Cyclic Fatigue Resistance of Rotary versus Reciprocating Endodontic Files: A Systematic Review and Meta-Analysis.

(1) Background: The failure of nickel-titanium (NiTi) rotary files is a complication related to endodontic instruments. The aim of this study was to compare the resistance to cyclic fatigue between rotary and reciprocating file systems. (2) Methods: Specific PICO: Population (P): artificial root canals; Interventions (I): instrumentation with NiTi rotary and reciprocating files; Comparison (C): rotary versus reciprocating files; Outcome (O): cyclic fatigue resistance. Studies were identified through bibliographic research using electronic databases (Medline, Embase, Scopus, SciELO, and WOS). The studies were combined using a random effects model by the inverse variance method. The effect size was the mean of the time to fracture (TTF) and number of cycles to fracture (NCF). Heterogeneity was assessed using the p value of the Q test for heterogeneity and the I2. (3) Results: TTF for rotary files was determined in 474.5 s and 839.1 for reciprocating without statistically significant differences. NCF for rotary systems was determined in 1444.2 and for reciprocating file systems in 4155.9 with statistically significant differences (p = 0.035), making reciprocating files more resistant. (4) Conclusions: Reciprocating files have better resistance to cyclic fatigue than rotary files. When tested in double curvature canals, reciprocating files also showed higher resistance.

Limas rotatorias de uso en Odontopediatría: revisión de la literatura / Rotary files for use in pediatric dentistry: Literature review

Introducción: Los dientes primarios juegan un importante papel en el crecimiento y desarrollo general de los niños, por lo que es necesario conservarlos hasta el momento de su recambio fisiológico. Cuando existe una afectación pulpar que compromete la vitalidad del diente, la pulpectomía se convierte en un reto para el odontopediatra debido a la compleja anatomía radicular de los dientes primarios. En esta revisión bibliográfica se darán a conocer diferentes sistemas de limas usados en odontopediatría, y así brindar una mirada actualizada de la instrumentación rotatoria al realizar pulpectomías en los molares primarios. Material y Método: se realizó una búsqueda bibliográfica en Pubmed y Web of Science de acuerdo con criterios de inclusión y exclusión previamente establecidos. Resultados: tras aplicar los criterios de inclusión y exclusión fueron seleccionados un total de 30 referencias bibliográficas de los últimos 15 años. Conclusión: las limas rotatorias pediátricas pueden considerarse alternativas seguras y más eficientes en la realización de pulpectomías en molares primarios, ya que se reduce el tiempo de tratamiento, se produce desbridamiento completo de los conductos y se mantiene la función del diente hasta su exfoliación. (AU)

Introduction: Primary teeth play an important role in the growth and development of children, so it is necessary to keep them until the moment of their physiological replacement. When there is a pulp involvement that compromises the vitality of the tooth, pulpectomy treatment becomes a challenge for the pediatric dentist due to the complex root anatomy of primary teeth. This review of the literature will present different file systems used in primary teeth and provide an updated look at rotary instrumentation when performing pulpectomies on primary molars. Material and Method: a bibliographic search was carried out in Pubmed and Web of Science according to previously established inclusion and exclusion criteria. Results: after applying the inclusion and exclusion criteria, a total of 30 bibliographic references from the last 15 years were selected. Conclusion: pediatric rotary files can be considered safe and more efficient alternatives in performing pulpectomies on primary molars, due to treatment time is reduced, complete debridement of the root canals is produced, and tooth function is maintained until exfoliation. (AU)

Limas rotatorias de uso en Odontopediatría: revisión de la literatura / Rotary files for use in pediatric dentistry: Literature review

Introducción: Los dientes primarios juegan un importante papel en el crecimiento y desarrollo general de los niños, por lo que es necesario conservarlos hasta el momento de su recambio fisiológico. Cuando existe una afectación pulpar que compromete la vitalidad del diente, la pulpectomía se convierte en un reto para el odontopediatra debido a la compleja anatomía radicular de los dientes primarios. En esta revisión bibliográfica se darán a conocer diferentes sistemas de limas usados en odontopediatría, y así brindar una mirada actualizada de la instrumentación rotatoria al realizar pulpectomías en los molares primarios. Material y Método: se realizó una búsqueda bibliográfica en Pubmed y Web of Science de acuerdo con criterios de inclusión y exclusión previamente establecidos. Resultados: tras aplicar los criterios de inclusión y exclusión fueron seleccionados un total de 30 referencias bibliográficas de los últimos 15 años. Conclusión: las limas rotatorias pediátricas pueden considerarse alternativas seguras y más eficientes en la realización de pulpectomías en molares primarios, ya que se reduce el tiempo de tratamiento, se produce desbridamiento completo de los conductos y se mantiene la función del diente hasta su exfoliación. (AU)

