Comparative analysis of two navigation techniques based on augmented reality technology for the orthodontic mini-implants placement.

To analyze and compare the accuracy and root contact prevalence, comparing a conventional freehand technique and two navigation techniques based on augmented reality technology for the orthodontic self-drilling mini-implants placement. Methods Two hundred and seven orthodontic self-drilling mini-implants were placed using either a conventional freehand technique (FHT) and two navigation techniques based on augmented reality technology (AR TOOTH and AR SCREWS). Accuracy across different dental sectors was also analyzed. CBCT and intraoral scans were taken both prior to and following orthodontic self-drilling mini-implants placement. The deviation angle and horizontal were then analyzed; these measurements were taken at the coronal entry point and apical endpoint between the planned and performed orthodontic self-drilling mini-implants. In addition, any complications resulting from mini-implant placement, such as spot perforations, were also analyzed across all dental sectors.Results The statistical analysis showed significant differences between study groups with regard to the coronal entry-point (p < 0.001), apical end-point(p < 0.001) and angular deviations (p < 0.001). Furthermore, statistically significant differences were shown between the orthodontic self-drilling mini-implants placement site at the coronal entry-point (p < 0.0001) and apical end-point (p < 0.001). Additionally, eight root perforations were observed in the FHT group, while there were no root perforations in the two navigation techniques based on augmented reality technology.Conclusions The navigation techniques based on augmented reality technology has an effect on the accuracy of orthodontic self-drilling mini-implants placement and results in fewer intraoperative complications, comparing to the conventional free-hand technique. The AR TOOTH augmented reality technique showed more accurate results between planned and placed orthodontic self-drilling mini-implants, comparing to the AR SCREWS and conventional free-hand techniques. The navigation techniques based on augmented reality technology showed fewer intraoperative complications, comparing to the conventional free-hand technique.

Photodynamic therapy in endodontic root canal treatment significantly increases bacterial clearance, preventing apical periodontitis.

OBJECTIVE: To analyze the antimicrobial activity of photodynamic therapy as an adjunct to conventional endodontic treatment, particularly against Enterococcus faecalis. METHOD AND MATERIALS: A total of 42 single-rooted teeth obtained from 33 patients with apical periodontitis were included. Sampling was developed in three stages: (1) immediately after accessing the root canal, (2) after chemical and mechanical instrumentation, and finally, (3) after photodynamic therapy application. The bacterial load of each sample was quantified by seeding on blood agar plates and selective M-Enterococcus agar. All growing colonies were identified using MALDI-TOF (Bruker; matrix-assisted laser desorption/ionization time-of-flight), and the entire bacterial microbiota composition was determined in the first sample by PCR-DGGE (polymerase chain reaction denaturing gradient gel electrophoresis), using 16 rDNA primers and selective nucleotide sequencing. RESULTS: The endodontic therapy obtained a mean reduction in the cultivable bacterial load of 1.12 log, whereas the photodynamic therapy combination significantly increased the bacterial clearance (P < .0001). Viable cells of E faecalis were detected in 16.6% of root canals, with a mean value of 93 CFU per tooth, which was reduced to 67 and 9 CFU/tooth after conventional endodontic and photodynamic therapy treatments, respectively. Molecular E faecalis detection demonstrated that this species was present in 23.2% of baseline samples. DGGE analysis demonstrated the existence of a more complex microbiota than those observed using classical cultures. CONCLUSION: Photodynamic therapy as an adjunct to root canal treatment produces a significant reduction in E faecalis bacterial load, and it should be considered in the prevention of apical periodontitis.

