Correlation between Tooth Position Parameters and Apical Fenestration: A Cone-Beam Computed Tomography Study.

This study aimed to assess the relationship between apical fenestration-a defect in the alveolar bone involving the root apex-and tooth position in all tooth groups, excluding the third molars, utilizing cone-beam computed tomography (CBCT) images. A total of 800 CBCT scans (400 maxillary and 400 mandibular) from patients undergoing various treatments were examined by a single professional (radiologist and endodontist). Statistical analyses, including the chi-square test or Fisher's exact test, were conducted using R software 2.7.3 (R Foundation, Vienna, Austria). Results indicated a significant association (p ≤ 0.05) between apical fenestration and tooth position. In the upper teeth, apical fenestrations were notably present in the mesio-buccal (17.17%) and disto-buccal (11.07%) roots of the first molars. Conversely, apical fenestrations in the lower teeth were relatively less frequent. The study revealed a negative correlation between apical fenestration and mesial inclination, rotation, and extrusion in the upper teeth. However, a positive correlation was observed between apical fenestration and lingual inclination in the upper teeth. In conclusion, this study illuminates the distribution of apical fenestration and its correlation with tooth positions, offering insights into factors influencing this defect in dental anatomy. The findings enhance our understanding of nuanced relationships between tooth position and apical fenestration in the upper and lower dental arches.

Panoramic radiography and cone-beam computed tomography to measure distances between root apexes and anatomical structures / Radiografía panorámica y tomografía computarizada de haz cónico para medir distancias entre ápices radiculares y estructuras anatómicas

Aim: To compare the accuracy of the panoramic radiography with cone-beam computed tomography (CBCT) scans in measuring the distances between root apexes and the adjacent anatomical structures including the maxillary sinus and the mandibular canal. Material and Methods: A total of 200 CBCT scans (100 maxillary and 100 mandibular) from patients who also had corresponding panoramic radiography were selected. Linear measurements (in mm) presenting centralized image were made between the apexes of the maxillary teeth and the inferior wall of the maxillary sinus, and between the apexes of the mandibular teeth and the superior border of the mandibular canal by using specific software for panoramic radiography and the measurements on the coronal sections in CBCT scans. Data were submitted to inferential statistical analysis and Student's t-test for comparison between measurements. Results: CBCT scans were significantly more accurate than panoramic radiography to measure the distances between the apexes of the maxillary teeth and the inferior wall of the maxillary sinus (p<0.05) and between the apexes of the mandibular teeth and the superior border of the mandibular canal or mental foramen (p<0.05). Conclusion: CBCT scans present more accurate measurements than panoramic radiography.

Objetivo: Comparar la precisión de la radiografía panorámica con las exploraciones de la tomografía computarizada dental de haz en cónico (CBCT) para medir las distancias entre los vértices radiculares y las estructuras anatómicas adyacentes, incluidos el seno maxilar y el canal mandibular. Material y Métodos: Se seleccionaron un total de 200 tomografías CBCT (100 maxilares y 100 mandibulares) de pacientes que además tenían la correspondiente radiografía panorámica. Se realizaron mediciones lineales (en mm) que presentaban imagen centralizada entre los ápices de los dientes maxilares y la pared inferior del seno maxilar, y entre los ápices de los dientes mandibulares y el borde superior del canal mandibular mediante software específico para radiografía panorámica. y las mediciones en las secciones coronales en escaneos CBCT. Los datos se sometieron a análisis estadístico inferencial y prueba t de Student para comparación entre mediciones. Resultados: Las exploraciones CBCT fueron significativamente más precisas que la radiografía panorámica para medir las distancias entre los ápices de los dientes maxilares y la pared inferior del seno maxilar (p<0,05) y entre los ápices de los dientes mandibulares y el borde superior de los dientes mandibulares. canal o agujero mentoniano (p<0.05). Conclusión: Las exploraciones CBCT presentan mediciones más precisas que la radiografía panorámica.

