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1.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 9-17, maio-ago. 2021. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1252898

RESUMEN

As reabsorções radiculares são classificadas em interna e externa e um correto diagnóstico é fundamental para o sucesso no tratamento e é de suma importância que a resolução clínica seja feita precocemente para que se tenha um prognóstico clínico favorável. Reabsorção interna não é comum em dentes permanentes, e seu processo se caracteriza por um aumento do canal radicular de forma oval. O presente estudo teve como objetivos demonstrar e descrever através de um relato de prontuário o tratamento de reabsorção radicular interna de incisivos superiores permanentes. Através da seleção de uma paciente pela disciplina de Triagem da clínica odontológica do Centro Universitário da Serra Gaúcha, a qual apresentou alterações radiográficas compatíveis com reabsorção radicular interna inflamatória na região de dois incisivos superiores permanentes, com lesão periapical estabelecida em ambos, concluiu-se o tratamento para então gerar este estudo do tipo retrospectivo observacional. A reabsorção quando não tratada pode avançar e envolver estruturas além do tecido conjuntivo inflamado e a lesão pode avançar em direção apical. Após estabelecido o diagnóstico, iniciou-se os tratamentos endodônticos dos elementos utilizando hidróxido de cálcio como medicação intracanal, após as trocas de medicações as reabsorções foram controladas e então, as obturações dos canais foram realizadas, buscando um preenchimento adequado para o caso. A reabsorção radicular interna inflamatória causa danos irreversíveis, mas seu processo foi controlado através de terapia endodôntica. Este desempenho é considerado uma patologia, e pode comprometer qualquer extensão da raiz, é comum que os casos permaneçam assintomáticos, portanto, deve ser tratado o mais breve possível assim que descobertos para evitar sua progressão, e consequentemente danos maiores(AU)


Root resorption is classified as either internal or external, and a correct diagnosis is essential for successful treatment. Internal resorption is not common in permanent teeth, and its process is characterized by an enlarged oval root canal. The present study aims to demonstrate and describe, through a medical record, the treatment of internal root resorption of permanent upper incisors. A patient was selected from the Triage Course of the Dental Clinic (Centro Universitário da Serra Gaúcha) who presented radiographic changes associated with inflammatory internal root resorption in two permanente upper incisors, with a periapical lesion established in both and a treatment was then carried out in order to generate this retrospective observational study. Resorption when left untreated can progress and involve structures beyond the inflamed connective tissue and the lesion can advance in the apical direction. After the diagnosis was confirmed, endodontic treatments were initiated using calcium hydroxide as an intracanal medication. After changing the medication, the resorption was controlled and then the canal fillings were performed, seeking an adequate filling for the case. Inflammatory internal root resorption causes irreversible damage, but its process has been controlled through endodontic therapy. This performance is considered a pathology, and can compromise any extension of the root, it is common for the cases to remain asymptomatic, therefore, it should be treated as soon as it's discovered to prevent its progression, and consequently greater damage(AU)


Asunto(s)
Humanos , Femenino , Adulto , Tratamiento del Conducto Radicular , Resorción Radicular , Resorción Radicular/terapia , Incisivo , Hidróxido de Calcio , Dentición Permanente , Diente no Vital , Cavidad Pulpar
2.
Braz Oral Res ; 35: e064, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34076189

RESUMEN

Sixty moderately curved canals of mandibular molars classified as Vertucci's type IV canal configuration were selected by micro-CT 1174. The teeth were divided into two groups according to the kinematics used, whether reciprocating or rotary motion (n=30, totaling 60 mesial root canals). The instruments used to perform the glide path procedures had identical features (0.15 mm of tip size, 0.04 mm/mm taper, thermal treatment, and square cross-section), but differed in the direction of the cutting blade. The duration of the procedure and the absolute and percentage frequency of the instruments to reach the full working length were recorded. The torsional test (3630-1; 1992) was performed on both used and unused instruments, to evaluate a possible reduction in the torsional resistance when using the glide path procedure. Statistical analysis was performed using the unpaired t-test and the chi-square test, and the level of significance was set at 5%. The type of kinematics used affected the duration of glide path procedures, and the reciprocating motion seemed to induce less torsional stress during glide path procedures.


