Dietary supplementation with multi-strain formula of probiotics modulates inflammatory and immunological markers in apical periodontitis.

OBJECTIVE: The aim of this study was to evaluate whether probiotics multi-strain formula affects the development of apical periodontitis (AP) induced in rats. METHODOLOGY: 16 Wistar rats were divided in two groups (n=8): rats with AP fed with regular diet (Control-C (CG)); rats with AP, fed with regular diet and supplemented with multi-strain formula (one billion colony-forming units (CFU)): GNC Probiotic Complex (PCG) ( Lactobacillus acidophilus, Lactobacillus salivaris, Lactobacillus plantarum, Lactobacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium animalis subs. lactis and Streptococcus thermofilus ). AP was induced in the upper and lower first molars by dental pulp exposure to the oral environment. PCG was administered orally through gavage for 30 days during the AP development. After this period the animals were euthanized and the mandibles were removed and processed for histologic analysis, and immunochemical assays for interleukin (IL)-6, IL-10, IL-1ß, RANKL, OPG, and TRAP. The Mann-Whitney U test and Student's t test were performed (P<.05). RESULTS: The CG showed more intense inflammatory infiltrate than the PCG group (P<.05). IL-1ß, IL 6 and RANKL decreased in the PCG group compared with CG (P<.05). The IL-10 level increased in the PCG group (P<.05). The OPG level was similar in both groups (P>.05). The number of mature osteoclasts (TRAP-positive multinucleated cells) was lower in PCG group when compared to the CG (P<.05). CONCLUSION: Probiotic Complex modulates inflammation and bone resorption in apical periodontitis.

Dietary supplementation with multi-strain formula of probiotics modulates inflammatory and immunological markers in apical periodontitis

Abstract Objective The aim of this study was to evaluate whether probiotics multi-strain formula affects the development of apical periodontitis (AP) induced in rats. Methodology 16 Wistar rats were divided in two groups (n=8): rats with AP fed with regular diet (Control-C (CG)); rats with AP, fed with regular diet and supplemented with multi-strain formula (one billion colony-forming units (CFU)): GNC Probiotic Complex (PCG) ( Lactobacillus acidophilus, Lactobacillus salivaris, Lactobacillus plantarum, Lactobacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium animalis subs. lactis and Streptococcus thermofilus ). AP was induced in the upper and lower first molars by dental pulp exposure to the oral environment. PCG was administered orally through gavage for 30 days during the AP development. After this period the animals were euthanized and the mandibles were removed and processed for histologic analysis, and immunochemical assays for interleukin (IL)-6, IL-10, IL-1β, RANKL, OPG, and TRAP. The Mann-Whitney U test and Student's t test were performed (P<.05). Results The CG showed more intense inflammatory infiltrate than the PCG group (P<.05). IL-1β, IL 6 and RANKL decreased in the PCG group compared with CG (P<.05). The IL-10 level increased in the PCG group (P<.05). The OPG level was similar in both groups (P>.05). The number of mature osteoclasts (TRAP-positive multinucleated cells) was lower in PCG group when compared to the CG (P<.05). Conclusion Probiotic Complex modulates inflammation and bone resorption in apical periodontitis.

Análise de dois métodos de desinfecção de condutos radiculares após preparo para pinos: proposta de protocolo protético: estudo in vitro / Analysis of two methods of root canal disinfection after preparation for pins: proposal of prosthetic protocol: in vitro study

Introdução: Quando existe perda de suporte coronário e ainda desgaste adicional devido a tratamento endodôntico, muitas vezes, é necessária a utilização de um retentor intrarradicular que devolva a retenção para a restauração, reestabelecendo estética e função às estruturas dentárias perdidas. A cadeia asséptica mantida durante a endodontia pode ser quebrada com alguns procedimentos clínicos. Objetivo: Testar um protocolo de desinfecção por E. faecalis dos condutos radiculares, nas etapas de confecção de um retentor intrarradicular, desmistificando que a quebra da cadeia asséptica e o surgimento de infecções radiculares sejam provenientes da reabilitação protética. Material e método: 50 dentes unirradiculares com endodontia concluída foram desobturados, tiveram seus condutos preparados para retentor intrarradicular e foram contaminados por Enterococcus faecalis. Os dentes foram separados em três grupos de acordo com a substância desinfectante: G1-solução fisiológica (n=10), G2- hipoclorito de sódio 2,5% (n=20), G3- clorexidina 2% (n=20). Em seguida, foi feita a desinfecção do conduto, secagem e análise da eficácia da solução. A avaliação da presença da bactéria foi feita através do cultivo em caldo Brain Heart Infusion, pelo método da turvação, e posterior identificação pelo meio Ágar Bílis-Esculina. A análise estatística foi feita pelo método do quiquadrado em tabulação cruzada, onde p<0,0001. Resultado: Observou-se a inibição bacteriana de 100% em G2 e G3 e crescimento bacteriano de 100% em G1. Conclusão: O emprego das substâncias avaliadas nas etapas protéticas de finalização de um retentor intrarradicular, como protocolado por esta pesquisa, é capaz de manter a cadeia asséptica sem interferir no sucesso da reabilitação protética.

