Influence of age and experience with magnification on locating the second mesiobuccal canal in maxillary first molars: A preliminary study.

The aim was to evaluate the effectiveness of clinical methods in identifying the presence of second mesiobuccal canal in maxillary first molars. The influence of age and experience with microscopy was also assessed. Sixty six teeth were selected and the mesiobuccal canal was confirmed in all of the samples by Cone-Beam Computed Tomography. After endodontic cavity access, teeth were evaluated through direct visual; dental loupe and operating microscope. None of the methods was successful in finding the mesiobuccal canal in all samples. Professionals <40, the magnification did not influence the location. Professionals >40, the magnification significantly influenced the location. In the direct vision, professionals >40 years located fewer canals than those <40 years of age with experience. In conclusion, these preliminary findings showed that when the microscope was used, the professionals with experience, regardless of age, found a higher number of canals. The use of the microscope was significant for professionals >40 years.

Prevalence of oral injuries and salivary changes in patients with chronic renal failure on hemodialysis: systematic review and meta-analysis

The objective of this study was to evaluate whether individuals with chronic renal failure (CRF) undergoing hemodialysis treatment have more salivary and oral mucosa alterations when compared to healthy individuals, through a systematic review followed by meta-analysis. A systematic literature review was performed, evaluating randomized clinical trials found in the Proquest, Embase, Scopus, Cochrane Library, Web of Science, Lilacs and Pubmed databases, using MeSH terms and other keywords. Initially, 40 articles were included in the study and, after reading the complete articles, only 15 clinical trials that analyzed oral lesions and salivary changes in patients with CRF undergoing hemodialysis treatment were eligible. Most of the clinical studies included were cross-sectional and composed of a study group and a control group. The mean age of participants in the study group was 50.19 years and in the control group, 48.95 years. The most common oral alterations found in the CRF group in relation to the control group were xerostomia, uremic breath, dysgeusia, coated tongue, gingival bleeding and pale mucosa. The salivary flow of patients with CRF was 46.6% lower than the control group. The salivary pH in the study group was also more alkaline when compared to the control group. Greater amounts of urea, phosphate, C-reactive protein and total proteins were found in the saliva of individuals with CRF. Individuals with CRF undergoing hemodialysis are more prone to changes in both the quantity and quality of saliva, as well as having a greater amount of oral changes.

Association between sella turcica bridging and impacted maxillary canines.

Changes in sella turcica (ST) development may be associated with impaction of the permanent canine teeth. Calcification of the interclinoid ligament, which forms a bridge between the anterior and posterior clinoid processes of the sphenoid bone, has been termed ST bridging. The aim of this study was to evaluate whether an association exists between ST bridging and the presence of impacted maxillary canines (IMCs) in a Brazilian population. In this case-control study, 2 blinded and calibrated examiners measured the length (interclinoidal distance), depth, and diameter of the ST on cephalometric radiographs of 64 adults divided into a case group with IMCs (n = 32) and a control group without IMCs (n = 32). The degree of calcification was established as no (class I), partial (class II), or complete (class III) calcification. A t test was used to compare ST dimensions between the groups, and a chi-square test was used to analyze the association between the degree of calcification and the groups. The association between ST bridging and IMC was estimated by means of logistic regression analysis (α = 0.05). The study findings showed that ST length in the case group was shorter than that in the control group (P = 0.042; t test), and the length was shorter in men than in women (P = 0.038; t test). The ST bridging frequency was higher in the case group (P = 0.03; chi-square test), and there was no difference between men and women. The presence of ST bridging might be associated with increased odds of IMCs (P < 0.01; adjusted odds ratio = 5.92). In this patient sample, the occurrence of IMCs was positively associated with the presence and severity of ST bridging.

Association between Orthodontic Force and Dental Pulp Changes: A Systematic Review of Clinical and Radiographic Outcomes.

