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1.
Rev. Odontol. Araçatuba (Online) ; 43(3): 48-53, set.-dez. 2022. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1381107

ABSTRACT

A ciência endodôntica possui um vasto conhecimento e com esse conhecimento os seus inúmeros questionamentos. Algumas teorias e conceitos mudam constantemente e trazem à tona contradições e divergências clínicas no âmbito biológico e prático. A patência foraminal é uma prática que permite que um instrumento de pequeno calibre ultrapasse o forame apical, com o intuito de limpar passivamente e prevenir o acúmulo de detritos e inibir a proliferação de microorganismos que podem causar infecções pós tratamento endodôntico. Essa prática gera discussão interna entre especialistas da área, mas as vantagens da técnica são inúmeras, principalmente no que diz respeito aos casos de polpa necrosada. Casos como esse não são solucionados com sucesso sem a utilização da patência apical. Por outro lado, existem contradições em relação aos casos em que a polpa está viva. Esse trabalho tem como objetivo analisar as vantagens e desvantagens da patência apical, bem como, se os benefícios excedem os possíveis danos que ela pode trazer(AU)


Endodontic science has vast knowledge and with this knowledge its countless questions. Some theories and concepts are constantly changing and bring to light clinical contradictions and divergences in the biological and practical scope. Foraminal patency is a practice that allows a small-caliber instrument to go beyond the apical foramen, in order to passively clean and prevent the accumulation of debris in the region and inhibit the proliferation of microorganisms that can cause infections after endodontic treatment. This practice generates internal discussion among specialists in the field, but the advantages of the technique are numerous, especially with regard to cases of necrotic pulp. Cases like this are not successfully resolved without the use of apical patency. On the other hand, there are contradictions regarding the cases where the pulp is alive. This work aims to analyze the advantages and disadvantages of apical patency, as well as whether the benefits exceed the harm it can bring(AU)


Subject(s)
Humans , Male , Adult , Root Canal Therapy , Tooth Apex , Root Canal Preparation , Infections
2.
Braz. j. oral sci ; 21: e224013, jan.-dez. 2022. ilus
Article in English | LILACS, BBO | ID: biblio-1354702

ABSTRACT

Aim: The aim of the study was to evaluate the cleaning of mandibular incisors with WaveOne Gold® (WO) under different preparation techniques. Methods: A total of 210 human mandibular incisors were selected and divided into seven groups (n = 30), prepared by WO single-files (Small 20/.07 ­ WOS; Primary 25/.07 ­ WOP; Medium 35/.06 ­ WOM; or Large 45/.05 - WOL) and sequential-file techniques (WOS to WOP; WOS to WOM; and WOS to WOL). Further subdivision was made according to irrigation protocol: control group (manual irrigation - CON), E1 Irrisonic® - EIR, and EDDY® - EDD. Debris removal and the smear layer were evaluated by scanning electron microscopy. Data were analyzed by using Spearman's correlation test. The significance level was set at 5%. Results: For debris and smear layer removal, WOS and WOP, EIR differed from CON and EDD (p <0.05). Conclusion: Regardless of the instrumentation used, the agitation of the irrigant solution provided better cleanability. These findings reinforce the need for agitation techniques as adjuvants in cleaning root canal systems in mandibular incisors


Subject(s)
Root Canal Irrigants , Microscopy, Electron, Scanning , Root Canal Preparation , Endodontics
3.
Rev. Odontol. Araçatuba (Online) ; 43(1): 18-23, jan.-abr. 2022. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1361569

ABSTRACT

O presente artigo tem como objetivo relatar um caso clínico de selamento de perfuração com uma técnica de inserção modificada do MTA. Após a anestesia, foi realizado o isolamento absoluto do dente e remoção do material presente na câmara, com o auxílio do inserto ultrassônico Smart X 1. Realizada a limpeza da perfuração utilizando hipoclorito de sódio e modelagem do canal com o instrumento rotatório, a obturação foi concebida com cone de guta percha e cimento AHPlus. Com broca Gates Glidden #3 foi removida a guta percha até o nível da perfuração. Em seguida, 5 mg de MTA branco foi manipulado, de acordo com recomendações do fabricante usando água destilada na proporção 1:1 e inserido na canaleta de uma régua endodôntica. Com o auxílio do instrumento de RHEM o material foi removido da canaleta e inserido na perfuração, concluindo o vedamento da mesma. Conclui-se neste caso clínico que o selamento de perfuração com MTA obteve sucesso clínico e radiográfico, utilizando a técnica de inserção com MTA modificada(AU)


This article aims to report a clinical case of sealing drilling rig with a modified MTA insertion technique. After anesthesia, the absolute isolation of the tooth and removing the material present in the Chamber, with the aid of ultrasonic Insert Smart X 1. Held drilling cleaning using sodium hypochlorite and modeling the canall with the Rotary instrument, the filling was designed with cone of gutta percha and cement AHPlus. With Gates Glidden bur #3 removed the gutta percha drilling level. Then 5 mg of white MTA was handled, according to manufacturer 's recommendations using distilled water in the ratio 1:1 and inserted in a canal endodontic ruler. With the aid of RHEM instrument the material was removed from the canal and inserted in drilling, completing the enclosure. It is concluded in this case that the sealing of drilling with clinical and radiographic success MTA, using the technique of does not avoid inserting rotating instrument. The obturation was performed with gutta percha cone and AHPlus cement. Removed gutta percha with Gates Glidden drill to drill level. Then, 5 mg of white MTA was handled, according to manufacturer 's recommendations using distilled water in the ratio 1: 1. Soon after, it was inserted in the caneleta of an endodontic ruler and with the aid of the instrument of RHEM the material was inserted in the indicated place. It is concluded in this clinical case that the perforation sealing with MTA obtained clinical and radiographic success, using the insertion technique with modified MTA(AU)


Subject(s)
Humans , Male , Middle Aged , Root Canal Filling Materials , Root Canal Obturation , Root Canal Therapy , Sodium Hypochlorite , Biocompatible Materials , Root Canal Preparation , Gutta-Percha
4.
Article in English | WPRIM | ID: wpr-929140

ABSTRACT

Various engine-driven NiTi endodontic files have been indispensable and efficient tools in cleaning and shaping of root canals for practitioners. In this review, we introduce the relative terms and conceptions of NiTi file, including crystal phase composition, the design of the cutting part, types of separation. This review also analysis the main improvement and evolution of different generations of engine-driven nickel-titanium instruments in the past 20 years in the geometric design, manufacturing surface treatment such as electropolishing, thermal treatment, metallurgy. And the variety of motion modes of NiTi files to improve resistance to torsional failure were also discussed. Continuous advancements by the designers, provide better balance between shaping efficiency and resistance to of NiTi systems. In clinical practice an appropriate system should be selected based on the anatomy of the root canal, instrument characteristics, and operators' experience.


