cleaning efficiency of both file systems tested. Mechanical preparation performed with saline solution decreased culturable bacteria from the root canal, but antimicrobial substances such as NaOCl should be used to achieve a significantly better disinfection.
Assuntos
Humanos , Preparo de Canal Radicular/instrumentação , Instrumentos Odontológicos , Cavidade Pulpar/anatomia & histologia , Carga Bacteriana , Hipoclorito de Sódio/uso terapêutico , Teste de Materiais , Infecções por Bactérias Gram-Positivas , Enterococcus faecalis/isolamento & purificação , Cavidade Pulpar/microbiologia , Desinfetantes/uso terapêutico , Solução Salina/uso terapêutico , IncisivoRESUMO
Abstract The aim of the present study was to evaluate the cytotoxic effects of five endodontic sealers (AH Plus, Endomethasone N, EndoSequence BC, MTA Fillapex and Pulp Canal Sealer EWT) using a three-dimensional (3D) cell culture model. A conventional bi-dimensional (2D) cell culture model was used as reference technique for comparison. Balb/c 3T3 fibroblasts were cultured in conventional bi-dimensional cell culture and in rat-tail collagen type I three-dimensional cell culture models. Then, both cell cultures were incubated with elutes of freshly mixed endodontic sealers for 24 h. Cell viability was measured by the methyl-thiazol-diphenyltetrazolium assay (MTT). Data were statistically analyzed using ANOVA and the Tukey test at a significance level of p<0.05. All tested sealers exhibited cytotoxic effects; however, cytotoxic effect was culture model- and sealer-dependent. Sealers showed higher cytotoxicity in 2D than in 3D cell culture model (p<0.05). In both conditions, EndoSequence BC showed the lowest cytotoxicity (p<0.05). MTA Fillapex was much more cytotoxic than the other tested endodontic sealers (p<0.05), with the exception of AH Plus in the 2D cell culture model (p>0.05). Endomethasone N and Pulp Canal Sealer EWT showed lower cytotoxic effects than AH Plus in 2D cell culture model (p<0.05); however no statistical differences was observed among these sealers in 3D cell culture model. It may be concluded that cytotoxicity was higher in 2D cell culture compared to 3D cell culture. EndoSequence BC sealer exhibited the highest cytocompatibility and MTA Fillapex the lowest cytocompatibility.
Resumo O objetivo do presente estudo foi avaliar os efeitos citotóxicos de cinco cimentos endodônticos (AH Plus, Endomethasone N, EndoSequence BC, MTA Fillapex e Pulp Canal Sealer EWT) utilizando um modelo de cultura celular tridimensional (3D). Utilizou-se um modelo convencional de cultura de células bidimensionais (2D) como técnica de referência para comparação. Os fibroblastos Balb/c 3T3 foram cultivados em culturas de células bidimensionais convencionais e em modelos de cultura de células tridimensionais de colagéno de cauda de rato do tipo I. Em seguida, ambas as culturas de células foram incubadas com eluções dos cimentos endodônticos recém manipulados, durante 24 h. A viabilidade celular foi medida pelo ensaio de MTT. Os dados foram analisados estatisticamente utilizando ANOVA e o teste de Tukey com nível de significância de p<0,05. Todos os cimentos testados exibiram efeitos citotóxicos. Contudo, o efeito citotóxico foi dependente do modelo de cultura e do cimento testado. Os cimentos apresentaram maior citotoxicidade no modelo 2D do que no modelo 3D (p<0,05). Em ambas as condições, a EndoSequence BC apresentou a menor citotoxicidade (p<0,05). MTA Fillapex foi mais citotóxico do que os outros cimentos endodônticos testados (p<0,05), com exceção do AH Plus no modelo de cultura de células 2D (p>0,05). Endomethasone N e EWT mostraram efeitos citotóxicos mais baixos do que AH Plus no modelo de cultura de células 2D (p<0,05); entretanto, não houve diferenças estatísticas entre esses cimentos no modelo de cultura de células 3D. Pode concluir-se que a citotoxicidade foi maior na cultura de células 2D em comparação com a cultura de células 3D. EndoSequence BC selante exibiu a maior citocompatibilidade e MTA Fillapex a menor citocompatibilidade.