Introduction: Primary teeth play an important role in the growth and development of children, so it is necessary to keep them until the moment of their physiological replacement. When there is a pulp involvement that compromises the vitality of the tooth, pulpectomy treatment becomes a challenge for the pediatric dentist due to the complex root anatomy of primary teeth. This review of the literature will present different file systems used in primary teeth and provide an updated look at rotary instrumentation when performing pulpectomies on primary molars. Material and Method: a bibliographic search was carried out in Pubmed and Web of Science according to previously established inclusion and exclusion criteria. Results: after applying the inclusion and exclusion criteria, a total of 30 bibliographic references from the last 15 years were selected. Conclusion: pediatric rotary files can be considered safe and more efficient alternatives in performing pulpectomies on primary molars, due to treatment time is reduced, complete debridement of the root canals is produced, and tooth function is maintained until exfoliation. (AU)

Mandibular third molar extraction: perceived surgical difficulty in relation to professional training.

BACKGROUND: Establishing the level of surgical difficulty pre-operatively is an essential step in ensuring correct treatment planning. This study set out to determine whether the knowledge and experience acquired by dentists who had received different levels of training influenced, firstly, the perceived levels of difficulty of a variety of cases of mandibular third molar (MTM) extraction and, secondly, the perceived difficulty deriving from a series of factors (patient-related factors, anatomical and radiographic factors, operative factors). METHODS: This cross-sectional, descriptive, observational study took the form of a survey. Using a visual analog scale (VAS), participants evaluated both the perceived difficulty of 30 cases of MTM extraction described by means of digital panoramic radiographs and the perceived difficulty deriving from a series of factors conditioning MTM extraction. The results underwent statistical analysis with SPSS Statistics 28.0 software. Non-parametric tests (Mann Whitney test for independent samples and the Kruskal-Wallis test) were applied. RESULTS: A total of 389 surveys were available for analysis. Dental practioners with no surgical training saw the intervention as presenting greater difficulty. Professionals with postgraduate training in oral surgery considered patient-related factors more important than operative factors, in contrast to dentists who had not received oral surgery training. CONCLUSIONS: Dental training has a signficant influence on the perceived difficulty of MTM extraction and also affects opinions about which factors have greater or lesser influence on surgical difficulty.

Analysis of the Importance of the Motion Used in the Resistance of Different Mechanical Instrumentation Systems in Endodontics: A Comparative Study.

Aim: The aim of this study was to compare the cyclic fatigue strength of different reciprocating rotary systems depending on the movement used. Methods: Four study groups were analyzed (n = 30): (1) Reciproc®, (2) Reciproc Blue®, (3) Wave One Gold® and (4) Procodile®. Each group was divided into three subgroups according to the motion used: (A) Reflex Dynamic® (n = 10), (B) ReFlex Smart® (n = 10) and (C) conventional reciprocating motion (n = 10). They were used in a dynamic cyclic fatigue prototype until their fracture, and the time was measured in seconds. The results obtained were analyzed with the ANOVA method, and for two-to-two comparisons, the Tukey method and Weibull statistics were used. Results: Procodile ReFlex Smart had the longest time to failure, and statistically significant differences were found between Procodile ReFlex Smart and the other files and motions (p < 0.05). Conclusion: Smart motions increase cyclic fatigue strength. ReFlex Smart® motion increases the cyclic fatigue strength of reciprocating rotary systems, and Procodile® ReFlex Smart was the most resistant system file.

Adding Two Antimicrobial Glasses to an Endodontic Sealer to Prevent Bacterial Root Canal Reinfection: An In Vivo Pilot Study in Dogs.

