Optimization of automated preparation of long oval-shaped root canals using supplementary instrumentation.

This study compared the preparation of long oval-shaped root canals using WaveOne Gold and XP-endo Shaper systems, both supplemented or not with manual instrumentation. Twenty-four long oval-shaped canals of mandibular incisors were distributed into two groups according to the instrumentation: WaveOne Gold Primary or XP-endo Shaper systems. All root canals were manually instrumented with a size 25 K-file after automated preparation. The specimens were scanned by using a micro-CT device (17.42 µm) before and after automated preparation and manual instrumentation. The increased surface of the root canal and the percentage of untouched areas were assessed. Both WaveOne Gold and XP-endo Shaper systems increased the root canal surface and had similar untouched areas (p>0.05). Supplementary instrumentation increased the surface of the root canal and decreased the untouched walls (p<0.05). WaveOne Gold and XP-endo Shaper systems provided a similar preparation of long oval-shaped canals and manual instrumentation improved their preparation.

Optimization of automated preparation of long oval-shaped root canals using supplementary instrumentation

Abstract This study compared the preparation of long oval-shaped root canals using WaveOne Gold and XP-endo Shaper systems, both supplemented or not with manual instrumentation. Twenty-four long oval-shaped canals of mandibular incisors were distributed into two groups according to the instrumentation: WaveOne Gold Primary or XP-endo Shaper systems. All root canals were manually instrumented with a size 25 K-file after automated preparation. The specimens were scanned by using a micro-CT device (17.42 µm) before and after automated preparation and manual instrumentation. The increased surface of the root canal and the percentage of untouched areas were assessed. Both WaveOne Gold and XP-endo Shaper systems increased the root canal surface and had similar untouched areas (p>0.05). Supplementary instrumentation increased the surface of the root canal and decreased the untouched walls (p<0.05). WaveOne Gold and XP-endo Shaper systems provided a similar preparation of long oval-shaped canals and manual instrumentation improved their preparation.

Resumo Este estudo comparou o preparo de canais radiculares ovais longos usando os sistemas WaveOne Gold e XP-endo Shaper, ambos complementados ou não com instrumentação manual. Vinte e quatro canais longos e ovais de incisivos inferiores foram distribuídos em dois grupos de acordo com a instrumentação: sistemas WaveOne Gold Primary ou XP-endo Shaper. Todos os canais foram instrumentados manualmente com uma lima K tamanho 25 após preparo automatizado. Os espécimes foram escaneados usando um dispositivo de micro-CT (17,42 µm) antes e após o preparo automatizado e instrumentação manual. O aumento de superfície do canal radicular e a porcentagem de áreas intocadas foram avaliadas. Ambos os sistemas WaveOne Gold e XP-endo Shaper aumentaram a superfície do canal radicular e apresentaram áreas intocadas semelhantes (p>0,05). A instrumentação complementar aumentou a superfície do canal radicular e diminuiu o percentual de áreas intocadas (p <0,05). Os sistemas WaveOne Gold e XP-endo Shaper tiveram o preparo de canais ovais longos semelhantes, e a instrumentação manual melhorou o preparo.

Immunohistological study of the effect of vascular Endothelial Growth Factor on the angiogenesis of mature root canals in rat molars.

Tissue bioengineering has been applied to Endodontics to seek a more biological treatment. The presence of blood vessels is crucial for cell nutrition during tissue formation. Objective This study analysed the application of vascular endothelial growth factor (VEGF) in the angiogenesis of mature root canals. Material and methods Upper first molars of twelve 13-week old Wistar male rats were used. The root pulp of the mesiobuccal canal was removed and the root canal instrumented with K-files up to size #25. Periapical bleeding was induced into the root canal by introducing a #15 K-file beyond the apex. The teeth on the right side of the arch were filled up with blood clot (G1), whereas those on the left side were filled up with blood clot plus 50 ng/ml of VEGF (G2). Teeth were sealed with light-curing glass-ionomer cement and the animals were sacrificed after 60 days. The maxilla was dissected and fixed before obtaining serial sections for histological processing with haematoxylin-eosin (HE) and immunohistochemical factor-VIII. Immunohistochemical labelling was evaluated using scores for statistical analysis. Results Immunohistological analysis demonstrated the presence of angiogenesis in both groups, but with higher angiogenic maturation in G2 during the experimental period (p<0.05). HE staining showed connective tissue with absence of odontoblasts in all specimens. Conclusions It can be concluded that it is possible to obtain angiogenesis in mature root canals with or without the use of VEGF, although the latter tends to accelerate blood vessel formation.