INTRODUCTION: Orthodontic force triggers a sequence of biological responses that can affect dental pulp. The aim of this study was to systematically evaluate the clinical and radiographic findings of orthodontic force application on dental pulp. METHODS: Two reviewers comprehensively and systematically searched 6 electronic databases (Latin American and Caribbean Health Sciences [LILACS], Embase, Cochrane Library, MEDLINE/PubMed, Scopus, and Web of Science) and the gray literature (Google Scholar, OpenGrey, and ProQuest) until April 2021. According to the PICOS criteria, randomized clinical trials and observational studies that evaluated clinical or radiographic findings compatible with dental pulp changes due to orthodontic force were included. Studies in open apex or traumatized teeth, case series or reports, and laboratory-based or animal studies were excluded. The Newcastle-Ottawa Scale and Cochrane Risk of Bias 2.0 tool were used to determine the risk of bias assessment. The overall certainty level was evaluated with the Grading of Recommendations, Assessment, Development and Evaluations tool. RESULTS: Twenty-six studies were included. Among the clinical findings, orthodontic force promoted an increased pulp sensibility response and decreased pulp blood flow. Changes in pulp cavity volume and increased incidence of pulp stones were the radiographic findings observed. The studies presented a moderate risk of bias for most of the domains. The certainty of the evidence was considered very low. CONCLUSIONS: Orthodontic force promoted changes in the dental pulp, generating clinical and radiographic findings. It is crucial to know these changes so that orthodontic mechanics can be safely performed. The clinician has effective noninvasive methods to assess the health and possible pulp changes during orthodontic treatment.

Effect of orthodontic force on dental pulp histomorphology and tissue factor expression.

OBJECTIVES: To evaluate the effects of orthodontic force on histomorphology and tissue factor expression in the dental pulp. MATERIALS AND METHODS: Two reviewers comprehensively and systematically searched the literature in the following databases: Latin American and Caribbean Health Sciences, Embase, Cochrane, PubMed, Scopus, Web of Science, and Grey literature (Google Scholar, OpenGrey, and ProQuest) up to September 2020. According to the Population, Intervention, Comparison, Outcomes, Studies criteria, randomized clinical trials (RCTs) and observational studies that evaluated the effects of orthodontic force on dental pulp were included. Case series/reports, laboratory-based or animal studies, reviews, and studies that did not investigate the association between orthodontic force and pulpal changes were excluded. Newcastle-Ottawa Scale and Cochrane risk-of-bias tool were used to assess the risk of bias. The overall certainty level was evaluated with the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS: 26 observational studies and five RCTs were included. A detailed qualitative analysis of articles showed a wide range of samples and applied methodologies concerning impact of orthodontic force on the dental pulp. The application of orthodontic force seems to promote several pulpal histomorphological changes, including tissue architecture, cell pattern, angiogenesis, hard tissue deposition, inflammation, and alteration of the expression levels of 14 tissue factors. CONCLUSIONS: Although the included articles suggest that orthodontic forces may promote histomorphological changes in the dental pulp, due to the very low-level of evidence obtained, there could be no well-supported conclusion that these effects are actually due to orthodontic movement. Further studies with larger samples and improved methods are needed to support more robust conclusions.

Prevalence of red and orange microbial complexes in endodontic-periodontal lesions: a systematic review and meta-analysis.