Capacidad antiséptica del digluconato de clorhexidina 0.05% y cloruro de cetilpiridinio 0.05%. Estudio clínico prospectivo y microbiológico / Antiseptic capacity of 0.05% Chlorhexidine digluconate and 0.05% Cetylpyridinium chloride. A prospective and microbiological clinical study

Introducción: El objetivo de este estudio consiste en evaluar la eficacia clínica y microbiológica de un colutorio a base de digluconato de clorhexidina (CHX) 0,05% y cloruro de cetilpiridinio (CPC) 0,05%, y otro colutorio sin propiedades antisépticas, empleados como coadyuvantes de los métodos de higiene oral. Material y métodos: Se llevó a cabo un estudio microbiológico que evaluó la capacidad de los colutorios para inhibir la formación y adherencia de un biofilm bacteriano de Streptococcus oralis mediante espectrofotometría, y un ensayo clínico, aleatorizado y doble ciego sobre una muestra de 48 pacientes, los cuales fueron asignados aleatoriamente a cada colutorio. A: CHX 0,05%, CPC 0,05% y lactato de cinc 0,14% y B: permethol 0.10% y provitamina B5 0.50%. El índice de placa (IP), el índice gingival modificado (IGM) y el índice de sangrado (IS) fueron evaluados con periodicidad mensual y trimestral. Resultados: El colutorio a base de CHX 0,05% y CPC 0,05% evidenció una elevada capacidad para inhibir la formación (P=0,013) y adherencia (P=0,001) del biofilm bacteriano Se observaron diferencias estadísticamente significativas en el IP inter-grupos a los tres meses de observación (P<0,001). También se observaron diferencias en el IGM al mes (P=0,034) y a los tres meses de observación (P<0,001); y en el IS al mes (P=0,004) y a los tres meses de observación (P=0,002). Conclusiones: El colutorio a base de CHX 0,05% y CPC 0,05% posee una capacidad superior para reducir la placa bacteriana y la gingivitis

Introduction: The aim of this study was to evaluate the clinical and microbiological efficacy of a mouthrinse containing 0.05% chlorhexidine digluconate (CHX) and 0.05% cetylpyridinium chloride (CPC), and another mouthrinse without antiseptic properties, used as adjuvants to oral hygiene methods. Material and methods: First a microbiological study using spectrophotometry was done to assess the ability of both mouthrinses to inhibit the formation and adhesion of an Streptococcus oralis biofilm. Then, a randomised, double-blind clinical trial was performed on a sample of 48 patients, who were randomly assigned to each mouthrinse. A: 0.05% CHX and 0.05% CPC, and B: 0.10% permethol and 0.50% provitamin B5. Plaque index (PI), modified gingival index (MGI) and bleeding index (BI) were assessed at one and three months. Results: The 0.05% CHX and 0.05% CPC mouthrinse showed a high capacity to inhibit the formation (P=0.013) and adhesion (P=0.001) of the bacterial biofilm. Statistically significant differences were observed in the inter-group PI after three months of monitoring (P<0.001). Differences were also observed in MGI after one month (P=0,034) and after three months of monitoring (P<0,001); and in BI after one month (P=0,004) and after three months of monitoring (P=0,002). Conclusions: The 0.05% CHX and 0.05% CPC mouthrinse has a good capacity to reduce bacterial plaque and gingivitis

Análisis comparativo in vitro de la capacidad de sellado marginal en cavidades a retro del MTA y del cemento de óxido de cinc-eugenol reforzado / In vitro analysis and comparison of the apical sealing capability of MTA and a reinforced zinc oxide-eugenol cement

Objetivo: El objetivo de este estudio consiste en comparar la capacidad de sellado apical de dos materiales empleados en la obturación de cavidades a retro en cirugía periapical: MTA y un cemento de óxido de cinc-eugenol reforzado (Super EBA(R)). Material y métodos: Se llevó a cabo un estudio in vitro con dientes unirradiculares extraídos, a fin de evaluar la capacidad de sellado apical de dos materiales empleados como material de obturación en cavidades a retro: cemento de óxido de cinc reforzado (Súper EBA(R)) (n = 30) y MTA (n = 30). Además, se creó un grupo control negativo (n = 5) y otro positivo (n = 5). Las muestras procesadas fueron sumergidas en tinta China y posteriormente diafanizadas. Tras secar las muestras, se cuantificó el grado de filtración (mm) mediante un software de análisis de imagen. Los resultados fueron analizados utilizando el test de la t de Student, empleando el programa SPSS versión 20.0. Un valor de p ≤ 0,05 fue considerado significativo. Resultados: El 6,6% y el 10% de las muestras obturadas con MTA o con Súper EBA(R), respectivamente, sufrieron una filtración completa. Estas referencias revelaron que el grado de filtración no depende del material empleado (p = 0,133). Conclusión: No existen diferencias respecto al grado de filtración entre ambos materiales empleados en el sellado retrocavitario

