Endodontic treatment during COVID-19 pandemic - Economic perception of dental professionals

Aim: This study evaluated, by the application of questionnaires, the impact of the COVID-19 pandemic on the clinical routine and inspection by the competent authorities, on the flow of patients in the office, as well as on possible changes in Endodontic treatment costs and the amounts charged to patients. Methods: This cross-sectional study was conducted from May 2nd, 2020 to May 6th, 2020, using an online questionnaire with a convenience sample. The inclusion criterion was professionals who perform endodontic treatments in daily clinical practice and who professional setting is private practice. The questionnaire brought questions about the impact on costs and the amount charged to the patient. Results: A total of 1042 questionnaires were answered from all the different states of Brazil, by professional who usually perform Endodontic treatment, and who is working in private practice. A total of 1010 (96.9%) respondents affirm it was necessary to modify the protective equipment in endodontic treatment due to pandemic and longer intervals between appointments was cited by 922 (88.5%), economically affecting the dental practice. There was no association between routine changes and economic impacts with gender, professional experience, area of residence or education level. Conclusion: In conclusion, most dental professionals recognized changes in the routine of endodontic treatment during the COVID-19 pandemic. They have a perception of increase in endodontic costs, and reduction in the volume of patients

Estudo ex vivo da elevação do pH em superfície radicular externa após agitação ultrassônica de diferentes pastas de hidróxido de cálcio / Assessment of pH increase in the external root surface after ultrasonic agitation of different calcium hydroxide pastes: Ex vivo study

Objetivo: O presente estudo teve por objetivo avaliar, ex vivo, a capacidade de elevação do pH da superfície radicular externa de diferentes pastas de hidróxido de cálcio (HC) utilizadas como medicação intracanal, além da influência da ativação ultrassônica (AUS) durante aplicação no interior do canal radicular. Métodos: Foram utilizados 100 incisivos humanos superiores unirradiculares, que tiveram os canais radiculares modelados e divididos aleatoriamente em seis grupos experimentais (n=15), de acordo com a pasta de HC, tendo como variáveis as medicações utilizadas e a ativação da pasta com AUS no momento da aplicação, além de um grupo controle (n=10): Pasta Calen; HC+clorexidina 2% gel (CX2%); e HC + água destilada. Os dentes foram mantidos imersos em água deionizada e as medidas do pH, verificadas nos períodos de 7, 14, 21 e 28 dias, com auxílio de pHmetro. Resultados: De acordo com os dados obtidos, verificou-se elevação do pH nos períodos de 7 e 14 dias em todos os grupos. Apenas os grupos em que foi utilizada a associação do HC com CX2% apresentou evolução com aumento significativo do pH ao longo dos períodos analisados (p<0,05). A ativação das pastas com AUS proporcionou incremento significativo dos valores de pH (p<0,05). Conclusão: De acordo com a metodologia empregada, pode-se concluir que todas as pastas utilizadas promovem elevação do pH no tecido dentinário, e a ativação das pastas com AUS influencia significativamente na elevação do pH no tecido dentinário (AU).

Objective: The aim of the present study was to evaluate, ex-vivo, the pH elevation capacity on the external root surface of different calcium hydroxide (HC) pastes, utilized as intracanal medication, it was also evaluated the influence of the ultrasonic activation at the application within the root canal. Methods: 100 human single root superior incisors were used, which had their root canals shaped and randomly divided into 6 experimental groups (n=15) according to the following HC pastes: Calen; HC + Chlorhex- idine 2% gel (CX2%); HC + distilled water, utilizing the medications and the ultrasonic activation of the paste at the time of the application as variables and 1 control group (n=10). The teeth were kept immersed in deionized water and the pH parameters were verified in 7, 14, 21 and 28 days with a pH measurement machine. Results: According to the data obtained, pH was elevated in the first week in all groups. Only the groups which the association of HC with CX2% was made, did show a significant increase in the pH level over the analyzed periods (p < 0,05). The activation of the pastes with US provided a significant increase in pH values (p < 0,05). Conclusion: According to the methodology used, we can conclude that all the HC pastes used, promote pH elevation in dentin tissue. And the acti- vation of the pastes with US significantly influences the pH increase in dentin tissue

Persistent extra-radicular bacterial biofilm in endodontically treated human teeth: scanning electron microscopy analysis after apical surgery.

