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1.
Rev. cuba. estomatol ; 57(4): e3076, Oct.-Dec. 2020. tab
Article in Portuguese | LILACS, CUMED | ID: biblio-1144450

ABSTRACT

Resumo Introdução: Os pinos de fibra de vidro têm sido amplamente utilizados na reconstrução de elementos com perda excessiva de estrutura dentária. Objetivo: Avaliar a força de adesão de pinos de fibra de vidro após diferentes tratamentos radiculares em diferentes regiões (terço cervical, médio e apical) da dentina radicular. Métodos: Este é um estudo experimental in vitro. Quarenta dentes bovinos foram selecionados, preparados e distribuídos em quatro grupos de acordo com o tratamento de superfície utilizado: adesivo (1), agente quelante (2), ácido poliacrílico (3), não tratado (4). A cimentação dos pinos de fibra de vidro foi realizada com cimento resinosante autocondicionante. Após vinte dias, cada raiz foi cortada em três fatias (um milímetro de espessura) obtidas de três regiões. A resistência de união de cada seção foi determinada usando um teste de resistência da junta de encaixe. Os dados de resistência à flexão (MPa) foram analisados pelos testes ANOVA e Tukey (α = 0,05). Resultados: Na porção cervical, o grupo com tratamento prévio com ácido poliacrílico apresentou menor resistência ao cisalhamento por extrusão (push-out) do que o grupo sem tratamento prévio. O grupo com aplicação do sistema adesivo (28,89 ± 6,64 MPa) e o grupo com tratamento prévio com EDTA (21,58 ± 6,39 MPa) não apresentaram diferenças estatisticamente significantes em relação ao grupo sem tratamento prévio (grupo controle) no terço cervical. Nas porções média e apical, o grupo tratado com adesivo FGM Ambar apresentou maiores valores de ligação em comparação com os outros grupos. Conclusão: A aplicação prévia do adesivo aumentou a resistência de união nos terços médio e apical, em comparação aos outros grupos, podendo ter um efeito benéfico no sucesso clínico do tratamento restaurador(AU)


Resumen Introducción: Los postes de fibra de vidrio se han utilizado ampliamente en la reconstrucción de elementos con pérdida excesiva de estructura dental. Objetivo: Evaluar la fuerza de adhesión de postes de fibra de vidrio después de distintos tratamientos de raíz en diferentes regiones (tercios cervical, medio y apical) de dentina de raíz. Métodos: Estudio experimental in vitro. Se seleccionaron cuarenta dientes bovinos, se prepararon y se distribuyeron en cuatro grupos de acuerdo con el tratamiento de superficie utilizado: (1) adhesivo, (2) agente quelante, (3) ácido poliacrílico, (4) sin tratar. La cementación de los postes de fibra de vidrio se realizó con cemento de resina autograbante. Después de 20 días, cada raíz se seccionó transversalmente en tres rodajas (1 mm de espesor) obtenidas de tres regiones. La resistencia a la unión de cada sección se determinó usando una prueba de resistencia al corte por extrusión (push-out). Los datos de resistencia a la flexión (MPa) se analizaron mediante pruebas ANOVA y Tukey (α = 0,05). Resultados: En la porción cervical, el grupo con tratamiento previo de ácido poliacrílico mostró menor resistencia que el grupo sin tratamiento previo. El grupo con aplicación del sistema adhesivo (28,89 ± 6,64 MPa) y el grupo con tratamiento previo de EDTA (21,58 ± 6,39 MPa) no presentaron diferencias estadísticamente significativas en comparación con el grupo sin tratamiento previo (grupo control) en el tercio cervical. En las porciones media y apical, el grupo tratado con adhesivo Ambar® de FGM Dental Group mostró valores más altos de unión en comparación con los otros grupos. Conclusión: La aplicación previa del adhesivo aumentó la fuerza de unión en los tercios medio y apical, en comparación con los otros grupos, puede tener un efecto beneficioso sobre el éxito clínico del tratamiento restaurador(AU)


ABSTRACT Introduction: Glass fiber posts have been widely used for the reconstruction of elements with excessive dental structure loss. Objective: Evaluate the bond strength of glass fiber posts after various root dentin treatments in different regions (cervical, middle and apical thirds). Methods: An experimental in vitro study was conducted. Forty bovine teeth were selected, prepared and distributed into four groups according to the surface treatment used: (1) adhesive, (2) chelating agent, (3) polyacrylic acid, (4) not treated. The glass fiber posts were cemented with self-etch resin cement. After 20 days, each root was sectioned crosswise into three slices (1 mm in thickness) obtained from three regions. Bond strength was determined in each section with a push-out bond strength test. Flexural strength data (MPa) were analyzed with ANOVA and Tukey's tests. Results: In the cervical portion, the group with previous polyacrylic acid treatment displayed lower push-out strength than the group without previous treatment. The group with application of the adhesive system (28.89 ± 6.64 MPa) and the group with previous EDTA treatment (21.58 ± 6.39 MPa) did not exhibit any statistically significant differences in comparison with the group without previous treatment (control group) in the cervical third. In the middle and apical portions, the group treated with the adhesive Ambar® of FGM Dental Group showed higher bond values in comparison with the other groups. Conclusion: Previous adhesive application increased bond strength in the middle and apical thirds in comparison with the other groups, and may thus have a beneficial effect on the clinical success of the restorative treatment(AU)


Subject(s)
Humans , Root Resorption/therapy , Root Canal Preparation/methods
2.
Int. j. odontostomatol. (Print) ; 14(1): 109-116, mar. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1056509

