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4.
Dentomaxillofac Radiol ; 49(2): 20190229, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31642713

RESUMEN

OBJECTIVES: To implement the quality control assurance protocol (including the re-establishment of baseline data from 2016) to monitor the stability of image quality of CBCT machines located within the UT Health San Antonio School of Dentistry. METHODS AND MATERIALS: Five CBCT machines ProMax 3D Mid® (Planmeca Oy, Helsinki, Finland), 3D Accuitomo XYZ Slice View Tomograph® (Model MCT-1, Type EX-1F8; Fushimi-ku, Kyoto: J. Morita Mfg. Corp), Veraviewepocs 3D (Model R100; Fushimi-ku, Kyoto: J. Morita Mfg. Corp), PreXion3D Excelsior® (PreXion, San Mateo, CA), and i-CAT FLX Series® (Imaging Sciences International, Hatfield, PA) were tested for Artifact, Contrast-to-Noise Ratio, Noise, Spatial Resolution, and Contrast Resolution using a custom insert configuration in the SEDENTEXCT IQ phantom. RESULTS: Four-scan benchmark mean values for Artifact, Contrast-to-Noise, Noise, Spatial Resolution, and Contrast Resolution were determined for the five machines tested with associated alert and action level thresholds calculated. CONCLUSION: This newly developed QA protocol established image quality baseline values. Recommended tests, frequency, and actions levels have been updated and control charts established for future trend analysis to enable proper implementation of a QA protocol monitoring CBCT machines at UT health San Antonio.

10.
Sci Rep ; 9(1): 10860, 2019 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-31350423

RESUMEN

Direct visualization of the spatial relationships of the dental pulp tissue at the whole-organ has remained challenging. CLARITY (Clear Lipid-exchanged Acrylamide Tissue hYdrogel) is a tissue clearing method that has enabled successful 3-dimensional (3D) imaging of intact tissues with high-resolution and preserved anatomic structures. We used CLARITY to study the whole human dental pulp with emphasis on the neurovascular components. Dental pulps from sound teeth were CLARITY-cleared, immunostained for PGP9.5 and CD31, as markers for peripheral neurons and blood vessels, respectively, and imaged with light sheet microscopy. Visualization of the whole dental pulp innervation and vasculature was achieved. Innervation comprised 40% of the dental pulp volume and the vasculature another 40%. Marked innervation morphological differences between uni- and multiradicular teeth were found, also distinct neurovascular interplays. Quantification of the neural and vascular structures distribution, diameter and area showed that blood vessels in the capillary size range was twice as high as that of nerve fibers. In conclusion whole CLARITY-cleared dental pulp samples revealed 3D-morphological neurovascular interactions that could not be visualized with standard microscopy. This represents an outstanding tool to study the molecular and structural intricacies of whole dental tissues in the context of disease and treatment methods.

12.
J Endod ; 45(6): 729-735, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31036381

RESUMEN

INTRODUCTION: A plethora of bioactive molecules present during tooth formation become sequestered in the mineralized dentin matrix and can be released into the pulp tissue after demineralization from carious lesions. However, neurotrophic factors are differentially expressed and secreted during various stages of odontogenesis. Thus, the aims of this study were (1) to investigate their presence and relative abundance in crown and root dentin and (2) to evaluate the bioactivity of dentin-derived proteins on neuronal cells. METHODS: Dentin matrix proteins (DMPs) were isolated from matched roots and crowns of extracted healthy human third molars. The total protein amount as well as the concentration of growth factors and neurotrophic proteins were quantified. The impact on neuritogenesis was determined with mouse trigeminal neurons in vitro and by a hydrogel implant model in vivo. Transient receptor potential cation channel subfamily V member 1 (TRPV1) sensitization of DMP-conditioned neurons was evaluated by single-cell calcium imaging. RESULTS: The relative concentration of neurotrophic molecules revealed that nerve growth factor is the most abundant neurotrophin with 3-fold increased expression in radicular dentin. Similarly, brain-derived neurotrophic factor and neurotrophin 3 are more abundant in radicular than coronal dentin. Conversely, glial cell line-derived neurotrophic factor is more abundant in coronal dentin, whereas neurotrophin 4 is equally distributed. Dentin matrix proteins promoted neurite outgrowth in vitro and axonal targeting in vivo, with a greater effect observed by radicular dentin extracts. Furthermore, DMPs sensitized TRPV1 responses in mouse trigeminal neurons with greater activity seen with extracts from root dentin. CONCLUSIONS: Neurotrophic factors are differentially distributed between coronal and radicular dentin with different effects of dentin-derived proteins on axonal growth and targeting as well as the sensitization of TRPV1. Thus, extracellular proteins from the dentin matrix are likely involved in neurogenic responses to caries and could be exploited in clinical regenerative endodontics to promote reinnervation and enhance tissue regeneration.


