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.

Deciduous Molars Complexity Anatomy Reveled by Computed Microtomography.

OBJECTIVE: The aim of this study was to analyze the internal morphology of deciduous molars through the use of computed microtomography in a sample from Rio de Janeiro. MATERIAL AND METHODS: Thirty maxillary and 30 mandibular deciduous molars (n = 60), divided in first and second primary molars, were scanned by computed microtomography. The teeth were evaluated for root number, root canals, Vertucci classification, root curvature, presence of lateral canals, furcation dentin thickness, structure model index (SMI), volume, and canal surface area. RESULTS: The results showed 100% of maxillary molars had three roots and Vertucci type I canal was more prevalent in this group. In the mandibular ones, type IV was more frequent in the mesial root and class I in the distal root and the cavo-interradicular canal occurred in 2 specimens. Dentin thickness in the furcation region measured 1.53 and 1.59 mm in the maxillary and mandibular, respectively. Volume and area parameters varied according to the evaluated canals and SMI demonstrated that all canals had a cylindrical shape. CONCLUSION: More detailed information about the internal anatomy of the primary molars has been described, which may help strategies in the preparation of these root canals.

Microtomographic Assessment of the Shaping Ability of the Hyflex CM and XP-endo Shaper Systems in Curved Root Canals.

OBJECTIVE: This study compared the shaping ability of the Hyflex CM and XP-endo Shaper rotary file systems in curved mesial canals of mandibular molars using micro-computed tomography. MATERIAL AND METHODS: Seventeen mesial roots of extracted first mandibular molars with two independent mesial canals were scanned before and after root canal preparation with the tested rotatory file systems. Each mesial canal from the same specimen was prepared with one of the two systems. The parameters analyzed were canal centering (transportation) for the cervical, middle, and apical segments, as well as for the entire canal (0-10 mm from the apex); and canal volume increase, canal surface area increase, and unprepared canal walls for two segments, 0 to 4 mm and 0 to 10 mm from the apex. RESULTS: There was no significant difference between both systems regarding canal centering (transportation), volume increase, and unprepared canal walls for the 0 to 10 mm segment (p> 0.05); however, a significant difference was observed for the 0 to 4 mm segment (p <0.01), where the Hyflex CM left 28.46% of unprepared walls and XP-endo Shaper left 13.26%. CONCLUSIONS: The shaping ability of the two tested rotatory file systems in mesial roots of first mandibular molars was similar for all parameters in all the segments evaluated, except for the 0 to 4 mm segment, where XP-endo Shaper left a smaller area of unprepared canal walls than Hyflex CM.

Microtomographic Evaluation of Canal Centralization and Dentine Removal after Canal Preparation with Two Rotary Systems: HyFlex EDM and ProTaper Next.

OBJECTIVE: This study compared the ProTaper Next (PTN; Dentsply Sirona, Tulsa, Oklahoma, United States) and HyFlex EDM (HEDM; Coltene/Whaledent AG, Alstätten, Switzerland) systems using micro-computed tomography (CT). MATERIALS AND METHODS: Twenty-one mesial roots classified as Vertucci's type IV from extracted mandibular first molars with curvatures between 20 and 40 degrees were selected. The teeth were scanned using a micro-CT before and after root canal preparation by both systems, applied to the same root, in alternating canals. The following parameters were analyzed: canal centering, apical transportation, root canal diameter/root diameter. RESULTS: No statistically significant differences between both systems were observed for any of the assessed morphological parameters (p > 0.05). All canals presented diameter enlargement of more than 40% in relation to root diameter in the cervical and middle segments. No statistically significant difference was noted between the HEDM and PTN groups. The wear percentage for the HEDM group in the cervical and middle thirds were 49.66 ± 8.65 and 46.48 ± 14.29, respectively, and 51.02 ± 11.81 and 45.48 ± 10.79 for the PTN group, respectively. CONCLUSION: Both systems displayed similar mandibular molar mesial canals preparation, with no differences noted for any of the assessed parameters. Both groups showed increased canal diameter in the cervical and middle thirds by more than 40%.

Cavernous Hemangioma in the Orbital Cavity: Case Report.