ABSTRACT

RESUMEN: Paredes sin instrumentar y con material obturador endodóntico residual pueden elevar la posibilidad de la falla adhesiva de postes de fibroresina. Las fresas de desobturación y conformación del espacio protésico poseen una sección circular, lo que dificulta una adecuada preparación y limpieza de las paredes de los conductos ovales. El objetivo del presente estudio fue evaluar la capacidad de limpieza ultrasónica del espacio protésico y cómo ésta influyó en la resistencia a la tracción de postes de fibroresina en conductos ovales. Se utilizaron 30 premolares con conducto ovalado divididos aleatoriamente en 3 grupos de estudio (n=10), siendo: grupo A: preparación rotatoria con complemento ultrasónico, grupo B: preparación rotatoria y grupo C: grupo control. Postes de fibra de vidrio fueron cementados y luego de 7 días se realizaron cortes de un milímetro de grosor del tercio cervical y medio de cada muestra y se evaluó microscópicamente el área de gutapercha remanente y área efectiva de adhesión. Estos fueron sometidos a una prueba de push out evaluando la resistencia adhesiva de los postes. Finalmente fueron observados microscópicamente para analizar tipo de falla. Los resultados se analizaron mediante el test de ANOVA, Bonferroni, Kruskal-Wallis y Mann Whitney (p < 0.05), registrando diferencias estadísticamente significativas en la resistencia a tracción, área de gutapercha remanente y área disponible para la adhesión; además de una relación directa entre gutapercha remanente y menor resistencia a la tracción. Conclusiones: La preparación ultrasónica del espacio protésico aumenta la resistencia a la tracción de postes de fibroresinas cementados en conductos ovalados.


ABSTRACT: Untouched canal walls with residual filling materials can increase the probability of adhesive failure of fiber posts. The drills used for desobturation and conformation of the prosthetic space, has a circular cross section, which does not allow a proper preparation and cleaning of oval-shaped canal walls. The objective of the study was to evaluate the ultrasonic cleaning of the prosthetic space and how this influences the adhesive strength of fiber posts in oval-shaped canals. Thirty (30) oval-shaped canal premolars were randomly divided into 3 groups (n = 10): Group A: rotary desobturation with ultrasonic complement, group B: rotary desobturation without ultrasonic complement and group C: control group. Fiberglass posts were cemented; after 7 days, one-millimeter slices were performed, one of the cervical and another from the middle third of the root. The slices were analyzed under an optical microscope to evaluate remaining gutta percha and effective adhesion area. Samples were subjected to a push-out test to evaluate bond strength of the fiber resin posts. Finally, samples were evaluated microscopically to analyze the type of failure. The results were analyzed using ANOVA, Bonferroni, KruskalWallis and Mann Whitney test (p < 0.05), recording statistically significant differences in bond strength, remaining gutta-percha area and clean walls for adhesion; In addition, to a direct relationship between remaining gutta percha and lower adhesive strength, the ultrasonic preparation of the prosthetic space increases bond strength of fiber posts in oval canals.


Subject(s)
Humans , Osteotomy/methods , Ultrasonics , Post and Core Technique , Dental Bonding , Root Canal Preparation/instrumentation , Specimen Handling , In Vitro Techniques , Intervention Studies , Analysis of Variance , Dentin-Bonding Agents , Root Canal Preparation/methods
3.
Braz. arch. biol. technol ; 63: e20180500, 2020. tab, graf
Article in English | LILACS | ID: biblio-1132200

ABSTRACT

Abstract The aim of this study was to assess the performance and surface alteration of two single-file systems according to the number of uses. Ten WaveOne Primary files (25/.08) and ten One Shape NG files (25/.06) were used for instrumentation of mesial root canals of mandibular molars. Each instrument was cleaned and sterilized after the preparation of two root canals and then reused. The time spent for instrumentation of each root canal was recorded and analyzed by using t-test. Microphotographs of the surface of the instruments were taken with a scanning electron microscope at different magnifications (i.e. 18x, 160x, 500x and 1000x) and at a distance of 4 mm from the instrument's tip before being analyzed by four observers. Presence of disruption of cutting edge, crack, craters and unwinding was assessed and submitted to Fisher's exact test. Both systems showed manufacturing defects and cracks. The presence of disruption of cutting edges was major in WaveOne files from the sixth use, whereas One Shape NG files showed more unwinding. Only preparation time using WaveOne files was influenced by the number of uses. One can conclude that WaveOne files had more disruption of cutting edges and took longer time for root canal preparation from the sixth use onwards, whereas the One Shape NG files showed more unwinding at the tenth use.


Subject(s)
Humans , Root Canal Preparation/methods , Microscopy, Electron, Scanning
4.
Int. j. odontostomatol. (Print) ; 13(4): 493-496, dic. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056490

ABSTRACT

ABSTRACT: The present study evaluated the presence of apical deviation and tapering in preparations performed with the use of the automated handpieces with continuous motion, the K3 Endo system (Group 1) and instrumentation manually with Protaper (Group 2). 30 simulated roots were divided into two groups and prepared according each technique. The alteration caused by root canal preparation was analyzed by radiographs obtained on a radiographic desk fabricated for the study. The results (X2), demonstrated that the K3 Endo produced a smaller incidence of apical deviation and Protaper produced a greater tapering of the root canals.


RESUMEN: El objetivo de este trabajo fue evaluar la presencia de desviación y conicidad adecuada apical con el uso del sistema de instrumentación de movimiento continuo K3 Endo (Grupo 1) respecto a la instrumentación manual realizada con Limas Protaper (Grupo 2). Treinta canales curvos simulados fueron divididos aleatoriamente en dos grupos e instrumentados por los diferentes sistemas. La alteración causada por la preparación de los canales fue analizada en radiografías obtenidas, en placas ad hoc. Los resultados (X2) demostraron que el K3. Endo produjo una menor incidencia de desviación apical y Protaper produjo una mayor conicidad de los canales radiculares.