Immunohistological study of the effect of vascular Endothelial Growth Factor on the angiogenesis of mature root canals in rat molars

Abstract Tissue bioengineering has been applied to Endodontics to seek a more biological treatment. The presence of blood vessels is crucial for cell nutrition during tissue formation. Objective This study analysed the application of vascular endothelial growth factor (VEGF) in the angiogenesis of mature root canals. Material and methods Upper first molars of twelve 13-week old Wistar male rats were used. The root pulp of the mesiobuccal canal was removed and the root canal instrumented with K-files up to size #25. Periapical bleeding was induced into the root canal by introducing a #15 K-file beyond the apex. The teeth on the right side of the arch were filled up with blood clot (G1), whereas those on the left side were filled up with blood clot plus 50 ng/ml of VEGF (G2). Teeth were sealed with light-curing glass-ionomer cement and the animals were sacrificed after 60 days. The maxilla was dissected and fixed before obtaining serial sections for histological processing with haematoxylin-eosin (HE) and immunohistochemical factor-VIII. Immunohistochemical labelling was evaluated using scores for statistical analysis. Results Immunohistological analysis demonstrated the presence of angiogenesis in both groups, but with higher angiogenic maturation in G2 during the experimental period (p<0.05). HE staining showed connective tissue with absence of odontoblasts in all specimens. Conclusions It can be concluded that it is possible to obtain angiogenesis in mature root canals with or without the use of VEGF, although the latter tends to accelerate blood vessel formation.

Blindagem coronorradicular simultânea em Endodontia: do preparo radicular à restauração coronária / Simultaneous crown-root shielding in endodontics: from root preparation to coronary restoration

Introdução: a restauração do dente tratado endodonticamente apresenta-se como um fator que pode influenciar de forma significativa no sucesso do tratamento. Nesse contexto, a restauração simultânea tanto radicular quanto coronária se apresenta como uma possibilidade restauradora. Uma excelente alternativa é a utilização de pinos de fibra de vidro associados a restaurações diretas em resina composta, principalmente pelas propriedades mecânicas e estéticas dos pinos de fibra associados às resinas compostas atuais. Objetivo: o objetivo desse trabalho foi apresentar, por meio de casos clínicos, uma técnica de instrumentação e restauração simultânea do sistema de condutos radiculares, que engloba desde o diagnóstico endo-restaurador, o preparo mecanizado do canal radicular, preparo ultrassônico do espaço para retentor visando a cimentação intrarradicular do pino de fibra de vidro, concluindo com a restauração funcional do dente tratado, considerando aspectos clínicos, mecânicos e biológicos do dente tratado endodonticamente. Resultados: nos controles clínicos e radiográficos, foi possível observar que ambos os casos clínicos encontravam-se assintomáticos, em oclusão e com reparação das lesões perirradiculares. Conclusões: pode- se concluir que essa técnica permite uma adequada restauração do dente tratado endodonticamente de forma simultânea em uma única sessão de tratamento, como foi possível observar nos casos apresentados.

