Shaping Ability of TRUShape and XP-endo Shaper in C-Shaped Canals Using 3D-Printed Replicas: A Micro-CT Study.

OBJECTIVE: This study compared the shaping ability of TRUShape and XP-endo Shaper systems on C-shaped root canals replicas using microcomputed tomography (micro-CT). MATERIAL AND METHODS: Thirty three-dimensional replicas based on a mandibular second molar classified as C1 type I C-shaped canal were randomly divided into two groups (n = 15): TRUShape (G.TRU) and XP-endo Shaper (G.XP) and instrumented with each system according to the manufacturer's instructions. Changes in volume and surface and the unprepared area of the root canal were measured by scanning on micro-CT before and after instrumentation. RESULTS: The unprepared areas were 39% in the G.TRU and 43% in the G.XP group with no significant difference between them (p > 0.05), but both the tested systems left a high percentage of unprepared root canal walls of C-shaped root canals. CONCLUSION: TRUShape and XP-endo Shaper showed a high rate of unprepared areas with similar results after C-shaped root canals replicas for root canal preparation.

Evaluation of Receptor Activator of Nuclear Factor Kappa B Ligand, Osteoprotegerin, Osteopontin, and Tumor Necrosis Factor Alpha on Chronic Apical Periodontitis in Smokers.

INTRODUCTION: Smoking can be considered a risk factor for chronic apical periodontitis (CAP). This study compared the immunoexpression of biomarkers receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), osteopontin (OPN), and tumor necrosis factor alpha (TNF-α) in CAP in smokers and nonsmokers. METHODS: Twelve smokers and 12 nonsmokers diagnosed with CAP and indicated for tooth extraction were selected. Exclusion factors were teeth with a diagnosis of root fracture, previous endodontic treatment, or endoperiodontal injury, in addition to individuals with systemic diseases, under 18 years of age, users of anti-inflammatory and/or antibiotics in the last 3 months, and drug users. Specimens were processed for histopathologic and immunohistochemical analysis. RESULTS: Qualitative analysis of RANKL expression showed 66.66% weak/moderate and 33.33% strong in smokers and 100% weak/moderate in nonsmokers. OPG and OPN expressions were 100% negative to focal in the smoker group and 50% negative to focal and 50% weak/moderate in the nonsmoker group. TNF-α was 25% negative to focal and 75% weak/moderate in the smoker group and 33.33% negative to focal and 66.66% weak/moderate in the nonsmoker group. Quantitative analysis of the data using the Mann-Whitney U test showed that there was a significant difference in the immunoexpression of RANKL (P < .05), OPG (P < .05), and OPN (P < .05), but there was no statistical difference in the immunoexpression of TNF-α (P > .05) between the 2 groups. CONCLUSIONS: These findings suggest that smoking is capable of altering the inflammatory response, influencing the evolution of CAP.

Immunoexpression of Interleukin 17, 6, and 1 Beta in Primary Chronic Apical Periodontitis in Smokers and Nonsmokers.

INTRODUCTION: The purpose of this study was to compare the immunoexpression of biomarkers interleukin (IL)-17, IL-6, and IL-1ß in primary chronic apical periodontitis in smokers and nonsmokers. METHODS: Teeth with primary chronic apical periodontitis indicated for extraction in 16 cigarette smokers and 16 nonsmokers were selected. Silanized sections of tissue were used for immunohistochemical analysis after being stained with hematoxylin-eosin for histopathologic categorization. Subsequently, the images were analyzed with an optical microscope, and each slide was subdivided into 5 high-magnification fields, with scores (0-2) being assigned according to the amount of staining for each antibody. RESULTS: The qualitative analysis of IL-17 cytokine expression showed no focal expression in 5.8%, weak to moderate expression in 17.6%, and strong expression in 76.4% of the smokers and no focal expression in 78.5% and weak to moderate expression in 21.4% of the nonsmokers. IL-6 expression was negative to focal in 13.3%, weak to moderate in 53.3%, and strong in 33.3% of the smokers and negative to focal in 33.3%, weak to moderate in 25%, and strong in 41.6% of the nonsmokers. IL-1ß expression was weak to moderate in 87.5% and negative to focal expression in 12.5% of the smokers and negative to focal expression in 100% of the nonsmokers. Quantitative evaluation of the data using the Mann-Whitney U test showed a significant difference in the immunoexpression of IL-17 (P < .0001) and IL-1ß (P < .0001) and no significant difference in the immunoexpression of IL-6 (P = .46) between the 2 groups (P < .05). CONCLUSIONS: The cytokines IL-17 and IL-1ß were more highly expressed in smokers than nonsmokers, whereas IL-6 expression was similar in the 2 groups.