Subject(s)
Humans , Root Canal Preparation/methods , X-Ray Microtomography/methods , ROC Curve , Root Canal Preparation/instrumentation , Imaging, Three-Dimensional , Dental Instruments
5.
J. oral res. (Impresa) ; 8(4): 325-330, nov. 5, 2019. graf
Article in English | LILACS | ID: biblio-1145355

ABSTRACT

The aim of the study was to quantify and compare apical debris extrusion in two systems of continuous and reciprocating rotary instrumentation with, and without, the use of a patency file. An experimental study was carried out in 120 mesial roots of lower first molars, which were randomized in the following 4 groups: Group A. Reciproc (VDW) R25 without a patency file, Group B Mtwo (VDW) without a patency file, Group C Reciproc (VDW) R25 with a patency file and Group D Mtwo with a patency file. Groups A, B and C presented statistically significant differences in comparison to group D, Mtwo with the use of a patency file (p<0.008 to 95% reliability). In conclusion, the greater amount of debris extruded through the apex occurred in roots instrumented with the reciprocating rotary system; this difference was statistically significant in relation to teeth treated with the Mtwo continuous rotary system with the use of a patency file.


El objetivo del estudio fue cuantificar y comparar la extrusión de residuos apicales en dos sistemas de instrumentación endodónticos rotativos, continuo y recíproco, con y sin el uso de una lima de pasaje apical. Se realizó un estudio experimental en 120 raíces mesiales de primeros molares inferiores, que se aleatorizaron en los siguientes 4 grupos: Grupo A. Reciproc (VDW) R25 sin lima de pasaje apical, Grupo B Mtwo (VDW) sin lima de pasaje apical, Grupo C Reciproc (VDW) R25 con lima de pasaje apical y Grupo D Mtwo con lima de pasaje apical. Los grupos A, B y C presentaron diferencias estadísticamente significativas encomparación con el grupo D, Mtwo con el uso de una lima de pasaje apical (p<0.008 a 95% de confiabilidad). En conclusión, la mayor cantidad de residuos extruidos a través del ápice ocurrió en raíces preparadas con el sistema rotativo recíproco; Esta diferencia fue estadísticamente significativa en relación a los dientes tratados con el sistema rotativo continuo Mtwo con el uso de una lima de pasaje apical.


Subject(s)
Humans , Root Canal Preparation/instrumentation , Root Canal Preparation/methods , Intervention Studies , Tooth Apex , Dental Instruments , Dental Pulp Cavity
6.
Rev. bras. odontol ; 76(1): 1-8, jan. 2019. ilus, tab
Article in English | LILACS | ID: biblio-1121564

ABSTRACT

Objetivo: conhecer as principais práticas adotadas atualmente por cirurgiões dentistas, clínicos gerais e endodontistas na realização do tratamento endodôntico. Material e Métodos: um questionário contendo 21 perguntas de múltipla escolha foi enviado para os profissionais, nas cinco regiões do país. As perguntas abordaram o tempo de experiência, tipos de técnicas, materiais e recursos auxiliares. Resultados: a maior parte dos respondentes são do Sudeste e Sul, endodontistas há menos de 10 anos. Realizam até 20 tratamentos/mês, utilizam localizador apical, instrumentação manual com limas de aço inoxidável associada a brocas gates glidden/largo, lupa e isolamento absoluto. O hipoclorito de sódio (2,5 a 5%) e o EDTA são os irrigantes mais utilizados juntamente com o ultrassom. O tratamento é feito em sessão única, porém o diagnóstico pulpar pode alterar o número de sessões. Quando é necessário o uso de medicação intracanal, o hidróxido de cálcio associado a outras formulações é a primeira escolha. Para obturação do sistema de canais radiculares é utilizada a técnica de condensação lateral e o cimento à base de óxido de zinco e eugenol. O selamento coronário entre sessões é feito com coltosol e com cimento de ionômero de vidro ao término do tratamento, quando os pacientes são encaminhados a outro profissional para restauração final. Atualizam-se através de artigos científicos e mostram abertura para testar novos produtos. Conclusão: a maioria dos participantes aderem a práticas atuais com uso de novas tecnologias durante o tratamento e se atualizam através da leitura de artigos científicos


Objective: to be aware of the main practices currently adopted by general dentists and endodontists when performing endodontic treatments. Material and methods: a questionnaire containing 21 multiple-choice questions was sent to professionals in the five regions of Brazil. These questions covered experience time, techniques, materials and auxiliary resources. Results: most participants are from the Southeast and South regions of Brazil and have been specialized in endodontic for less than 10 years. They perform up to 20 treatments per month, use apex locator, manual instrumentation with stainless steel files associated with gates-glidden or largo burs, magnifying loupes and absolute isolation. Sodium hypochlorite (2.5 to 5.0%) and EDTA are the most used substances for irrigation associated with ultrasound. The treatment is done in a single visit, but pulp diagnosis might alter the number of visits. When intracanal medication is required, calcium hydroxide associated with other formulations is the first choice. For root canal filling, lateral condensation technique, zinc oxide and eugenol based sealers are used. Coronal sealing between sessions is done with Coltosol® and glass ionomer cement at the end of treatment, when patients are referred to another professional for final restoration. These professionals update their knowledge with scientific articles and show availability to test new products. Conclusion: most participants have been adhering to current practices (new technologies) during treatment and has kept updated by reading scientific articles


Subject(s)
Root Canal Irrigants , Root Canal Obturation , Root Canal Preparation/instrumentation , Root Canal Preparation/methods , Dental Restoration, Permanent , Dental Restoration, Temporary
7.
J. appl. oral sci ; 27: e20180420, 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-1012513