Instrumentação foraminal: repercussões locais e sistêmicas / Foraminal enlargement: Local and systemic repercussions

Introdução: A infecção endodôntica pode alcançar a saída foraminal e, inclusive, ir além dela. Logo, a determinação da constrição apical como o limite ideal para instrumentação e obturação tem sido questionada. A instrumentação foraminal intencional é realizada com o intuito de diminuir o contingente microbiano a níveis mais favoráveis ao reparo. Entretanto, repercussões locais e sistêmicas estão associadas à sua execução. Objetivo: Realizar uma revisão crítica da literatura sobre repercussões locais e sistêmicas relativas à instrumentação foraminal intencional. Métodos: Em março de 2018, uma busca eletrônica realizada na base de dados PUBMED utilizando os termos "foraminal enlargement" OR "foraminal widening" OR "apical limit" AND "endodontics" identificou 74 artigos científicos. Esses artigos, a análise de suas referências bibliográficas e a utilização de mais 5 artigos base resultaram nos 111 estudos consultados para a realização dessa pesquisa. Resultados: A ampliação foraminal intencional nem sempre pode ser praticada em virtude de razões anatômicas e morfológicas. Quanto maior a ampliação do forame apical, maior a possibilidade de extravasamento de substâncias e/ou materiais utilizados para a realização do tratamento endodôntico. A instrumentação foraminal intencional parece ser contraindicada em pacientes que fazem ou fizeram uso de bisfosfonatos recentemente, com distúrbios de coagulação e/ou sob uso crônico de anticoagulantes e com alto risco de bacteremia. Conclusões: Os impactos da instrumentação foraminal intencional sobre o sucesso do tratamento endodôntico devem ser investigados. Contudo, os delineamentos metodológicos dos estudos clínicos devem ser cuidadosos, principalmente no tocante às condições sistêmicas dos pacientes que farão parte do universo amostral (AU).

Introduction: endodontic infection can reach and even go beyond the apical foramen. Therefore, determining apical constriction as the ideal limit for instrumentation and obturation has been questioned. Intentional foraminal enlargement is performed for the purpose of reducing the microbial contingent to levels more favorable to repair. However, local and systemic repercussions have been associated with this approach. Objectives: to critically review the literature on local and systemic repercussions relative to intentional foraminal enlargement. Methods: in March 2018, an electronic search performed on the PUBMED database using the terms "foraminal enlargement" OR "foraminal widening" OR "apical limit" AND "endodontics" identified 74 scientific articles. These articles, analysis of their references and use of another 5 base articles resulted in the 115 studies used for performing this research. Results: intentional foraminal enlargement cannot always be performed due to the anatomical and morphological conditions. The greater the apical foramen enlargement, the greater the possibility of extrusion of substances and/or materials used to perform endodontic treatment. Intentional foraminal enlargement seems to be contraindicated in patients who are taking or have recently used bisphosphonates, those with coagulation disorders and/ or under chronic use of anticoagulants and at high risk for bacteremia. Conclusions: the impacts of intentional foraminal enlargement on the success of endodontic treatment should be investigated. However, the methodological procedures of clinical studies should be carefully designed, especially taking into consideration the systemic conditions of patients who will be part of the sample (AU).

Three Dimensional mapping of the root apex: distances between apexes and anatomical structures and external cortical plates.

This study aimed to determine the mean distances between apexes of the maxillary posterior teeth and the maxillary sinus, between apexes of the mandibular posterior teeth and the mandibular canal, and between the root apexes of all teeth and the adjacent cortical plates. A total of 800 cone-beam computed tomography (CBCT) scans (400 maxillary and 400 mandibular) were obtained from patients indicated for several treatments. The proximity between apexes and anatomical structures, and the relationship between apexes and adjacent cortical plates were assessed together with the risk of over-instrumentation. Paired-sample comparisons were performed by using the paired t-test. The means were compared by ANOVA, Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests. a) Most of the apexes classified as A (high-risk proximity) were observed in maxillary first and second molars, in mandibular first and second molars, and in second premolars in relation to near anatomical structures. b) A predominance of class A (86.42%) was noticed in the first premolars, between apexes of maxillary teeth and adjacent cortical plates. c) The distance between apexes of mandibular teeth and buccal cortical plates showed a predominance of medium-risk proximity (B) in all the groups, except the first premolars, with the highest risk (82.22%), and the second molars, with low-risk proximity (C) to distal and mesiobuccal apexes (91.77% and 89.62%). CBCT images are important for endodontic diagnosis and treatment, since many teeth have high risk proximity to near anatomical structures and adjacent cortical plates.

