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1.
Aust Endod J ; 2021 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-33754413

RESUMO

This study evaluated the ability of reciprocating glide path instruments to reach the full working length (RFWL). Thirty mesial roots of mandibular molars were matched into 2 groups (n = 15 teeth, 30 root canals), according to the system used for glide path: WaveOne Gold Glider (WOGG) and R-Pilot. The samples with fractured instruments or when it was not possible to RFWL were scanned using micro-computed tomography. Fractured instruments were also visualised through a scanning electron microscopy to verify the type of fracture. The parameters were compared statistically by Fisher's and chi-square tests (P < 0.05). No instrument fractures were observed in the R-pilot, while 2 fractures occurred in the WOGG group (P > 0.05). RFLW was achieved in 29 canals (96.66%) and 28 canals (93.33%) with R-pilot and WOGG instruments, respectively (P > 0.05). The instruments are able to RFWL in mesial canals of mandibular molars. WOGG showed two fractures while no R-Pilot instruments fractured.

2.
Clin Oral Investig ; 2020 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-33236240

RESUMO

OBJECTIVES: This study evaluated the danger zone (DZ) in mesial roots of mandibular molars and the correlation between anatomical references of the DZ and some anatomical landmarks including tooth/root length, depth of mesial and distal grooves, and inter-canal orifices distance. MATERIAL AND METHODS: Twenty-eight mesial roots of mandibular molars with 2 independent canals were scanned and divided into 2 groups according to root length. The anatomical landmarks were correlated (Pearson or Spearman coefficients) with root level, thickness, and position of the DZ and also compared (independent samples t or Mann-Whitney tests) between the 2 groups at α = 5%. RESULTS: No statistical difference was observed between groups regarding DZ parameters and depth of mesial and distal grooves (P > 0.05). Orifice distance in group 2 (4.49 ± 0.75 mm) was significantly greater than group 1 (3.76 ± 0.89 mm) (P < 0.05). Significant correlations (P < 0.05) were found between (i) DZ level and root/tooth length (r = 0.54 and 0.49, respectively), (ii) DZ thickness and distal groove depth (r = - 0.45), and orifice distance (r = 0.38), and (iii) DZ position and depth of mesial (r = 0.39) and distal (r = 0.40) grooves. Other variables such as root length and distal groove depth (r = 0.28), and orifice distance and mesial groove depth (r = 0.36) were also correlated (P < 0.05). CONCLUSIONS: The length of tooth/root, the distance of canal orifices, and the depth of mesial/distal grooves of mesial roots of mandibular molars might be predictive factors for the root level, position, and thickness of the DZ. CLINICAL RELEVANCE: The length, distance of mesial canal orifices, and the depth of mesial and distal grooves of the mesial roots of mandibular molars might be moderate predictive factors for the root level, position, and thickness of the DZ.

3.
Clin Oral Investig ; 24(9): 3299-3305, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31965283

RESUMO

OBJECTIVES: To assess C-shaped root canal configuration by identifying its prevalence and each configuration type proportion, according to tooth (mandibular first or second molar) and demographic characteristics in a Brazilian population, using cone-beam computed tomography (CBCT). Moreover, it was verified if there is a relationship between root canal configuration observed in two-dimensional reconstructions of CBCT and presence of C-shape. METHODS: Mandibular jaw CBCT scans (184 males and 220 females, aged 15 to 80 years), which presented 1464 mandibular molars (710 first molars and 754 second molars), were assessed. Teeth were evaluated for the presence and type of C-shaped root canals by observing the roots at five levels in CBCT axial reconstructions. Root canal configuration was assessed in panoramic reconstructions. Data were statistically analyzed at a significance level of 5%. RESULTS: Of the 1464 mandibular molars, 125 (8.5%) were classified as C-shaped. This variation was more prevalent in females (n = 107, 85.6%) and in second molars (n = 108, 86.4%). C1 (uninterrupted C-shaped canal) was the most prevalent type of C-shaped configuration (41.76%), while C5 (no canal lumen) was the least prevalent type (0.96%). Single root with single canal in panoramic reconstructions was the most predominant configuration for C-shaped teeth (n = 54, 43.2%). Fused roots presented 17.2 higher odds of being associated with C-shaped root canals than non-fused roots. CONCLUSIONS: C-shaped root canals were more prevalent in mandibular second molars and in females. Additionally, clinicians should bear in mind the greater possibility of C-shaped configuration in mandibular molars with fused roots. CLINICAL RELEVANCE: Mandibular molars with C-shaped canals present a clinical challenge. A higher C-shaped proportion was noted in radiographic fused root types, which had 17.2 higher odds of presenting such anatomy when compared to radiographic non-fused roots. Root radiographic features may help in diagnosis of complex C-shaped morphologies.

