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1.
Aust Endod J ; 2020 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-33247881

RESUMO

This report describes the second attempt at pulp revascularisation, using an association between 2% chlorhexidine (CHX) and calcium hydroxide (CH) as intracanal dressing, in an immature traumatised anterior tooth with pulp necrosis. A 21-year-old woman complained of pain and dental crown darkening of a permanent maxillary right central incisor. Her medical records presented a history of dental trauma, and at age 15, the first attempt at revascularisation was performed, using triple antibiotic paste (TAP) as the intracanal dressing. Recent radiographs then showed a periapical lesion associated with an immature root, which demonstrated the failure of the first attempt. The second pulp revascularisation was performed, using an association between CHX and CH as intracanal medication. The case was followed up for 24 months. Observations showed evidence of root development, dentinal wall thickening and periapical healing. In this case, the association between CHX and CH showed favourable results as an intracanal medication.

2.
Mater Sci Eng C Mater Biol Appl ; 112: 110852, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32409029

RESUMO

The present study describes the development of a chlorhexidine long-term drug delivery system using starch as a biodegradable polymer base. Three batches of thermoplastic starch films, containing starch particles/nanoparticles and chlorhexidine (CHX), were manufactured by casting. Morphological characterization showed an irregular surface with particles incorporated with chlorhexidine agglomerated in a starch matrix. Nanoindentation showed that the control film (without chlorhexidine) presented a more plastic and rigid behavior in relation to the films containing CHX. CHX was partially bounded to starch and prevented starch crystallization. Starch nanoparticles formed by precipitation were observed through transmission electron microscopy. By incorporating CHX into the solution, the nanoparticles presented different morphology, suggesting absorption of the drug. In vitro drug release was observed for 21 days by UV-vis spectrophotometry and released CHX amounted up to 19 mg/100 ml. Films presented microbiological potential for inhibiting Staphylococcus aureus growth as evaluated by the disk diffusion test in agar. It has been concluded that the developed film met the main requirements for a drug delivery system and that it is possible to be produced from a simple, cheap and reproduceable process.

3.
Rev. bras. odontol ; 77(1): 1-7, jan. 2020. ilus; tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1102870

RESUMO

Objective: to evaluate the root canal treatment (RCT) and non-surgical root canal retreatment (NSRCR), associated with foraminal enlargement, performed on a singlevisit. Material and Methods: 125 teeth with apical periodontitis and follow-up period ranging from 6 to 12 months were included. The success was considered by the absence of signs and symptoms and complete or incomplete periapical repair. Logistic regression analyses were used to identify factors associated with the repair (p<0.05). Results: RCT showed 71.58% of complete healing and 23.16% of acceptable healing. NSRCR showed 80% of complete healing and 20% of acceptable healing. Age, gender, type of treatment and preoperative pain were not statistically significant for the healing process (p>0.05). Premolars showed the greatest chance of periapical repair. Pulp Canal Sealer showed a greater chance of periapical repair when compared to Sealapex (p<0.05). Conclusion: RCT and NSRCR using a foraminal enlargement protocol provided a favorable prognosis of periapical healing


Objetivo: avaliar o tratamento endodôntico (TE) e o retratamento não cirúrgico do canal radicular (RNCCR), associado a ampliação foraminal, realizado em sessão única. Material e Métodos: foram incluídos 125 dentes com periodontite apical e proservação de 6 a 12 meses. O sucesso foi considerado pela ausência de sinais e sintomas e reparo periapical completo ou incompleto. Análises de regressão logística foram utilizadas para identificar fatores associados ao reparo (p<0,05). Resultados: o TE mostrou 71,58% de cicatrização completa e 23,16% de cicatrização aceitável. O RNCCR mostrou 80% e 20% cicatrização completa e aceitável, respectivamente. Idade, sexo, tipo de tratamento e dor pré-operatória não foram estatisticamente significantes para o processo de cicatrização (p>0,05). Os pré-molares apresentaram a maior chance de reparo periapical. O cimento Pulp Canal Sealer mostrou maior chance de reparo periapical quando comparado ao Sealapex (p<0,05). Conclusão: o TE e RNCCR utilizando um protocolo de alargamento foraminal, proporcionaram um prognóstico favorável da cicatrização periapical


Assuntos
Periodontite Periapical , Tratamento do Canal Radicular/métodos , Preparo de Canal Radicular
4.
Gen Dent ; 67(3): 58-61, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31199746

RESUMO

This study evaluated the effect of previous irrigation with chlorhexidine (CHX) on the bond strength of a calcium silicate-based material, Biodentine, when used for furcal repair. Furcal perforations were produced in 30 extracted mandibular molars. Teeth were divided into 3 groups according to the irrigant used: distilled water (DW), CHX followed by DW (CHX), and CHX followed by ethylenediaminetetraacetic acid (EDTA) and DW (CHX/EDTA). Biodentine was used to repair the perforations. A push-out bond strength test was performed after 7 days, and data were statistically analyzed using Kruskal-Wallis and Dunn tests (P < 0.05). The CHX/EDTA group showed significantly lower values than the DW and CHX groups (P < 0.05). The failure mode of the DW group was mainly mixed, while that of the CHX group was cohesive. The CHX/EDTA group exhibited adhesive and mixed failures. Irrigation with CHX prior to furcation repair did not result in a statistically significant difference, compared to the use of DW, in the push-out bond strength of Biodentine.