Subject(s)
Dental Alloys/chemistry , Dental Instruments , Equipment Design , Nickel/chemistry , Root Canal Preparation , Titanium/chemistry
5.
Braz. dent. sci ; 25(2): 1-14, 2022. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1370579

ABSTRACT

Objective: Various glide path preparation techniques have been introduced, providing easiness to the practitioners. Recent literature has shown that glide path preparation influences the levels of postoperative pain occurrence in individuals receiving endodontic therapy. This systematic review aims to compare the different glide path preparation system in reduction of postoperative pain. Material and Methods: Electronic databases such as PubMed, Scopus, Cochrane Library, LILACS, Google Scholar, and European PMC were searched for published articles until July 2020. The studies included were randomized control trial (RCT) studies published during this time frame with comparison of continuous glide path system with various other glide path systems in reducing postoperative pain. The studies were reviewed using Preferred Reporting Items for Systematic reviews and Meta­Analyses (PRISMA) guidelines. The studies were reviewed independently by two reviewers who had assessed the included studies, extracted data and the quality using the Cochrane risk of bias assessment tool. Results:544 studies were received from the initial search, 11 articles were included in full text appraisal, 4 studies were obtained for qualitative analysis. Mean VAS Scores showed an increased reduction of postoperative pain in continuous glide path treated individuals (1.90-0.20) compared to reciprocating glide path (2.00-0.50) and manual glide path (3.80-0.85). The consumptions of analgesics were seen to be as follows; Manual Glide Path > Reciprocating Glide Path > Continuous Glide Path. Three out of four studies showed an overall "high" risk of bias and another study showed an overall "unclear" bias. Conclusion: From the achieved results, continuous glide path with 5.25% NaOCl irrigation has shown better reduction of postoperative pain compared to other glide path systems. Individuals who had undergone manual glide path preparation showed higher incidence of postoperative pain compared to other systems. The consumption of analgesics was seen to be higher in manual glide path prepared individuals followed by reciprocating glide path and least being continuous glide path.(AU)


Objetivo: Várias técnicas de preparação do glide path têm sido introduzidas, permitindo maior facilidade aos profissionais. A literatura tem mostrado que a forma de preparação do glide path influencia nos níveis de dor pós-operatória em indivíduos que recebem tratamento endodôntico. Esta revisão sistemática tem como objetivo comparar os diferentes sistemas de preparação do glide path na redução de dor pós-operatória. Material e Métodos: Bases de dados eletrônicas como PubMed, Scopus, Cochrane Library, LILACS, Google Escolar, e European PMC foram utilizadas para pesquisar artigos publicados até Julho de 2020. Os estudos incluídos foram ensaios clínicos randomizados controlados (ECRC) publicados até este período de tempo que compararam sistema de glide path contínuo com outros sistemas de glide path na redução de dor pós-operatória. Para revisão dos estudos, foi utilizado o 'Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines'. Dois revisores analisaram, independentemente, os estudos incluídos, os dados extraídos e a qualidade através da ferramenta de avaliação de risco de viés da Cochrane. Resultados: 544 estudos foram encontrados na pesquisa inicial, 11 artigos foram selecionados para avaliação de texto completo, 4 estudos foram obtidos para a análise qualitativa. A pontuação média do VAS mostrou um aumento na redução de dor pós-operatória em indivíduos nos quais foi utilizado o sistema de glide path rotatório contínuo (1.90-0.20) quando comparados àqueles nos quais foram utilizados o glide path reciprocante (2.00-0.50) e o glide path manual (3.80-0.85). A utilização de analgésicos foi vista da seguinte forma: Glide path Manual > Glide Path Reciprocante > Glide Path Contínuo. Três dos quatro estudos apresentaram um "alto" risco de viés geral e o outro estudo apresentou risco de viés geral "incerto". Conclusão: O glide path contínuo com irrigração de 5.25% de NaOCl mostrou a melhor redução de dor pós-operatória comparado aos demais sistemas de glide path. Indivíduos que foram submetidos à preparação de glide path pelo sistema manual apresentaram a maior incidência de dor pós-operatória. O consumo de analgésicos foi maior diante do uso do glide path manual, seguido pelo glide path reciprocante, e por último pelo glide path contínuo. (AU)


Subject(s)
Pain , Sodium Hypochlorite , Root Canal Preparation , Endodontics , Analgesics
6.
Dent. press endod ; 11(3): 75-82, Sept-Dec.2021. Ilus
Article in English | LILACS | ID: biblio-1379665

