The effect of EDTA on the antibacterial activity of sodium hypochlorite.

The combination of ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) has been suggested as an irrigant for root canal therapy. However, the chemical interaction between these agents is a complex subject that is not completely understood. The aim of this study was to evaluate the interference of an EDTA chelating agent in the antibacterial ability of NaOCl, while also considering variations in methodology. Various concentrations of NaOCl and EDTA solutions were prepared from 6% and 17% solutions, respectively. The antibacterial potential of pure solutions and their combinations was assessed using a direct contact test against Enterococcus faecalis. In the first experiment, NaOCl and EDTA solutions were mixed 5 minutes before the addition of the E faecalis bacterial suspension. In the second experiment, both solutions were simultaneously put in contact with the bacterial suspension. Data were submitted to a Spearman correlation coefficient and chi-square test. Results indicated that growth of E faecalis was significantly dependent on the solution-mixing method. In the first experiment, high concentrations (17% and 8.5%) of EDTA prevented the complete killing of E faecalis by 6% NaOCl at all experimental timepoints. In the second experiment, all concentrations of NaOCl were able to eliminate E faecalis, even in the presence of EDTA. In conclusion, when NaOCl and EDTA were added simultaneously to a bacterial suspension without premixing, NaOCl was able to exert its full bactericidal action.

Ex-vivo effect of intracanal medications based on ozone and calcium hydroxide in root canals contaminated with Enterococcus faecalis.

This ex vivo study evaluated the antibacterial effect of intracanal medications in root canals contaminated with Enterococcus faecalis. Fifty single-rooted human teeth were contaminated with E. faecalis (ATCC 29212) and incubated at 37°C for 21 days. The specimens were randomly divided into 5 groups according to the intracanal medication used: OZ-PG: ozonized propylene glycol; CH/CPMC: calcium hydroxide/camphorated paramonochlorophenol; OZ-PG/CH ozonized PG/CH; PC: positive control group (no medication); and NC: negative control group (no contamination). The samples were collected after 7 days (post-medication) and 14 days (final). Bacterial growth was checked by counting the colony-forming units (CFU). OZ-PG and CH/CPMC reduced significantly the CFU counts compared with PC in the post-medication and final samples, with no statistically significant differences among them. On the other hand, OZ-PG/CH did not reduce significantly the number of bacteria compared with PC. In conclusion, among the evaluated medications OZ-PG and CH/CPMC were the most effective against E. faecalis.

Ex-vivo Effect of Intracanal Medications Based on Ozone and Calcium Hydroxide in Root Canals Contaminated with Enterococcus faecalis

This ex vivo study evaluated the antibacterial effect of intracanal medications in root canals contaminated with Enterococcus faecalis. Fifty single-rooted human teeth were contaminated with E. faecalis (ATCC 29212) and incubated at 37°C for 21 days. The specimens were randomly divided into 5 groups according to the intracanal medication used: OZ-PG: ozonized propylene glycol; CH/CPMC: calcium hydroxide/camphorated paramonochlorophenol; OZ-PG/CH ozonized PG/CH; PC: positive control group (no medication); and NC: negative control group (no contamination). The samples were collected after 7 days (post-medication) and 14 days (final). Bacterial growth was checked by counting the colony-forming units (CFU). OZ-PG and CH/CPMC reduced significantly the CFU counts compared with PC in the post-medication and final samples, with no statistically significant differences among them. On the other hand, OZ-PG/CH did not reduce significantly the number of bacteria compared with PC. In conclusion, among the evaluated medications OZ-PG and CH/CPMC were the most effective against E. faecalis.