Asunto(s)
Dentina , Factores de Crecimiento Nervioso , Canales Catiónicos TRPV , Diente , Nervio Trigémino , Animales , Dentina/fisiología , Humanos , Ratones , Factores de Crecimiento Nervioso/metabolismo , Neurotrofina 3 , Odontogénesis , Células Receptoras Sensoriales , Canales Catiónicos TRPV/metabolismo , Nervio Trigémino/fisiología
13.
J Endod ; 45(4): 414-419, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30771898

RESUMEN

INTRODUCTION: Neurotrophic factors play a significant role in the innervation of the pulp-dentin complex during and after organogenesis. There have been numerous bioactive molecules identified in the dentin extracellular matrix; however, the expression of neurotrophic factors in the dentin matrix and their biological activity are largely unknown. The purpose of this study was to characterize the relative expression of neurotrophic factors in human dentin matrix proteins (DMPs) and their effect on neurite outgrowth of trigeminal (TG) neurons. METHODS: Dentin was powdered in liquid nitrogen from noncarious human third molar teeth. DMPs were solubilized through an EDTA extraction method, dialyzed, and lyophilized until use. The relative expression of nerve growth factor, brain-derived neurotrophic factor, glial cell-line derived neurotrophic factor, neurotrophin 3, and neurotrophin 4/5 was determined by the enzyme-linked immunosorbent assay. Rat TG neurons were cultured and exposed to different concentrations of DMPs (1-105 ng/mL) or vehicle, and a quantitative neurite outgrowth assay was performed. RESULTS: Human DMPs contained all of the tested neurotrophic factors, with glial cell-line derived neurotrophic factor and neurotrophin 4/5 found at the highest levels. DMPs were able to promote the neurite outgrowth of rat TG neurons at an optimum concentration of 10-102 ng/mL, whereas the effect was partially inhibited at higher concentrations (>103 ng/mL). CONCLUSIONS: The human dentin extracellular matrix is a rich reservoir for neurotrophic factors that are key components for neuronal homeostasis, differentiation, and regeneration. These data suggest that neurotrophins in DMPs could play an important role as signaling molecules for the innervation of the pulp-dentin complex during the processes of tooth formation, repair, and regeneration.


Asunto(s)
Dentina/metabolismo , Factores de Crecimiento Nervioso/metabolismo , Factores de Crecimiento Nervioso/farmacología , Proyección Neuronal/efectos de los fármacos , Nervio Trigémino/crecimiento & desarrollo , Animales , Células Cultivadas , Relación Dosis-Respuesta a Droga , Ácido Edético , Ensayo de Inmunoadsorción Enzimática , Humanos , Masculino , Tercer Molar , Factores de Crecimiento Nervioso/fisiología , Ratas , Ratas Sprague-Dawley , Estimulación Química
14.
J Endod ; 45(2): 156-160, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30711171

RESUMEN

INTRODUCTION: Several irrigants have been used for disinfection in regenerative endodontic procedures including chlorhexidine (CHX). In this context, the antibacterial properties of disinfectants are mainly in focus of research even though they may have an undesirable impact on the fate of stem cells. In this study, we hypothesized that CHX has both a direct effect when applied to stem cells of the apical papilla (SCAPs) and an indirect effect when SCAPs are exposed to dentin previously conditioned with CHX. METHODS: Cell toxicity was evaluated in vitro using the CellTox green fluorescence assay (Promega, Madison, WI) and CellTiter-Glo (Promega) after SCAPs were exposed directly to a dynamic concentration range of CHX; apical papilla explant cultures were stained with ApopTag (Merck Millipore, Billerica, MA) after culture with CHX. Furthermore, standardized slabs from human dentin were treated with CHX and consecutively rinsed in EDTA, L-α-lecithin (Sigma-Aldrich, St Louis, MO), or L-α-lecithin followed by EDTA. After that, SCAPs were cultured on the slabs for 5 days, and cellular viability was determined (indirect effect). Data were treated nonparametrically and analyzed using the Krukal-Wallis test (P ≤ .05). RESULTS: Direct exposure of SCAPs to CHX highly affected cell viability at concentrations above 10-3%, whereas lower concentrations had no adverse effect. During the initial 60 minutes, concentrations of 10-2% CHX or higher resulted in early pronounced toxicity with a maximum effect within 15 minutes after exposure. Likewise, CHX-conditioned dentin slabs were detrimental to SCAP survival; however, the deleterious effects were completely reversed by neutralization with L-α-lecithin. CONCLUSIONS: Chlorhexidine is toxic to SCAPs when applied directly or indirectly via conditioned dentin. If applied for a short time and neutralized by L-α-lecithin, it can be a gentle and cell-preserving disinfectant before endodontic regeneration.


