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1.
J Appl Oral Sci ; 28: e20190100, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31800872

RESUMEN

OBJECTIVE: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. METHODOLOGY: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. RESULTS: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). CONCLUSION: Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar.


Asunto(s)
Cavidad Pulpar/microbiología , Periodontitis Periapical/terapia , Tratamiento del Conducto Radicular/instrumentación , Terapia por Ultrasonido/instrumentación , Adolescente , Adulto , Análisis de Varianza , Bacterias/aislamiento & purificación , Carga Bacteriana , Recuento de Colonia Microbiana , Tomografía Computarizada de Haz Cónico , Sondas de ADN , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Irrigantes del Conducto Radicular/uso terapéutico , Tratamiento del Conducto Radicular/métodos , Hipoclorito de Sodio/uso terapéutico , Irrigación Terapéutica/instrumentación , Irrigación Terapéutica/métodos , Resultado del Tratamiento , Terapia por Ultrasonido/métodos , Adulto Joven
2.
Braz Oral Res ; 33: e021, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31508722

RESUMEN

This study investigated the effectiveness of XP-Endo Finisher (XPF) associated with XP-Endo Shaper (XPS) or Reciproc Blue (RB) files in reducing bacterial load in oval-shaped root canals (RC) during chemomechanical preparation (CMP) using 0.9% saline solution (NaCl) or 2.5% sodium hypochlorite (NaOCl). Eighty mandibular incisors with single oval-shaped RC were contaminated with Enterococcus faecalis. The teeth were randomly assigned to eight experimental groups (n = 10) according to the CMP, as follows: G1: XPS, G2: XPS + XPF, G3: RB, and G4: RB + XPF. CMP was performed with NaCl or NaOCl. The reduction of bacterial load was assessed by colony-forming unit count before (S1) and after (S2) CMP. Data normality was verified by using Shapiro-Wilk test. ANOVA, Tukey's test, and Bonferroni post-hoc test were used at a 5% significance level. Culturable bacteria were present in all S1 samples (p>0.05). All instrumentation techniques were effective in reducing bacterial load, irrespective of the irrigating solution (p < 0.05). With the use of NaCl, RB was more effective than XPS (p = 0.035). With the use of NaOCl, XPS and RB presented similar effectiveness (p = 0.779). XPF enhanced the bacterial reduction of both systems tested (p < 0.05). The use of NaOCl improved the CMP, irrespective of the instrumentation technique used (p < 0.05). In conclusion, XPS and RB files are effective in reducing bacterial levels in oval-shaped RC. The use of XPF as a method of agitation of the irrigating solution improved the cleaning efficiency of both file systems tested. Mechanical preparation performed with saline solution decreased culturable bacteria from the root canal, but antimicrobial substances such as NaOCl should be used to achieve a significantly better disinfection.


Asunto(s)
Carga Bacteriana , Instrumentos Dentales , Cavidad Pulpar/anatomía & histología , Preparación del Conducto Radicular/instrumentación , Cavidad Pulpar/microbiología , Desinfectantes/uso terapéutico , Enterococcus faecalis/aislamiento & purificación , Infecciones por Bacterias Grampositivas , Humanos , Incisivo , Ensayo de Materiales , Solución Salina/uso terapéutico , Hipoclorito de Sodio/uso terapéutico
3.
J Biol Regul Homeost Agents ; 33(3 Suppl. 1): 1-9, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31538444

RESUMEN

Blood contamination of the canal during preparation and obturation can be a problem in Endodontics; this may result in apical microleakage. The purpose of this investigation was to observe and evaluate the hemostatic properties of biofilm decontaminant material (sulfonic/sulphuric acid solution, HybenX, EPIEN Medical) used in teeth with necrotic pulp and unstoppable bleeding after root canal shaping. A prospective study was designed with 2 randomized parallel groups: decontaminant material (experimental group) and sodium hypochlorite 5% (control group). The analysis of the root canal bleeding was evaluated by the clinician before and after the application of the sulfonic/sulphuric solution or sodium hypochlorite 5%, by measuring the millimeters of blood on a sterile paper point introduced in the root canal. Sixty patients with necrotic pulp and unstoppable bleeding were enrolled in this study and randomly divided into 2 groups: decontaminant material in 30 patients (experimental group) or sodium hypochlorite 5% in 30 patients (control group). T-test showed that the percentage change in millimeters of blood detected in the root canal was statistically greater for experimental group [mean difference: 0.74 (IC: 0.66-0.82); p less than 0.0001]. The hemostatic properties were better in the experimental group than in the sodium hypochlorite 5% group (control). Further research may be needed to confirm the results of this study..