Resumo Este estudo ex vivo avaliou o efeito antibacteriano de medicações intracanal em canais radiculares contaminados com Enterococcus faecalis. Cinquenta dentes humanos unirradiculares foram contaminados com E. faecalis (ATCC 29212) e incubados a 37°C durante 21 dias. Os espécimes foram aleatoriamente divididos em diferentes grupos de acordo com a medicação intracanal utilizada: PG-OZ: propilenoglicol ozonizado; HC/PMCC: hidróxido de cálcio/paramonoclorofenol canforado; PG-OZ/CH; CP: controle positivo (sem medicação); e CN: controle negativo (sem contaminação). As amostras foram coletadas após 7 dias (pós-medição) e 14 dias (final). O crescimento bacteriano foi verificado através da contagem das unidades formadoras de colônias (UFC). PG-OZ e HC/PMCC reduziram estatisticamente o número de bactérias quando comparados com o CP nas amostras pós-medição e final, sem diferenças estatísticas entre si. Por outro lado, PG-OZ/HC não reduziu significativamente o número de bactérias em comparação com o CP. Em conclusão, entre as medicações avaliadas, PG-OZ e HC/PMCC foram as mais eficazes contra E. faecalis. .

Use of cone-beam tomography and digital subtraction radiography for diagnosis and evaluation of traumatized teeth treated with endodontic surgery and MTA. A case report.

The aim of this paper was to report the diagnosis and evaluation of periradicular bone repair by using computed tomography and digital subtraction radiography in an endodontic surgery case treated with mineral trioxide aggregate (MTA). The patient had local swelling and fistula 7 years after trauma in the upper jaw. Periapical lesion on tooth #12 and root resorption of tooth #11 were detected radiographically. Endodontic therapy and placement of intracanal medication were carried out. After 3 months, with no improvement in the clinical signs and symptoms, computed tomography was performed, showing extensive apical bone resorption on tooth #12 and dental resorption promoting communication of the root canal with the periodontium of tooth #11. The patient was referred to endodontic surgery. After surgery and postoperative periods of 15, 30, 60, 90, and 120 days, standardized radiographs were taken, digitized, and subjected to digital subtraction of the images using Adobe Photoshop CS software. Four years later, a cone-beam computed tomography was performed, showing bone repair and absence of root resorption at tooth #11. In this clinical case, digital subtraction radiography was effective for early detection of new bone formation and evolution of repair.

Pulp sensibility test in elderly patients.

BACKGROUND: The ageing process transforms the histological composition of the dental pulp and may affect the response to pulp sensibility tests. OBJECTIVES: The aim of this study was to assess the influence of age on pulp response time and on pain intensity. MATERIAL AND METHODS: Fifty elderly patients and 50 young patients were selected. Different classes of teeth were evaluated. The pulp sensibility test was performed with a refrigerant spray. The pulp response time was measured in seconds and the pain intensity was assessed by visual analogue scale. RESULTS: The Spearman coefficient was calculated and detect a positive correlation between age and pulp response time for maxillary incisors, premolars, mandibular incisors, and mean (p < 0.05). On the contrary, there was a negative correlation between age and pain intensity for maxillary incisors, mandibular incisors, and mean (p < 0.05). Also, the results of elderly and young groups were compared by Mann-Whitney test. Significant difference was noted regarding the pulp response time for maxillary incisors, premolars, mandibular incisors, and mean (p < 0.05). Significant difference was detected regarding the pain intensity for mandibular incisors only (p < 0.05). CONCLUSIONS: Pulp response time increases when people get older while pain intensity decreases. There were variations among the classes of teeth.

Endodontic and orthodontic management of traumatically intruded teeth with horizontal root fracture: a case report.

This report describes the case of an 8-year-old boy that was referred to endodontic and orthodontic treatment after suffering an injury that led to intrusion of the maxillary right permanent central incisor, palatal displacement of the upper right lateral incisor, and root fracture of both central incisors. Both injured teeth were immature and had open apices. The intruded tooth was repositioned by endodontic and orthodontic management. Endodontic therapy was performed in both teeth with periodical changes of calcium-hydroxide-based paste as root canal dressing and introduction of MTA as an apical barrier. The postoperative course was uneventful with clinical and radiographic success up to 3 and 1/2 years of follow up. In the present case, orthodontic repositioning combined with endodontic therapy constitued a viable alternative treatment for intrusive luxations in immature permanent teeth.

