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1.
Int Endod J ; 54(1): 5-14, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32871615

RESUMO

AIM: To evaluate the 10-year survival rate of root filled teeth treated by general dental practitioners (GDPs), and to identify possible prognostic factors. METHODOLOGY: In 2006, 3676 individuals had at least one tooth root filled by a GDP within the Norrbotten Public Dental Service, Sweden. Over the next 10 years, 331 individuals died and were excluded. A random sample of 302 of the remaining individuals was included in the study, of whom 280 (n = 280 teeth) were included in the analysis. Dental records were reviewed retrospectively by a calibrated researcher to collect predetermined data regarding individual, pre-operative, intra-operative and post-operative factors. The outcome measure was tooth extraction over time, and cases with no events were censored, regardless of apical status or symptoms, until last known date of tooth survival. In case of missing data, individuals were recalled for a control visit. Kaplan-Meier survival tables and Cox regression models were used for analysis. P < 0.05 was considered statistically significant. RESULTS: The cumulative 10-year survival was 81.7% (standard error: 2.6%), and the mean incidence of tooth extraction during the 10 years was 1.8% per year. The univariate analysis identified three possible prognostic factors (P < 0.05) that were associated with extraction: molars, two or more emergency inter-appointment visits during the treatment, and root canal treatments consisting of five or more separate sessions. A multivariate regression analysis revealed no significant relationships for the variables gender, tooth type, number of contacts, any emergency visits during endodontic treatment, number of sessions to complete endodontic treatment, pulp diagnosis, or type of permanent restoration and extraction. CONCLUSIONS: The mean incidence of tooth loss over the first 10 years after completion of root canal treatment performed by a GDP was approximately 2% per year. No prognostic factors could be identified.


Assuntos
Cavidade Pulpar , Odontólogos , Seguimentos , Humanos , Papel Profissional , Estudos Retrospectivos , Tratamento do Canal Radicular , Suécia/epidemiologia
2.
Int Endod J ; 54(1): 112-129, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32880989

RESUMO

AIM: To investigate the anti-biofilm efficacy of irrigation using a simulated root canal model, the chemical effect of irrigants against biofilms grown on dentine discs and their impact on biofilm viscoelasticity, the efficacy of the irrigants in decontaminating infected dentinal tubules and the capacity of bacteria to regrow. METHODOLOGY: Biofilm removal, viscoelastic analysis of remaining biofilms and bacterial viability were evaluated using a simulated root canal model with lateral morphological features, dentine discs and a dentinal tubule model, respectively. Experiments were conducted using a two-phase irrigation protocol. Phase 1: a modified salt solution (RISA) and sodium hypochlorite (NaOCl) were used at a low flow rate to evaluate the chemical action of the irrigants. Ultrasonic activation (US) of a chemically inert solution (buffer) was used to evaluate the mechanical efficacy of irrigation. Phase 2: a final irrigation with buffer at a high flow rate was performed for all groups. Optical coherence tomography (OCT), low load compression testing (LLCT) and confocal scanning laser microscopy analysis were used in the different models. One-way analysis of variance (anova) was performed for the OCT and LLCT analysis, whilst Kruskal-Wallis and Wilcoxon ranked tests for the dentinal tubule model. RESULTS: US and high flow rate removed significantly more biofilm from the artificial lateral canal. For biofilm removal from the artificial isthmus, no significant differences were found between the groups. Within-group analysis revealed significant differences between the steps of the experiment, with the exception of NaOCl. For the dentine discs, no significant differences regarding biofilm removal and viscoelasticity were detected. In the dentinal tubule model, NaOCl exhibited the greatest anti-biofilm efficacy. CONCLUSIONS: The mechanical effect of irrigation is important for biofilm removal. An extra high flow irrigation rate resulted in greater biofilm removal than US in the artificial isthmus. The mechanical effect of US seemed to be more effective when the surface contact biofilm-irrigant was small. After the irrigation procedures, the remaining biofilm could survive after a 5-day period. RISA and NaOCl seemed to alter post-treatment remaining biofilms.