ABSTRACT

Introdução: Perfuração radicular é a comunicação entre as paredes do canal radicular e o espaço periodontal. O tempo, a localização e a dimensão da perfuração são fatores que afetam no prognóstico do dente. Objetivo: Relatar um caso clínico de tratamento de perfuração radicular supraóssea associado a enxertia de tecido conjuntivo em área estética. Relato do caso: Paciente relatou ter sido submetido, há 3 meses, ao tratamento endodôntico do dente #22; porém, esse não foi finalizado. Ao exame clínico, o dente apresentava ausência de dor e presença de fístula na região da gengiva inserida. As imagens radiográficas e tomográficas revelaram imagem sugestiva de perfuração radicular na região vestibular do dente #22, além de área hipodensa/radiolúcida circunscrita ao ápice radicular, conduzindo ao diagnóstico de periodontite apical assintomática associada a perfuração radicular supraóssea. Inicialmente, foi realizado preparo do canal radicular e utilizada medicação intracanal por 21 dias. Posteriormente, foi realizada a obturação do canal radicular e restauração definitiva em resina composta na face palatal. Na mesma sessão, foi realizado o acesso cirúrgico para selamento da perfuração com resina composta, associado a enxertia de tecido conjuntivo no dente #22, para evitar recessão tecidual marginal. Foi observada, após 12 meses, neoformação óssea na região periapical do dente #22, com ausência de dor e preservação da estética na região periodontal. Conclusão: O diagnóstico e o planejamento multidisciplinar são fatores importantes no tratamento de perfurações radiculares, assim como a correta escolha do material selador (AU).


Introduction: Root perforation is the communication between the walls of the root canal and the periodontal space. The time, location and size of the perforation are factors that affect the prognosis of the tooth. Objective: To report a clinical case of treatment of supraosseous root perforation associated with grafting of connective tissue in aesthetic area. Case report: Patient reported that 3 months had started root canal treatment of tooth 22, but was not finalized. At the clinical examination, the tooth presented absence of pain and presence of sinus tract in the region of attached gingiva. Radiographic and tomographic images revealed an image suggestive of root perforation in the buccal region of tooth 22, as well as a hypodense / radiolucent area circumscribed to the root apex, leading to the diagnosis of asymptomatic apical periodontitis associated with supraosseous root perforation. Initially, it were performed root canal preparation and intracanal medication. After 21 days, root canal obturation and composite restoration were performed on the palatal face. In the same session, the surgical access was made to sealing the perforation with composite resin, associated to the grafting of connective tissue in tooth 22, to avoid marginal tissue recession. It was observed after 12 months new bone formation in the periapical region of tooth 22, with absence of pain and preservation of aesthetics in the periodontal region. Conclusion: Multidisciplinary diagnosis and planning are important factors in the treatment of root perforations, as well as the correct selection of materials used to seal root perforations (AU).


Subject(s)
Humans , Tissue Transplantation , Composite Resins , Root Canal Preparation , Esthetics , Periapical Periodontitis , Research Report
7.
Dent. press endod ; 11(3): 87-93, Sept-Dec.2021. Ilus
Article in English | LILACS | ID: biblio-1380050

ABSTRACT

Introdução: O alargamento do forame refere-se ao alargamento mecânico intencional do forame para reduzir a carga bacteriana em uma área afetada frequentemente por infecções endodônticas além do limite da constrição apical. Objetivo: O objetivo do presente relato de caso é apresentar a técnica de alargamento do forame de um dente com lesão periapical extensa, como complemento do tratamento endodôntico e alternativa precoce à microcirurgia periapical. Métodos: É apresentado o caso de um incisivo lateral superior endodonticamente tratado, com uma extensa lesão periapical associada. Devido à história clínica e radiográfica, tempo decorrido desde o tratamento endodôntico inicial e alta probabilidade de áreas de reabsorção apical com biofilme extrarradicular, o retratamento endodôntico com alargamento do forame foi indicado como primeira opção, adiando a indicação de cirurgia endodôntica de acordo com a evolução. Resultados: Na avaliação de acompanhamento de dois anos, por exame de imagem, observou-se evolução clínica favorável ao retratamento, com aumento total da densidade óssea. O procedimento cirúrgico endodôntico complementar foi descartado. Conclusão: O alargamento do forame é uma alternativa complementar viável em casos de periodontite apical de longa duração com suspeita de biofilme no nível do forame. Pode ser considerado uma opção antes da indicação de retratamento endodôntico cirúrgico (AU).


Introduction: Foraminal enlargement refers to intentional mechanical enlargement of the foramen to reduce the bacterial load in an area frequently affected by endodontic infections beyond the limits of the apical constriction. The objective of this case report is to present the foraminal enlargement technique of a tooth with an extensive periapical lesion as a complement in the endodontic treatment and an early alternative to periapical microsurgery. Materials and methods: The case is presented of an endodontically treated upper lateral incisor with an extensive associated periapical lesion. Due to the clinical and radiographic history, the time elapsed since the initial endodontic treatment, and the high probability of areas of apical resorption with extra-radicular biofilm, endodontic retreatment with foraminal enlargement was indicated as the first option, postponing the indication for endodontic surgery according to evolution. Results: In the follow-up appointment at 2 years, a favorable clinical imaging evolution of retreatment was observed, with a total increase in bone density. The complementary endodontic surgical procedure was discarded. Conclusion: Foraminal enlargement is a viable complementary alternative in cases of long-term apical periodontitis with suspicion of biofilm at the foramen level. It can be considered an option before the indication of surgical endodontic retreatment (AU).


Subject(s)
Humans , Periapical Periodontitis , Wound Healing , Bacterial Load , Apicoectomy , Root Canal Preparation/instrumentation , Retreatment
8.
Dent. press endod ; 11(3): 52-57, Sept-Dec.2021. Tab, Ilus
Article in English | LILACS | ID: biblio-1379356