ABSTRACT

Abstract Objective: This in vitro study aimed to compare the efficacy of irrigants using various irrigation activation methods to the push-out bond strengths of fiber post to root canal luted with self-adhesive resin cement (SARC). Methodology: Forty-eight decoronated human canines were used. The specimens were divided into four groups corresponding with the post-space irrigation process and were treated as follows: distilled water (DW) (Control) group received 15 mL of DW; sodium hypochlorite (NaOCl)+ethylenediaminetetraacetic acid (EDTA) group was treated with 5 mL of 5.25% NaOCl, 5 mL of 17% EDTA, and 5 mL of DW; passive ultrasonic irrigation (PUI) group was treated with 5 mL of 5.25% NaOCl, 5 mL of 17% EDTA, and 5 mL of DW, and each irrigant was agitated with an ultrasonic file; and laser activated irrigation (LAI) group was treated with 5 mL of 5.25% NaOCl, 5 mL of 17% EDTA, and 5 mL of DW, and each irrigant was irradiated with Nd: YAG laser. Fiber posts were luted with SARC, and a push-out test was performed. Data was analyzed using one-way analysis of variance and Tukey HSD test. Results: The bond strength values for the groups obtained were as follows: Control (10.04 MPa), NaOCl+EDTA (11.07 MPa), PUI (11.85 MPa), and LAI (11.63 MPa). No statistically significant differences were found among all experimental groups (p>0.05). The coronal (12.66 MPa) and middle (11.63 MPa) root regions indicated a significantly higher bond strength compared with the apical (9.16 MPa) region (p<0.05). Conclusions: Irrigant activation methods did not increase the bond strength of fiber post to canal.


Subject(s)
Humans , Root Canal Irrigants/radiation effects , Root Canal Irrigants/chemistry , Ultrasonic Therapy/methods , Post and Core Technique , Lasers, Solid-State , Self-Curing of Dental Resins/methods , Reference Values , Sodium Hypochlorite/radiation effects , Sodium Hypochlorite/chemistry , Surface Properties , Materials Testing , Reproducibility of Results , Analysis of Variance , Edetic Acid/radiation effects , Edetic Acid/chemistry , Root Canal Preparation/methods , Dental Restoration Failure , Dental Pulp Cavity/drug effects , Dental Pulp Cavity/radiation effects , Dentin/drug effects , Dentin/radiation effects
8.
J. appl. oral sci ; 27: e20180045, 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-975882

ABSTRACT

Abstract Objective To evaluate the efficacy of different sonic and ultrasonic devices in the elimination of debris from canal irregularities in artificial root canals. Materials and Methods A resin model of a transparent radicular canal filled with dentin debris was used. Five groups were tested, namely: Group 1 - ultrasonic insert 15.02; Group 2 - ultrasonic insert 25/25 IRRI K; Group 3 - ultrasonic insert 25/25 IRRI S; Group 4 - sonic insert 20/28 Eddy on a vibrating sonic air-scaler handpiece; Group 5 - 20.02 K-file inserted on a Safety M4 handpiece. Two different irrigants (5% sodium hypochlorite and 17% EDTA) and 3 different times of activation (20, 40, and 60 seconds) were tested. Means and standard deviations were calculated and statistically analyzed with the Kruskal-Wallis and Wilcoxon tests (p<0.05). Results No statistically significant differences were found between the two irrigants used. Group 4 removed more debris than the other groups (p<0.05). Groups 1, 2, and 3 removed more debris than group 5 (p<0.05). A statistically significant difference (p<0.05) was found for the time of activation in all groups and at all canal levels, except between 40 and 60 seconds in group 4 at coronal and middle third level (p>0.05). Conclusions No significant differences were found between 5% sodium hypochlorite and 17% EDTA. When the time of activation rises, the dentin debris removal increases in all groups. Both sonic and ultrasonic activation demonstrate high capacity for dentin debris removal.


Subject(s)
Humans , Ultrasonic Therapy/instrumentation , Root Canal Preparation/instrumentation , Dental Instruments/standards , Therapeutic Irrigation/instrumentation , Reference Values , Root Canal Irrigants/chemistry , Sodium Hypochlorite/chemistry , Sonication/instrumentation , Sonication/methods , Surface Properties , Time Factors , Materials Testing , Reproducibility of Results , Edetic Acid/chemistry , Statistics, Nonparametric , Root Canal Preparation/methods , Dentin , Therapeutic Irrigation/methods
9.
Braz. dent. j ; 29(6): 530-535, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-974189

ABSTRACT

Abstract In order to evaluate the volume of dentinal cracks taking into account the age of the dentin and the type of file system used for endodontic procedures, forty freshly extracted single-rooted lower incisive teeth presenting similar root volume, were divided into two groups according to the age of the patient: Group Young (18 - 30 years old) and Group Old (60 years old or more). Each specimen was scanned by microcomputed tomography (micro-CT) in three stages: (i) before any treatment, (ii) after endodontic treatment with Reciproc files (REC), and (iii) after subsequent endodontic retreatment. Each group was subdivided into two subgroups, according to the retreatment technique used: retreatment with REC or with ProTaper Universal Retreatment (PUR) files. For each subgroup, the images were analyzed for differences in the volume of dentinal cracks in the middle and apical thirds of the teeth , according to the dentin age. In both stages (before and after instrumentation), the micro-CT images of the old root dentin presented with higher volume of cracks than those of the young root dentin, statistical significance notwithstanding (p>0.01). The use of REC files appeared to have no statistically significant differences in the generation of cracks in any type of root dentin when compared with PUR files (p>0.01). When retreated with PUR, the old root dentin presented with a significantly higher volume of cracks (p<0.01) when compared with the old root dentin initially.