Asunto(s)
Cavidad Pulpar , Hemorragia/prevención & control , Hemostáticos/uso terapéutico , Irrigantes del Conducto Radicular/uso terapéutico , Humanos , Estudios Prospectivos , Tratamiento del Conducto Radicular , Hipoclorito de Sodio/uso terapéutico
4.
Microsc Res Tech ; 82(12): 1975-1981, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31444946

RESUMEN

The purpose of this in vitro study was to investigate the effect of Trigonella foenum graecum seed extract (TFGSE) as a root canal irrigation agent on the surface of instrumented root canals and on changes in the mineral contents of the root dentin. A total of 90 extracted human mature maxillary central incisor teeth with a single root and without root resorption were selected. The specimens were subdivided into five groups according to irrigation protocol groups G0: distilled water (n = 15): G1: Sodium hypochlorite (5.25% NaOCl); G2: 1% TFGSE G3: NaOCl +17% EDTA (3 min); G4: NaOCl+1% TFGSE; G5: 1% TFGSE +17% EDTA. All the roots were sectioned longitudinally into two halves and examined under scanning electron microscope/energy dispersive X-ray analysis (SEM/EDX) to assess changes in the mineral content of the tooth. Smear layer removal from root canals was evaluated with scanning electron microscopy (SEM). A statistical analysis was performed using the Kruskal-Wallis test. The most effective irrigation protocols in removing smear layer occurred with TFGSE and NaOCl, both with rinsing with 17% EDTA. TFGSE was more effective than NaOCl for removing the smear layer. The results showed the ability of 1% TFGSE to remove the smear layer from the root canals. TFGSE is a promising alternative irrigation agent for root canals.


Asunto(s)
Cavidad Pulpar/efectos de los fármacos , Extractos Vegetales/farmacología , Irrigantes del Conducto Radicular/farmacología , Preparación del Conducto Radicular/métodos , Trigonella/química , Ácido Edético/farmacología , Humanos , Incisivo/efectos de los fármacos , Microscopía Electrónica de Rastreo , Semillas/química , Hipoclorito de Sodio/uso terapéutico
5.
Photodiagnosis Photodyn Ther ; 27: 396-401, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31301436

RESUMEN

This study aimed to determine the effects of photodynamic therapy (PDT) on postoperative pain after treatments of teeth with necrotic pulps. This randomized clinical trial consisted of 60 patients who presented for treatment of asymptomatic teeth. The patients were randomly assigned into the Control Group (CG) or the PDT Group (PG). The canals were instrumented with a reciprocating instrument (50.05) under 2.5% NaOCL irrigation. After instrumentation was completed, the canals were flooded with 1.56 µM/mL of methylene blue (MB), the optical fiber was inserted to the working length and applied for 3 min (P =100 mW, t =3 min, E = 18 J). The device emitted PDT only for the PG. The operator and the patient were both masked to the treatment protocol. After PDT, the root canal treatment was completed and the canals were filled. A card was given to the patients to document their pain perception through the 0-10 visual analogue scale (VAS) at 24 h, 72 h, and 1-week intervals. The Mann-Whitney and Fisher´s exact tests were used for statistical analysis (P < .05). The average pain level for the CG was 1.33 at 24 -hs and 0.50 at 72 -hs; for the PG, the average pain level was 0.37 at 24 -h and 0 at 72 -h (P < .05). After 1-week there was no report of pain. PDT had a significant effect in decreasing postoperative pain at 24- and 72 -h intervals in treatment of single-rooted teeth with necrotic pulps performed in one visit.


Asunto(s)
Azul de Metileno/administración & dosificación , Dolor Postoperatorio/prevención & control , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/administración & dosificación , Tratamiento del Conducto Radicular/métodos , Adulto , Anciano , Cavidad Pulpar/efectos de los fármacos , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Estudios Prospectivos , Irrigantes del Conducto Radicular/uso terapéutico , Hipoclorito de Sodio/uso terapéutico
6.
J Endod ; 45(6): 736-741, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30981431

RESUMEN

INTRODUCTION: This ex vivo study evaluated the intracanal bacterial reduction promoted by chemomechanical preparation using a single-file technique varying the volume, concentration, and retention time of sodium hypochlorite (NaOCl) irrigation in comparison with a multifile system. METHODS: Palatal roots from extracted maxillary first molars were selected and anatomically matched based on microcomputed tomographic analysis for group distribution. The canals were contaminated with a fresh mixed bacterial culture grown in anaerobiosis and recently obtained from a tooth with apical periodontitis. Specimens were divided into 4 groups of 24 each according to the following preparation protocols: REC-6LOW (Reciproc R50 instrument [VDW, Munich, Germany], 6% NaOCl, low irrigant volume), REC-2.5LOW (R50, 2.5% NaOCl, low irrigant volume), REC-2.5HI (R50, 2.5% NaOCl, high irrigant volume), and BR-2.5HI (BioRaCe [FKG Dentaire, LaChaux-de-Fonds, Switzerland], 2.5% NaOCl, high irrigant volume). The total time of preparation was recorded. Intracanal bacteriologic samples were taken before and after preparation; DNA was extracted and subjected to quantitative polymerase chain reaction. RESULTS: Bacteria were detected in 22 initial samples from the REC-2.5LOW group and in 23 from the other groups. Intragroup analysis showed that all tested preparation protocols were highly effective in significantly reducing the intracanal bacterial counts (P < .001). Intergroup comparison of bacterial reduction levels revealed a statistically significant difference between BR-2.5HI and REC-2.5LOW (P < .05). Counts of bacteria were 2.5 times significantly higher in REC-2.5LOW compared with BR-2.5HI. No other significant differences were found in quantitative findings (P > .05). CONCLUSIONS: The concerted effects of multiple instruments, the high volume of irrigation, and the long retention time of NaOCl irrigant had a positive influence on intracanal disinfection during chemomechanical preparation.


