Knowledge of Dentists on the Management of Tooth Avulsion Injuries in Rio de Janeiro, Brazil.

PURPOSE: To evaluate dentists' professional experience and knowledge of emergency management of tooth avulsion injuries in Rio de Janeiro, Brazil. MATERIALS AND METHODS: A total of 100 questionnaires were evaluated. The first part of the questionnaire consisted of questions regarding personal information. The second part evaluated dentists' knowledge of emergency management in cases of dental avulsion. The responses for each question were counted and expressed as percentages. RESULTS: All dentists had a college degree or above. Only three dentists had a Master's or PhD degree. Most of the dentists (94.5%) considered time and storage media important for the prognosis of avulsed teeth. However, the dentists did not show consistent responses about the adequate time and ideal storage media to transport avulsed teeth. CONCLUSION: The study highlighted Brazilian dentists' need for continuing education in order to improve current knowledge in emergency management of avulsed teeth.

Mechanical performance of original; yellowish and blueish ProFile instruments: isolating heat-treatment as a variable.

The present study aimed to perform two different heat-treatments in an austenitic NiTi ProFile instrument and to compare the mechanical performance of original and heat-treated instruments. Heat treatment of ProFile (tip size 25 and 0.06 taper) instruments were carried out in a furnace in argon atmosphere using a heating rate of 10° C/min. After reaching the programmed temperatures of 450 ºC or 500 ºC the system remained at a constant temperature for 10 minutes; followed by cooling in water at room temperature. Afterwards; the three groups (n=30 per group) of instruments were compared regarding their cyclic fatigue (n=10 per group); bending (n=10 per group); and buckling resistance (n=10 per group). After cyclic fatigue tests; a scanning electron microscope was used to analyze the fracture surfaces and observe the fracture mode. Statistical analysis was performed using One-way ANOVA and Student-Newman-Keuls test; with an alpha type error set at 0.05. Yellowish and blueish coloration was observed in the ProFile instruments after 450 ºC or 500 ºC heat treatments; respectively. Conventional ProFile instruments showed the lower cyclic fatigue; and the higher bending and buckling resistance (P<0.05). In contrast; yellowish ProFile instruments (heat treated at 500° C) showed the higher cyclic fatigue; and the lower bending and buckling resistance (P>0.05). It can be concluded that the different heat treatments performed on ProFile instruments increased its cyclic fatigue resistance and improved the flexibility and buckling resistance.

O presente estudo teve como objetivo realizar dois tratamentos térmicos diferentes em instrumentos de NiTi austenítico ProFile e comparar o desempenho mecânico de instrumentos originais e tratados termicamente. O tratamento térmico dos instrumentos ProFile (tamanho de ponta 25 e conicidade 0.06) foi realizado em um forno em atmosfera de argônio usando uma taxa de aquecimento de 10°C/min. Após atingir as temperaturas programadas de 450 ºC ou 500 ºC o sistema permaneceu em temperatura constante por 10 minutos; seguido de resfriamento em água à temperatura ambiente. Em seguida; os três grupos de instrumentos (n=30 por grupo) foram comparados quanto à fadiga cíclica (n=10 por grupo); flexão (n=10 por grupo) e resistência à flambagem (n=10 por grupo). Após testes de fadiga cíclica; um microscópio eletrônico de varredura foi utilizado para analisar as superfícies de fratura e observar o modo de fratura. A análise estatística foi realizada por meio dos testes de One-way ANOVA e teste de Student-Newman-Keuls; com erro de tipo alfa fixado em 0.05. Coloração amarelada e azulada foi observada nos instrumentos ProFile após tratamentos térmicos a 450 ºC ou 500 ºC; respectivamente. Os instrumentos ProFile originais apresentaram menor fadiga cíclica e maior resistência à flexão e flambagem (P<0.05). Em contraste; os instrumentos ProFile azulados (tratados termicamente a 500°C) apresentaram maior fadiga cíclica e menor resistência à flexão e flambagem (P>0.05). Pode-se concluir que os diferentes tratamentos térmicos realizados nos instrumentos ProFile aumentaram sua resistência à fadiga cíclica e melhoraram a flexibilidade e resistência à flambagem.

