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1.
Photodiagnosis Photodyn Ther ; : 102073, 2020 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-33232819

RESUMO

INTRODUCTION: The prognosis of patients with Oral squamous cell carcinoma (OSCC) are directly related to the stage of development of the tumor at the time of diagnosis, but it is estimated an average delay in diagnosis of 2 to 5 months. New non-invasive techniques for the early diagnosis of OSCC are being developed, such as methodologies to detect spectral changes of tumor cells. We conducted a systematic review to analyze the potential use of autofluorescence and/or fluorescent probes for OSCC diagnosis. MATERIAL AND METHODS: Four databases (PubMed, Scopus, Embase and Web of Science) were used as research sources. Protocol was registered with PROSPERO. It was included studies that evaluated tissue autofluorescence and/or used fluorescent probes as a method of diagnosing and/or treatment of oral cancer in humans. RESULTS: Forty-five studies were selected for this systematic review, of which 28 dealt only with autofluorescence, 18 on fluorescent probes and 1 evaluated both methods. The VELscope® was the most used device for autofluorescence, exhibiting sensitivity (33% to 100%) and specificity (12% to 88.6%). 5-Aminolevulinic acid (5-ALA) was the most used fluorescent probe, exhibiting high sensitivity (90% to 100%) and specificity (51.3% to 96%). Hypericin, rhodamine 6 G, rhodamine 610, porphyrin and γ-glutamyl hydroxymethyl rhodamine green have also been reported. CONCLUSION: Thus, the autofluorescence and fluorescent probes can provide an accurate diagnosis of oral cancer, assisting the dentist during daily clinical activity, but it is not yet possible to suggest that this method may replace histopathological examination.

2.
Photodiagnosis Photodyn Ther ; : 102025, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32987169

RESUMO

BACKGROUND: The antimicrobial photodynamic therapy (PDT), one of the adjunctive therapies developed to improve the effectiveness of root canal disinfection, has been extensively studied. The aim of this study was to analyze the antimicrobial effect of PDT on intracanal biofilm. METHODS: Two reviewers conducted a literature search in PubMed, MEDLINE, Lilacs, SciELO, EMBASE and Google Scholar using the following search strategy: photochemotherapy "[Mesh] OR (photodynamic therapy) AND" dental plaque "[Mesh] OR (dental biofilm) AND (root canal). The following data were collected: publication year, author's name, study site, type of study, participant number, type of photosensitizer, type of laser, method of data collection, application time and results. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS). RESULTS: After selection based on title, abstract and full text, 27 studies were included in this systematic review. PDT reduced bacterial viability in most studies when combined with conventional endodontic techniques. CONCLUSION: PDT reduced bacterial counts in most studies, especially when used as an adjunct to the conventional endodontic technique to treat refractory infection. However, PDT effects on in vitro bacterial biofilm were not accurately quantified because of the numerous biases in the studies reviewed.

3.
Photodiagnosis Photodyn Ther ; 29: 101625, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31866534

RESUMO

INTRODUCTION: This study aimed to evaluate the antimicrobial action of calcium hypochlorite(Ca[OCl]2) and sodium hypochlorite (NaOCl) with reciprocating instrumentation and photodynamic therapy(PDT), and its influence on root dentin structure. METHODS: One hundred and ten human teeth were used to antimicrobial evaluation, inoculated with Enterococcus faecalis and divided into 11 groups (n = 10): G1 - distilled water(control); G2-1 % NaOCl; G3-5.25 % NaOCl; G4-1 % Ca(OCl)2; G5-5.25 % Ca(OCl)2; G6-PDT; G7-distilled water + PDT; G8-1 % NaOCl + PDT; G9-5.25 % NaOCl + PDT; G10-1 % Ca(OCl)2+PDT; G11-5.25 % Ca(OCl)2+PDT. In all groups, except G6, the root canals were instrumented with #R50 Reciproc file in the working length in association with tested chemical auxiliary substance. The counting of colony forming units (CFUs) was performed to calculate the bacterial percentage reduction of each group. Following, 55 bovine teeth were used to microhardness evaluation and divided into the same 11 groups (n = 5), with no instrumentation and immersion in the tested protocols. The modification of root dentin microhardness was evaluated by using the Vicker tester. Finally, 33 bovine teeth were used to organic components evaluation and divided into the same 11 groups (n = 3), with no instrumentation and immersion in the tested protocols. The modification of organic components of root dentin was evaluated by light microscopy. Specific statistical analysis was performed for each evaluation. RESULTS: The higher bacterial reduction was observed in groups 3,4,5,8,9,10 and 11, with no statistical difference between them (p > 0.05). The higher microhardness reduction was observed in groups 8,9,10 e 11, with no statistical difference between them (p > 0.05). The highest modification on organic components was observed in groups 3,5,9 and 11, with no statistical difference between them (p > 0.05). CONCLUSIONS: The association of Ca(OCl)2, reciprocating instrumentation and PDT promotes effective antimicrobial action. Moreover, lower modification was induced in microhardness and organic components of root dentin, by using Ca(OCl)2 in low concentration associated to PDT.

