Role of professional expertise in the decision-making process for periodontally compromised teeth.

The objective of this study was to evaluate factors that may influence decision-making with regard to extraction or maintenance of periodontally compromised teeth. A questionnaire with 2 distinct clinical scenarios, each including a radiographic image, was provided to students in their final year of dental school and practicing dentists. The participants were asked to record the action that they would take in each case (tooth maintenance vs extraction) and provide a justification for their decision. The questionnaires were answered by 158 dental students and 57 dentists (N = 215). Among the sample as a whole, 31.16% of participants recommended extraction in scenario 1, while only 5.58% recommended that action in scenario 2. In scenario 1, there was a statistically significant difference in the recommendations of the dental students and the dentists, with the former group significantly more disposed to conservative action, that is, maintenance of the tooth (P < 0.001; chi-square test). When the actions recommended by participants specializing in implants or periodontics (or both) were compared with those recommended by other specialists, there was a statistically significant difference between the groups regarding maintenance and extraction (P = 0.012; Fisher exact test), with the former group recommending fewer extractions. When the responses were evaluated in terms of the participants' years of specialty practice, it was observed that professionals with fewer than 20 years of practice were more conservative in their decisions, choosing tooth maintenance significantly more often than specialists with longer experience (P = 0.031; Fisher exact test). Among the majority of both dental students and practicing dentists, the decision in both scenarios was to maintain the compromised teeth; however, the results suggested that that both the years of experience of the individual and the specialty of the practitioner can influence decision-making.

Recommendations for Managing Endodontic Emergencies during Coronavirus Disease 2019 Outbreak.

INTRODUCTION: The management of endodontic emergencies has been particularly challenging during the coronavirus disease 2019 (COVID-19) outbreak because of the possible generation of airborne particles and aerosols. The aim of this report was to contribute to the practice of endodontics by proposing a general protocol for the management of emergencies showing the rationale for remote diagnosis, clinical procedures, and the use of personal protective equipment and barriers at the dental office during the COVID-19 outbreak. METHODS: A review of the literature was conducted up to May 2020 on relevant institutional sites, aiming to retrieve the best updated evidence. The reporting considered the Reporting Tool for Practice Guidelines in Health Care statement. RESULTS: Recommendations from Cochrane Oral Health, the American Dental Association, and the Centers for Disease Control and Prevention were included along with the American Association of Endodontists resources and scientific articles that addressed the issue. CONCLUSIONS: The proposed protocol could contribute to the management of endodontic emergencies at the dental office during the COVID-19 outbreak.

Avaliação do desvio apical após o preparo com sistema Protaper com e sem o uso prévio de limas PathFile / Evaluation of apical transportation in Protaper system with and without PathFile files

O presente estudo verificou se a pré-instrumentação com limas PathFile diminui a possibilidade de desvio apical durante o preparo endodôntico com limas Protaper nos canais simulados em blocos de resina. Foram confeccionadas fotografias antes e após a instrumentação e realizada uma análise computadorizada por meio de superposição das imagens. Os dados obtidos foram tratados estatisticamente com teste T de comparação de médias, havendo diferença estatisticamente significante (p=0,000, t=-25,383). De acordo com os resultados obtidos, concluiu-se que a instrumentação prévia dos canais radiculares com as limas Pathfile (Dentsply®/Maillefer) pode contribuir consideravelmente na redução da possibilidade de desvio no terço apical de canais radiculares curvos.

This study has aimed at verifying if the use of PathFile files minimizes the possibility of apical deviation during endodontic treatment with Protaper files in resin blocks with simulated canals. Digital photographs were taken before and after instrumentation and a computerized analysis through overlapping images. Data were statistically analyzed with t-test for comparison of means, and demonstrated a statistically significant difference (p = 0.000, t = -25.383). According to the results of this research, the authors concluded that previous instrumentation with PathFile (Dentsply©/Maillefer) system can contribute to a great reduction of transportation possibility on the apical third of curved root canals

Avaliação da adaptação de cones de guta-percha no segmento apical de canais ovais / Evaluation the adaptation of guta-percha in apical segment of long oval canals

O presente estudo teve por finalidade avaliar, in vitro, o grau de adaptação de cones de guta-percha no segmento apical de canais ovais longos de 40 primeiros pré-molares inferiores, obturados pela técnica de compactação lateral da guta-percha (TCL) e de Schilder (TS). Cortes a 1, 3 e 5 mm aquém do ápice radicular perpendiculares, ao longo eixo do dente, revelaram superfícies que foram analisadas com auxílio de estereomicroscópio e as imagens avaliadas através de um software. A média da área do terço apical não preenchida por guta-percha a 1 mm grupo 1 = 38,72% e grupo 2 = 22,64%; a 3 mm grupo 1 = 30,32% e grupo 2 =15,80%; a 5 mm grupo 1 = 57,38% e grupo 2 = 26,42%. A técnica de Schilder foi mais eficaz.

The present study aimed to evaluate in vitro the degree of adaptation of gutta-percha in the apical segment of the long oval canals first 40 premolars, filled by lateral compaction technique of gutta-percha (TCL) and Schilder (TS). Cuts at 1, 3 and 5 mm below the apex perpendicular to the long axis of the tooth surfaces revealed that analyzed with stereomicroscope and images evaluated through software. The average area of the apical third not filled with gutta-percha to the 1 mm group 1 = 3 8.72% and G roup 2 = 2 2.64%, the 3 m m g roup 1 = 3 0.32% a nd G roup 2 = 15.80% , the 5 mm group 1 = 57.38% and group 2 = 26.42%. Schilder's technique was more effective.

Avaliação da contaminação de cones de papel absorvente / Evaluation of contamination of absorvent papel points

A umidade no sistema de canais radiculares poderá interferir no perfeito selamento da obturação. O papel absorvente na forma de cones é o último material a ser inserido nos canais antes da obturação dos canais radiculares. Neste contexto, instrumentos e materiais devem estar livres de micro-organismos que poderão contribuir para a instalação e persistência das patologias perirradiculares. O objetivo deste estudo foi avaliar a presença de contaminação microbiana em três marcas comerciais de cones de papel absorvente denominadas esterilizadas. Foram avaliadas as marcas Dentsply e Endopoints em apresentação cell pack e a marca Roeko em embalagem plástica com subdivisões. As marcas Dentsply e Roeko não evidenciaram contaminação. A marca Endopoints evidenciou contaminação em todas as amostras avaliadas.