Three Dimensional mapping of the root apex: distances between apexes and anatomical structures and external cortical plates

Abstract This study aimed to determine the mean distances between apexes of the maxillary posterior teeth and the maxillary sinus, between apexes of the mandibular posterior teeth and the mandibular canal, and between the root apexes of all teeth and the adjacent cortical plates. A total of 800 cone-beam computed tomography (CBCT) scans (400 maxillary and 400 mandibular) were obtained from patients indicated for several treatments. The proximity between apexes and anatomical structures, and the relationship between apexes and adjacent cortical plates were assessed together with the risk of over-instrumentation. Paired-sample comparisons were performed by using the paired t-test. The means were compared by ANOVA, Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests. a) Most of the apexes classified as A (high-risk proximity) were observed in maxillary first and second molars, in mandibular first and second molars, and in second premolars in relation to near anatomical structures. b) A predominance of class A (86.42%) was noticed in the first premolars, between apexes of maxillary teeth and adjacent cortical plates. c) The distance between apexes of mandibular teeth and buccal cortical plates showed a predominance of medium-risk proximity (B) in all the groups, except the first premolars, with the highest risk (82.22%), and the second molars, with low-risk proximity (C) to distal and mesiobuccal apexes (91.77% and 89.62%). CBCT images are important for endodontic diagnosis and treatment, since many teeth have high risk proximity to near anatomical structures and adjacent cortical plates.

Pictograph system for diagnosis making and data management in endodontics / Sistema de pictograma para elaboração de diagnóstico e gerenciamento de dados em endodontia

Objective: this questionnaire aimed to evaluate the approval of a new pictograph system for endodontic diagnosis by undergraduate and graduate students/endodontist instead of a conventional method. Methods: after a presentation to a total of 224 participants explaining the pictograph system, the participants (166 undergraduate students and 58 graduate students/endodontist) received a standardized questionnaire with three questions. The data were analyzed using the mult prop macro basing on Tukey's test for multiple comparison with (P ≤ 0.05). The first question was to define the education level of the participants; the second question about which diagnosis method is preferred; and the third question about the intention of using one of the methods in the future. The questionnaire was realized in May 2019. The response rate was 97.7%. Results: the first question showed that 74.10% and 25.90% were under graduate and graduate students/endodontist respectively. After statistical analysis there was no significant difference between the groups in the second and the third questions. In the second question (71.08% and 62.06%) of undergraduate and graduate student/endodontists respectively preferred the pictograph method over the conventional method. In the third question (60.24% and 51.72%) of undergraduate and graduate student/endodontists respectively showed interest in using the pictograph method in their professional career. Conclusion: the pictograph method in endodontic diagnosis is accepted by the majority of undergraduate and graduate students/endodontists. Training and experience affect the diagnosis making. (AU)

Objetivo: este questionário teve como objetivo avaliara aprovação de um novo sistema de imagem para diagnóstico endodôntico por estudantes de graduação e pós-graduação/endodontista, em vez de um método convencional. Métodos: após uma apresentação a um total de 224 participantes explicando o sistema de pictograma, os participantes (166 estudantes de graduação e 58 de pós graduação/endodontista) receberam um questionário padronizado com três perguntas. Os dados foram analisados usando a macro multi propósito baseada no teste de Tukey para comparação múltipla com (P ≤ 0,05). A primeira pergunta foi definir o nível de escolaridade dos participantes; a segunda pergunta sobre qual método de diagnóstico é preferido; e a terceira pergunta sobre a intenção de usar um dos métodos no futuro. O questionário foi realizado em maio de 2019. A taxa de resposta foi de 97,7%. Resultados: a primeira pergunta mostrou que 74,10% e 25,90% eram estudantes de graduação e pós-graduação / endodontista, respectivamente. Após análise estatística, não houve diferença significativa entre os grupos na segunda e na terceira questões. Na segunda questão (71,08% e 62,06%) dos estudantes de graduação e pós-graduação / endodontistas, respectivamente, preferiram o método de pictograma ao método convencional. Na terceira questão (60,24% e 51,72%) dos estudantes de graduação e pós-graduação /endodontistas, respectivamente, demonstraram interesse em utilizar o método de pictograma em sua carreira profissional. Conclusão: o método do pictograma no diagnóstico endodôntico é aceito pela maioria dos estudantes de graduação e pós-graduação / endodontistas. Treinamento e experiência afetam a elaboração do diagnóstico (AU)