4.
Clin Oral Investig ; 23(11): 4019-4027, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30864115

RESUMO

OBJECTIVE: This study assessed tissue responses after furcation perforation and immediate sealing with either Biodentine™ or MTA Angelus™. MATERIAL AND METHODS: Sixty male Wistar rats were used (n = 6 per group/period). The mandibular first molars had the furcation mechanically exposed and sealed with either MTA or Biodentine™ and restored with silver amalgam. In an additional test group, teeth were sealed only with Biodentine™. Furcation sealing with gutta-percha and silver amalgam restoration served as positive control, and healthy untreated teeth were the negative control. Histological evaluation was performed after 14 or 21 days. Kruskal-Wallis and Dunn's post hoc tests were performed to analyze the extent and intensity of tissue inflammation, bone resorption, and cementum repair (p < 0.05). RESULTS: Biodentine™ and MTA presented satisfactory results, showing a milder inflammatory response when compared to the control, regardless of the material used for coronal sealing and of the experimental period evaluated (p < 0.0001). All test groups showed less bone resorption than the positive control after 21 days (p < 0.05), and such differences were more pronounced in teeth restored with silver amalgam. Cementum repair was performed in 30% of MTA and Biodentine™ samples but not carried out in any positive control specimen. CONCLUSIONS: Biodentine™ and MTA promoted similar responses when used to seal furcation perforations and should therefore be regarded as a promising alternative. CLINICAL RELEVANCE: Knowledge about tissue responses to restorative materials is essential for improving root perforation sealing protocols. The present results showed that both Biodentine™ and MTA promoted appropriate periradicular tissue reactions in a preclinical test for evaluating furcation perforation treatments.


Assuntos
Compostos de Alumínio , Reabsorção Óssea , Compostos de Cálcio , Cemento Dentário , Óxidos , Silicatos , Animais , Combinação de Medicamentos , Masculino , Ratos , Ratos Wistar
5.
Dent J (Basel) ; 7(1)2019 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-30634460

RESUMO

Bacteriophages, viruses capable of killing bacteria, were discovered in 1915, but the interest in their study has been limited since the advent of antibiotics. Their use in dentistry is still very limited. The authors reviewed studies about bacteriophage structure, mode of action, uses in oral health, and possible future uses in dentistry associated with their possible action over biofilm, as well as the advantages and limitations of phage therapy.

6.
Clin Oral Investig ; 23(4): 2001-2003, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30635786

RESUMO

Figures 2 and 3 in the published version of this article contained a mistake. CCP and DCP should have been FEG and NFEG. Correct figures are presented here.

7.
Aust Endod J ; 45(1): 57-63, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30105835

RESUMO

We compared the antimicrobial efficacy of EDTA and 0.5% peracetic acid (PAA), with manual agitation (MA) or passive ultrasonic irrigation (PUI) in an Enterococcus faecalis biofilm model. Fifty-five single-rooted human premolar teeth were chemo-mechanically prepared and inoculated with E. faecalis for biofilm formation. These were divided into five groups (n = 11): saline solution, PAA+MA, PAA+PUI, EDTA+MA and EDTA+PUI. Root canal sampling and scanning electron microscopy of the canal lumen and dentinal tubule areas at the different root thirds were performed. The images were ranked based on contamination level. Only the PAA groups presented with no bacterial growth, with the remaining groups not presenting significant differences among them. PAA+PUI presented with the highest median position rankings in every third and location, whereas EDTA+MA performed similarly to the saline control. No differences were found when comparing MA and PUI within the same solution, however, PUI was associated with lower contamination levels mean rankings.


