Effect of low-power diode laser on infected root canals

Abstract This study evaluated the effect of photodynamic therapy (PDT) on infected root canals. Twenty-one human teeth were selected, and 18 were infected by E. faecalis for 60 days. The antimicrobial strategies tested were: G1. Root canal preparation (RCP) using Niquel-Titanium (NiTi) rotary instruments, 2.5% NaOCl, and final irrigation with 17% EDTA, followed by PDT with methylene blue photosensitizer and laser diode low power; G2. RCP using stainless steel files and the same irrigation and PDT protocols as G1; G3. Same RCP protocol as G1 without PDT; G4. Only irrigation with 2.5% NaOCl; G5. Same PDT protocol as G1 without RCP; G6. Negative control; G7. Positive control. Samples for microbiological tests were collected initially (S1), after RCP (S2), and after PDT (S3). Subsequently, the roots were sectioned and prepared for Scanning Electron Microscopy (SEM) analysis. Bacterial growth was analyzed according to the turbidity of the culture medium, followed by spectrophotometric optical density (nm). The effect of PDT on the dentinal structure was evaluated at magnifications 1,600X and 5,000X and described qualitatively. The Wilcoxon test was used for the comparisons from the same specimens, and the Mann-Whitney test was used to compare groups ((=5%). Bacteria were found in all experimental groups' microbiological samples (S1, S2 and S3). The optical density of culture media was lower in S2 than in S1 of G1, 2, 3, and 4 (p> 0.05). After PDT (S3) in G1 and 2, there was an additional reduction in optical density of the culture medium, respectively (p>0.05). In Group 5, the analysis of culture media at S2 revealed an increase in optical density compared to S1(p>0.05). In SEM images of G1, 2, and 5, dentin with melting and recrystallization areas were evidenced. After preparation of the root canal with the rotary system or manually associated with 2.5% NaOCl, PDT was not able to completely eliminate E. faecalis present in the root canal.

Resumo Este estudo avaliou o efeito da terapia fotodinâmica (PDT) em canais radiculares infectados com E. faecalis. Vinte e um dentes humanos extraídos foram selecionados, e 18 foram infectados por E. faecalis por 60 dias. As estratégias antimicrobianas testadas foram: G1. Preparo do canal radicular (PCR) com instrumentos rotatórios de NiTi, NaOCl 2,5% e irrigação final com EDTA 17%, seguido de PDT com fotossensibilizador azul de metileno e laser diodo de baixa potência; G2. PCR usando limas de aço inoxidável e os mesmos protocolos de irrigação e PDT do G1; G3. Protocolo de PCR similar que G1 sem PDT; G4. Somente irrigação com NaOCl 2,5%; G5. Protocolo similar ao G1, sem PCR; G6. Controle negativo; G7. Controle positivo. Amostras para exames microbiológicos foram coletadas inicialmente (S1), após PCR (S2) e após PDT (S3). Na sequência, as raízes foram seccionadas e preparadas para análise em microscopia eletrônica de varredura (MEV). O crescimento bacteriano foi analisado de acordo com a turbidez do meio de cultura seguida pela densidade óptica espectrofotométrica (nm). O efeito da PDT na estrutura dentinária foi avaliado em aumentos de 1.600X e 5.000X, e descrito qualitativamente. O teste de Wilcoxon foi utilizado para as comparações dos mesmos espécimes e o teste de Mann-Whitney para as comparações entre os grupos ((=5%). Bactérias foram encontradas em todos os grupos experimentais, e em todas as coletas microbiológicas (S1, S2 e S3). A densidade óptica dos meios de cultura foi menor em S2 do que em S1 de G1, 2, 3 e 4 (p>0,05). Após a PDT (S3) em G1 e 2, houve redução adicional na densidade óptica do meio de cultura de 90,0% e 92,0%, respectivamente (p>0,05). No Grupo 5, a análise dos meios de cultura em S2 revelou um aumento de 3,2% na densidade óptica em comparação com S1(p>0,05). Nas imagens de MEV do G1, 2 e 5 foram evidenciadas dentina com áreas de fusão e recristalização. O PDT utilizado após preparo do canal radicular com sistema rotatório ou manual, associado ao NaOCl 2,5%, não foi capaz de eliminar completamente o E. faecalis em biofilme maduro presente no canal radicular.

Effect of low-power diode laser on infected root canals.

This study evaluated the effect of photodynamic therapy (PDT) on infected root canals. Twenty-one human teeth were selected, and 18 were infected by E. faecalis for 60 days. The antimicrobial strategies tested were: G1. Root canal preparation (RCP) using Niquel-Titanium (NiTi) rotary instruments, 2.5% NaOCl, and final irrigation with 17% EDTA, followed by PDT with methylene blue photosensitizer and laser diode low power; G2. RCP using stainless steel files and the same irrigation and PDT protocols as G1; G3. Same RCP protocol as G1 without PDT; G4. Only irrigation with 2.5% NaOCl; G5. Same PDT protocol as G1 without RCP; G6. Negative control; G7. Positive control. Samples for microbiological tests were collected initially (S1), after RCP (S2), and after PDT (S3). Subsequently, the roots were sectioned and prepared for Scanning Electron Microscopy (SEM) analysis. Bacterial growth was analyzed according to the turbidity of the culture medium, followed by spectrophotometric optical density (nm). The effect of PDT on the dentinal structure was evaluated at magnifications 1,600X and 5,000X and described qualitatively. The Wilcoxon test was used for the comparisons from the same specimens, and the Mann-Whitney test was used to compare groups ((=5%). Bacteria were found in all experimental groups' microbiological samples (S1, S2 and S3). The optical density of culture media was lower in S2 than in S1 of G1, 2, 3, and 4 (p> 0.05). After PDT (S3) in G1 and 2, there was an additional reduction in optical density of the culture medium, respectively (p>0.05). In Group 5, the analysis of culture media at S2 revealed an increase in optical density compared to S1(p>0.05). In SEM images of G1, 2, and 5, dentin with melting and recrystallization areas were evidenced. After preparation of the root canal with the rotary system or manually associated with 2.5% NaOCl, PDT was not able to completely eliminate E. faecalis present in the root canal.