Resumo Para avaliar o volume de fissuras dentinárias levando em consideração a idade da dentina e o tipo de sistema de limas utilizadas para procedimentos endodônticos, 40 dentes unirradiculares, incisivos inferiores, apresentando similar volume radicular, recentemente extraídos foram divididos em dois grupos de acordo com a idade do paciente: Grupo Jovem (18 a 30 anos) e Grupo Idoso (60 anos ou mais). Cada espécime foi scaneada por microtomografia computadorizada (micro-CT) em três estágios: (i) antes de qualquer tratamento, (ii) após tratamento endodôntico com limas Reciproc (REC) e (iii) após subsequente retratamento endodôntico. Cada grupo foi subdividido em dois subgrupos, de acordo com a técnica de retratamento utilizada: retratamento com REC ou com lima ProTaper Universal Retreatment (PUR). As imagens foram analisadas quanto às diferenças no volume das fissuras dentinárias nos terços médio e apical dos dentes de acordo com a idade da dentina. Em ambos os estágios (antes e depois da instrumentação), as imagens de micro-CT da dentina radicular idosa apresentaram maior volume de trincas do que as jovens, sem significância estatística (p>0.01). O uso das limas REC mostram não ter diferença estatística significante na geração de fissuras, em qualquer tipo de dentina, quando comparadas às limas PUR (p>0.01). Quando retratada com PUR, a dentina radicular idosa apresentou um volume de trincas significativamente maior (p<0.01) quando comparado com a dentina radicular idosa inicialmente.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Tooth Fractures/diagnostic imaging , Root Canal Preparation/methods , Dentin/injuries , Dentin/diagnostic imaging , In Vitro Techniques , Age Factors , Retreatment , X-Ray Microtomography
10.
Int. j. odontostomatol. (Print) ; 12(3): 211-218, Sept. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-975735

ABSTRACT

RESUMEN: La creencia de que el tratamiento de endodoncia es el tratamiento dental más doloroso es algo habitual. A pesar de ello, la percepción intraoperatoria durante el tratamiento de endodoncia ha sido poco estudiada. Por ello, el objetivo de esta investigación fue describir la percepción de dolor y la experiencia intraoperatoria del paciente tratado en endodoncia, durante la etapa de acceso endodóntico. Se analizaron las valoraciones sobre dolor intraoperatorio realizadas por 20 pacientes, tratados en la clínica de especialidad de una universidad tradicional chilena, durante la etapa de acceso endodóntico en molares. Para ello se utilizaron escalas cuantitativas de valoración de la intensidad del dolor y el análisis de contenido cualitativo de una entrevista semi-estructurada. Se observó que los participantes de sexo femenino, los tratamientos en molares mandibulares y en dientes con diagnóstico de pulpitis irreversible sintomática obtuvieron medias mayores en cuanto a la valoración de la intensidad del dolor. Sin embargo, en la mayoría de los casos el dolor fue descrito como leve. En el análisis cualitativo lo descrito por los participantes se agrupó en 10 categorías. Se observó un mayor porcentaje de referencias a la categoría "Ansiedad ante el tratamiento" (16 %) seguido de "Percepción de la atención profesional" (14 %). Sin embargo, también destacaron las referencias al dolor en su totalidad (25 %) ya sea a "Ausencia de dolor" (13 %) o a "Presencia de dolor en algún grado" (12 %). Se concluyó que entre los participantes de esta investigación existió percepción de dolor intraoperatorio durante la etapa de acceso endodóntico, sin embargo, este fue de carácter leve en la mayoría de los casos.


ABSTRACT: There is a common belief that endodontic treatment is the most painful dental treatment of all. Despite this idea, intraoperative perception during endodontic treatment has not been fully studied. Therefore, the aim of this research was to describe the perception of pain and the intraoperative experience of endodontic treated patients, during the endodontic access cavity preparation. We analyzed the valuations on intraoperative pain completed by 20 patients, treated at the endodontic clinic of a traditional Chilean university, during the endodontic access cavity preparation in molars. For this purpose, quantitative scales of pain intensity assessment and qualitative content analysis of a semi-structured interview were employed. Female participants, treatments in mandibular molars and in teeth diagnosed with symptomatic irreversible pulpitis obtained higher means in terms of assessment of pain intensity. However, in most cases the pain was described as mild. In the qualitative analysis the participant's descriptions were grouped into 11 categories. There was a higher percentage of references to the category "Anxiety before treatment" (16 %) followed by "Perception of professional care" (14 %). However, references to pain in its totality (25 %) either to "Absence of pain" (13 %) or to "Presence of pain to some degree" (12 %) also stood out. It was concluded that among the participants of this investigation there was perception of intraoperative pain during the endodontic access stage, however, this was mild in most cases.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Tooth Root/anatomy & histology , Root Canal Preparation/methods , Pain , Chile , Epidemiology, Descriptive , Surveys and Questionnaires , Root Canal Preparation/instrumentation , Dental Instruments , Pain Perception , Informed Consent
11.
Braz. dent. j ; 29(2): 184-188, Mar.-Apr. 2018. graf
Article in English | LILACS | ID: biblio-951535

ABSTRACT

Abstract This study evaluated the amount of apically extruded debris after chemo-mechanical preparation (CMP) using positive and negative pressure irrigation systems [Conventional irrigation (CI) and EndoVac (EV)] in association with different irrigants [6% Sodium Hypochlorite (NaOCl), 2% Chlorhexidine gel + saline solution (CHXg + SS), 2% Chlorhexidine solution (CHXs) or Saline solution (SS)]. Eighty mandibular premolars with single root canals were selected and randomly assigned into 8 groups (n = 10) according to the irrigation system and the irrigant used during CMP: G1 (EV + NaOCl), G2 (EV + CHXg + SS), G3 (EV + CHXs), G4 (EV + SS), G5 (CI + NaOCl), G6 (CI + CHXg + SS), G7 (CI + CHXs) and G8 (CI + SS). Reciproc® R25 files (25/.08) were used during the CMP and the extruded debris from each tooth was collected in pre-weighted Eppendorf tubes and dried. The average weight of debris was assessed using a microbalance, and the data were statistically analyzed using ANOVA and the post hoc Tukey's test (a = 0.05). All groups were associated with debris extrusion. EV was the irrigation system with less extruded debris (p < 0.05). No differences were observed regarding the irrigant when EV was used. When CI was used, CHXg + SS were associated with lower debris extrusion (p < 0.05). It was concluded that no irrigation protocol succeeded in preventing debris extrusion. EV resulted in lower levels of debris extrusion than CI. The use of CHXg + SS resulted in lower debris extrusion.