Assuntos
Compostos de Cálcio/química , Clorexidina/química , Colagem Dentária , Materiais Restauradores do Canal Radicular , Silicatos/química , Cálcio , Análise do Estresse Dentário , Dentina , Irrigantes do Canal Radicular/química , Hipoclorito de Sódio
5.
Dent. press endod ; 9(1): 72-81, jan.-mar. 2019.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1024254

RESUMO

Introdução: um dos objetivos da terapia endodôntica é a redução dos fatores microbianos no interior dos canais radiculares, o que pode ser conseguido por meio do preparo químico-mecânico (PQM). O PQM tem como finalidade criar um ambiente propício à condição de reparo, por meio da limpeza e modelagem do sistema de canais radiculares (SCR), que associa a ação mecânica dos instrumentos ao uso de substâncias químicas auxiliares. Em relação ao limite apical desse preparo e ao diâmetro apical final da instrumentação, podemos observar que não há consenso entre os profissionais. Introdução: o objetivo do presente estudo foi avaliar, por meio de uma revisão de literatura, a eficiência de duas técnicas no preparo e desinfecção do terço apical do SCR: a técnica de ampliação foraminal e a técnica de batente apical com manutenção da patência foraminal. Métodos: foi realizada uma busca nas bases de dados PubMed, Medline, BBO, Lilacs e SciELO, usando os seguintes termos: canal radicular, forame apical, endodontia, lima de patência, tamanho apical, lima apical final, preparo biomecânico, ampliação foraminal, comprimento de trabalho, anatomia dental, tratamento endodôntico, patência foraminal, preparo do canal radicular e batente apical. Cada um desses termos foi combinado utilizando os operadores booleanos E/OU. Após leitura dos resumos, 65 artigos foram selecionados e incluídos nessa revisão. Resultados: os resultados demonstraram que o alargamento do terço apical, seja com ou sem ampliação foraminal, parece favorecer o prognóstico do tratamento endodôntico, devido à redução do conteúdo infeccioso em toda a extensão do SCR. A manutenção da patência foraminal é um fator essencial para um PQM adequado quando a técnica de batente apical é realizada. Conclusão: conclui-se que preparos apicais mais amplos promovem resultados mais previsíveis, e que a ampliação foraminal possibilita o melhor debridamento e desinfeção do SCR (AU).


Introduction: Endodontic therapy should reduce the microbial load within the root canals, which can be achieved during chemomechanical preparation (CMP). The purpose of CMP of the root canal system (RCS) is to create a favorable environment for healing. CMP associates the mechanical action of instruments with the use of auxiliary chemical substances. There is no consensus among professionals about what should be the diameter of the apical foramen after CMP. This literature review evaluated the efficiency of two apical preparation techniques: foraminal enlargement and apical stop with maintenance of foraminal patency. Material and methods: A literature search was conducted in PubMed, Medline, BBO, Lilacs and Scielo using the following terms: root canal, apical foramen, endodontics, patency file, apical size, master apical file, biomechanical preparation, foraminal enlargement, working length, dental anatomy, endodontic treatment, foraminal patency, root canal preparation, and apical stop. All terms were combined using the Boolean operators AND/OR. After the abstracts were analyzed, 65 full texts were selected and included in this review. Results: The enlargement of the apical third, with or without foraminal enlargement, seems to improve endodontic treatment prognosis due to the reduction of infectious contents throughout the RCS. Foraminal patency is essential for adequateCMP when the apical stop technique is performed. Conclusion: Apical preparations with a greater diameter have more predictable results, and foraminal enlargement ensures better debridement and disinfection of the RCS (AU).