Dental trauma in primary dentition, its effect on permanent successors and on Oral Health-Related Quality of Life: a 4-year follow-up case report.

Traumatic dental injury (TDI) in deciduous teeth can affect itself and subsequent dentition due to its close anatomical relationship with the permanent germ. Besides, it can have psychologically undesirable effects on children and their parents and impact their Oral Health-Related Quality of Life (OHRQoL). In this case report, we aimed to describe a TDI in primary dentition that presented sequel on primary and on permanent dentition as well to describe the impact on OHRQoL after 4 years of follow-up. A 4-year-old boy was referred to the Dental Trauma Care Program (DTCP) six months after an accident at school that resulted in TDI. In deciduous dentition, the tooth 51 presented periapical lesion due to lateral luxation and tooth 61 presented pulp canal obliteration due to a concussion. The teeth received appropriate treatment. After 4 years of follow-up, in the permanent dentition, tooth 11 presented mild disturbance (demarcated opacity) as sequel of TDI in deciduous dentition. The patient's OHRQoL was evaluated throughout this process until the eruption of the permanent tooth. TDI and the sequelae on permanent tooth had a negative impact on the patient's OHRQoL. TDI treatment improved the patient's OHRQoL. This case report reinforces the importance of regular follow-up of traumatized teeth as it can affect both dentitions with a negative impact on OHRQoL.

Do Antimicrobial Photodynamic Therapy and Low-Level Laser Therapy Minimize Postoperative Pain and Edema After Molar Extraction?

PURPOSE: This study was designed to examine the efficacy of antimicrobial photodynamic therapy (aPDT) and low-level laser therapy (LLLT) in reducing postoperative pain and edema after molar extractions. METHODS: The investigators designed a single-blind randomized controlled study and enrolled subjects requiring extraction of at least one of the first or second molars. They were randomized to one of the following four groups: control group, aPDT group, LLLT group, and aPDT and LLLT group. Patients were blinded to the group assigned. The outcome variables were postoperative pain and edema. Pain intensity was measured on a visual analog scale (recorded every day for 7 days after tooth extraction). Facial edema was assessed by measuring the perimeter between the tragus, base of the jaw, and labial commissure, which was recorded once before surgery and then on the third and seventh days after surgery. Other variables were age, sex, ethnicity, decayed/missing/filled teeth, and tooth types. Appropriate univariate and bivariate statistics were computed and statistical significance was set at a value of P < .05. RESULTS: The sample was composed of 40 patients with a mean age of 41.25 ± 13.97 years and 25 (62.5%) of them were women. There were 10 subjects in each treatment group. The mean of postoperative pain within the groups was associated with a significant continuous decrease over time (P < .05). Postoperative pain was lowest in the aPDT + LLLT group in the 1st, 2nd, 3rd, 5th, 6th, and 7th day after tooth extraction (P < .05). There were no significant differences in edema among the groups (P > .05). CONCLUSION: The combined use of aPDT and LLLT was effective in reducing postoperative pain. These procedures can be applied in everyday surgical practice.

Genetic Polymorphism and Expression of Matrix Metalloproteinases and Tissue Inhibitors of Metalloproteinases in Periapical Lesions: Systematic Review.

INTRODUCTION: Recent studies involving genetic polymorphism and expression have provided information about their role in periapical lesions. This study aimed to evaluate if there is an association between the genetic polymorphism and gene and protein expressions of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) in the periapical inflammatory response. METHODS: A systematic review was conducted through a rigorous search in electronic databases as well as a hand search. Two reviewers (κ = 0.90) evaluated the studies considering predetermined eligibility criteria, extracted data for interpretation, and finally used the Strengthening the Reporting of the Genetic Association statement to determine the quality of the scientific evidence. RESULTS: The initial search identified 251 studies. After excluding the duplicates and applying the eligibility criteria, 15 studies were eligible to be assessed in full. Two studies had grade A and 13 grade B quality according to the Strengthening the Reporting of the Genetic Association and were included. The selected studies showed that the periapical lesion tissue samples had a high concentration of MMPs; moreover, there was an expressive decrease in the concentration of MMPs and TIMPs in patients with periapical lesions after mechanical chemical preparation. In relation to genetic polymorphisms, MMP1, MMP2, MMP3, and MMP8 were associated with a higher risk of periapical lesions. Moreover, MMPs 1, 2, 3, 7, 8, 9, 13, 14, 16, and 25 and TIMP 1, 2, 3, and 4 can play an important role in the progression of periapical lesions. CONCLUSIONS: Based on articles with medium to high quality, MMPs and TIMPs are associated with the formation of periapical lesions (PROSPERO number: CDR42018100406).