Comparison of some physical properties of finger spreaders made of stainless steel or nickel-titanium alloys.

The purpose of this study was to evaluate the flexibility, shape, and surface finishing of stainless steel (SS) and nickel-titanium (NiTi) finger spreaders as well as to compare the load required to insert these spreaders along a gutta-percha point adapted to the apical segment of curved or straight artificial canals. Instrument flexibility was investigated by using a universal testing machine in the cantilever-flexibility test. Scanning electron microscopy (SEM) was used to examine the shape and surface finishing of different sizes of SS and NiTi finger spreaders. Penetration load was evaluated only for spreaders size C by using the universal testing machine in a compressive test. As for flexibility, the load needed to bend the SS finger spreader sizes A, B, C, and D was approximately 167%, 146%, 102%, and 64% greater than the respective sizes of NiTi finger spreaders. SEM analysis revealed that the instrument tips were always tapered, but with different vertices. NiTi spreaders showed tips with circumferential grooves; whereas, those from SS spreaders exhibited longitudinal grooves. NiTi finger spreaders required a significantly higher penetration load than SS spreaders. This difference was probably related to the different shapes and surface finishing of the instrument tips. Different characteristics of finger spreaders may result in different clinical performance during the lateral compaction technique.

Mechanical performance of original; yellowish and blueish ProFile instruments: isolating heat-treatment as a variable

Resumo O presente estudo teve como objetivo realizar dois tratamentos térmicos diferentes em instrumentos de NiTi austenítico ProFile e comparar o desempenho mecânico de instrumentos originais e tratados termicamente. O tratamento térmico dos instrumentos ProFile (tamanho de ponta 25 e conicidade 0.06) foi realizado em um forno em atmosfera de argônio usando uma taxa de aquecimento de 10°C/min. Após atingir as temperaturas programadas de 450 ºC ou 500 ºC o sistema permaneceu em temperatura constante por 10 minutos; seguido de resfriamento em água à temperatura ambiente. Em seguida; os três grupos de instrumentos (n=30 por grupo) foram comparados quanto à fadiga cíclica (n=10 por grupo); flexão (n=10 por grupo) e resistência à flambagem (n=10 por grupo). Após testes de fadiga cíclica; um microscópio eletrônico de varredura foi utilizado para analisar as superfícies de fratura e observar o modo de fratura. A análise estatística foi realizada por meio dos testes de One-way ANOVA e teste de Student-Newman-Keuls; com erro de tipo alfa fixado em 0.05. Coloração amarelada e azulada foi observada nos instrumentos ProFile após tratamentos térmicos a 450 ºC ou 500 ºC; respectivamente. Os instrumentos ProFile originais apresentaram menor fadiga cíclica e maior resistência à flexão e flambagem (P<0.05). Em contraste; os instrumentos ProFile azulados (tratados termicamente a 500°C) apresentaram maior fadiga cíclica e menor resistência à flexão e flambagem (P>0.05). Pode-se concluir que os diferentes tratamentos térmicos realizados nos instrumentos ProFile aumentaram sua resistência à fadiga cíclica e melhoraram a flexibilidade e resistência à flambagem.

