Marginal gaps and voids using two warm compaction techniques and different sealers: a micro-CT study.

OBJECTIVE: To assess the percentage of marginal gaps and voids in oval-shaped canals obturated by using two warm compaction techniques with a Bio-C sealer and AH Plus Jet. MATERIALS AND METHODS: Forty canines with oval canals were scanned by microcomputed tomography (micro-CT), and root canal preparation was performed with an XP-endo Shaper system and irrigated with 5.25% sodium hypochlorite. Then, the specimens were paired into four groups (n=10) according to the root canal filling technique and endodontic sealer: Bio-C sealer and continuous wave of condensation, Bio-C sealer and Tagger's hybrid, AH Plus Jet and continuous wave of condensation, and AH Plus Jet and Tagger's hybrid. After root canal filling, a new scan was performed. The percentage of marginal gaps and voids was calculated with the ImageJ software, and the data were analyzed statistically using two-way ANOVA and Tukey tests, with a significance level of 5%. RESULTS: The percentage of marginal gaps was significantly lower in the Bio-C sealer than in AH Plus Jet (p=0.021) regardless of the technique. However, no difference was found in the percentage of voids between root canal filling techniques and the endodontic sealer (p>0.05). CONCLUSION: Both sealers and techniques demonstrated good quality of root canal filling. However, the use of the Bio-C sealer enhanced the filling ability by reducing marginal gaps, regardless of the root canal filling technique. CLINICAL RELEVANCE: This study highlights the better performance of the Bio-C sealer in the quality of the root canal filling, reducing marginal gaps when compared to AH Plus Jet independent of the technique.

The thermoplastic techniques or single-cone technique on the quality of root canal filling with tricalcium silicate-based sealer: An integrative review.

Background: The filling of the root canal system (RCS) is an important step in endodontic treatment and aims to obtain a three-dimensional sealing of the root canal spaces to prevent bacterial contamination. For this, the selection of an appropriate sealer must be performed synchronously with the choice of the root canal filling technique. This study aims, through an integrative review, to evaluate the quality of root canal filling by comparing thermoplastic and single-cone (SC) techniques. Material and Methods: The Medline/PubMed, Scopus, Web of Science and Virtual Health Library (VHL) databases were used to find articles published until November 2021. The eligibility criteria comprised articles that evaluating the quality of root canal filling comparing thermoplastic techniques with the SC technique using tricalcium silicate-based sealer. Studies that evaluated primary teeth, endodontic retreatment or perforations, different outcomes, and studies that considered artificial teeth or different sealer and material for obturation of different techniques were excluded. For articles that were not available for access, an additional contact with authors were considered. A total of 1699 articles were found. After duplicate removal, the title and abstract of 828 articles were screened. Sixteen articles were considered for full-text analysis, but only ten articles met the eligibility criteria. Data extracted from the studies were discussed and tabulated to allow the comparison of desired factors. Results: Concerning the formation of gaps/voids, the thermoplastic techniques showed better results than the SC technique in 3 articles. On the other hand, 2 articles reported no statistical difference between the tested techniques. In addition, about the penetration of tricalcium silicate-based sealer in the dentinal tubules, of the 5 articles selected, in 4 there was no significant difference between the tested techniques and only one study showed better penetration of the sealer when using thermoplastic techniques. Conclusions: The thermoplastic technique was better in most selected studies regarding gaps and voids, but regarding the penetration of the sealer into the tubules, both techniques were effective. Key words:Root canal filling, thermoplastic techniques, tricalcium silicate.

Bio-C Repair - A New Bioceramic Material for Root Perforation Management: Two Case Reports.