Asunto(s)
Cavidad Pulpar , Preparación del Conducto Radicular , Hipoclorito de Sodio , Desinfección , Alemania , Humanos , Irrigantes del Conducto Radicular , Hipoclorito de Sodio/uso terapéutico
7.
J Am Anim Hosp Assoc ; 55(3): 117-123, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30870602

RESUMEN

The emergence of methicillin-resistant Staphylococcus pseudintermedius has increased the interest in topical therapy for treating canine pyoderma. Shampooing with chlorhexidine followed by dilute bleach rinses are often recommended, but household bleach can dry the skin and is unpleasant to use. A shampoo formulated with sodium hypochlorite and salicylic acid was evaluated as sole therapy for dogs with superficial pyoderma associated with S. pseudintermedius, including methicillin-resistant strains. Client-owned dogs were recruited based on positive culture for methicillin-resistant staphylococci or prior failure of pyoderma to respond to antibiotics. This prospective, open-label pilot study assessed the efficacy of the shampoo when used three times weekly for 4 wk. Dogs were evaluated at baseline and at 2 and 4 wk by cytology, clinical examination, and owner assessment. Digital images were also obtained. Baseline bacterial counts, clinical assessments and owner scores were significantly improved at 2 and 4 wk. Clients completing the study reported excellent lathering and dispersion, reduction in odor, and brightening of white and light coats. No owners reported skin dryness or other adverse events during the study. We conclude that this shampoo containing sodium hypochlorite in a vehicle that avoids skin drying is an effective treatment for canine pyoderma.


Asunto(s)
Enfermedades de los Perros/tratamiento farmacológico , Resistencia a la Meticilina , Ácido Salicílico/uso terapéutico , Hipoclorito de Sodio/uso terapéutico , Infecciones Cutáneas Estafilocócicas/veterinaria , Staphylococcus/efectos de los fármacos , Animales , Antiinfecciosos/uso terapéutico , Perros , Formas de Dosificación , Femenino , Masculino , Meticilina/farmacología , Proyectos Piloto , Ácido Salicílico/administración & dosificación , Hipoclorito de Sodio/administración & dosificación , Infecciones Cutáneas Estafilocócicas/tratamiento farmacológico
8.
Niger J Clin Pract ; 22(3): 305-312, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30837416

RESUMEN

Objective: To evaluate the clinical and radiographical success of primary molar pulpotomies which used 15.5% ferric sulfate (FS) or 1.25% sodium hypochlorite (NaOCl) for hemostasis and zinc oxide-eugenol (ZOE) and calcium hydroxide (CH) pastes as base materials. Methods: In 29 healthy children, 80 primary molars were randomly allocated to one of the study groups: Group 1: FS-ZOE, Group 2: FS-CH, Group 3: NaOCl-ZOE, and Group 4: NaOCl-CH. After hemostasis with the respective solutions, pulp stumps and floor of the pulp chambers were covered with either ZOE or CH pastes. All teeth were restored with stainless steel crowns. Follow-up examinations were carried out at 1, 3, 6, and 12 months. Results: One tooth in Group 1 and two teeth in Group 4 were extracted because of pain and periapial pathosis at sixth month. After 12 months, clinical success rates of pulpotomies in Groups 1-4 were 95%, 100%, 100%, and 89.5%, respectively. The differences were not significant (P = 0.548). Radiographic success rates for Groups 1-4 were 80%, 88.9%, 78.9%, and 84.2%, respectively. No statistically significant difference was found (P = 0.968). Pain on percussion was the most observed clinical finding. However, internal root resorption was the most common radiological finding and it was observed significantly more in mandibular primary molars (P < 0.05). Conclusion: Both ZOE and CH can be preferred as base materials after hemostasis achieved by the use of 15.5% FS or 1.25% NaOCl in primary tooth pulpotomy.


Asunto(s)
Hidróxido de Calcio/uso terapéutico , Pulpa Dental/diagnóstico por imagen , Compuestos Férricos/uso terapéutico , Hemostáticos , Pulpotomía/métodos , Irrigantes del Conducto Radicular/uso terapéutico , Hipoclorito de Sodio/uso terapéutico , Diente Primario/diagnóstico por imagen , Cementos para Huesos , Niño , Preescolar , Caries Dental/terapia , Femenino , Estudios de Seguimiento , Humanos , Masculino , Radiografía Dental , Resorción Radicular , Resorción Dentaria/etiología , Diente Primario/cirugía , Resultado del Tratamiento , Cemento de Óxido de Zinc-Eugenol/uso terapéutico
9.
Av. odontoestomatol ; 35(1): 33-43, ene.-feb. 2019. ilus
Artículo en Español | IBECS | ID: ibc-182636