Biofilms are the main cause of endodontic failures. Even the best executed endodontic treatment can fail, when the infection is resistant to treatment or when it is located in inaccessible areas, such as the external surface of the root apex. The purpose of this study was to evaluate, by scanning electron microscopy, the presence of bacterial biofilm on endodontically treated teeth considered clinical failures and suitable for apical surgery. Root apices were collected from 20 teeth undergoing apical surgery and one negative control and analyzed under SEM. Digital photomicrographs of the root apices of 21 specimens at different magnifications were taken. Data were analyzed using descriptive statistics. Apical biofilms were observed in 100% of root canal treatments considered endodontic failure. Topographical analysis of the root apices revealed areas of resorption, microcracks, and apical foramina in 90%, 80%, and 50% of cases, respectively. Within the limits of this study, it can be concluded that endodontic failures present bacterial biofilm in areas inaccessible to conventional endodontic treatment, such as the external surfaces of the root apex.

Prevalência de dois canais em incisivos inferiores permanentes humanos / Prevalence of two root canal in humans permanent lower incisors

Introdução e objetivo: O sucesso do tratamento endodôntico requer um amplo conhecimento da anatomia do dente e de suas variações. Assim, o presente estudo teve como objetivo avaliar através das imagens radiográficas a prevalência de dois canais em incisivos inferiores permanentes humanos, determinando com isso o local de união desses canais. Material e métodos: Utilizou-se 100 dentes incisivos inferiores permanentes humanos. Inicialmente, em cada dente obteve-se um corte transversal na junção cemento-esmalte, logo após, realizou-se avaliação radiográfica em todos os dentes, visando identificar a presença ou não de dois canais. Posteriormente, identificou-se o local de bifurcação dos dentes com dois canais, através de radiografias. Resultado: Observou-se no exame radiográfico que 28% dos espécimes (28 dentes) examinados possuíam dois canais. Destes, 85,7% dos espécimes (23 dentes) apresentaram canais com união no terço apical, 7,1% dos espécimes (3 dentes) tinham canais independentes, 3,6% dos espécimes (1 dente) possuíam canais com união no terço médio e nenhum apresentava união dos canais no terço cervical. Em um dos dentes estudados (3,6%), não foi possível fazer essa avaliação. Conclusão: Conclui-se que a prevalência de dois canais em incisivos inferiores permanentes humanos foi de 28% dos espécimes, sendo que o principal local de união é o terço apical (85,7%).

Introduction and Objective: The success of endodontic treatment requires a comprehensive knowledge of tooth anatomy and its variations. So, this study aimed to evaluate the prevalence of two root canals in human permanent lower incisors, determining the place of union of these root canals. Materials and methods: A hundred human mandibular incisors were used. First, a cement-enamel cross section was obtained in each tooth, after that radiographic evaluation was performed in all the teeth in order to identify the presence or not of two root canals. Subsequently, the location of the bifurcation of two root canals teeth was identified through radiography. Results: It was observed through radiographic examination that 28% of the specimens (28 teeth) examined had two root canals. 85.7% of these specimens (23 teeth) presented union in the apical third, 7.1% of the specimens (3 teeth) had independent canals, 3.6% of the specimens (1 tooth) had canals with the union in the third medium and none of them presented union in the cervical third. In one of the teeth studied (3.6%), it was not possible to make this assessment. Conclusion: It was concluded that the prevalence of two root canal in human permanent lower incisors was of 28%, and that most unions occurred is the apical third (85.7%).

