Acidente com hipoclorito de sódio durante tratamento endodôntico: análise de prontuário / Accident injection with sodium hypochlorite during endodontic treatment: case report

O sucesso do tratamento endodôntico está diretamente ligado ao processo de limpeza e modelagem dos canais radiculares. E para se conseguir a limpeza e desinfecção são utilizadas substâncias químicas auxiliares como coadjuvantes ao preparo mecânico, pois são essenciais na redução de microrganismos presentes no sistema de canais radiculares. Dentre as principais substâncias químicas auxiliares empregadas, a que apresenta maior destaque é o Hipoclorito de Sódio. O objetivo do presente estudo é mostrar através de uma análise de prontuário, um relato de um acidente com hipoclorito de sódio durante um atendimento odontológico. Para isso, um prontuário foi selecionado, onde a paciente procurou a clínica do Curso de Odontologia do Centro Universitário da Serra Gaúcha para realizar tratamento endodôntico do dente 16. Durante este procedimento, ocorreu um extravasamento do hipoclorito de sódio aos tecidos periapicais, e partir deste fato foi possível relatar maneiras de como prevenir, tratar e evitar esse tipo situação(AU)

The success of endodontic treatment is directly related to the root canal cleaning and modeling process. In order to achieve cleaning and disinfection, auxiliary chemical substances are used as auxiliaries to the mechanical preparation, since they are essential in the reduction of microorganisms present in the root canal system. Among the main auxiliary chemical substances employed, the most prominent is Sodium Hypochlorite. The objective of the present study is to show through an analysis of medical records, an account of an accident with sodium hypochlorite during a dental care. For this, a chart was selected, where the patient sought the clinic of the Dentistry Course of the University Center of Serra Gaúcha to perform endodontic treatment of the tooth 16. During this procedure, an extravasation of the sodium hypochlorite occurred to the periapical tissues, and from this It was possible to report on ways to prevent, treat and avoid this type of situation(AU)

Efficacy of a thermally treated single file compared with rotary systems in endodontic retreatment of curved canals: a micro-CT study.

OBJECTIVES: This study aimed to compare WaveOne Gold with ProTaper and RaCe systems regarding remaining filling material, apical transportation (AT), and working time (WT) after (i) filling removal and (ii) shaping of curved canals. METHODS: Thirty mesiobuccal canals of maxillary molars were prepared and filled. After 30 days, they were randomly assigned into three groups (n = 10), according to the instruments used for filling removal and shaping, respectively: WOG-WaveOne Gold Primary and Medium; PTG-ProTaper Retreatment and ProTaper Next; RCG-D-RaCe and RaCe. Micro-CT analysis assessed the residual filling material and AT. WT was recorded. Data were statistically analyzed (α = .05). RESULTS: There was no significant difference between groups in the amount of filling material at any evaluated moment (P > .05). All groups presented low AT values. The WT was similar in all groups in filling removal (P > .05), and in shaping step WOG was faster than PTG and RCG (P < .05). CONCLUSIONS: Neither system could completely remove the filling material. The instruments evaluated were safe and the reciprocating system was faster than the rotary systems in shaping the canals. CLINICAL RELEVANCE: This study provided consistent information on filling material removal capacity of WaveOne Gold. Considering that all tested systems were safe, WaveOne Gold may be an alternative with cost-effectiveness and shorter learning curve for endodontic retreatment.

Cell Viability and Tissue Reaction of NeoMTA Plus: An In Vitro and In Vivo Study.

INTRODUCTION: The aim of this study was to evaluate the cell viability and tissue reaction of NeoMTA Plus (NMP; Avalon Biomed Inc, Houston, TX) compared with mineral trioxide aggregate (MTA; Angelus, Londrina, PR, Brazil) and Biodentine (BD; Septodont, Saint-Maur-de-Fossés, France). METHODS: Fibroblasts (3T3) were plated and exposed to 1% extract from the test material before and after setting. Cytotoxicity assessment was performed using the 3-(4,5-dimethyl-thiazoyl)-2,5-diphenyl-tetrazolium bromide and sulforhodamine B assays. In vivo evaluation consisted of polyethylene tube implantation of the materials in rat subcutaneous tissue. Histologic analysis occurred at 7, 30, and 90 days, scoring inflammatory events and collagen fiber formation. Analysis of variance and the Tukey and t tests were used for cytocompatibility assays, and the Kruskal-Wallis test followed by the Dunn test were used for biocompatibility assays (P ≤ .05). RESULTS: The materials in the cytotoxicity assays presented greater viability after setting (P ≤ .05). NMP and MTA presented higher viability than the control (Dulbecco modified Eagle medium) on the 3-(4,5-dimethyl-thiazoyl)-2,5-diphenyl-tetrazolium bromide assay before and after setting (P ≤ .05). The sulforhodamine B assay showed that MTA and BD presented less viability than NMP and the control, and NMP was similar to the control before setting. After setting, MTA and BD presented higher viability when compared with the control group (P ≤ .05), and NMP was similar to control. Inflammatory infiltrate reduction occurred throughout the test periods for all materials. At 7 days, neutrophils were present in BD (P ≤ .05), and granuloma and giant cells were present in BD and MTA. At 30 days, BD showed intense inflammatory infiltrates and a large number of macrophages when compared with NMP, MTA, and the control (P ≤ .05). At 90 days, BD presented a thick fiber layer compared with NMP (P ≤ .05). CONCLUSIONS: NMP showed similar biocompatible behavior to MTA and BD.