Abstract The present study aimed to perform two different heat-treatments in an austenitic NiTi ProFile instrument and to compare the mechanical performance of original and heat-treated instruments. Heat treatment of ProFile (tip size 25 and 0.06 taper) instruments were carried out in a furnace in argon atmosphere using a heating rate of 10° C/min. After reaching the programmed temperatures of 450 ºC or 500 ºC the system remained at a constant temperature for 10 minutes; followed by cooling in water at room temperature. Afterwards; the three groups (n=30 per group) of instruments were compared regarding their cyclic fatigue (n=10 per group); bending (n=10 per group); and buckling resistance (n=10 per group). After cyclic fatigue tests; a scanning electron microscope was used to analyze the fracture surfaces and observe the fracture mode. Statistical analysis was performed using One-way ANOVA and Student-Newman-Keuls test; with an alpha type error set at 0.05. Yellowish and blueish coloration was observed in the ProFile instruments after 450 ºC or 500 ºC heat treatments; respectively. Conventional ProFile instruments showed the lower cyclic fatigue; and the higher bending and buckling resistance (P<0.05). In contrast; yellowish ProFile instruments (heat treated at 500° C) showed the higher cyclic fatigue; and the lower bending and buckling resistance (P>0.05). It can be concluded that the different heat treatments performed on ProFile instruments increased its cyclic fatigue resistance and improved the flexibility and buckling resistance.

Influence of the geometry of curved artificial canals on the fracture of rotary nickel-titanium instruments subjected to cyclic fatigue tests.

INTRODUCTION: This study evaluated the influence of different features of canal curvature geometry on the number of cycles to fracture of a rotary nickel-titanium endodontic instrument subjected to a cyclic fatigue test. METHODS: BioRaCe BR4C instruments (FKG Dentaire, La Chaux-de Fonds, Switzerland) were tested in 4 grooves simulating curved metallic artificial canals, each one measuring 1.5 mm in width, 20 mm in total length, and 3.5 mm in depth with a U-shaped bottom. The parameters of curvature including the radius and arc lengths and the position of the arc differed in the 4 canal designs. Fractured surfaces and helical shafts of the separated instruments were analyzed by scanning electron microscopy. RESULTS: The Student's t test showed that a significantly lower number of cycles to fracture values were observed for instruments tested in canals with the smallest radius, the longest arc, and the arc located in the middle portion of the canal. Scanning electron microscopic analysis of the fracture surfaces revealed morphologic characteristics of ductile fracture. Plastic deformation was not observed in the helical shaft of the fractured instruments. CONCLUSIONS: Curvature geometry including the radius and arc lengths and the position of the arc along the root canal influence the number of cycles to fracture of rotary nickel-titanium instruments subjected to flexural load.

Torsional properties of pathfinding instruments.

INTRODUCTION: This study compared the torsional properties of 2 stainless steel endodontic pathfinding instruments: C-Pilot (VDW, Munich, Germany) and C(+) files (Maillefer/Dentsply, Ballaigues, Switzerland). Stainless steel conventional K-type instruments (KCC(+), VDW) were used as controls. METHODS: File sizes 10 were subjected to a torsional assay in clockwise rotation. The 2 parameters evaluated were maximum torque and angular deflection at failure. The fractured surfaces and the helical shafts of the fractured instruments were then examined by scanning electron microscopy (SEM). RESULTS: The results indicated that the angular deflection to fracture decreased in the following order: KCC(+) > C-Pilot > C(+). As for the maximum torque values, the results revealed the following descending order: C(+) > KCC(+) > C-Pilot. SEM analysis revealed that plastic deformation occurred along the helical shaft of the fractured instruments and that the fractured surfaces were of the ductile type. CONCLUSIONS: The instruments tested showed different torsional behavior depending on the parameter evaluated. Considering that high angular deflection values may serve as a safety factor for instruments used as pathfinders, the conventional K file showed significantly better results than both C-Pilot and C(+) files.

Cyclic fatigue resistance of ProTaper Universal instruments when subjected to static and dynamic tests.