4.
Eur Endod J ; 4(1): 33-37, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32161884

RESUMO

Objective: This study investigated the influence of different irrigants and the use of orange oil solvent in the removal of filling materials during root canal retreatment. Methods: Forty maxillary premolars were shaped using the ProTaper System up to file F3 (size 30, 0.09 taper) and filled by Tagger's hybrid technique using the AH Plus. Samples were randomly assigned to four groups (n=10) according to the irrigating protocol during endodontic retreatment with the ProTaper Universal Re-treatment System: G1, 2% chlorhexidine (CHX) gel; G2, 2% CHX gel with an orange oil solvent; G3, 5% sodium hypochlorite (NaOCl); and G4, 5% NaOCl with an orange oil solvent. Afterwards, the samples were longitu-dinally split into two halves, and the root wall images were prepared by scanning electron microscopy. Two pre-calibrated evaluators analyzed the images using a filling materials remnants score system. Data were statistically analyzed using the Kruskal-Wallis and Dunn's tests (p<0.05). Results: All samples had residual filling materials in the root canal walls after instrumentation. According to the presence of the filling material remnants in the total area of samples, the groups were ranked in the follow-ing order: G2=G4>G1=G3. No statistical differences were found when the CHX and NaOCl were used (p>0.05). Groups in which a solvent was used showed a less effective cleaning ability (p<0.05). The use of NaOCl with solvent presented the highest amounts of filling materials remnants in the critical apical area (p<0.05). Conclusion: The use of orange oil with NaOCl or CHX does not improve the removal of residual root canal filling materials.

6.
Restor Dent Endod ; 42(1): 60-64, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28194366

RESUMO

Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT) imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3), two distobuccal (DB1 and DB2), and two palatal (P1 and P2). Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.

7.
Clin Oral Investig ; 21(5): 1531-1536, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27460565

RESUMO

OBJECTIVES: The aim of the present study was to evaluate cytotoxic effects and cytokine production of calcium silicate-based sealers (EndoSeal, EndoSequence BC Sealer, and MTA Fillapex) using an in vitro root canal filling model and three-dimensional (3D) cell culture. AH Plus as a reference was compared to contemporary calcium silicate cements regarding cell viability and cytokine production. MATERIAL AND METHODS: Root canals of 30 human maxillary incisors were prepared using a single-file reciprocating technique. The samples were randomly distributed and canals filled with either AH Plus, EndoSeal, EndoSequence BC Sealer, and MTA Fillapex (n = 6). In the negative control group, the root canal remained unfilled. Sealers were placed into the canals along with a gutta-percha cone placed to working length. Balb/c 3T3 fibroblasts, cultured in a type I collagen 3D scaffold, were exposed to filling material and the respective root apex for 24 h. Cytocompatibility of the materials was evaluated using the methyl-thiazoldiphenyl-tetrazolium (MTT) assay. The production of IL-1ß, IL-6, and IL-8 was analyzed using enzyme-linked immunosorbent assay (ELISA). One-way analysis of variance was performed, and when the F-ratios were significant, data were compared by Duncan's multiple-range test. The alpha-type error was set at 0.05. RESULTS: EndoSeal, Endosequence BC Sealer and AH Plus showed cell viability that was similar to the negative control group (P > 0.05), while MTA Fillapex sealer was cytotoxic (P < 0.05). Varying production of IL-1ß, IL-6, and IL-8 was detected in all samples. CONCLUSIONS: In an in vitro root canal filling model with 3D cell culture, AH Plus, EndoSeal, and EndoSequence BC Sealer were cytocompatible. CLINICAL RELEVANCE: These results may suggest that AH Plus, EndoSeal and EndoSequence BC Sealer may achieve better biological response when compared to MTA Fillapex.