These case reports aimed to describe the management of lateral perforation in the middle cervical third of the root in two maxillary incisors with pulp canal calcification using Bio-C Repair, with safe and viable clinical treatment strategies. Digital radiographic exams were obtained with different angles and analyzed using different filters. Cone-beam computed tomography (CBCT) images were requested to show the actual position of the canal, location of the perforation, and guide the strategic planning of the case. Subsequently, cavity access was prepared with the aid of dental operating microscopy. After perforation was identified, granulation tissue was removed and the original canal was identified and then dressed with calcium hydroxide. In the second visit, the perforation was filled with Bio-C Repair and the canal system filled with gutta-percha points and a root canal sealer (Bio-C Sealer). The teeth were restored with glass fiber post, 4 mm beyond the perforation level, and provisory crowns. Both teeth treated as described above were functional and asymptomatic with a 1-year clinical and radiographic assessment. The Bio-C Repair is suggested as a new cement option for the management of lateral canal perforations, with effective results as observed after a one-year follow-up.

O uso da tomografia computadorizada de feixe cônico no diagnóstico e no gerenciamento de insucesso endodôntico: relato de caso clínico / The use of cone beam computed tomography in the diagnosis and management of endodontic failure: clinical case report

Objetivo: descrever um caso clínico em que a tomografia computadorizada de feixe cônico (TCFC) foi utilizada para auxiliar no diagnóstico e no melhor gerenciamento de retratamento endodôntico. Relato de caso: uma paciente compareceu à clínica com queixa de uma fístula na região dos molares superiores do lado direito há aproximadamente dois meses. Radiograficamente, observou-se lesão periapical do elemento 17. Após a confirmação da necessidade do retratamento, a paciente relatou já ter feito duas intervenções endodônticas nesse elemento. Assim, optou-se por solicitar um exame de TCFC, para melhores diagnóstico e planejamento do caso. Ao avaliar a TCFC, verificou-se presença de lesão periapical extensa, presença de espaços vazios no canal mesiovestibular (MV) e palatino (P), cone de guta percha além do ápice no canal distovestibular (DV) e localização do canal mesiopalatino (MP), que não havia sido manuseado anteriormente, rompimento de cortical óssea vestibular e palatino. Após planejamento, a paciente foi submetida ao retratamento endodôntico. Foi realizada a desobstrução dos canais radiculares com remoção do cone ultrapassando no canal DV, localização do MP e instrumentação completa de todos os canais. O hidróxido de cálcio foi utilizado como medicamento intracanal entre as consultas. Ao observar a regressão da fistula e os canais sem presença de exsudato, realizou-se a obturação do canal radicular. Considerações finais: a TCFC permitiu a visualização de erros operatórios pertinentes ao caso durante os tratamentos endodônticos prévios, o que possibilitou a indicação de um novo tratamento endodôntico e a manutenção do dente na arcada dentária.(AU)

Objective: to describe a clinical case where cone beam computed tomography (CBCT) was used to assist in the diagnosis and better management of endodontic retreatment. Case report: the patient attended the clinic complaining of a fistula in the upper molar region on the right side for approximately two months. Radiographically, the presence of a periapical lesion of element 17 was observed. After confirming the need for retreatment, the patient reported having already undergone two endodontic interventions on this tooth. Thus, it was decided to request a CBCT exam for better diagnosis and case planning. When assessing the CBCT, there was the presence of extensive periapical lesion, presence of empty spaces in the mesiobuccal (MB) and palatal (P) canal, gutta percha cone beyond the apex in the distobuccal (DB) canal and location of the mesiopalatal (MP) canal - which had not been previously handled -, rupture of the cortex vestibular and palatal bone. After planning, the patient underwent endodontic retreatment. Then, all the previous filling material were removed, including the gutta-percha by passing into the DB canal, MP was localized and complete instrumentation of all root canals were done. Calcium hydroxide was used as an intracanal medication between appointments. When the regression of the fistula was observed and canals were without exudate, root canal filling was performed. Final considerations: the CBCT allowed the visualization of operative errors pertinent to the case during previous endodontic treatments, which allowed the indication of a new endodontic treatment and the maintenance of the tooth in the dental arch.(AU)

