A periodontite apical como fator de risco às manifestações sistêmicas: uma perspectiva histórica atualizada / Apical periodontitisas a risk factor to systemic manifestations: a updated historical perspective

Objetivo: O objetivo deste trabalho foi revisar a literatura científica pertinente, dando enfoque ao tratamento endodôntico e dentes portadores de necrose pulpar associados à periodontite apical como fator de risco às manifestações sistêmicas, desde a teoria da infecção focal até os dias atuais. Metodologia: Empregou-se fontes de catalogação bibliográfica identificadas eletronicamente pelo MEDLINE, até setembro de 2018. Os artigos relacionados pela busca eletrônica foram selecionados, por três revisores independentes, avaliando os critérios de inclusão e exclusão. Resultados: A busca apresentou 107 artigos, sendo que destes, 17 estudos satisfizeram os critérios de inclusão, o que possibilitou a análise dos dados. Conclusão: Muitos dos preceitos da teoria da infecção focal estão sendo reerguidos por pesquisas que mostram cada vez mais a existência de associações entre patologias endodônticas e sistêmicas.

Objective: The aim of this work was to review the pertinent scientific literature, focusing on endodontic treatment and teeth with pulp necrosis associated with apical periodontitis as a risk factor for systemic manifestations, from the focal infection theory to the present day. Methodology: The sources of bibliographic cataloging electronically identified by MEDLINE were used until September 2018. Articles related to the electronic search were selected by three independent reviewers, evaluating the inclusion and exclusion criteria. Results: The search presented 107 articles, of which, 17 studies met the inclusion criteria, which made it possible to analyze the data. Conclusion: Many of the precepts of the focal infection theory are being reinstated by research that increasingly shows the existence of associations between endodontic and systemic pathologies.

Analysis of the effect of ultrasonic agitation on the cleaning of root canals using different periods during the final irrigation

Introduction: The ultrasonic agitation was introduced as an adjuvant to conventional chemo-mechanical debridement during endodontic treatment to overcome the persistence of biofilms. Objective: To verify the cleaning of root canals irrigated with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), with or without an ultrasonic agitation, using different time periods and images obtained by scanning electron microscope (SEM). Material and methods: Forty mandibular incisors were cleaned, shaped and randomly divided into five groups according to the final irrigation protocol: SH10 group (ultrasonic agitation with NaOCl for 10 s), SH30 group (ultrasonic agitation with NaOCl for 30 s), SHE30 group (ultrasonic agitation with NaOCl and EDTA for 10 s), SHE90 group (ultrasonic agitation with NaOCl and EDTA for 30 s), and control group (NaOCl and EDTA without ultrasonic agitation). The teeth were prepared and analyzed by SEM at ×2000. The Kruskal-Wallis test was used with a 5% level of significance. Results: For the cervical and medial thirds, there was no statistically significant difference in cleaning among the protocols used (p > 0.05). For the cleaning of the apical third, SHE90 group demonstrated a significant difference (p < 0.05), as compared to the control and SH10 groups. Conclusion: For the final irrigation, an ultrasonic agitation with NaOCl and EDTA for 30 s allowed a better cleaning of the debris in the apical third of the root canal.