Avaliação da relação endo-sinusal por meio da tomografia computadorizada de feixe cônico ­ relato de três circunstâncias clínicas / Assessment of relationship between endodontic treatment and the maxillary sinus through the use of cone-beam computed tomography ­ three case reports

Lesões periapicais podem provocar alterações inflamatórias no revestimento da mucosa sinusal, podendo causar o desenvolvimento de uma sinusite. Sabe-se que 10% a 12% de todos os casos de sinusite maxilar são de origem odontogênica. O objetivo deste trabalho foi avaliar a estreita proximidade e comprometimento entre o assoalho do seio maxilar e os ápices das raízes dos dentes posteriores, por meio de Tomografia Computadorizada de Feixe Cônico (TCFC). Material e método: radiografias periapicais intraorais e cortes de TCFC foram realizados na avaliação de três pacientes com presença de lesões apicais muito extensas, com dor, congestão nasal ou queixas respiratórias. No primeiro caso, foi realizado o tratamento endodôntico. No segundo caso, foi realizada uma cirurgia paraendodôntica. Já no terceiro caso, extração do dente. Foram feitos controles clínicos, radiográficos e tomográficos aos 6 e 12 meses para nova avaliação dos casos. Resultados: no primeiro caso, apesar da proximidade da lesão apical com o seio maxilar, o paciente não apresentava queixa dolorosa nem comprometimento sinusal. No segundo caso, foi constatada uma mucosite sinusal de origem odontogênica. Já no terceiro caso, comprometimento da raiz palatina com o seio maxilar caracterizou o quadro de sinusite que foi evidente através da TCFC. Conclui-se com base nesses casos apresentados que a TCFC é útil no diagnóstico precoce da sinusite de origem odontogênica. Nesses três casos, obteve-se uma boa resolução clínica dos casos, sabendo-se a proximidade exata e grau de comprometimento do seio maxilar com as lesões apicais existentes (AU).

Periapical lesions may cause inflammatory changes in the lining of the sinus mucosa which may cause the development of sinusitis. It is known that 10% to 12% of all cases of maxillary sinusitis are of odontogenic origin. The objective of this study was to evaluate the close proximity and compromise between the floor of the maxillary sinus and posterior teeth apexes roots through the use of Cone-Beam Computed Tomography (CBCT). Material and method: Intraoral periapical radiographs and CBCT slices were performed in the assessment of three patients with presence of very large apical lesions, pain, nasal congestion or respiratory complaints. In the first case, endodontic treatment was performed. In the second case, paraendodontic surgery was performed. While in the third case tooth extraction was performed. Six and twelve month clinical, radiographic and tomographic follow-up reassessment of the three cases was performed. Results: In the first case, despite the proximity of apical lesion to the maxillary sinus, the patient showed no signs of pain or sinus involvement. In the second case, signs of mucositis of odontogenic origin were observed. In the third case, there was compromise of palatal root with the maxillary sinus which characterized the symptoms of sinusitis which were evident through the use of CBCT. Conclusion: It was concluded based in the cases presented that CBCT is useful in the early diagnosis of sinusitis of odontogenic origin. In these three cases, good clinical resolution was obtained due to the knowledge of the exact proximity and degree of compromise of the maxillary sinus with existing apical lesions (AU).

Importância do uso do ultrassom no acesso endodôntico de dentes com calcificação pulpar / Importance of ultrasound in endodontic access of teeth with pulp calcification

Um dos desafios da Endodontia é a localização dos canais radiculares, para que esses possam ser limpos, remodelados e obturados adequadamente. O uso do ultrassom e da visualização do campo operatório sob magnificação tem aumentado a segurança em determinados tratamentos endodônticos, garantindo resultados ótimos. O objetivo deste trabalho é mostrar uma abordagem clínica de tratamento de um dente com calcificação na entrada dos condutos, no qual realizou-se o acesso à câmera pulpar e, em seguida, a remoção da calcificação e a localização dos condutos foram feitas por meio de pontas ultrassônicas sob magnificação, concluindo-se o caso com a blindagem corono-radicular definitiva em sessão única. Pode-se concluir que a associação do uso do ultrassom sob magnificação é uma estratégia clínica viável para acessar áreas de calcificação.