Probióticos em endodontia: uma revisão de literatura / Probiotics in endodontics: a literature review

Introdução: Os probióticos são micro-organismos vivos que geram benefícios à saúde do hospedeiro. Seus mecanismos de ação consistem, principalmente, em efeitos anti-inflamatórios e antimicrobianos que os tornam importantes no processo de saúde-doença. Na endodontia, a permanência de infecção no interior do sistema de canais radiculares é a principal causa do insucesso do tratamento endodôntico. A partir do sucesso obtido por outras especialidades odontológicas, a utilização de probióticos como nova abordagem no tratamento endodôntico vem sendo alvo de pesquisas com a expectativa de ajudar a combater as infecções endodônticas e manter o equilíbrio da microbiota oral. Objetivo: O objetivo desta revisão de literatura foi apresentar os principais resultados disponíveis até o presente momento na literatura científica acerca do uso dos probióticos na endodontia. Fonte dos dados: As bases de dados utilizadas foram Pubmed, Web of Science e Embase e a pesquisa foi realizada até junho de 2021. Síntese dos dados: Foi encontrado um total de oito artigos sobre o tema, avaliando diversos aspectos relacionados ao tratamento endodôntico, como o uso de probióticos contra patógenos endodônticos, como irrigantes, como medicação intracanal e no tratamento da periodontite apical. Conclusão: Embora grande parte dos artigos tenham apresentado resultados positivos acerca do uso dos probióticos, os mesmos apresentam baixo nível de evidência, isso porque foram utilizados modelos in vitro e em animais. Portanto, para embasar a introdução dos probióticos em Endodontia, existe a necessidade da realização de pesquisas clínicas.

Introduction: Probiotics are live microorganisms that produce health benefits for the host. Their mechanisms of action consist mainly of antimicrobial effects and make them important in the health-disease process. In endodontics, the permanence of infection within the root canal system is the main cause of endodontic treatment failure. Based on the success obtained by other dental specialties, the use of probiotics as a new approach in endodontic treatment has been the subject of research with the prevention of oral microbiota. Purpose: The purpose of this review of literature was to present the main results available so far in the scientific literature on the use of probiotics in endodontics. Data source: The databases used were Pubmed, Web of Science and Embase and the search was carried out until June 2021. Data synthesis: A A total of eight articles on the subject, evaluating various aspects of endodontic treatment, such as the use of probiotics against endodontic pathogens, as irrigants, as intracanal treatment and in the treatment of apical periodontitis. Conclusion: Although many of the foods presented positive results close to the same use presented in the low level of articles, this is because animal models were used. Therefore, to support the introduction of probiotics in Endodontics, there is a need for clinical research.

The internal root canal morphology of single-rooted mandibular canines revealed by micro-computed tomography.

CONTEXT: The lack of thorough knowledge regarding morphological and anatomical variations of the root canal system can result in failure to identify all root canals and lead to inadequate instrumentation and consequent failure of the endodontic treatment. AIMS: The aim of the study was to evaluate the anatomy of single-rooted mandibular canines using micro-computed tomography (micro-CT). SUBJECTS AND METHODS: Eighty mandibular canines were scanned by micro-CT to determine anatomic parameters: Vertucci's classification, number of lateral canals, roundness, and minor and major diameters. The shape of root canal orifices, volume, surface area, and convexity structure model index (SMI) were also evaluated. ANALYSIS USED: The CTAn and CTvol software were used to three-dimensional and morphometric analysis. RESULTS: All canals were classified as Vertucci Type I. Lateral canals were verified in 42.4% of the roots, in apical third. The canal diameters were decreased near the apex. The cross sections at the cementoenamel junction and 1 mm from the apex were oval in 38.3% and 79.4% of the canals, respectively. The mean canal volumes and surface areas were 11.48 ± 4.41 mm3≥ and 67.29 ± 19.18 mm2, respectively. The SMI values indicated that mandibular canine was approximately rod like. CONCLUSIONS: The morphology of the root canal of single-rooted canines varied widely at different root levels.