Resumo Este estudo avaliou a quantidade de debris extruídos apicalmente após o preparo químico-mecânico (PQM) utilizando sistemas de irrigação com pressão positiva e negativa [irrigação convencional (IC) e EndoVac (EV)] em associação com diferentes irrigantes [hipoclorito de sódio 6% (NaOCl), clorexidina gel + solução salina (CLXg + SS), solução de clorexidina 2% (CLXs) ou solução salina (SS)]. Oitenta pré-molares inferiores com único canal radicular foram selecionados e aleatoriamente alocados em 8 grupos (n=10) de acordo com o sistema de irrigação e irrigante utilizado durante o PQM: G1 (EV + NaOCl), G2 (EV + CLXg + SS), G3 (EV + CLXs), G4 (EV + SS), G5 (IC + NaOCl), G6 (IC + CLXg + SS), G7 (IC + CLXs) e G8 (IC + SS). Limas Reciproc® R25 foram utilizadas durante o PQM e os debris extruídos de cada dente foi coletado em tubos pré-pesados e secos. O peso médio de debris foi avaliado por meio de microbalança, e os dados foram analisados estatisticamente utilizando ANOVA e teste de Tukey (a = 0.05). Todos os grupos foram associados com extrusão de debris. EV foi o sistema de irrigação com menos debris extruídos (p<0.05). Não foram observadas diferenças entre os irrigantes quando o EV foi utilizado. Quando foi utilizada IC, CLXg + SS foram associados a menor extrusão de debris (p<0.05). Concluiu-se que nenhum protocolo de irrigação conseguiu prevenir extrusão de debris. EV resultou em menores níveis de extrusão de debris que a IC. A utilização da CLXg + SS resultou em menor extrusão de debris.


Subject(s)
Humans , Root Canal Irrigants/administration & dosage , Sodium Hypochlorite/administration & dosage , Chlorhexidine/administration & dosage , Root Canal Preparation/methods , Saline Solution/administration & dosage , Therapeutic Irrigation/methods , In Vitro Techniques , Random Allocation , Tooth Apex/metabolism
12.
J. oral res. (Impresa) ; 7(1): 24-29, ene. 22, 2018. ilus, graf, tab
Article in English | LILACS | ID: biblio-1119249

ABSTRACT

The aim of this study was to observe the penetration of an aqueous solution into the root canal dentin under sonic activation and ultrasonic activation. Materials and Method: this study consisted of experimental in vitro research. In order to achieve a closed system, the apex of 45 single-rooted teeth was sealed with wax. The step-back technique was manually performed using a K50 apical master file and 3 groups were organized according to the protocol of the final irrigant activation: group I: non-activated chinese ink for 30 seconds, group II: chinese ink sonically activated with EndoActivator for 30 seconds, and group III: chinese ink ultrasonically activated with Varios 350 equipment for 30 seconds. Teeth were sectioned longitudinally, and the samples obtained were observed under a stereomicroscope at 1X magnification in order to be photographed and scanned to calculate the penetration area using the Image J software. The tinted radicular area was evaluated in relation to the total area of the root dentin. The tukey's post-hoc test and ANOVA were used for the statistical analysis (p<0.05). Results: group I and II obtained 9.13 percent and 9.42 percent penetration respectively, while in group III the highest degree of dye infiltration was achieved (13.9 percent), being statistically significant (p<0.001). Conclusions: ultrasonic activation produced a significantly higher penetration of the dye when compared to conventional activation and sonic activation.


Subject(s)
Humans , Root Canal Irrigants/administration & dosage , Root Canal Preparation/methods , Dental Pulp Cavity/microbiology , Sonication , Ultrasonics , Intervention Studies , Root Canal Preparation/instrumentation , Therapeutic Irrigation/instrumentation , Therapeutic Irrigation/methods
13.
J. appl. oral sci ; 26: e20170215, 2018. tab, graf
Article in English | LILACS, BBO | ID: biblio-893700

ABSTRACT

Abstract Objective To evaluate the amount of apically extruded debris, percentage of foraminal enlargement and apical foramen (AF) deformation that occurred during root canal preparation with different reciprocation systems: Reciproc, WaveOne (M-Wire), and ProDesign R (Shape Memory Technology Wire) at two different working lengths (WLs): 0.0 and 1.0 mm beyond the AF. Material and methods The AF of 120 root canals in 60 mesial roots of mandibular molars were photographed with stereomicroscope and randomly assigned into four groups: manual, Reciproc (REC), WaveOne (WO), and ProDesign R (PDR); subsequently, they were further subdivided according to the WL (n=15). Teeth were instrumented, coupled to a dual collecting chamber, and then another photograph of each AF was captured. Extrusion was analysed by determining the weight of extruded debris. Each AF diameter was measured in pre- and post-instrumentation images to determine deformation, which was analysed, and afterwards the final format of AFs was classified (circular/oval/deformed). Results We found no significant differences when analysing each system at different WLs. When considering each WL, REC and WO showed highest extrusion values (P<.05); for AF enlargement, differences were observed only for WO, when it was used beyond the AF; differences were observed among M-Wire groups beyond the AF (P<.05). AF deformation was observed in all groups; PDR showed the lowest AF deformation values at both WLs; M-Wire groups showed 50% strain beyond the AF. Conclusion Authors concluded that beyond the apical limit, the alloy and taper are important aspects when considering extrusion and deformation.