The influence of kinematics of engine-driven nickel-titanium instruments on root canal shape assessed by micro-computed tomography: a systematic review.

AIM: To evaluate if the kinematics of engine-driven instruments affect the root canal shape. METHOD: The systematic review was registered in PROSPERO (CRD 42017077043). A broad search was performed for articles published before 26 September 2018 in the electronic databases: pubmed, scopus, web of science and Lilacs using MeSH and free terms. Only in vitro studies with human teeth that evaluated root canal shape by volume, surface area and unprepared surface area using reciprocating and rotary system assessed by micro-computed tomography were included. A modified checklist for randomized controlled trials from the Joanna Briggs Institute was used to assess the risk of bias. RESULTS: Twenty-one articles were selected. According to quality assessment, all studies were considered 'moderate methodological quality'. Eighteen articles analysed volume increase, only four studies showed statistically significant difference, three indicating that the reciprocating movement obtained a greater increase in volume than the rotary system and one rotary system obtained a greater increase. Twelve studies analysed surface area, only three studies showed statistically significant difference, two presented a reciprocating system revealing greater amount of surface area and one showed a rotary system obtained a greater amount of surface area. Ten articles evaluated unprepared surface area, two studies that analysed total length, one study presented that the rotary system revealed lower unprepared surface area while another study showed reciprocating with less unprepared area. One study analysed middle and apical third, and observed that the rotary system presented lower unprepared surface area in the middle third. CONCLUSIONS: Both the rotary and reciprocating kinematics produce changes in volume and surface area and leave unprepared areas in the root canal, however reciprocating system showed greater increase of volume and surface area, while the rotary system maintains less unprepared surface area.

Investigations of the prevalence and virulence of Candida albicans in periodontal and endodontic lesions in diabetic and normoglycemic patients.

OBJECTIVE: The aim of this study was to investigate the prevalence of isolated Candida albicans from periodontal endodontic lesions in diabetic and normoglycemic patients, and the fungi's virulence in different atmospheric conditions. MATERIAL AND METHODS: A case-control study was conducted on 15 patients with type 2 diabetes mellitus (G1) and 15 non-diabetics (G2) with periodontal endodontic lesions. Samples of root canals and periodontal pockets were plated on CHROMagar for later identification by polymerase chain reaction (PCR) and virulence test. RESULTS: C. albicans was identified in 79.2% and 20.8% of the 60 samples collected from diabetic and normoglycemic patients, respectively. Of the 30 samples collected from periodontal pockets, 13 showed a positive culture for C. albicans, with 77% belonging to G1 and 23% to G2. Of the 11 positive samples from root canals, 82% were from G1 and 18% from G2. Production of proteinase presented a precipitation zone Pz<0.63 of 100% in G1 and 72% in G2, in redox and negative (Pz=1), under anaerobic conditions in both groups. Hydrophobicity of the strains from G1 indicated 16.4% with low, 19.3% with moderate, and 64.3% with high hydrophobicity in redox. In G2, 42.2% had low, 39.8% had moderate, 18% had high hydrophobicity in redox. In anaerobic conditions, G1 showed 15.2% with low, 12.8% with moderate, and 72% with high hydrophobicity; in G2, 33.6% had low, 28.8% had moderate, and 37.6% had high hydrophobicity. There was statistical difference in the number of positive cultures between G1 and G2 (p<0.05) with predominance in G1. There was statistical difference for all virulence factors, except hemolysis (p=0.001). CONCLUSIONS: Candida albicans was isolated more frequently and had higher virulence in diabetic patients.

Investigations of the prevalence and virulence of Candida albicans in periodontal and endodontic lesions in diabetic and normoglycemic patients

Abstract Pulpal and periodontal tissues have similar microbiota that allows cross-contamination between the pulp and periodontal tissues. Objective The aim of this study was to investigate the prevalence of isolated Candida albicans from periodontal endodontic lesions in diabetic and normoglycemic patients, and the fungi's virulence in different atmospheric conditions. Material and Methods A case-control study was conducted on 15 patients with type 2 diabetes mellitus (G1) and 15 non-diabetics (G2) with periodontal endodontic lesions. Samples of root canals and periodontal pockets were plated on CHROMagar for later identification by polymerase chain reaction (PCR) and virulence test. Results C. albicans was identified in 79.2% and 20.8% of the 60 samples collected from diabetic and normoglycemic patients, respectively. Of the 30 samples collected from periodontal pockets, 13 showed a positive culture for C. albicans, with 77% belonging to G1 and 23% to G2. Of the 11 positive samples from root canals, 82% were from G1 and 18% from G2. Production of proteinase presented a precipitation zone Pz<0.63 of 100% in G1 and 72% in G2, in redox and negative (Pz=1), under anaerobic conditions in both groups. Hydrophobicity of the strains from G1 indicated 16.4% with low, 19.3% with moderate, and 64.3% with high hydrophobicity in redox. In G2, 42.2% had low, 39.8% had moderate, 18% had high hydrophobicity in redox. In anaerobic conditions, G1 showed 15.2% with low, 12.8% with moderate, and 72% with high hydrophobicity; in G2, 33.6% had low, 28.8% had moderate, and 37.6% had high hydrophobicity. There was statistical difference in the number of positive cultures between G1 and G2 (p<0.05) with predominance in G1. There was statistical difference for all virulence factors, except hemolysis (p=0.001). Conclusions Candida albicans was isolated more frequently and had higher virulence in diabetic patients.