Assuntos
Animais , Camundongos , Materiais Restauradores do Canal Radicular , Células 3T3 , Camundongos Endogâmicos BALB CRESUMO
Abstract This study was designed to investigate the resistance to dislodgment provided by MTA HP, a new high-plasticity calcium silicate-based cement. Biodentine and White MTA Angelus were used as reference materials for comparison. Three discs 1 ± 0.1 mm thick were obtained from the middle third of the roots of 5 maxillary canines. Three 0.8-mm-wide holes were drilled on the axial surface of each root disc. Standardized irrigation was performed. Then the holes were dried with paper points and filled with one of the three tested cements. The filled dental slices were immersed in a phosphate-buffered saline (PBS) solution (pH 7.2) for 7 days before the push-out assessment. The Kruskal-Wallis test was applied to assess the effect of each endodontic cement on the push-out bond strength. Mann-Whitney with Bonferroni correction was used to isolate the differences. The alpha-type error was set at 0.05. All specimens had measurable push-out values and no premature failure occurred. There were significant differences among the materials (p <0.05). The Biodentine specimens had the highest push-out bond strength values (p < 0.05). MTA HP had significantly higher bond strength than White MTA (p < 0.05). MTA HP showed better push-out bond strength than its predecessor, White MTA; however, Biodentine had higher dislodgment resistance than both MTA formulations.
Assuntos
Humanos , Óxidos/química , Colagem Dentária/métodos , Silicatos/química , Compostos de Cálcio/química , Compostos de Alumínio/química , Cimentos Dentários/química , Materiais Restauradores do Canal Radicular/química , Fatores de Tempo , Bismuto/química , Teste de Materiais , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Preparo de Canal Radicular/métodos , Combinação de MedicamentosRESUMO
INTRODUCTION: The objective of this study was to evaluate the success rates of standardized techniques for removing or bypassing fractured instruments from root canals and determine whether visualization of the fractured instrument with the aid of an operating microscope has any impact on the success rates. METHODS: In this prospective study, attempts were made to visualize 112 fractured instruments under a dental operating microscope after creating a straight-line access to the fragment. By using ultrasonic tips alone or associated with bypassing, the Ruddle technique was attempted to remove the 68 visible instruments. Bypassing was performed for the 44 nonvisible fragments. The χ(2) test was performed to assess whether any significant difference occurred between the success rates observed for the visible and nonvisible fractured instrument groups. RESULTS: The overall success rate (removal and bypassing) was 70.5% (n = 79). In the visible fragment group, the success rate was 85.3% (n = 58), and in the nonvisible fragment group it was 47.7% (n = 21). Success rates were significantly higher when the fragment was visible (P = .0009). CONCLUSIONS: The standardized techniques used in this study for removing or bypassing fractured instruments were effective, and approximately 2 times greater success rate was obtained when the fragment was visible inside the root canal compared with when it was nonvisible.
Assuntos
Cavidade Pulpar , Corpos Estranhos/terapia , Preparo de Canal Radicular/instrumentação , Dente Pré-Molar/patologia , Dente Canino/patologia , Materiais Dentários/química , Cavidade Pulpar/patologia , Desenho de Equipamento , Falha de Equipamento , Corpos Estranhos/classificação , Humanos , Incisivo/patologia , Microcirurgia/instrumentação , Dente Molar/patologia , Piezocirurgia/instrumentação , Estudos Prospectivos , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/efeitos adversos , Hipoclorito de Sódio/uso terapêutico , Titânio/química , Resultado do Tratamento , Zircônio/químicaRESUMO
O objetivo desse trabalho foi determinar se o uso do Microscópio Operatório poderia aumentar o número de orifícios de canais radiculares localizados em incisivos inferiores de humanos. Foram utilizados 100 incisivos inferiores. Após a cirurgia de acesso realizada a olho nu, o total de canais localizados foram anotados. Utilizando um microscópio operatório com magnificação variando de X8 a X20, todos os dentes tiveram o preparo da cirurgia de acesso revisados. Após o uso do microscópio, foram localizados 20 canais a mais, o que representou um aumento significativo de 17,85% no total do número de canais localizados. O microscópio proporciona melhor visualização aumentando o número de orifícios de canal lingual encontrados em incisivos inferiores extraídos de humanos.
The purpose of this study was to determine whether the use of the dental operating microscope (DOM) could increase the number of root canal orificies located in human mandibular incisors. One hundred extracted incisors were used. With naked eye, ali access cavities were prepared and orifices were located. Using DOM with x8 - x12 magnification ali access cavities preparations were again examined. After the DOM examination, 20 more canais could be visualized. With the use of operating microscope, we have an increase of located canais in mandibular incisors, what representing an increase of 17,85%.
Assuntos
Humanos , Masculino , Feminino , Endodontia/métodos , Incisivo/anatomia & histologia , Microscopia/métodosRESUMO
A presença de tecido duro mineralizado obliterando o espaço pulpar representa uma dificuldade clínica para a exploração dos canais durante o tratamento endodôntico. O objetivo deste relato de casos clínicos foi apresentar um protocolo de tratamento utilizando o microscópio clínico operatório e insertos de ultrassom para a localização de canais calciflcados. De quarenta e dois dentes indicados para especialistas com este objetivo, em trinta e cinco dentes os canais puderam ser explorados e o tratamento endodôntico concluído normalmente, representando um índice de sucesso de 83,33%.