Hypochlorite-induced severe cellulitis during endodontic treatment: case report

Introduction: Sodium hypochlorite is a solution used in endodontic treatment, and if an accidental apical extrusion occurs, serious complications may affect soft tissue. Objective: The aim of this article is to present a case of apical extrusion of sodium hypochlorite (NaOCl) during root canal system instrumentation. Case report: A 28-year-old woman sought a local dental service for root canal treatment of tooth #24. Conventional endodontic treatment was adopted, which consisted of the use of 2.5% NaOCl solution as irrigation solution applied with a 10-ml syringe and 22G hypodermic needle. At that time, the patient reported extreme pain and a burning sensation in the left maxillary region, followed by the formation of intense edema. A clinical diagnosis of hypochlorite-induced cellulitis was made. The patient was treated immediately with amoxicillin (500 mg, orally) at intervals of 8 h for 7 days and dexamethasone (4 mg, intramuscularly) at intervals of 24 h for 3 days. In the subsequent endodontic treatment, 2% chlorhexidine gel applied with a 5-ml syringe and 24G needle was used as irrigation for a better control of treatment and to prevent new accidents. The root canals were instrumented using adequate crown-down technique, which provides a conical shape, and filled by lateral condensation technique. The patient was symptom free at the 8-month clinical follow-up. Conclusion: Dentists should always carefully follow all stages of dental treatment planning without neglecting any of them, paying attention to the solutions used and their storage as well as performing a specific technique with maximum accuracy. If an accident occurs, the appropriate handling of the situation will enable the satisfactory completion of treatment.

Filling lateral canals: influence of calcium hydroxide paste as a root canal dressing.

CONTEXT: The use of intracanal medication aims to provide antimicrobial activity in the root canal system, leading to a more satisfactory condition for root canal obturation. However, it is important to evaluate whether such medication would affect the sealing-off from the main root canal of ramifications such as lateral canals. AIM: Evaluate the influence of calcium hydroxide [Ca(OH)2] paste on the filling of lateral canals. SETTINGS AND DESIGN: Ex vivo quantitative laboratory study. MATERIALS AND METHODS: Sixty single-rooted teeth with lateral canals created were used, 10 teeth per group. Group A was described respectively as lateral condensation technique (subgroup 1), thermomechanical compaction (subgroup 2), and continuous wave of condensation (subgroup 3). In Group B, subgroups 4, 5, and 6 were filled with Ca(OH)2 for 7 days before filling using the techniques applied in subgroups 1, 2, and 3. Radiographic evaluation was performed to count the number of filled lateral canals in each group. The teeth were cross-sectioned over the lateral canals; thus, 180 specimens were obtained. Each specimen was immersed in a polyester resin. Digital images were obtained and specific software (Image Tool; ) was used to evaluate the number of obturated lateral canals and the filling length in each lateral canal of groups. STATISTICAL ANALYSIS USED: Data were statistically analyzed using SPSS 12.0 for Windows (Descriptive statistical analysis and Newman-Keuls test). RESULTS: A greater number of simulated lateral canals were filled in Group A (91.1%). Group B had less filled lateral canals (33.3%). The sealing of lateral canals was statistically different between Group B (26.15%) and Group A (74.43%). CONCLUSIONS: According to the radiographic analysis and the linear filling measurement, the use of Ca(OH)2 decreased the number and the length of sealed lateral canals.