Evaluation in the danger zone of mandibular molars after root canal preparation using novel CBCT software.

This study measured the thickness of cementum/dentin in the danger zone of the mandibular molars after root canal preparation using novel cone-beam computed tomography (CBCT) software. Eighty-four teeth were distributed into four groups: ProTaper Next, BioRace, Reciproc Blue, and WaveOne Gold. E-Vol DX® CBCT software was used to measure initial and final remaining cementum-dentin thicknesses after root canal preparation of the mesial root of mandibular molars at 1 and 3 mm from the furcation. The Kolmogorov-Smirnov test was used to test variable symmetry. The variables were described as mean and standard deviations, compared among the groups using analysis of variance (ANOVA), and within the groups using the Student t test. A generalized estimating equation model was used to compare the variation before and after root canal preparation. The level of significance was set at 5%. Differences between mean initial and final thicknesses of the mesiobuccal (MB) and mesiolingual (ML) canals were not statistically significant. The mean initial thickness was 3 mm (0.900 mm ± 0.191), considering that a mean lower than 1 mm (1.035 mm ± 0.184) indicates the danger zone. Although cementum/dentin is thinner at 3 mm from the furcation (0.715±0.186) after root canal preparation, the greatest amount of dentin removed was found at 1 mm (0.734 ± 0.191). The cementum-dentin remaining after preparation was thicker than 0.715 mm in root canals prepared using #35 (WaveOne Gold®) and #40 (ProTaper Next®, BioRace® and Reciproc Blue®) instruments. This confirms the safety of canal preparation in the danger zone using these systems.

Evaluation in the danger zone of mandibular molars after root canal preparation using novel CBCT software

Abstract: This study measured the thickness of cementum/dentin in the danger zone of the mandibular molars after root canal preparation using novel cone-beam computed tomography (CBCT) software. Eighty-four teeth were distributed into four groups: ProTaper Next, BioRace, Reciproc Blue, and WaveOne Gold. E-Vol DX® CBCT software was used to measure initial and final remaining cementum-dentin thicknesses after root canal preparation of the mesial root of mandibular molars at 1 and 3 mm from the furcation. The Kolmogorov-Smirnov test was used to test variable symmetry. The variables were described as mean and standard deviations, compared among the groups using analysis of variance (ANOVA), and within the groups using the Student t test. A generalized estimating equation model was used to compare the variation before and after root canal preparation. The level of significance was set at 5%. Differences between mean initial and final thicknesses of the mesiobuccal (MB) and mesiolingual (ML) canals were not statistically significant. The mean initial thickness was 3 mm (0.900 mm ± 0.191), considering that a mean lower than 1 mm (1.035 mm ± 0.184) indicates the danger zone. Although cementum/dentin is thinner at 3 mm from the furcation (0.715±0.186) after root canal preparation, the greatest amount of dentin removed was found at 1 mm (0.734 ± 0.191). The cementum-dentin remaining after preparation was thicker than 0.715 mm in root canals prepared using #35 (WaveOne Gold®) and #40 (ProTaper Next®, BioRace® and Reciproc Blue®) instruments. This confirms the safety of canal preparation in the danger zone using these systems.

Interference of coronal enamel and dentin thickness and ambient light on pulse oximetry interpretation.

This study evaluated the interference of enamel and coronal dentin thickness and ambient light in pulse oximetry interpretation, using SaO2the human finger as a reference. Forty-two intact human permanent mandibular molars were sectioned mesiodistally in the central portion. Buccal and lingual dentin surfaces were drilled, and 4 mm, 3 mm and 2 mm enamel/dentin thicknesses were interposed between finger and device, after which SaO2 levels were measured by finger pulse oximetry. A reference device was designed to align pulse oximeter light-emitting diode, buccal surface of tooth, little finger, lingual surface of tooth and photodiode. Variables were described as means and standard deviation, and the confidence interval was reported. Repeated measures analysis of variance (ANOVA) was used to compare the groups, followed by Bonferroni correction. Student t test for paired samples was used to determine presence of ambient light (α = 0.05). Mean SaO2 level was lower at 4.0 ± 0.2 mm thickness, regardless of presence or absence of ambient light (92.7% and 89.3%). The other thicknesses yielded values of 95.5% and 94.5% at 3.0 ± 0.2 mm, and 96.4% and 96.0% at 2.0 ± 0.2 mm (p < 0.001). There were significant differences between SaO2 values at 4.0 ± 0.2 mm, 3.0 ± 0.2 mm and 2.0 ± 0.2 mm thicknesses, in the presence of ambient light. Mean SaO2 level in positive control was 96.3%, and mean pulse rate was 69.5 bpm in presence of ambient light; in the absence of light, these values were 96% and 70.5 bpm. Enamel and dentin thickness interfere with SaO2, regardless of presence or absence of ambient light. The lowest SaO2 levels were found for the thickest tooth samples.

CBCT assessment of bone thickness in maxillary and mandibular teeth: an anatomic study.

OBJECTIVE: The site of the sinus tract depends on the rate of resistance against abscess exudate drainage, bone morphology, and distance from the root apex to the outer cortical bone. To assess apical bone thickness in buccal and palatal/lingual aspects of maxillary and mandibular teeth, using a high-resolution cone-beam computed tomography (CBCT) system. METHODOLOGY: In total, 422 CBCT examinations were included in the study, resulting in a sample of 1400 teeth. The scans were acquired by PreXion 3D, with a high-resolution protocol. The bone thickness was taken as the distance between the center of the apical foramen and the buccal and lingual/palatal cortical bone. The quantitative variables were expressed as mean values±standard deviation. The independent samples were analyzed using the t-test or the Mann-Whitney test (p<0.05). RESULTS: The lowest mean value of bone thickness was observed in the buccal cortical bone of the upper canines (1.49 mm±0.86) and in the upper central incisors (1.59 mm±0.67). In premolar teeth, the lowest values were found in the buccal cortical bone of upper first premolars (1.13 mm±0.68). In the posterior teeth, the lowest values were found in the buccal cortical bone of upper first molars (1.98 mm±1.33). In the lower second molar region, the buccal cortical bone (8.36 mm±1.84) was thicker than the lingual cortical bone (2.95 mm±1.16) (p<0.05). CONCLUSIONS: The lowest mean values of bone thickness are in the buccal cortical bone of the maxillary teeth. In the mandible, bone thickness is thinner in the buccal bone around the anterior and premolar teeth, and in the lingual aspect of mandibular molars. All these anatomic characteristics could make the occurrence of the sinus tract more susceptible in these specific regions of the maxillary and mandibular alveolar bone.