Assuntos
Materiais Biocompatíveis/farmacologia , Compostos de Cálcio/farmacologia , Materiais Restauradores do Canal Radicular/farmacologia , Silicatos/farmacologia , Compostos de Alumínio/farmacologia , Compostos de Alumínio/toxicidade , Materiais Biocompatíveis/toxicidade , Compostos de Cálcio/toxicidade , Fosfatos de Cálcio , Técnicas de Cultura de Células , Células Cultivadas , Citocinas/metabolismo , Combinação de Medicamentos , Resinas Epóxi , Guta-Percha/farmacologia , Guta-Percha/toxicidade , Humanos , Técnicas In Vitro , Incisivo , Teste de Materiais , Óxidos/farmacologia , Óxidos/toxicidade , Materiais Restauradores do Canal Radicular/toxicidade , Silicatos/toxicidade , Propriedades de Superfície
8.
Clin Oral Investig ; 21(7): 2327-2333, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27942985

RESUMO

OBJECTIVES: The aim of this study was to evaluate the occurrence of pulp stones by cone-beam computed tomography (CBCT) and to correlate their prevalence with patient's gender, location of tooth (right or left of maxillary or mandibular arch), group of teeth, and restorations. MATERIALS AND METHODS: CBCT images of 382 patients randomly selected from the database of the University Oral Radiology Department were retrospectively examined. A total of 2833 tooth images obtained using the i-CAT 3D Imaging System were evaluated. Image analysis was performed with the i-CAT software, and all teeth were evaluated in sagittal, axial, and coronal views. All the measurements were subjected to chi square test, odds ratio, and Fisher's exact tests (p < 0.05). RESULTS: The prevalence of pulp stones was similar between patient's genders and tooth locations. Pulp stones were detected in 31.9% of patients and 9.5% of teeth. Maxillary and mandibular molars were the groups of teeth with the highest frequency of pulp stones. The presence of restorations increased the chance of occurrence of pulp stones by 2.1 times in all teeth examined (p < 0.0001) and by 4.7 times in maxillary teeth (p < 0.0001). CONCLUSIONS: Pulp stones had a high prevalence with molar teeth showing the highest prevalence. The presence of restorations increased the chance of occurrence of these calcifications, specifically in maxillary teeth. CLINICAL RELEVANCE: CBCT provides accurate anatomical details in three dimensions, offering the possibility to view an individual tooth in axial, sagittal, and coronal views. This study performed an investigation of the occurrence of pulp stones by CBCT.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Calcificações da Polpa Dentária/diagnóstico por imagem , Adulto , Idoso , Calcificações da Polpa Dentária/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Fatores de Risco
9.
Quintessence Int ; 47(1): 19-24, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26417615

RESUMO

OBJECTIVE: Several studies demonstrate variability of root canal morphology of anterior teeth. This in-vivo study was designed to analyze and characterize root canal morphology of maxillary and mandibular anterior teeth using three-dimensional imaging. METHOD AND MATERIALS: Patients who required CBCT radiographic examinations as part of their routine examination, diagnosis, and treatment planning were enrolled on the study. A total of 1,200 healthy, untreated, fully developed maxillary and mandibular incisors and canines were included. The following observations were recorded: (i) number of roots and their morphology; (ii) number of canals per root; and (iii) primary variations in the morphology of the root canal systems. RESULTS: Root canal morphology of maxillary teeth was consistent with a single canal extending from the pulp chamber to the apex in 98% of the cases. In contrast, in mandibular central and lateral incisors, the presence of a single canal represented 64.5% and 60.5% respectively. The second most common morphology was the presence of one canal leaving the pulp chamber, which divided into two within the root, and then merged to exit as one canal in 18% and 25.5% respectively. The presence of one canal leaving the pulp chamber and dividing short of the apex into two separate and distinct canals with separate apical foramina (variant 5) was recorded in 14.5% and 12% respectively. CONCLUSION: There was a low incidence of anatomical variation in maxillary anterior teeth. In contrast, mandibular anterior teeth presented with a high prevalence of two canals, especially central and lateral incisors. The reported data may help clinicians understand the variations in root canal morphology of anterior teeth in order to overcome problems associated with shaping and cleaning procedures.