Assuntos
Tratamento do Canal Radicular , Preparo de Canal Radicular , Doenças Periapicais , Ápice Dentário
6.
Aust Endod J ; 45(2): 196-201, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30230115

RESUMO

The aim of this study was to evaluate the root canal configuration of maxillary premolars using cone-beam computed tomography (CBCT). CBCT images of 999 maxillary premolars from a database were analysed to determine the frequency of the number of roots, root canals and Vertucci's classification. The associations among these variables were evaluated by Chi-square test (P < 0.05). In the first premolars, 42.2% of single-rooted teeth had a type II configuration, whereas 98.7% of 2-rooted teeth showed type IV. In the second premolars, type I was the most prevalent (49.9%). The presence of two roots was more prevalent in first premolars, and the presence of one root was more prevalent in second premolars (P < 0.05). Male patients had a higher percentage of two roots compared with female patients (P < 0.05). Type IV and I was more prevalent in first and second premolars respectively (P < 0.05). There was a high frequency of 2-rooted and single-rooted teeth among maxillary first and second premolars respectively.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Dente Pré-Molar , Feminino , Humanos , Masculino , Tratamento do Canal Radicular , Raiz Dentária
7.
J Prosthet Dent ; 121(3): 485-491, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30409721

RESUMO

STATEMENT OF PROBLEM: Nonthermal argon plasma may increase the surface energy of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) dental ceramics. However, studies that evaluated the effect of increased plasma treatment times on the bond strength of resin cements to Y-TZP ceramics are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the effect of different nonthermal argon plasma (NTAP) treatment times on the surface energy and bond strength of a self-adhesive resin cement to Y-TZP ceramic. MATERIAL AND METHODS: Forty-eighty Y-TZP plates were divided into 2 groups (n=24): as-sintered (AS) and airborne-particle abrasion (APA) with 50-µm Al2O3, which were subdivided into 4 groups (n=6) according to the time of NTAP treatment: 0, 20, 60, and 120 seconds. The surface energy was evaluated with a goniometer. Forty Y-TZP blocks submitted to the same surface treatments (8 groups; n=5) were cemented to composite resin blocks, using a self-adhesive resin cement. After storage in distilled water at 37°C for 24 hours, the Y-TZP-composite resin blocks were cut into beams and submitted to a microtensile bond strength (µTBS) test. Data were analyzed using 2-way ANOVA and the Tukey honestly significant differences test (α=.05). RESULTS: Treatment with NTAP increased the surface energy for AS and APA groups (P<.05). For both groups, the µTBS was as follows: 0 seconds < 20 seconds < 60 seconds = 120 seconds (P<.05). Only after 120 seconds of NTAP treatment was the µTBS of APA higher than that of AS (P<.05). CONCLUSIONS: Treatment with NTAP improved the surface energy and increased the µTBS of self-adhesive resin cement to Y-TZP ceramic, with higher times of plasma treatment resulting in higher bond strength.


Assuntos
Colagem Dentária , Gases em Plasma , Argônio , Cerâmica , Cimentos Dentários , Análise do Estresse Dentário , Teste de Materiais , Cimentos de Resina , Resistência ao Cisalhamento , Propriedades de Superfície , Ítrio , Zircônio
8.
Clin Oral Investig ; 23(1): 53-63, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29572688

RESUMO

OBJECTIVE: The aim of the present study was to investigate the effects of a calcium hydroxide-based intracanal medication (ICM) on periodontal and endodontic infectious/inflammatory contents and on periodontal clinical parameters in teeth with primary periodontal lesion and secondary endodontic involvement. MATERIALS AND METHODS: Ten patients with abnormal pulp test results and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Samples were collected from root canals (RC) and periodontal pockets (PP) in order to investigate the microbiological status, levels of endotoxin (LPS), cytokines, and matrix metalloproteinases (MMP), before and after ICM. PCR was used for microbiological assessment. The kinetic-chromogenic LAL assay was used for LPS quantification. Quantikine ELISA kits were used for measurement of IL-1 α, IL-1 ß, TNF-α, PGE2, MMP-2, MMP-3, MMP-8, MMP-9, and MMP-13 levels. The statistical analyses were made using the Friedman and Wilcoxon tests (p < 0.05). T test was used to compare data on periodontal characteristics. RESULTS: ICM did not reduce the number of microorganisms in PP and RC, except for Fusobacterium nucleatum in RC. There was a significant reduction in LPS, MMPs, IL-1 ß, and TNF-α levels in PP after ICM. In RC, LPS, MMP13, PGE2, and IL-1ß levels remained unaltered (p > 0.05); however, the levels of the other MMPs and cytokines were reduced (p < 0.05). After 1 year of the root canal treatment, tooth mobility was significantly reduced (p ≤ 0.05). CONCLUSIONS: The use of a calcium hydroxide-based ICM showed positive effects for periodontal treatment prognosis, as it reduced LPS, cytokine, and MMP levels in periodontal pockets. CLINICAL SIGNIFICANCE: Patients presenting deep probing depth and undergoing periodontal treatment for at least 6 months, with no positive response to periodontal therapy, might benefit with the endodontic treatment.