Intrusive luxation of an immature permanent incisor: a 10-year follow-up.

Intrusive luxation in the permanent dentition is rare and considered the most severe form of dental trauma. Intrusion is characterized by the axial displacement of the tooth into the alveolar bone. It normally affects pulpal vitality and the periodontal ligament. The most common forms of treatment are waiting for spontaneous reeruption, repositioning with orthodontic procedures, or immediate surgical repositioning. A well-planned approach to the treatment of an intrusive luxation is necessary to obtain a successful result. This case report describes treatment of an 8-year-old boy who suffered intrusive luxation of his permanent maxillary right central incisor while root formation was incomplete. The patient was followed clinically and radiographically for 10 years.

Conhecimento e Atitudes com Relação ao Atendimento Emergencial das Injúrias Dentárias Traumáticas / Knowledge and Attitudes Regarding Emergency Care of Traumatic Dental Injuries

Injúrias dentárias traumáticas ­ IDT apresentam elevada prevalência e estão entre os principais agravos à saúde de crianças e adolescentes. A adoção de medidas adequadas no momento do acidente é fundamental para a manutenção do elemento dentário. Assim, o objetivo do presente estudo foi avaliar o nível de conhecimento e atitudes de pessoas leigas frente às IDT. Um estudo transversal foi realizado, coletando-se dados a partir de um questionário estruturado. Os dados foram tabulados (SPSS 16.0), obtidas as frequências e a relação das atitudes com idade, nível de escolaridade, experiência com IDT (teste exato de Fisher, p<0,05). Dos 455 indivíduos entrevistados, 76,3% relataram não ter conhecimento sobre IDT, 55,2% não se sentiam preparados para realizar o atendimento emergencial e 89,5% demonstraram-se receptivos a novos conhecimentos. Apenas 27,3% reconheceram a gravidade do IDT em ambas as dentições. Não foi observada associação entre experiência prévia de IDT e atitudes (p<0,05). Em relação à escolaridade, pessoas com menor grau de escolaridade apresentaram maior índice de acerto quanto ao tempo de procura para o atendimento (p=0,01). Quanto à idade, os mais jovens obtiveram um maior percentual de acerto quanto ao procedimento de reimplante de dentes permanentes (p=0,01). Concluiu-se que o conhecimento e atitude em relação ao atendimento emergencial das IDT não é o adequado, sendo importante a implementação de ações de conscientização.(AU)

Traumatic dental injury (TDI) has high prevalence, and is considered one of the major health problems of children and adolescents. The adoption of appropriate measures at the time of the accident is critical for maintaining the tooth. The objective of this study was to evaluate the level of knowledge and attitudes of lay people in the face of TDI. A cross-sectional study was conducted by collecting data from a structured questionnaire. Data were tabulated (SPSS 16.0), obtaining the frequencies and the relationship of attitudes to age, education level, experience with TI (Fisher exact test, p <0.05). Of the 455 individuals interviewed, 76.3% reported not having knowledge on TDI, 55.2% did not feel prepared to carry out emergency care, and 89.5% proved to be receptive to new knowledge. Only 27.3% recognized the seriousness of TDI in both dentitions. There was no association between prior experience on TDI and attitudes (p <0.05). Regarding education, people with less education had a higher rate of success on the search of time for care (p = 0.01). Regarding age, younger had the highest percentage of success as the reimplantation procedure of permanent teeth (p = 0.01). It was concluded that the level of knowledge and attitude toward the emergency care of TDI is not appropriate, this it is important to implement awareness actions.(AU)

Aspergillus in endodontic infection near the maxillary sinus / Aspergillus em infecções endodônticas próximas ao seio maxilar

ABSTRACT INTRODUCTION: Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. OBJECTIVE: To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. METHODS: Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. RESULTS: Filamentous fungi were isolated from 6 of 60 canals (10%):Aspergillus niger (6.7%), Aspergillus versicolor (1.6%), and Aspergillus fumigatus(1.6%). CONCLUSION: Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus.