Current endodontic procedures continue to be unsuccessful for completely removing pathogens present inside the root canal system, which can lead to recurrent infections. In this study, we aimed to assess the antimicrobial capacity and tissue response of two inorganic bactericidal additives incorporated into a paste root canal sealer on contaminated root dentin in vivo. An experimental study was performed in 30 teeth of five Beagle dogs. After inducing microbiological contamination, root canal systems were treated by randomly incorporating one of two antimicrobial additives into a commercial epoxy-amine resin sealer (AH Plus), i.e., G3T glass-ceramic (n = 10) and ZnO-enriched glass (n = 10); 10 samples were randomized as a control group. After having sacrificed the animals, microbiological, radiological, and histological analyses were performed, which were complemented with an in vitro bactericidal test and characterization by field emission scanning electron microscopy. The tested groups demonstrated a non-significant microbiological reduction in the postmortem periapical index values between the control group and the bactericidal glass-ceramic group (p = 0.885), and between the control group and the ZnO-enriched glass group (p = 0.169). The histological results showed low values of inflammatory infiltrate, and a healing pattern characterized by fibrosis in 44.4% of the G3T glass-ceramic and 60.0% of ZnO-enriched glass. Bactericidal glassy additives incorporated in this root canal sealer are safe and effective in bacterial reduction.

A Comparative Study of Biocompatibility in Rat Connective Tissue of a New Mineral Trioxide Compound (Theracal) versus MTA and a Bioactive G3 Glass.

The aim of this paper was to assess the differences in tissue response to implantation during 15, 30 and 45 days in the subcutaneous connective tissue of Wistar rats from three biomaterials: Angelus MTA®, Theracal LC®, and Angelus MTA® to which 25% bioglass G3 was added. Twenty-four Wistar rats were used, the materials were inserted into the rat's dorsal area in silicone tubes 5 mm long by 1.5 mm diameter. Histological reaction was assessed at 15, 30, and 45 days after implantation. They were then stained with hematoxylin eosin and evaluated by two observers. Data were analyzed using Fisher's exact test and Mann-Whitney's U test was used to determine the association between variables. Angelus MTA induced the formation of dystrophic calcifications twice as much as Theracal LC (p < 0.05). The addition of G3 did not affect the greater or lesser occurrence of calcifications (p > 0.05). Theracal LC and MTA plus G3 caused an inflammatory reaction, which was chronic at 15 days and decreased in intensity, almost disappearing after 45 days. Theracal LC, as well as Angelus MTA plus G3, were well tolerated when implanted in the subcutaneous connective tissue of rat. Histologically, no inconvenience was found for the use by direct contact of Theracal LC, and the mixture of MTA with 25% bioactive glass G3, in the tissue of Wistar rats.

Photodynamic therapy in endodontic root canal treatment significantly increases bacterial clearance, preventing apical periodontitis.

OBJECTIVE: To analyze the antimicrobial activity of photodynamic therapy as an adjunct to conventional endodontic treatment, particularly against Enterococcus faecalis. METHOD AND MATERIALS: A total of 42 single-rooted teeth obtained from 33 patients with apical periodontitis were included. Sampling was developed in three stages: (1) immediately after accessing the root canal, (2) after chemical and mechanical instrumentation, and finally, (3) after photodynamic therapy application. The bacterial load of each sample was quantified by seeding on blood agar plates and selective M-Enterococcus agar. All growing colonies were identified using MALDI-TOF (Bruker; matrix-assisted laser desorption/ionization time-of-flight), and the entire bacterial microbiota composition was determined in the first sample by PCR-DGGE (polymerase chain reaction denaturing gradient gel electrophoresis), using 16 rDNA primers and selective nucleotide sequencing. RESULTS: The endodontic therapy obtained a mean reduction in the cultivable bacterial load of 1.12 log, whereas the photodynamic therapy combination significantly increased the bacterial clearance (P < .0001). Viable cells of E faecalis were detected in 16.6% of root canals, with a mean value of 93 CFU per tooth, which was reduced to 67 and 9 CFU/tooth after conventional endodontic and photodynamic therapy treatments, respectively. Molecular E faecalis detection demonstrated that this species was present in 23.2% of baseline samples. DGGE analysis demonstrated the existence of a more complex microbiota than those observed using classical cultures. CONCLUSION: Photodynamic therapy as an adjunct to root canal treatment produces a significant reduction in E faecalis bacterial load, and it should be considered in the prevention of apical periodontitis.