ABSTRACT

Objetivo: O objetivo do presente estudo foi avaliar a influência do pré-alargamento coronário na resistência à fadiga cíclica de dois instrumentos reciprocantes tratados termicamente. Métodos: 20 instrumentos Reciproc Blue (R25 Blue) e 20 instrumentos X1 Blue (X1) foram utilizados para instrumentar blocos de resina simulando um molar superior com três canais radiculares. Os dentes foram divididos em quatro grupos (n=10), de acordo com o instrumento e com a técnica de instrumentação utilizada: grupos R25 e X1 - instrumentação com R25 Blue (25/0.08) ou X1 Blue (25/0.06), respectivamente, sem alargamento prévio; e grupos R25 ou X1 + pré-alargamento cervical - pré-alargamento com os instrumentos ProTaper Universal SX e S1 antes da instrumentação com R25 Blue ou X1. Os instrumentos foram testados com relação à fadiga cíclica utilizando-se um canal simulado de aço inoxidável com ângulo de curvatura de 86 graus e raio de curvatura de 6 mm. Os instrumentos foram acionados utilizando-se o movimento "RECIPROC ALL" do motor endodôntico (VDW) e o tempo de instrumentação até a fratura do instrumento foi contabilizado. Os resultados foram analisados pelo teste t de Student (p<0,05). Resultados: Os instrumentos X1 apresentaram maior resistência à fadiga cíclica do que R25 Blue em ambas as condições testadas (p<0,05). Não houve diferença entre os grupos com e sem pré-alargamento coronário para os instrumentos R25 Blue e X1 (p>0,05). Conclusão: O instrumento X1 Blue apresentou maior resistência à fadiga cíclica do que o Reciproc Blue. O pré-alargamento coronário não foi capaz de aumentar a resistência à fratura por fadiga cíclica dos instrumentos testados (AU).


Objective: The aim of this study was to evaluate the influence of cervical pre-flaring on the cyclic fatigue resistance of two heat-treated reciprocating instruments. Methods: 20 Reciproc Blue (R25 Blue) instruments e 20 X1 Blue File (X1) were used to instrument resin blocks simulating an upper molar with 3 root canals. The specimens were divided into four groups (n=10) according the instrument and type of instrumentation used: R25 and X1 groups: root canal preparation with R25 Blue (25/0.08) ou X1 Blue (25/0.06), without cervical pre-flaring; R25 or X1 + cervical pre-flaring- pre-flaring with ProTaper Universal SX e S1 before instrumentation with R25 Blue or X1 blue. After instrumentation the instruments were tested for cyclic fatigue using a simulated stainless steel root canal with 86 degree bending angle and 6 mm bending radius. The instruments were triggered using the "RECIPROC ALL" motion of a reciprocating endodontic motor (VDW) and the instrumentation time until instrument fracture was accounted. Results were analyzed by Students t-test (p<0.05). Results: Statistical analysis showed that the X1 Blue showed higher resistance to cyclic fatigue than the R25 Blue under both conditions tested (p<0.05). There were no differences between the groups with and without coronary pre-flaring for the R25 Blue and X1 Blue (p<0.05). Conclusion: X1 Blue showed higher resistance to cyclic fatigue than the R25 Blue. The cervical pre-flaring did not increased the resistance to cyclic fatigue fracture of the tested instruments (AU)


Subject(s)
Stainless Steel , Root Canal Preparation/instrumentation , Flexural Strength , Hot Temperature , Simulation Exercise , Fatigue
9.
Braz. j. oral sci ; 20: e21378, jan.-dez. 2021. tab
Article in English | LILACS, BBO | ID: biblio-1254637

ABSTRACT

Aim: To evaluate the apical extrusion of debris in flat-oval canals, using three reciprocating systems at two different working lengths (WL), 0 mm and 1 mm from the apical foramen. Methods: Ninety mandibular incisors were randomly divided into three groups based on the systems: WaveOne Gold #25.07 (WOG), ProDesign R #25.06 (PDR), and X1 Blue #25.06 (X1B). Extruded debris were collected and dried in pre-weighed Eppendorf tubes. Three consecutive weighings were performed for each tube, and the mean was calculated. If the assumptions of normality and homogeneity of variance were not met, the Kruskal-Wallis test was used to analyze the amount of extruded debris between groups with the same WL, and the Mann-Whitney U test was used for comparison within groups for each WL. Results: All groups had extruded debris, with higher median values occurring at 1 mm. No significant difference regarding the amount of debris extrusion was observed at 0 mm (p>0.05) and 1 mm (p>0.05) between groups. However, within the groups, at different WL, there was greater extrusion at 1 mm (p<0.05), with PDR differing significantly from the other systems (p<0.05). Conclusion: The extrusion of debris occurred regardless of the group, with higher values at 1 mm. However, using PDR at 1 mm from the apical foramen showed the highest values of extrusion


Subject(s)
Root Canal Preparation , Tooth Apex , Dental Pulp Cavity
10.
Rev. Asoc. Odontol. Argent ; 109(2): 81-85, ago. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1348364

ABSTRACT

Objetivo: Comparar el tiempo empleado por los instrumen- tos TruNatomy Medium y ProTaper Next X3 para penetrar hasta la longitud de trabajo la masa de obturaciones realizadas con Gut- taCore Primary y sellador en conductos curvos simulados. Materiales y métodos: Se prepararon 20 conductos curvos simulados con instrumentos rotatorios WaveOne Gold Primary y se obturaron con GuttaCore Primary y AH Plus. Las muestras fueron divididas en dos grupos de 10 cada uno. Grupo 1: El material de obturación fue penetrado hasta la lon- gitud de trabajo con instrumentos TruNatomy Medium. Gru- po 2: El material de obturación fue penetrado hasta la longitud de trabajo con instrumentos ProTaper Next X3. Se registraron los tiempos de penetración requeridos para cada grupo y los valores obtenidos fueron analizados mediante la prueba t de Student. Resultados: Los instrumentos ProTaper Next X3 pe- netraron la masa del material de obturación más rápidamente que los instrumentos TruNatomy MediumTM. Las diferencias observadas entre ambos instrumentos fueron estadísticamente significativas (P <0.01). Conclusión: Si bien los instrumentos ProTaper Next X3 y TruNatomy MediumTM penetraron la masa de Gutta- Core Primary de manera eficiente, ProTaper Next X3 penetró hasta la longitud de trabajo más rápidamente (AU)