Assuntos
Cavidade Pulpar , Irrigantes do Canal Radicular , Biofilmes , Dentina , Irrigantes do Canal Radicular/farmacologia , Preparo de Canal Radicular , Hipoclorito de Sódio/farmacologia , Irrigação Terapêutica
3.
Int Endod J ; 54(1): 46-60, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32892394

RESUMO

AIM: To investigate the microbial profile, and levels of endotoxin (LPS) and lipoteichoic acid (LTA), in infected dentine (ID) and root canals (RC) at different phases of root canal treatment in teeth with symptomatic irreversible pulpitis. METHODOLOGY: Ten volunteers were included, and samples were collected from infected dentine (ID) and the root canal lumen (RC) using sterile excavators and paper points, respectively. RC samples were taken before (S1) and after (S2) chemo-mechanical canal preparation (CMP), and after intracanal medication (ICM; S3). Checkerboard DNA-DNA hybridization was used for microbial analysis. The levels of LPS and LTA were evaluated using the limulus amebocyte lysate assay and ELISA, respectively. Shapiro-Wilk's test was used to verify data normality. Friedman's test was used to evaluate statistical differences using checkerboard DNA-DNA hybridization in the ID and RC at the different phases of the RC treatment. Post hoc Dunn's multiple comparison test was used to verify significant differences recorded at the different time-points. The levels of LPS and LTA were analysed statistically by using repeated measures anova and Tukey's post hoc test to evaluate differences in both sites. The significance level was set at 5% (P < 0.05). RESULTS: A total of 40 DNA probes were used for microbial investigation of ID and RC samples using checkerboard DNA-DNA hybridization. The levels and complexity of bacteria were similar in the ID and initial RC samples. The levels of LPS and LTA in ID were significantly higher than the initial RC samples (S1; P < 0.05). Canal preparation was effective in significantly decreasing the levels of bacteria, LPS and LTA (P < 0.05). ICM did not provide additional reduction in the levels of bacteria and LPS (P > 0.05). However, a significant reduction in the levels of LTA was observed after ICM (P < 0.05). CONCLUSION: The microbial profile of infected dentine and root canals of teeth with irreversible pulpitis was complex, harbouring different species including Gram-positive and Gram-negative, cocci and bacilli, and facultative and strict anaerobes. Root canal preparation was effective in reducing the levels of bacteria, LPS and LTA from the root canals of teeth with pulpitis.


Assuntos
Periodontite Periapical , Pulpite , Cavidade Pulpar , Endotoxinas , Humanos , Lipopolissacarídeos , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Ácidos Teicoicos
4.
Int Endod J ; 54(1): 74-84, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32894604

RESUMO

AIM: To identify dominant microorganisms in root filled teeth with apical periodontitis by Pan-PCRs in comparison with a culture-dependent approach, focusing on fungal species profiling. METHODOLOGY: The root filling material (gutta-percha) removed from 42 teeth with periapical radiolucencies undergoing root canal retreatments was analysed by molecular genetics techniques. Real-Time Pan-PCRs were conducted for the diagnosis of predominant bacteria (targeting 16S rDNA) and fungi (targeting ITS1-2 region). Identification of microorganisms was performed by Sanger sequencing of the PCR products and BLAST analysis. Additionally, subgingival plaque samples were collected and cultured to review the composition of the microbial flora. The McNemar test and the repeated measures anova were used for statistical analyses (significance level was set at P < 0.05). RESULTS: Overall, 42/42 plaque samples had bacterial growth, whereas 32/42 gutta-percha samples had bacterial growth with a dominance of Streptococcus spp. (12/42) and Enterococcus faecalis (9/42). The mean number of bacterial taxa per gutta-percha sample was 1.6 cultivatable taxa, significantly lower than in the plaque sample that had six taxa/sample (P < 0.001). Fungus-specific cultures were negative for gutta-percha samples, and only one plaque sample had growth of a fungus. In total, 36/42 plaque samples were positive in bacterial Pan-PCRs. In bacterial Pan-PCRs of 31/42 gutta-percha samples, dominant microorganisms were identified including Streptococcus spp. (5/42) and E. faecalis (4/42). Moreover, in 7/42 gutta-percha samples, DNA of bacteria which are difficult-to-cultivate in microbiology routine culture (Acinetobacter,Pyramidobacter,Bacteroidetes,Synergistes,Atopobium and Pseudoramibacter) was found. DNA of Candida spp. was detected in 5/42 root canals by fungal Pan-PCR (1/5) and genus-specific Candida-PCR (5/5). CONCLUSIONS: Pan-PCR assays remain appropriate as a broad-range approach for the detection of a dominant pathogen in gutta-percha samples which have less diverse microbial composition. The molecular genetic Pan-PCR approach has the advantage of detecting microorganisms that are as-yet-uncultivable or difficult-to-cultivate and should be therefore complement conventional microbiological diagnostics.