The presence of mineralized dentin obliterating the pulpal space, is still a challenge for the clinician during root canal theraphy. The purpose of this case series report was to describe a protocol using a clinical operating microscope and ultrasonic inserts for location of calcified canais. From 42 teeth refered to specialists with this objetive, 35 had ali the canais explorated and root canal therapy could be completed, representing a levei of sucesso of 83,33%.
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Microscopia/métodos , Calcificação de DenteRESUMO
O reconhecimento e diagnóstico de dentes com fratura vertical da raiz (FVR) ainda é um desafio para o clínico. O objetivo deste relato de 203 dentes diagnosticados com fratura vertical da raiz (FVR) é apresentar os sinais e sintomas clínicos mais frequentemente associados a essa patologia. Os fatores avaliados mais recorrentes foram: dor à mastigação, fístula localizada no terço cervical e médio da raiz, aumento do espaço do ligamento periodontal ou lesões ósseas laterais.
Recognition and diagnosis of teeth with vertical root fracture (VRF) is challenge for the clinician. The objective of this case series of 203 teeth with confirmed diagnosis of VRF was to present clinical signs and symptoms frequently associated with this pathology. From all factors studied the most frequent were: pain during chewing, fistulae located in the medial/cervical portion of the roots and widening of periodontal membrane or lateral osseous lesions.
Assuntos
Humanos , Masculino , Feminino , Adulto , Retratamento , Raiz Dentária/lesõesRESUMO
OBJECTIVE: This study compared the efficacy of gutta-percha/sealer removal from endodontically treated extracted human teeth with and without the aid of a clinical operating microscope/ultrasonic instruments. STUDY DESIGN: Forty human extracted maxillary central incisors were prepared using a modified crown-down technique and filled with lateral compactation. Teeth were divided into 2 groups: group I, re-treated using a conventional technique with burs and solvent; and group II, re-treated using a conventional technique with burs and solvent plus clinical operating microscope/ultrasonic tips. Teeth were split longitudinally and photographed, and coded photos transfered to a computer workstation. Total canal space and remaining gutta-percha/sealer were quantified, and ratio of remaining filling material and root canal periphery was computed. Mean percentage of remaining gutta-percha/sealer in each group was compared using analysis of variance. RESULTS: The average percentage of remaining gutta-percha/sealer was 25.21% in group I and 9.31% in group II, showing a statistically significant difference (P = .05). CONCLUSION: The use of the dental operating microscope and ultrasonic tips removed the filling material from root canal walls better, but all examined teeth, in both groups, had remaining filling material on canal walls.
Assuntos
Cavidade Pulpar/patologia , Guta-Percha/uso terapêutico , Microcirurgia/instrumentação , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/instrumentação , Terapia por Ultrassom/instrumentação , Humanos , Processamento de Imagem Assistida por Computador , Fotografação , Retratamento , Irrigantes do Canal Radicular/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Solventes/uso terapêuticoRESUMO
Fístulas cutâneas extra-orais de origem dental podem representar um desafio diagnóstico na área da saúde. Este artigo descreve o caso de uma paciente em tratamento dermatológico, no qual a causa de uma fístula cutânea estava associada a um pré-molar superior portador de lesão óssea periapical de origem endodôntica. Serão apresentados e discutidos tanto a rotina de diagnóstico odontológico quanto os protocolos do tratamento endodôntico.
Cutaneous sinus tracts of dental origen are a diagnostical challenge in the medical held. This article describes the case of patient during dermatalogical treatment but the origin of a cutaneous sinus tract was associated with a superior premolar with periapical endodontic lesion. It will be presented and discussed the dental diagnostic routin as well as the endodontic protocols of treatment.
Assuntos
Humanos , Feminino , Adulto , Fístula Cutânea/diagnóstico , Tratamento do Canal RadicularRESUMO
O tratamento de complicações endodônticas representa um desafio até mesmo para os profissionais mais experientes. A recente introdução do uso do microscópio clínico propicia um campo operatório com magnificação e iluminação adequadas, conferindo maior precisão aos procedimentos clínicos. Este relato de caso envolvendo três dificuldades conjuntas - remoção de cones de prata, localização de canal calcificado e tratamento de perfuração de furca - em um único dente, permite discutir e ilustrar a utilização dessa nova tecnologia, que é simples, apresenta resultado previsível e permite um prognóstico favorável