RESUMEN

El tratamiento de conductos está indicado en caso de daño pulpar irreversible; en la actualidad se evidencian considerables avances en cuanto al diagnóstico, tratamiento y mantenimiento de un diente endodónticamente tratado, pese a ello persisten elementos y materiales usados desde sus inicios, como es el caso del hipoclorito de sodio (NaOCl.). El objetivo principal de este artículo será enfatizar en los riesgos y las secuelas ocasionadas por el uso de este irrigante y documentar un caso clínico de una reacción anafiláctica severa por su uso, el manejo dado, además se realizara una revisión de la literatura


Endodontics is a treatment that is required after the irreversible pulpal damage. At present, there has been considerable progress in the diagnosis, treatment, and maintenance of an endodontically treated tooth. Despite this there remain elements and materials used since its inception, as is the case of the sodium hypochlorite (NaOCl.) The main objective of this article is to emphasize the risks and the consequences caused by the use of this irrigante and document a clinical case of a severe anaphylactic reaction by its use, management, in addition there will be a review of the literature


Asunto(s)
Humanos , Hipoclorito de Sodio/administración & dosificación , Hipoclorito de Sodio/uso terapéutico , Endodoncia/instrumentación , Hipersensibilidad a las Drogas/complicaciones , Hipersensibilidad a las Drogas/diagnóstico , Edema/inducido químicamente , Anafilaxia , Enfermedades Periapicales/diagnóstico por imagen , Enfermedades Periapicales/terapia , Diagnóstico Diferencial
10.
Int Endod J ; 52(1): 19-27, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29884999

RESUMEN

AIM: The aim of this systematic review was to answer the following question: in patients with primary endodontic infection, is there a statistically significant difference in the endotoxin levels after chemomechanical preparation with sodium hypochlorite (NaOCl) or chlorhexidine (CHX)? METHODOLOGY: A protocol was prepared and registered on PROSPERO (CRD42017069996). Four electronic databases (MEDLINE via PubMeb, Scopus, Web of Science and Cochrane Library) were searched from their start dates to 1 March 2017 using strict inclusion and exclusion criteria and reviewed following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Only clinical trials (randomized and nonrandomized) that compared the effectiveness of NaOCl and CHX to reduce endotoxins during chemomechanical preparation of teeth with primary endodontic infection were included. Two reviewers independently assessed the eligibility for inclusion, extracted data and assessed the quality using the risk of bias tool. RESULTS: From 712 articles that resulted from the initial search, 37 studies were included for full-text appraisal; four studies met the inclusion criteria for quantitative synthesis. A single meta-analysis was performed to compare the endotoxin levels before and after chemomechanical preparation with NaOCl or CHX. The forest plot of lipopolysaccharide (LPS) levels indicated that the data were heterogeneous [I2  = 63.9%; Tau2  = 574.5 (P = 0.04)]. The use of NaOCl and CHX during chemomechanical preparation significantly reduced the LPS levels compared to the initial ones. CONCLUSIONS: Chemomechanical canal preparation with both NaOCl and CHX reduced the endotoxin levels compared to the initial ones found in primary endodontic infections. When NaOCl was used during chemomechanical preparation, endotoxins levels were lower than those obtained after chemomechanical preparation with CHX.


Asunto(s)
Clorhexidina/uso terapéutico , Endotoxinas/análisis , Irrigantes del Conducto Radicular/uso terapéutico , Hipoclorito de Sodio/uso terapéutico , Ensayos Clínicos como Asunto , Bases de Datos Factuales , Cavidad Pulpar , Endotoxinas/metabolismo , Humanos , Lipopolisacáridos , Ensayos Clínicos Controlados Aleatorios como Asunto , Preparación del Conducto Radicular
12.
Clin Oral Investig ; 23(6): 2759-2766, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30367257

RESUMEN

OBJECTIVE: The objective of this work was to investigate in vivo the effects of calcium hydroxide-based intracanal medication (ICM) on the levels of bacteria, pro-inflammatory cytokines (PICs), and matrix metalloproteinases (MMPs) in root canals and periradicular tissues of teeth with failure of the root canal treatment and apical periodontitis. MATERIALS AND METHODS: Twenty infected root canals of single-rooted teeth were randomly assigned into two groups according to the irrigant used for chemomechanical preparation (CMP) (n = 10 per group): G1 - 2% chlorhexidine (CHX) gel and G2 - 6% sodium hypochlorite (NaOCl). Root canal contents were taken by using paper points before CMP (S1) and after 30 days of calcium hydroxide-based ICM (S2). Microbial reduction was calculated by means of colony-forming unit count (CFU/mL), with PICs and MMPs (pg/mL) being measured by using enzyme-linked immunosorbent assay (ELISA). RESULTS: Culturable bacteria (101.2 ± 79.2), PICs (IL-1ß 1.2 ± 0.4 and TNF-α 8.8 ± 4.7), MMP-2 (803.7 ± 96.4), MMP-3 (453.9 ± 229.3), MMP-8 (245.9 ± 122.4), MMP-9 (129.4 ± 29.6), and MMP-13 (70.8 ± 12.8) were present in all S1 samples. After 30 days of ICM (S2), a 99.5% microbial reduction was observed, together with a significant reduction of PICs in all groups. Overall, it was observed a decrease in the levels of MMPs (S2), except MMP-13, which was found in increased levels after ICM (P < .05), independently of the groups. CONCLUSIONS: Calcium hydroxide-based intracanal medications have had a positive effect on the microbial reduction by decreasing the levels of PICs and MMPs. Both auxiliary chemical substances (i.e., 2% CHX and 6% NaOCl) presented similar effects when calcium hydroxide was used as intracanal medication. CLINICAL RELEVANCE: Teeth with failure of the root canal treatment and apical periodontitis, and consequently with high levels of bacteria, PIC, and MMP, may present a better prognosis after a 30 days of a calcium hydroxide-based ICM.