Endodontic treatment of a large periapical cyst with the aid of antimicrobial photodynamic therapy: case report / Tratamento endodôntico de um grande cisto periapical com o auxílio de terapia fotodinâmica antimicrobiana: relato de caso

Introduction: Periapical cysts, especially those of great extension, represent a challenge for endodontics, due to the ineffectiveness of traditional root canal treatment (RCT) in such cases. The aim of this case report was to evaluate the effectivity of antimicrobial photodynamic therapy "aPDT" when associated with calcium hydroxide Ca(OH)2 in treating such cysts. Case report: A 40-years-old female patient complained of bulging in the upper anterior region of the mouth. The clinical examination showed an extensive swollen periodontal area, painful with digital palpation, with a negative response to thermal tests on teeth 11 and 21. After traditional RCT, the canals of teeth 11 and 21 were filled with photosensitizer methylene blue 0.005% for 5 min pre irradiation time (PIT) and irradiated by low power diode laser with visible red wavelength (660 nm) during 2 minutes without intervals, using an optical fiber delivering system with a helical movement from apical to cervical. Then the canals were filled with Ca(OH)2 paste for 45 days and had been changed each 15 days, and repeating the radiation. Results: After 45 days, the patient already had a bulging remission, with painless resistance to the apical pressure over the region and signs of bone repair confirmed with the radiographic examination, and total absence of signs or symptoms. Conclusion: the association of aPDT with Ca(OH)2 paste is effective in treating of periapical lesions of great extension and avoids surgical treatment. (AU)

Introdução: os cistos periapicais, especialmente os de grande extensão, representam um desafio para a endodontista, uma vez que não são reparados com o tratamento endodôntico tradicional. O objetivo deste relato de caso foi avaliar a efetividade da terapia fotodinâmica antimicrobiana "aPDT" quando associada ao hidróxido de cálcio Ca(OH)2 no tratamento desses cistos. Relato de caso: paciente do sexo feminino, 40 anos, com queixa de abaulamento na região ântero-superior da boca. O exame clínico evidenciou extensa área periodontal inchada, dolorosa com palpação digital, com resposta negativa aos testes térmicos dos dentes 11 e 21. Após o tratamento endodôntico tradicional, os canais dos dentes 11 e 21 foram preenchidos com fotossensibilizador de azul de metileno a 0,005% de tempo de pré-radiação de 5 min e irradiados por laser de diodo de baixa potência com comprimento de onda vermelho visível (660 nm) por 2 min sem intervalos, usando um sistema de fornecimento de fibra ótica com um movimento helicoidal do apical ao cervical. Em seguida, o canal foi preenchido com pasta de Ca(OH)2 por 45 dias sendo trocados a cada 15 dias e repetida a radiação. Resultados: Após 45 dias, o paciente já apresentava uma remissão volumosa, com resistência indolor à pressão apical na região e sinais de reparo ósseo ao exame radiográfico e ausência total de sinais ou sintomas. Conclusão: a associação de aPDT com Ca(OH)2 é eficaz no tratamento de lesões periapicais de grande extensão e evitar tratamento cirúrgico (AU)

Acting and knowledge of emergency rescue teams in dental trauma / Atuação e conhecimento de equipes de resgate de emergência em casos de trauma dental