Análise da prevalência do quarto canal de primeiros e segundos molares superiores permanentes humanos: avaliação clínica versus avaliação microscópica / Analysis of the prevalence of the fourth canal in first and second molars permanent humans: clinical evaluation versus microscopic evaluation

O objetivo deste estudo foi analisar a prevalência do quarto canal em primeiros e segundos molares superiores humanos e identificar onde esses canais uniam-se. Foram avaliados 89 dentes primeiros e segundos molares superiores humanos. Primeiramente, foi realizada uma análise clínica convencional em todos os dentes, procurando identificar o 4O canal, chamado MP. Em seguida, foi realizada uma nova análise desses dentes com o auxílio do Microscópio Operatório (MO), comparando os resultados. A última etapa deste trabalho foi identificar, através de radiografias, onde os canais da raiz mésio vestibular uniam-se. Observou-se que no exame clínico o 4O canal estava presente em 47,2% (42) dos dentes examinados, já no exame microscópico houve um considerável aumento, fazendo com que 65,1% (58) dos dentes examinados apresentassem o canal MP. Em 43,2% dos dentes analisados, os canais da raiz mésio vestibular estavam independentes. O MO é um instrumento muito importante para o domínio da anatomia interna dos dentes, aumentando de forma significante a quantidade de dentes em que o canal MP foi encontrado, em relação à análise clínica

The objective of this study was to analyze the prevalence of the mesiopalatine canal present in first and second maxillary permanent molars humans and identify where the fusion of the mesiobuccal root canals occur. Eighty-nine first and second maxillary permanent human molars were selected and evaluated clinically in order to determine the location of the mesiopalatine canal. After the samples were observed under a light microscope 40X magnification with the same purpose. Finally, X-rays were taken from those teeth to determine the canal pathway. In the clinical examination, the mesiopalatine canal was present in 47.2% (42) of the teeth examined, in the microscopic examination there was a considerable increase, making 65.1% (58) of the teeth examined has the canal orifice. In 43.2% of teeth examined mesiopalatine canals were independent. Operation microscope is a very important arsenal to diagnosis of the internal anatomy of teeth, increasing significantly the number of teeth in the canal orifice was found in relation to clinical analysis

Microbiological evaluation of infected root canals and their correlation with pain

Introduction and Objective: The aim of this study was to evaluate the endodontic microbiota of human teeth without pulp vitality presenting radiographically visible periapical lesions and its correlation with pre- and postoperative pain symptomatology. Material and methods: Sixteen young adult patients, both genders, aging from 18 to 45 years, presenting 21 single-rooted teeth with pulp necrosis and needing endodontic treatment were selected in the multidisciplinary clinic at the University of Fortaleza (UNIFOR). After crown surgical access, the root canals were embedded with 0.9% saline solution and the material from root canals was collected with sterile paper point. The paper points were placed into Stuart transport medium and sent to the microbiology laboratory of the University of Fortaleza. Isolation and identification of bacteria were made by culture technique. The cleaning and shaping of root canals was performed by crown-down technique. Intra-canal medication comprised calcium hydroxide mixed with chlorhexidine and after 14 days the canals were filled. Patients were asked about the occurrence of pain before treatment and 24 hours after cleaning and shaping procedures. Results: The most prevalent microbial group was Streptococcus sp. followed by Fusobacterium nucleatum, although Gram-positive cocci, non-sporulating Gram-positive bacilli, Gram-negative bacilli, pigmented Gram-negative bacilli, Veillonella, Staphylococcus aureus, Pseudomonas sp. were also frequently isolated. Conclusion: According to the results, it can be concluded that Fusobacterium nucleatum and Gram-negative bacilli were more related to pre-operative pain. Regarding to postoperative pain, the most prevalent bacteria were Gram-positive cocci.

Análise da capacidade de preenchimento de canais radiculares com guta-percha promovida por três diferentes técnicas de obturação de canais radiculares / Analysis of gutta-percha's root canal filling capacity through three different obturation techniques