Assuntos
Hidróxido de Cálcio/farmacologia , Cavidade Pulpar/efeitos dos fármacos , Cavidade Pulpar/microbiologia , Periodontite Periapical/tratamento farmacológico , Periodontite Periapical/microbiologia , Irrigantes do Canal Radicular/farmacologia , Tratamento do Canal Radicular , Adulto , Citocinas/análise , Endotoxinas/análise , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Metaloproteinases da Matriz/análise , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase
9.
Dent. press endod ; 8(3): 34-40, set.-dez. 2018. tab, graf
Artigo em Português | BBO - Odontologia | ID: biblio-948767

RESUMO

Introdução: diferentes irrigantes têm sido estudados, propostos e utilizados durante a terapia endodôntica. Objetivo: o objetivo deste estudo foi determinar as tendências atuais em irrigação, entre os endodontistas brasileiros. Métodos: um total de 398 endodontistas brasileiros respondeu a um questionário de pesquisa na internet, com 15 questões de múltipla escolha, seleções múltiplas e rankings numéricos, sobre sua seleção de irrigante, concentração, remoção da smear layer e uso de coadjuvantes para irrigação. Resultados: o hipoclorito de sódio foi o irrigante mais utilizado em uma concentração inferior a 5,0%. Clorexidina (CHX) foi o segundo irrigante primário mais utilizado, sendo a CHX 2% em gel a forma de apresentação mais prevalente. Em relação à remoção da smear layer, 88,4% dos entrevistados declararam realizar a remoção, onde o EDTA foi o irrigante mais utilizado (93,7%). Mais de 70% dos endodontistas utilizam um sistema coadjuvante durante a irrigação, dos quais 39,9% utilizam ativação ultrassônica; 24,4%, lima plástica e 1%, ativação sônica. O uso de EndoVac não foi relatado. Conclusões: a maioria dos entrevistados utiliza hipoclorito de sódio e remove rotineiramente a smear layer durante o tratamento endodôntico utilizando EDTA. Os endodontistas brasileiros utilizam técnicas coadjuvantes à irrigação. (AU)


Assuntos
Irrigantes do Canal Radicular , Preparo de Canal Radicular , Cavidade Pulpar , Endodontia/tendências
10.
Braz. j. oral sci ; 16: e17045, jan.-dez. 2017. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-883737

RESUMO

Aim: To determine the current trends in technological armamentarium and endodontic treatment among Brazilian endodontists. Methods: A total of 279 endodontists answered a web-based survey questionnaire about their region of activity in Brazil and years as a specialist, average number of endodontic cases treated per month, number of visits to complete the treatment, use of rubber dam for isolation, type of irrigant, obturation technique and device used for this purpose, temporary filling materials, and greater difficulty encountered during treatment and technological armamentarium. A descriptive analysis, expressed in terms of frequency and percentage, was performed and the data were correlated using the chi-square test (p<0.05). Results: Most of the respondents had up to 10 years as specialists. More than 50% of endodontists preferred to complete the endodontic treatment in a single visit. Ninety-nine percent of endodontists used rubber dam for isolation. NaOCl was the most widely used irrigant. Most of the respondents associated different techniques for root canal filling. Lateral condensation and Continuous wave of condensation were the isolated technique most reported. Filling devices (thermocompactors) were used by 53% of endodontists. Glass ionomer was the preferred temporary filling material. The answers for the use of technological armamentarium revealing that 94% of endodontists used an apex locator; 67.38% utilized magnification (loupe: 23.66%; microscope: 35.48%; microscope and loupe: 8.24%); 58% reported to digital radiography; and 47.31% used computed tomography as a complementary tool. About mechanized instrumentation, 44.44% endodontists employed rotary and reciprocating files. The difficulties encountered during endodontic treatment were classified as preparation > access > obturation > anesthesia > isolation. Conclusions: Most endodontists have implemented new technologies, such as mechanical instrumentation, apex locators, magnification, digital radiography, computed tomography, ultrasound, and obturation tools, in their clinical practice (AU)


Assuntos
Humanos , Masculino , Feminino , Endodontia/tendências , Endodontistas , Irrigantes do Canal Radicular , Obturação do Canal Radicular , Tratamento do Canal Radicular , Inquéritos e Questionários
11.
Braz Dent J ; 28(4): 447-452, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29160396

RESUMO

This study compared the effect of intermediate flush with distilled water delivered by conventional irrigation, EndoVac microcannula or Self-Adjusting File (SAF) system in the prevention of chemical smear layer (CSL) formation. Thirty human premolars were used. Canals were prepared with Reciproc system and 5.25% NaOCl. After chemomechanical preparation, samples were divided in 3 groups (n=10) according to the intermediate irrigation protocol with distilled water using: conventional irrigation, EndoVac microcannula or SAF. A final flush with 2% chlorhexidine solution was used and scanning electron microscopy was performed to assess protocol effectiveness. Two calibrated evaluators attributed scores according the presence or absence of CSL on the surface of the root canal walls at the coronal, middle and apical thirds, as follows: (1) no CSL; (2) small amounts of CSL; (3) moderate CSL; and (4) heavy CSL. Differences between protocols were analyzed with Kruskal-Wallis and Mann-Whitney U tests. Friedman and Wilcoxon signed rank tests were used for comparison between each root canal third. SAF resulted in less formation of CSL when compared with the conventional irrigation and EndoVac microcannula (p<0.05). When root canal thirds were analyzed, conventional irrigation and EndoVac groups showed less CSL formation at coronal and middle thirds in comparison to the apical third (p<0.05). In SAF group, there was no difference among the thirds (p>0.05). It may be concluded that an intermediate flush of distilled water, delivered by the SAF system resulted in a better reduction of CSL formation during chemomechanical preparation.