Diagnóstico e planejamento em cirurgiaparendodôntica: utilização da tomografiacone beam / Diagnosis and planning in apical surgery: useof cone-beam tomography

Introdução e objetivos: A capacidade de avaliar áreas patológicase anatômicas em três dimensões no planejamento de cirurgiaparendodôntica apresenta uma série de vantagens. A tomografiacomputadorizada cone beam (TCCB) foi desenvolvida para aplicaçõesodontológicas. Os objetivos deste artigo são realizar um levantamentobibliográfico sobre a TCCB, destacando suas vantagens em relaçãoà tomografia computadorizada convencional (TC) e à radiografiaconvencional, e discutir suas aplicações clínicas na cirurgiaparendodôntica. Revisão de literatura e conclusão: Diferentementeda TC, a TCCB captura um volume de dados em uma rotação única de360°, oferecendo vantagens como maior precisão, melhor resolução,redução do tempo de digitalização e diminuição da dose de radiação.Na região maxilofacial, a TCCB é mais usada na avaliação de patologiadentoalveolar e na traumatologia bucal. A TCCB favorece o diagnóstico e a análise quantitativa do nível ósseo alveolar e tem sido utilizada empacientes que necessitam de cirurgia de reconstrução facial, cirurgiaortognática, implantes dentários, exodontias mais complexas, alémde ser uma ferramenta valiosa na prática endodôntica moderna, comimportantes aplicações na cirurgia parendodôntica.

Introduction and objective: The ability to tridimensionally evaluatepathological and anatomical areas, in apical surgery planning, presentsa number of advantages. Cone beam computed tomography (CBCT)was developed for dental applications. This paper aims to presenta literature review on CBCT, highlighting its advantages over bothconventional computed tomography (CT) and radiography. Moreover, itsclinical applications in apical surgery are discussed. Literature reviewand conclusion: Unlikely CT, CBCT captures a volume of data in asingle 360° rotation, providing benefits such as higher accuracy, betterresolution, reduced scanning time and reduced radiation dose. In themaxillofacial region, CBCT has been mainly used in the assessmentof dento-alveolar pathology and oral traumatology. CBCT provides abetter diagnosis and quantitative information on periodontal bonelevels than conventional radiography. It has also been used for patientsrequiring surgical facial reconstruction, orthognathic surgery, dentalimplants, and more complex tooth extractions. Besides that, it seemsto be a significant tool in modern endodontic practice, presenting usefulapplications in apical surgery.

Avaliação da difusão de íons hidroxila e da atividade antibacteriana de medicações intracanal à base de hidróxido de cálcio / Evaluation of hydroxil ions diffusion and antibacterial activity of calcium hydroxide based intracanal medication