Introdução e objetivo: O objetivo deste estudo foi determinar a deste estudo foi determinar a capacidade de preenchimento de canais radiculares com guta-percha por meio de três diferentes técnicas de obturação endodôntica. Material e métodos: Utilizaram-se 60 dentes unirradiculados, os quais foram limpos, modelados e divididos aleatoriamente em três grupos. Recorreuse a três técnicas distintas de obturação para cada grupo de estudo: grupo I ­ condensação lateral; grupo II ­ compressão hidráulica; grupo III ­ híbrida de Tagger. Todos os procedimentos foram executados por dois operadores calibrados em momento anterior. Após os procedimentos de obturação, seccionaram-se os espécimes transversalmente em quatro medidas a partir do ápice radicular (3 mm, 6 mm, 9 mm e 12 mm), com auxílio de disco de diamante montado em IsoMet®, sob intensa refrigeração e baixa rotação. Esses cortes foram incluídos em resina plástica e lixados, e as imagens dos canais radiculares capturadas e analisadas com auxílio do programa Image Tool 3.0. Mensuraram-se as áreas dos canais radiculares e de toda a massa de guta-percha presente no interior do canal radicular, a fim de obter a porcentagem de preenchimento do canal radicular com material guta-percha para cada corte. Resultados: Os resultados foram tabulados e avaliados por intermédio do programa GMC 10.0 (Kruskal-Wallis). A análise dos resultados evidenciou que a técnica híbrida de Tagger (95,1%) foi superior às demais na capacidade de preenchimento do canal radicular com guta-percha, seguida das técnicas da compressão hidráulica (89,1%) e da condensação lateral (70,6%). Os resultados mostraram-se diferentes estatisticamente entre as técnicas empregadas (p < 0,01) para todos os cortes obtidos. Quanto às análises intragrupos, notou-se diferença estatística significante apenas no grupo I (p < 0,01), porém os cortes executados em 6 mm e 9 mm foram iguais (p > 0,05). Conclusão: Das técnicas de obturação de canais radiculares testadas, a híbrida de Tagger possui a maior capacidade de preenchimento do sistema de canais radiculares com guta-percha. Depois vêm as técnicas da compressão hidráulica e da condensação lateral

Introduction and objective: The aim of this study was to determine gutta-percha's root canal filling capacity through three different filling techniques. Material and methods: Sixty single-rooted human teeth were cleaned, shaped and randomly divided according to the filling technique: Group I: Lateral condensation; Group II: Hydraulic compression; Group III: Tagger's hybrid. All procedures were performed by two previously calibrated operators. The teeth were transversely sectioned into four cuts, starting from the root apex (at 3 mm, 6 mm, 9 mm, and 12 mm), by using an Isomet diamond blade (wafering blade, series 15 high concentration, 5 inch blade, Buehler Ltd., Lake Bluff, IL, USA), mounted in an IsoMet® Low Speed Saw (Buehler Ltd., Lake Bluff, IL, USA), and water as a cooling medium. Each group's cut was embedded in acrylic resin and polished. Root canal images were captured and then analysed by Image Tool 3.0 software (Department of Dental Diagnostic Science, University of Texas, Health Science Center, San Antonio, Texas). Measurements of root canal overall area and gutta-percha-filled area were executed, therefore, obtaining the percentage of gutta-percha's root canal filling capacity for each slice. Results: Data were analyzed by GMC software 10.0 and Kruskal-Wallis test. Tagger's hybrid technique (95.1%) was superior to the other two techniques, followed by Hydraulic compression (89.1%) and lateral condensation (70.6%). The results were statistically different among the three techniques, for all cuts (p < 0.01). Intra-group analyses showed statistically significant differences only in Group I (p < 0.01). However, slices obtained at 6 mm and 9 mm were statistically equal (p > 0.05). Conclusion: These results suggest that Tagger's hybrid technique may yield better root canal filling capacity than Hydraulic compression and lateral condensation technique, which showed the worst filling capacity of all the three techniques employed

Antimicrobial effect of propolis and other substances against selected endodontic pathogens.