Asunto(s)
Cavidad Pulpar , Preparación del Conducto Radicular , Fenómenos Biomecánicos , Diseño de Equipo , Diente Molar/diagnóstico por imagen , Microtomografía por Rayos X
3.
Shanghai Kou Qiang Yi Xue ; 30(2): 124-128, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-34109348

RESUMEN

PURPOSE: To investigate the clinical outcomes, including survival and periapical healing rates and failure causes, of root canal treatment for patients with periapical lesion. METHODS: A retrospective cohort study was conducted which enrolled patients admitted for the evaluation and management of periapical lesion with root canal treatment. The primary predictor variables were difficulty assessment of root canal therapy (DARCT),which was divided into lower(DARCT =3-4), medium (DARCT =5-7) and higher (DARCT =8-9) difficulty root canal, in terms of canal length, curvature and calcification. The primary outcome measurement was the incidence of periapical healing and survival rate. Potential confounders included patient demographics, canal number, root canal filling, and coronal restoration. SPSS 21.0 software package was used for data analysis. RESULTS: The 5-year survival rate was 81.4%(83/102) and healing rate was 77.1% (64/83). DARCT was significantly associated with the survival rate(P=0.017). Root fracture, deep pockets lesions and periodontal abscess were observed in DARCT with a value of 8-9(P=0.027), leading to tooth extraction. The teeth with multiple root canals were extracted due to recurrent or persistent periapical lesion (P=0.004). Chi-square test showed that root canal number (P=0.021), quality of root canal filling (P=0.006) as well as DARCT (P=0.000) were significantly correlated with the final healing rate. Multivariate logistic regression analysis showed that DARCT (P=0.000) and the quality of root canal filling (P=0.033) were associated with the final healing rate. CONCLUSIONS: DARCT and the quality of root canal filling play key roles in the clinical prognosis of periapical lesion, DARCT and number of root canal are more likely to be correlated with failure.


Asunto(s)
Periodontitis Periapical , Materiales de Obturación del Conducto Radicular , Cavidad Pulpar , Humanos , Periodontitis Periapical/terapia , Estudios Retrospectivos , Obturación del Conducto Radicular , Tratamiento del Conducto Radicular
4.
J Appl Oral Sci ; 29: e20200870, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33950079

RESUMEN

OBJECTIVE: Bio-C Pulpecto (Bio-CP) was recently developed as the first bioceramic root filling material for primary teeth. To evaluate the physicochemical properties of radiopacity, setting time, pH, cytocompatibility and potential of Bio-CP to induce mineralisation, compared with (1) Calen thickened with zinc oxide (Calen-ZO), and (2) zinc oxide and eugenol (ZOE). METHODOLOGY: Physicochemical properties were evaluated according to ISO 6876. Saos-2 (human osteoblast-like cell line) exposed to extracts of the materials were subjected to assays of methyl thiazolyl tetrazolium, neutral red, alkaline phosphatase (ALP) activity and mineralised nodule production. The results were analysed using one-way or two-way ANOVA and Tukey's or Bonferroni's post-tests (α=0.05). RESULTS: All the materials showed radiopacity higher than 3 mm Al. Bio-CP had lower pH than Calen-ZO, but higher pH than ZOE. Calen-ZO and Bio-CP did not set. The setting time for ZOE was 110 min. The cytocompatibility order was Calen-ZO > Bio-CP > ZOE (1:2, 1:4 dilutions) and Calen-ZO > Bio-CP = ZOE (1:12, 1:24 dilutions) and Calen-ZO = Bio-CP > ZOE (1:32 dilution). Bio-CP induced greater ALP activity at 7 days, and greater mineralised nodule production, compared to Calen-ZO (p<0.05). Conclusions Bio-CP showed adequate physicochemical properties, cytocompatibility and potential to induce mineralisation.


Asunto(s)
Cavidad Pulpar , Materiales de Obturación del Conducto Radicular , Biología , Humanos , Osteoblastos , Obturación del Conducto Radicular , Diente Primario , Cemento de Óxido de Zinc-Eugenol
5.
BMC Oral Health ; 21(1): 227, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33933066

RESUMEN

BACKGROUND: The objective of the present micro-computed tomography (micro-CT) study was to assess the presence of voids in band-shaped isthmuses obturated using three different filling techniques. METHODS: Twenty-four artificial molar teeth with a band-shaped isthmus were allocated to three groups (n = 8) for obturation, according to the filling technique: single-cone (SC), continuous wave of condensation (CWC) or lateral condensation (LC). Obturation was performed with gutta-percha (GP) cones and iRoot SP (Innovative Bioceramix, Vancouver, Canada). Post-filling micro-CT scanning was performed. The percentage of filling materials and void volumes were calculated in the isthmus areas and data were analyzed using one-way ANOVA and Tukey tests. RESULTS: The mean percentage of void volumes and corresponding filling percentages in the isthmus areas after obturation in the SC groups was 22.98 % ± 1.19 %, 77.02 % ± 1.19 %; in the CWC groups 10.46 % ± 2.28 %, 89.54 % ± 2.28 %; and in the LC groups was 13.14 % ± 1.85 %, 86.86 % ± 1.85 %, respectively. CONCLUSIONS: In band-shaped isthmus area, the obturation quality of CWC was superior to SC and LC techniques.