Introduction: When there is loss of the coronary supports and still further wear due to endodontic treatment, very often, it is necessary to use a intraradical retainer to restore aesthetics and function of lost dental structures. Within this rehabilitation, the aseptic chain which was maintained during endodontics can be broken using some clinical procedures. Aim: Test a disinfection protocol by E. faecalis of root canals, in the steps of making an intraradicular retainer, demystifying that the fracture of the aseptic chain and the emergence of root infections are coming from prosthetic rehabilitation. Materials and method: 50 single-rooted teeth with complete endodontics were unfilled, they had their conduits prepared for an intraradical retainer and contaminated by Enterococcus. faecalis. The teeth were divided into 3 groups according to the disinfectant solution. G1- saline (n= 10), G2 2.5% sodium hypochlorite (n=20), G3- chlorhexidine 2% (n=20). Then, a disinfection of conduit, drying and analysis of the efficacy of the solution was made. The evaluation of the presence of Enterococcus faecalis was made by cultivating in Brain Heart Infusion broth by the method of turbidity, and subsequent identification by means Agar Bile-Esculin. Statistical analysis were performed using the chi-square method in cross-tabulation, where p <0.0001. Result: As a result, it was observed 100% bacteria inhibition in G2 and G3, and bacterial growth of 100% in G1. Conclusion: The use of substances assessed in the prosthetic stages of finalizing an intraradical retainer, as filed by this research, is able to maintain the aseptic chain without interfering with success of prosthetic rehabilitation.

Fracture Incidence of WaveOne and Reciproc Files during Root Canal Preparation of up to 3 Posterior Teeth: A Prospective Clinical Study.

INTRODUCTION: Reciprocating instruments were developed to improve and simplify the preparation of the root canal system by allowing greater centralization of the canal and requiring a shorter learning curve. Despite the risk of instrument separation, using a reciprocating instrument in more than 1 case is a relatively common clinical practice. The aim of this study was to evaluate the fracture resistance of Reciproc (R25; VDW, Munich, Germany) and WaveOne (Primary; Dentsply Maillefer, Ballaigues, Switzerland) instruments according to the number of uses during the preparation of root canals in up to 3 posterior teeth. METHODS: A prospective clinical study was conducted by 3 experienced specialists who performed treatment of 358 posterior teeth (1130 canals) over a period of 12 months using 120 reciprocating instruments, 60 of which were Reciproc R25 and 60 were WaveOne Primary. The motion used during instrumentation followed the recommendations of the respective manufacturers. After each use, the instruments were observed under a dental operating microscope at 8× magnification. In the case of fracture or deformation, the instrument was discarded. RESULTS: None of the instruments showed any signs of deformation, but 3 instruments fractured (0.26% of the number of canals and 0.84% of the number of teeth). All fractures occurred in mandibular molars (1 WaveOne Primary file during the third use and 2 Reciproc R25 files, 1 during the first use and the other during the third use). CONCLUSIONS: There was a low incidence of fracture when reciprocating files were used in up to 3 cases of endodontic treatment in posterior teeth.

Variação anatômica de primeiro molar inferior e a importância de uma descontaminação efetiva

Introdução: a literatura tem relatado vários casos clínicos sobre variações anatômicas de molares mandibulares.Entretanto, poucos relatos mostraram tratamentos de primeiros molares inferiores permanentes com vistas à Endodontia atual. Objetivo: este trabalho tem o objetivo de relatar o tratamento endodôntico bem-sucedido de um primeiro molar mandibular que apresentava cinco canais radiculares diagnosticado com pulpite sintomática irreversível.Caso clínico: o acesso à câmara pulpar foi realizado,seguido da localização dos canais radiculares. Três canais na raiz mesial e dois na distal foram observados. Em seguida, o preparo químico mecânico foi realizado com limas manuais e rotatórias e irrigação copiosa com hipoclorito de sódio 2,5% durante toda a instrumentação. A obturação foi feita por meio da técnica híbrida de Tagger, e a restauração definitiva foi completada após uma semana. Conclusão: o conhecimento da anatomia do sistema de canais radiculares de primeiros molares mandibulares agrega informações à área,assim como contribuirá para o tratamento endodôntico com mais sucesso pelos profissionais.