Aim: Compare the time required by the instruments TruNatomy Medium and ProTaper Next X3 to penetrate up to the working length the mass of fillings made with GuttaCore Primary and sealant in simulated curved canals. Materials and methods: The simulated canals of 20 EndoTraining Blocks were prepared with WaveOne Gold Pri- mary and obturated with GuttaCore Primary and AH Plus. The sample was divided into two groups of 10 each. Group 1: The sealing material was penetrated up to working length with TruNatomy Medium. Group 2: The sealing material was penetrated up to working length with ProTaper Next X3. The penetration time was recorded in each group and the obtained values were statistically analyzed with the Student's t test. Results: ProTaper Next X3 instruments penetrated the sealing material mass faster than TruNatomy Medium. Statis- tically significant differences were observed between the two instruments (P <0.01). Conclusion: While the ProTaper Next X3 and TruNat- omy Medium penetrated the GuttaCore mass to the working length efficiently, the ProTaper Next X3 did it in less time (AU)


Subject(s)
Root Canal Filling Materials , Root Canal Preparation/instrumentation , Retreatment , Gutta-Percha , Time Factors , Dental High-Speed Equipment , Dental Instruments , Dental Pulp Cavity/anatomy & histology
11.
Braz. dent. j ; 32(3): 1-9, May-June 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1345506

ABSTRACT

Abstract Decontamination of the root canal (RC) system is essential for successful endodontic therapy. In this in vitro study, it was evaluated the disinfection potential of an electrofulguration device, the Endox® Endodontic System (EES), in RC infected with Enterococcus faecalis. Sixty-five human lower premolars were instrumented with MTwo® system. The specimens were distributed into six experimental groups (n = 10), according to the irrigation protocol: 2% chlorhexidine gel (CHX); CHX + EES; 5.25% sodium hypochlorite (NaOCl); NaOCl + EES; saline solution (SS); and SS + EES. Five specimens were untreated (control). RC samples were collected before (C1) and after EES treatment (C2), after chemo-mechanical preparation (CMP) (C3), and after final EES treatment (C4). All samples were plated for colony forming units (CFU/mL) onto solid media. The data were analyzed by Wilcoxon and Friedman tests for intragroup comparisons and by Kruskal Wallis test followed by Dunn's test for intergroup comparisons (α = 0.05). Treatment with the EES did not significantly reduce the number of CFU/mL as compared to baseline levels (C1 vs. C2, p> 0.05). After CMP (C3), all groups showed a significantly reduced amount of CFU/mL (p <0.05), with no difference between CHX- and NaOCl-treated samples (p >0.05). Lastly, treatment with the EES following CMP (C4) did not significantly reduce the amount of CFU/mL (C3 vs. C4, p> 0.05). To conclude, the use of the Endox® Endodontic System did not result in considerable bacterial reduction at all operative times, while treatment with NaOCl and CHX was equally efficient for this purpose.


Resumo A descontaminação do sistema do canal radicular (CR) é essencial para o sucesso da terapia endodôntica. Neste estudo in vitro, foi avaliado o potencial de desinfecção de um dispositivo de eletrofulguração, o Endox® Endodontic System (EES), em CR infectado com Enterococcus faecalis. Sessenta e cinco pré-molares inferiores humanos foram instrumentados com o sistema MTwo®. As amostras foram distribuídas em seis grupos experimentais (n = 10), de acordo com o protocolo de irrigação: clorexidina gel a 2% (CHX); CHX + EES; Hipoclorito de sódio 5,25% (NaOCl); NaOCl + EES; solução salina (SS); e SS + EES. Cinco amostras não foram tratadas (controle). As amostras de CR foram coletadas antes (C1) e após o tratamento com EES (C2), após preparo químico-mecânico (PQM) (C3) e após o tratamento final com EES (C4). Todas as amostras foram plaqueadas para unidades formadoras de colônias (CFU / mL) em meio sólido. Os dados foram analisados pelos testes de Wilcoxon e Friedman para comparações intragrupos e pelo teste de Kruskal Wallis, seguidos pelo teste de Dunn para comparações intergrupos (α = 0,05). O tratamento com o EES não reduziu significativamente o número de CFU / mL em comparação com os níveis basais (C1 vs. C2, p> 0,05). Após PQM (C3), todos os grupos apresentaram uma quantidade significativamente reduzida de CFU / mL (p <0,05), sem diferença entre as amostras tratadas com CHX e NaOCl (p> 0,05). Por fim, o tratamento com o EES após PQM (C4) não reduziu significativamente a quantidade de CFU / mL (C3 vs. C4, p> 0,05). Concluindo, o uso do Endox® Endodontic System não resultou em redução bacteriana considerável em todos os momentos operatórios, enquanto os tratamentos com NaOCl e CHX foram igualmente eficientes para esse fim.


Subject(s)
Humans , Root Canal Irrigants , Dental Pulp Cavity , Sodium Hypochlorite , Chlorhexidine , Enterococcus faecalis , Root Canal Preparation
12.
Odontol. Clín.-Cient ; 20(3): 79-82, jul.-set. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1372467

ABSTRACT

A periodontite apical assintomática consiste na inflamação e na destruição do periodonto apical em decorrência de uma infecção no sistema de canais radiculares, após a necrose do tecido pulpar. O tratamento proposto para manutenção dos dentes que apresentam essa patologia é o tratamento endodôntico que pode ser realizado em sessão única ou múltiplas sessões. O objetivo desse estudo é relatar um caso clínico de regressão de uma periodontite apical assintomática, no dente 37, realizada em sessão única, com acompanhamento clínico e radiográfico de 60 e 90 dias. O preparo químico- -mecânico foi realizado com o sistema Reciproc blue (25.08 e 40.06) e uso do hipoclorito de sódio a 2,5%, como substância química auxiliar. O acompanhamento clínico e radiográfico foi realizado 60 e 90 dias após o procedimento, no qual, foi possível verificar a ausência de sintomatologia dolorosa, edema ou fístula na região da mucosa. A imagem radiolúcida, na região periapical, apresentou uma redução progressiva, sugerindo a evolução do reparo tecidual. Dessa forma, dentes com periodontite apical assintomática, após uma efetiva limpeza química e mecânica, realizados em sessão única, apresentam redução nos sinais clínicos e radiográficos, podendo obter um reparo tecidual... (AU)