Assuntos
Cavidade Pulpar , Materiais Restauradores do Canal Radicular , Bactérias , Fungos , Guta-Percha , Projetos Piloto , Obturação do Canal Radicular , Preparo de Canal Radicular
5.
Int Endod J ; 54(1): 61-73, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32896000

RESUMO

AIM: To investigate the presence of resolvins E1 (RvE1) and D2 (RvD2) in teeth with primary endodontic infections and apical periodontitis, and to assess the influence of calcium hydroxide medication [Ca(OH)2 ], in association with 2% chlorhexidine gel (2% CHX gel), and N-acetylcysteine (NAC) on the levels of RvE1 and RvD2 in periapical tissues. METHODOLOGY: Thirty-six single-rooted teeth with primary endodontic infections and apical periodontitis were selected and randomly divided into three groups according to the medication: [Ca(OH)2 ] + saline solution (SSL) [Ca(OH)2  + SSL group] (n = 12), Ca(OH)2  + 2% chlorhexidine gel [Ca(OH)2  + 2% CHX gel group] (n = 12) and NAC [NAC group] (n = 12). Samples were collected from the periapical interstitial fluid at two different sampling times: before (S1) and after 14 days of intracanal medications (S2). Resolvins were measured using the enzyme-linked immunosorbent assay. Data were analysed using paired t-test, Wilcoxon test and Kruskal-Wallis test, followed by Dunn's post hoc test; all statistical tests were performed at a significance level of 5%. RESULTS: RvE1 and RvD2 were detected in 100% of the samples (36/36) at S1 and S2. Ca(OH)2 medication did not increase the levels of RvE1 or RvD2 (both P > 0.05); however, NAC significantly increased the levels of RvE1 and RvD2 after 14 days of treatment (P < 0.05). CONCLUSIONS: RvE1 and RvD2 were detected in periapical tissues from teeth with root canal infections. Moreover, calcium hydroxide medication did not increase the levels of resolvins in apical periodontitis. In contrast, the use of NAC intracanal medication significantly increased the levels of RvE1 and RvD2 after 14 days of treatment.


Assuntos
Hidróxido de Cálcio , Periodontite Periapical , Acetilcisteína , Clorexidina , Cavidade Pulpar , Humanos , Periodontite Periapical/tratamento farmacológico , Irrigantes do Canal Radicular , Preparo de Canal Radicular
6.
Acta Odontol Scand ; 79(1): 37-42, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32529874

RESUMO

OBJECTIVE: This study evaluated the radiographic outcome of root canal treatments (RCTs) performed by general dental practitioners (GDPs) with focus on tooth type and quality of root filling. MATERIALS AND METHODS: The target population included all patients receiving root filling by GDPs in City of Helsinki in 2010-2011. Equal numbers of each tooth type (anteriors, premolars, molars) by jaw were included, resulting in 426 teeth. Pre- and post-operative periapical radiographs were assessed to evaluate periapical status and quality of root filling. Statistical evaluation utilized Chi-squared tests, Cohen's kappa and logistic regression modelling. RESULTS: The overall success rate of RCT was 67.4%, being 76.8%, 69.7% and 55.6% (p < .001) for anteriors, premolars and molars, respectively. The quality of root fillings varied by tooth type (p < .001); optimal fillings were least frequent (43%) in molars. In multifactorial analysis, RCTs were more likely to succeed in non-molars (OR = 1.8), in teeth with optimal root fillings (OR = 3.6) and in teeth without apical periodontitis (OR = 3.2). CONCLUSION: The quality of root fillings and radiographic outcome of RCTs varied considerably according to tooth type; success was least likely in molars. Improvement is needed in quality of RCTs by GDPs.