Este estudo objetivou avaliar a capacidade de liberação e difusão de íons hidroxila, e a atividade antibacteriana de medicações intracanal, in vitro. No primeiro experimento, canais radiculares de dentes bovinos foram instrumentados. Uma cavidade de 4 mm de comprimento, 2 mm de largura e 0,5 mm de profundidade foi confeccionada no terço médio/apical radicular de cada amostra. A abertura coronária e a superfície externa radicular foram seladas com adesivo e esmalte para unhas, exceto a área da cavidade preparada. Os canais radiculares foram preenchidos com as seguintes medicações: G1: hidróxido de cálcio (Ca(OH) 2 )/soro; G2: Calen; G3: Calen/PMCC; G4: Calen/Clorexidina (CLX) a 0,4%. Os dentes foram armazenados individualmente em frascos contendo água destilada a 37o C. As medições do pH foram realizadas nos períodos de 1, 3, 7, 14, 21, 30 e 60 dias, com utilização de pHmetro digital. Os resultados mostraram aumento significativo do pH a partir de 3 dias para a pasta Calen/CLX e para as demais pastas a partir de 7 até os 14 dias. Para a pasta Calen ocorreu aumento até os 21 dias. A pasta Calen/PMCC apresentou pH mais elevado até 21 dias, sendo os resultados semelhantes para todos grupos aos 30 dias. Aos 60 dias, os maiores valores de pH foram observados para as pastas Calen/PMCC e Calen. Conclui-se que as diferentes composições de pastas à base de Ca(OH) 2 proporcionam difusão de íons hidroxila pela dentina radicular. Em outro experimento, 106 dentes humanos unirradiculados tiveram seus canais radiculares contaminados com Enterococcus faecalis e incubados a 37°C por 21 dias. Em seguida, foram divididos de acordo com a medicação intracanal e o período em: G1: Calen - 7 dias; G2: Calen - 14 dias; G3: Calen/PMCC - 7 dias; G4: Calen/PMCC - 14 dias; G5: Calen/CLX a 0,4% - 7 dias; G6: Calen/CLX a 0,4% - 14 dias; G7: Calen/CLX a 1% - 7 dias; G8: Calen/CLX a 1% - 14 dias. Coletas microbiológicas foram realizadas imediatamente após a remoção da medicação intracanal e decorrido o período de sete dias. Após diluições decimais seriadas, alíquotas foram semeadas em placas de TSa e a contagem de UFC/mL determinada. Foi observado que, para todas as medicações analisadas, houve ausência de E. faecalis logo após sua remoção. Porém, todos os espécimes apresentaram aumento na contagem bacteriana após sete dias. Na coleta final, Calen/PMCC e Calen/CLX apresentaram menor número de UFC/mL que o Calen. Nenhuma medicação intracanal analisada foi capaz de eliminar completamente E. faecalis do sistema de canais radiculares

The aim of this study was to evaluate the release and diffusion of hydroxil ions, and the antibacterial activity of intracanal medication, in vitro. At first study, root canals from bovine teeth were instrumented. A cavity with 4 mm of length, 2 mm of width and 0.5 mm of depth was opened at middle/apical third of each sample. The coronal opening and the external surface of the roots were coated with a nail polish layer and a layer of sticky wax, except on the cavity area. Root canals were filled with the following intracanal medication: G1: calcium hydroxide powder with saline solution (Ca(OH) 2 ); G2: Calen; G3: Calen/PMCC; G4: Calen/Chlorhexidine (CHX) 0.4%. Teeth were stored individually in recipients with distilled water at 37o C. Measurements of pH were made at periods of 1, 3, 5, 7, 14, 21, 30 and 60 days, using a digital pH meter. Results showed a significant increase of pH from 3 days for Calen/PMCC, and from 7 until 14 days for the other medications. For Calen, an increase was observed until 21 days. Calen/PMCC showed the highest pH until 21 days, and all the groups had similar results at 30 days. At 60 days, the highest pH values were observed for Calen/PMCC and Calen. It is possible to conclude that different compositions of calcium hydroxide pastes caused diffusion of hydroxil ions through radicular dentin. In another study, 106 single-rooted human teeth had their root canals contaminated with Enterococcus faecalis and incubated at 37o C for 21 days. Then, these teeth were divided according to intracanal medication and periods: G1: Calen - 7 days; G2: Calen - 14 days; G3: Calen/PMCC - 7 days; G4: Calen/PMCC - 14 days; G5: Calen/CHX 0.4% - 7 days; G6: Calen/CHX 0.4% - 14 days; G7: Calen/CHX 1% - 7 days; G8: Calen/CHX 1% - 14 days. Microbiological samples were collected immediately after intracanal medication removal and after seven days. After serial 10-fold dilutions and culture in TSa plates, CFU/mL counts were determined. It was observed that, for all analyzed medications, there was a lack of E. faecalis right after their removal. However, all specimens presented an increase at bacterial count after seven days. At final sample collection, Calen/PMCC and Calen/CHX presented a lower number of CFU/mL than Calen. None of analyzed intracanal medication was able for fully eliminating E. faecalis from root canals system