Subject(s)
Humans , Titanium/chemistry , Root Canal Preparation/adverse effects , Root Canal Preparation/instrumentation , Tooth Apex/chemistry , Nickel/chemistry , Reference Values , Random Allocation , Reproducibility of Results , Statistics, Nonparametric , Root Canal Preparation/methods , Tooth Apex/anatomy & histology , Dental Instruments/adverse effects , Equipment Design
14.
Braz. oral res. (Online) ; 32: e13, 2018. tab
Article in English | LILACS | ID: biblio-889468

ABSTRACT

Abstract The aim of this study was to compare in vitro the bond strength (BS) between fiberglass posts and flared root canals reinforced with different materials. The roots of 48 premolars were endodontically treated. After one week, the root canals were prepared to simulate an oversized root canal, except for the positive control group (PCG), which was cemented with a prefabricated fiber post (PFP) compatible with the root canal size, simulating an ideal adaptation. The other samples (n=8/group) were used to test alternative restorative techniques for filling root canals: negative control group (NCG [PFP with a smaller diameter than of the root canal]), composite resin group - CRG, bulkfill group - BFG, self-adhesive cement group - SAG, and glass ionomer group - GIG. The posts were cemented and after 1 week, each root was sectioned transversely into six 1-mm thick discs and the push-out test was done to evaluate the BS. Data were analyzed by two-way repeated measures ANOVA and Tukey's tests (α=0.05). The highest BS value was observed for PCG. The NCG and the GIG groups showed the lowest BS values. Root reinforcement with conventional and bulk-fill composite resins showed the highest BS values; however, the bulk-fill resin was the only treatment able to maintain high BS values in all regions of the root canal. The self-adhesive cement showed intermediate results between CRG and GIG. Root reinforcement with bulk-fill composite resin is an effective option for flared root canals before cementation of a prefabricated fiber post.


Subject(s)
Humans , Dental Bonding/methods , Dental Materials/chemistry , Dental Pulp Cavity/drug effects , Glass/chemistry , Post and Core Technique , Root Canal Preparation/methods , Analysis of Variance , Dental Pulp Cavity/anatomy & histology , Dental Restoration Failure , Materials Testing , Reference Values , Reproducibility of Results , Time Factors
15.
Braz. oral res. (Online) ; 32: e16, 2018. tab, graf
Article in English | LILACS | ID: biblio-889502

ABSTRACT

Abstract The presence of residues within the root canal after post-space preparation can influence the bond strength between resin cement and root dentin when using fiberglass posts (FGPs). Currently, there is no consensus in the literature regarding what is the best solution for the removal of debris after post-space preparation. This systematic review involved "in vitro" studies to investigate if cleaning methods of the root canal after post-space preparation can increase the retention of FGPs evaluated by the push-out test. Searches were carried out in PubMed (MEDLINE) and Scopus databases up to July2017. English language studies published from 2007 to July 2017 were selected. 475 studies were found, and 9 were included in this review. Information from the 9 studies were collected regarding the number of samples, storage method after extraction, root canal preparation, method of post-space preparation, endodontic sealer, resin cement, cleaning methods after post-space and presence of irrigant activation. Five studies presented the best results for the association of sodium hypochlorite (NaOCl) and ethylenediamine tetra-acetic acid (EDTA), while in the other 4 studies, the solutions that showed improved retention of FGPs were photon-induced photoacoustic streaming (PIPS), Qmix, Sikko and EDTA. The results showed heterogeneity in all comparisons due to a high variety of information about cleaning methods, different concentrations, application time, type of adhesive system and resin cements used. In conclusion, this review suggests that the use of NaOCl/EDTA results in the retention of FGPs and may thus be recommended as a post-space cleaning method influencing the luting procedure.


Subject(s)
Humans , Dental Prosthesis Retention/methods , Glass , Post and Core Technique , Root Canal Irrigants/therapeutic use , Root Canal Preparation/methods , Dental Bonding/methods , Dental Pulp Cavity/drug effects , Dentin/drug effects , Edetic Acid/therapeutic use , Reproducibility of Results , Sodium Hypochlorite/therapeutic use , Treatment Outcome
16.
Braz. oral res. (Online) ; 32: e88, 2018. tab, graf
Article in English | LILACS | ID: biblio-952167

ABSTRACT

Abstract The aim of this study was to evaluate the influence of a novel ultrasonic tip as an auxiliary method for removing filling material from flattened/oval-shaped canals. The null hypothesis tested was that this method does not influence removing the filling material in flattened/oval-shaped canals. Forty-five mandibular incisors were selected and randomly divided into three experimental groups (n = 15) according to different protocols for removing root canal filling material. Group R: Reciproc R25/.08, Group RC: Reciproc R25/.08 + Clearsonic tip, and Group CR: Clearsonic tip + Reciproc R25/.08. The teeth were scanned pre and post-operatively by means of a micro-computed tomography system. Data were analyzed using non-parametric Kruskal-Wallis and Dunn tests (p < 0.05). The percentage of residual root canal filling material between the experimental groups was examined. Statistically significant differences between the experimental groups were found in the root canal. Group R had the highest percentage of residual root canal filling material when compared with Groups RC and CR. The lowest percentage of residual root canal filling material was observed in Group CR. In the apical third of the root canal, statistically significant differences were found between the different protocols. The use of the ClearSonic tip followed by the Reciproc 25/.08 file to remove filling material resulted in the lowest percentage of residuals in the whole root canal and in the apical third.


Subject(s)
Humans , Root Canal Filling Materials , Ultrasonics/instrumentation , Root Canal Preparation/instrumentation , Dental Instruments , Dental Pulp Cavity/anatomy & histology , Reference Values , Ultrasonics/methods , Materials Testing , Reproducibility of Results , Analysis of Variance , Statistics, Nonparametric , Root Canal Preparation/methods , Retreatment , Equipment Design , X-Ray Microtomography , Incisor/anatomy & histology
17.
Braz. oral res. (Online) ; 32(supl.1): e65, 2018. tab, graf
Article in English | LILACS | ID: biblio-974475

ABSTRACT

Abstract: Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals. In infected teeth, bacteria may persist not only in difficult-to-reach areas such as isthmuses, ramifications, dentinal tubules, and recesses from C-shaped or oval/flattened canals, but also in areas of the main canal wall that remain untouched by instruments. If bacteria withstand chemomechanical procedures, there is an augmented risk for post-treatment apical periodontitis. This article discloses the reasons why some areas remain unprepared by instruments and discusses strategies to circumvent this issue and enhance infection control during endodontic treatment/retreatment of teeth with apical periodontitis.