OBJECTIVE: The aim of this study was to determine the antimicrobial effect of ethanol extract of propolis (EEP) and intracanal medicaments calcium hydroxide, camphorated paramonochlorophenol, and formocresol by means of the macrodilution method using the reinforced clostridial medium (RCM) and brucella and brain heart infusion media. STUDY DESIGN: The antimicrobial agents were sequentially diluted and tested against anaerobic bacteria Prevotella nigrescens, Fusobacterium nucleatum, Actinomyces israelii, and Clostridium perfringens and against Enterococcus faecalis, with the 5 x 10(5) CFU/mL standardized inocula. The tubes were anaerobically incubated and the minimum inhibitory concentration was detected. Blood agar RCM subcultures were performed to provide minimum bactericidal concentration. The results were analyzed by analysis of variance test. RESULTS: All drugs were effective against all tested strains, without statistical differences. E. faecalis was the less susceptible strain, and RCM broth promoted faster bacterial growth, but there were no significant differences in these results. Ethanol did not influence the antimicrobial effect of EEP.

Penetraçäo intratubular de cimentos endodônticos / Intratubular penetration of root canal sealers

Este estudo foi desenvolvido para avaliar a capacidade de penetraçäo de diferentes cimentos endodônticos (Endo Fill, Sealapex, AH Plus e Pulp Canal Sealer) nos túbulos dentinários em dentes devidamente modelados e obturados. Foram utilizados 72 incisivos centrais superiores, os quais foram instrumentados no sentido coroa-ápice pela técnica de forças balanceadas. O comprimento de trabalho foi estabelecido a 1mm do ápice radicular. Durante a limpeza e modelagem, todos os dentes foram irrigados com 10 ml de hipoclorito de sódio a 5,25 por cento. Os dentes foram divididos em 4 grupos, sendo 1 para cada tipo de cimento. Estes grupos foram entäo subdivididos em funçäo do uso ou näo de EDTA a 17 por cento previamente à obturaçäo dos canais radiculares, para a remoçäo da lama dentinária. Todos os dentes foram obturados pela técnica da onda de condensaçäo com cone médio calibrado. Após obturaçäo, as raízes foram seccionadas no sentido mesio-distal e foi escolhida a secçäo de melhor qualidade visual. Estas foram entäo analisadas em microscopia eletrônica de varredura (MEV), sendo o foco de observaçäo sempre a interface dentina material obturador. Após obtençäo das imagens, mensurou-se os prolongamentos dos cimentos para o interior dos túbulos dentinários. O cimento de Rickert (Pulp Canal Sealer) apresentou a maior capacidade de penetraçäo nos túbulos dentinários, sendo os piores resultados apresentados pelo grupo que se utilizou o Sealapex. Os resultados foram avaliados estatisticamente pelo teste de SPEARMAN, o qual mostrou diferença estatisticamente significante (P0,01) entre os grupos que o EDTA foi utilizado

Activity of endodontic antibacterial agents against selected anaerobic bacteria.

The antimicrobial activity of substances used as antibacterial agents (solutions of 10% calcium hydroxide, camphorated paramonochlorophenol - PMCC, 2% chlorhexidine digluconate and 10% castor oil plant detergent) on anaerobic bacteria (Fusobacterium nucleatum ATCC 25586, Prevotella nigrescens ATCC 33563, Clostridium perfringens ATCC 13124 and Bacteroidesfragilis ATCC 25285), using a broth dilution technique, was evaluated in vitro. For determination of minimum inhibitory and minimum bactericide concentrations (MIC and MBC), two culture broths, Reinforced Clostridial Medium (RCM) and supplemented Brucella, standardized inoculum and serially diluted solutions were used. All antibacterial agents presented antimicrobial activity that varied for different bacteria. There were no differences in the performance of the two broths. Chlorhexidine digluconate was the most effective, with the lowest MICs, followed by castor oil detergent, PMCC and calcium hydroxide. C. perfringens and B. fragilis were the most resistant bacteria to all agents.

In vitro effect of intracanal medicaments on strict anaerobes by means of the broth dilution method.