Bio-c repair - a new bioceramic material for root perforation management: two case reports

Abstract These case reports aimed to describe the management of lateral perforation in the middle cervical third of the root in two maxillary incisors with pulp canal calcification using Bio-C Repair, with safe and viable clinical treatment strategies. Digital radiographic exams were obtained with different angles and analyzed using different filters. Cone-beam computed tomography (CBCT) images were requested to show the actual position of the canal, location of the perforation, and guide the strategic planning of the case. Subsequently, cavity access was prepared with the aid of dental operating microscopy. After perforation was identified, granulation tissue was removed and the original canal was identified and then dressed with calcium hydroxide. In the second visit, the perforation was filled with Bio-C Repair and the canal system filled with gutta-percha points and a root canal sealer (Bio-C Sealer). The teeth were restored with glass fiber post, 4 mm beyond the perforation level, and provisory crowns. Both teeth treated as described above were functional and asymptomatic with a 1-year clinical and radiographic assessment. The Bio-C Repair is suggested as a new cement option for the management of lateral canal perforations, with effective results as observed after a one-year follow-up.

Resumo O presente relato de caso teve como objetivo descrever o manejo da perfuração lateral no terço médio cervical da raiz em dois incisivos superiores com calcificação pulpar utilizando o Bio-C Repair, com estratégias de tratamento clínico seguras e viáveis. Radiografias digitais foram obtidas em diferentes ângulos e analisadas com diferentes filtros. Imagens de tomografia computadorizada de feixe cônico (TCFC) foram solicitadas para mostrar a real posição do canal e a localização da perfuração, e orientar o planejamento estratégico do caso. Posteriormente, o acesso à cavidade foi preparado com auxílio de microscopia cirúrgica. Após a identificação da perfuração, o tecido de granulação foi removido, o canal original foi identificado e, em seguida, recebeu medicação intracanal à base de hidróxido de cálcio. Na segunda visita, a perfuração foi selada com Bio-C Repair e o sistema de canais obturado com cones de guta-percha e cimento endodôntico (Bio-C Sealer). Os dentes foram restaurados com pino de fibra de vidro, 4 mm além do nível da perfuração, e coroas provisórias. Ambos os dentes tratados conforme descrito acima se mostraram funcionais e assintomáticos na avaliação clínica e radiográfica de 1 ano. O Bio-C Repair é sugerido como uma nova opção de cimento endodôntico para o manejo de perfurações laterais, com resultados efetivos observados após um ano de acompanhamento.

The importance of bioceramics and computed tomography in the late clinical management of a horizontal root fracture: A case report.

Root fractures resulting from dental trauma involve dentin, cementum and pulp. The present study aimed to demonstrate the importance of cone-beam computed tomography (CBTC) and bioceramics in the correct planning and intervention of a horizontal root fracture case in tooth 11 with late treatment in an 18-year-old patient. Clinical and radiographic examinations revealed tooth displacement, pain on vertical percussion and images suggestive of a horizontal root fracture. Pulp necrosis was diagnosed and CBTC was requested for treatment planning. Subsequently, endodontic treatment was performed using a bioceramic apical plug. A 2-year follow-up indicated the absence of root resorption and normal periodontal and periapical tissues. It was concluded that endodontic treatment associated with the use of bioceramics and the aid of CBTC is an effective therapeutic option in cases of permanent horizontal root fractures. Key words:Bioceramics, Cone-beam computed tomography, dental Injuries, root fracture.