Cavernous hemangiomas are benign malformations of vascular origin, usually well circumscribed and slow to grow. These lesions can be asymptomatic, being discovered unintentionally in imaging exams or symptomatic, indicated mainly by the presence of proptosis, diplopia, and visual disturbances by optic nerve compression. The complementary exams involve computed tomography associated with contrast, color Doppler, magnetic resonance, and angiography. Treatment can be conservative or surgical depending on the case, and the open therapy usually involves lateral, supraorbital, transconjunctival, transantral, pterional, transnasal, and extradural endoscopic orbitotomy. The present study aimed to report a recurrent case of hemangioma in the orbital cavity signaled by ocular proptosis, hyperemia, and ocular pain.The lesion was achieved through the Weber-Ferguson access with zygomatic osteotomy and preservation of the infraorbital nerve. The excision of the lesion was performed, and the previously displaced fragments were fixed with 1.5 mm mini plates. The patient has a chance of progressing with visual impairment due to considerable manipulation of the optic nerve and is being followed up.The reported case showed a successful diagnosis and therapeutic conduct, remaining now in the evolution and follow-up scenario.

Final Endodontic Irrigation with 2% Peracetic Acid: Antimicrobial Activity and Cytotoxicity.

OBJECTIVE: The aim of present study was to assess the cytotoxicity and antimicrobial efficacy of 2% peracetic acid (PAA) compared with 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine (CHX). MATERIAL AND METHODS: For the cytotoxicity test, 100 µl of the tested solutions were added in 12 wells with ECV 304 endothelial cells in each group: NaOCl, CHX, and PAA, in addition to the control group. Each solution was evaluated after 24 hours of contact in four dilutions: 0.2, 0.1, 0.05 and 0.025 through mitochondrial function using MTT colorimetric assay. In the antimicrobial evaluation, 40 dentin blocks 5 mm in length and 0.2 g in weight were incubated with 400 µl of Enterococcus faecalis suspension for 21 days at 37°C. The contaminated samples were divided into three experimental groups within 5 minutes of contact: NaOCl group, CHX group, PAA group, as well as the positive control group. The specimens received treatment and were transferred to a tube with saline for serial dilution of the solution and seeding for isolation and colony forming unit (CFU) count. STATISTICAL ANALYSIS: The results obtained were expressed as mean (A570 nm) ± standard deviation (SD) and in a multiple linear regression model and multiple comparisons conducted. RESULTS: The antimicrobial evaluation revealed that the NaOCl and CHX groups showed a statistically significant difference compared with the control group (p < 0.001), while the PAA reduced only the CFU growth. It can be concluded that, among the agents tested, PAA expressed greater cell viability, followed by CHX and NaOCl. However, it did not show greater antimicrobial activity in vitro in the mature biofilm of Enterococcus faecalis.

A barodontalgia em voo e o diagnóstico diferencial de dor odontogênica: relato de caso / In flight barodontalgia and the differential diagnosis of odontogenic pain: a case report

Introdução: A barodontalgia é uma condição aguda que ocorre pela diferença de pressão atmosférica e que afeta a saúde e o bem-estar dos pilotos durante o voo. Os pilotos militares estão mais suscetíveis às diferenças de pressão em razão das manobras rápidas e situações extremas que enfrentam ou por não haver cabine pressurizada na aeronave. Tal ocorrência pode levar a vertigem, incapacitação do profissional e finalização prematura do voo. Sua origem pode estar no dente, relacionada a alguma patologia pré-existente ou não, e ainda em outras estruturas da face, principalmente no seio maxilar. Dos casos relatados na literatura, 70% decorreram de pulpite relacionada a restaurações profundas e a maior parte (81%) ocorreu na decolagem da aeronave. Objetivo: Apresentar um caso clínico de um piloto de T-29 da Força Aérea Brasileira, atendido na Odontoclínica de Aeronáutica Santos-Dumont, imediatamente após o pouso. Relato de caso: A anamnese apontou a diferença de pressão como fator desencadeador da dor dentária aguda. Após o diagnóstico de necrose pulpar, o dente foi submetido ao tratamento endodôntico em sessão única, pelo uso de sistema rotatório Protaper Universal® e obturação com técnica termoplastificada Híbrida de Tagger. Na consulta de reavaliação, o paciente não relatou qualquer outro episódio de dor dentária em voo. Conclusão: Torna-se evidente a relevância do conhecimento desta condição por cirurgiões-dentistas civis e militares, para a correta condução do diagnóstico e do tratamento de aeronavegantes.