Avaliação da difusão de íons hidroxila e da atividade antibacteriana de medicação intracanal á base de hidróxido de cálcio / Evaluation of hydroxil ions diffusion and antibacterial activity of calcium hydroxide based intracanal medication

Este estudo objetivou avaliar a capacidade de liberação e difusão de íons hidroxila, e a atividade antibacteriana de medicações intracanal, in vitro. No primeiro experimento, canais radiculares de dentes bovinos foram instrumentados. Uma cavidade de 4 mm de comprimento, 2 mm de largura e 0,5 mm de profundidade foi confeccionada no terço médio/apical radicular de cada amostra. A abertura coronária e a superfície externa radicular foram seladas com adesivo e esmalte para unhas, exceto a área da cavidade preparada. Os canais radiculares foram preenchidos com as seguintes medicações: G1: hidróxido de cálcio (Ca(OH)2)/soro; G2: Calen; G3: Calen/PMCC; G4: Calen/Clorexidina (CLX) a 0,4%. Os dentes foram armazenados individualmente em frascos contendo água destilada a 37oC. As medições do pH foram realizadas nos períodos de 1, 3, 7, 14, 21, 30 e 60 dias, com utilização de pHmetro digital. Os resultados mostraram aumento significativo do pH a partir de 3 dias para a pasta Calen/CLX e para as demais pastas a partir de 7 até os 14 dias. Para a pasta Calen ocorreu aumento até os 21 dias. A pasta Calen/PMCC apresentou pH mais elevado até 21 dias, sendo os resultados semelhantes para todos grupos aos 30 dias. Aos 60 dias, os maiores valores de pH foram observados para as pastas Calen/PMCC e Calen. Conclui-se que as diferentes composições de pastas à base de Ca(OH)2 proporcionam difusão de íons hidroxila pela dentina radicular. Em outro experimento, 106 dentes humanos unirradiculados tiveram seus canais radiculares contaminados com Enterococcus faecalis e incubados a 37°C por 21 dias. Em seguida, foram divididos de acordo com a medicação intracanal e o período em: G1: Calen - 7 dias; G2: Calen - 14 dias; G3: Calen/PMCC - 7 dias; G4: Calen/PMCC - 14 dias; G5: Calen/CLX a 0,4% - 7 dias; G6: Calen/CLX a 0,4% - 14 dias; G7: Calen/CLX a 1% - 7 dias; G8: Calen/CLX a 1% - 14 dias...

Abstract: The aim of this study was to evaluate the release and diffusion of hydroxil ions, and the antibacterial activity of intracanal medication, in vitro. At first study, root canals from bovine teeth were instrumented. A cavity with 4 mm of length, 2 mm of width and 0.5 mm of depth was opened at middle/apical third of each sample. The coronal opening and the external surface of the roots were coated with a nail polish layer and a layer of sticky wax, except on the cavity area. Root canals were filled with the following intracanal medication: G1: calcium hydroxide powder with saline solution (Ca(OH)2); G2: Calen; G3: Calen/PMCC; G4: Calen/Chlorhexidine (CHX) 0.4%. Teeth were stored individually in recipients with distilled water at 37oC. Measurements of pH were made at periods of 1, 3, 5, 7, 14, 21, 30 and 60 days, using a digital pH meter. Results showed a significant increase of pH from 3 days for Calen/PMCC, and from 7 until 14 days for the other medications. For Calen, an increase was observed until 21 days. Calen/PMCC showed the highest pH until 21 days, and all the groups had similar results at 30 days. At 60 days, the highest pH values were observed for Calen/PMCC and Calen. It is possible to conclude that different compositions of calcium hydroxide pastes caused diffusion of hydroxil ions through radicular dentin. In another study, 106 single-rooted human teeth had their root canals contaminated with Enterococcus faecalis and incubated at 37oC for 21 days. Then, these teeth were divided according to intracanal medication and periods: G1: Calen - 7 days; G2: Calen - 14 days; G3: Calen/PMCC - 7 days; G4: Calen/PMCC - 14 days; G5: Calen/CHX 0.4% - 7 days; G6: Calen/CHX 0.4% - 14 days; G7: Calen/CHX 1% - 7 days; G8: Calen/CHX 1% - 14 days. Microbiological samples were collected immediately after intracanal medication removal and after seven days. After serial 10-fold dilutions and culture...