Assuntos
Anti-Infecciosos , Enterococcus faecalis , Biofilmes , Cavidade Pulpar , Ácido Edético , Humanos , Ácido Peracético , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Hipoclorito de Sódio , Irrigação Terapêutica , Ultrassom
8.
Clin Oral Investig ; 23(4): 1985-1991, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30386994

RESUMO

OBJECTIVES: The aim of this study was to evaluate the influence of foraminal enlargement on the healing of induced apical periodontitis in a rat model. MATERIAL AND METHODS: Periapical lesions were bilaterally induced in mandibular first molars of 24 Wistar rats, through root canals exposure to the oral environment during 3 weeks. Endodontic treatment was performed in the mesial canal of right molars, which were separated into two experimental groups (n = 12/group). The foraminal enlargement group (FEG) received instrumentation in the entire root canal length, including the cemental canal, while in the non-foraminal enlargement group (NFEG), instrumentation was carried out 1 mm short of the apical foramen. Root canals were filled with gutta-percha and AH Plus sealer, in the same visit, 1 mm short of the apical foramen in both experimental groups. Left molars were not treated and served as a baseline control group. The animals were killed after 4 weeks, and their hemi-mandibles were prepared for radiographic and histological analysis. Data were analyzed by Student's t test and ANOVA. RESULTS: Only FEG presented lower areas of periapical radiolucency compared to the control (p < .05). Both FEG and NFEG allowed decreased inflammation intensity (p < .0001 and p < .01) and higher scores of cementum neoformation when compared to non-treated samples (p < .0001). FEG was more effective than NFEG in promoting biological seal, i.e., apical closure with cementum (p < .01). FEG, but not NFEG, showed lower scores of root resorption than the control. CONCLUSIONS: Foraminal enlargement during root canal preparation improved periapical healing in rat molars. CLINICAL SIGNIFICANCE: Foraminal enlargement has been suggested to improve disinfection at the apical portion of root canals. This procedure may favor the healing of chronic periapical lesions.


Assuntos
Dente Molar/patologia , Periodontite Periapical/terapia , Materiais Restauradores do Canal Radicular , Preparo de Canal Radicular , Ápice Dentário/patologia , Animais , Desinfecção , Resinas Epóxi , Guta-Percha , Ratos , Ratos Wistar
9.
Photodiagnosis Photodyn Ther ; 23: 347-352, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30053480

RESUMO

INTRODUCTION: The aim of this study is to evaluate the antimicrobial activity of hypochlorite solutions and reciprocating instrumentation associated with photodynamic therapy (PDT). METHODS: One hundred and thirty two root canals were enlarged up to #35 K-file and inoculated with E.faecalis for 14 days. The 132 samples were randomly divided into eleven groups (n = 12) and subjected to the following protocols: G1-distilled water + Reciproc R40 (control), G2-1% sodium hypochlorite (NaOCl) + Reciproc R40, G3-2.5% NaOCl + Reciproc R40; G4-1% calcium hypochlorite (Ca[OCl]2) + Reciproc R40, G5-2.5% Ca(OCl)2 + Reciproc R40; G6-PDT; G7-distilled water + Reciproc R40 + PDT, G8-1% NaOCl + Reciproc R40 + PDT, G9-2.5% NaOCl + Reciproc R40 + PDT; G10-1% Ca(OCl)2 + Reciproc R40 + PDT, G11-2.5% Ca(OCl)2 + Reciproc R40 + PDT. The percentage bacterial reduction was checked by counting the colony-forming units (CFUs) in 10 samples of each group. The remaining 2 samples of each group were submitted to scanning electronic microscopy (SEM) to illustrate the effectiveness of the proposed treatments. Data were subjected to one-way ANOVA followed by Tukey's post hoc test (α = 0.05). RESULTS: The greatest ability to promote bacterial reduction was observed in groups 8 (1% NaOCl + R40 + PDT), 9 (2.5% NaOCl + R40 + PDT), 10 (1% Ca[OCl]2 + R40 + PDT), and 11 (2.5% Ca[OCl]2 + R40 + PDT), with no significant difference between them (p < 0.05). CONCLUSIONS: The association of PDT with hypochlorite solutions and reciprocating instrumentation provides effective elimination of E.faecalis.


