Photodynamic therapy in the root canal treatment of primary teeth: A systematic review of clinical trials.

BACKGROUND: Dental caries is the most common oral disease worldwide, and it is estimated to affect 2.3 billion people, with at least 530 million of them being schoolchildren with decayed primary teeth. This condition can rapidly evolve into irreversible pulp inflammation and pulp necrosis and thus requiring endodontic intervention. Photodynamic therapy (PDT) is a supplementary method to conventional pulpectomy and is used to improve the protocol used for disinfection. AIM: The main objective of this study was to evaluate through a systematic review the efficacy of supplementary PDT on the pulpectomy of primary teeth. This review was registered a priori on the PROSPERO database (CRD42022310581). DESIGN: Two independent and blinded reviewers carried out a comprehensive search in five databases: PubMed, Cochrane, Scopus, Embase, and Web of Science. Eligible studies were randomized and nonrandomized clinical trials that evaluated in vivo microbiological load or clinical outcomes after using supplementary PDT in infected primary teeth. RESULTS: After the selection process, four studies met the inclusion criteria and were included in this study. Data regarding the sample characteristics and PDT protocols were retrieved. All included trials used phenothiazinium salts as photosensitizer agents. Only one study observed a significant difference in the in vivo microbiological load reduction outcome when performing PDT on primary teeth. The remaining studies all discussed the possible benefits of this intervention; however, none observed a significant difference in this outcome. CONCLUSION: In this systematic review, moderate-to-low certainty of the available evidence was observed, and thus, no significant conclusions can be drawn from the findings.

Endodontic treatment during pregnancy: case series and literature review / Tratamento endodôntico na gestação: série de casos e revisão da literatura

ABSTRACT The aim of this paper is to provide a scientific basis for conducting safe root canal treatment in pregnant women, illustrating with case reports treated in the extension project Maternal-Child Dental Care at the Federal University of Pelotas. The scientific bases address the main doubts of professionals when performing prenatal dental care: use of radiographic examination, local anesthetics, prescription of medications, among other essential factors in the care of pregnant women. The assisted pregnant women sought care with dental pain. In two cases symptomatic irreversible pulpitis was diagnosed, while a third was experiencing acute apical periodontitis. Endodontic procedures were performed under controlled and standardized conditions. The root canals were prepared in a single session, using mechanical instrumentation with reciprocating kinematics (Wave One® Gold Primary - Dentsply Sirona), and the root canal length was determined by an electronic apex locator FinePex (Schuster). Root canal filling was performed by the single cone technique with Wave One® gutta-percha points. After endodontic treatment, coronal sealing was performed with composite resin A2 Z350 XT (3M ESPE). The care related to the gestational condition is highlighted, and the patients remain under monitoring. It is concluded that the use of apical locators and mechanical instrumentation, using reciprocating files associated with the single cone obturation technique with a standardized cone for each system, represents advances for the accomplishment of endodontic treatment in pregnant patients due to the shorter clinical time and greater comfort of the procedure.

RESUMO O objetivo deste trabalho é fornecer embasamento científico para condução do tratamento endodôntico em gestantes através de uma revisão de literatura e série de casos clínicos conduzidos em sessão única no projeto de extensão Atenção Odontológica Materno-infantil da Faculdade de Odontologia da Universidade Federal de Pelotas. As bases científicas abordam as principais dúvidas do profissional na condução do pré-natal odontológico: uso do exame radiográfico, anestésico local, prescrição de medicamentos, entre outros fatores essenciais no atendimento da gestante. As gestantes assistidas procuraram atendimento apresentando dor de origem dentária. Em dois casos foi diagnosticado pulpite irreversível sintomática, enquanto um terceiro se travava de periodontite apical aguda. Os procedimentos endodônticos foram realizados sob condições controladas e padronizadas, sob supervisão de um professor de Endodontia. O preparo dos canais radiculares foi realizado em sessão única, através de instrumentação mecanizada de cinemática reciprocante (Wave One® Gold Primary (Dentsply Sirona), sendo o comprimento dos canais determinado por meio de localizador foraminal FinePex (Schuster). A obturação dos canais foi realizada pela técnica do cone único com cones do sistema Wave One®. Após o tratamento endodôntico foi realizada blindagem coronária com resina composta cor A2 Z350 XT (3M ESPE). Os cuidados relacionados à condição gestacional estão destacados, sendo que as pacientes permanecem em acompanhamento no projeto. Conclui-se que o uso de localizadores foraminais e da instrumentação mecanizada, utilizando limas reciprocantes associadas à técnica de obturação com cone único padronizado para cada sistema representam avanços para a realização do tratamento endodôntico em pacientes gestantes devido ao menor tempo clínico e maior conforto do procedimento.