The determination of bacterial susceptibility to intracanal medicaments is a necessity. Nevertheless, few studies utilize the proper methodology to carry out that evaluation with anaerobes. In this study, the steps of a broth dilution method, carried out in microplates (microdilution) and tubes (macrodilution), to test the effect of traditional intracanal medicaments on anaerobic bacteria are described. The results are presented as values of minimal inhibitory and bactericidal concentrations (MIC and MBC). Standardized inocula of the anaerobic bacteria Prevotella nigrescens (ATCC 33563), Fusobacterium nucleatum (ATCC 25586) and Clostridium perfringens (ATCC 13124), in reinforced Clostridium medium (RCM) and supplemented Brucella broth, were submitted to different concentrations of calcium hydroxide, chlorhexidine digluconate, camphorated paramonochlorophenol and formocresol solutions. The drugs were diluted in the same culture broths, in microplates and tubes, and were then incubated in anaerobiosis jars at 37 degrees C for 48 or 96 hours. The determination of MICs was carried out through visual and spectrophotometric readings, and the determination of MBCs, through the plating of aliquots on RCM-blood agar. For that kind of study, the macromethod with spectrophotometric reading should be the natural choice. MICs and MBCs obtained with the macromethod were compatible with the known clinical performance of the studied medications, and the values varied according to the bacteria and culture media employed. RCM was the most effective medium and C. perfringens, the most resistant microorganism.

In vitro effect of intracanal medicaments on strict anaerobes by means of the broth dilution method

A determinaçäo da suscetibilidade bacteriana aos medicamentos intracanal é uma necessidade, mas säo poucos os estudos que utilizam metodologia própria para anaeróbios estritos nessa avaliaçäo. Neste estudo, säo descritos os passos de um método de diluiçäo em caldo, feito em microplacas (microdiluiçäo) e em tubo (macrodiluiçäo), para testar a açäo de medicamentos intracanal tradicionais sobre bactérias anaeróbias estritas, com apresentaçäo dos resultados em Concentraçöes Inibitória e Bactericida Mínimas (CIM e CBM). Inóculos padronizados dos anaeróbios Prevotella nigrescens (ATCC 33563), Fusobacterium nucleatum (ATCC 25586) e Clostridium perfringens (ATCC 13124), em caldo Reinforced Clostridium Medium (RCM) e caldo Brucella suplementado, foram submetidos a diferentes concentraçöes de soluçöes de hidróxido de cálcio, digluconato de clorexidina, paramonoclorofenol canforado e formocresol, diluídas nos mesmos caldos de cultura, em microplacas e tubos, e depois incubados em jarras de anaerobiose a 37ºC por 48h ou 96h. A determinaçäo das CIMs foi feita através de leituras visual e em espectrofotômetro, e das CBMs, pela semeadura de alíquotas em ágar RCM-sangue. Para esse tipo de estudo, o macrométodo com leitura em espectrofotômetro deve ser a escolha natural. As CIMs e CBMs do macrométodo foram compatíveis com seu conhecido desempenho clínico, variando com as bactérias e meios de cultura empregados. O caldo RCM foi o mais efetivo e o C. perfringens, o microrganismo mais resistente

[Intratubular penetration of root canal sealers]. / Penetração intratubular de cimentos endodônticos.

The purpose of this study was to evaluate the capacity of penetration of four endodontic sealers (Endo Fill, Sealapex, AH Plus and Pulp Canal Sealer) into dentinal tubules. Seventy-two extracted human maxillary anterior teeth were utilized in this study. The teeth were cleaned and shaped by means of the balanced-forces technique. The work length was established at 1 mm beyond the apex. Copious irrigation with 10 ml of 5.25% sodium hypochlorite was carried out. The teeth were divided in 8 groups - 4 had the smear layer maintained, and 4 had it removed. The smear layer was removed with a commercial solution of 17% EDTA, and the root canal system was flushed for 3 min. Finally, the roots were irrigated with 3 ml of 5.25% sodium hypochlorite. All teeth were sealed by means of the technique of the condensation wave with a medium nonstandardized cone. After filling, the roots were grooved, longitudinally split and examined under a scanning electron microscope (SEM). The focus of observation was the interface between the dentin and the sealing material. The Rickert sealer (Pulp Canal) presented the maximum penetration depths into the dentinal tubules, and Sealapex, the minimum. The Spearman test was used to determine whether there were significant differences between the groups. The removal of smear layer allowed significant penetration of the sealers (p <= 0.01).