Assuntos
Enterococcus faecalis/efeitos dos fármacos , Ácido Hipocloroso/uso terapêutico , Azul de Metileno/uso terapêutico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Preparo de Canal Radicular/métodos , Carga Bacteriana , Compostos de Cálcio/uso terapêutico , Terapia Combinada , Cavidade Pulpar/microbiologia , Relação Dose-Resposta a Droga , Humanos , Hipoclorito de Sódio/uso terapêutico
10.
Photomed Laser Surg ; 35(7): 364-371, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28294706

RESUMO

OBJECTIVE: The aim of this study was to evaluate in vivo, by histological and radiographic analysis, the response of apical tissues of rats' teeth with experimentally induced apical periodontitis, after one- and two-session endodontic treatment with and without photodynamic therapy (PDT). A microbiological analysis was also performed to verify bacterial reduction after each treatment. BACKGROUND DATA: Studies carried out in recent years highlighted the antibacterial potential of PDT when associated with conventional endodontic therapy in vitro. Although the antimicrobial effect of PDT is well-established, tissue response to PDT in teeth with apical periodontitis lacks studies. METHODS: Thirty-two rats' root canals were assigned to four groups: one session/PDT-[chemomechanical preparation (CMP)+root canal filling (RCF)]; two sessions/PDT- [CMP+calcium hydroxide (CH) for 14 days+RCF]; one session/PDT+ [CMP+PDT+RCF], and two sessions/PDT+ [CMP+PDT+CH for 14 days+RCF]. For microbiological evaluation, samples were collected before and after proposed treatments. For radiographic and histological analysis, the animals were euthanized after 28 days and the mandibles surgically removed. RESULTS: PDT associated with conventional endodontic therapy was able to promote significant bacterial reduction in root canals with induced apical periodontitis, but this reduction was not significantly different to conventional endodontic therapy alone. Although radiographic evaluation showed no significant differences, histological analysis showed lower scores for neutrophils/eosinophils in PDT-treated groups and macrophages/giant cells in CH groups. CONCLUSIONS: The use of low-level laser as light source did not promote major improvement on radiographic and histological repair, but since the number of inflammatory cells slightly decreased, it may optimize repair by modulating inflammatory process. PDT may be indicated as an adjunct to conventional endodontic therapy for teeth with apical periodontitis, in association with an interappointment dressing with CH, in an attempt to produce better conditions to stimulate repair.


Assuntos
Periodontite Periapical/diagnóstico por imagem , Periodontite Periapical/tratamento farmacológico , Fotoquimioterapia/métodos , Tratamento do Canal Radicular/métodos , Análise de Variância , Animais , Anti-Infecciosos/farmacologia , Biópsia por Agulha , Modelos Animais de Doenças , Imuno-Histoquímica , Lasers Semicondutores/uso terapêutico , Masculino , Dente Molar/efeitos dos fármacos , Dente Molar/efeitos da radiação , Periodontite Periapical/patologia , Radiografia Dentária/métodos , Distribuição Aleatória , Ratos , Ratos Wistar , Valores de Referência , Medição de Risco , Estatísticas não Paramétricas , Resultado do Tratamento
11.
Photodiagnosis Photodyn Ther ; 17: 216-220, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28065860

RESUMO

INTRODUCTION: The aim of the present study was to evaluate the influence of ultrasonic activation (US) of the final irrigant in the removal of the photosensitizer from root canal walls after photodynamic therapy. METHODS: The root canals of 60 single-rooted bovine extracted teeth were filled with 0.01% methylene blue and submitted to photodynamic therapy for 90s. After that, the roots were divided into six groups (n=10) according to the final irrigation protocol: distilled water (DW), DW+US, 17% EDTA, QMix, EDTA+US, and QMix+US. Then, the samples were submitted to scanning electron microscopy where a scoring system was used to evaluate the images and effectiveness of proposed treatments in the cervical, middle and apical regions of the root canals. The data were statistically analyzed by the Kruskal-Wallis and Mann-Whitney U tests for intergroup comparisons as well as the Wilcoxon and Friedman tests for intragroup comparisons at 5% of significance. RESULTS: The 17% EDTA+US and QMix+US treatments were most effective in the removal of the photosensitizer in all regions of the root canal; the difference was statistically significant when compared to all other groups (p<0.05). There were no significant differences in the intragroup analysis comparing the effectiveness in the different regions of the same group (p<0.05). CONCLUSIONS: US can aid 17% EDTA and QMix in removing the photosensitizer after photodynamic therapy and contributes to cleaning root canal walls.


