Accuracy of Root ZXII, E-PEX and FIND apex locators in teeth with vital pulp: an in vivo study.

This research evaluated, in vivo, the accuracy of three electronic apex locators - EALs (Root ZXII, E-PEX and FIND) in teeth with vital pulp submitted to biopulpectomy, preserving the periodontal stump. For this study, 90 single-rooted teeth with extraction indication were selected. After positive pulpal cold sensitivity test, pulp chamber access was performed. The cervical and middle thirds of root canals were instrumented with Reciproc R25, and the K#15 file was used as a standard instrument to determine working length, forming 2 groups: Constriction (insertion of the instrument until the apical constriction limit) and Foramen (insertion of the instrument until the foramen and then repositioning at constriction, without removing the file from the canal). The hand file was stabilized with a light-cured flow resin. After extraction, the samples were analyzed through microCT SkyScan 1272, with CTAN software, which evaluated the proximity between the tip of the file to the apical constriction, providing data for comparative analysis using Kruskal-Wallis and Dunn tests (p<0.05). There was a statistically significant difference in the abilities of the EALs to detect the apical constriction after reaching the foramen with Root ZX II showing higher accuracy (89%). However, there was no difference in the accuracy of the three EALs in detecting the apical constriction without reaching the foramen. Based on the present results, we conclude that EALs may show accurate measures in detecting apical constriction and foramen, even without damaging the periodontal stump in biopulpectomy.

Accuracy of Root ZXII, E-PEX and FIND apex locators in teeth with vital pulp: an in vivo study

Abstract: This research evaluated, in vivo, the accuracy of three electronic apex locators - EALs (Root ZXII, E-PEX and FIND) in teeth with vital pulp submitted to biopulpectomy, preserving the periodontal stump. For this study, 90 single-rooted teeth with extraction indication were selected. After positive pulpal cold sensitivity test, pulp chamber access was performed. The cervical and middle thirds of root canals were instrumented with Reciproc R25, and the K#15 file was used as a standard instrument to determine working length, forming 2 groups: Constriction (insertion of the instrument until the apical constriction limit) and Foramen (insertion of the instrument until the foramen and then repositioning at constriction, without removing the file from the canal). The hand file was stabilized with a light-cured flow resin. After extraction, the samples were analyzed through microCT SkyScan 1272, with CTAN software, which evaluated the proximity between the tip of the file to the apical constriction, providing data for comparative analysis using Kruskal-Wallis and Dunn tests (p<0.05). There was a statistically significant difference in the abilities of the EALs to detect the apical constriction after reaching the foramen with Root ZX II showing higher accuracy (89%). However, there was no difference in the accuracy of the three EALs in detecting the apical constriction without reaching the foramen. Based on the present results, we conclude that EALs may show accurate measures in detecting apical constriction and foramen, even without damaging the periodontal stump in biopulpectomy.

Survey of endodontic pain treatment performed in prompt dental care: need for protocol / Levantamento de tratamento de dor endodôntica, realizado em Pronto Atendimento Odontológico: necessidade de protocolo

A dor de caráter endodôntico acomete grande parte da população mundial que procura por tratamento de urgência em pronto atendimento. Poucos trabalhos observam a casuística e o protocolo de atendimento que estão inseridos nos prontos atendimentos como: diagnóstico, presença de selamento coronário provisório, utilização de medicação intracanal, medicação sistêmica e o retorno do paciente com dor. Mediante ao exposto, foi realizado uma pesquisa quantitativa descritiva, retrospectiva e documental, e o levantamento de protocolo de urgência nas seguintes instituições: Serviços de Pronto Atendimento da cidade de Araçatuba (PAO) e na Faculdade de Odontologia da Universidade Estadual Paulista de "Júlio de Mesquita Filho" (FOA/UNESP). Dados como tipo de medicação intracanal, selamento coronário, medicação sistêmica e retorno do paciente com dor foram tabulados e avaliados estatisticamente pelo software SigmaPlot 13.0. O protocolo FOA/PAO foram semelhantes nos diagnósticos de pulpite irreversível e necrose pulpar, não havendo associação (P>0.05). Houve associação (P<0.05) apenas no diagnóstico de abscesso endodôntico, o protocolo do PAO foi prescrever medicação sistêmica, não realizar selamento e não MIC, diferentemente da FOA. Referente a prescrição de medicação sistêmica, houve associação (P<0.05), pois o PAO realiza prescrição em todos os casos: pulpite irreversível, necrose e abscesso, já a FOA apenas em necrose e abscesso. No retorno do paciente com dor, nota-se associação (P<0.05) nos casos de abscesso que receberam MIC adversa e não retornaram com dor. Embora o protocolo FOA/PAO seja diferente para os casos de abscesso o objetivo do tratamento de urgência em ambas instituições foi alcançado, pois removeram a dor do paciente(AU)