Capacidade de Adesão de Cimentos Biocerâmicos e Resinosos com a Dentina Radicular: Uma Revisão Integrativa / Adhesion capacity of bioceramic and resin-based root canal sealer to root dentin: an integrative review

Objetivo: comparar a capacidade de adesão do cimento biocerâmico EndoSequence BC e do cimento resinoso AH Plus através de uma revisão integrativa. Material e Métodos: os bancos de dados online Medline/PubMed, Scopus, Web of Science e BVS foram utilizados para a revisão da literatura. Os critérios de elegibilidade incluíram artigos disponíveis na íntegra nas bases de dados pesquisadas, em inglês, e o conteúdo referente à adesão do cimento Endosequence BC sealer em comparação ao AH Plus. Resultados: foram encontrados 45 artigos. Após a remoção duplicada, 22 artigos foram selecionados. Após a leitura dos resumos, textos completos e aplicação dos critérios de inclusão, foram incluídos no total oito artigos. Em relação à capacidade de adesão dos cimentos testados, o AH Plus apresentou melhor adesão do que o cimento BC sealer em três artigos e menor adesão em dois artigos. Força de adesão semelhante foi observada entre os grupos em três estudos. Conclusões: com base nos estudos incluídos, o AH Plus apresenta maior resistência de união quando comparado ao BC Sealer

Aim: To compare the adhesion capacity of the bioceramic EndoSequence BC sealer and the AH Plus sealer through an integrative review. Methodology: The Medline/PubMed, Scopus, Web of Science and VHL online databases were used for the literature review. Eligibility criteria comprised articles available in full on the researched databases, in English, and content addressing Endosequence BC sealer adhesion compared to AH Plus sealer. Results: A total of 45 articles were found. After duplicate removal, 22 articles were selected. After reading the abstracts, full texts and applying the inclusion criteria, eight articles in total were included in the present study. Concerning the adhesion capacity of the tested cements, the AH Plus was reported as presenting better adhesion than the BC sealer in three articles, and less adhesion in two articles. Similar adherence strength was observed between groups in three studies. Conclusions: Based on the included studies, the AH Plus displays greater bond strength when compared to the BC Sealer.

Intrusive Dislocation in Permanent Teeth: Review of Literature and Clinical Case Report / Luxación Intrusiva en Dientes Permanentes: Revisión de Literatura e Informe de Caso Clínico

ABSTRACT: Intrusive dislocation is an unusual and severe trauma, where the tooth is displaced axially into the alveolar bone, causing damage to the periodontal and pulpal tissues. The objective was to report a case of intrusive dislocation on a right maxillary central incisor of a 12-year-old patient, where the proposed treatment was immediate surgical repositioning. Clinical and radiographic examination revealed partial tooth intrusion and complete root formation. The impacted tooth was surgically repositioned and immobilized. Subsequently, the endodontic treatment of the tooth associated with intracanal medication was performed. After 10 months of successive calcium hydroxide changes, the root canal system was filled. Clinical-radiographic follow-ups were performed over 5 years and 7 months, revealing discrete root resorption. It was concluded that immediate surgical repositioning, associated with adequate root canal therapy may be an effective therapeutic option in cases of intrusive dislocation of permanent teeth.

RESUMEN: La luxación intrusiva es un trauma inusual y severo, en el que el diente se desplaza axialmente hacia el hueso alveolar, causando daño a los tejidos periodontales y pulpares. El objetivo fue informar un caso de luxación intrusiva en un incisivo central superior derecho de un paciente de 12 años, donde el tratamiento propuesto fue el reposicionamiento quirúrgico inmediato. El examen clínico y radiográfico reveló una intrusión dental parcial y la formación completa de la raíz. El diente afectado fue reposicionado e inmovilizado quirúrgicamente. Posteriormente, se realizó el tratamiento endodóntico del diente asociado con la medicación intracanal. Después de 10 meses de sucesivos cambios de hidróxido de calcio, se llenó el sistema de conductos radiculares. Los seguimientos clínico-radiográficos se realizaron durante 5 años y 7 meses, revelando la resorción discreta de la raíz. Se concluyó que el reposicionamiento quirúrgico inmediato, asociado con la terapia adecuada del conducto radicular, puede ser una opción terapéutica efectiva en casos de luxación intrusiva de dientes permanentes.