Asymptomatic apical periodontitis consists of inflammation and destruction of the apical periodontium due to an infection in the root canal system, after pulp tissue necrosis. The proposed treatment for the maintenance of teeth that present this pathology is endodontic treatment that can be performed in a single session or multiple sessions. The objective of this study is to report a clinical case of regression of an asymptomatic apical periodontitis, in tooth 37, performed in a single session, with clinical and radiographic follow-up for 60 and 90 days. The chemical-mechanical preparation was carried out with the Reciproc blue system (25.08 and 40.06) and the use of 2.5% sodium hypochlorite as an auxiliary chemical. Clinical and radiographic follow-up was performed 60 and 90 days after the procedure, in which it was possible to verify the absence of painful symptoms, edema or fistula in the mucosa region. The radiolucent image in the periapical region showed a progressive dimensional reduction, suggesting the evolution of tissue repair. Thus, teeth with asymptomatic apical periodontitis, after an effective chemical and mechanical cleaning, performed in a single session, present a reduction in clinical and radiographic signs, which can lead to tissue repair... (AU)


Subject(s)
Humans , Female , Adult , Periapical Periodontitis , Periapical Tissue , Root Canal Preparation , Dental Pulp Cavity , Endodontics , Mucous Membrane
13.
Rev. Odontol. Araçatuba (Impr.) ; 42(1): 9-13, jan.-abr. 2021. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1148159

ABSTRACT

O objetivo do presente estudo foi mensurar o pH externo radicular de dentes bovinos que foram desinfetados em solução de cloramina por 7 dias. Neste estudo foram utilizadas soluções irrigadoras, hipoclorito de sódio 1%, clorexidina 0,12% e hipoclorito de sódio 2,5% associadas ao edta e as medicações intracanais, hidróxido de cálcio, hidróxido de cálcio com PMCC e clorexidina gel 2%. O preparo químico mecânico foi realizado com as limas easy logic e as soluções foram agitadas com ultrassom durante 3 minutos e após os dentes foram imersos em água deionizada em eppendorfs estéreis e mantidos em estufa a 37°C. O pH externo foi analisado utilizando as fitas medidoras de pH no período de 24 horas, 48 horas, 7 dias, 10 dias e 15 dias. A normalidade dos valores obtidos de cada ensaio foi testada através do teste Kolmogorof- Smirnov, e o teste estatístico foi ANOVA de uma via e comparações múltiplas de Tukey. Os resultados mostraram que houve diferença estatística nos valores de pH nos grupos avaliados dentro dos tempos (p< 0,05). Concluiu-se que mesmo com as variações de pH nos períodos avaliados, as medicações e as soluções irrigantes podem ser utilizadas de forma associadas na endodontia, com o intuito de eliminar o maior número de microrganismos dos canais radiculares(AU)


The objective of the present study was to measure the external root pH of bovine teeth that were disinfected in chloramine solution for 7 days. Irrigating solutions, 1% sodium hypochlorite, 0.12% chlorhexidine and 2.5% sodium hypochlorite associated with edta and intracanal medications, calcium hydroxide, calcium hydroxide with PMCC and chlorhexidine gel 2%. The mechanical chemical preparation was performed with the easy logic files and the solutions were shaken with ultrasound for 3 minutes and after the teeth were immersed in deionized water in eppendorfs and kept in an oven at 37 ° C. The external pH was analyzed using the pH measuring tapes in the period of 24 hours, 48 hours, 7 days, 10 days and 15 days. The normal values obtained from each test were tested using the Kolmogorof-Smirnov test, and the statistical test was one-way ANOVA and Tukey's multiple comparisons. The results showed that there was a statistical difference in pH values in the groups evaluated within the times (p< 0.05). It was concluded that even with pH variations in the evaluated periods, medications and irrigating solutions can be used in an associated way in endodontics, in order to eliminate the largest number of microorganisms in the root canals(AU)


Subject(s)
Root Canal Irrigants , Root Canal Preparation , Sodium Hypochlorite , Calcium Hydroxide , Chloramines , Chlorhexidine , Analysis of Variance , Edetic Acid , Endodontics
14.
J. oral res. (Impresa) ; 10(1): 1-7, feb. 24, 2021. ilus, graf, tab
Article in English | LILACS | ID: biblio-1282565

ABSTRACT

Objective: The aim of this study was to assess the micro-push-out bond strength of a mineral-based root canal sealer, BioRoot RCS in canals prepared by K3XF rotary systems of two different tapers. Material and Methods: Eighty caries free maxillary central incisors were used in this study. The samples were allocated into 4 groups (n=20) according to the root canal sealer and taper of the rotary instruments. The samples were obturated using single cone obturation technique. From each root 1mm thick slices at coronal, middle and apical thirds were collected using hard tissue microtome under continuous water coolant. Push-out tests were done for these sections using a Universal testing machine (INSTRON 8801) at a crosshead speed of 1mm/min. One-way analysis of variance (ANOVA) was used to compare the bond strengths within groups and Tukey's multiple post hoc analysis was used for pair-wise comparison of bond strengths. Results: AH Plus exhibited higher micro-push-out bond strength than BioRootRCS though they did not differ significantly (p>0.05). Preparation of root canals with 6% taper rotary instruments showed higher bond strength than 4% though they did not differ significantly (p>0.05). Conclusion: There was no significant difference between micro-push-out bond strength values of BioRoot RCS and AH Plus. The bond strength values were high in 6% taper canals than 4% canals though the difference was not significant statistically.