CBCT assessment of bone thickness in maxillary and mandibular teeth: an anatomic study

Abstract The site of the sinus tract depends on the rate of resistance against abscess exudate drainage, bone morphology, and distance from the root apex to the outer cortical bone. Objective To assess apical bone thickness in buccal and palatal/lingual aspects of maxillary and mandibular teeth, using a high-resolution cone-beam computed tomography (CBCT) system. Methodology In total, 422 CBCT examinations were included in the study, resulting in a sample of 1400 teeth. The scans were acquired by PreXion 3D, with a high-resolution protocol. The bone thickness was taken as the distance between the center of the apical foramen and the buccal and lingual/palatal cortical bone. The quantitative variables were expressed as mean values±standard deviation. The independent samples were analyzed using the t-test or the Mann-Whitney test (p<0.05). Results The lowest mean value of bone thickness was observed in the buccal cortical bone of the upper canines (1.49 mm±0.86) and in the upper central incisors (1.59 mm±0.67). In premolar teeth, the lowest values were found in the buccal cortical bone of upper first premolars (1.13 mm±0.68). In the posterior teeth, the lowest values were found in the buccal cortical bone of upper first molars (1.98 mm±1.33). In the lower second molar region, the buccal cortical bone (8.36 mm±1.84) was thicker than the lingual cortical bone (2.95 mm±1.16) (p<0.05). Conclusions The lowest mean values of bone thickness are in the buccal cortical bone of the maxillary teeth. In the mandible, bone thickness is thinner in the buccal bone around the anterior and premolar teeth, and in the lingual aspect of mandibular molars. All these anatomic characteristics could make the occurrence of the sinus tract more susceptible in these specific regions of the maxillary and mandibular alveolar bone.

Interference of coronal enamel and dentin thickness and ambient light on pulse oximetry interpretation

Abstract This study evaluated the interference of enamel and coronal dentin thickness and ambient light in pulse oximetry interpretation, using SaO2the human finger as a reference. Forty-two intact human permanent mandibular molars were sectioned mesiodistally in the central portion. Buccal and lingual dentin surfaces were drilled, and 4 mm, 3 mm and 2 mm enamel/dentin thicknesses were interposed between finger and device, after which SaO2 levels were measured by finger pulse oximetry. A reference device was designed to align pulse oximeter light-emitting diode, buccal surface of tooth, little finger, lingual surface of tooth and photodiode. Variables were described as means and standard deviation, and the confidence interval was reported. Repeated measures analysis of variance (ANOVA) was used to compare the groups, followed by Bonferroni correction. Student t test for paired samples was used to determine presence of ambient light (α = 0.05). Mean SaO2 level was lower at 4.0 ± 0.2 mm thickness, regardless of presence or absence of ambient light (92.7% and 89.3%). The other thicknesses yielded values of 95.5% and 94.5% at 3.0 ± 0.2 mm, and 96.4% and 96.0% at 2.0 ± 0.2 mm (p < 0.001). There were significant differences between SaO2 values at 4.0 ± 0.2 mm, 3.0 ± 0.2 mm and 2.0 ± 0.2 mm thicknesses, in the presence of ambient light. Mean SaO2 level in positive control was 96.3%, and mean pulse rate was 69.5 bpm in presence of ambient light; in the absence of light, these values were 96% and 70.5 bpm. Enamel and dentin thickness interfere with SaO2, regardless of presence or absence of ambient light. The lowest SaO2 levels were found for the thickest tooth samples.

Effect of dental bleaching on pulp oxygen saturation in maxillary central incisors - a randomized clinical trial

Abstract Objective To assess pulp oxygen saturation levels (SaO2) in maxillary central incisors after dental bleaching. Materials and Methods 80 participants (160 teeth) were randomly allocated to four groups: G1 In-office bleaching with two applications of 35% hydrogen peroxide (HP) (20 minutes), followed by at-home bleaching with 10% carbamide peroxide (CP) (2 hours/day for 16 days); G2 - Same protocol as G1, plus desensitizing toothpaste; G3 - In-office bleaching with 35% HP and one application of placebo gel (20 minutes), followed by at-home bleaching with 10% CP (2 hours/day for 16 days); and G4 - Same protocol as G3, plus desensitizing toothpaste. Pulp SaO2 levels were measured before (T0) and immediately after (T1) in-office bleaching; on the 5th (T2), 8th (T3), 12th (T4), and 16th days of at-home bleaching (T5); and on the 7th (T6) and 30th (T7) days. Mean (SD) pulp SaO2 levels were compared within groups by generalized estimating equations (GEE) and Student's t-test (P<0.05). Results Mean pulp SaO2 at T0 was 84.29% in G1, 84.38% in G2, 84.79% in G3, and 85.83% in G4. At T1, these values decreased to 81.96%, 82.06%, 82.19%, and 81.15% in G1, G2, G3, and G4 respectively, with significant difference in G4 (P<0.05). During home bleaching, pulp SaO2 levels varied in all groups, with 86.55%, 86.60%, 85.71%, and 87.15% means at T7 for G1, G2, G3, and G4, respectively; G2 presented significant difference (P<0.05). Conclusions Pulp SaO2 level in maxillary central incisors was similar at baseline, reducing immediately after in-office bleaching, regardless of using desensitizing toothpaste and increasing at 30 days after dental bleaching.