Apically Extruded Debris in Curved Root Canals Using the WaveOne Gold Reciprocating and Twisted File Adaptive Systems.

INTRODUCTION: The purpose of this study was to evaluate apical debris extrusion associated with different kinematics in curved root canals. METHODS: Forty-five extracted mandibular molars with root curvature angles ranging between 20° and 40° and curvature radii <10 mm were randomly assigned to 3 groups (n = 15) according to the kinematics used for root canal preparation: reciprocating motion with the WaveOne Gold system (Dentsply Tulsa Dental, Tulsa, OK), rotary/reciprocating motion with the Twisted File Adaptive system (SybronEndo, Orange, CA), and the manual technique. The debris apically extruded during preparation was collected into preweighed Eppendorf tubes. The tubes were then stored in an incubator at 70°C for 5 days. The extruded debris was quantified by subtracting the preinstrumentation from the postinstrumentation weight of the Eppendorf tubes. The time required for each instrumentation procedure was recorded. Data were analyzed using 1-way analysis of variance Tukey post hoc tests (∝ = 0.05). RESULTS: The WaveOne Gold reciprocating single-file system was associated with less extrusion of debris compared with hand files (P < .05) and the Twisted File Adaptive system (P > .05). The preparation time required by hand files was significantly longer than that required by the other techniques (P < .05). CONCLUSIONS: Under the conditions of this study, all of the instrumentation systems caused apical debris extrusion to some degree. The WaveOne Gold reciprocating system was associated with less debris extrusion in curved root canals compared with the manual technique and the Twisted File Adaptive system although the difference between the WaveOne Gold and Twisted File Adaptive systems was not significant.

Apically extruded debris in filling removal of curved canals using 3 NiTi systems and hand files

Abstract The aim of this study was to assess the amount of apically extruded debris during filling removal with WaveOne Gold (WOG), ProTaper Universal Retreatment (PTR), D-RaCe Retreatment (DRR) or hand files (HF), to compare the working time during filling removal, and to describe failures of NiTi instruments. Forty mesiobuccal roots of maxillary first molars were prepared with WOG Primary, obturated and divided into 4 groups (n=10), according to the instruments used: WOG, PTR, DRR or HF. Distilled water was used as irrigant and the extruded debris were collected in Eppendorf tubes and dried. The amount of extruded debris was determined by subtracting the final from the initial weight. The time of filling removal for each canal was recorded and the instruments used were analyzed pre and post-operatively by SEM. Kruskal-Wallis and Dunn's test analyzed extruded debris data and ANOVA, followed by Tukey's test, compared the working time data (a=0.05). Instrument deformation and fracture were described. WOG produced significantly less debris compared with HF and DRR (p<0.05), and similar to PTR (p>0.05). HF, PTR and DRR showed no significant difference (p>0.05). Working time in HF group was significantly higher than others (p<0.05). SEM analyses showed, from the 18 instruments evaluated, 3 fractures and 10 deformations. All instruments tested caused debris extrusion. WOG was associated with less extrusion than DRR and HF. Filling removal with HF was slower than with the other instruments. All NiTi systems presented fracture and deformation.