Endodontic pain affects a large part of the world population, which leads for a seek for urgency treatment. Few reports studied the casuistry and protocol of dental care inserted in the prompt attendance, such as: diagnosis, provisional coronal sealing, in tracanal medication, systemic medication and patient with pain complaint. The objective of this study was to carry out a survey of the urgency protocol in both dental care institutions: Prompt Dental Care Services of Araçatuba city (PAO) and the Araçatuba School of Dentistry/Sao Paulo State Univ ersity Júlio de Mesquita Filho (FOA/UNESP). The medical records of patients who voluntarily sought care in the urgency department, with anamnesis and a description of the performed procedure, were evaluated. Data suc h as intracanal medication, coronary sea ling, systemic medication and patient return with pain complaint were tabulated and statistically evaluated via SigmaPlot 13.0 software, with no association of these variables and the patient return with pain complai nt (P> 0.05). However, association (P<0. 05) was observed between attendance institution where urgency was carried out and the presence of temporary coronal sealing in cases with abscess, whereas FOA performs the coronal sealing as attendance protocol and P AO doesn't. There was also an associatio n (P<0.05) between diagnosis, prescription of systemic medication and dental care attendance institution, since PAO performed the largest number of medication prescriptions. It is concluded that, although dental care attendance protocols were similar in ca ses of pulpitis or necrosis, differing only in abscess, the main objective of urgency treatment was achieved in both treatment protocols, since treated patients were painless for more than 7 days(AU)

Use of sonic waves in bubble formation, microhardness and fluoride release of a high-viscosity glass-ionomer cement.

AIM: High-viscosity glass-ionomer cements (HV-GIC) are indicated for restorations but their viscosity favors the inclusion of bubbles within it. This study aimed to evaluate the use of ultrasonic and sonic waves in bubble formation, microhardness and fluoride release in a HV-GIC, also considering a different powder:liquid ratio (P/L). METHODS: Twenty-four molars with occlusal cavities were divided into four groups (N = 6): CG, HV-GIC with manual insertion; UG, application of ultrasonic waves; SG, application of sonic waves; and FG, HV-GIC fluid (1:2 P/L) with manual insertion. After 24 hours, bubbles and microhardness (50 g/5 s) were measured. Fluoride release (N = 10) was evaluated in CG, SG and UG after cariogenic challenge for 11 days. Microhardness, total area and number of bubbles, and fluoride release were submitted to ANOVA and Tukey's test. The average size of bubbles was analyzed by Kruskal-Wallis test (α = 5%). RESULTS: FG presented the lowest value of microhardness and higher average size for bubbles (P < .05). Differences concerning total number, total area occupied by bubbles and fluoride release were not found (P > .05). CONCLUSION: The use of sonic and ultrasonic waves had no influence on bubble formation, microhardness and fluoride release of a HV-GIC. Changing the P/L is not recommended.

Cleaning effectiveness of a nickel-titanium ultrasonic tip in ultrasonically activated irrigation: a SEM study.

In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer's protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey's tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.

Cleaning effectiveness of a nickel-titanium ultrasonic tip in ultrasonically activated irrigation: a SEM study

Abstract In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer's protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey's tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.