Objectives: The aim of this study was to compare the apical sealing capabilities of the mineral trioxide aggregate (MTA) and of the reinforced zinc oxide-eugenol cement Super EBA(R). Material and methods. An in vitro study was carried out using extracted single-rooted teeth samples. Two materials were tested as root-end filling materials: a reinforced zinc oxide-eugenol cement (Super EBA(R)) (n = 30) and mineral trioxide aggregate (MTA) (n = 30). Another two groups were created as negative (n = 5) and positive (n = 5) control groups. The samples were put in Chinese ink and then diafanizated. Once dried, the level of leakage (mm) was measured by an image software program. The results were analysed using Student's t-test, using the SPSS version 20.0. Differences with p value lower or equal 0.05 were considered significant. Results: Mean filtration in MTA group was 0.77 ± 1.006, whereas in the SuperEba group it was 1.20 ± 1.186 (p = 0.133). Complete leakage was found in 6.6% of the samples filled with MTA and in 10% of those filled with Super EBA(R) (p = 0.133). The level of leakage was not influenced by the material used and null hypothesis can be accepted. Conclusion: Both type of root-end filling materials analysed in this research, are indicated for sealing the retropreparation, without differences in the leakage

Diagnosis and endodontic treatment of type II dens invaginatus by using cone-beam computed tomography and splint guides for cavity access: a case report.

BACKGROUND AND OVERVIEW: Dens invaginatus (DI) is defined as a rare dental malformation. The inherent structural variants of this anatomic disorder make it difficult to perform conventional endodontic treatment procedures by means of a conservative access cavity. In this clinical case report, the authors describe the treatment of a type II DI by means of guided splints for cavity access. CASE DESCRIPTION: This is a clinical report of a case of type II DI in a maxillary lateral incisor. The authors established the diagnosis by means of cone-beam computed tomography (CBCT). The authors manufactured 3 splint guides from a Digital Imaging and Communications in Medicine file and a stereolithography file obtained from a plaster model of the patient by using software for guided implant placement, for access opening, and for locating the root canals. CONCLUSIONS: CBCT is an effective method for obtaining information about the root canal system in teeth with DI. In addition, guided implant surgery software is effective for manufacturing splint guides for endodontic treatment with conservative pulp chamber access. PRACTICAL IMPLICATIONS: Information obtained from CBCT allows the clinician to fabricate splint guides for minimally invasive access opening in this type of case, thus reducing the loss of dental tissue.

Manejo endodóntico y quirúrgico ante una reabsorción cervical invasiva. Revisión de la literatura. A propósito de un caso / Endodontic and surgical management to invasive cervical resorption. A review of the literatura. A case report

Introducción: Reabsorción cervical invasiva(RCI) es un tipo de reabsorción radicular externa. Se caracteriza por la pérdida de tejidos duros dentales por la acción de los odontoclastos. Aparece con mayor frecuencia en la región cervical de la superficie radicular de los dientes. Objetivos: Presentar un caso clínico describiendo el protocolo de actuación ante una reabsorción cervical invasiva y revisión bibliográfica de su etiología, diagnóstico y tratamiento. Caso clínico: Paciente mujer de 19 años de edad, sin antecedentes médicos relevantes, acude a nuestra consulta debido a una coloración rosácea en la superficie cervico-vestibular del incisivo central superior derecho. El diente presentaba ausencia de dolor a la percusión y palpación. La vitalidad del diente fue negativa. Tras riguroso análisis, se procedió a realizar el tratamiento que constó de2 fases, una primera fase no quirúrgica seguida de una fase quirúrgica. La reconstrucción del defecto se llevo a cabo usando un cemento de ionómero de vidrio. Conclusiones: Es importante para el endodoncista comprender y manejar aspectos periodontales y restaurativos para tratar la RCI. Tras el tratamiento, la paciente quedó satisfecha del resultado estético