Objetivo: O traumatismo dentário é regularmente freqüente em pacientes atendidos por equipes de resgate em locais de acidentes e por equipes de emergência em hospitais. No entanto, esses profissionais recebem pouca ou nenhuma informação sobre como cuidar e atuar em casos de lesões traumáticas em tecidos duros e moles. O objetivo deste estudo foi avaliar o nível de conhecimento dos profissionais das equipes de resgate e emergência (médicos, enfermeiros e paramédicos) sobre o atendimento do traumatismo dentário. Material e métodos: 196 profissionais das unidades de resgate e emergência receberam um questionário padronizado de 5 questões referentes ao atendimento do traumatismo dentário e preservação de tecido dentário avulsionado (um dente ou seu fragmento). Resultados: os resultados mostraram um alto nível de atendimento de pacientes de traumatismo dentário por paramédicos, enfermeiros e médicos, com conhecimento muito baixo sobre como lidar com esses casos, e com resultados moderados sobre o melhor meio para preservar o dente avulsionado, e as ações tomadas durante o processo de resgate. Conclusão: há uma alta ocorrência de casos de traumatismos dentários atendidos por equipes de resgate e emergência, com falta de conhecimento, o que sugere a necessidade de mais campanhas educativas para esses profissionais com acompanhamento a longo prazo. (AU)

Anticoagulant effects of phytotherapeutic drugs and their importance in surgical dental procedures / Efeitos anticoagulantes de drogas fitoterapicas e sua importância em procedimentos odontológicos cirúrgicos

ABSTRACT Phytotherapeutic drugs are plant-derived products with medicinal properties. They are used for treating or preventing several diseases. However, patients who use these substances and even health professionals are unaware of their negative effects. One of the most common negative effects of phytotherapeutic drugs reported in the literature is the inhibition of natural coagulation factors in the human body. Therefore, the aim of this study was to perform a brief review of the literature concerning the anticoagulant effects of phytotherapeutic drugs and their importance in surgical dental procedures. Preventive measures, clarification and monitoring of patients taking phytotherapeutic drugs are recommended before performing surgical dental procedures, in order to prevent against complications such as hemorrhage.

RESUMO Fitoterápicos são produtos derivados de plantas com propriedades medicinais. Eles são utilizados para o tratamento ou a prevenção de diversas doenças. No entanto, os pacientes que fazem uso destas substâncias, na sua grande maioria, desconhecem seus efeitos negativos. Portanto, o objetivo deste estudo foi realizar uma breve revisão de literatura sobre os efeitos anticoagulantes de fitoterápicos e sua importância diante da realização de procedimentos odontológicos cirúrgicos. Medidas de prevenção, esclarecimento e acompanhamento de pacientes que se utilizam destes medicamentos são recomendados antes da realização destes procedimentos a fim de prevenir complicações como processos hemorrágicos.

Mapeamento tridimensional do ápice radicular em relação às corticais ósseas externas e estruturas anatômicas adjacentes / Three-dimensional risk mapping of root apices in relation to external cortical bones and adjacent anatomical structures