Assuntos
Cavidade Pulpar , Azul de Metileno/efeitos adversos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/efeitos adversos , Irrigantes do Canal Radicular/farmacologia , Ultrassom/métodos , Animais , Biguanidas/administração & dosagem , Bovinos , Ácido Edético/administração & dosagem , Azul de Metileno/uso terapêutico , Microscopia Eletrônica de Varredura , Fotoquimioterapia/efeitos adversos , Fármacos Fotossensibilizantes/uso terapêutico , Polímeros/administração & dosagem , Água/administração & dosagem
12.
Clin Oral Implants Res ; 28(3): 362-371, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26920844

RESUMO

OBJECTIVES: To evaluate new bone formation in calvarial critical size defects (CSD) under dense polytetrafluoroethylene (d-PTFE), microporous membranes for guided bone regeneration (GBR) in healthy, osteoporotic and osteoporotic treated with zoledronic acid (ZA) rats. METHODS: Forty-eight, female, 6-month old Wistar rats were included in the study. Osteoporosis was induced by ovariectomy (OVX) and calcium-deficient diet in 32 rats. Sixteen OVX rats were treated with a single dose of Zolendronic Acid (ZA) (OZ), while 16 OVX rats received no treatment (O). The remaining 16 rats were sham-operated and used as healthy controls (C). At 6 weeks following osteoporosis induction, two 5 mm CSD were created in the parietal bones and one of them was treated with a double d-PTFE membrane. The healing periods were 30 and 60 days. New bone formation (NB) was assessed by qualitative and quantitative histological analysis. RESULTS: After 30 days of healing, NB (mean% (95% CI)) was 78.9% (21), 93.1% (9.3) and 84.2% (26.9) in the membrane treated defects and 18.8% (24.1), 27.1% (7.9) and 31% (38.8) in the untreated defects of group O, OZ and C, respectively. After 60 days of healing, NB was 78.3% (14.4), 95.8% (9) and 90.1% (26.1) in the membrane treated defects and 10.8% (17.4), 51.6% (39.4) and 15.7% (12.1) in the untreated defects of group O, OZ and C, respectively. Hierarchical analysis of variance showed that treatment with ZA (P = 0.001) and the use of membrane (P = 0.000) significantly increased new bone formation while presence of osteoporosis may have reduced new bone formation (P = 0.028). CONCLUSION: d-PTFE membranes for GBR promote bone healing in osteoporotic and healthy rats. Treatment with ZA may improve new bone formation in osteoporotic rats.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Regeneração Óssea/efeitos dos fármacos , Difosfonatos/uso terapêutico , Imidazóis/uso terapêutico , Osteoporose/tratamento farmacológico , Animais , Conservadores da Densidade Óssea/farmacologia , Difosfonatos/farmacologia , Modelos Animais de Doenças , Feminino , Imidazóis/farmacologia , Osteoporose/fisiopatologia , Ovariectomia , Osso Parietal/patologia , Osso Parietal/fisiologia , Ratos Wistar , Ácido Zoledrônico
13.
Clin Oral Investig ; 21(7): 2173-2182, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27888349

RESUMO

OBJECTIVES: The aim of this study was to evaluate the effect of different irrigation protocols on the root dentin structure using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). MATERIALS AND METHODS: Thirty-nine lower bovine incisors were hemisected longitudinally and randomly divided into 13 groups (n = 3). After the root halves were reassembled, it was applied a specific irrigation protocol for each group, as following: G1, distilled water (control); G2, 0.9% saline; G3, saline + 17% EDTA; G4, saline + PUI; G5, saline + PUI + EDTA; G6 to G9 received the same protocol as above replacing 0.9% saline by 2.5% NaOCl; and G10 to G13 by 2% CHX. One-half of each sample was prepared and evaluated using SEM and the other one by TEM observations. RESULTS: TEM descriptive analysis showed modifications in dentin organic ultrastructure, characterized by the thinning of dentin collagen fibrils, caused by NaOCl, enhanced by EDTA and/or PUI. SEM analysis showed that NaOCl with PUI caused significantly larger erosion of the peritubular dentin than in all the other groups (P < 0.05), followed by NaOCl + EDTA and NaOCl + EDTA + PUI. CONCLUSIONS: NaOCl caused ultrastructural alterations in the dentin collagen, and enhanced by EDTA and/or PUI, promoted peritubular and intertubular erosion. CLINICAL RELEVANCE: The effect of irrigating solutions on dentin ultrastructure was still unclear. The acknowledgment about the kind of solution, concentrations, application time, and sequence of use was important to achieve the right sanitization without jeopardizing the dentin ultrastructure quality.