RESUMO Introdução: Doenças do seio maxilar têm sido associadas à raízes com tratamento endodôntico próximas ao seio maxilar. Objetivo: Investigar a presença de fungos filamentosos em raízes com tratamento endodôntico e lesão periapical, próximas ao seio maxilar, alertando para uma possível contaminação do seio maxilar por via odontogênica. Método: Estudo transversal em sessenta raízes palatinas de primeiros molares superiores próximas ao seio maxilar, com tratamento endodôntico e lesão periapical. Após remoção do material obturador, raspas de dentina foram coletadas e inseridas em tubos de ensaio contendo Agar Sabouraud Dextrose e Clorafenicol. O fenótipo foi determinado pela análise macroscópica e microscópica das colônias. Para o PCR utilizou-se iniciadores ITS-5 e ITS-4. As sequencias obtidas foram comparadas as disponíveis no GenBank utilizando Basic Local Alignment Search Tool. Resultados: Fungos filamentosos foram isolados de 6 dos 60 canais (10%):Aspergillus niger (6,7%), Aspergillus versicolor (1,6%) e Aspergillus fumigatus(1,6%). Conclusão: Raízes próximas ao seio maxilar com tratamento endodôntico e lesão periapical, podem apresentar cultura positiva para fungos filamentosos. Profissionais afins devem estar alerta, pois este micro-organismo possuem características de patogenicidade podendo causar doenças no seio maxilar de origem odontogênica.

Aspergillus in endodontic infection near the maxillary sinus.

INTRODUCTION: Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. OBJECTIVE: To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. METHODS: Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. RESULTS: Filamentous fungi were isolated from 6 of 60 canals (10%): Aspergillus niger (6.7%), Aspergillus versicolor (1.6%), and Aspergillus fumigatus (1.6%). CONCLUSION: Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus.

Confiabilidade de dois aparelhos localizadores apicais / Accuracy of two apex locators

O objetivo deste trabalho foi avaliar in vitro a eficácia dos localizadores apicais Root ZX II e NovAPEX em canais mesiovestibulares de molares inferiores nas medidas 0,5mm e 1mm aquém do forame apical. Vinte molares foram acessados coronalmente e a porção cervical dos canais foi alargada com brocas Gates Glidden e irrigados com hipoclorito de sódio 5,25%. Foram feitas 120 medições divididas em 6 grupos. As medidas reais dos canais foram tomadas com a introdução de uma lima tipo K#15 até que a ponta da lima atingisse o forame apical. Dessa medida foram subtraídos 1mm e 0,5mm e os valores registrados. Grupo 1 (n=20) medida real a 1mm aquém do ápice, Grupo 2 (n=20) medida real a 0,5mm aquém, Grupo 3 (n=20) localizador Root ZX II a 1mm aquém, Grupo 4 (n=20) localizador Root ZX II a 0,5mm aquém, Grupo 5 (n=20) localizador NovAPEX a 1mm aquém, Grupo 6 (n=20) localizado NovAPEX a 0,5mm aquém, localizadores apicais foram programados de acordo com as instruções dos fabricantes para a medição dos canais a 0,5mm e 1mm aquém do ápice, sendo que as medidas obtidas foram registradas e comparadas com as medidas reais. O teste estatístico T Student foi aplicado aos resultados e observou-se que não houve diferença estatisticamente significativa (p>0.05) entre ambos os localizadores apicais, e que os dois foram eficazes para se medir o comprimento de trabalho de canais radiculares. As porcentagens de confiabilidade dos aparelhos foram 96% para o localizador apical Root ZX II a 1mm, 98,4% a 0,5mm e 96% para o localizador apical NovAPEX a 1mm e 91,2% a 0,5mm.

The objective of the current study was to evaluate in vitro the accuracy of Root ZX II and NovAPEX apex locators in mesical buccal root canals of mandibular molars in measures 0.5 mm and 1 mm from the apical foramen. Twenty molars were coronally accessed and cervical portion of the root canals was enlarged with Gates Glidden drills and irrigated with sodium hypochlorite 5.25%. It was done 120 measurements divided into six groups. Reals measurements of the canals were taken with the introduction of a K file # 15 until the file tip reached the apical foramen. This measure were subtracted 1 mm and 0.5 mm and the values recorded. Group 1 (n = 20) the real measure 1 mm from the apex, Group 2 (n = 20) measured 0.5 mm below the real, Group 3 (n = 20) locator Root ZX II to 1mm below, Group 4 (n = 20) locator Root ZX II to 0.5 mm below, Group 5 (n = 20) locator NovAPEX to 1mm below, Group 6 (n = 20) locator NovAPEX to 0.5 mm below, apex locators were programmed according to manufacturers’ instructions for measuring cannals to 0.5 mm and 1 mm from the apex, and the measurements were recorded and compared with actual measurements. The statistical T test was applied and the results showed that there was no statistically significant difference (p> 0.05) between the two apex locators, and that both were effective for measuring the working length of root canals. The percentages of reliability of the devices were 96% for the apex locator Root ZX II to 1 mm, 98.4% to 0.5 mm and 96% for the apical NovAPEX 1 mm and 91.2% to 0.5mm.