Subject(s)
Humans , Root Canal Preparation/methods , Dental Pulp Cavity/microbiology , Periapical Periodontitis/therapy , Root Canal Irrigants/therapeutic use , Treatment Outcome , Root Canal Preparation/instrumentation , Dental Instruments , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , X-Ray Microtomography/methods
18.
Braz. oral res. (Online) ; 32(supl.1): e67, 2018. tab, graf
Article in English | LILACS | ID: biblio-974471

ABSTRACT

Abstract: The introduction of automated instrumentation in endodontics represented a major advance in progress for this specialty, with improvements in the quality and predictability of root canal preparation and a significant reduction in procedural errors. In recent years, endodontic instruments have undergone a series of changes brought about by modifications in design, surface treatments, and thermal treatments. In addition, new movements have also been incorporated to offer greater safety and efficiency, optimizing the properties of the NiTi alloy, especially through eccentric rotary motion. An understanding of the mechanical properties of these new NiTi instruments and their effect on the clinical performance of root canal preparation is essential if dental practitioners are to select the instruments that provide optimal clinical outcomes, especially in curved or flattened canals. The objective of this literature review is to present and discuss the characteristics of the NiTi alloys used in the major instrumentation systems available in the market, as well as the influence of the metallurgical and mechanical properties of NiTi instruments and the movements that drive them, to enable more accurate and predictable planning of root canal preparation.


Subject(s)
Humans , Root Canal Preparation/instrumentation , Equipment Design , Alloys/chemistry , Surface Properties , Root Canal Preparation/methods , Dental Alloys/chemistry , Dental Instruments
19.
Braz. oral res. (Online) ; 32(supl.1): e66, 2018. tab, graf
Article in English | LILACS | ID: biblio-974468

ABSTRACT

Abstract: This literature review has critically analyzed the published research related to the biomechanical preparation of root canals with three-dimensional analysis using micro-computed tomography (micro-CT). In December 2017, six databases (PubMed, Cochrane, Web of Science, Embase, Scopus, and Science Direct) were accessed using keywords to find articles including the use of the micro-CT analysis in biomechanical root canal preparation. There were 60 full articles that were selected, which were screened and read by two authors. The research that was reviewed and analyzed included root canal anatomy and sample selection, changes in canal shape and untouched canal areas, canal transportation and centering ability, and kinematics (motion). Of the studies selected, 49.18% discussed anatomical characteristics, with 54.1% of these studies describing mesial roots of mandibular molars with moderate curvature. Only 35% used a stratified distribution based on root canal system morphology and quantitative data obtained by micro-CT. The analysis of canal transportation and centering ability showed that transport values in the apical third exceeded the critical limit of 0.3 mm in mesial roots of mandibular molars with moderate curvature, especially in the groups in which a reciprocating system was used. In relation to kinematics, 91.70% of the reviewed studies evaluated continuous rotating instruments, followed by reciprocating rotation (38.33%), vibratory (15%), and the adaptive kinematics, which was in only 8.33%. The reciprocating kinematics was associated with higher canal decentralization and transportation indexes, as well as a greater capacity for dentin removal and debris accumulation. This literature review showed that the anatomy, the type of design and kinematics of instruments, and the experimental design are factors that directly influence the quality of biomechanical preparation of root canals analyzed in a qualitative and quantitative manner by micro-CT.


Subject(s)
Humans , Root Canal Preparation/methods , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , X-Ray Microtomography/methods , Root Canal Preparation/instrumentation , Imaging, Three-Dimensional , Dental Instruments , Equipment Design , Alloys , Mandible , Molar
20.
Rev. Asoc. Odontol. Argent ; 105(4): 141-147, dic. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-973111

ABSTRACT

Objetivo: evaluar cuantitativamente la cantidad de residuos extruidos a través del foramen apical, comparando los sistemas Mtwo y Reciproc. Materiales y métodos: se usaron 20 premolares inferiores unirradiculares, con ápice maduro, curvaturas de 0 a 10 grados y oramen permeable a limas tipo K flexibles #10 y #15. Se realizó la cavidad de acceso de manera convencional con piedra redonda de diamante y fresa Endo Z. Se determinó visualmente la longitud de trabajo a 1 mm del foramen apical. Los dientes fueron divididos al azar en dos grupos de 10 especímenes cada uno. Grupo 1: instrumentación con sistema Mtwo (VDW GmbH) a la longitud de trabajo. Grupo 2: instrumentación con sistema Reciproc (VDW GmbH) con movimientos de picoteo por tercios. Se utilizó como irrigante 12,5 ml de agua destilada por elemento dentario. Para la recolección de restos, se usó la técnica de Myers y Montgomery. Los residuos y el irrigante extruidos fueron recolectados en un frasco vial prepesado. El peso de los restos fue calculado por la diferencia de las medidas pre- y posinstrumentación. Resultados: los datos fueron analizados estadísticamente con el test de normalidad de Kolmogorov-Smirnov. Posteriormente, los datos de dichas variables, dependientes pre- y po-, fueron analizados con la prueba T para muestras pareadas. No se registraron diferencias significativas entre ambos grupos (P>0,05). Conclusión: ambos sistemas rotatorios produjeron extrusión apical de residuos de manera similar.


Subject(s)
Root Canal Preparation/instrumentation , Root Canal Preparation/methods , Dental High-Speed Equipment , In Vitro Techniques , Dental Instruments , Data Interpretation, Statistical , Tooth Apex/anatomy & histology
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