Activity of endodontic antibacterial agents against selected anaerobic bacteria

The antimicrobial activity of substances used as antibacterial agents (solutions of 10 calcium hydroxide, camphorated paramonochlorophenol - PMCC, 2 chlorhexidine digluconate and 10 castor oil plant detergent) on anaerobic bacteria (Fusobacterium nucleatum ATCC 25586, Prevotella nigrescens ATCC 33563, Clostridium perfringens ATCC 13124 and Bacteroidesfragilis ATCC 25285), using a broth dilution technique, was evaluated in vitro. For determination of minimum inhibitory and minimum bactericide concentrations (MIC and MBC), two culture broths, Reinforced Clostridial Medium (RCM) and supplemented Brucella, standardized inoculum and serially diluted solutions were used. All antibacterial agents presented antimicrobial activity that varied for different bacteria. There were no differences in the performance of the two broths. Chlorhexidine digluconate was the most effective, with the lowest MICs, followed by castor oil detergent, PMCC and calcium hydroxide. C. perfringens and B. fragilis were the most resistant bacteria to all agents.

Activity of endodontic antibacterial agents against selected anaerobic bacteria%Atividade antimicrobiana de agentes antibacterianos utilizados em Endodontia sobre bactérias anaeróbias estritas

Foi avaliada in vitro a capacidade antimicrobiana de substâncias utilizadas como agentes antimicrobianos (solução de hidróxido de cálcio 10 por cento, paramonoclorofenol canforado - PMCC, digluconato de clorexidina 2 por cento e detergente de mamona 10 por cento) sobre bactérias anaeróbias (Fusobacterium nucleatum ATCC 25586, Prevotella nigrescens ATCC 33563, Clostridium perfrigens ATCC 13124 e Bacteroides fragilis ATCC 25285), utilizando-se a técnica da diluição em caldo. Para a determinação das concentrações inibitória e bactericida mínimas (CIM e CBM), dois caldos, Reinforced Clostridial Medium (RCM) e Brucella suplementado, inóculo padronizado e diluições seriadas foram utilizados. Todos os agentes antimicrobianos apresentaram atividade antimicrobiana, variando para as diferentes espécies bacterianas, não havendo diferença entre os caldos utilizados. O digluconato de clorexidina demonstrou a melhor eficiência, com as menores CIMs, seguido pelo detergente de mamona, PMCC e hidróxido de cálcio. C. perfringens e B. fragilis foram as espécies mais resistentes aos agentes

Uso do laser DIAGNOdent no diagnóstico de cárie / DIAGNOdent laser efficacy in caries diagnosis

A cárie e as sequelas de sua evoluçäo säo responsáveis pela grande maioria dos tratamentos invasivos realizados pelos cirugiöes-dentistas. Seu diagnóstico pode ser realizado por vários métodos, entre eles o laser, como o DIAGNOdent, avaliado nesse trabalho. Esse dispositivo emite um feixe de laser diiodo e mede a quantidade de luz refletida na superfície dentária íntegra ou alterada. Mostrou resultados eficientes na detecçäo precoce de cáries incipientes e detecçäo de pontos de cáries profundas, sem ser fiel em determinar a sua profundidade. Portanto, é mais um meio auxiliar eficaz na detecçäo de cáries e da integridade das paredes de cavidades restauradoras