Does the rehabilitation treatment predispose the patient with cleft to endodontic treatment?

Aim: to verify the relation between endodontic treatment of teeth adjacent to the cleft area and the rehabilitation of patients with unilateral cleft lip and palate, at the Hospital for Rehabilitation of Craniofacial Anomalies. Methods: the present split-mouth study was composed of 406 individuals with complete unilateral cleft lip and palate who had completed the rehabilitation process in a single tertiary cleft center (55.9% males). The information was collected from the dental history on the patients' records and radiographs. The frequency of endodontic treatment in the upper incisors and canines was calculated for the cleft and non-cleft sides. The comparison between sides was performed by the chi-square test (p <0.05). Results: endodontic treatment was more frequent in teeth adjacent to the cleft than in contralateral teeth. The frequency of endodontic treatment in at least one tooth adjacent to the cleft was 18.97%, and 11.6% on the contralateral side. It was observed that endodontic treatment was necessary in 63.5% of patients who had been submitted to orthodontic treatment, 42.4% of those rehabilitated with fixed partial dentures and 12.0% of patients who underwent dental reshaping of teeth adjacent to the cleft. The treatments performed included vital pulp therapy (46.1%), non-vital pulp therapy (46.8%) and endodontic retreatment (7.1%). Conclusion: in individuals with complete cleft lip and palate, teeth close to the bone defect area and used for rehabilitation treatment presented greater need of endodontic intervention

Avaliação da instrumentação rotatória e reciprocante na desobturação de condutos radiculares curvos: Análise por meio de microtomografia computadorizada / Evaluation of the rotary and reciprocating instrumentation for removing filling material in curved canals: a micro-computed tomographic analysis

O presente estudo teve por objetivo avaliar ex vivo a eficiência de sistemas reciprocantes e rotatórios (Wave One e ProTaper Universal Retratamento), na desobturação de molares inferiores, por meio de microtomografia computadorizada. Foram utilizados canais mesiais com curvatura entre 20 e 40 graus, de 50 molares inferiores, preparados com ProTaper Universal, obturados com cone do próprio sistema e cimento AH Plus, pela técnica de condensação lateral. Para a desobturação, os dentes foram divididos em 5 grupos (I: Instrumentos manuais associados ao uso de brocas Gates Glidden e solvente; II: Sistema ProTaper Universal Retratamento; III: Sistema ProTaper Universal Retratamento e solvente; IV: Sistema Wave One; V: Sistema Wave One e solvente. Durante a desobturação, a quantidade de detritos extruídos, bem como o tempo de desobturação foram mensurados. A captura de imagem foi realizada por meio de microtomografia computadorizada onde foi avaliado o volume de material obturador remanescente nos canais. Os dados obtidos foram tabulados e submetidos a análise estatística por meio do teste de Kruskal-Wallis para determinar a ocorrência de diferença estatística entre os grupos experimentais (p<0,05). Nenhum dos métodos avaliados removeu por completo o material obturador. O método que utilizou o sistema ProTaper Retratamento com solvente apresentou menor volume percentual médio de material obturador remanescente no terço apical, entretanto, não houve diferença estatística significante entre os grupos testados em nenhum dos terços analisados. O sistema WaveOne com solvente teve o maior volume de extrusão de material após a desobturação. Os grupos que utilizaram o sistema ProTaper Retratamento, com e sem o auxílio da solução solvente, foram os que apresentaram menor tempo para remoção de material obturador. Concluiu-se que o uso de Sistema ProTaper Retratamento favorece uma desobturação mais rápida e com menor extrusão de material obturador.(AU)

This study aimed to evaluate ex vivo the efficiency of reciprocating and rotary systems (Wave One and ProTaper Universal Retreatment), in the disobturation of mandibular molars, using micro-computed tomography. Mesial canals were used with curvature between 20o and 40o, from 50 mandibular molars prepared with ProTaper Universal, obturated with ProTaper single cones and AH Plus sealer using the lateral condensation technique. For the disobturation, the teeth were divided into 5 groups (I: manual instruments associated with the use of Gates Glidden drills and solvent; II: Protaper Universal Retreatment system; III: Protaper Universal Retreatment system and solvent; IV: Wave One system; V: Wave One system and solvent. During the disobturation the amount of extruded debris, as well as the time of the retreatment procedure, were measured. The capture of images was performed using microcomputed tomography which assessed the volume of the filling material remaining in the canals. Data were tabulated and submitted to statistical analysis using theKruskal-Wallis test to determine the occurrence of statistical differences among the experimental groups (p<0.05). None of the methods evaluated completely removed the filling material. The method that used the ProTaper Retreatment system with solvent showed lower average percent volume of remaining filling material in the apical third. However, there was no statistically significant difference between the groups tested in any of the analyzed thirds. The Wave One system with solvent had the largest volume of extrusion material after the disobturation. Groups using the ProTaper Retreatment system, with and without the use of solvent solution, were those that demanded less time for the removal of the filling material. The study concluded that the use of ProTaper Retreatment system favors a faster disobturation and with less extrusion of filling material.(AU)