OBJECTIVE: This systematic review assesses the prevalence of microbial complexes in endodontic-periodontal lesion. MATERIALS AND METHODS: Nine databases were searched through August 2020. Experts were consulted to indicate additional studies. Studies were blindly selected by two reviewers based on pre-defined eligibility criteria. Studies that evaluated the prevalence of microbial orange and red complexes among patients with endodontic-periodontal lesion were considered eligible. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. RESULTS: From 572 articles found on all databases, 11 clinical studies were finally included. The following microorganisms were investigated: P. gingivalis, T. forsythia, T. denticola, F. nucleatum, F. periodonticum, P. micra, P. intermedia, P. nigrescens, S. constellatus, C. gracilis, C. rectus, C. showae and E. nodatum. Considering the orange complex, P. micra, E. nodatum and S. constellatus were prevalent in both root canal and periodontal pockets. P. gingivalis and T. forsythia belonging to the red complex were prevalent only in periodontal pockets. The red complex microorganisms were not found very frequently in root canal. CONCLUSIONS: There is a similarity between the microbiome of root canal and periodontal pockets, with prevalence of the three microorganisms of the orange complex. Two microorganisms from the red complex were prevalent only in periodontal pockets. CLINICAL RELEVANCE: The prevalence of specific microorganisms in endodontic-periodontal lesion is important to understand the microbiological profile of the patients involved and to correlate it with possible clinical and repair conditions of this pathology.

A second attempt at pulp revascularisation on an immature traumatised anterior tooth: a case report with two-year follow-up.

This report describes the second attempt at pulp revascularisation, using an association between 2% chlorhexidine (CHX) and calcium hydroxide (CH) as intracanal dressing, in an immature traumatised anterior tooth with pulp necrosis. A 21-year-old woman complained of pain and dental crown darkening of a permanent maxillary right central incisor. Her medical records presented a history of dental trauma, and at age 15, the first attempt at revascularisation was performed, using triple antibiotic paste (TAP) as the intracanal dressing. Recent radiographs then showed a periapical lesion associated with an immature root, which demonstrated the failure of the first attempt. The second pulp revascularisation was performed, using an association between CHX and CH as intracanal medication. The case was followed up for 24 months. Observations showed evidence of root development, dentinal wall thickening and periapical healing. In this case, the association between CHX and CH showed favourable results as an intracanal medication.

Adhesion to high-performance polymers applied in dentistry: A systematic review.

OBJECTIVE: The aim of this systemic review, conducted in accordance with the PRISMA statement, was to investigate the impact of surface pretreatments on the bonding strength of high performance polymers (HPPs). METHODS: Eight databases were searched through March 2019. Risk of bias was assessed and random effects meta-analyses were applied to analyze mean differences in shear bond strength (SBS) and tensile bond strength (TBS), considering surface pretreatments and bonding agents after 24h and thermocycling. RESULTS: A total of 235 relevant titles and abstracts were found, yielding 11 final selections. Low risk of bias was observed in most studies. For polyetheretherketone (PEEK) specimens, random-effect models showed that, compared to non-treated controls, pretreatments associated with Visio.link® (Bredent, Senden, GE) increased TBS by 26.72MPa (95% confidence interval (CI), 19.69-33.76; p<0.00001) and increased SBS by 4.86MPa (95% CI, 2.61-7.10; p<0.00001). Air abrasion improved SBS by 4.90MPa (95% CI, 3.90-5.90; p<0.00001) (50µm alumina) and 4.51MPa (95% CI, 1.85-7.18; p=0.0009) (silica-coated CoJet). In comparison to non-treated controls, Visio.link® and Signum PEEK Bond® (Heraeus Kulzer, Hanau, GE) increased SBS by 33.76MPa (95% CI, 18.72-48.81; p<0.00001) and 33.28MPa (95% CI, 17.48-49.07; p<0.00001), respectively. No differences were found between Visio.link® and Signum PEEK Bond® or Monobond Plus/Heliobond® (Ivoclar Vivadent, Schaan, LH) (p>0.05). Similar results were observed for polyetherketoneketone (PEKK) specimens. SIGNIFICANCE: This review shows improved HPP bonding following the application of various surface pretreatments, including air abrasion and bonding agents.

Prevalence of dentofacial injuries among combat sports practitioners: A systematic review and meta-analysis.