Assuntos
Cavidade Pulpar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem
10.
Braz Dent J ; 26(3): 216-21, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26200143

RESUMO

The aim of the present study was to evaluate and compare postoperative pain after foraminal instrumentation using 5.25% sodium hypochlorite (NaOCl) or 2% chlorhexidine (CHX) gel irrigation protocol in nonvital single-rooted teeth after reciprocating instrumentation. Sixty-two volunteers presenting a single root canal diagnosed with asymptomatic necrosis and apical periodontitis were randomized into 2 experimental groups regarding the irrigation protocol (ie, 5.25% NaOCl and 2% CHX gel groups). Endodontic treatment was performed in a single session under reciprocating instrumentation with foraminal instrumentation. Volunteers were instructed to record pain intensity. Scores from 1 to 4 were attributed to each kind of pain after 24, 48, and 72 h. Kolmogorov-Smirnov and Student´s t tests were used to determine significant differences at p<0.05. On average, the percentage of patients that had no or mild pain after 24, 48 or 72 h was 77.4%, 88.7% and 95.1%, respectively. No statistically significant age difference was found between the groups (p>0.05, Student´s t test). Postoperative pain showed no statistically significant difference at any observation period when using 5.25% NaOCl or 2% CHX gel (p>0.05). Moreover, no significant difference was observed in the mean number of analgesic tablets used between the groups (p>0.05). In conclusion, the use of 5.25% NaOCl or 2% CHX gel resulted in the same postoperative pain. Therefore, it can be inferred that irrigant choice has no relation with short-term follow up regarding postoperative pain.


Assuntos
Clorexidina , Instrumentos Odontológicos , Dor Pós-Operatória , Irrigantes do Canal Radicular , Hipoclorito de Sódio , Feminino , Humanos , Masculino
11.
Restor Dent Endod ; 39(4): 282-7, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25383347

RESUMO

OBJECTIVES: The aim of the present study was to investigate the bond strength of RelyX Unicem (3M) to root canal dentin when used as an endodontic sealer. MATERIALS AND METHODS: Samples of 24 single-rooted teeth were prepared with Gates Glidden drills and K3 files. After that, the roots were randomly assigned to three experimental groups (n = 8) according to the filling material, (1) AH Plus (Dentsply De Trey GmbH)/Gutta-Percha cone; (2) Epiphany SE (Pentron)/Resilon cone; (3) RelyX Unicem/Gutta-Percha cone. All roots were filled using a single cone technique associated to vertical condensation. After the filling procedures, each tooth was prepared for a push-out bond strenght test by cutting 1 mm-thick root slices. Loading was performed on a universal testing machine at a speed of 0.5 mm/min. One-way analysis of variance and Tukey test for multiple comparisons were used to compare the results among the experimental groups. RESULTS: Epiphany SE/Resilon showed significantly lower push-out bond strength than both AH Plus/Gutta-Percha and RelyX Unicem/Gutta-Percha (p < 0.05). There was no significant difference in bond strength between AH Plus/Gutta-Percha and RelyX Unicem/Gutta-Percha (p > 0.05). CONCLUSIONS: Under the present in vitro conditions, bond strength to root dentin promoted by RelyX Unicem was similar to AH Plus. Epiphany SE/Resilon resulted in lower bond strength values when compared to both materials.