Introduction: The barodontalgia is an acute condition due to the air pressure difference that affects the health and the well being of pilots during flight. Military pilots are more susceptible to pressure differences due to quick maneuvering, the extreme situations in flight, or due the lack of pressure into aircraft cabin. Such occurrence can lead to dizziness and premature end of the flight. Its origin may be in the tooth, related to some pre-existing condition or not, and also in other structures of the face, especially in the maxillary sinus. Of the cases reported, 70% came from pulpitis related to deep restorations, and most cases (81%) appeared in the aircraft taking off. Aim: To report a clinical case of a T-29 Brazilian Air Force pilot, who came to Santos-Dumont Air Force Dental Clinic, immediately after landing. The patient interview pointed out barodontalgia as a cause of his acute toothache. After the diagnosis of necrotic pulp, the tooth was endodontically treated in single session by using the Protaper Universal rotary system, and filling with Hybrid Tagger thermoplasticized technique. In the query of reevaluation, the patient reported no further episodes of dental pain in flight. Conclusion: It is evident the relevance of knowledge of this condition by military and civilian dentists, to conduct proper diagnosis and treatment of airmen.

A remodelação óssea de extensa lesão periapical apósuso de PRP e hidróxido de cálcio - relato de caso clínico / The remodeling of extensive periapical lesion after use of PRP and calcium hydroxide- case report

Durante o preparo do canal radicular, em algunscasos, se faz necessário o uso de medicação intracanal(MIC) com o objetivo de continuar asanificação do sistema de canais radiculares.Dentre o arsenal de medicamentos do endodontista,encontra-se o PRP (paramonoclorofenol2%, Rinossoro e polietilenoglicol), umacombinação de antissépticos que pode, ainda,ser associada ao hidróxido de cálcio, por suaspropriedades antimicrobianas e capacidade deindução da reparação tecidual. Este trabalhoteve por objetivo apresentar um caso clínicoda paciente F.G.M., 19 anos, leucoderma, quecompareceu à Odontoclínica de AeronáuticaSantos-Dumont, queixando-se de dor intensanos dentes anteriores. Ao exame clínico-radiográficofoi observado edema no palato, percussãovertical positiva e extensa lesão periapical doincisivo lateral superior direito. Após anestesia eisolamento absoluto, procedeu-se acesso, penetraçãodesinfetante, preparo químico-mecânicoe aplicação de pasta de PRP e hidróxido de cálcio,como MIC. Foram realizadas trocas mensaisdesta MIC por seis meses, até que se observassea regressão da lesão. A observação clínica e radiográficademonstrou que a associação dessesmedicamentos parece induzir boa resposta tecidual,culminando com a remodelação óssea dostecidos periapicais.

During root canal preparation, in some cases,it is necessary the use of intracanal medication(ICM) in order to continue the sanitation of theroot canal system. Among the variety of endodonticmaterials, there is PRP (paramonochlorophenol2%, Rinossoro and polyethylene glycol),a combination of antiseptics, which can also beassociated with calcium hydroxide because ofits antimicrobial properties and induction of tissuerepair ability. This study aimed to present aclinical case of FGM patient, 19 years old, Caucasian,who attended the Santos-Dumont AirForce Dental Clinic, reporting intense pain in the maxillary anterior teeth. After physical and radiographicexamination, an edema was observed onthe palate region, presenting positive vertical percussionand an extensive periapical lesion of upperright lateral incisor. After anesthesia and rubberdam isolation were carried out the access, chemical-mechanical preparation and application of PRPpaste and calcium hydroxide as MIC. Exchangesof MIC were conducted on a monthly basis for sixmonths until was observed the regression of thelesion. The clinical and radiographic observationshowed that the combination of these drugs seemto induce good tissue response, culminating in therepair of periapical tissues.