O conhecimento da posição topográfica dos ápices dentários em relação às corticais ósseas externas e estruturas anatômicas é de importância para a endodontia, sobretudo quando da instituição de técnicas com sobreinstrumentação. A tomografia computadorizada de feixe cônico (TCFC) permite uma análise tridimensional da localização do ápice radicular, estimando os riscos em relação a essas estruturas. Os objetivos desta pesquisa foram: a) aferir a medida linear entre os ápices radiculares de dentes posteriores e canino superiores e o seio maxilar e entre os ápices de dentes posteriores inferiores e o canal mandibular, relacionando os achados com gênero e idade; b) comparar as medições realizadas em tomografias entre ápices e estruturas anatômicas, com as realizadas em radiografias panorâmicas; c) verificar a proximidade dos ápices radiculares dos dentes superiores com a respectiva cortical óssea externa adjacente e dos ápices radiculares dos dentes inferiores com as corticais ósseas externas vestibular e lingual; d) verificar a ocorrência de fenestrações apicais, em todos os grupos dentais e e) classificar riscos de sobreinstrumentação baseando-se nas medidas lineares entre ápices radiculares e estruturas anatômicas/ corticais ósseas externas. Foram selecionados 800 TCFCs e 200 radiografias panorâmicas obtidas de pacientes com indicações diversas. Na TCFC, foram encontradas médias entre os ápices radiculares e o seio maxilar, variando de 0,37mm até 6,22mm, e na mandíbula, entre os ápices e o forame mentoniano, variando de 2,81mm até 4,92mm. Ao comparar as distâncias determinadas pela TCFC e panorâmica, verificou-se superestimação e subestimação das medidas na maxila e mandíbula, respectivamente (p<0,01). As distâncias entre cada ápice e sua respectiva cortical óssea foram classificadas de acordo com a distância, com maioria de ápices a menos de 1mm de distância na maxila e com mais de 3mm na mandíbula. A ocorrência de fenestrações registrou maiores índices na maxila, sendo que em mandíbula foram registrados em relação às fenestrações da cortical óssea lingual. Concluímos que a) há determinados ápices que estão frequentemente em posição de risco em relação às estruturas anatômicas, sobretudo o seio maxilar; b) houve diferenças estatisticamente significantes entre as medições realizadas em tomografias e radiografias panorâmicas; c) há determinados ápices, principalmente na maxila, que estão em íntimo contato com as corticais ósseas externas; d) houve ocorrências importantes de fenestração apical em determinados ápices dentais, e e) os riscos de sobreinstrumentação determinados pelas medidas lineares entre ápices e estruturas anatômicas e corticais ósseas externas foram altos para determinados ápices e esses riscos foram mais importantes para sobreinstrumentações maiores que 1mm(AU)

It is important to know the topographic position of dental root apices in relation to external cortical bones and adjacent anatomical structures for endodontics, mainly regarding the use of over-instrumentation techniques. Cone beam computed tomography (CBCT) allows for analysis of the root apex position and estimation of the risks in relation to these structures. The objectives of this study were: a) to assess the linear measurement between root apices of posterior teeth and upper canine and maxillary sinus as well as between apices of lower posterior teeth and mandibular canal according to gender and age; b) to compare tomographic measurements of apices and anatomical structures to those from panoramic radiographs; c) to verify the proximities of the root apices of upper teeth to corresponding adjacent cortical bones and of lower teeth to buccal and lingual cortical bones; d) to verify the occurrence of apical fenestrations in all dental groups; and e) to assess the risks of over-instrumentation based on linear measurements between root apices and anatomical structures/external cortical bones. A total of 800 tomographs and 200 panoramic radiographs were selected. CBCT images showed mean distances between root apices and maxillary sinus ranging from 0.37mm to 6.22mm and between root apices and mental foramen ranging from 2.81mm to 4.92mm. By comparing the tomographs to panoramic radiographs, over-estimation and sub-estimation were found in the maxillary and mandibular measurements, respectively (P < 0.01). The distances between each root apex and corresponding cortical bone were ranked according to distance, with the majority of the apices located less than 1 mm from the cortical bone in the maxilla and greater than 3mm in the mandible. Higher rates of fenestrations were found in the maxilla, whereas lingual bone plate was more affected in the mandible. We have concluded that: a) there are certain root apices which are frequently at risk position in relation to anatomical structures, mainly in the maxillary sinus; b) there were statistically significant differences between tomographic and radiographic measurements; c) there are certain root apices, mainly in the maxilla, which are in close contact with external cortical bones; d) there were major occurrences of apical fenestrations in certain root apices, and e) the risks of over-instrumentation as determined by linear measurements between apices and anatomical structures/external cortical bones were found be high for certain root apices, and these risks were more significant regarding over-instrumentations greater than 1 mm(AU)

Diagnóstico diferencial da sinusite de origem odontológica por meio da tomografia computadorizada / Differential diagnosis of dental sinusitis with the aid of computed tomography

O objetivo do presente artigo é apresentar três casos clínicos com diagnóstico de sinusite de origem odontológica, ou síndrome endo-antral, um quadro inflamatório infeccioso de origem endodôntica que acomete dos tecidos e mucosa do seio maxilar adjacentes aos ápices radiculares.Os casos apresentados chamam a atenção para a dificuldade do diagnóstico apenas coma radiografia periapical e a importância da tomografia computadorizada como recurso auxiliar.