BACKGROUND/AIM: Combat sports might result in injuries to the face and teeth. However, it is unclear how often they occur and which sports presents the highest rates. The aim of this study was to investigate the prevalence of dentofacial injuries in combat sports participants. MATERIAL AND METHODS: A systematic review was performed. Six main electronic databases and three grey literature databases were searched. Studies were blindly selected by two reviewers based on pre-defined eligibility criteria. Studies that evaluated the prevalence of dentofacial injuries (teeth, alveolar bone, jaw, lips, and/or cheekbones) among combat sports participants were considered eligible. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The software r statistics version was used to perform all meta-analyses. Cumulative evidence of the included articles was evaluated using GRADE criteria (Grading of Recommendations Assessment, Development and Evaluation). RESULTS: From 1104 articles found on all databases, 27 were finally included. Eighteen studies were judged at low, seven at moderate, and two at high risk of bias. The following sports were investigated: boxing, capoeira, fencing, jiu-jitsu, judo, karate, kendo, kickboxing, kung fu, muay thai, sumo, taekwondo, wrestling, and wushu. Results from the meta-analysis suggested a dental pooled prevalence of 25.2% (12.3%-40.8%, i2  = 100%) and dentofacial pooled prevalence of 30.3 (18.1%-44.1%, i2  = 100%). Considering the sports' categories individually, jiu-jitsu had the highest pooled prevalence of dentofacial injuries (52.9% [37.9%-67.8%, i2  = 92%]), while judo was the sport with the lowest pooled prevalence (25.0% [7.6%-48.2%, i2  = 98%]). Among Panamerican sports, boxing had the highest prevalence of dental injuries (73.7% [58.7%-86.3%, i2  = 0%]). For dentofacial injuries, the GRADE criteria were considered low. CONCLUSIONS: Overall pooled prevalence of dentofacial injuries in combat sports was approximately 30%. Raising awareness regarding the frequency of these injuries might encourage the use of protective devices and reduce complications related to these incidents.

Effect of previous irrigation with chlorhexidine on the push-out bond strength of a calcium silicate-based material.

This study evaluated the effect of previous irrigation with chlorhexidine (CHX) on the bond strength of a calcium silicate-based material, Biodentine, when used for furcal repair. Furcal perforations were produced in 30 extracted mandibular molars. Teeth were divided into 3 groups according to the irrigant used: distilled water (DW), CHX followed by DW (CHX), and CHX followed by ethylenediaminetetraacetic acid (EDTA) and DW (CHX/EDTA). Biodentine was used to repair the perforations. A push-out bond strength test was performed after 7 days, and data were statistically analyzed using Kruskal-Wallis and Dunn tests (P < 0.05). The CHX/EDTA group showed significantly lower values than the DW and CHX groups (P < 0.05). The failure mode of the DW group was mainly mixed, while that of the CHX group was cohesive. The CHX/EDTA group exhibited adhesive and mixed failures. Irrigation with CHX prior to furcation repair did not result in a statistically significant difference, compared to the use of DW, in the push-out bond strength of Biodentine.

Effect of a sonic device on bonding of fiberglass posts to root canals

Aim: This study evaluated the effect of a sonic device on the bonding of fiberglass posts cemented with a self-etching adhesive combined with conventional cement or a self-adhesive cement to root dentin. Methods: Forty single-rooted bovine incisors were endodontically prepared using a step-back technique. Gutta-percha and AH Plus sealer were used for root canal filling, combined with a thermoplasticization technique. After 1 week, the post space was prepared and the roots were divided into four groups according to the following factors: adhesive system/resin cement (Ambar/ AllCem Core [FGM] and RelyX U200 [3M]) and application mode (manual or sonic). The posts were cemented and the roots were cut into discs and submitted to push-out bond strength (POBS) test. The failure mode was evaluated using a stereoscope at 25x magnification. The data were analyzed statistically using ANOVA and Tukey's post-hoc test (α = 0.05). Results: The sonically activated RelyX U200 group was superior to the other groups. RelyX U200 manually applicated showed similar results to those of sonically activated Âmbar/AllCem. These three groups outperformed the Âmbar/AllCem manually applicated group. Adhesive failure between dentin and resin cement was the most predominant pattern. Conclusion: Sonic application of self-etching adhesive and self-adhesive cement improved the POBS of fiber posts to the root canal