Asunto(s)
Materiales de Obturación del Conducto Radicular , Obturación del Conducto Radicular , Canadá , Cavidad Pulpar , Gutapercha , Humanos , Preparación del Conducto Radicular , Microtomografía por Rayos X
6.
BMC Oral Health ; 21(1): 236, 2021 05 04.
Artículo en Inglés | MEDLINE | ID: mdl-33947383

RESUMEN

BACKGROUND: Mandibular premolars are complicated teeth to endodontically treat due to the anatomical variations that can present. The purpose of this study was to determine the presence of C-shaped configurations in mandibular premolars by cone-beam computed tomography (CBCT). METHODS: 380 mandibular first premolars and 308 mandibular second premolars cone-beam computed tomographic images were obtained from 292 patients (175 female and 117 male). Tooth position, number of roots, root canals, C-shaped root canal system configuration, level of canal bifurcation and radicular grooves were evaluated by two endodontists trained in CBCT evaluation; previously calibrated between them, and a radiologist with endodontic experience. Data were statistically compared by The Chi-square test (α = 0.05) to examine any significant difference between gender and C-shaped root canal system and any significant difference between C-shaped configuration according to Fan criteria and gender. RESULTS: Overall 100% (n = 688) teeth examined, 19.2% (n = 132) had a C-shaped root canals system. 9.16% (n = 63) in male patients and 10.03% (n = 69) in female patients. The prevalence of C-shaped root canal system in mandibular first premolar was 83.33 and 16.66% in mandibular second premolars. According to Fan classification, the mandibular first premolars showed 3.63% as C1, 9.09% C2, 59.09% C3, 21.81% C4a, 1.8% C4b. Mandibular second premolars showed 13.63% as C1, 18.18% C2, 13.63% C3, 27.27% C4a, 9.09% C4b. Male patients showed 4.54% as C1, 3.78% C2, 22.72% C3, 11.36% C4a, 0.75% C4b, and 4.54% out of classification. Female patients showed 0.75% as C1, 6.81% C2, 30.03% C3, 9.84 C4a, 2.27% C4b, and 2.27% out of classification. The 53.36% canal bifurcation in mandibular first premolars and 50.09% in mandibular second premolars were in the middle third. No statistical differences were found between C-shaped root canal system and gender or C-shaped configuration according to Fan criteria and gender. P was < 0.05. CONCLUSIONS: Within the limitation of this study, the presence of C-shaped anatomical system is relatively low in mandibular second premolars than in mandibular first premolars.


Asunto(s)
Cavidad Pulpar , Raíz del Diente , Diente Premolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Cavidad Pulpar/diagnóstico por imagen , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen
7.
J Contemp Dent Pract ; 22(1): 56-61, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34002710

RESUMEN

AIM: The aim of this ex vivo randomized study is to evaluate the efficiency of gutta-percha cones that match a nickel-titanium instrumentation system and nonmatching greater taper cones, when used with continuous warm vertical condensation technique. MATERIAL AND METHODS: Thirty-six straight canals were prepared using ProTaper Next files, and the apical third was obturated using either ProTaperNext cones (group A), ISO uniform greater taper cones (group B), or nonstandardized cones (group C). Cone adaptation time was quantified by the number of required modifications. Micro-computed tomography was used to measure voids and sealer percentage. RESULTS: There was no significant difference between the groups regarding void volume (p = 0.666), percentage (p = 0.379), and the number of modifications (p = 0.757). Sealer percentage, however, was significantly lower in group B when compared to group A (p = 0.0194). CONCLUSION: In straight canals, matching gutta-percha cones were not associated with significantly better obturation or saving time to fit the cone. CLINICAL SIGNIFICANCE: Using gutta-percha cones that do not match a nickel-titanium instrumentation system to obturate the straight canals with continuous warm vertical condensation technique is as efficient as using matching cones in terms of obturation quality and ease of cone fit.


Asunto(s)
Gutapercha , Materiales de Obturación del Conducto Radicular , Cavidad Pulpar , Obturación del Conducto Radicular , Preparación del Conducto Radicular , Microtomografía por Rayos X
8.
J Contemp Dent Pract ; 22(1): 69-72, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34002712