Oximetria de pulso na avaliação da vitalidade pulpar: análise crítica / Pulse oximetry in evaluation of pulp vitality: critical analysis

O diagnóstico da condição pulpar é essencial para o estabelecimento do tratamento adequado, e continua sendo um desafio na prática clínica atual. Os testes pulpares térmicos e elétrico são os mais comumente utilizados, porém apresentam as limitações inerentes por avaliarem apenas a sensibilidade pulpar, através da aplicação de estímulos na superfície dentária. A vitalidade da polpa dentária está relacionada à sua vascularização, e testes que avaliam o fluxo sanguíneo pulpar têm sido desenvolvidos e estudados. A oximetria de pulso é amplamente utilizada na medicina para determinação dos níveis de saturação de oxigênio sanguíneos, e tem apresentado-se como recurso para determinação da vitalidade pulpar. Com a utilização de adaptadores, os níveis de saturação de oxigênio da polpa dentária têm sido determinados em diferentes condições clínicas, direcionando para um diagnóstico mais preciso. Resultados promissores obtidos em diversos estudos reforçam as vantagens do oxímetro de pulso em comparação aos testes de sensibilidade, por se tratar de um método mais acurado, objetivo, não invasivo e que não provoca dor e desconforto ao paciente. Nesta perspectiva, os avanços científicos e tecnológicos têm aprimorado o uso de métodos de diagnóstico pulpar inovadores, e o oxímetro de pulso é um potencial recurso para aplicação na rotina clínica dos cirurgiões-dentistas.

Dental pulp diagnosis is essential for the establishment of appropriate treatment and remains a challenge in current clinical practice. Thermal and electrical pulp tests are the most commonly used, but they have the inherent limitations of only evaluating the pulp sensitivity through the application of stimuli on the dental surface. The vitality of the dental pulp is related to its vascularization, and tests that evaluate pulp blood flow have been developed and studied. Pulse oximetry is widely used in medicine for determination of blood oxygen saturation levels and has been presented as a resource for pulp vitality determination. With use of adapters, the levels of oxygen saturation of the dental pulp have been determined in different clinical conditions, leading to a more accurate diagnosis. Promising results obtained in several studies reinforce the advantages of the pulse oximeter in comparison to the sensitivity tests, because it is a more accurate, objective, non-invasive method that does not cause pain and discomfort to the patient. In this perspective, scientific and technological advances have improved the use of innovative pulp diagnostic methods, and the pulse Oximeter is a potential resource for application in the clinical routine of dentists.

Evaluation of crown inclination and angulation after orthodontic treatment using digital models : Comparison to the prescription of the brackets used.

PURPOSE: To compare crown inclination and angulation results obtained after orthodontic treatment to the Roth prescription. METHODS: The study design was based on files and documents obtained from a database of 26 patients who had undergone orthodontic treatment using the straight-wire technique and the Roth prescription. The crown inclination and angulation were measured using a three-dimensional (3D) cephalometric module (VistaDent, Dentsply, New York, NY, USA) by an orthodontist. A coordinate system (x, y, z) was developed for each tooth that used the Andrews plane as a para-axial reference. Descriptive statistical analysis provided the mean and standard deviation (SD) of crown inclination and angulation obtained after orthodontic treatment, which were compared to the Roth prescription. RESULTS: Method reproducibility is an important test to investigate the margin of error and to verify the reliability of results. The results at time 1 (1.6°â€¯± 1.1°) and time 2 (1.7°â€¯± 1.2°) of the pilot study were not statistically different (p = 0.99). Maxillary lateral and central incisors presented significant differences in crown angulation (p < 0.05) compared to the Roth prescription. The crown angulation of maxillary second premolars with regard to the occlusal plane presented a similar value to the Roth prescription. CONCLUSION: Crown inclination and angulation found at the end of orthodontic treatment did not match the prescription of the brackets for most teeth, as measured using digital models.

The use of three-dimensional cephalometric references in dentoskeletal symmetry diagnosis

OBJECTIVE: The aim of this study is to assess dentoskeletal symmetry in cone-beam computed tomography (CBCT) scans of Brazilian individuals with Angle Class I malocclusion. MATERIAL: A total of 47 patients (22 females and 25 males) aged between 11 and 16 years old (14 years) seen in a private radiology service (CIRO, Goiânia, GO, Brazil) were assessed. All CBCT scans were obtained from January, 2009 to December, 2010. Cephalometric measurements were taken by multiplanar reconstruction (axial, coronal and sagittal) using Vista Dent3DPro 2.0 (Dentsply GAC, New York, USA). Minimum, maximum, mean and standard deviation values were arranged in tables, and Student t-test was used to determine statistical significance (P < 0.05). RESULTS: Data were homogeneous, and differences between the right and left sides were not significant. CONCLUSIONS: Cephalometric measurements of Brazilian individuals with Angle Class I malocclusion can be used to establish facial symmetry and three-dimensional standard references which might be useful for orthodontic and surgical planning. .

OBJETIVO: o objetivo deste estudo é avaliar a simetria dentoesqueléticas em imagens de tomografia computadorizada de feixe cônico (TCFC) de indivíduos brasileiros com má oclusão Classe I de Angle. MÉTODOS: quarenta e sete pacientes (22 meninas e 25 meninos), com idades entre 11 e 16 anos (14 anos, em média), foram atendidos em um serviço de radiologia privado. Todas as imagens de TCFC foram adquiridas a partir de janeiro de 2009 a dezembro de 2010. Medições cefalométricas foram realizadas por reconstruções multiplanares (axial, coronal e sagital) usando o VistaDent 3D Pro 2.0 ( Dentsply GAC, Nova Iorque, EUA). O desvio-padrão mínimo, máximo e a média foram descritos em tabelas, e o teste t de Student foi utilizado para definir significância estatística (p < 0,05). RESULTADOS: os dados foram homogêneos e as diferenças entre os lados direito e esquerdo não foram significativas. CONCLUSÕES: as medidas cefalométricas de indivíduos brasileiros com má oclusão Classe I de Angle podem ser usadas para definir a simetria facial e referências de padrão tridimensional, que podem ser úteis para o planejamento ortodôntico e cirúrgico. .