OBJECTIVE: This study evaluated the number of cycles to fracture of ProTaper Universal S2 instruments when subjected to static and dynamic cyclic fatigue tests. STUDY DESIGN: ProTaper Universal S2 instruments were used until fracture in an artificial curved canal under rotational speed of 300 rpm in either a static or a dynamic test model. Afterward, the length of the fractured segments was measured and fractured surfaces and helical shafts analyzed by scanning electron microscopy (SEM). RESULTS: The number of cycles to fracture was significantly increased when instruments were tested in the dynamic model (P<.001). Instrument separation occurred at the point of maximum flexure within the artificial canals, i.e., the midpoint of the curved canal segment. SEM analysis revealed that fractured surfaces exhibited characteristics of the ductile mode. Plastic deformation was not observed in the helical shaft of fractured instruments. CONCLUSIONS: The number of cycles to fracture ProTaper Universal S2 instruments significantly increased with the use of instruments in a dynamic cyclic fatigue test compared with a static model. These findings reinforce the need for performing continuous pecking motions during rotary instrumentation of curved root canals.

Effects of electropolishing surface treatment on the cyclic fatigue resistance of BioRace nickel-titanium rotary instruments.

INTRODUCTION: This study evaluated the influence of electropolishing surface treatment on the number of cycles to fracture of BioRace rotary nickel-titanium endodontic instruments. METHODS: BioRace size BR5C instruments with or without electropolishing surface treatment were used in an artificial curved canal under rotational speed of 300 rpm until fracture. Fractured surfaces and the helical shafts of fractured instruments were analyzed by scanning electron microscopy (SEM). RESULTS: Polished instruments displayed a significantly higher number of cycles to fracture when compared with nonpolished instruments (P < .001). Actually, the number of cycles to fracture of a polished BR5C instrument was 124% higher than that of a nonpolished instrument. SEM analysis showed that the fractured surface of both polished and nonpolished BR5C instruments had ductile morphologic characteristics. Evaluation of the separated fragments after cyclic fatigue testing showed the presence of microcracks near the fracture surface. Polished instruments exhibited fine cracks that assumed an irregular path (zigzag crack pattern), whereas nonpolished instruments showed cracks running along the machining grooves. CONCLUSIONS: Electropolishing surface treatment of BioRace endodontic instruments significantly increased the cyclic fatigue resistance.

Photodynamic therapy with two different photosensitizers as a supplement to instrumentation/irrigation procedures in promoting intracanal reduction of Enterococcus faecalis.

INTRODUCTION: This in vitro study aimed to investigate the antibacterial effects of photodynamic therapy (PDT) with methylene blue (MB) or toluidine blue (TB) (both at 15 microg/mL) as a supplement to instrumentation/irrigation of root canals experimentally contaminated with Enterococcus faecalis. METHODS: Seventy extracted teeth had their root canals contaminated with an endodontic strain of E. faecalis for 7 days, instrumented with nickel-titanium instruments and irrigated either with 2.5% NaOCl or with 0.85% NaCl, and then randomly distributed into four experimental groups: MB/NaOCl (PDT with MB and NaOCl as the irrigant), TB/NaOCl (PDT with TB and NaOCl as the irrigant), MB/NaCl (PDT with MB and NaCl as the irrigant), and TB/NaCl (PDT with TB and NaCl as the irrigant). For PDT, the photosensitizer remained in the canal for 2 minutes before exposed to red light emitted from a diode laser for 4 minutes. Samples were taken before and after instrumentation/irrigation and following the specific PDT procedure for each group, plated onto Mitis-salivarius agar and the colony forming units counted. RESULTS: Regardless of the irrigant used (NaOCl or NaCl), instrumentation significantly reduced bacterial counts in comparison to the baseline (p < 0.001). NaOCl as the irrigant was significantly more effective than NaCl, and this difference persisted after PDT, irrespective of the photosensitizer used (p < 0.05). PDT with either MB or TB did not significantly enhance disinfection after chemomechanical preparation using NaOCl as irrigant (p > 0.05). No significant differences were observed between the two photosensitizers (p > 0.05). CONCLUSION: These in vitro results suggest that PDT with either MB or TB may not exert a significant supplemental effect to instrumentation/irrigation procedures with regard to intracanal disinfection. Further adjustments in the PDT protocol may be required to enhance predictability in bacterial elimination before clinical use is recommended.