Objetivo: El objetivo de este estudio fue evaluar la fuerza de unión por micro-expulsión de un sellador de conductos radiculares de base mineral, BioRoot RCS, en conductos preparados por sistemas rotativos K3XF con dos conos diferentes. Material y Métodos: En este estudio se utilizaron 80 incisivos centrales superiores libres de caries. Las muestras se distribuyeron en cuatro grupos (n = 20) de acuerdo al sellador del conducto radicular y al cono de los instrumentos rotativos. Las muestras se obturaron mediante la técnica de obturación de un solo cono. De cada raíz se recogieron rodajas de 1 mm de grosor en los tercios coronal, medio y apical utilizando un micrótomo de tejido duro con refrigeración continua por agua. Posteriormente, se realizó una prueba de expulsión para estas secciones utilizando una máquina de prueba universal (INSTRON 8801) a una velocidad del cabezal transversal de 1mm/min. Se utilizó el análisis de varianza unidireccional (ANOVA) para comparar las resistencias de la unión dentro de los grupos y el análisis post hoc multiple de Tukey se utilizó para la comparación por pares de las resistencias de la unión. Resultados: AH Plus exhibió una fuerza de unión de micro-expulsión más alta que BioRootRCS, aunque no difirieron significativamente (p>0,05). La preparación de los conductos radiculares con instrumentos rotativos ahusados al 6% mostró una fuerza de unión superior al 4%, aunque no difirieron significativamente (p>0,05). Conclusión: No hubo diferencias significativas entre los valores de fuerza de unión de micro-expulsión de BioRoot RCS y AH Plus. Los valores de la fuerza de unión fueron más altos en canales cónicos al 6% que en canales al 4%, aunque la diferencia no fue significativa estadísticamente.


Subject(s)
Humans , Root Canal Filling Materials , Root Canal Obturation/methods , Dentin-Bonding Agents , Flexural Strength , Resins, Synthetic , Analysis of Variance , Root Canal Preparation , Dental Pulp Cavity , Epoxy Resins/chemistry , Minerals
15.
Braz. dent. j ; 32(1): 104-110, Jan.-Feb. 2021. graf
Article in English | LILACS, BBO | ID: biblio-1180730

ABSTRACT

Abstract These case reports aimed to describe the management of lateral perforation in the middle cervical third of the root in two maxillary incisors with pulp canal calcification using Bio-C Repair, with safe and viable clinical treatment strategies. Digital radiographic exams were obtained with different angles and analyzed using different filters. Cone-beam computed tomography (CBCT) images were requested to show the actual position of the canal, location of the perforation, and guide the strategic planning of the case. Subsequently, cavity access was prepared with the aid of dental operating microscopy. After perforation was identified, granulation tissue was removed and the original canal was identified and then dressed with calcium hydroxide. In the second visit, the perforation was filled with Bio-C Repair and the canal system filled with gutta-percha points and a root canal sealer (Bio-C Sealer). The teeth were restored with glass fiber post, 4 mm beyond the perforation level, and provisory crowns. Both teeth treated as described above were functional and asymptomatic with a 1-year clinical and radiographic assessment. The Bio-C Repair is suggested as a new cement option for the management of lateral canal perforations, with effective results as observed after a one-year follow-up.


Resumo O presente relato de caso teve como objetivo descrever o manejo da perfuração lateral no terço médio cervical da raiz em dois incisivos superiores com calcificação pulpar utilizando o Bio-C Repair, com estratégias de tratamento clínico seguras e viáveis. Radiografias digitais foram obtidas em diferentes ângulos e analisadas com diferentes filtros. Imagens de tomografia computadorizada de feixe cônico (TCFC) foram solicitadas para mostrar a real posição do canal e a localização da perfuração, e orientar o planejamento estratégico do caso. Posteriormente, o acesso à cavidade foi preparado com auxílio de microscopia cirúrgica. Após a identificação da perfuração, o tecido de granulação foi removido, o canal original foi identificado e, em seguida, recebeu medicação intracanal à base de hidróxido de cálcio. Na segunda visita, a perfuração foi selada com Bio-C Repair e o sistema de canais obturado com cones de guta-percha e cimento endodôntico (Bio-C Sealer). Os dentes foram restaurados com pino de fibra de vidro, 4 mm além do nível da perfuração, e coroas provisórias. Ambos os dentes tratados conforme descrito acima se mostraram funcionais e assintomáticos na avaliação clínica e radiográfica de 1 ano. O Bio-C Repair é sugerido como uma nova opção de cimento endodôntico para o manejo de perfurações laterais, com resultados efetivos observados após um ano de acompanhamento.


Subject(s)
Humans , Root Canal Filling Materials , Root Canal Preparation , Root Canal Obturation , Calcium Hydroxide , Dental Pulp Cavity , Gutta-Percha
16.
Braz. oral res. (Online) ; 35: e003, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132743

ABSTRACT

Abstract: The present study investigated the intracanal decontamination and apical extrusion of bacteria and debris from root canals instrumented with rotary and reciprocating systems (ProDesign Logic or ProDesign R), with different file diameters and using conventional syringe irrigation (CSI) or passive ultrasonic irrigation (PUI). Eighty extracted mandibular premolars were contaminated with Enterococcus faecalis and randomly assigned to eight experimental groups according to the root canal instrumentation and irrigation technique employed (n = 10): G1: Prodesign Logic 25.06; G2: Prodesign R 25.06; G3 and G4 were instrumented with the same single-file systems, respectively, using 35.05 diameters and CSI. G5, G6, G7, and G8 were instrumented like the previous groups, but with PUI. Apically extruded debris during instrumentation was collected into pre-weighed microtubes. The weight of the empty microtube was subtracted from the final weight to establish the amount of extruded debris. Bacteria from root canals and extruded debris were collected for a microbiological evaluation of colony forming units (CFU/mL). For statistical analyses, the Mann-Whitney and Kruskal-Wallis followed by the Dunn's tests were used (α = 0.05). All instruments caused extrusion of debris. For irrigation techniques, PUI promoted greater debris and bacterial extrusion (p < 0.05). The CFU/mL count indicated that the instrumentation of the experimental groups were equally effective in the decontamination of the root canal (p > 0.05). The systems tested (regarding file diameter and kinematics) were associated with similar amounts of apically extruded debris and root canal decontamination. PUI was associated with greater debris and bacterial extrusion.