Obturação com MTA associada à cirurgia parendodôntica no retratamento de reabsorção radicular apical externa: relato de caso / Root canal filling using MTA in association with parendodontic surgery in the retreatment of an external apical root resorption: case report

Introdução e objetivo: O tratamento de reabsorções inflamatórias apicais deve ser direcionado ao combate da infecção endodôntica. Em determinados casos, a resolução clínica por meio de tratamento endodôntico convencional pode tornar-se inexequível em função das dificuldades de efetuar a instrumentação e a obturação adequadas da região apical. Nessas situações, técnicas alternativas de preparo do canal radicular e de obturação podem ser necessárias, além da instituição de tratamento cirúrgico complementar. Relato do caso: Este trabalho apresenta uma alternativa de retratamento de um caso de reabsorção radicular apical externa com o uso do tampão de MTA associado à cirurgia parendodôntica. Após remoção do material obturador, limpeza e desinfecção do canal radicular, foi instituída terapia com hidróxido de cálcio por 45 dias. Depois desse período, o canal foi obturado com MTA, e em uma sessão posterior foram feitas curetagem da lesão periapical e apicectomia. A proservação do caso deu-se 34 meses e demonstrou reparo da lesão periapical e íntimo contato do trabeculado ósseo com o MTA. Conclusão: O uso do MTA como material obturador, complementado pela cirurgia parendodôntica, mostrou-se como uma alternativa para o tratamento de dentes com reabsorção radicular apical externa.

Introduction and objective: The treatment of external apical root resorption should be directed to eliminate the endodontic infection. In some cases, the clinical resolution by conventional endodontic treatment cannot be performed, due to instrumentation and root canal filling complexity. In these cases, alternative instrumentation and obturation techniques may be necessary, additionally to apical surgery. Case report: This case report shows an alternative to external apical root resorption retreatment, using obturation with MTA associated to parendodontic surgery. After the removal of obturation material and the root canal cleaning and shaping, calcium hydroxide therapy was performed during 45 days. After that the canal was filled with MTA, and in a posterior session apical curettage and apicoectomy were performed. After 34 months, the periapical healing could be radiographically noticed, with close contact between trabecular bone and MTA. Conclusion: The use of MTA as a root canal filling material associated with parendodontic surgery seemed to be an adequate alternative to external apical root resorptions.

In vitro evaluation of root canal preparation using oscillatory and rotary systems in flattened root canals

OBJECTIVE: The aim of this study was to evaluate the biomechanical preparation of flattened root canals using the following systems: Endo-Eze AET stainless steel oscillatory instruments (Ultradent) and RaCe rotary NiTi instruments (FKG Dentaire). MATERIAL AND METHODS: Twenty extracted human mandibular incisors were randomly assigned to two groups: Group 1 - Instrumentation with oscillatory Endo-Eze AET files (oscillatory technique); Group 2 - Instrumentation with rotary NiTi RaCe files (rotary technique). The teeth were decoronated, had their apices and coronal openings sealed with sticky wax and were embedded in crystal-clear orthophtalic polyester resin. The roots were sectioned transversally with diamond discs at 10 mm (middle third) and 5 mm (apical third) from the apex and the segments were reassembled for instrumentation. The sections were photographed before and after root canal instrumentation and evaluated with respect to whether the original root canal shape was modified by instrumentation. To evaluate the differences in the root canal shape before and after biomechanical preparation, scores were given regarding the instruments touch on the intracanal walls. RESULTS: In middle third of the root canals instrumented with the rotary system, there was a change in the original canal anatomy (p<0.05), with formation of a protuberance in the mesiodistal direction. This protuberance did not occur when the oscillatory instrumentation was used. The oscillatory system had better results in the middle and apical thirds as evaluated by Dunn's multiple-comparison test (p>0.05). CONCLUSION: Under the tested conditions, Endo-Eze oscillatory system yielded the instrumentation of all flattened root canal walls, maintaining the canal original shape throughout the biomechanical preparation, and was more effective than RaCe rotary system.