RESUMEN

AIM: This study was done to assess the time to achieve the working distance based on the size of the glide path, operating kinetics, and the fracture resistance of different file systems. MATERIALS AND METHOD: One hundred and eighty mandibular premolars were divided into two groups of 90 each. Group I was subjected to continuous 360° rotary motion and group II to adaptive motion. Twisted File (TF) and Endostar E3 file methods were practiced in groups. The time (seconds) to achieving desired working length was recorded. Failures were classified as torsional failure or flexural failure. RESULTS: The time taken by glide path size 15 in group I was 5.90 ± 4.06 seconds and in group II was 6.12 ± 4.16 seconds. The time taken by glide path size 20 in group I was 5.86 ± 3.12 seconds and in group II was 4.22 ± 2.10 seconds, with 25 size the time taken in group I was 5.32 ± 2.48 seconds and in group II was 3.16 ± 3.14 seconds. The time taken by group I was less as compared to group II, and the difference was significant (p < 0.05). There was a significant difference in time taken with different number files in both groups (p < 0.05). The mean time taken reaching the working length for continuous rotation was less as compared to TF adaptive motion; however, the difference was nonsignificant (p > 0.05). CONCLUSION: We recorded higher instrument separation and deformation with the TF method and adaptive gesture. The TF system showed additional time to achieve the working distance as compared to the Endostar E3 system. CLINICAL SIGNIFICANCE: The TF system showed higher instrument separation and deformation, and it requires additional time to achieve the working distance compared to the Endostar E3 system. Hence, the Endostar E3 system is effective in achieving required clinical results.


Asunto(s)
Cavidad Pulpar , Preparación del Conducto Radicular , Diseño de Equipo , Cinética , Diente Molar , Rotación
9.
J Appl Oral Sci ; 29: e20200799, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33886941

RESUMEN

OBJECTIVES: This study aimed to investigate patterns and risk factors related to the feasibility of achieving technical quality and periapical healing in root canal non-surgical retreatment, using regression and data mining methods. METHODOLOGY: This retrospective observational study included 321 consecutive patients presenting for root canal retreatment. Patients were treated by graduate students, following standard protocols. Data on medical history, diagnosis, treatment, and follow-up visits variables were collected from physical records and periapical radiographs and transferred to an electronic chart database. Basic statistics were tabulated, and univariate and multivariate analytical methods were used to identify risk factors for technical quality and periapical healing. Decision trees were generated to predict technical quality and periapical healing patterns using the J48 algorithm in the Weka software. RESULTS: Technical outcome was satisfactory in 65.20%, and we observed periapical healing in 80.50% of the cases. Several factors were related to technical quality, including severity of root curvature and altered root canal morphology (p<0.05). Follow-up periods had a mean of 4.05 years. Periapical lesion area, tooth type, and apical resorption proved to be significantly associated with retreatment failure (p<0.05). Data mining analysis suggested that apical root resorption might prevent satisfactory technical outcomes even in teeth with straight root canals. Also, large periapical lesions and poor root filling quality in primary endodontic treatment might be related to healing failure. CONCLUSION: Frequent patterns and factors affecting technical outcomes of endodontic retreatment included root canal morphological features and its alterations resulting from primary endodontic treatment. Healing outcomes were mainly associated with the extent of apical periodontitis pathological damages in dental and periapical tissues. To determine treatment predictability, we suggest patterns including clinical and radiographic features of apical periodontitis and technical quality of primary endodontic treatment.


Asunto(s)
Cavidad Pulpar , Periodontitis Periapical , Minería de Datos , Cavidad Pulpar/diagnóstico por imagen , Humanos , Retratamiento , Estudios Retrospectivos , Tratamiento del Conducto Radicular
10.
Gen Dent ; 69(3): 52-56, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33908879

RESUMEN

This study evaluated the effect of fiber post customization and laser application on the results of pull-out tests in endodontically treated teeth. Forty-eight bovine incisors were stored in aqueous 2% formaldehyde (pH 7.0) for 30 days. At the end of the storage period, the incisors were scraped with No. 11/12 periodontal curettes, rinsed with water and sodium bicarbonate, and stored in 0.9% saline solution for 7 days. Roots with similar shape and dimensions were selected and sectioned to a standard 17-mm length. Root canals were prepared and filled to a depth of 12 mm. The roots were divided into 4 groups (n = 12): 1, conventional fiber post and no laser application; 2, customized fiber post and no laser application; 3, conventional fiber post and laser application; and 4, customized fiber post and laser application. After removal of the obturation material for post space preparation, the canals were enlarged, and a laser beam was applied to the roots of teeth in groups 3 and 4 as an auxiliary disinfection procedure. After cementation of the posts, a pull-out test was performed using an axial tensile load at 0.5 mm/min in a universal testing machine. Analysis of variance and the Tukey test were used for statistical analysis of the results. The mean (SD) maximum tensile force was 10.18 (4.73) kgf in group 1, 38.89 (6.49) kgf in group 2, 27.74 (10.07) kgf in group 3, and 38.92 (6.89) kgf in group 4. These values were significantly higher in groups 2 and 4 than in group 1 (P < 0.05). The customization of fiber posts used for the restoration of pulpless teeth resulted in significantly (P < 0.05) greater pull-out test values, a thinner cement layer, and improved retention.