Asunto(s)
Hidróxido de Calcio/uso terapéutico , Clorhexidina/uso terapéutico , Periodontitis Periapical/complicaciones , Irrigantes del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular , Hipoclorito de Sodio/uso terapéutico , Adulto , Bacterias/aislamiento & purificación , Recuento de Colonia Microbiana , Citocinas/metabolismo , Cavidad Pulpar/microbiología , Humanos , Metaloproteinasas de la Matriz/metabolismo , Persona de Mediana Edad , Periodontitis Periapical/microbiología
13.
Med Oral Patol Oral Cir Bucal ; 23(6): e716-e722, 2018 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-30341268

RESUMEN

BACKGROUND: The main objective of the present study is to evaluate the effects and possible benefits with regard to the postoperative period of lower third molar extractions, comparing the intraalveolar application of a bioadhesive gel of 0.2% chlorhexidine (CHX) to the use of a mouthwash with a super-oxidized solution, (SOS) Dermacyn® Wound Care (Oculus Innovative Sciences lnc., California, USA). MATERIAL AND METHODS: A randomized double-blind study was carried out in 20 patients with a split-mouth design, with a total of 40 extractions of symmetrically impacted bilateral lower third molars. Patients were divided into two groups, a control group (C = 20) and an experimental group (D = 20). Any infectious complications, wound healing, plaque accumulation in the stitches, and presence of trismus and inflammation were evaluated using the distance between different facial points, at three, eight, and fifteen days after extraction. Pain, swelling, and amount of analgesics taken were evaluated using the VAS scale throughout the 15 days following extraction. Tolerance to treatment was evaluated using a verbal scale. Results were statistically compared using the Student's t- and chi-squared tests. RESULTS: No statistically significant differences were found between the two groups with regard to infectious complications, swelling, or wound healing. Use of analgesics and self-reported pain levels were slightly lower in the experimental group than in the control group during days 6 and 7 of the study (p < 0.05). The global treatment tolerance was satisfactory and similar in both groups. CONCLUSIONS: Both CHX and SOS are effective at improving the postoperative period after extraction of lower third molars.


Asunto(s)
Clorhexidina/administración & dosificación , Edema/prevención & control , Ácido Hipocloroso/uso terapéutico , Tercer Molar/cirugía , Antisépticos Bucales/uso terapéutico , Dolor Postoperatorio/prevención & control , Complicaciones Posoperatorias/prevención & control , Hipoclorito de Sodio/uso terapéutico , Extracción Dental , Cicatrización de Heridas/efectos de los fármacos , Adulto , Método Doble Ciego , Combinación de Medicamentos , Femenino , Geles , Humanos , Masculino , Mandíbula , Estudios Prospectivos
14.
J Dent ; 78: 46-50, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30077808

RESUMEN

INTRODUCTION: The present study examined the effects of irrigant flow rate and simulated intraosseous sinusoidal pressure on the rate of NaOCl extrusion from the apical terminus of a faux root canal. METHODS: An extrusion setup was designed to enable irrigant extrusion to be opposed by 30 mm Hg simulated intraosseous pressure. The faux canal apex was opposed by atmospheric + 30 mm Hg pressure (experimental) or atmospheric pressure only (control group). Using five irrigant delivery rates (15.6 8.0, 4.0, 3.4 or 3.0 mL/min), the extrusion rates of 2% NaOCl from the faux apex were measured in both groups (n = 16). Data were analysed with two-factor ANOVA and pairwise comparisons at α = 0.05. Correlation between NaOCl delivery rates and extrusion rates in both groups were analysed with the Pearson product-moment procedure. RESULT: Irrespective of the presence or absence of simulated sinusoidal pressure, NaOCl extrusion rates were positively-correlated with irrigant flow rates. For the factor "irrigant flow rates", significant differences in NaOCl extrusion rates were identified among all flow rates (p < 0.05), except for the pairwise comparison between 4.0 and 3.4 mL/min in the control. For all irrigant flow rates, NaOCl extrusion rate was significantly lower in the presence of 30 mm Hg simulated sinusoidal pressure than that obtained in the absence of opposing pressure (p < 0.05). CONCLUSION: In the presence of 30 mm Hg simulated intraosseous pressure, NaOCl delivered via a side-vented needle inserted to 1 mm short of working length may be prevented from extrusion when its flow rate is ≤ 3.0 mL/min. CLINICAL SIGNIFICANCE: When opposed by intraosseous sinusoidal pressure, NaOCl delivered via a side-vented needle inserted to 1 mm short of working length may be prevented from extrusion when its flow rate is ≤ 3.0 mL/min.