In vitro evaluation of root canal preparation using oscillatory and rotary systems in flattened root canals.

OBJECTIVE: The aim of this study was to evaluate the biomechanical preparation of flattened root canals using the following systems: Endo-Eze AET stainless steel oscillatory instruments (Ultradent) and RaCe rotary NiTi instruments (FKG Dentaire). MATERIAL AND METHODS: Twenty extracted human mandibular incisors were randomly assigned to two groups: Group 1 - Instrumentation with oscillatory Endo-Eze AET files (oscillatory technique); Group 2 - Instrumentation with rotary NiTi RaCe files (rotary technique). The teeth were decoronated, had their apices and coronal openings sealed with sticky wax and were embedded in crystal-clear orthophtalic polyester resin. The roots were sectioned transversally with diamond discs at 10 mm (middle third) and 5 mm (apical third) from the apex and the segments were reassembled for instrumentation. The sections were photographed before and after root canal instrumentation and evaluated with respect to whether the original root canal shape was modified by instrumentation. To evaluate the differences in the root canal shape before and after biomechanical preparation, scores were given regarding the instruments touch on the intracanal walls. RESULTS: In middle third of the root canals instrumented with the rotary system, there was a change in the original canal anatomy (p<0.05), with formation of a protuberance in the mesiodistal direction. This protuberance did not occur when the oscillatory instrumentation was used. The oscillatory system had better results in the middle and apical thirds as evaluated by Dunn's multiple-comparison test (p>0.05). CONCLUSION: Under the tested conditions, Endo-Eze oscillatory system yielded the instrumentation of all flattened root canal walls, maintaining the canal original shape throughout the biomechanical preparation, and was more effective than RaCe rotary system.

Uso de antiinflamatórios näo-esteroidais (AINEs) no controle da resposta inflamatória inespecífica: uma revisäo / The use of non-steroidal anti-inflammatory drugs (NSAIDs) for the control of non-specific inflammatory reactions: a review

Situaçöes patológicas ou clínicas que desencadeiam reaçäo inflamatória inespecífica, gerando dor e desconforto, requerem administraçäo de fármacos antiinflamatórios como coadjuvantes terapêuticos. Embora a inflamaçäo constitua reaçäo fisiopatológica de defesa e reparaçäo, quando fora de controle se autoperpetua, cronifica-se e acarreta lesäo tecidual indesejada e desnecessária. Dentro deste panorama, os fármacos säo usados no sentido de modular seu desenvolvimento, procurando mantê-la em níveis compatíveis com boa evoluçäo clínica. Conquanto o melhor meio para o controle da resposta inflamatória seja a eliminaçäo de suas causas, o uso paliativo de antiinflamatórios, principalmente do grupo dos näo-esteroidais (AINEs), é recurso coadjuvante de valor na terapêutica de diversos estados mórbidos odontológicos. Em anos recentes, a melhor compreensäo sobre a ativaçäo da cascata do ácido araquidônico no fenômeno inflamatório propiciou a introduçäo de novos medicamentos na prática clínica. O tema é revisto neste trabalho, intencionando elucidar algumas características peculiares ao uso de AINEs, tanto os clássicos quanto os de introduçäo mais recente em terapêutica