Endodontic re-treatment and restorative treatment of a dens invaginatus type II through new technologies.

BACKGROUND: The complex anatomy of dens invaginatus makes access cavity to root canal system difficult, which has an impact on the prognosis of these teeth. A novel technique, based on new technologies, is proposed to make access cavity conservative and guided with minimal dental structure lost. MATERIAL AND METHODS: This case report shows the root canal retreatment and the endodontic surgery of a dens invaginatus type II in a left lateral upper incisor previously treated which was affected by a chronic apical abscess and an apical fracture. A Cone Beam Computed Tomography was performed to better diagnosis the dental anatomy. An intraoral scan was performed to get a digital 3D model. A computer-guided implant planning software was used to plan the access cavity and design the splint guided. Finally, the clinical crown was restored by a resin nanoceramic veneer made by a chairside system made up of an intraoral scanning unit and a grinding unit. Last, the authors carried through the endodontic surgery to extract the apical fractured fragment. RESULTS: Follow-up appointments at 6, 12 and 18 months showed a radiographic reduction of the periapical lesion and absence of clinical signs. CONCLUSIONS: The splint guide allowed a guided and conservative access cavity to root canal system. It facilitates the root canal retreatment and improves the prognosis of the teeth with dental malformations. Key words:CAD-CAM, Cone-Beam Computed Tomography, dens in dente, dens invaginatus, dental pulp cavity, endodontics.

Histological analysis of different local haemostatic agents used for periapical surgery: An experimental study with Sprague-Dawley rats.

The aim of the present study was to analyse differences in the tissue response to the different haemostatic agents used for periapical surgery (BloodSTOP iX® (oxicellulose), Expazen® (aluminum chloride), calcium sulphate (CS), Gelatamp® (gelatin sponge) and Hemocor® (ferric sulphate). Seventy-two bone defects were made on the calvarium of 36 Sprague-Dawley rats. The specimens were euthanised at 3, 6 and 12 weeks. Histological analysis revealed a giant cell foreign body reaction against BloodStop iX® , Gelatamp® and Hemocor® . Leukocytes persisted at the surgical bed during the healing process longer as expected with Gelatamp® (6 weeks) and Hemocor® (12 weeks). We confirmed a generalised delay in bone formation. Calcium sulphate did not cause any foreign body reaction. CS showed excellent results with a high degree of compatibility, there was no inflammatory reaction with this agent after 12 weeks and was not associated with a significant foreign body reaction at any time during the study.

Endodontic treatment of dens evaginatus by performing a splint guided access cavity.

AIM: Dens evaginatus (DE) is described as an unusual dental malformation. Tooth structure variations attached to this anatomical disturbance complicates the performance of a conservative access cavity for a conventional root canal treatment. Author's purpose is to describe the treatment of a type V DE by using splits as guides to perform access cavity. CLINICAL CONSIDERATIONS: This clinical case shows a root canal treatment of a type V DE diagnosed by using a cone beam computed tomography (CBCT). Access cavity was planned through an osseointegrated implant planning software and guided by a stereolithographied split. After endodontic treatment, tooth was sculpted for placing a veneer, processed by a chair-side system in a single session. CONCLUSIONS: CBCT is an effective method for obtaining internal anatomical information of teeth with anatomical malformations. The osseointegrated implant planning software is an effective method for planning root canal treatment and designing stereolithograped splits (for performing minimally invasive access cavities). CLINICAL SIGNIFICANCE: Stereolithographed splints allow performing a guided and conservative access cavity of teeth affected by dental malformations whereas digital technology allows us to esthetically reconstruct a tooth in a single session.