Asunto(s)
Recubrimiento Dental Adhesivo , Técnica de Perno Muñón , Diente no Vital , Animales , Bovinos , Cavidad Pulpar , Análisis del Estrés Dental , Vidrio , Humanos , Rayos Láser , Ensayo de Materiales , Cementos de Resina
11.
BMC Oral Health ; 21(1): 177, 2021 04 07.
Artículo en Inglés | MEDLINE | ID: mdl-33827540

RESUMEN

BACKGROUND: We established an in vivo intraradicular biofilm model of apical periodontitis in pigs in which we compared the efficacy of different irrigant activation techniques for biofilm removal. METHODS: Twenty roots from the deciduous mandibular second premolar of 5 male pigs were used. After pulpectomy, canals were left open for 2 weeks and then sealed for 4 weeks to enable the development of an intracanal biofilm. The intraradicular biofilms was evaluated using SEM and bacterial 16S rRNA gene-sequencing. To investigate the efficacy of biofilm removal, root canal irrigations were performed using conventional needle, passive ultrasonic, subsonic, or laser-activated irrigation. Real-time PCR was conducted to quantitate the remaining biofilm components. Statistical analysis was performed using ANOVA followed by a Tukey kramer post-hoc test with α = 0.05. RESULTS: The pulp exposure model was effective in inducing apical periodontitis and SEM analysis revealed a multi-layer biofilm formation inside the root canal. 16S rRNA sequence analysis identified Firmicutes, Bacteroidetes, and Fusobacteria as the predominant bacterial phyla components, which is similar to the microbiome profile seen in humans. None of the tested irrigation techniques completely eradicated the biofilm components from the root canal, but the subsonic and laser-activated irrigation methods produced the lowest bacterial counts (p < 0.05). CONCLUSIONS: An experimental intraradicular biofilm model has been successfully established in pigs. Within the limitations of the study, subsonic or laser-activated irrigation demonstrated the best biofilm removal results in the pig system.


Asunto(s)
Cavidad Pulpar , Irrigantes del Conducto Radicular , Animales , Biopelículas , Masculino , ARN Ribosómico 16S/genética , Preparación del Conducto Radicular , Hipoclorito de Sodio , Porcinos , Irrigación Terapéutica
12.
Braz Dent J ; 32(1): 104-110, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33913996

RESUMEN

These case reports aimed to describe the management of lateral perforation in the middle cervical third of the root in two maxillary incisors with pulp canal calcification using Bio-C Repair, with safe and viable clinical treatment strategies. Digital radiographic exams were obtained with different angles and analyzed using different filters. Cone-beam computed tomography (CBCT) images were requested to show the actual position of the canal, location of the perforation, and guide the strategic planning of the case. Subsequently, cavity access was prepared with the aid of dental operating microscopy. After perforation was identified, granulation tissue was removed and the original canal was identified and then dressed with calcium hydroxide. In the second visit, the perforation was filled with Bio-C Repair and the canal system filled with gutta-percha points and a root canal sealer (Bio-C Sealer). The teeth were restored with glass fiber post, 4 mm beyond the perforation level, and provisory crowns. Both teeth treated as described above were functional and asymptomatic with a 1-year clinical and radiographic assessment. The Bio-C Repair is suggested as a new cement option for the management of lateral canal perforations, with effective results as observed after a one-year follow-up.


Asunto(s)
Materiales de Obturación del Conducto Radicular , Preparación del Conducto Radicular , Hidróxido de Calcio , Cavidad Pulpar , Gutapercha , Humanos , Obturación del Conducto Radicular
13.
J Adhes Dent ; 23(2): 167-175, 2021 Apr 07.
Artículo en Inglés | MEDLINE | ID: mdl-33825430