Introduction: Invasive cervical resorption (ICR) is a type of external resorption. ICR is the loss of dental hard tissue as a result of odontoclastic action. It usually begins on the cervical region of the root surface of the teeth. Objetive: To present a clinical case describing the protocol to an invasive cervical resorption and literature review of etiology, diagnosis and treatment. Clinical case: Female patient of 19 years of age, without medical history of interest, who went to the consultation due to presenting a pink coronal discoloration at the labial surface in the cervical region of the right central upper incisor. There was no pain on percussion and palpation. The tooth reacted negative to pulp sensitivity testing. After rigorous analysis, the treatment took place in two phases, nonsurgical therapy followed by surgical treatment. Reconstruction of the defect was achieved using resin ionomer cement. Conclusion: It is important for endodontists to understand the periodontal and restorative aspects to treating ICR. After the treatment, the patient was satisfied with the esthetic result

Reabsorción radicular interna. A propósito de un caso / Internal root resorption. A case report

Las reabsorciones radiculares internas (RRI) se describen como un proceso infrecuente localizado en el interior del conducto radicular, que acontece como resultado de un aumento de la actividad odontoclástica. La aparición de este proceso patológico se encuentra vinculado al grado de afectación del complejo dentinopulpar; advirtiéndose una mayor incidencia en aquellos dientes afectados por necrosis pulpar (77%) y periodontitis apical crónica (75%). Los dientes afectados por RRI se muestran asintomáticos con frecuencia, pudiendo observarse lesiones fistulosas en los casos más avanzados. El diagnostico por imagen constituye el método más eficaz para establecer un diagnóstico precoz, y el tratamiento de conductos supone la terapia de elección. Este caso clínico describe el caso de una reabsorción radicular interna secundaria a un antecedente traumático. Con objeto de favorecer la desinfección del defecto cavitario, se planificó la aplicación de medicación intraconducto entre citas. La obturación del conducto radicular se llevó a cabo mediante una técnica de gutapercha termoplástica. Durante esta fase se produjo una sobreextensión del material de obturación radicular, hecho que justificó la cirugía endodóntica a la que se sometió a la paciente posteriormente. La retrocavidad configurada en el extremo apical resultó obturada con MTA, atendiendo a su elevada capacidad de sellado marginal y sus propiedades osteoinductoras

The internal root resorption ( IRR ) are described as an uncommon process located inside the root canal, that occurs as a result of the increase of clastic cells stimulated by pulpal inflammation. The appearance of this disease process is linked to the degree of involvement of the dentin-pulp complex, noticeable a higher incidence in those teeth affected by pulp necrosis (77%) and chronic apical periodontitis (75 %). Teeth affected by IRR are often non-symptomatic, fistulous lesions can be seen in more advanced cases. The imaging diagnostic is the most effective method to establish an early diagnosis and root canal treatment involves the treatment of choice. This case report describes the case of internal root resorption secondary to a traumatic history. In order to promote disinfection cavitary defect ,the application of intracanal medication was planned between appointments. The root canal filling was carried out by a technique of thermoplastic guttapercha. Throughout this phase there was an overextension of root canal filling material, a fact which justified endodontic surgery the patient underwent later. The rootend preparation was sealed with MTA , based on its high level of marginal seal and osteoinductive properties

Management of perforating internal root resorption with periodontal surgery and mineral trioxide aggregate: a case report with 5-year follow-up.