Estudo retrospectivo de 92 dentes decíduos avulsionados em 69 crianças atendidas em um serviço de urgência odontológica / A retrospective study of 92 avulsed primary teeth in 69 children assisted at a dental urgency service

O objetivo deste estudo foi avaliar os aspectos epidemiológicos da avulsão de dentes decíduos. A amostra do estudo foi composta por 69 pacientes (92 dentes avulsionados) atendidos no Serviço de Urgência Odontológica da Faculdade de Odontologia da Universidade Federal de Goiás, entre os anos de 1998 e 2005. As seguintes informações foram retiradas dos registros odontológicos de cada paciente: gênero, idade, fator etiológico, distribuição sazonal, grupo dentário, número de dentes avulsionados e tipo de tratamento. O tratamento estatístico analisou os dados frente à distribuição de frequência e qui-quadrado. O nível de significância foi de p<0,05. Observou-se elevada ocorrência de avulsões em meninos (52.17%) com 4 anos de idade (31.88%). Os principais fatores etiológicos foram quedas (82.61%) e acidentes de trânsito (5.80%). A maioria dos episódios de avulsão ocorreu durante os dias da semana (82.61%). A distribuição sazonal evidenciou elevado número de traumatismos nos períodos de março a junho (outono; n=28; 40.58%) e setembro a dezembro (primavera; n=18; 26.09%). O dente mais comumente afetado foi o incisivo central superior (68.48%), seguido pelo incisivo lateral superior (22.83%). As modalidades terapêuticas mais comumente realizadas foram exame clínico e anamnese (64 dentes; 69.57%) e mantenedor de espaço (18 dentes; 19.58%). Verificou-se elevado número de avulsões dentárias em meninos, com idade inferior a 4 anos e decorrentes de quedas...

The purpose of this study was to evaluate the epidemiological aspects associated with avulsion of primary teeth. The sample consisted of 92 avulsed teeth of 69 patients seen at the dental urgency service of the Dental School of the Federal University of Goiás, Brazil, from 1998 to 2005. The data obtained from the records included children's gender and age, causes of tooth avulsion, daily and monthly distribution, type and number of avulsed teeth and the treatment procedures. Frequency distribution and the chi-square test were calculated. The level of significance was set at 5% for all analyses. The highest incidence was found among boys (52.17%) aged 4 years (31.88%). The main etiologic factors were falls (82.61%) and traffic accidents (5.80%). Most cases occurred during weekdays (82.61%), from March to June (autumn; n=28; 40.58%) and from September to December (spring; n=18; 26.09%). Most avulsed teeth were maxillary central incisors (68.48%), followed by maxillary lateral incisors (22.83%). The most frequent treatments were analysis of clinical history and clinical exam (64 teeth; 69.57%) and space maintainer (18 teeth; 19.57%). The epidemiological and clinical aspects of tooth avulsion in this study were similar to those reported in other studies. There was a high number of avulsed primary teeth in boys aged less than 4 years and caused by falls...

Análise crítica das estratégias de sanificação na limpeza do canal radicular / A critical analysis of the sanitization strategies on root canal cleaning

Avaliar, em estudos longitudinais, a eficácia das soluções irrigantes utilizadas no tratamento endodôntico sobre a limpeza, remoção da smear layer e poder de dissolução tecidual, através de revisão sistemática. Método: Empregaram-se fontes de catalogação bibliográfica identificadas eletronicamente pelo portal MEDLINE (http://www.ncbi.nlm.nih.gov/PubMed), a partir de 1966 até 10 de janeiro de 2012. Na estratégia de busca empregou-se a combinação dos unitermos: (Endodontic or root canal) and (Smear layer or clean* or tissue dissolution or organic dissolution) and (irrigants or NaOCl or sodium hypochlorite or Milton Solution or Dakin solution or Labarraque solution or chlorinated soda or chlorine or chloride or hypoclean or hypochlor or niclor or Chlor-xtra or chlorhexidine or chx or cloreximid or peridex or periogard or EDTA or Acid or citric or acetic or peracetic or malic or vinegar or citrate or Hydrogen peroxide or h2o2 or Iodine or iodide or povidone or povidine or PVP or Ozone or ozonated or MTAD or Tetraclean or Endoptc or Rc prep or Morinda citrifolia or Aquatine or hydroxyethylcellulose or cat's claw or propolis). Os estudos foram selecionados por dois revisores, independentes, que determinaram os critérios de inclusão e exclusão. Resultados: A busca apresentou 817 artigos relacionados. Quatro (04) estudos satisfizeram os critérios de inclusão e exclusão preestabelecidos. A avaliação histológica foi realizada a 1, 2 e 3 mm do ápice radicular. O hipoclorito de sódio a 5,25% e 6% foi a única solução irrigante a apresentar evidências científicas de ação de limpeza sobre as paredes dos canais radiculares. Conclusão: A utilização do ultrassom melhorou o potencial de limpeza das soluções irrigantes. As regiões de istmo apresentaram menor percentual de áreas livres de detritos...