Assuntos
Cavidade Pulpar/efeitos dos fármacos , Dentina/efeitos dos fármacos , Irrigantes do Canal Radicular/farmacologia , Irrigação Terapêutica/métodos , Animais , Bovinos , Clorexidina/farmacologia , Cavidade Pulpar/ultraestrutura , Dentina/ultraestrutura , Ácido Edético/farmacologia , Técnicas In Vitro , Incisivo , Microscopia Eletrônica de Varredura , Microscopia Eletrônica de Transmissão , Cloreto de Sódio/farmacologia , Hipoclorito de Sódio/farmacologia
14.
Braz Dent J ; 26(3): 228-33, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26200145

RESUMO

This study aimed to evaluate histologically the effect of irrigation with 400 ppm Sterilox, 2% and 5% sodium hypochlorite (NaOCl), with and without photo-activated therapy (PAD), in a single-visit root canal treatment of dog's teeth with apical periodontitis (AP). Ten dogs were randomly divided into two groups (n=5): with and without PAD, and the root canals into four subgroups, according to the irrigating solution: SX (400 ppm Sterilox), SH2 (2% NaOCl), SH5 (5% NaOCl) and SS (saline solution) as positive control. A total of 134 root canals were opened and left exposed to the oral environment for 14 days and then sealed for 60 days for AP induction. Then, root canals were treated according to each proposed disinfecting protocol and filled in the same session. After 120 days, the dogs were euthanized and the periapical inflammatory events were evaluated under light microscopy. Qualitative data were submitted to Kruskal-Wallis and Mann-Whitney tests (α=0.05). PAD did not produce significant differences in the scores for apical inflammation when used after chemo-mechanical preparation (p>0.05). The irrigating solutions SX, SH2 and SH5 without PAD were statistically different from SS (p<0.05) that presented the greatest scores for apical inflammation. PAD did not show any additional effect for the treatment of root canals with pulp necrosis and AP in a single visit and 400 ppm Sterilox may be considered an alternative to NaOCl in root canal treatment.


Assuntos
Peróxido de Hidrogênio , Fototerapia , Irrigantes do Canal Radicular , Tratamento do Canal Radicular , Hipoclorito de Sódio , Animais , Cães
15.
J Dent ; 43(9): 1125-1131, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26144188

RESUMO

OBJECTIVES: The aim of the present study is to evaluate risk factors influencing the success rates of pulpotomies both in young and adult populations. METHODS: Pulpotomies (n=273) performed by a single endodontic specialist were analyzed, and data on success rates were collected. Additionally, possible explanatory variables were noted such as: age, gender, clinical findings (teeth, type of restoration after pulpotomy), radiographic findings (dentin bridge formation) and systemic conditions. The follow-up period varied from 1 to 29 years, and the results were analyzed by Kaplan-Meier survival curves and also by Cox regression. RESULTS: Age at the time of pulpotomy ranged from 8 to 79 and had not influenced the success rates (p=0.35). The formation of dentin bridge had a strong protective effect (hazard ratio-HR=0.16, p<0.001). The prosthetic crown restorations following pulpotomy had the smallest failure rate, and amalgam has not increased the risk of failure significantly in relation to prosthesis. Resin composite restorations following pulpotomy increased in 263% the risk of failure (HR=3.63, p<0.001). CONCLUSION: This study allowed inferences that pulpotomy may be a successful treatment at any age, and not only for young permanent teeth. It was also possible to conclude that the use of direct composite restorations following pulpotomies is associated with higher failure rates.


Assuntos
Pulpotomia/métodos , Pulpotomia/estatística & dados numéricos , Resinas Acrílicas , Adolescente , Adulto , Idoso , Criança , Resinas Compostas , Amálgama Dentário , Capeamento da Polpa Dentária/métodos , Capeamento da Polpa Dentária/estatística & dados numéricos , Falha de Restauração Dentária , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Poliuretanos , Estudos Retrospectivos , Risco , Fatores de Risco , Dente/diagnóstico por imagem , Adulto Jovem
16.
J Endod ; 41(6): 925-30, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25791074

RESUMO

INTRODUCTION: This study aimed to evaluate the effects of Sterilox (Sx), a superoxidized water, 5% and 2% sodium hypochlorite (5NaOCl and 2NaOCl), and 17% EDTA (E) on the organic and inorganic components of bovine dentin. METHODS: Eighty bovine incisors were randomly divided into 8 groups (n = 10): 5NaOCl, 5NaOCl + E, 2NaOCl, 2NaOCl + E, Sx, Sx + E, E alone, and distilled water (H2O). Root canal instrumentation was performed by using the corresponding irrigant. The apical 15 mm was longitudinally sectioned into 2 fragments, one for light microscopy analysis in slides stained with picrosirius red (organic component) and the other for scanning electron microscopy analysis (inorganic component). Scores data obtained in the light microscopy analysis were submitted to the Kruskal-Wallis test, followed by multiple comparisons test (P < .05). Scanning electron microscopy images were analyzed descriptively. RESULTS: The chemical solution 5NaOCl had a greater effect on the organic component of dentin in area and depth than 2NaOCl. The chemical solutions 5NaOCl + E, 5NaOCl and 2NaOCl + E caused the greatest change in the collagenous organic matrix near the root canal lumen. The chemical solution 2NaOCl showed similar behavior to Sx, associated or not with E, promoting more superficial disorganization of collagen in a smaller area. Demineralization was observed in all groups in which E was used. However, areas of erosion and open dentinal tubules were detected only when it was combined with NaOCl. CONCLUSIONS: Five percent NaOCl promoted the most extensive damage to the organic component of dentin, and when associated to EDTA, dentinal erosion could be seen. Considering these specific aspects, 2% NaOCl and Sx had milder effects on bovine root dentin.