Assuntos
Preparo de Canal Radicular/instrumentação , Camada de Esfregaço , Irrigação Terapêutica , Clorexidina/administração & dosagem , Humanos , Microscopia Eletrônica de Varredura , Preparo de Canal Radicular/métodos , Hipoclorito de Sódio/administração & dosagem
12.
J Endod ; 43(12): 1978-1983, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29033085

RESUMO

INTRODUCTION: The proximity of the roots of maxillary posterior teeth to the maxillary sinus floor can be associated with the development of chronic maxillary sinusitis (CMS). Therefore, this study evaluated the correlation between the presence of endodontic infection and periodontal disease in maxillary posterior teeth and the presence of CMS. METHODS: A total of 83 patients (159 maxillary sinuses) were selected and underwent clinical dental examination to assess tooth mobility and pulp condition. In addition, cone-beam computed tomography was performed to evaluate the presence of periapical lesion and periodontal bone loss, and measure the distance from the root apex to the cortical of the maxillary sinus. The maxillary sinuses were divided into 2 groups: CMS and no maxillary sinusitis. Data were analyzed using χ2 test and binary logistic regression analysis (P < .05). RESULTS: Periodontal disease was positively associated with CMS, leading to a 3.45-fold higher association between these disorders (P < .05). CMS was significantly more common in patients with periodontal disease or endodontic infection in close proximity with the maxillary sinus. Periodontal disease or endodontic infection that was more distant from the maxillary sinus was more common in patients with no maxillary sinusitis (P < .05). To the extent that the tooth is more distant from the maxillary sinus floor, the chance of presenting CMS is reduced up to 2.5-fold (P < .05). CONCLUSION: Periodontal disease and proximity to the maxillary sinus are more common in cases of CMS, requiring a dental assessment and cone-beam computed tomography evaluation in patients with CMS with ineffective treatment.


Assuntos
Infecções Bacterianas/complicações , Tomografia Computadorizada de Feixe Cônico , Sinusite Maxilar/diagnóstico por imagem , Sinusite Maxilar/etiologia , Doenças Periodontais/complicações , Doenças Periodontais/diagnóstico por imagem , Adolescente , Adulto , Idoso , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino , Sinusite Maxilar/microbiologia , Pessoa de Meia-Idade , Doenças Periodontais/microbiologia , Adulto Jovem
13.
J Appl Oral Sci ; 25(4): 396-403, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28877278

RESUMO

Objective: The aim of this study was to evaluate the effect of photodynamic therapy (PDT) and non-thermal plasma (NTP) on adhesion and sealer penetration in root canals. Material and Methods: Sixty single-rooted premolars were used. The teeth were prepared using a crown-down technique. NaOCl and EDTA were used for irrigation and smear layer removal, respectively. The root canals were divided into three groups: control, PDT, and NTP. After treatments, the roots were filled using gutta-percha and either AH Plus (AHP) or MTA Fillapex (MTAF) sealers. Samples were sectioned at 4, 8, and 12 mm from the apex (1-mm slices)and analyzed by the push-out bond strength test (adhesion) and confocal laser scanning microscopy (sealer penetration). Data were statistically evaluated using Kruskal-Wallis, Dunn's, and Spearman's tests. Results: Regarding AHP, bond strength was similar in the NTP group and in the control group, but significantly lower in the PDT group. As to MTAF, both therapies showed lower values than the control group. In the confocal analysis of AHP, maximum and mean penetration, and penetrated area were statistically higher in the control group than in the PDT and NTP groups. Penetrated perimeter was similar among groups. Regarding MTAF, all parameters yielded better results in the NTP than in the control group. The PDT and control groups showed similar results except for penetrated area. Conclusion: PDT and plasma therapy affected the adhesion and sealer penetration of root canals filled with AH Plus and MTA Fillapex and there is no positive correlation between adhesion and sealer penetration.