RESUMEN

PURPOSE: To investigate the effects of root canal irrigants, dentin surface treatment, and timing of the restoration on the microtensile bond strength (µTBS) of a universal adhesive to deep coronal dentin. MATERIALS AND METHODS: Ninety (90) intact molars were grouped according to the irrigation protocol: group 0 (saline, control group); group 1: 5.25% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA) followed by 5.25% NaOCl; group 2: 18% etidronic acid (HEDP) + 5.25% NaOCl in a single mixture. Groups 1 and 2 were divided into 2 subgroups (n = = 10) according to the time of restoration: immediate (subgroup A) and after 7 days (subgroup B). Four other groups (n = 10) were created according to the dentin surface pretreatment and received an immediate restoration: group 3: 5.25% NaOCl - 17% EDTA and AH Plus Cleaner; group 4: 5.25% NaOCl - 17% EDTA and 100% ethanol; group 5: 5.25% NaOCl + 18% HEDP and AH Plus Cleaner; group 6: 5.25% NaOCl + 18% HEDP and 100% ethanol. µTBS testing was carried out for each subgroup and interfaces were analyzed through SEM. The µTBS was analyzed with Welch statistics and the post-hoc Games-Howell test for multiple comparisons (p < 0.05). RESULTS: Statistically significant differences were observed between test groups and control groups (p < 0.001), except for group 3 (p = 0.349). No significant differences were recorded between groups 1A (27.5 ± 8.7 MPa), 2A (32.6 ± 14.5 MPa) and 3 (27.3 ± 14.3 MPa). Group 6 (48.6 ± 11.6 MPa) exhibited the highest µTBS among all tested groups. For groups 1 and 2, significantly higher values were recorded for subgroups 1B (39.3 ± 7.6 MPa) and 2B (43.8 ± 8.3 MPa) compared to subgroups 1A (27.5 ± 8.7 MPa) and 2A (32.6 ± 14.5 MPa). CONCLUSION: When using NaOCl as root canal irrigant, it is advisable to delay the placement of a post-endodontic-treatment restoration.


Asunto(s)
Recubrimiento Dental Adhesivo , Cementos Dentales , Cavidad Pulpar , Análisis del Estrés Dental , Dentina , Ácido Edético , Ensayo de Materiales , Irrigantes del Conducto Radicular , Preparación del Conducto Radicular , Hipoclorito de Sodio
14.
Ann Palliat Med ; 10(5): 5027-5045, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33894717

RESUMEN

BACKGROUND: The aim of this study was to analyze the outcome and prognostic factors of root canal treatment (RCT) and endodontic microsurgery (EMS) in the treatment of apical periodontitis (AP), respectively, and to compare the outcome and prognostic factors between initial RCT and nonsurgical retreatment (re-RCT) for AP. METHODS: Patients with AP were recruited from the Stomatology Department of Peking University Third Hospital from January 2016 to December 2019. Data were collected by medical records review. Univariate analysis of treatment outcome was performed for the total RCT group, initial RCT group, re-RCT group and EMS group, respectively. Multivariate logistic regression was performed for the three RCT groups, respectively, but not for the EMS group. RESULTS: The overall success of treatment for AP was 73.8%. The success rate of RCT in 229 cases was 70.7%, while that of EMS in 34 cases was 94.1%. The failure of RCT was significantly higher for elderly patients [odds ratio (OR) =1.025, P=0.013], teeth with incomplete fracture (OR =7.082, P=0.013), teeth with a greater crown root ratio (OR =1.198, P=0.029), teeth treated by a general dentist (OR =2.16, P=0.042) and teeth with unqualified treatment (OR =2.841, P=0.002). Of the 166 teeth treated by initial RCT, the success was 68.1%. A greater crown root ratio (OR =1.333, P=0.004) was identified as a risk factor for treatment. Of the 63 teeth treated by re-RCT, the success was 77.8%. A lower success was observed in teeth with unqualified treatment (OR =5.291, P=0.018). With regard to EMS, the univariate analysis showed that none of the variables were significantly related to the outcome. CONCLUSIONS: For AP treated by RCT, age, incomplete tooth fracture, crown root ratio, doctor classification and unqualified treatment had a strong impact on determining outcome. For initial RCT, crown root ratio was a significant outcome predictor, while for re-RCT, unqualified treatment was a strong statistically significant factor. No significant difference was found between the success of initial RCT and re-RCT for AP.


Asunto(s)
Microcirugia , Periodontitis Periapical , Anciano , Estudios de Cohortes , Cavidad Pulpar , Humanos , Periodontitis Periapical/terapia , Tratamiento del Conducto Radicular
15.
J Mech Behav Biomed Mater ; 119: 104385, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33823357