Avaliação do escoamento e radiopacidade de dois cimentos endodônticos / Evaluation of flow and radiopacity of two root canal sealers

Introdução: O objetivo deste estudo é avaliar as propriedades do escoamento e radiopacidade de dois cimentos endodônticos, Endofill e EZ-Fill de acordo com a especificação número 57 da ADA. Método: Para análise do escoamento foram feitas 20 amostras divididas em GRUPO 1 (Endofill) e GRUPO 2 (EZ-Fill). Para tal 0,5 ml do cimento era depositado no centro de uma placa de vidro de 10 X 10 cm. Decorridos 3 minutos, outra placa de vidro e um peso de chumbo, totalizando 120 g, foram colocados sobre o material. Após 10 min o peso foi removido e a média do diâmetro maior e menor dos discos obtidos foi determinada por um paquímetro. Para a análise da radiopacidade 10 anéis metálicos foram utilizados: 5 do Grupo 3 (EZ-Fill) e 5 do Grupo 4 (Endofill) foram preenchidos com os cimentos. Os corpos de prova foram radiografados com uma escala de alumínio com 10 degraus uniformes. Para a obtenção das radiografias foi utilizado um aparelho de raio X Dabi Atlante a uma distância foco objeto de 400 mm e tempo de exposição 0,1 seg. As radiografias foram digitalizadas, armazenadas em um microcomputador e analisadas através de um software específico. Os dados foram submetidos ao teste t de Student a 5% apresentando diferença significante (p<0,0001). Resultados: Os resultados encontrados demonstraram escoamento superior a 25 mm em ambos os cimentos dos grupos 1 e 2 e radiopacidade superior a 3 mm de alumínio dos grupos 3 e 4, cumprindo-se a especificação número 57 da ADA. Conclusão: O cimento Endofill apresentou escoamento superior, enquanto o cimento EZ-Fill apresentou maior radiopacidade

Introduction: The purpose of this study is to evaluate the flow properties and radiopacity of two root canal sealers filling, the Endofill (Grossman of cement) and EZ-Fill according to ADA specification number 57 for filling materials). Methods: 20 samples were divided into two groups: Group 1 (Endofill), Group 2 (EZ-Fill).Each group was composed of 10 samples. For the analysis of flow 0.5 ml of material was loaded into a disposable syringe and deposited in the center of a placar glass 10 cm X 10 cm. 180 seconds after the start of operation, another plate of glass and a weight of lead were placed over the material, totaling 120 g. 10 minutes after the beginning of the mixture the weight was removed and the average diameter of the largest and smallest of the disc obtained was determined by a caliper. For the analysis of radiopacity, 10 metal rings, 5 of Group 3 (EZ-Fill) and 5 of Group 4 (Endofill) containing holes of 2 mm in height and 10 mm in diameter were filled with cement. The samples were radiographed together with a ranger of 99% aluminum (alloy 1100) with 10 uniform steps (1 mm to 10 mm thick). To obtain the radiographs an X-ray apparatus Dabi Atlante (70 kvp, 8 mA) was used to a focus object distance of 400 mm and exposure time 0.1 seconds. The radiographs were digitized using a Kodak scanner ? LS 85 Film Digitizer, USA, stored in a microcomputer and analyzed by a specific software for reading images (Image J). The data were submitted to the Student t test at 5% showing a significant difference (p < 0.0001). Results: The results obtained were: flow higher than 25 mm in both cements of Group 1 (Endofill 54.69 mm) and Group 2 (EZ-Fill 42.41 mm) and radiopacity of Group 3 (EZ-Fill) equivalent to 10 mm of aluminum and Group 4 (Endofill) equivalent to 7 mm aluminum. It was concluded that the cement Endofill showed a higher flow than the cement EZ-Fill and the EZ-Fill cement presented a higher radiopacity of the cement Endofill

Comparação entre os solventes: óleo de laranja e eucaliptol no retratamento de canais radiculares / Comparison between two solvents: orange oil and eucalyptol in root canal retreatment