Análisis in vitro de la capacidad antimicrobiana del hidróxido de calcio según diferentes vehículos y concentraciones / In vitro analysis of the antimicrobial capability of calcium hydroxide according to different vehicles and concentrations

Objetivos. El objetivo de este estudio in vitro fue evaluar la efectividad del hidróxido de calcio frente al Enterococcus faecalis, utilizando diferentes agentes solventes. Material y métodos. El estudio se llevó a cabo utilizando 120 placas de agar sangre con E. faecalis. Se establecieron tres grupos de estudio en función del agente solvente del hidróxido de calcio: anestésico local (N = 40), solución salina (N = 40) y digluconato de clorhexidina (N = 40). Se utilizaron diferentes concentraciones de cada una de las disoluciones: 60 mg / ml (1,6 M), 30 mg / ml (0,8 M), 15 mg/ml (0,4 M) y 12 mg/ml (0,3 M). Se midieron los halos inhibitorios del crecimiento con el software Image J(R) de análisis y los datos fueron analizados estadísticamente mediante el test de Tukey. Resultados. La concentración de hidróxido de calcio que tuvo mayor efectividad frente a E. faecalis fue la de 0,3M. No se encontraron diferencias estadísticamente significativas en la efectividad frente al E. faecalis entre las diferentes disoluciones de hidróxido de calcio preparadas con los tres tipos de solventes (p > 0.05). Conclusiones. El hidróxido de calcio es efectivo frente al E. faecalis, independientemente del agente solvente utilizado

Aim. This in vitro study aims to assess the effectiveness against Enterococcus faecalis of calcium hydroxide, dissolved in different solvent agents. Material and methods. The study was carried out using 120 agar blood agar plates with E. faecalis. Three different group of study were established depending on agent solvent: anesthesia (N=40), saline solution (N=40) and chlorhexidine digluconate (N=40). Different concentrations of each agent were used 60 mg/ml (1,6 M), 30 mg/ml (0,8 M), 15 mg/ml (0,4 M) and 12 mg/ml (0,3 M). Growth inhibition halos were measured with analysis software Image J(R). Data was analyzed using the Tukey test. Results. The calcium hydroxide concentration more effective against E. faecalis was 0,3 M. No statistically significant differences were found in the effectiveness against E. faecalis between the different solutions of calcium hydroxide prepared with the three types of solvents (p > 0.05). Conclusions. Calcium hydroxide is effective against E. faecalis, regardless of the used solvent agent

An analysis in vivo of intracanal bacterial load before and after chemo-mechanical preparation: A comparative analysis of two irrigants and two activation techniques.

BACKGROUND: The goals of this randomized double-blind trial were to assess the antimicrobial activity in vivo of Sodium hypochlorite (NaOCl) vs. chlorhexidine gluconate (CHX) used in combination either with EndoActivator® or IRRI S® files in patients with apical periodontitis. MATERIAL AND METHODS: A total of 120 patients with apical periodontitis (in single or multiple root canals) were randomly assigned to the four irrigation protocols outlined below: Group A: 5.25% sodium hypochlorite (NaOCl) + EndoActivator®; Group B: 5.25% NaOCl + IRRI S® files; Group C: 2% chlorhexidine gluconate (CHX) + EndoActivator®; Group D: 2% CHX + IRRI S® files. Paper points were used to collect microbiological samples before (1A samples) and after (1B samples) irrigation. Viable colony-forming units (CFU) were quantified twice: (1) without speciation, and (2) only for Enterococcus Faecalis(EF). Statistical analysis was performed using SPSS 22.0 for Windows. RESULTS: No significant differences were observed between NaOCl and CHX in the reduction of CFU; in fact, reduction was < 93% for the two irrigants. Conversely, statistically significant differences were found between the two activation techniques (sonic and ultrasonic) in the reduction of Enterococcus Faecalis(EF). Thus, the effectiveness of ultrasonic activation was significantly higher (< 93%; p=0.012) as compared to sonic activation. Following the combination of the two irrigants with the two activation techniques (groups A, B, C and D), significant differences were observed between group A and B (p=0.025) in the reduction of EF populations, reaching up to 94%. CONCLUSIONS: NaClO and CHX are effective in reducing intracanal bacterial load. Ultrasonic activation is the most effective activation technique in reducing EF populations. KEY WORDS: Chlorhexidine gluconate, sodium hypochlorite, ultrasonic irrigation, sonic irrigation, apical periodontitis, Enterococcus faecalis.