Associação Brasileira de Odontologia (ABO/GV)

O sucesso do tratamento endodôntico envolve a devida capacidade de limpeza e modelagem dos sistemas de canais radiculares, contudo, não há consenso na literatura sobre os sistemas de lima única Reciproc e WaveOne em termos de formatação do canal. Objetivo: comparar a efetividade na formatação dos canais radiculares utilizando os sistemas Reciproc e WaveOne, no que tange ao transporte e à centralização do preparo. Método: o plano sistemático para a execução desta revisão integrativa consistiu em quatro etapas. Realizou-se um levantamento bibliográfico nas seguintes bases de dados: SciELO, PubMed e Lilacs, com os seguintes descritores: Reciproc e WaveOne, shaping canal, centering canal. Foi feita a leitura dos resumos que constavam nos artigos e documentos selecionados e a seleção daqueles que contemplavam de três a cinco descritores sobre o tema desta pesquisa. Em seguida, foi feita a leitura dos textos na íntegra, seguida pela construção de uma tabela com as informações levantadas nesse processo. Resultados: dos artigos selecionados, sete foram publicados em revistas odontológicas, sendo cinco publicados em revistas de área específica (endodontia) e apenas um foi publicado em uma revista de pesquisa básica de tecnologia. Verificou-se que a maior parte dos estudos foi publicada nos anos 2014 e 2015, a maioria publicada no Brasil e na Coreia. Conclusão: com base nos artigos estudados, não foi possível concluir que há diferença entre os instrumentos avaliados, quanto à centralização e à formatação do preparo após a utilização de Reciproc e WaveOne.

Avaliação comparativa da citotoxicidade dos cimentos MTA Fillapex e AH Plus: revisão integrativa / Comparative evaluation of cytotoxicity of MTA Fillapex and AH Plus cements: an integrative review

Objetivo: O objetivo deste estudo foi realizar uma revisão integrativa comparando a citotoxicidade dos cimentos MTA Fillapex e AH Plus aos tecidos periapicais. Métodos: Foram utilizados artigos na íntegra, nos idiomas português e inglês, publicados durante os períodos de 2010 a 2017, selecionados na base de dados Scielo e Pubmed, utilizando os seguintes descritores: AH Plus, MTA Fillapex e citotoxicidade. Foram excluídos, os trabalhos no idioma não inglês, artigos sem resumo, trabalhos realizados em dentes decíduos e casos clínicos. Resultados: Foram identificados dezenove artigos nas bases de dados, sendo dois artigos no SciELO e dezessete artigos no Pubmed. Após a leitura aprofundada desses artigos, foram excluídos seis artigos por não atenderem aos critérios de inclusão. Dessa forma, a amostra final foi composta por treze artigos científicos, todos de modelos experimentais, publicados em periódicos de procedência internacional, da área odontológica, sendo 50% dos estudos do ano de 2013. Conclusão: Os estudos demonstraram que o MTA Fillapex apresentou maior citotoxicidade aos tecidos periapicais que o cimento AH Plus.(AU)

Aim: This study aimed to perform an integrative review, comparing the cytotoxicity of MTA Fillapex and AH Plus cements to periapical tissues. Methods: Full articles were used in the Portuguese and English languages, published during from 2010 to 2017, selected in the Scielo and Pubmed database, using the following descriptors: AH Plus, MTA Fillapex, and cytotoxicity. Excluded were nonEnglish works, articles without abstracts, work done on primary teeth, and clinical cases. Results: Nineteen articles were identified in the databases, two articles in SciELO and seventeen articles in Pubmed. After the in-depth reading of these articles, six articles were excluded because they did not meet the inclusion criteria. Thus, the final sample consisted of thirteen scientific articles, all of which were experimental models published in international journals in the field of dentistry, with 50% of the studies published in 2013. Conclusion: The studies showed that MTA Fillapex presented greater cytotoxicity to periapical tissues than did the AH Plus cement.(AU)