To assess the efficacy of irrigant solutions used in endodontic treatment in terms of cleanliness, smear layer removal and tissue dissolving potency by means of a systematic review of longitudinal studies. Method: Articles were identified in electronic bibliographies accessible via MEDLINE. Searches were run on the PubMed Database (http://www.ncbi.nlm. nih.gov/PubMed) for articles published from 1966 to January 10, 2012, using combinations of the following keywords: (Endodontic or root canal) and (Smear layer or clean* or tissue dissolution or organic dissolution) and (irrigants or NaOCl or sodium hypochlorite or Milton Solution or Dakin solution or Labarraque solution or chlorinated soda or chlorine or chloride or hypoclean or hypochlor or niclor or Chlor-xtra or chlorhexidine or chx or cloreximid or peridex or periogard or EDTA or Acid or citric or acetic or peracetic or malic or vinegar or citrate or Hydrogen peroxide or H2O2 or Iodine or iodide or povidone or povidine or PVP or Ozone or ozonated or MTAD or Tetraclean or Endoptc or Rc prep or Morinda citrifolia or Aquatine or hydroxyethylcellulose or cat's claw or propolis). Studies were assessed for inclusion and exclusion criteria by two independent examiners. Results: The search returned 817 articles. Four (04) studies met the preestablished inclusion criteria and not the exclusion criteria. Teeth were assessed histologically at points 1, 2 and 3 mm from the root apex. Sodium hypochlorite at 5.25% and 6% was the only irrigating solution for which there is scientific evidence of root wall cleaning activity. Conclusions: Addition of ultrasound improved the cleaning potency of irrigant solutions. Isthmus regions had the lowest percentages of area free from debris...

Efeito antibacteriano de antissépticos bucais sobre bactérias facultativas / Antibacterial effect of oral antiseptics on facultative bacteria

Avaliar o efeito antibacteriano de antissépticos bucais sobre bactérias facultativas por meio de testes de difusão em ágar e teste por exposição direta. Metodologia: Cepas de S. mutans (ATCC 25175), E. faecalis (ATCC 29212) e P. aeruginosa (ATCC 27853) foram inoculadas em 7 mL de brain heart infusion (BHI) e incubadas a 37°C por 24 horas. Para o teste de difusão em ágar, 15 placas de Petri com 20 mL de brain heart infusion agar (BHIA) foram inoculadas com 0,1 mL das suspensões microbianas, com auxílio de swabs esterilizados, de modo a se obter um crescimento confluente e uma placa de Petri não foi inoculada. Trinta e seis discos de papel com 9 mm de diâmetro foram imersos nas soluções experimentais de cloreto de cetilpiridínio 0,07%, cloreto de cetilpiridínio 0,075%, gluconato de clorexidina 0,12% e cloreto de benzalcônio 0,13% durante 1 minuto. A seguir, três discos de papel contendo uma das soluções irrigantes foram colocados sobre a superfície do BHIA. As placas foram mantidas por 1 hora em temperatura ambiente e incubadas a 37°C por 48 horas. Os diâmetros dos halos de inibição microbiana foram medidos valendo-se de duas medidas de forma perpendicular entre si, sendo obtida a média de seus comprimentos. Para o teste de exposição direta, 216 cones de papel absorventes esterilizados nº 50 foram imersos na suspensão de micro-organismos por 5 minutos, e a seguir foram colocados em placas de Petri e cobertos com 10 mL de uma das soluções testes. Em intervalos de 1, 5, 10 e 30 minutos, 3 cones de papel absorventes foram retirados do contato com as substâncias, transportados individualmente e imersos em 7 mL de Letheen Broth, e incubados a 37°C por 48 horas. O crescimento microbiano foi avaliado pela turbidade do meio de cultura. Um inóculo de 0,1 mL obtido do Letheen Broth foi transferido para 7 mL de BHI, e incubado nas mesmas condições descritas. O crescimento microbiano foi novamente avaliado pela turbidade do meio de cultura...

Purpose: To evaluate the antibacterial effect of four oral antiseptics (two solutions of cetylpyridinium chloride, chlorhexidine gluconate and benzalkonium chloride) on facultative bacteria using two methods. Methods: Strains were inoculated in 7 mL of brain heart infusion (BHI) and incubated at 37°C for 24 hours. For the agar diffusion test, 15 Petri plates with 20 mL of brain heart infusion agar (BHIA) were inoculated with 0.1 mL of microbial suspensions using sterile swabs to produce confluent growth; one Petri plate was not inoculated. Thirty-six 9-mm paper discs were immersed in the experimental solutions (0.07% cetylpyridinium chloride, 0.075% cetylpyridinium chloride, 0.12% chlorhexidine gluconate, and 0.13% benzalkonium chloride) for 1 minute. Subsequently, three paper discs containing irrigant solutions were placed on the BHIA in each plate. The plates were kept at room temperature for 1 hour and incubated at 37°C for 48 hours. Two measurements of the inhibition zones were made on the paper discs containing the solutions, and mean values were calculated. For the direct exposure test, 216 #50 sterilized paper points were immersed in the microorganism suspensions for 5 minutes, placed onto Petri plates and covered with 10 mL of irrigant solution. At one, five, 10 and 30 minutes, three paper points were removed from the contact substances, transported individually, immersed in 7 mL Letheen broth and incubated at 37°C for 48 hours. Bacterial growth was evaluated by turbidity. An inoculum of 0.1 mL Letheen broth was transferred to 7 mL BHI, and incubated as described above. Bacterial growth was evaluated according to turbidity. Results: Inhibition zones were greater than 10 mm for all substances and all microorganisms under study. The antibacterial...

Long-term evaluation of apical root resorption after orthodontic treatment using periapical radiography and cone beam computed tomography

OBJECTIVE: To evaluate the frequency of Apical Root Resorption (ARR) after orthodontic treatment at 52-288 months using periapical radiography (PR) and cone beam computed tomography (CBCT). METHODS: Radiographic images obtained from 58 patients, before (T1) and after orthodontic treatment (T2), and following 52-288 months of treatment were analyzed by three members of the Brazilian Board of Orthodontics. Apical structures were evaluated by PR images (T2 and T3), using Levander and Malmgren scores. The presence of ARR on CBCT images were detected only at T3. The Kolmogorov-Smirnov test was used for statistical analyses, and the level of significance was set at 5%. Kappa statistics determined interobserver agreement. RESULTS: The more frequent ARR were with scores 1 in T2 (51.6%) and T3 (53.1%), when evaluated by PR (p > 0.05). When compared the frequencies of ARR in T3 among PR and CBCT images, the differences were significant for maxillary and mandibular pre-molar groups, and for mandibular molar group (p > 0.05). The teeth with highest frequency of ARR presence using CBCT images were maxillary lateral incisors (94.5%) and mandibular central incisors (87.7%), while the premolars showed the lowest frequency. The CBCT images showed that the teeth involved in orthodontic treatment with extraction present higher ARR frequency (p < 0.05). CONCLUSION: PR showed more frequency of ARR in posterior teeth groups when compared with CBCT images. ARR did not change in long-term post treatment.