Assuntos
Dentina/efeitos dos fármacos , Desinfetantes/farmacologia , Ácido Edético/farmacologia , Peróxido de Hidrogênio/farmacologia , Irrigantes do Canal Radicular/farmacologia , Hipoclorito de Sódio/farmacologia , Raiz Dentária/efeitos dos fármacos , Animais , Bovinos , Colágeno/efeitos dos fármacos , Desinfetantes/administração & dosagem , Ácido Edético/administração & dosagem , Peróxido de Hidrogênio/administração & dosagem , Incisivo , Distribuição Aleatória , Irrigantes do Canal Radicular/administração & dosagem , Hipoclorito de Sódio/administração & dosagem
17.
Photomed Laser Surg ; 33(3): 175-82, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25719896

RESUMO

Recently, several in vitro and in vivo studies demonstrated promising results about the use of photodynamic therapy during root canal system disinfection. However, there is no consensus on a standard protocol for its incorporation during root canal treatment. The purpose of this study was to summarize the results of research on photodynamic therapy in endodontics published in peer-reviewed journals. A review of pertinent literature was conducted using the PubMed database, and data obtained were categorized into sections in terms of relevant topics. Studies conducted in recent years highlighted the antimicrobial potential of photodynamic therapy in endodontics. However, most of these studies were not able to confirm a significant improvement in root canal disinfection for photodynamic therapy as a substitute for current disinfection methods. Its indication as an excellent adjunct to conventional endodontic therapy is well documented, however. Data suggest the need for protocol adjustments or new photosensitizer formulations to enhance photodynamic therapy predictability in endodontics.


Assuntos
Endodontia/métodos , Fotoquimioterapia , Humanos , Tratamento do Canal Radicular/métodos
18.
J Endod ; 40(12): 2057-60, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25306306

RESUMO

INTRODUCTION: This study aimed to investigate the correlation and the agreement between periapical radiography (PR) and cone-beam computed tomography (CBCT) correlating to histologic findings in the diagnosis of apical periodontitis (AP). METHODS: One hundred thirty-four premolar root canals from 10 dogs were treated after AP induction. Four months later, the animals were killed, and standard digital PRs were obtained. The area of AP was measured by using ImageJ software. CBCT (i-CAT) images from each arch were obtained, and AP area and volume were measured by using Osiri-X software. The apical inflammatory infiltrate was evaluated under light microscopy. The correlation between imaging methods was evaluated by using the Pearson coefficient. The Bland-Altman method was used to assess the agreement between PR and CBCT data. The Spearman coefficient was used to correlate the imaging data and histologic findings. RESULTS: Despite a strong correlation between PR and CBCT areas, the agreement limits were very broad (95% limits of agreement, 0.19-1.08). PR only measured, on average, 63% of CBCT values. Although there was a strong correlation between PR area and CBCT volume, the Bland-Altman method suggests that the larger the CBCT volume, the more underestimated the PR value. When APs had a volume smaller than 6 mm(3), the PR estimation of CBCT data was unpredictable. A positive correlation was found for PR area, CBCT area, CBCT volume, and histology data. CONCLUSIONS: The diagnosis of AP based on PR data is clinically limited, and it should not be used for scientific investigations.