Subject(s)
Humans , Root Canal Preparation , Tooth Apex , Ultrasonics , Biomechanical Phenomena , Decontamination , Dental Pulp Cavity
17.
Braz. oral res. (Online) ; 35: e008, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132748

ABSTRACT

Abstract: The aim of this study was to assess the influence of micro-computed tomography (micro-CT) voxel size on the evaluation of debris accumulation after passive ultrasonic irrigation (PUI) in curved root canals prepared with rotary nickel-titanium files. Mesial root canals (n = 24) of mandibular molars with curvature between 25° and 35° were prepared using ProDesign Logic 30/.05 (PDL) or HyFlex EDM 25/.08 (HEDM). PUI was performed after root canal preparation of all root canals. The specimens were scanned using high-resolution (5 μm voxel size) micro-CT imaging before and after experimental procedures. The percentage of debris was analyzed in the middle and apical thirds using images with 5, 10 and 20 μm voxel sizes. Data were compared using unpaired and paired Student's t-test, ANOVA and Tukey's statistical tests (α = 0.05). There were no differences among the debris analyses performed at different voxel sizes (5, 10 and 20 μm) (p > 0.05). The percentage of debris was similar between the root canals prepared by PDL and HEDM before and after PUI (p > 0.05). In both groups, the percentage of debris decreased in the middle third after PUI (p < 0.05). Within the limitations of this ex vivo study, it can be concluded that the voxel sizes evaluated did not have a significant impact on the analysis of accumulated debris. However, the results showed a tendency for detection of more debris in the analysis performed using a lower voxel size. PUI decreased the debris accumulation in the middle third of curved root canals.


Subject(s)
Humans , Root Canal Preparation , Dental Pulp Cavity/diagnostic imaging , X-Ray Microtomography , Molar/diagnostic imaging
18.
Braz. oral res. (Online) ; 35: e080, 2021. graf
Article in English | LILACS, BBO | ID: biblio-1278598

ABSTRACT

Abstract: This research evaluated, in vivo, the accuracy of three electronic apex locators - EALs (Root ZXII, E-PEX and FIND) in teeth with vital pulp submitted to biopulpectomy, preserving the periodontal stump. For this study, 90 single-rooted teeth with extraction indication were selected. After positive pulpal cold sensitivity test, pulp chamber access was performed. The cervical and middle thirds of root canals were instrumented with Reciproc R25, and the K#15 file was used as a standard instrument to determine working length, forming 2 groups: Constriction (insertion of the instrument until the apical constriction limit) and Foramen (insertion of the instrument until the foramen and then repositioning at constriction, without removing the file from the canal). The hand file was stabilized with a light-cured flow resin. After extraction, the samples were analyzed through microCT SkyScan 1272, with CTAN software, which evaluated the proximity between the tip of the file to the apical constriction, providing data for comparative analysis using Kruskal-Wallis and Dunn tests (p<0.05). There was a statistically significant difference in the abilities of the EALs to detect the apical constriction after reaching the foramen with Root ZX II showing higher accuracy (89%). However, there was no difference in the accuracy of the three EALs in detecting the apical constriction without reaching the foramen. Based on the present results, we conclude that EALs may show accurate measures in detecting apical constriction and foramen, even without damaging the periodontal stump in biopulpectomy.


Subject(s)
Tooth Apex/diagnostic imaging , Dental Pulp Cavity , Tooth Root , Root Canal Preparation , X-Ray Microtomography , Odontometry
19.
Braz. oral res. (Online) ; 35: e064, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1249380

ABSTRACT

Abstract: Sixty moderately curved canals of mandibular molars classified as Vertucci's type IV canal configuration were selected by micro-CT 1174. The teeth were divided into two groups according to the kinematics used, whether reciprocating or rotary motion (n=30, totaling 60 mesial root canals). The instruments used to perform the glide path procedures had identical features (0.15 mm of tip size, 0.04 mm/mm taper, thermal treatment, and square cross-section), but differed in the direction of the cutting blade. The duration of the procedure and the absolute and percentage frequency of the instruments to reach the full working length were recorded. The torsional test (3630-1; 1992) was performed on both used and unused instruments, to evaluate a possible reduction in the torsional resistance when using the glide path procedure. Statistical analysis was performed using the unpaired t-test and the chi-square test, and the level of significance was set at 5%. The type of kinematics used affected the duration of glide path procedures, and the reciprocating motion seemed to induce less torsional stress during glide path procedures.


Subject(s)
Root Canal Preparation , Dental Pulp Cavity , Biomechanical Phenomena , Equipment Design , X-Ray Microtomography , Molar/diagnostic imaging
20.
Braz. oral res. (Online) ; 35: e021, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1153624

ABSTRACT

Abstrac The aim of the present study was to evaluate the cyclic fatigue, torsional resistance and surface roughness of Reciproc R25 instruments in four different situations, namely as new instruments and as instruments tested after clinical preparation of one, two or three maxillary molars with four root canals. The total time required to perform each root canal preparation was recorded. Cyclic fatigue resistance was determined by the time to fracture using a customized testing device (n = 10 per group). The torsional test evaluated the torque and angle of rotation to failure according to ISO 3630-1 (n = 10 per group). The roughness of the working parts of new and used instruments was evaluated with a profilometer (n = 5 per group). Statistical analysis was performed using one-way ANOVA and Tukey's test. The level of significance was set at 5%. No fractures or deformations were observed after clinical use. Higher preparation time was needed during the third use of the instruments for all root canals (p < 0.05). There were no significant differences among the groups in regard to either cyclic fatigue or torsional resistance (p > 0.05). Regarding the roughness measurements, groove depth was higher on new and one- versus two- or three-maxillary-molar-prepared instruments (p < 0.05). It can be concluded that the clinical use of Reciproc instruments increased preparation time and decreased surface roughness. However, clinical use did not affect the cyclic fatigue or torsional resistance of the Reciproc instruments.


Subject(s)
Titanium , Root Canal Preparation , Stress, Mechanical , Materials Testing , Torque , Dental Instruments , Equipment Design
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