OBJETIVO: avaliar a frequência de reabsorção radicular apical (RRA) após tratamento ortodôntico, em longo prazo, por meio de imagens de radiografia periapical (RP) e tomografia computadorizada de feixe cônico (TCFC). MÉTODOS: as imagens radiográficas obtidas de dentes de 58 pacientes, antes (T1), após o tratamento ortodôntico (T2) e decorridos pelo menos 52 meses do tratamento (T3), foram analisadas por três examinadores, membros do Board Brasileiro de Ortodontia e Ortopedia Facial. As estruturas apicais foram avaliadas por meio de imagens de RP (T2 e T3), utilizando o sistema de escores de Levander e Malmgren modificado. A presença de RRA nas imagens tomográficas obtidas em T3 foi detectada por um especialista em radiologia com experiência em TCFC. Os dados foram estatisticamente analisados pelo teste de Kolmogorov-Smirnov, com nível de significância de 5%. O teste kappa determinou o nível de concordância entre os observadores. RESULTADOS: as RRAs mais frequentes foram as de escore 1 em T2 (51,6%) e em T3 (53,1%), quando avaliadas por RPs (p > 0,05). Quando comparadas as frequências de RRAs em T3, entre imagens de RP e de TCFC, a diferença foi estatisticamente significativa para o grupo de pré-molares da maxila e da mandíbula, e de molares mandibulares. Os dentes que apresentaram maior frequência de RRA quando analisados por meio de imagens de TCFC, foram os incisivos laterais superiores (94,5%) e os centrais inferiores (87,7%), enquanto os de menor frequência foram os pré-molares. As imagens de TCFC mostraram que os dentes envolvidos em tratamentos ortodônticos com extrações apresentaram maior frequência de RRA (p < 0,05). CONCLUSÃO: as radiografias periapicais mostraram maior frequência de RRAs que as imagens de TCFC para os grupos de pré-molares e molares, não evidenciando alteração em longo prazo.

Profile of scientific production in endodontics in high-impact journals / Perfil da produção científica em endodontia em periódicos de alto impacto

Objetivo: Caracterizar o perfil da produção científica na área de endodontia em periódicos de alto impacto. Métodos: Foram avaliados os artigos publicados entre janeiro de 2001 e dezembro de 2011 nos periódicos Journal of Endodontics, International Endodontic Journal e Australian Endodontic Journal. Vários aspectos foram avaliados, a saber: tipo de artigo, origem geográfica dos autores, mudanças no perfil dos artigos ao longo do período estudado (em termos de país de origem e tipo de artigo) e relação entre o investimento em ciência/tecnologia e o número de publicações. Resultados: Um total de 3.993 artigos foram publicados no período de 10 anos estudado. Artigos de pesquisa básica representaram 67,85% da produção, comparados com 1,35% de revisões sistemáticas/metanálises. Os Estados Unidos ficaram em primeiro lugar em número de publicações (23,69%), seguidos pelo Brasil (14,22%) e pela China (6,42%). Apesar dos baixos investimentos feitos em ciência, os países emergentes Brasil, China e Turquia ficaram entre os cinco países com maiores números de publicações, especialmente como resultado do aumento nos números de artigos nos anos mais recentes. Conclusão: Países emergentes estão investindo cada vez mais em ciência e tecnologia, o que permitiu um grande número de publicações em periódicos de alto impacto nos últimos anos.

Objective: To characterize the profile of scientific production in the field of endodontics in high-impact journals. Methods: Articles published from January 2001 to December 2011 in the Journal of Endodontics, International Endodontic Journal, and Australian Endodontic Journal were evaluated. Various aspects were assessed: type of article, authors' geographic origin, changes in the profile of papers over the studied period (in terms of country of origin and type of article), and ratio between budget for science/technology and number of publications. Results: A total of 3,993 articles were published in the 10-year period assessed. Basic research articles accounted for 67.85% of the production, compared to 1.35% of systematic reviews/meta-analyses. The U.S. ranked first in number of publications (23.69%), followed by Brazil (14.22%) and China (6.42%). Despite the low investments made in science, the emerging countries Brazil, China, and Turkey were able to figure among the top five countries in number of publications, especially as a result of increasing numbers of articles in the latest years. Conclusion: Emerging countries are investing increasing amounts in science and technology, which has allowed for a large number of publications in high-impact journals. Keywords: Endodontics, science, technology, impact factor, journal article.

Prevalência de dentes pilares de prótese fixa convencional em subpopulação brasileira / Prevalence of abutment teeth for conventional fixed prostheses in a Brazilian subpopulationf

The purpose of this cross-sectional study was to evaluate the prevalence of abutment teeth for conventional fixed prostheses in a Brazilian subpopulation. Panoramic radiographs for a total of 1,401 patients taken from August 2002 to September 2007 were randomly selected from the database of the Radiological Center of Orofacial Images of Cuiabá (Cuiabá, Brazil). A total of 1,401 radiographs were examined to determine the frequency of abutment teeth for conventional fixed prostheses. Data concerning age, sex, and dental group were recorded. Frequency distribution and the chi-square test were used for statistical analysis. The level of significance was set at α = 5%. Of the 29,467 teeth included in the evaluation, 4,967 (16.8%) were abutments for conventional fixed prostheses. A high prevalence of abutment teeth for conventional fixed prostheses was observed in individuals aged between 46 and 60 years (49.9%). Maxillary canines and second premolars were the teeth most often involved in rehabilitation (10.5% and 10.3%). Missing teeth were identified in 24.8% of the sample. The prevalence of abutment teeth for conventional fixed prostheses was 16.8%, and the teeth most frequently used were maxillary canines and maxillary second premolars.