Internal root resorption (IRR) is characterized by progressive loss of tooth substance initiating at the root canal wall as a result of clastic activity. The use of periodontal surgery and mineral trioxide aggregate is a good approach to repair lesions with periodontal communication (perforating IRR). This case describes the treatment and follow-up of a maxillary central incisor with perforating IRR in a 56-year-old male patient where root canal treatment, periodontal surgery, and white mineral trioxide aggregate were employed to achieve complete repair and to restore function. Clinical findings and periapical radiographs indicated success after a 5-year follow-up.

Determinación del calibre apical posterior al preflaring / No disponible

Objetivo: Calibrar y determinar cuál es el diámetro apical adecuado en función del caso y del tipo de conducto. Para llegar a determinar el diámetro apical adecuado nos propusimos, por un lado, valorar si el preflaring facilita la instrumentación apical, y por otro, verificar si los conductos pueden ser instrumentados a tamaños ISO mayores a los que habitualmente lo son. Material y métodos: Después de realizar una preparación del tercio coronal de 40 conductos mesiales (mv-ml) de 23 molares inferiores exodonciados mediante instrumentación rotatoria, se determinó la longitud de trabajo (LT) tras la cual se llevó a cabo la preparación apical. Para ello, se instrumentó (manualmente) en primer lugar, el conducto a LT-1 mm para eliminar cualquier tipo de interferencia posterior entre las limas y el propio conducto. Una vez finalizado dicho ensanchamiento, se procedió a repermeabilizar el conducto y continuar con la preparación apical a LT (manualmente). Nuestros datos se analizaron estadísticamente por medio del test de ANOVA y t de Student. Resultados: De la muestra estudiada, los datos obtenidos fueron que de un 87,5% de los conductos (35) su diámetro apical se encontraba entre 0,30 y 0,35 mm (30-35 ISO) (15 y 20 conductos respectivamente), el 10% de los conductos (4) tenían un diámetro apical de 0,40 mm (40 ISO) y el 2,5% restante de los conductos (1) se correspondían con un diámetro apical de 0,25 mm (25 ISO). Conclusiones: Se debe tratar de alcanzar un diámetro apical adecuado que nos permite el paso de irrigantes y conseguir así un desbridamiento químico y mécanico del conducto y del periápice, pero sin debilitar en exceso el conducto, De ahí la importancia del ensanche del tercio coronal (preflaring) y del equilibrio de los binomios instrumentación-irrigantes y limpieza-debilitamiento (AU)

Objetive: To calibrate and determine the appropriate apical diameter regarding to the case and the type of root canal. In other to determine the appropriate apical diameter, first of all we set out to assess whether or not the apical instrumentation facilitates preflaring and secondly, to verify if root canal can be instrumented to ISO sizes larger than the ones usually used. Material and Methods: After performing an expansion of the coronal third of 40 mesial root canals (mv-ml) of 23 extracted lower molars done by mechanical instrumentation, we investigated the working length (WL) in which the apical preparation was conducted. To that end, the duct first was implemented (manually) to 1mm above the working length WL) so any further interference between the files and the duct itself would be eliminated. Having completed this enlargement, we continue to working the canal and proceed to the apical preparation to WL (manually). Results. Of the sample studied, data obtained was that 87.5% of the ducts (35) apical diameter was between 0,30 and 0,35 mm (30-35 ISO) (15 and 20 channels respectively), 10% of the ducts (4) had an apical diameter of 0,40 mm the remaining 2.5% of the tubes (1) correspond to apical diameter of 0,25 mm (25 ISO). Conclusions. Proper apical diameter should be obtain in order to let the irrigants flow trough the canal and thereby achieving a chemical and mechanical debridement of the canal and the periapical, but without excessively weaken the canal. That is the reason of the importance of widening the coronal third of the duct (opreflaring) and the balance of the binomial-instrumentation irrigants and cleaning-weakening (AU)