Asunto(s)
Antiinfecciosos Locales/efectos adversos , Supervivencia Celular/efectos de los fármacos , Clorhexidina/efectos adversos , Papila Dental/citología , Desinfectantes/efectos adversos , Irrigantes del Conducto Radicular/efectos adversos , Células Madre/efectos de los fármacos , Ápice del Diente/citología , Antiinfecciosos Locales/administración & dosificación , Células Cultivadas , Clorhexidina/administración & dosificación , Clorhexidina/antagonistas & inhibidores , Clorhexidina/toxicidad , Desinfectantes/administración & dosificación , Desinfectantes/antagonistas & inhibidores , Desinfectantes/toxicidad , Relación Dosis-Respuesta a Droga , Humanos , Lecitinas/farmacología , Endodoncia Regenerativa , Irrigantes del Conducto Radicular/administración & dosificación , Irrigantes del Conducto Radicular/toxicidad
15.
J Endod ; 45(1): 51-56, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30558798

RESUMEN

INTRODUCTION: Endodontic sealers have traditionally been used to seal dentinal tubules, creating a homogenous interface between the obturation material and the dentinal walls. However, bioceramic sealers have potential added benefits because of their bioactivity. After adequate endodontic therapy, osseous healing is largely dependent on the differentiation and activity of osteoblasts. We hypothesized that EndoSequence BC Sealer (Brasseler, Savannah, GA) and ProRoot ES (Dentsply Tulsa Dental Specialties, Johnson City, TN) have superior biocompatibility and osteogenic potential compared with Roth (Roth International, Chicago, IL) and AH Plus (Dentsply DeTrey Gmbh, Konstanz, Germany) sealers. METHODS: A murine osteoblast precursor cell line (IDG-SW3) was exposed to a wide range of concentrations for each of the sealers for 7 days. The relative cell viability was determined by luminescence assay based on adenosine triphosphate quantification (CellTiter-Glo [Promega, Madison, Wisconsin]). The osteogenic potential was determined by fluorescence microscopy of DMP-1 expression, alizarin red staining, and real-time reverse transcription polymerase chain reaction with primers specific for known markers of osteogenesis such as DMP-1, ALP, and Phex. Data were analyzed with 2-way analysis of variance or 1-way analysis of variance with the Bonferroni post hoc test. RESULTS: Both bioceramic sealers have excellent biocompatibility even at high concentrations. Conversely, cell death was detected when Roth and AH Plus were used at concentrations 100× lower than the bioceramic groups. Importantly, both bioceramic sealers significantly enhanced osteoblastic differentiation although greater responses were noted with EndoSequence BC Sealer. This was evidenced by increased DMP-1 expression, robust up-regulation of osteogenic marker gene expression, and superior mineral deposition. Osteoblastic differentiation and function were significantly impaired when Roth or AH Plus sealer was used. CONCLUSIONS: EndoSequence BC Sealer and ProRoot ES were significantly more biocompatible and promoted osteoblastic differentiation, a bioactivity not found in AH Plus and Roth sealers.