O objetivo deste estudo transversal foi avaliar a prevalência de dentes pilares de próteses fixas convencionais em uma subpopulação brasileira. Radiografias panorâmicas de um total de 1.401 pacientes, realizadas entre agosto de 2002 e setembro de 2007, foram aleatoriamente selecionadas do banco de dados do Centro de Radiologia e Imagens Orofaciais de Cuiabá (Cuiabá, MT, Brasil). Um total de 1.401 imagens radiográfi cas foram examinadas para a determinação da prevalência de dentes pilares de prótese fixa convencional. Dados referentes a idade, gênero e grupo dentário foram coletados e tabulados. O tratamento estatístico analisou os dados frente à distribuição de frequência e o teste qui-quadrado. O nível de significância foi de α = 5%. Foram avaliados 29.467 dentes, dos quais 4.967 (16,8%) eram pilares de prótese fixa convencional. Elevada prevalência de dentes pilares de prótese fixa convencional foi observada em indivíduos da faixa etária de 46- 60 anos (49,9%). Caninos superiores e segundos pré-molares superiores foram os dentes mais frequentemente envolvidos nas reabilitações: 10,5 e 10,3%, respectivamente. Ausências dentárias foram identificadas em 24,8% da amostra. A prevalência de dentes pilares associados com prótese fixa convencional foi de 16,8%, sendo mais frequente em caninos superiores e segundos prémolares superiores.

Three-dimensional image contribution for evaluation of operative procedural errors in endodontic therapy and dental implants

Acceptable therapeutic protocol in dentistry depends on the outcomes obtained with follow up. Operative procedural errors (OPE) may occur and they represent risk factors able to compromise a tooth or a dental implant. The aim of this study was to detect the OPE in endodontically treated teeth and dental implants, using cone beam computed tomography (CBCT).Eight hundred and sixteen CBCT exams were performed between January 2009 and October 2010, and only those which presented endodontically treated teeth and/or dental implants were selected. The sample was as follows: 195 CBCT exams (n=200 teeth and 200 dental implants), 72 male, 123 female, with mean age of 51 years.In endodontically treated teeth, OPE included underfilling, overfilling, and root perforation; OPEin dental implants were thread exposures, contact with anatomical structures, and contact with adjacent teeth. Kolmogorov-Smirnov test was used for statistical analysis, with significance level set at α=0.05. Underfilling, overfilling, and root perforations were detected in 33.5%, 8% and 4.5% of the teeth, respectively. Dental implants with thread exposures, contact with important anatomical structures and contact with adjacent teeth were seen in 37.5%, 13% and 6.5% of the cases, respectively. OPE were detected in endodontically treated teeth and dental implants, and underfilling and thread exposures were the most frequent occurrences, respectively.

Protocolos terapêuticos aceitáveis em odontologia dependem de resultados observados com a proservação. Erros de procedimentos operatórios podem ocorrer e representam fatores de risco capazes de comprometer um dente ou um implante dentário. O objetivo deste artigo é detectar os erros de procedimentos operatórios em dentes tratados endodonticamente e implantes dentários por meio de tomografia computadorizada de feixe cônico. Oitocentos e dezesseis (816) exames tomográficos foram realizados entre Janeiro de 2009 e Outubro de 2010, e apenas aqueles que apresentaram dentes tratados endodonticamente e/ou implantes dentários foram selecionados. A amostra final envolveu 195 exames tomográficos (n=200 dentes e 200 implantes dentários), 72 do gênero masculino, 123 do gênero feminino, com idade média de 51 anos. Em dentes tratados endodonticamente os erros de procedimentos operatórios incluídos foram: subobturação, sobreobturação, e perfuração radicular; enquanto que, para implantes dentários foram incluídos: roscas de implantes expostas, implantes em contato com estruturas anatômicas, e em contato com dentes adjacentes. O nível de significância foi estabelecido em α=5%. Subobturações, sobreobturações e perfurações radiculares foram detectadas em 33,5%, 8% e 4,5%, respectivamente. Implantes dentários com roscas expostas, em contato com estruturas anatômicas, e em contato com dentes adjacentes apresentaram valores de 37,5%, 13% e 6,5%, respectivamente. Erros de procedimentos operatórios foram detectados em dentes tratados endodonticamente e implantes dentários. Os erros mais frequentes foram subobturação em dentes tratados endodonticamente, e roscas expostas em implantes dentários.

Effect of root canal filling materials on dimensions of cone-beam computed tomography images

OBJECTIVE:To evaluate the discrepancy of root canal filling (RCF) measurements obtained from original root specimens and cone-beam computed tomography (CBCT) images. MATERIAL AND METHODS: Seventy-two human maxillary anterior teeth were prepared up to an ISO #50 K-File 1 mm short of the apical foramen. Thus, the teeth were randomly divided into 8 groups, according to the root canal filling material: Sealapex ®, Sealapex®+gutta-percha points, Sealer 26®, Sealer 26®+gutta-percha points, AH PlusTM, AH PlusTM+gutta-percha points, Grossman Sealer, and Grossman Sealer+gutta-percha points. After root canal preparation and RCF, CBCT scans were acquired and the specimens were sectioned in axial, sagittal and coronal planes. The RCF measurements were obtained in different planes and thicknesses to determine the discrepancy between the original root specimens (using a digital caliper) and the CBCT images (using the scanner’s proprietary software). One-way analysis of variance and Tukey tests were used for statistical analyses. The significance level was set at α=5%. RESULTS: Measurements of the different endodontic filling materials were 9% to 100% greater on the CBCT images than on the original root specimens. Greater RCF dimensions were found when only sealers were used, with statistically significant difference among the groups. CONCLUSIONS: RCF dimensions were greater on CBCT images than on the original root specimens, especially when only sealer was used.