Primeiro pré-molar inferior com três canais: relato de caso clínico / First mandibular premolar with three canals: case report

Objetivo: o objetivo deste relato de caso foi descrever o tratamento endodôntico de um primeiro pré-molar inferior com três canais. Relato do caso: paciente do sexo masculino, 54 anos de idade, procurou o serviço de emergência da Universidade Federal do Rio de Janeiro com dor no dente #34. Ao exame clínico/radiográfico, observou-se cárie extensa. O teste de sensibilidade pulpar exibia resposta positiva e exacerbada, com ausência de sintomatologia periapical ao exame de palpação e percussão. Portanto, foi diagnosticado um quadro de pulpite irreversível. O paciente foi anestesiado, realizou-se o isolamento absoluto e a abertura coronária. O preparo mecânico foi realizado com a técnica manual crown-down, sendo o comprimento de trabalho estabelecido a 1 mm aquém do ápice radicular, nos três canais. O hipoclorito de sódio a 2,5% foi usado como solução irrigadora e, para remoção da smear layer, utilizou-se EDTA a 17%. A obturação dos canais radiculares foi realizada pela técnica híbrida de Tagger, utilizando-se o cimento Endofill e cones de guta-percha. A radiografia final exibiu a presença de três canais, um lingual e dois vestibulares, que se encontravam no início do terço apical. Observou-se, ainda, uma ramificação ligando os canais vestibulares (interconduto). Considerações finais: o conhecimento e o domínio da anatomia do canal são fatores chave para o sucesso do tratamento endodôntico.

Tomografia computadorizada de feixe cônico ­ um recurso de diagnóstico em Endodontia: relato de caso / Cone beam computed tomography - a diagnosis resource in Endodontics: case report

Introdução: o diagnóstico é a base para o sucesso do tratamento endodôntico, sendo estabelecido a partir da anamnese, associada ao exame físico e a outros exames complementares ­ entre eles, os exames radiográficos. A Endodontia é a especialidade da Odontologia que mais se utiliza das técnicas de diagnóstico por imagem para a obtenção de maiores informações e detalhamento dos dentes que estão sendo avaliados. Por se tratar de uma imagem bidimensional, a radiografia dentária clássica apresenta limitações que dificultam ou impossibilitam um correto planejamento. Objetivo: esse trabalho tem por objetivo relatar um caso clínico onde a tomografia computadorizada de feixe cônico foi fundamental para o diagnóstico e planejamento endodôntico. Métodos: por meio da radiografia periapical convencional, foi identificada uma imagem sugestiva de reabsorção inflamatória externa perirradicular na raiz do incisivo central superior. Clinicamente, o dente apresentava-se com alteração cromática após ter sofrido trauma. Como o diagnóstico da reabsorção inflamatória externa é baseado unicamente na manifestação radiográfica, foi solicitada uma tomografia computadorizada de feixe cônico para investigação mais detalhada. Resultados: o laudo tomográfico do dente investigado apontou ausência de reabsorção radicular externa, apresentando morfologia radicular distinta, caracterizada por intensa dilaceração radicular. Conclusão: por meio do caso clínico relatado, evidenciou-se o impacto significativo da tomografia computadorizada de feixe cônico na eficácia da decisão terapêutica em Endodontia.