Assuntos
Compostos de Alumínio/química , Compostos de Cálcio/química , Cavidade Pulpar/efeitos dos fármacos , Resinas Epóxi/química , Óxidos/química , Fotoquimioterapia/métodos , Gases em Plasma/química , Materiais Restauradores do Canal Radicular/química , Silicatos/química , Colagem Dentária/métodos , Combinação de Medicamentos , Humanos , Teste de Materiais , Microscopia Confocal , Valores de Referência , Reprodutibilidade dos Testes , Obturação do Canal Radicular/métodos , Estatísticas não Paramétricas
14.
J. appl. oral sci ; 25(4): 396-403, July-Aug. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-893636

RESUMO

Abstract Objective The aim of this study was to evaluate the effect of photodynamic therapy (PDT) and non-thermal plasma (NTP) on adhesion and sealer penetration in root canals. Material and Methods Sixty single-rooted premolars were used. The teeth were prepared using a crown-down technique. NaOCl and EDTA were used for irrigation and smear layer removal, respectively. The root canals were divided into three groups: control, PDT, and NTP. After treatments, the roots were filled using gutta-percha and either AH Plus (AHP) or MTA Fillapex (MTAF) sealers. Samples were sectioned at 4, 8, and 12 mm from the apex (1-mm slices)and analyzed by the push-out bond strength test (adhesion) and confocal laser scanning microscopy (sealer penetration). Data were statistically evaluated using Kruskal-Wallis, Dunn's, and Spearman's tests. Results Regarding AHP, bond strength was similar in the NTP group and in the control group, but significantly lower in the PDT group. As to MTAF, both therapies showed lower values than the control group. In the confocal analysis of AHP, maximum and mean penetration, and penetrated area were statistically higher in the control group than in the PDT and NTP groups. Penetrated perimeter was similar among groups. Regarding MTAF, all parameters yielded better results in the NTP than in the control group. The PDT and control groups showed similar results except for penetrated area. Conclusion PDT and plasma therapy affected the adhesion and sealer penetration of root canals filled with AH Plus and MTA Fillapex and there is no positive correlation between adhesion and sealer penetration.


Assuntos
Humanos , Compostos de Alumínio/química , Compostos de Cálcio/química , Cavidade Pulpar/efeitos dos fármacos , Resinas Epóxi/química , Óxidos/química , Fotoquimioterapia/métodos , Gases em Plasma/química , Materiais Restauradores do Canal Radicular/química , Silicatos/química , Colagem Dentária/métodos , Combinação de Medicamentos , Teste de Materiais , Microscopia Confocal , Valores de Referência , Reprodutibilidade dos Testes , Obturação do Canal Radicular/métodos , Estatísticas não Paramétricas
15.
Braz. dent. j ; 28(4): 447-452, July-Aug. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-888663

RESUMO

Abstract This study compared the effect of intermediate flush with distilled water delivered by conventional irrigation, EndoVac microcannula or Self-Adjusting File (SAF) system in the prevention of chemical smear layer (CSL) formation. Thirty human premolars were used. Canals were prepared with Reciproc system and 5.25% NaOCl. After chemomechanical preparation, samples were divided in 3 groups (n=10) according to the intermediate irrigation protocol with distilled water using: conventional irrigation, EndoVac microcannula or SAF. A final flush with 2% chlorhexidine solution was used and scanning electron microscopy was performed to assess protocol effectiveness. Two calibrated evaluators attributed scores according the presence or absence of CSL on the surface of the root canal walls at the coronal, middle and apical thirds, as follows: (1) no CSL; (2) small amounts of CSL; (3) moderate CSL; and (4) heavy CSL. Differences between protocols were analyzed with Kruskal-Wallis and Mann-Whitney U tests. Friedman and Wilcoxon signed rank tests were used for comparison between each root canal third. SAF resulted in less formation of CSL when compared with the conventional irrigation and EndoVac microcannula (p<0.05). When root canal thirds were analyzed, conventional irrigation and EndoVac groups showed less CSL formation at coronal and middle thirds in comparison to the apical third (p<0.05). In SAF group, there was no difference among the thirds (p>0.05). It may be concluded that an intermediate flush of distilled water, delivered by the SAF system resulted in a better reduction of CSL formation during chemomechanical preparation.