RESUMEN

OBJECTIVES: The aim of this study was to assess the fatigue loading behavior and fracture resistance of endodontically treated teeth restored with adhesively luted bundled fiber posts in comparison to solid fiber posts. Image analysis (2D and 3D) was applied to evaluate modes of failure and to characterize susceptible parts of the post-and-core interface. METHOD: Crowns of 72 human similar-sized central upper incisors were removed and roots received a conventional root canal filling prior to establishing 4 groups of core build-up: No Post group (nP) received a 4 mm deep filling made of composite inside the canal with no dental post, fiber post group (FP) received a conventional solid post, and two experimental groups received bundles of 6 (FB6) or 12 (FB12) 0.3 mm thin fiber posts, respectively. Posts were placed adhesively inside the root canal using a dual-curing build-up composite in combination with a self-etch adhesive, the latter was also used for nP group. Upon completion of core build-ups, all teeth received full-ceramic crowns that recreated the original tooth form. Samples were subjected in a 135° angle to thermo-mechanical loading (TML) for 1.2 Mill. chewing cycles followed by static load tests (fracture resistance). Fracture modes as well as intracanal failure modes with respect to failed interfaces were analyzed using optical and electron microscopy (SEM). Microcomputer tomography (µCT) was used to exemplary compare pre and post TML geometries. RESULTS: Static load test was significantly different between groups (p < 0.0005; Kruskal-Wallistest). Pairwise comparison showed that the nP group (221 ± 103N) failed at significantly lower forces compared to the FP (454 ± 184N), FB6 (477 ± 250N) and FB12 (478 ± 260N) groups (p ≤ 0,001; Mann-Whitney-U-test). Fracture modes were significantly affected by the presence or absence of a post (p ≤ 0,016; Chi-square test) revealing increased incidence of restorable fractures at the cervical region for nP group. Microscopic analysis revealed more intracanal failures at interfaces between post surfaces and composite for solid posts, whereas fiber bundled posts mostly failed at the interfaces between composite and dentin. Micro-CT analysis showed no alterations of the root-post-and-core structure after TML except slight deformations of occasionally entrapped voids. CONCLUSION: Fracture resistance and fracture modes were significantly affected by the presence or absence of a post, whereas the investigated post groups did not differ from each other. However intracanal failure revealed differences in adhesive failures between solid fiber posts and bundled fiber posts. Deformations of entrapped voids, revealed by micro-Ct analyses after TML, lead to the assumption that applied forces result in alterations in the regions of voids.


Asunto(s)
Técnica de Perno Muñón , Fracturas de los Dientes , Resinas Compuestas , Cavidad Pulpar , Análisis del Estrés Dental , Dentina , Fatiga , Vidrio , Humanos
16.
J Mech Behav Biomed Mater ; 119: 104524, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33895663

RESUMEN

AIM: Bioceramic root canal sealers like BioRoot RCS have received significant attention for use in endodontics. The addition of a nanophase material like multi-walled carbon nanotubes (MWCNTs) and titanium carbide (TC) to its matrix combined with pressureless sintering might have the potential for improved physiochemical, microstructure, and compressive strength properties. METHOD: ology: MWCNTs and TC nanomaterials were added at a percentage of 1 wt% to a definite weight of pristine BioRoot RCS. Two composites were prepared by ball milling followed by pressureless sintering in static nitrogen at temperatures 600 °C and 800 °C. The setting time, solubility, pH, compressive strength, and density were determined and compared to pristine BioRoot RCS. The microstructural properties of the composites were investigated by XRD, FTIR, Raman spectroscopy, and SEM. RESULTS: The final setting time before and after sintering at 600 °C of the composites was accelerated compared to Bioroot RCS (p = 0.016). The solubility of Bioroot/TC sintered at 600 °C was the lowest (p = 0.07) and its compressive strength was the highest among the sintered samples (p = 0.01). The incorporation of MWCNTs and TC had a significant increase in the compressive strength of Bioroot RCS (p < 0.05). CONCLUSION: The obtained results support the addition of nanomaterials to Bioroot RCS and the use of pressureless sintering.


Asunto(s)
Nanotubos de Carbono , Materiales de Obturación del Conducto Radicular , Compuestos de Calcio , Fuerza Compresiva , Cavidad Pulpar , Silicatos , Temperatura , Titanio
17.
BMC Oral Health ; 21(1): 185, 2021 04 12.
Artículo en Inglés | MEDLINE | ID: mdl-33845806

RESUMEN

High-resolution micro-computed tomography is a powerful tool to analyze and visualize the internal morphology of human permanent teeth. It is increasingly used for investigation of epidemiological questions to provide the dentist with the necessary information required for successful endodontic treatment. The aim of the present paper was to propose an image processing method to automate parts of the work needed to fully describe the internal morphology of human permanent teeth. One hundred and four human teeth were scanned on a high-resolution micro-CT scanner using an automatic specimen changer. Python code in a Jupyter notebook was used to verify and process the scans, prepare the datasets for description of the internal morphology and to measure the apical region of the tooth. The presented method offers an easy, non-destructive, rapid and efficient approach to scan, check and preview tomographic datasets of a large number of teeth. It is a helpful tool for the detailed description and characterization of the internal morphology of human permanent teeth using automated segmentation by means of micro-CT with full reproducibility and high standardization.