Intentional foraminal enlargement: a systematic review with bibliometric analysis / Ampliação foraminal intencional: uma revisão sistemática com análise bibliométrica

Objective: The purpose of this systematic review with bibliometric analysis was to map the available scientific evidence on intentional foraminal enlargement (IFE) and explore publication trends. Methods: This review is in accordance with the PRISMA 2020 Statement and is registered on the Open Science Framework. Two independent reviewers carried out a comprehensive search of seven databases (PubMed/MEDLINE, Cochrane Library, Scopus, Embase, Web of Science, LILACS, and BBO) up to January 31 st, 2022. Studies that investigated IFE were considered eligible, and the data were analyzed using the VOSViewer software. Results:The search identified a total of 55 IFE-related articles from 10 countries and 25 journals, with an increasing trend for publications over the last decade. The majority of evidence was based on laboratory assays (65.4%), followed by randomized clinical trials (18.1%) with follow-up periods of up to 2 months. The main clinical outcome evaluated was post-operative pain. The highest number of studies were carried out by the State University of Campinas, and published in the Journal of Endodontics. Also, studies with the highest level of evidence found that IFE resulted in greater post-operative pain in the initial days post-treatment. Conclusion:This systematic review with bibliometric analysis mapped the scientific progress and publication trends in the field of IFE, thus shedding light on gaps in the literature with the aim of guiding researchers to conduct more high-impact investigations by performing clinical studies evaluating rates of periapical repair and IFE treatment success using long-term observation periods (AU)

Objetivo: O objetivo desta revisão sistemática com análise bibliométrica foi mapear as evidências científicas disponíveis sobre ampliação foraminal intencional (IFE) e explorar as tendências de publicação. Métodos: Esta revisão está de acordo com a declaração PRISMA 2020 e está registrada no Open Science Framework. Dois revisores independentes realizaram uma busca abrangente em sete bases de dados (PubMed/MEDLINE, Cochrane Library, Scopus, Embase, Web of Science, LILACS e BBO) até 31 de janeiro de 2022. Os estudos que investigaram IFE foram considerados elegíveis e os dados foram analisados usando o software VOSViewer. Resultados: A busca identificou um total de 55 artigos relacionados ao IFE provenientes de 10 países e 25 periódicos, com tendência crescente de publicações na última década. A maioria das evidências foi baseada em ensaios laboratoriais (65,4%), seguido de ensaios clínicos randomizados (18,1%) com períodos de follow-up de até 2 meses. O principal desfecho clínico avaliado foi a dor pós-operatória. O maior número de estudos foi realizado pela Universidade Estadual de Campinas e publicado no Journal of Endodontics. Estudos com os maiores níveis de evidência constataram que IFE resultou em maior dor pós-operatória nos primeiros dias pós- tratamento. Conclusão: Esta revisão sistemática com análise bibliométrica mapeou o progresso científico e as tendências de publicação na área de IFE, lançando luz sobre lacunas na literatura com o objetivo de orientar pesquisadores a realizar investigações de maior impacto, realizando estudos clínicos avaliando taxas de reparo periapical e sucesso do tratamento usando essa técnica e com acompanhamento à longo prazo. (AU)