Resumo O objetivo deste estudo foi avaliar a extrusão apical de debris durante a desobturação com WaveOne Gold (WOG), ProTaper Universal Retratamento (PTR), D-RaCe (DRR) ou limas manuais (HF), comparar o tempo de trabalho durante a desobturação, e descrever as falhas dos instrumentos de NiTi. Quarenta canais de raízes mésio-vestibulares de primeiros molars superiores foram preparados com WOG Primary, obturados e divididos em 4 grupos (n = 10), de acordo com os instrumentos a serem utilizados: WOG, PTR, DRR ou HF. Água destilada foi utilizada como irrigante, e os debris extruídos foram coletados em tubos Eppendorf e secos. A quantidade de debris extruídos foi determinada subtraindo-se o peso inicial do peso final. O tempo de cada desobturação foi anotado e os instrumentos utilizados foram analisados no pré e pós-operatório em MEV. Os testes Kruskal-Wallis e Dunn foram utilizados para analisar os dados da extrusão de debris, e os testes ANOVA e Tukey para comparar os dados do tempo de trabalho (a=0.05). As deformações e fraturas dos instrumentos foram descritas. O grupo WOG produziu significativamente menos debris quando comparado aos grupos HF e DRR (p<0.05), e foi similar ao grupo PTR (p>0.05). Os grupos HF, PTR e DRR não apresentaram diferença estatisticamente significante (p>0.05). O tempo de trabalho no grupo HF foi significativamente maior do que nos outros grupos (p<0.05). A análise em MEV mostrou que, dos 18 instrumentos avaliados, 3 fraturaram e em 10 foi observado deformação. Todos os sistemas testados causaram extrusão apical de debris. WOG foi associado com menor extrusão do que DRR e HF. A desobturação com HF foi mais lenta do que com os demais instrumentos. Todos os sistemas de NITI apresentaram fratura e deformação.

Apically extruded debris in filling removal of curved canals using 3 NiTi systems and hand files.

The aim of this study was to assess the amount of apically extruded debris during filling removal with WaveOne Gold (WOG), ProTaper Universal Retreatment (PTR), D-RaCe Retreatment (DRR) or hand files (HF), to compare the working time during filling removal, and to describe failures of NiTi instruments. Forty mesiobuccal roots of maxillary first molars were prepared with WOG Primary, obturated and divided into 4 groups (n=10), according to the instruments used: WOG, PTR, DRR or HF. Distilled water was used as irrigant and the extruded debris were collected in Eppendorf tubes and dried. The amount of extruded debris was determined by subtracting the final from the initial weight. The time of filling removal for each canal was recorded and the instruments used were analyzed pre and post-operatively by SEM. Kruskal-Wallis and Dunn's test analyzed extruded debris data and ANOVA, followed by Tukey's test, compared the working time data (a=0.05). Instrument deformation and fracture were described. WOG produced significantly less debris compared with HF and DRR (p<0.05), and similar to PTR (p>0.05). HF, PTR and DRR showed no significant difference (p>0.05). Working time in HF group was significantly higher than others (p<0.05). SEM analyses showed, from the 18 instruments evaluated, 3 fractures and 10 deformations. All instruments tested caused debris extrusion. WOG was associated with less extrusion than DRR and HF. Filling removal with HF was slower than with the other instruments. All NiTi systems presented fracture and deformation.

Microscópio operatório na Endodontia: magnificação visual e luminosidade / Operating microscope in Endodontics: visual magnification and luminosity

Introdução: O microscópio operatório vem sendo utilizado na Endodontia com o intuito de minimizar a obscuridade do campo operatório, pois proporciona alta magnificação e luminosidade, favorecendo os procedimentos realizados e proporcionando um resultado de maior qualidade. Objetivo e revisão de literatura: O objetivo deste trabalho foi revisar a literatura discorrendo sobre a situação atual da microscopia operatória na Endodontia, com ênfase em suas vantagens e limitações. Apesar de ser um instrumento tecnológico de custo relativamente elevado e necessitar de um período de aprendizagem e adaptação, o uso desse aparato tem se difundido gradativamente. Conclusão: A importância da magnificação está embasada cientificamente na Odontologia, de tal forma que o seu uso proporcionou à Endodontia uma melhora significativa na visão e na iluminação do campo operatório, oferecendo trabalhos de melhor qualidade com proporcionais índices de sucesso nos tratamentos, além de melhorar a comunicação entre profissionais e entre profissionais e pacientes e auxiliar na documentação legal para fins jurídicos.

Introduction: The surgical microscope has been used in Endodontics in order to minimize the obscurity of the surgical , because it provides a high magnification and luminosity, thereby enhancing the procedures performed and providing a final result of higher quality. Objective and literature review: The objective of this study was to review the literature by addressing the current situation of the operating microscope in Endodontics, emphasizing its advantages and limitations. Despite being a technological tool that is relatively costly and that requires a period of learning and adaptation, the use of this apparatus has been spreading gradually. Conclusion: The importance of magnification is scientifically based in Dentistry, in such a way that its use has provided significant improvement to Endodontics with regards to vision and lighting of the operative , by offering better quality of work with proportional success rates in treatments, besides improving communication between professionals and patients and assisting in the documentation for legal purposes.