O objetivo deste estudo foi avaliar a presença de resíduos de material obturador nas paredes dos canais radiculares após sua desobturação com a utilização de dois solventes distintos: óleo de casca de laranja e eucaliptol, com auxílio das limas manuais e do microscópio óptico. Foram utilizados 20 caninos instrumentados pela técnica Crown-Down, e posteriormente obturados com guta-percha e cimento Endofill pela técnica Híbrida de Tagger modificada. As amostras foram divididas, aleatoriamente, em dois grupos iguais, de acordo com o solvente utilizado: Grupo I – óleo de laranja e Grupo II – eucaliptol. Os canais foram desobturados com brocas Gates Glidden e limas endodônticas tipo Kerr com o auxílio dos solventes e do microscópio óptico. Clivadas as raízes, ambas as hemissecções, foram fotografadas e observadas, sendo avaliadas por três observadores calibrados, atribuindo escores a cada uma delas de acordo com a quantidade de resíduo encontrado no interior dos canais. Durante a análise fotográfica verificou-se a presença de resíduos remanescentes de material obturador nas paredes dos canais radiculares em ambos os grupos. Os resultados foram analisados através do teste de aderência e do teste U de Mann-Whitney. Não foi evidenciado uma diferença estatística significante (a nível de > 0,05), entre os dois solventes. Pôde-se concluir que o óleo de laranja e o eucaliptol mostraram-se eficazes na remoção de resíduos de material obturador nas paredes dos canais radiculares.

The aim of this study was to evaluate the presence of debris from fillings material on the canal walls, after the desobturation with the use of two solvents: orange oil and eucalyptol, with aid of the manual endodontic files and optic microscope. Twenty canines were prepared through Crown-down technique, and after obturated with gutta-percha and endofill cement through modified Hybrid of Tagger technique. The sample were divided, randomly, into two equal groups in accordance with the solvent used: group I – orange oil and group II – eucalyptol. The root canal obturations were removed with endodontic drills Gates Glidden and endodontic files type Kerr with the AID of the solvents and the optic microscope. Divided the roots in two, both pieces, were photographed and observed, being evaluated for three calibrated observers, attributing scores to each one of them in accordance of the amount of residue found in the inside of the canals. During the photographic analysis was verified the remaining presence of debris from filling material on the root canal walls in both groups. The result were analised through adherence tests and U the Mann-Whitney tests. Were evidenced a not-significant statistical differences between two solvents. Was concluded that orange oil and eucalyptol have proved effective in the removal of debris from fillings material on the root canal walls.

Avulsão dentária na dentição permanente: tratamento e prognóstico: relato de caso / Avulsion in dental permanent dentition: treatment and prognosis: case report

A avulsão dentária acomete principalmente crianças em idade escolar, devido a pouca resistência do elemento dentário ainda em formação. Dentre os traumatismos a avulsão dentária é pouco frequente, porém é o que apresenta um dos piores prognósticos, pois pode resultar na perda de elementos hígidos, principalmente o incisivo central superior, acarretando problemas estéticos, funcionais e emocionais ao paciente. Um período extra-alveolar curto e um meio de armazenamento adequado são fundamentais para o reparo do ligamento periodontal do elemento dental avulsionado e de uma possível revascularização em dentes com rizogênese incompleta. Porém o reimplante deve ser realizado, pois a permanência do dente no alvéolo irá adiar a confecção de uma prótese ou implante. Os profissionais da área da saúde, professores da rede escolar e a população deveriam ser informados e capacitados a agir adequadamente no caso deste traumatismo, situações onde se espera que este trabalho venha contribuir. O objetivo deste relato de caso foi investigar o prognóstico e tratamento dos dentes permanentes avulsionados traumaticamente.

The dental avulsion usually happens in the childhood, due to the less resistance of the tooth, which is not completelu formed. The dental avulsion is not so frequent but it shows the worst prognosis because implicates in the total displacement of a tooth from its alveolus, reaching mainly the upper central incisor. It provokes serious functional, esthetic and emotional problems to the patient. A short extra-alveolar time, the storage media and the management of the traumatized tooth contribuites in a considerable way to the periodontal ligament repair. The replantation of the tooth in the alveolus is always indicated because the tooth is conserved in function, the esthetic is restored and the patient has an adequate time to a psychological preparation, until it could be performed a definitive treatment. Dentists, teachers and parents should be orientated for the ready attendance of patients with dental traumatisms. The aim of this case reported was investigate the treatment and prognosis of avulsioned permanent teeth.