Asunto(s)
Materiales Biocompatibles/farmacología , Diferenciación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Osteoblastos/fisiología , Osteogénesis/efectos de los fármacos , Materiales de Obturación del Conducto Radicular/farmacología , Animales , Compuestos de Calcio/farmacología , Fosfatos de Calcio/farmacología , Células Cultivadas , Relación Dosis-Respuesta a Droga , Resinas Epoxi/farmacología , Proteínas de la Matriz Extracelular/genética , Proteínas de la Matriz Extracelular/metabolismo , Expresión Génica , Ensayo de Materiales/métodos , Ratones , Osteoblastos/metabolismo , Osteogénesis/genética , Silicatos/farmacología , Cemento de Óxido de Zinc-Eugenol/farmacología
16.
Braz Dent J ; 29(6): 517-529, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30517473

RESUMEN

Cone-beam computed tomography (CBCT) has promoted changes in approaches in Endodontics, and enhanced decision-making in complex clinical cases. Despite the technological advancements in CBCT hardware, the interpretation of the acquired images is still compromised by viewing software packages that often have limited navigational tools and lack adequate filters to overcome some challenges of the CBCT technology such as artefacts. This study reviews the current limitations of CBCT and the potential of a new CBCT software package (e-Vol DX, CDT- Brazil) to overcome these aspects and support diagnosing, planning and managing of endodontic cases. This imaging method provide high resolution images due to submillimeter voxel sizes, dynamic multi-plane imaging navigation and ability to change the volume parameters such as slice thickness and slice intervals and data correction applying imaging filters and manipulating brightness and contrast. The main differences between e-Vol DX and other software packages are: compatibility with all current CBCT scanners with the capacity to export DICOM Data, a more comprehensive brightness and contrast library, as other applications, in which adjustments are limited, do not usually support all the DICOM dynamic range features; Custom slice thickness adjustment, often limited and pre-defined in other applications; Custom Sharpening adjustment, often limited in other applications; advanced noise reduction algorithm that enhances image quality; preset imaging filters, dedicated endodontic volume rendering filters with the ability to zoom the image over 1000x (3D reconstructions) without loss of resolution and automatic imaging parameters customization for better standardization and opportunities for research; capture screen resolution of 192 dpi, with a 384 dpi option, in contrast to the 96 dpi of most similar applications. This new CBCT software package may support decision-making for the treatment of complex endodontic cases and improve diagnosis and treatment results. Effective improvement of image quality favors the rational prescription and interpretation of CBCT scans.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Endodoncia , Interpretación de Imagen Radiográfica Asistida por Computador , Programas Informáticos , Brasil , Humanos
17.
Braz. dent. j ; 29(6): 517-529, Nov.-Dec. 2018. graf
Artículo en Inglés | LILACS-Express | ID: biblio-974200

RESUMEN

Abstract Cone-beam computed tomography (CBCT) has promoted changes in approaches in Endodontics, and enhanced decision-making in complex clinical cases. Despite the technological advancements in CBCT hardware, the interpretation of the acquired images is still compromised by viewing software packages that often have limited navigational tools and lack adequate filters to overcome some challenges of the CBCT technology such as artefacts. This study reviews the current limitations of CBCT and the potential of a new CBCT software package (e-Vol DX, CDT- Brazil) to overcome these aspects and support diagnosing, planning and managing of endodontic cases. This imaging method provide high resolution images due to submillimeter voxel sizes, dynamic multi-plane imaging navigation and ability to change the volume parameters such as slice thickness and slice intervals and data correction applying imaging filters and manipulating brightness and contrast. The main differences between e-Vol DX and other software packages are: compatibility with all current CBCT scanners with the capacity to export DICOM Data, a more comprehensive brightness and contrast library, as other applications, in which adjustments are limited, do not usually support all the DICOM dynamic range features; Custom slice thickness adjustment, often limited and pre-defined in other applications; Custom Sharpening adjustment, often limited in other applications; advanced noise reduction algorithm that enhances image quality; preset imaging filters, dedicated endodontic volume rendering filters with the ability to zoom the image over 1000x (3D reconstructions) without loss of resolution and automatic imaging parameters customization for better standardization and opportunities for research; capture screen resolution of 192 dpi, with a 384 dpi option, in contrast to the 96 dpi of most similar applications. This new CBCT software package may support decision-making for the treatment of complex endodontic cases and improve diagnosis and treatment results. Effective improvement of image quality favors the rational prescription and interpretation of CBCT scans.