Assuntos
Tomografia Computadorizada de Feixe Cônico/estatística & dados numéricos , Periodontite Periapical/diagnóstico por imagem , Radiografia Interproximal/estatística & dados numéricos , Animais , Cães , Eosinófilos/patologia , Processamento de Imagem Assistida por Computador/estatística & dados numéricos , Leucócitos Mononucleares/patologia , Neutrófilos/patologia , Periodontite Periapical/patologia , Tratamento do Canal Radicular/métodos , Dente não Vital/diagnóstico por imagem
19.
Photodiagnosis Photodyn Ther ; 11(4): 472-8, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25102161

RESUMO

AIM: The purpose of this study was to evaluate, in vitro, the influence of ultrasonic activation on photodynamic therapy over root canal system infected with Enterococcus faecalis. MATERIAL AND METHODS: The root canals of 50 single-rooted human extracted teeth were enlarged up to a file 60, autoclaved, inoculated with Enterococcus faecalis and incubated for 30 days. The samples were divided into five groups (n=10) according to the protocol of decontamination: G1 (control group) - no procedure was performed; G2 - photosensitizer (0.01% methylene blue); G3 - ultrasonic activation of photosensitizer (0.01% methylene blue); G4 - photodynamic therapy with no ultrasonic activation; and G5 - photodynamic therapy with ultrasonic activation. Microbiological tests (CFU counting) and scanning electron microscopy (SEM) were performed to evaluate and illustrate, respectively, the effectiveness of proposed treatments. Data were subjected to one-way ANOVA followed by post hoc Tukey test (α=0.05). RESULTS: The microbiological test demonstrated that G5 (photodynamic therapy with ultrasonic activation) showed the lowest mean contamination (3.17 log CFU/mL), which was statistically different from all other groups (p<0.05). G4 (photodynamic therapy) showed a mean of contamination of 3.60 log CFU/mL, which was statistically different from groups 1, 2 and 3 (p<0.05). CONCLUSION: The use of ultrasonic activation on photodynamic therapy improved its potential for decontamination, resulting in the higher elimination Enterococcus faecalis from the root canal space.


Assuntos
Cavidade Pulpar/microbiologia , Enterococcus faecalis/efeitos dos fármacos , Infecção Focal Dentária/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Fonoforese/métodos , Fotoquimioterapia/métodos , Preparo de Canal Radicular/métodos , Sobrevivência Celular/efeitos dos fármacos , Cavidade Pulpar/efeitos dos fármacos , Cavidade Pulpar/efeitos da radiação , Enterococcus faecalis/citologia , Infecção Focal Dentária/patologia , Infecções por Bactérias Gram-Positivas/patologia , Ondas de Choque de Alta Energia , Humanos , Técnicas In Vitro , Sonicação/métodos , Resultado do Tratamento
20.
J Endod ; 39(12): 1634-8, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24238463

RESUMO

INTRODUCTION: This study aimed at evaluating the influence of rotational speed and number of uses on the cutting efficiency of 4 nickel-titanium coronal flaring instruments against 2 substrates, bovine dentin and acrylic blocks. METHODS: BioRaCe BR0, HyFlex CM1, ProFile OS#2, and ProTaper Sx were used in simulated lateral action against both substrates at 250 and 500 rpm up to 5 times, producing 5 notches in each block. Notch areas and lengths were measured under a stereomicroscope, and data were compared by using parametric tests (α = 0.05). RESULTS: Against both substrates, HyFlex CM1 and ProFile OS#2 were the most and the least cutting efficient instruments, respectively (P < .05). Against acrylic, area and length values at 500 rpm were significantly higher than those at 250 rpm for all brands. Against dentin, significant differences were detected between 250 and 500 rpm for HyFlex CM1 and ProTaper Sx (area) and for BioRace BR0, HyFlex CM1, and ProTaper Sx (length). Regarding cutting efficiency loss, area and length for notches 1 and 2 (first notches) and 4 and 5 (last notches) were similar against acrylic. Against dentin, length values for notches 1 and 2 were significantly higher than those for notches 4 and 5 in ProFile OS#2 and ProTaper Sx. A strong correlation was detected between the overall results obtained on acrylic and dentin for area and length (P < .0001), although further analysis showed that data against acrylic were a poor predictor of data against dentin after repeated use. CONCLUSIONS: HyFlex CM1 was the most cutting efficient instrument in lateral action. An increase in rotational speed improved the cutting efficiency. Results against acrylic showed a high correlation to data against dentin, but acrylic may not be a proper substrate when the intention is to assess cutting efficiency loss with repeated use.


Assuntos
Ligas Dentárias/química , Níquel/química , Preparo de Canal Radicular/instrumentação , Titânio/química , Animais , Bovinos , Análise do Estresse Dentário/instrumentação , Dentina/ultraestrutura , Desenho de Equipamento , Teste de Materiais , Polimetil Metacrilato/química , Rotação , Propriedades de Superfície , Fatores de Tempo , Torque
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