Resumo O presente estudo comparou o efeito da utilização de uma irrigação intermediária com água destilada usando a irrigação convencional, a microcânula EndoVac ou o sistema Self-Adjusting File (SAF) na prevenção de formação da smear-layer química (SLQ). Trinta pré-molares humanos foram utilizados. Os canais foram preparados com sistema Reciproc e irrigados com NaOCl a 5,25%. Após o preparo químico mecânico, as amostras foram divididas em 3 grupos (n=10) de acordo com o protocolo de irrigação intermediária com água destilada utilizado: irrigação convencional, a microcânula EndoVac ou SAF. Utilizou-se uma lavagem final com solução de clorexidina a 2% e a microscopia electrónica de varredura foi utilizada para avaliar a eficácia dos protocolos. Dois avaliadores calibrados atribuíram escores de acordo com a presença ou ausência de SLQ nas paredes do canal radicular nos terços coronal, médio e apical, como a seguir: (1) sem SLQ; (2) pequenas quantidades de SLQ; (3) SLQ moderada e (4) muita SLQ. As diferenças entre protocolos foram analisadas com testes de Kruskal-Wallis e Mann-Whitney U. Os testes Friedman e Wilcoxon foram utilizados para comparação entre cada terço do canal radicular. SAF resultou em menor formação de SLQ quando comparado com a irrigação convencional e a microcânula EndoVac (p<0,05). Quando os terços dos canais radiculares foram analisados, os grupos irrigação convencional e microcânula EndoVac apresentaram menor formação de SLQ nos terços coronal e médio em relação ao terço apical (p<0,05). No grupo SAF, não houve diferença entre os terços (p>0,05). Dentro dos resultados do presente estudo, pode-se concluir que um fluxo intermediário de água destilada, administrado pelo sistema SAF resultou em melhor redução da formação de SLQ durante o preparo químico mecânico.


Assuntos
Humanos , Preparo de Canal Radicular/instrumentação , Camada de Esfregaço , Irrigação Terapêutica , Clorexidina/administração & dosagem , Microscopia Eletrônica de Varredura , Preparo de Canal Radicular/métodos , Hipoclorito de Sódio/administração & dosagem
16.
Mater Sci Eng C Mater Biol Appl ; 77: 257-262, 2017 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-28532027

RESUMO

Surface treatment of fiber-reinforced posts can increase adhesion, especially on the post/resin cement interface. The purpose of this in vitro study was to evaluate the effect of different surface treatments on fiber post cemented with a self-adhesive system. Sixty fiberglass epoxy resin posts were cleaned, dried and divided into 6 groups (n=10): Control (no surface treatment), silane (silane coupling agent was applied homogeneously on surface), 24% hydrogen peroxide (H2O2) (immersion during 1min), blasting (blasting with aluminum oxide for 30s), NH3 plasma (plasma treatment for 3min) and HMDSO plasma (plasma treatment for 15min). After the treatments, posts were inserted into a silicon matrix that was filled with the resin cement RelyX U200. Afterwards, the post/cement specimens were cut perpendicularly to the long axis of the posts into six 1.0mm thick discs and submitted to a push-out bond strength (POBS) test. Failure pattern was classified in 5 types: type I: cohesive in post; type II: cohesive in cement; type III: cohesive post and cement; type IV: adhesive post/cement; and type V: mixed (association between cohesive and adhesive). Data were analyzed by one-way ANOVA and Tukey HSD post hoc test (α=0.05). Silane (15.94±6.5), blasting (13.13±3.6), NH3 plasma (14.44±4.0) and HMDSO plasma (13.23±5.3) showed higher POBS when compared to control (p<0.05) and similar among them. H2O2 (9.40±4.0) treatment showed POBS values statistically similar to control (9.65±3.6). Failures were predominantly cohesive post and cement, type III, in all groups. In conclusion, surface treatments influenced in the adhesion of fiberglass post with the self-adhesive cement RelyX U200. Silane, blasting with aluminum oxide and plasmas (NH3 and HMDSO) showed results superior to 24% hydrogen peroxide.


Assuntos
Adesivos , Colagem Dentária , Análise do Estresse Dentário , Peróxido de Hidrogênio , Teste de Materiais , Técnica para Retentor Intrarradicular , Cimentos de Resina , Propriedades de Superfície
17.
Restor Dent Endod ; 42(2): 105-110, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28503475

RESUMO

OBJECTIVES: This study investigated the cleaning ability of ultrasonically activated irrigation (UAI) and a novel activation system with reciprocating motion (EC, EasyClean, Easy Equipamentos Odontológicos) when used with a relatively new chelating agent (QMix, Dentsply). In addition, the effect of QMix solution when used for a shorter (1 minute) and a longer application time (3 minutes) was investigated. MATERIALS AND METHODS: Fifty permanent human teeth were prepared with K3 rotary system and 6% sodium hypochlorite. Samples were randomly assigned to five groups (n = 10) according to the final irrigation protocol: G1, negative control (distilled water); G2, positive control (QMix 1 minute); G3, QMix 1 minute/UAI; G4, QMix 1 minute/EC; G5, QMix 3 minutes. Subsequently the teeth were prepared and three photomicrographs were obtained in each root third of root walls, by scanning electron microscopy. Two blinded and pre-calibrated examiners evaluated the images using a four-category scoring system. Data were statistically analyzed using Kruskal-Wallis and Dunn tests (p < 0.05). RESULTS: There were differences among groups (p < 0.05). UAI showed better cleaning ability than EC (p < 0.05). There were improvements when QMix was used with auxiliary devices in comparison with conventional irrigation (p < 0.05). Conventional irrigation for 3 minutes presented significantly better results than its use for 1 minute (p < 0.05). CONCLUSIONS: QMix should be used for 1 minute when it is used with UAI, since this final irrigation protocol showed the best performance and also allowed clinical optimization of this procedure.