Técnica de ultrassom associada a limas manuais para remoção de instrumentos fraturados no sistema de canais radiculares: uma série de casos / Ultrasonic technique associated with manual les to remove broken les from root canals system: a case series

Introdução: a anatomia complexa dos canais radiculares, aliada ao uso repetido e/ou inadequado dos instrumentos, pode ocasionar sua fratura. Objetivo: demonstrar, por meio de três relatos de casos clínicos, uma técnica de remoção de limas endodônticas fraturadas, em diferentes terços do canal radicular, por meio da associação de limas manuais e ultrassom. Métodos: nessa série de casos, três dentes que apresentavam limas fraturadas no interior dos canais radiculares foram tratados de forma similar, por meio da associação de limas endodônticas manuais e ultrassom. Para todos os casos, havia uma estimativa de insucesso, devido ao tamanho e posição do fragmentos no interior dos canais. Porém, o protocolo adotado demonstrou 100% de e cácia. Conclusão: a presente técnica, associando limas manuais e ultrassom, se mostrou e caz, permitindo a remoção de limas manuais fraturadas no interior dos canais radiculares.

Antimicrobial and cytotoxic effects of phosphoric acid solution compared to other root canal irrigants.

UNLABELLED: Phosphoric acid has been suggested as an irrigant due to its effectiveness in removing the smear layer. OBJECTIVES: The purpose of this study was to compare the antimicrobial and cytotoxic effects of a 37% phosphoric acid solution to other irrigants commonly used in endodontics. MATERIAL AND METHODS: The substances 37% phosphoric acid, 17% EDTA, 10% citric acid, 2% chlorhexidine (solution and gel), and 5.25% NaOCl were evaluated. The antimicrobial activity was tested against Candida albicans, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Actinomyces meyeri, Parvimonas micra, Porphyromonas gingivalis, and Prevotella nigrescens according to the agar diffusion method. The cytotoxicity of the irrigants was determined by using the MTT assay. RESULTS: Phosphoric acid presented higher antimicrobial activity compared to the other tested irrigants. With regard to the cell viability, this solution showed results similar to those with 5.25% NaOCl and 2% chlorhexidine (gel and solution), whereas 17% EDTA and 10% citric acid showed higher cell viability compared to other irrigants. CONCLUSION: Phosphoric acid demonstrated higher antimicrobial activity and cytotoxicity similar to that of 5.25% NaOCl and 2% chlorhexidine (gel and solution).

Antimicrobial and cytotoxic effects of phosphoric acid solution compared to other root canal irrigants

Phosphoric acid has been suggested as an irrigant due to its effectiveness in removing the smear layer. Objectives : The purpose of this study was to compare the antimicrobial and cytotoxic effects of a 37% phosphoric acid solution to other irrigants commonly used in endodontics. Material and Methods : The substances 37% phosphoric acid, 17% EDTA, 10% citric acid, 2% chlorhexidine (solution and gel), and 5.25% NaOCl were evaluated. The antimicrobial activity was tested against Candida albicans, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Actinomyces meyeri, Parvimonas micra, Porphyromonas gingivalis, and Prevotella nigrescens according to the agar diffusion method. The cytotoxicity of the irrigants was determined by using the MTT assay. Results : Phosphoric acid presented higher antimicrobial activity compared to the other tested irrigants. With regard to the cell viability, this solution showed results similar to those with 5.25% NaOCl and 2% chlorhexidine (gel and solution), whereas 17% EDTA and 10% citric acid showed higher cell viability compared to other irrigants. Conclusion : Phosphoric acid demonstrated higher antimicrobial activity and cytotoxicity similar to that of 5.25% NaOCl and 2% chlorhexidine (gel and solution). .

Dentine bond strength and antimicrobial activity evaluation of adhesive systems.