Análise da adaptação marginal de materiais retrobturadores / Marginal adaptation of root-end filling materials

Objetivo: Avaliar a capacidade de adaptação de diferentes materiais retrobturadores às paredes cavitárias do preparo apical. Método: Foram realizadas apicetomia e preparo cavitário empregando-se ultra-som em 24 raízes palatinas de molares superiores (extraídos e conservados em timol a 1%). Para a fase de retrobturação as raízes foram divididas aleatoriamente em 8 grupos contendo 3 amostras cada: G1 - amálgama, G2 - guta percha, G3 - OZE (Óxido de Zinco e Eugenol), G4 - IRM (Intermediate Restorative Material), G5 - N-Rickert, G6 - Ketac-CEM, G7 - Super-EBA, G8 - MTA (Agregado Trióxido Mineral). A seguir os espécimes foram fotografados ao microscópio óptico (MO) e eletrônico de varredura (MEV) com aumentos de 50x e 150x. Os resultados foram analisados por 3 examinadores calibrados e estabelecidos escores (0- adaptação do material retrobturador em todas as paredes do preparo apical, 1- ausência da adaptação do material retrobturador em uma ou duas paredes do preparo apical, 2-ausência de adaptação do material retrobturador em três ou mais paredes do preparo apical). Os dados foram analisados através do teste de Kruskal Wallis. Resultados: A média dos escores entre as amostras foi: Amálgama(MO- 1,22 e MEV- 2), guta percha (MO- 1 e MEV- 2), OZE (MO- 1 eMEV- 1,55), IRM (MO- 2 e MEV- 2), N-Rickert (MO- 1,66 e MEV-1,88), Ketac-CEM (MO- 1,66 e MEV- 1,88), Super-Eba (MO- 0,22 eMEV- 0,55) e MTA (MO- 0 e MEV- 0). Verificou-se diferença estatisticamente significante entre os grupos (p<0,01). Conclusão: Os melhores resultados foram obtidos pelo MTA seguido pelo Super-EBA. Os demais materiais não apresentaram boa adaptação às paredes do preparo cavitário.

Avaliação da reparação pós-tratamento endodôntico de dentes de cães em sessão única ou empregando curativos de demora / Evaluation of tissue repair after endodontic therapy in dog's teeth in sigle visit or using intracanal dressing

A proposta deste estudo foi avaliar a resposta tecidual ao tratamento endodôntico em dentes de cães, empregando-se curativo de demora durante 15 dias ou obturando-se em sessão única. Após indução de lesão periapical, 36 raízes foram divididas em três grupos: Grupo 1 - Sessão única; Grupo 2 - Curativo de demora com iodofórmio + Carbowax; Grupo 3 - Curativo de demora com hidróxido de cálcio + água destilada. Por meio de um cronograma de trabalho, foram obtidas amostras de 30 e 90 dias de cada um dos animais que, após o sacrifício, tiveram seus dentes descalcificados e preparados para análise histopatológica. Os resultados demonstraram que, nos espécimes em que se empregou curativo de demora, houve inflamação branda e frequente visualização de processos de neoformação de tecido ósseo e cementário. Por outro lado, no grupo de sessão única, encontrou-se infiltrado inflamatório severo, sem indícios de processos de reparação. Pôde-se concluir ser importante a utilização de curativo de demora em dentes portadores de necrose pulpar e lesão periapical, no processo de reparo tecidual da região apical e periapical.

The purpose of this study was to evaluate the tissue response after endodontic therapy in dogs teeth, using intracanal dressing for a period of 15 days, or filling it in a single visit. After inducing periapical lesions, 36 roots were divided in 3 groups: Group 1- Single visit; Group 2 - Intracanal medication with iodoform plus carbowax; Group 3 - Intracanal medication with calcium hydroxide plus destiled water. By means of a schedule it was obtained samples with 30 and 90 days in each animal which were sacrificed and its teeth were descalcified for histologic analyses. The results showed that the intracanal dressing's samples showed a mild inflammatory response and frequent biological apical sealing. On the other hand the single visit therapy samples showed a severe inflammatory tissue with total absence of biological sealing. It can be concluded that the intracanal dressing is important in the process of periapical and apical repair in teeth with necrotic pulp and periapicallesions.

Effect of crown fracture on the surrounding periodontium.

Clinical and histological alterations were analyzed in the periodontium of dog's teeth that had been submitted to crown fracture. To reach the long axis of the tooth, an impact device was applied to eight teeth of four adult dogs to produce trauma. Crown fractures involving the enamel and dentin, with or without pulpar exposure and without dislocation, mobility or gingival bleeding were analyzed within the post-trauma periods of 30 min, 1, 3, and 7 days. The force of impact that resulted in coronary fracture, although dissipated at the time of fracture, reverberated in the surrounding periodontium and may generate not only light histological alterations with a rapid re-establishment of the tissues, but also an intense inflammatory condition required as long as 7 days to clear up. The gravity of these inflammatory reactions unleashed in these teeth's periapical tissues depends on the absorption of impact by the periodontal structures and the individual susceptibility of each organism.