18.
Restor Dent Endod ; 42(2): 125-133, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28503478

RESUMO

OBJECTIVES: This study compared the effect of hexamethyldisiloxane (HMDSO) and ammonia (NH3) plasmas on the bond strength of resin cement to fiber posts with conventional treatments. MATERIALS AND METHODS: Sixty-five fiber posts were divided into 5 groups: Control (no surface treatment); H2O2 (24% hydrogen peroxide for 1 min); Blasting (blasting with aluminum oxide for 30 sec); NH3 (NH3 plasma treatment for 3 min); HMDSO (HMDSO plasma treatment for 15 min). After the treatments, the Ambar adhesive (FGM Dental Products) was applied to the post surface (n = 10). The fiber post was inserted into a silicon matrix that was filled with the conventional resin cement Allcem Core (FGM). Afterwards, the post/cement specimens were cut into discs and subjected to a push-out bond strength (POBS) test. Additionally, 3 posts in each group were evaluated using scanning electron microscopy. The POBS data were analyzed by one-way analysis of variance and the Tukey's honest significant difference post hoc test (α = 0.05). RESULTS: The Blasting and NH3 groups showed the highest POBS values. The HMDSO group showed intermediate POBS values, whereas the Control and H2O2 groups showed the lowest POBS values. CONCLUSION: Blasting and NH3 plasma treatments were associated with stronger bonding of the conventional resin cement Allcem to fiber posts, in a procedure in which the Ambar adhesive was used.

19.
Quintessence Int ; 48(7): 555-561, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28555199

RESUMO

Intrusive luxation is a severe trauma-related event with a high frequency of pulp necrosis and root resorption. A common complication following intrusion is tooth ankylosis, which can extend to progressive replacement root resorption. An increasing infraposition in growing individuals can also occur. Decoronation is a new conservative treatment for cases of tooth ankylosis in young patients who have not finished growing. In this surgical technique, the tooth crown is removed and the root with replacement resorption process remains inside the alveolus. This treatment allows the alveolar bone to continue to develop, thus preserving bone dimensions. The purpose of this article is to report a multidisciplinary case of a young patient with anterior open bite, dental ankylosis, and tooth infraposition affected by intrusive luxation. Decoronation was the treatment of choice for this patient. The patient was then referred to orthodontic treatment to maintain the space of the maxillary right central incisor and open bite correction. After 5 years of follow-up, good clinical and radiologic results were obtained.


Assuntos
Ortodontia Corretiva/métodos , Reabsorção da Raiz/terapia , Mantenedor de Espaço em Ortodontia/métodos , Anquilose Dental/terapia , Coroa do Dente/cirurgia , Acidentes por Quedas , Criança , Terapia Combinada , Humanos , Incisivo/lesões , Masculino , Mordida Aberta/terapia , Reabsorção da Raiz/etiologia , Anquilose Dental/etiologia
20.
Dent. press endod ; 7(1): 14-19, Jan-Apr. 2017. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-846720

RESUMO

Objetivo: o objetivo deste relato de caso foi descrever o tratamento endodôntico de um primeiro pré-molar inferior com três canais. Relato do caso: paciente do sexo masculino, 54 anos de idade, procurou o serviço de emergência da Universidade Federal do Rio de Janeiro com dor no dente #34. Ao exame clínico/radiográfico, observou-se cárie extensa. O teste de sensibilidade pulpar exibia resposta positiva e exacerbada, com ausência de sintomatologia periapical ao exame de palpação e percussão. Portanto, foi diagnosticado um quadro de pulpite irreversível. O paciente foi anestesiado, realizou-se o isolamento absoluto e a abertura coronária. O preparo mecânico foi realizado com a técnica manual crown-down, sendo o comprimento de trabalho estabelecido a 1 mm aquém do ápice radicular, nos três canais. O hipoclorito de sódio a 2,5% foi usado como solução irrigadora e, para remoção da smear layer, utilizou-se EDTA a 17%. A obturação dos canais radiculares foi realizada pela técnica híbrida de Tagger, utilizando-se o cimento Endofill e cones de guta-percha. A radiografia final exibiu a presença de três canais, um lingual e dois vestibulares, que se encontravam no início do terço apical. Observou-se, ainda, uma ramificação ligando os canais vestibulares (interconduto). Considerações finais: o conhecimento e o domínio da anatomia do canal são fatores chave para o sucesso do tratamento endodôntico.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Dente Pré-Molar/anatomia & histologia , Endodontia , Obturação do Canal Radicular/métodos , Tratamento do Canal Radicular/métodos
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