Resumo A tomografia computadorizada de feixe cônico (TCFC) promoveu mudanças nas abordagens de Endodontia e melhorou a tomada de decisões em casos clínicos complexos. Apesar dos avanços tecnológicos no hardware da TCFC, a interpretação da imagem adquirida ainda é comprometida pela visualização dos softwares, que muitas vezes têm ferramentas de navegação limitadas e falta de filtros adequados para superar estes desafios, como artefatos. Este estudo analisa as limitações atuais da TCFC e o potencial de um novo software (e-Vol DX, CDT-Brasil) para superar estes aspectos e apoiar o diagnóstico, planejamento e monitoramento de casos endodônticos. Este método de imagem fornece imagens em alta resolução devido a tamanhos submilimétricos de voxel, navegação dinâmica de imagens em vários planos e capacidade de alterar os parâmetros de volume como espessura de corte, intervalos de corte, correção de dados por meio de filtros de imagem, e manipulação do brilho e do contraste. As principais diferenças entre o e-Vol DX e outros software são: compatibilidade com todos os scanners de TCFC atuais com capacidade de exportar dados DICOM, com ajuste de brilho e contraste mais abrangente comparado a outros aplicativos, em que os ajustes são limitados, e geralmente não suportam todos os recursos da faixa dinâmica DICOM; ajuste de espessura de corte personalizado, muitas vezes limitado e pré-definido em outras aplicações; ajuste de nitidez personalizado, muitas vezes limitado em outras aplicações; algoritmo avançado de redução de ruído que melhora a qualidade da imagem; filtros de imagem predefinidos, filtros de para análise de volume do canal radicular com a capacidade de ampliar a imagem em mais de 1000x (reconstruções em 3D) sem perda de resolução, e personalização de parâmetros de imagem automática para melhor padronização e oportunidades de pesquisa; captura com resolução da tela de 192 dpi, com uma opção de 384 dpi, em contraste com os 96 dpi das aplicações similares. Este novo software de TCFC pode apoiar as tomadas de decisões para o tratamento de casos endodônticos complexos e melhorar os resultados do diagnóstico e do tratamento. A melhoria efetiva da qualidade da imagem favorece a prescrição e a interpretação racional das imagens de TCFC.

18.
J Endod ; 44(12): 1802-1811, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30477666

RESUMEN

INTRODUCTION: Regeneration of the pulp-dentin complex is the penultimate goal of regenerative endodontic procedures (REPs). Histological outcomes have demonstrated reparative tissue formation in human teeth extracted post-REPs. However, lack of accurate characterization has precluded identification of the true nature of tissues formed post-REP. METHODS: Here, we present 2 case reports of tooth #29 and #9 treated with REPs and demonstrate their clinical, radiographic, and histological outcomes. RESULTS: Clinical outcomes revealed healing of apical periodontitis in both teeth and re-establishment of vitality responses in tooth #29. Moreover, radiographic assessments using 2D and 3D-volumetric analyses demonstrate considerable increase in root development for both teeth. Further, histological outcomes evaluated using Hematoxylin and Eosin and immunohistochemical staining demonstrates presence of vascular and lymphatic structures as well as immune cell markers indicative of regeneration of an immunocompetent pulp. Lastly, examination of hard tissue deposition shows dentin-like tissue in parts of tooth #29 demonstrating for the first time, regeneration of a pulp-dentin complex post-REP. CONCLUSIONS: Collectively, this is the first study demonstrating recapitulation of several tissues commonly found as part of a pulp-dentin complex in teeth treated with REPs.


Asunto(s)
Pulpa Dental/fisiología , Dentina/fisiología , Periodontitis Periapical , Regeneración , Endodoncia Regenerativa/métodos , Raíz del Diente/fisiología , Niño , Pulpa Dental/diagnóstico por imagen , Pulpa Dental/inmunología , Pulpa Dental/inervación , Necrosis de la Pulpa Dental/terapia , Dentina/diagnóstico por imagen , Dentina/inmunología , Dentina/inervación , Femenino , Humanos , Imagen Tridimensional , Regeneración Nerviosa , Periodontitis Periapical/diagnóstico por imagen , Periodontitis Periapical/patología , Periodontitis Periapical/fisiopatología , Periodontitis Periapical/terapia , Radiografía Dental , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/inmunología , Raíz del Diente/inervación , Resultado del Tratamiento , Cicatrización de Heridas
19.
J Endod ; 44(11): 1741-1748, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30266469