Análisis comparativo in vitro de la capacidad de sellado marginal en cavidades a retro del MTA y del cemento de óxido de cinc-eugenol reforzado / In vitro analysis and comparison of the apical sealing capability of MTA and a reinforced zinc oxide-eugenol cement

Objetivo: El objetivo de este estudio consiste en comparar la capacidad de sellado apical de dos materiales empleados en la obturación de cavidades a retro en cirugía periapical: MTA y un cemento de óxido de cinc-eugenol reforzado (Super EBA(R)). Material y métodos: Se llevó a cabo un estudio in vitro con dientes unirradiculares extraídos, a fin de evaluar la capacidad de sellado apical de dos materiales empleados como material de obturación en cavidades a retro: cemento de óxido de cinc reforzado (Súper EBA(R)) (n = 30) y MTA (n = 30). Además, se creó un grupo control negativo (n = 5) y otro positivo (n = 5). Las muestras procesadas fueron sumergidas en tinta China y posteriormente diafanizadas. Tras secar las muestras, se cuantificó el grado de filtración (mm) mediante un software de análisis de imagen. Los resultados fueron analizados utilizando el test de la t de Student, empleando el programa SPSS versión 20.0. Un valor de p ≤ 0,05 fue considerado significativo. Resultados: El 6,6% y el 10% de las muestras obturadas con MTA o con Súper EBA(R), respectivamente, sufrieron una filtración completa. Estas referencias revelaron que el grado de filtración no depende del material empleado (p = 0,133). Conclusión: No existen diferencias respecto al grado de filtración entre ambos materiales empleados en el sellado retrocavitario

Objectives: The aim of this study was to compare the apical sealing capabilities of the mineral trioxide aggregate (MTA) and of the reinforced zinc oxide-eugenol cement Super EBA(R). Material and methods. An in vitro study was carried out using extracted single-rooted teeth samples. Two materials were tested as root-end filling materials: a reinforced zinc oxide-eugenol cement (Super EBA(R)) (n = 30) and mineral trioxide aggregate (MTA) (n = 30). Another two groups were created as negative (n = 5) and positive (n = 5) control groups. The samples were put in Chinese ink and then diafanizated. Once dried, the level of leakage (mm) was measured by an image software program. The results were analysed using Student's t-test, using the SPSS version 20.0. Differences with p value lower or equal 0.05 were considered significant. Results: Mean filtration in MTA group was 0.77 ± 1.006, whereas in the SuperEba group it was 1.20 ± 1.186 (p = 0.133). Complete leakage was found in 6.6% of the samples filled with MTA and in 10% of those filled with Super EBA(R) (p = 0.133). The level of leakage was not influenced by the material used and null hypothesis can be accepted. Conclusion: Both type of root-end filling materials analysed in this research, are indicated for sealing the retropreparation, without differences in the leakage

Diagnosis and endodontic treatment of type II dens invaginatus by using cone-beam computed tomography and splint guides for cavity access: a case report.

BACKGROUND AND OVERVIEW: Dens invaginatus (DI) is defined as a rare dental malformation. The inherent structural variants of this anatomic disorder make it difficult to perform conventional endodontic treatment procedures by means of a conservative access cavity. In this clinical case report, the authors describe the treatment of a type II DI by means of guided splints for cavity access. CASE DESCRIPTION: This is a clinical report of a case of type II DI in a maxillary lateral incisor. The authors established the diagnosis by means of cone-beam computed tomography (CBCT). The authors manufactured 3 splint guides from a Digital Imaging and Communications in Medicine file and a stereolithography file obtained from a plaster model of the patient by using software for guided implant placement, for access opening, and for locating the root canals. CONCLUSIONS: CBCT is an effective method for obtaining information about the root canal system in teeth with DI. In addition, guided implant surgery software is effective for manufacturing splint guides for endodontic treatment with conservative pulp chamber access. PRACTICAL IMPLICATIONS: Information obtained from CBCT allows the clinician to fabricate splint guides for minimally invasive access opening in this type of case, thus reducing the loss of dental tissue.

Reabsorción radicular interna. A propósito de un caso / Internal root resorption. A case report