OBJECTIVES: This study evaluated the dentine bond strength (BS) and the antibacterial activity (AA) of six adhesives against strict anaerobic and facultative bacteria. METHODS: Three adhesives containing antibacterial components (Gluma 2Bond (glutaraldehyde)/G2B, Clearfil SE Protect (MDPB)/CSP and Peak Universal Bond (PUB)/chlorhexidine) and the same adhesive versions without antibacterial agents (Gluma Comfort Bond/GCB, Clearfil SE Bond/CSB and Peak LC Bond/PLB) were tested. The AA of adhesives and control groups was evaluated by direct contact method against four strict anaerobic and four facultative bacteria. After incubation, according to the appropriate periods of time for each microorganism, the time to kill microorganisms was measured. For BS, the adhesives were applied according to manufacturers' recommendations and teeth restored with composite. Teeth (n=10) were sectioned to obtain bonded beams specimens, which were tested after artificial saliva storage for one week and one year. BS data were analyzed using two-way ANOVA and Tukey test. RESULTS: Saliva storage for one year reduces the BS only for GCB. In general G2B and GCB required at least 24h for killing microorganisms. PUB and PLB killed only strict anaerobic microorganisms after 24h. For CSP the average time to eliminate the Streptococcus mutans and strict anaerobic oral pathogens was 30 min. CSB showed no AA against facultative bacteria, but had AA against some strict anaerobic microorganisms. CONCLUSIONS: Storage time had no effect on the BS for most of the adhesives. The time required to kill bacteria depended on the type of adhesive and never was less than 10 min. CLINICAL SIGNIFICANCE: Most of the adhesives showed stable bond strength after one year and the Clearfil SE Protect may be a good alternative in restorative procedures performed on dentine, considering its adequate bond strength and better antibacterial activity.

Análise da contaminacão em cones de papel absorvente e sua influência no tratamento endodôntico / Contamination analysis of absorbent paper points and the influence in endodontic treatment

O objetivo do presente estudo foi avaliar microbiologicamente cones de papel absorvente presentes em embalagens lacradas, convencionais ou do tipo "CELL PACK", e cones de papel que já estavam sendo utilizados em consultórios pelos Cirurgiões-Dentistas. Assim, verificar se o manuseio e o ambiente em que os mesmos se encontram expostos, contribui para que ocorra contaminação. Foram utilizadas 4 marcas de cones de papel (EndoPoints, Tanary, Precise e Meta) provenientes de embalagens lacradas, denominadas esterilizadas pelo fabricante e, contidas em embalagens convencionais e do tipo "CELL PACK"; e 90 cones de papel absorvente, de 4 marcas comerciais (Tanary, Roeko, Endo Points, Conne Teckl coletados de 30 consultórios particulares e que já estavam sendo utilizados nos consultórios. Todas as amostras foram transferidas para tubos de ensaio contendo BHI caldo e incubadas, em aerobiose, a 37°C sob atmosfera de C02 Na presença de contaminação, as amostras foram plaqueadas em BHI Agar e a identificação bacteriana realizada através de testes bioquímicos específicos. Os cones de papel provenientes das caixas lacradas não apresentaram crescimento microbiano. No entanto, foi observado contaminação dos cones que estavam em uso clínico. Os resultados mostraram que cones de papel absorvente presentes em embalagens lacradas, inicialmente se apresentam estéreis. No entanto, se as embalagens permanecem abertas, os cones podem se tornar contaminados, contribuindo para o insucesso do tratamento endodõntico. Dessa forma, embalagens do tipo "CELL PACK" são mais e seguras eficazes, pois apresentam um numero suficiente de cones embalados em células individualizadas.

The purpose of this study was evaluate microbiologically absorbent paper points present in conventional sealed packages or "CELL PACK" type, and paper points that were already being used in clinical practice. So check handling and environment in which they are exposed, contributes to contamination and if the microorganisms found influence in the outcome of endodontic treatment. Were used 4 brands of paper points (EndoPoints, Tanary, Precise and Meta) from sealed packages, called sterilized by the manufacturer in conventional packages and "CELL PACK" type. And 90 absorbent paper points (Ta na ry, Roeko, Endo Points, Conne Teck), collected from 30 private practices and already being used in clinical practice. Ali samples were transferred to tubes containing BHI broth and incubated at 37°C under an atmosphere of C02. In the presence of contamination, samples were plated on BHI agar and bacterial identification performed through specific tests. None of paper cones from the sealed packs showed microbial growth. However, there was contamination of cones which were in clinical use. The authors conclude that absorbent paper points present in sealed packages, initially are sterile. However, the "CELL PACK" type are more effective and sa fe r, because they have a sufficient number of cones in individual cells. Furthermore, paper points of conventional packs, after opening, may present contamination, contributing to the failure of endodontic treatment.