Influence of rotational speed on the cyclic fatigue of rotary nickel-titanium endodontic instruments.

INTRODUCTION: During the preparation of curved canals, rotary nickel-titanium (NiTi) instruments are subjected to cyclic fatigue, which can lead to instrument fracture. Although several factors may influence the cyclic fatigue resistance of instruments, the role of the rotational speed remains uncertain. This study was intended to evaluate the effects of rotational speed on the number of cycles to fracture of rotary NiTi instruments. METHODS: ProTaper Universal instruments F3 and F4 (Maillefer SA, Ballaigues, Switzerland) were used in an artificial curved canal under rotational speeds of 300 rpm or 600 rpm. The artificial canal was made of stainless steel, with an inner diameter of 1.5 mm, total length of 20 mm, and arc at the end with a curvature radius of 6 mm. The arc length was 9.4 mm and 10.6 mm on the straight part. The number of cycles required to fracture was recorded. Fractured surfaces and the helical shafts of the fractured instruments were analyzed by scanning electron microscopy. RESULTS: The results showed approximately a 30% reduction in the observed number of cycles to fracture as rotational speed was increased from 300 to 600 RPM (p < 0.05). The morphology of the fractured surface was always of ductile type, and no plastic deformation was observed on the helical shaft of fractured instruments. CONCLUSIONS: The present findings for both F3 and F4 ProTaper instruments revealed that the increase in rotational speed significantly reduced the number of cycles to fracture.

Estudo epidemiológico das fraturas coronárias em pacientes atendidos em um projeto de trauma dental em um período de 6 anos / Epidemiological study of coronal fractures in patients treated in a dental trauma project in a 6 years periods

O presente estudo teve como objetivo realizar um levantamento epidemiológico sobre os casos de fratura coronária em pacientes que foram atendidos no Projeto Trauma Dental da Escola de Odontologia da Unigranrio, no período de 2005 a 2011. O estudo foi baseado nos dados coletados dos prontuários e as informações obtidas estão relacionadas ao gênero, idade, etiologia da fratura, local do pronto atendimento, tempo decorrido até o pronto atendimento, dentes acometidos, situação clínica e a necessidade de tratamento endodôntico. Foi observada uma maior incidência em pacientes do gênero masculino, com a idade mais afetada entre 6 e 10 anos. Os resultados mostram a distribuição etiológica, clínica e demográfica das fraturas coronárias em um projeto de trauma dentário na cidade de Duque de Caxias.

The aim of the present study was to conduct an epidemiological survey on coronal fracture cases in patients treated at the Dental Trauma Project at Unigranrio School of Dentistry, from 2005 to 2011. This study was based on data collected from records and information related to gender, age, fracture cause, prompt service, elapsed time from the accident, affected teeth, clinical condition of the teeth and the need of endodontic treatment. It was observed a higher incidence in male patients, with the most affected age between 6 to 10 years. The results show the etiological, clinical and demographic distribution of coronal fractures in a project of dental trauma in Duque de Caxias city.

Estudo comparativo da resistência em flexão de instrumentos endodônticos de NiTi mecanizados / Comparative study of the bending resistance of engine-driven NiTi instruments

No presente trabalho avaliou-se e comparou-se a carga necessária para induzir uma determinada deformação elástica de instrumentos endodônticos de NiTi mecanizados de mesmo número e de quatro marcas comerciais. Nos ensaios mecânicos de flexão em cantilever os instrumentos foram fixados em uma das extremidades e a carga aplicada na extremidade oposta. Os resultados obtidos demonstraram que em termos de flexibilidade: TF > BioRace > K3 > ProTaper.

In the present study evaluated and compared the load required to induce a certain elastic deformation of NiTi endodontic instruments mechanized same number and four trademarks. In the mechanical cantilever bending the instruments were set at one end and the load applied at the opposite end. The results showed that in terms of flexibility: TF> BioRace> K3> ProTaper.