Asunto(s)
Presión , Irrigantes del Conducto Radicular , Preparación del Conducto Radicular , Hipoclorito de Sodio , Irrigación Terapéutica , Humanos , Agujas , Irrigantes del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/métodos , Hipoclorito de Sodio/uso terapéutico
15.
Photodiagnosis Photodyn Ther ; 23: 347-352, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30053480

RESUMEN

INTRODUCTION: The aim of this study is to evaluate the antimicrobial activity of hypochlorite solutions and reciprocating instrumentation associated with photodynamic therapy (PDT). METHODS: One hundred and thirty two root canals were enlarged up to #35 K-file and inoculated with E.faecalis for 14 days. The 132 samples were randomly divided into eleven groups (n = 12) and subjected to the following protocols: G1-distilled water + Reciproc R40 (control), G2-1% sodium hypochlorite (NaOCl) + Reciproc R40, G3-2.5% NaOCl + Reciproc R40; G4-1% calcium hypochlorite (Ca[OCl]2) + Reciproc R40, G5-2.5% Ca(OCl)2 + Reciproc R40; G6-PDT; G7-distilled water + Reciproc R40 + PDT, G8-1% NaOCl + Reciproc R40 + PDT, G9-2.5% NaOCl + Reciproc R40 + PDT; G10-1% Ca(OCl)2 + Reciproc R40 + PDT, G11-2.5% Ca(OCl)2 + Reciproc R40 + PDT. The percentage bacterial reduction was checked by counting the colony-forming units (CFUs) in 10 samples of each group. The remaining 2 samples of each group were submitted to scanning electronic microscopy (SEM) to illustrate the effectiveness of the proposed treatments. Data were subjected to one-way ANOVA followed by Tukey's post hoc test (α = 0.05). RESULTS: The greatest ability to promote bacterial reduction was observed in groups 8 (1% NaOCl + R40 + PDT), 9 (2.5% NaOCl + R40 + PDT), 10 (1% Ca[OCl]2 + R40 + PDT), and 11 (2.5% Ca[OCl]2 + R40 + PDT), with no significant difference between them (p < 0.05). CONCLUSIONS: The association of PDT with hypochlorite solutions and reciprocating instrumentation provides effective elimination of E.faecalis.


Asunto(s)
Enterococcus faecalis/efectos de los fármacos , Ácido Hipocloroso/uso terapéutico , Azul de Metileno/uso terapéutico , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Preparación del Conducto Radicular/métodos , Carga Bacteriana , Compuestos de Calcio/uso terapéutico , Terapia Combinada , Cavidad Pulpar/microbiología , Relación Dosis-Respuesta a Droga , Humanos , Hipoclorito de Sodio/uso terapéutico
16.
Int Endod J ; 51(12): 1349-1357, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29855054

RESUMEN

AIM: To detect the unknown components of the oral microbiome and the effects of root canal treatment in a Turkish population and to evaluate the changes in microbial diversity in the root canals before and after treatment. METHODOLOGY: Single-rooted central and lateral maxillary incisors with one canal were chosen from 20 patients. Baseline samples of intact intracanal microbiota were collected from 20 root canals of permanent teeth with necrotic pulps using sterile paper points. After root canal preparation, the root canals were filled with a calcium hydroxide paste for 7 days. Calcium hydroxide was removed from root canal with 2.5% sodium hypochlorite and 17% EDTA using passive ultrasonic irrigation (PUI). A second bacteriologic samples were taken with sterile paper points prior to root filling. The samples were processes with DNase-I treatment using next-generation sequencing (NGS). Reduction in bacterial numbers during root canal treatment was evaluated using real-time quantitative PCR (qPCR). All statistical analyses were conducted using the MINITAB 17 software (Minitab Ltd. Co., Coventry, UK). A one-sample t-test was used to analyse the data. Statistical significance was accepted at P < 0.05. RESULTS: Relative abundances of Mycoplasma sp., Paludibacter sp., Tannerella sp., Prevotella spp. and an uncultured species from the order Bacteroidales decreased with root canal preparation and medication (98.7%, 99.8%, 98.8%, 97.7% and 99.3%, respectively), whilst the relative abundances of Methylobacterium sp., Corynebacterium sp. and Streptococcus infantis increased (93.1%, 94.8% and 99.4%, respectively). Considerable numbers of Streptophyta species were detected before and after treatment. The ratio of Agrobacterium sp. in the treated teeth community and the ratio of order Streptophyta in the infected canals had negative correlations with the success of bacterial elimination. CONCLUSIONS: The combination of NGS and qPCR techniques resulted in detection of previously unknown components of the oral microbiome and the effects of root canal treatment on their relative abundance in a Turkish population.