Evaluation of cytotoxicity, antimicrobial activity and physicochemical properties of a calcium aluminate-based endodontic material.

UNLABELLED: A calcium aluminate-based endodontic material, EndoBinder, has been developed in order to reduce MTA negative characteristics, preserving its biological properties and clinical applications. OBJECTIVES: The aim of this study was to evaluate the cytotoxicity, antimicrobial activity, pH, solubility and water sorption of EndoBinder and to compare them with those of white MTA (WMTA). MATERIAL AND METHODS: Cytotoxicity was assessed through a multiparametric analysis employing 3T3 cells. Antimicrobial activity against Enterococcus faecalis (ATCC 29212), Staphylococcus aureus. (ATCC 25923) and Candida albicans (ATCC 10556) was determined by the agar diffusion method. pH was measured at periods of 3, 24, 72 and 168 hours. Solubility and water sorption evaluation were performed following ISO requirements. Data were statistically analyzed by ANOVA and Tukey`s test with a significance level of 5%. RESULTS: EndoBinder and WMTA were non-cytotoxic in all tested periods and with the different cell viability parameters. There was no statistical differences between both materials (P>.05). All tested materials were inhibitory by direct contact against all microbial strains tested. EndoBinder and WMTA presented alkaline pH in all tested times with higher values of pH for WMTA (P<.05). Both materials showed values complying with the solubility minimum requirements. However, EndoBinder showed lower solubility than WMTA (P<.05). No statistical differences were observed regarding water sorption (P>.05). CONCLUSION: Under these experimental conditions, we concluded that the calcium aluminate-based endodontic material EndoBinder demonstrated suitable biological and physicochemical properties, so it can be suggested as a material of choice in root resorption, perforations and root-end filling.

Evaluation of cytotoxicity, antimicrobial activity and physicochemical properties of a calcium aluminate-based endodontic material

A calcium aluminate-based endodontic material, EndoBinder, has been developed in order to reduce MTA negative characteristics, preserving its biological properties and clinical applications. Objectives: The aim of this study was to evaluate the cytotoxicity, antimicrobial activity, pH, solubility and water sorption of EndoBinder and to compare them with those of white MTA (WMTA). Material and Methods: Cytotoxicity was assessed through a multiparametric analysis employing 3T3 cells. Antimicrobial activity against Enterococcus faecalis (ATCC 29212), Staphylococcus aureus. (ATCC 25923) and Candida albicans (ATCC 10556) was determined by the agar diffusion method. pH was measured at periods of 3, 24, 72 and 168 hours. Solubility and water sorption evaluation were performed following ISO requirements. Data were statistically analyzed by ANOVA and Tukey`s test with a significance level of 5%. Results: EndoBinder and WMTA were non-cytotoxic in all tested periods and with the different cell viability parameters. There was no statistical differences between both materials (P>.05). All tested materials were inhibitory by direct contact against all microbial strains tested. EndoBinder and WMTA presented alkaline pH in all tested times with higher values of pH for WMTA (P<.05). Both materials showed values complying with the solubility minimum requirements. However, EndoBinder showed lower solubility than WMTA (P<.05). No statistical differences were observed regarding water sorption (P>.05). Conclusion: Under these experimental conditions, we concluded that the calcium aluminate-based endodontic material EndoBinder demonstrated suitable biological and physicochemical properties, so it can be suggested as a material of choice in root resorption, perforations and root-end filling. .