Las reabsorciones radiculares internas (RRI) se describen como un proceso infrecuente localizado en el interior del conducto radicular, que acontece como resultado de un aumento de la actividad odontoclástica. La aparición de este proceso patológico se encuentra vinculado al grado de afectación del complejo dentinopulpar; advirtiéndose una mayor incidencia en aquellos dientes afectados por necrosis pulpar (77%) y periodontitis apical crónica (75%). Los dientes afectados por RRI se muestran asintomáticos con frecuencia, pudiendo observarse lesiones fistulosas en los casos más avanzados. El diagnostico por imagen constituye el método más eficaz para establecer un diagnóstico precoz, y el tratamiento de conductos supone la terapia de elección. Este caso clínico describe el caso de una reabsorción radicular interna secundaria a un antecedente traumático. Con objeto de favorecer la desinfección del defecto cavitario, se planificó la aplicación de medicación intraconducto entre citas. La obturación del conducto radicular se llevó a cabo mediante una técnica de gutapercha termoplástica. Durante esta fase se produjo una sobreextensión del material de obturación radicular, hecho que justificó la cirugía endodóntica a la que se sometió a la paciente posteriormente. La retrocavidad configurada en el extremo apical resultó obturada con MTA, atendiendo a su elevada capacidad de sellado marginal y sus propiedades osteoinductoras

The internal root resorption ( IRR ) are described as an uncommon process located inside the root canal, that occurs as a result of the increase of clastic cells stimulated by pulpal inflammation. The appearance of this disease process is linked to the degree of involvement of the dentin-pulp complex, noticeable a higher incidence in those teeth affected by pulp necrosis (77%) and chronic apical periodontitis (75 %). Teeth affected by IRR are often non-symptomatic, fistulous lesions can be seen in more advanced cases. The imaging diagnostic is the most effective method to establish an early diagnosis and root canal treatment involves the treatment of choice. This case report describes the case of internal root resorption secondary to a traumatic history. In order to promote disinfection cavitary defect ,the application of intracanal medication was planned between appointments. The root canal filling was carried out by a technique of thermoplastic guttapercha. Throughout this phase there was an overextension of root canal filling material, a fact which justified endodontic surgery the patient underwent later. The rootend preparation was sealed with MTA , based on its high level of marginal seal and osteoinductive properties

Estudio in vitro de la eficacia del hipoclorito de sodio y la clorhexidina contra el enterococcus faecalis / Antimicrobial effects of sodium hipochlorite and clorhexidine against Enterococcus faecalis. A in vitro study

Objetivo. El propósito principal de esta investigación in vitro es comparar el efecto antimicrobiano de la clorhexidina (CHX) y del hipoclorito de sodio (NaCIO) a diferentes concentraciones contra el E. faecalis, analizando a la vez distintos tiempos de acción de cada una de las sustancias de estudio. Material y método. Las sustancias de estudio han sido: NaCIO caliente al 2,5%, NaCIO al 5,25%, CHX líquida al 2% NaCIO caliente al 2,5% junto al CHX líquida al 2%, NaCIO al 5,25% junto a CHX líquida al 2% y suero salino como grupo control Los tiempos analizados: 15", 30", 1', 3', 5', 10', 15', 30' y 1 hora. Para la identificación bacteriana hemos empleado dos métodos diferentes: la tinción diferencial de Gram y la diferencias estadísticamente significativas valores de p<=0,05. Resultados. Mayor eficacia en la erradicación de bacterias de la CHX líquida 2% frente al resto de irrigantes, hallando diferencias estadísticamente significativas con todos, excepto con NaCIO 5,25% + CHX líquida 2%. Conclusiones. La combinación del NaCIO y la CHX no supera la acción antimicrobiana de la CHX aislada (AU)

Objetive. To investigate in vitro the antimicrobial activity of sodium hypochlorite (NaCIO) and clorhexidine (CHX) in different concentrations against Enterococcus faecalis, compared with the efficacy of the combination of the same irrigating substances. Material and methods. The substances tested wre: 2,5% warm NaCIO 5,25% NaCIO, 2% liquid CHX 2,5 warm NaCIO with 2% liquid CHX, 5,25% NaCIO with 2% liquid CHX. Sterile saline was used as control Analyzed times: 15", 30", 1', 3', 5', 10', 15', 30' and 1 hour. For the bacterial identification we have used two different methods: the agar diffusion test and a biochemical identification kit (API 20 Strep, Biomereux, Madrid). Statistical analysis was conducted with the Student's t test. Differences were considered statistically significant when p<=0.05. Results. Inferential analysis revealed a statistically significant difference in the reduction of bacteria between CHX liquid 2% and the rest of irrigants, except with NaCIO 5,25% + liquid CHX 2%. Conclusions. The association of NaCIO and CHX did not improve the antimicrobial activity of CHX alone (AU)