Asunto(s)
Bacterias/clasificación , Cavidad Pulpar/microbiología , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Microbiota , Boca/microbiología , Adolescente , Adulto , Bacterias/genética , Hidróxido de Calcio/uso terapéutico , ADN Bacteriano/análisis , Necrosis de la Pulpa Dental/microbiología , Necrosis de la Pulpa Dental/terapia , Ácido Edético/uso terapéutico , Femenino , Humanos , Incisivo , Masculino , Maxilar , Microbiota/genética , ARN Ribosómico 16S/genética , Materiales de Obturación del Conducto Radicular/uso terapéutico , Irrigantes del Conducto Radicular/uso terapéutico , Obturación del Conducto Radicular/métodos , Preparación del Conducto Radicular/métodos , Tratamiento del Conducto Radicular/métodos , Hipoclorito de Sodio/uso terapéutico , Ápice del Diente/microbiología , Turquia , Ultrasonido , Adulto Joven
17.
J Endod ; 44(5): 813-815, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29550010

RESUMEN

INTRODUCTION: The aim of this study was to evaluate porcine palatal mucosa dissolution by sodium hypochlorite (NaOCl) with or without an auxiliary dissolving agent containing glycocholic acid and a mixture of surfactants (Keratobacter [KB]; Saint Joseph DID, Valencia, Spain). METHODS: One hundred forty samples were obtained from porcine palatal mucosa and weighed using a high-precision balance. The samples were randomly divided into 4 experimental groups (n = 35) based on the test solution used: distilled water (the negative control), CanalPro NaOCl 6% (Coltene Whaledent, Altstätten, Switzerland), KB, and a 9:1 vol/vol mixture of NaOCl with KB (NaOCl + KB). After 5, 10, 15, and 20 minutes of immersion in the solutions at 27°C ± 1°C, the samples were weighted by a blinded assessor. The intergroup weight at the different time points was statistically analyzed using the analysis of variance test with the Bonferroni posttest. RESULTS: All test groups presented with tissue dissolution although complete dissolution did not occur in any sample. The largest percent in weight reduction occurred between time points (t) = 0 minutes and t = 5 minutes for the NaOCl + KB group (22.5%) followed by KB (18.5%) for the same time period. NaOCl presented with similar tissue dissolution activity during the different time points, ranging from 7.8% (t = 10 minutes-t = 15 minutes) to 6.8% (t = 15 minutes-t = 20 minutes). Significant weight differences were found among the different experimental groups after 5, 10, and 15 minutes of incubation, with the only exception being KB versus NaOCl + KB. No significant differences were found when comparing the test groups at t = 20 minutes. CONCLUSIONS: The addition of KB to NaOCl increased porcine palatal mucosa dissolution in vitro.


Asunto(s)
Ácido Glicocólico/uso terapéutico , Mucosa Bucal/efectos de los fármacos , Irrigantes del Conducto Radicular/uso terapéutico , Tensoactivos/uso terapéutico , Animales , Sinergismo Farmacológico , Técnicas In Vitro , Paladar (Hueso) , Hipoclorito de Sodio/uso terapéutico , Porcinos
18.
Braz Oral Res ; 32: e16, 2018 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-29561949

RESUMEN

The presence of residues within the root canal after post-space preparation can influence the bond strength between resin cement and root dentin when using fiberglass posts (FGPs). Currently, there is no consensus in the literature regarding what is the best solution for the removal of debris after post-space preparation. This systematic review involved "in vitro" studies to investigate if cleaning methods of the root canal after post-space preparation can increase the retention of FGPs evaluated by the push-out test. Searches were carried out in PubMed (MEDLINE) and Scopus databases up to July2017. English language studies published from 2007 to July 2017 were selected. 475 studies were found, and 9 were included in this review. Information from the 9 studies were collected regarding the number of samples, storage method after extraction, root canal preparation, method of post-space preparation, endodontic sealer, resin cement, cleaning methods after post-space and presence of irrigant activation. Five studies presented the best results for the association of sodium hypochlorite (NaOCl) and ethylenediamine tetra-acetic acid (EDTA), while in the other 4 studies, the solutions that showed improved retention of FGPs were photon-induced photoacoustic streaming (PIPS), Qmix, Sikko and EDTA. The results showed heterogeneity in all comparisons due to a high variety of information about cleaning methods, different concentrations, application time, type of adhesive system and resin cements used. In conclusion, this review suggests that the use of NaOCl/EDTA results in the retention of FGPs and may thus be recommended as a post-space cleaning method influencing the luting procedure.