Surface morphology alterations in bovine dentin exposed to different bleaching agents

Aim: This study evaluated the morphological changes caused by internal bleaching agents on dentin surface. Methods: Twenty crowns of bovine incisors were cut into slabs that were randomly distributed in six experimental groups (n = 5), according to the bleaching agent used: G1 – sodium perborate + water, G2 – sodium perborate + 2% chlorhexidine gel, G3 – sodium perborate + 30% hydrogen peroxide, G4 – 30% hydrogen peroxide, G5 – 37% carbamide peroxide and G6 – gel base without carbamide. Two Control Groups were used: C1 with distilled water and C2 with 2% chlorhexidine gel. The specimens were immersed in the respective test bleaching agent and incubated at 37 °C for seven days. Following, they were prepared for scanning electron microscopy and five images from each tooth segment were recorded and analyzed for surface morphological alterations, by three previously calibrated examiners. Inter-examiner agreement was verified using the Kappa test. The rank averages obtained for the groups were subjected to Kruskal-Wallis analysis of variance at 5% significance level. Results: The analysis of the scores obtained indicated that all tested materials caused some morphological alteration on dentin, except for sodium perborate + water (G1) and Control Groups 1 and 2. Hydrogen peroxide and carbamide peroxide caused significantly more severe alterations (p < 0.05) to dentin structure, than the other bleaching agents evaluated. Conclusions: Sodium perborate-based pastes seemed to be the most harmless agent to dentinstructures in non-vital tooth bleaching, while hydrogen peroxide solutions and carbamide peroxide agents caused the greatest alterations.

In vitro assessment of a gel base containing 2% chlorhexidine as a sodium perborate's vehicle for intracoronal bleaching of discolored teeth.

The purpose of this study was to assess a gel base containing 2% chlorhexidine (CHX) as a vehicle to be mixed with sodium perborate for intracoronal bleaching of discolored teeth, comparing its bleaching efficacy to sodium perborate mixed with other vehicles; 37% carbamide peroxide and 30% hydrogen peroxide. There were 110 fresh bovine incisors artificially stained using whole blood. The samples were divided into 11 groups and the intracoronal bleaching was performed using the "walking bleach technique". The bleaching agents were replaced three times at 7-day intervals. Using digital photos and a shade guide created for bovine teeth, the samples were evaluated at day 0, 7, 14, 21, and 28. On evaluation day, the photos were examined by three endodontists giving scores from 1 to 5 based on the shade guide created. Data were analyzed statistically by Kruskall-Wallis test. After 28 days, all evaluated teeth received scores that were statistically similar. Groups that used sodium perborate and a liquid vehicle bleached faster than those that used a gel based vehicle. The CHX gel allowed dissociation for the bleaching agent. The 2% CHX gel exhibited a good potential for use as a vehicle for sodium perborate or as a complement for carbamide peroxide.

Remoçäo de Smear Layer dos canais radiculares utilizando o irrigante Endoquil / Evaluation of the Smear Layer removal in root canals using Endoquil irrigant

O trabalho teve o objetivo de avaliar a capacidade de remoçäo de smear layer dos canais radiculares empregando diferentes tipos de irrigantes endodônticos. Foram utilizados 20 dentes, distribuídos entre quatro grupos: EDTA 17 por cento; hipoclorito de sódio a 5,25 por cento; Endoquil©; tendo a água destilada como grupo controle. Os dentes foram instrumentados e clivados, sendo as amostras submetidas à análise em microscopia eletrônica de varredura. Os resultados mostraram que os grupos do EDTA 17 por cento e Endoquil© obtiveram superior capacidade de limpeza das paredes dos canais radiculares

Avaliaçäo de métodos de localizaçäo radiográfica para o clínico geral: parte II / Evaluation of radiographic localization techniques for the general practitioner: part II

A presença de dentes näo irrompidos é frequente na prática diária dos consultórios odontológicos e nem sempre as imagens radiográficas obtidas através de técnicas de rotina permitem um diagnóstico satisfatório dessa condiçäo. As limitaçöes das técnicas radigráficas empregadas rotineiramente podem ser superadas pelos métodos de localizaçäo radiográfica, os quais säo de grande valor para um correto diagnóstico e planejamento de terapêuticas. Este trabalho teve como objetivo apresentar os métodos de localizaçäo radiográfica de Johson, temporotuberosidade, Lnaglais e Donovan, citando suas indicaçöes, procedimentos técnicos para a correta execuçäo e interpretaçäo radiográfica dos resultados