Asunto(s)
Cavidad Pulpar , Dentición Permanente , Humanos , Procesamiento de Imagen Asistido por Computador , Reproducibilidad de los Resultados , Raíz del Diente , Microtomografía por Rayos X
18.
J Indian Soc Pedod Prev Dent ; 39(1): 74-78, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33885391

RESUMEN

Background: In the last few decades, the availability of synchrotron sources has initiated revolutionary advances in X-ray imaging. Aims: The study aimed to evaluate the incidence of apical transportation after root canal preparation with ProTaper Gold (PTG), Hyflex electro discharge machining (HEDM), Reciproc (RPC), and WaveOne Gold (WOG) using synchrotron radiation-based micro-computed tomographic (SR-µCT) analysis. Materials and Methods: Forty mandibular molars were assigned to four experimental groups (n = 10) according to the file system used for the root canal preparation: Group 1: PTG (25/0.08), Group 2: HEDM (25/0.08), Group 3: RPC (25/0.08), and Group 4: WOG (25/0.07). The specimens were scanned on SR-µCT system before and after the root canal preparation. Apical transportation was assessed at 1, 2, 3, 4, and 5 mm section. Statistical Analysis: Two-way analysis of variance and Wilcoxon Mann-Whitney test was used. Results: No significant difference was found between the groups. Transportation in the mesial direction was of greater magnitude than distal transportation for all the files systems. Conclusion: SR-µCT can be used as a reliable diagnostic tool for further implications.


Asunto(s)
Níquel , Titanio , Cavidad Pulpar/diagnóstico por imagen , Humanos , Preparación del Conducto Radicular , Sincrotrones , Microtomografía por Rayos X
19.
J Indian Soc Pedod Prev Dent ; 39(1): 79-84, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33885392

RESUMEN

Objective: Metapex/Vitapex is one of the most commonly used obturating materials in pediatric dental practice in recent times. It is available in a premixed syringe which poses numerous practical difficulties. This study aimed to calculate the root canal volume of maxillary and mandibular canine and second molar using cone-beam computed tomography (CBCT) to determine the quantity/grams of obturation material to obturate a single tooth (mass = density × volume). Materials and Method: This nonrandomized clinical trial is comprised of two parts. The first part involved calculation of average root canal volume using CBCT which was used to calculate the quantity/grams of obturating material. This predetermined quantity was used to obturate primary mandibular second molars and canines, and the quality of obturation was assessed. Results: Assessment of quality of obturation showed optimum length obturation in 53.33% primary second molars and 66.66% primary canines. Conclusion: It can be inferred that even with the use of exact predetermined quantity/grams of obturating material, optimum quality obturation could be achieved, thus avoiding wastage, preventing cross contamination, and simultaneously offering good clinical results. Hence, this study opens further gateways to device ampules containing predetermined mass of obturating material for a single use for obturation of a single primary tooth.


Asunto(s)
Cavidad Pulpar , Diente Molar , Niño , Tomografía Computarizada de Haz Cónico , Cavidad Pulpar/diagnóstico por imagen , Humanos , Diente Molar/diagnóstico por imagen , Raíz del Diente , Diente Primario
20.
Chin J Dent Res ; 24(1): 49-54, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33890455

RESUMEN

OBJECTIVE: To compare the accuracy of electronic apex locators in the presence of blood and CBCT images obtained with two different voxel sizes (0.125 mm and 0.25 mm) in determining root canal length up to the perforation area. METHODS: Forty extracted, single-rooted human teeth were selected and an artificial root perforation (0.4 ± 0.1 or 1.0 ± 0.2 mm diameter) was created in the middle third of the root. The actual root canal length up to the perforation area was determined under a stereomicroscope. CBCT images were obtained with a voxel size of 0.125 mm and 0.25 mm. The root canal length up to the perforation area was measured on CBCT images and recorded as the radiographic length. The teeth were embedded in alginate and root canal length up to the perforation area was measured using two different EALs (DentaPort ZX [Morita, Tokyo, Japan] and Gold Reciproc motor [VDW, Munich, Germany]) and recorded as the electronic length. RESULTS: In teeth with an artificial root perforation 0.4 mm in diameter, the measurements obtained with DentaPort ZX were more accurate than with the Gold Reciproc motor (P ˂ 0.05), and on CBCT images, more accurate measurements were obtained with a voxel size of 0.125 mm compared to 0.25 mm (P ˂ 0.05). In teeth with an artificial root perforation 1.0 mm in diameter, the radiographic length was closer to actual length than the electronic length (P ˂ 0.05). CONCLUSION: In artificial root perforations with a diameter of 0.4 mm, CBCT gives more reliable results than EALs. Both EAL and CBCT measurements were closer to actual length in artificial perforations that were 1.0 mm in diameter.


Asunto(s)
Tomografía Computarizada de Haz Cónico Espiral , Ápice del Diente , Cavidad Pulpar/diagnóstico por imagen , Electrónica , Alemania , Humanos , Odontometría , Preparación del Conducto Radicular , Ápice del Diente/diagnóstico por imagen
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