12.
Gen Dent ; 62(5): 40-3, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25184714

RESUMO

Management of post-treatment apical periodontitis after surgery--assuming the tooth is restorable, periodontally sound, and the patient desires to retain it--includes nonsurgical retreatment and surgical reintervention. This article presents 2 cases of surgical reintervention using a modern surgery technique that utilized an operating microscope, ultrasonic tips, and biocompatible materials. After the reinterventions were performed, adequate periradicular healing was observed in both cases. These cases reinforce the precept that combining knowledge about the biologic aspects of endodontics with surgical endodontic treatment using a modern technique is a predictable treatment option.


Assuntos
Tratamento do Canal Radicular , Adulto , Feminino , Humanos
13.
Microsc Res Tech ; 76(3): 311-5, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23335503

RESUMO

The aim of this study was to evaluate the biocompatibility of mineral trioxide aggregate (MTA) Bio and Portland cement (PC) and compare with those of ProRoot MTA. Polyethylene tubes were filled with materials and placed into dorsal subcutaneous connective tissue of Wistar albino rats. After 7, 30, and 60 days after the surgical procedure, the implants with the surrounding tissue were removed. Tissue samples were subjected to histological processing, and sections were stained with hematoxylin and eosin. Sections were evaluated for the intensity of inflammation, predominant cell type, presence of fibrous capsule and granulation tissue. Data were submitted to Kruskal-Wallis test at a significant level of P ≤ 0.05. No statistical differences were observed at any evaluated condition among tested materials (P > 0.05). Statistically significant differences were observed between mean inflammatory scores, cell types and granulation tissue of the same material in different experimental periods (P < 0.05). Can be concluded that biocompatibility of MTA bio and PC were comparable with that of ProRoot MTA.


Assuntos
Materiais Biocompatíveis/efeitos adversos , Tecido Conjuntivo/efeitos dos fármacos , Cimentos Dentários/efeitos adversos , Animais , Tecido Conjuntivo/patologia , Histocitoquímica , Teste de Materiais , Camundongos
14.
Indian J Dent Res ; 23(4): 542-5, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23257493

RESUMO

Furcal perforations are significant iatrogenic complications of endodontic treatment and could lead to endodontic failure. Mineral trioxide aggregate (MTA) has been regarded as an ideal material for perforation repair, retrograde filling, pulp capping, and apexification. This case report describes a furcal perforation in a maxillary first molar, which was repaired using MTA. The tooth was endodontically treated and coronally restored with resin composite. After 2 years, the absence of periradicular radiolucent lesions, pain, and swelling along with functional tooth stability indicated a successful outcome of sealing the perforation using MTA.


Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Cimentos Dentários/uso terapêutico , Dente Molar/lesões , Óxidos/uso terapêutico , Preparo de Canal Radicular/efeitos adversos , Silicatos/uso terapêutico , Raiz Dentária/lesões , Adulto , Resinas Compostas/química , Materiais Dentários/química , Restauração Dentária Permanente/métodos , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Doença Iatrogênica , Obturação do Canal Radicular/métodos , Preparo de Canal Radicular/métodos , Dente não Vital/terapia , Resultado do Tratamento
15.
Iran Endod J ; 6(2): 86-9, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-23130058

RESUMO

INTRODUCTION: The aim of this study was to evaluate the apical and coronal seal of endodontic filling promoted by the combined use of Sealer 26/gutta-percha, Endofill/gutta-percha and Resilon/ Epiphany. MATERIALS AND METHODS: A total of 38 extracted human canine teeth were selected; 10 teeth for each test group and 4 for each control group. After conducting conventional endodontic treatment, the teeth were immersed in saline solution for thirty days, and subsequently sealed and stored in India ink for seven days. They were then cleaned and evaluated for infiltration by stereoscopic microscope. The data were statistically analyzed by ANOVA and Bonferroni tests. RESULTS: The results showed no significant differences between the three groups of filling materials used. CONCLUSION: Within the limitations of this in vitro study, no material showed superiority in their apical and coronal seal.

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