The aim of the current article is to report three clinical cases diagnosed as sinusitis of dental origin, or endo-antral syndrome, an inflammatory condition of endodontic infection origin that affects the tissues and mucosa of the adjacent maxillary sinus up to the root apex. The presented cases draw attention to the difficulty of diagnosis only with periapical radiography and the importance of computed tomography as an auxiliary resource.

The Impact of Apical Patency in the Success of Endodontic Treatment of Necrotic Teeth with Apical Periodontitis: A Brief Review.

Accumulation of soft tissue or dentinal remnants in the apical region is a common event that can cause blockage of root canals. This event can be avoided if apical patency is performed during the root canal shaping procedures. However, there is no consensus on the role of apical patency in relation to the success of endodontic treatment of necrotic teeth with apical periodontitis. Therefore, the purpose of this paper was to conduct a brief review on the role of apical patency in guaranteeing the success of endodontic treatments of necrotic teeth with apical periodontitis considering two other key points; the root canal anatomy and microbiology.

Antimicrobial activity of calcium hydroxide associated with anew vehicle (Triethanolamine) / Atividade antimicrobiana do hidróxido de cálcio associado à um novo veículo (Trietanolamina)

Objetivo: O objetivo deste estudo foi avaliar a capacidade antimicrobiana do hidróxido de cálcio associado à dois veículos convencionais (anestésico líquido e azeite de oliva) e um novo veículo (Trietanolamina). Material e Métodos: Inicialmente, os micro-organismos foram coletados de quatro incisivos superiores de um mesmo paciente que apresentavam tratamentos endodônticos insatisfatórios e periodontites apicais persistentes utilizando cones de papel absorvente esterilizados inseridos nos canais radiculares após a remoção do material obturador. Em seguida, estes foram cultivados em BHI durante 24 h e colocados em 10 placas de Petri com três orifícios preenchidos com as medicações avaliadas. Após 48 e 72 h, os halos de inibição foram aferidos. Resultados: Após aplicação do teste de Kruskal-Wallis com nível de significância de 1% (α = 0,01) foi observado que, hidróxido de cálcio associado à Trietanolamina, apresentou resultados semelhantes àqueles produzidos pelo líquido anestésico. Ambas as combinações foram superiores ao hidróxido de cálcio veiculado ao azeite de oliva. Conclusão: Considerando os resultados deste estudo in vitro, é possível concluir que Trietanolamina pode ser uma alternativa viável para ser utilizada como veículo associado ao hidróxido de cálcio.

Objective: The aim of this study was to evaluate the antimicrobial effectiveness of calcium hydroxide associated with a two conventional (anesthetic liquidand olive oil) and a new vehicle (Triethanolamine). Material and methods: Initially, microorganisms were collected from four upper incisors presenting unsatisfactory root canal treatments and persistent apical periodontitis from the same patient using sterile absorbent paper cones placed inside the root canal following initial access and root filling removal. Next, they were grown in a BHI culturemedium for 24 h. Afterwards, they were placed in 10 Petri dishes with 3 holes, where different formulations of the medications studied were placed. After 48 and 72 h, readings were taken of the growth inhibition halos. Results: After using Kruskal-Wallis test with significance level of 1% (α = 0.01) it was observed that, calcium hydroxide associated with Triethanolamine, produced results similar to those produced by the anesthetic liquid. Both combinations were superior to the association with olive oil. Conclusion: Considering the results of this in vitrostudy, it is possible to consider that Triethanolamine can be a viable alternative to be used as a vehicleassociated with the calcium hydroxide.

Dental trauma and level of information: mouthguard use in different contact sports.

The objective of the present work was to study the occurrence of dental trauma in different sports, as well as to check if athletes used mouthguard during sport activities, and knew the significance of its utilization. The professional and semi-professional athletes who practised contact sports were interviewed, and were analyzed to determine the occurrence of dental trauma during sport practice, as well as if the athletes used a mouthguard and knew its indication. Results showed a high rate of dental trauma in athletes compared to the general population. The majority of athletes also demonstrated little utilization of mouthguard, in spite of the information about usage during sports practices and a general knowledge of its uses.