RESUMEN

INTRODUCTION: The purpose of this study was to determine the position of the apical foramen (AF) in relation to root surfaces of human permanent teeth using cone-beam computed tomographic (CBCT) imaging and novel advanced imaging analysis software (e-Vol DX; CDT Software, Bauru, SP, Brazil). METHODS: The AF position was determined on CBCT scans viewed and analyzed using e-Vol DX of 1400 teeth (422 patients) according to the root surface as follows: buccal, mesiobuccal, mesial, mesiolingual/palatal, lingual/palatal, distolingual/palatal, distal, distobuccal, and central. Categoric variables were described as frequencies and percentages. Frequencies were reported with their confidence intervals (95%). Categoric variables were analyzed using the chi-square test with Yates correction. The level of significance was set at α = 0.05. RESULTS: The most frequent AF position in maxillary anterior teeth was central (46%-60%). The AF in mandibular central incisors was buccal in 44% of the cases. In maxillary first and second premolars, 39.98% and 42.56% of all AFs were central. In maxillary first and second molars, 46.12% and 57.49% of all AFs were central. The most frequent AF position in mandibular first and second premolars was central (42.85% and 50.98%). In mandibular first molars, 48.72% of all AFs were central. CONCLUSIONS: The AF position in human permanent teeth was central in 48.95% and 42.08% of the maxillary and mandibular teeth. CBCT images analyzed by e-Vol DX can be used to determine the true anatomic position of the AF and can be a useful tool for the treatment planning of nonsurgical and surgical endodontic treatments.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Dentición Permanente , Radiografía Dental/métodos , Programas Informáticos , Ápice del Diente/anatomía & histología , Ápice del Diente/diagnóstico por imagen , Raíz del Diente/anatomía & histología , Raíz del Diente/diagnóstico por imagen , Adulto , Femenino , Humanos , Masculino
20.
J Endod ; 44(10): 1474-1479, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30144986

RESUMEN

INTRODUCTION: This randomized clinical study compared the antibacterial effectiveness of treatment protocols using either a triple antibiotic solution (1 mg/mL) or calcium hydroxide/chlorhexidine paste as interappointment medication in infected canals of teeth with primary apical periodontitis. METHODS: The root canals of single-rooted teeth with apical periodontitis were prepared by using a reciprocating single-instrument technique with 2.5% sodium hypochlorite irrigation and then medicated for 1 week with either a triple antibiotic solution (minocycline, metronidazole, and ciprofloxacin) at 1 mg/mL (n = 24) or a calcium hydroxide paste in 2% chlorhexidine gluconate (n = 23). Samples were taken from the canal at the baseline (S1), after chemomechanical preparation (S2), and after intracanal medication (S3). DNA extracts from clinical samples were evaluated for total bacterial reduction using a 16S ribosomal RNA gene-based quantitative polymerase chain reaction assay. RESULTS: All S1 samples were positive for the presence of bacteria, and counts were substantially reduced after treatment procedures (P < .01). Bacterial levels in S2 and S3 samples did not significantly differ between groups (P > .05). S2 to S3 reduction was 97% in the antibiotic group and 39% in the calcium hydroxide/chlorhexidine group; only the former reached statistical significance (P < .01). There were significantly more quantitative polymerase chain reaction-negative S3 samples in the antibiotic group than in the calcium hydroxide group (P < .05). CONCLUSIONS: Interappointment medication with a triple antibiotic solution at the concentration of 1 mg/mL significantly improved root canal disinfection, and its effects were at least comparable with the calcium hydroxide/chlorhexidine paste. Effectiveness and easy delivery of the antibiotic solution make it an appropriate medicament as part of a disinfecting protocol for conventional nonsurgical endodontic treatment and possibly regenerative endodontic procedures.


Asunto(s)
Antibacterianos/administración & dosificación , Infecciones Bacterianas/microbiología , Infecciones Bacterianas/prevención & control , Hidróxido de Calcio/administración & dosificación , Clorhexidina/administración & dosificación , Ciprofloxacino/administración & dosificación , Desinfectantes Dentales/administración & dosificación , Metronidazol/administración & dosificación , Minociclina/administración & dosificación , Periodontitis Periapical/microbiología , Periodontitis Periapical/cirugía , Irrigantes del Conducto Radicular/administración & dosificación , Preparación del Conducto Radicular/métodos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pomadas , Soluciones , Adulto Joven
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