Asunto(s)
Retención de Prótesis Dentales/métodos , Vidrio , Técnica de Perno Muñón , Irrigantes del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/métodos , Recubrimiento Dental Adhesivo/métodos , Cavidad Pulpar/efectos de los fármacos , Dentina/efectos de los fármacos , Ácido Edético/uso terapéutico , Humanos , Reproducibilidad de los Resultados , Hipoclorito de Sodio/uso terapéutico , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
19.
J Dent ; 72: 71-75, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29571954

RESUMEN

OBJECTIVES: The effect of irrigation time on the antimicrobial efficacy of an apical negative pressure irrigation system was examined in vitro, followed by validation of the antimicrobial effect in vivo using the identified optimal irrigation time. METHODS: For the in vitro experiment, 44 extracted premolars were decoronated, instrumented, autoclaved and inoculated with Enterococcus faecalis (ATCC 29212) for 21 days. Four teeth were used as positive control, without irrigation. Each of the remaining 40 teeth was irrigated with 2.5% NaOCl, delivered via the EndoVac MacroCannula for 10 s, and subsequently via the EndoVac MicroCannula for 15, 30, 45, 60 or 90 s per canal, respectively (N = 8). After irrigation, microbial samples were collected, transferred to BHI broth and incubated for counting of bacterial colony forming units (CFUs). Based on the in vitro results, 8.25% NaOCl was delivered via the EndoVac MicroCannula for 60 s, during root canal treatment of 20 human subjects presented with apical periodontitis. Microbial samples retrieved in vivo prior to canal instrumentation (S0), after chemomechanical debridement (S1) and after irrigation with EndoVac (S2) were cultured in an anaerobic chamber for 7 days for CFU evaluation. RESULTS: Compared with the control, irrigation significantly reduced bacterial populations (p < .05). Irrigation delivery via the EndoVac demonstrated improved antibacterial efficacy with increased irrigation time (p < .05). Samples retrieved from canals after NaOCl delivery in vivo with the EndoVac for 60 s were all culture-negative. CONCLUSIONS: Microbial elimination may be achieved with 8.25% NaOCl delivered via the EndoVac apical negative pressure irrigation device for 60 s. CLINICAL SIGNIFICANCE: With the use of the EndoVac apical negative pressure irrigant delivery system, optimal elimination of the intracanal bacterial load can only be achieved when sodium hypochlorite is delivered via the MicroCannula for at least 60 s per canal.


Asunto(s)
Antiinfecciosos/uso terapéutico , Enterococcus faecalis/efectos de los fármacos , Presión , Irrigantes del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/métodos , Tratamiento del Conducto Radicular/métodos , Aleaciones , Carga Bacteriana , Diente Premolar , Desbridamiento/métodos , Cavidad Pulpar/efectos de los fármacos , Cavidad Pulpar/microbiología , Desinfección/métodos , Humanos , Periodontitis Periapical/tratamiento farmacológico , Tratamiento del Conducto Radicular/instrumentación , Hipoclorito de Sodio/uso terapéutico , Tiosulfatos , Factores de Tiempo
20.
Int Endod J ; 51(9): 1030-1036, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29505173

RESUMEN

AIM: To evaluate the effectiveness of NaOCl, NaOCl-EDTA and NaOCl + HEBP activated by ultrasonics and XP-endo Finisher on organic tissue removal from simulated internal root resorption cavities. METHODOLOGY: The root canals of 144 single-rooted teeth were instrumented. The teeth were split longitudinally, and semicircular cavities were prepared in the canal walls on each half of the roots. Samples obtained from ground bovine muscle tissue were weighed and adapted into the semicircular cavities. The root fragments were reassembled and cemented to create a circular simulated resorption cavity within the canal. Teeth were divided into twelve groups (n = 12) according to the irrigation protocols: group 1: NaOCl, no activation; group 2: NaOCl, passive ultrasonic irrigation (PUI); group 3: NaOCl, XP-endo Finisher; group 4: NaOCl-EDTA, no activation; group 5: NaOCl-EDTA, PUI; group 6: NaOCl-EDTA, XP-endo Finisher; group 7: NaOCl + HEBP, no activation; group 8: NaOCl + HEBP, PUI; group 9: NaOCl + HEBP, XP-endo Finisher; group 10: distilled water, no activation; group 11: distilled water, PUI; and group 12: distilled water, XP-endo Finisher. The teeth were disassembled, and the tissue remaining inside the resorption cavities were weighed. The data were analysed statistically using two-way anova and Fisher's LSD tests with a significance level of 0.05. RESULTS: The use of XP-endo Finisher with the experimental solutions resulted in the greatest tissue weight loss compared to the other activation protocols (P < 0.001). There was no significant difference between NaOCl and NaOCl + HEBP in terms of tissue removal. CONCLUSION: The use of a NaOCl + HEBP mixture activated with XP-endo Finisher was an effective irrigation regimen for removing simulated organic tissues from artificial internal root resorption cavities in the straight root canals of single-rooted teeth.


Asunto(s)
Obturación del Conducto Radicular/métodos , Resorción Radicular/cirugía , Ácido Edético/uso terapéutico , Ácido Etidrónico/uso terapéutico , Humanos , Irrigantes del Conducto Radicular/uso terapéutico , Obturación del Conducto Radicular/instrumentación , Hipoclorito de Sodio/uso terapéutico , Irrigación Terapéutica , Ultrasonido/métodos
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