Assuntos
Cavidade Pulpar , Periodontite Periapical , Odontologia Geral , Humanos , Periodontite Periapical/diagnóstico por imagem , Periodontite Periapical/terapia , Prognóstico , Obturação do Canal Radicular , Tratamento do Canal Radicular , Resultado do Tratamento
8.
Int J Paediatr Dent ; 31(1): 131-142, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32815216

RESUMO

BACKGROUND: The hand and rotary instruments are used for cleaning and shaping of root canals during biomechanical preparation in primary teeth. AIM: To determine clinical differences of hand versus rotary root canal instrumentation in primary teeth. DESIGN: Comprehensive searches were made in four electronic databases [MEDLINE (via PubMed), EMBASE, Google Scholar, and The Cochrane Central Register of Controlled Trials] till March 2020, and prospective studies that met the inclusion criteria were included. The primary outcome was instrumentation time, whereas the secondary outcomes were quality of obturation, obturation time, and clinical and radiographic success. From 604 screened studies, eleven studies qualified for meta-analysis. The random-effect model and generic inverse variance approach were used for meta-analysis. RESULTS: There was significant decrease in instrumentation time [MD-5.00 minutes (95% CI: 3.05-6.94), P < .00001, moderate evidence quality] and obturation time [MD-0.43 minutes (95% CI: 0.15-0.71), P = .003, low evidence quality] with rotary instrumentation. Optimal quality of obturation was achieved in significantly more number of teeth [risk ratio (RR) = 0.71(95% CI: 0.53-0.95),P = .02, moderate to high evidence quality] with rotary instrumentation. Similar clinical and radiographic success was observed in hand and rotary instrumentation techniques. CONCLUSION: Significant reduction in instrumentation time of five minutes was observed using rotary instrumentation with moderate quality evidence.


Assuntos
Preparo de Canal Radicular , Dente Decíduo , Cavidade Pulpar , Humanos , Estudos Prospectivos , Tratamento do Canal Radicular , Titânio
9.
J Endod ; 47(1): 112-124, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32941891

RESUMO

With the adoption of limited-volume cone beam computed tomographic (CBCT) imaging in dentistry, high resolution of the maxillomandibular complex has led to the recognition of numerous accessory neurovascular canals. The preoperative identification of these structures is essential to facilitate the safe performance of an assortment of invasive dental procedures; however, there is limited information in the endodontic literature regarding mapping of these neurovascular canals and their anatomic variants. To emphasize the utility of accessory neurovascular channel mapping in conjunction with endodontic therapy, we have presented the clinical findings of 4 diverse cases. Comprehensive evaluation of the CBCT scans showed relevant underlying etiopathologies, prompting clinical modifications that led to enhanced patient outcomes.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Variação Anatômica , Cavidade Pulpar/diagnóstico por imagem , Humanos , Projetos de Pesquisa
10.
J Endod ; 47(1): 100-104, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33045262

RESUMO

INTRODUCTION: This study assessed the number of mesial and distal canals of mandibular molars in which the R-Pilot pathfinding reciprocating instrument reached the working length (WL) during macro glide path procedure. Fracture and deformation rates were also evaluated. METHODS: One hundred fifty-six root canals of 52 teeth were scouted to the length of the apical foramen. Then the R-Pilot instrument was positioned at the canal orifice and activated. The instrument was moved by using a pecking motion and light apical pressure. This procedure was repeated in an attempt to reach the WL. The type of fracture and/or instrument deformation was assessed by scanning electron microscopy, whereas the roots with fractured instruments were scanned through micro-computed tomography. The percentage frequency distribution of fractures, deformations, and root canals in which the R-Pilot reached the WL were recorded and statistically compared by using the Pearson's χ2 test with α = 5%. RESULTS: R-Pilot instruments reached the WL in 139 root canals (89.10%), and χ2 test showed a significant difference between the observed frequencies and the expected frequencies (χ2 = 95.41, P = .000). The observed frequencies of fractures (2.56%) and deformations (1.92%) were also significantly lower than the expected (fracture: χ2 = 140.41, P = .000; deformation: χ2 = 144.23, P = .000). Fractures occurred mostly at the apical and curved parts of the root canals. CONCLUSIONS: R-Pilot reached the WL in 89.10% of the root canals of mandibular molars with fracture and deformation rates of 2.56% and 1.92%, respectively.


Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Cavidade Pulpar/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Ápice Dentário , Microtomografia por Raio-X
11.
J Endod ; 47(1): 133-139, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33045264

RESUMO

Guided endodontics has been used for the treatment of anterior teeth with a successful outcome. This approach is not only limited to anterior teeth because it can also be used for the treatment of premolars and molars. However, in such cases, space may be a limitation because a long bur has to be used in addition to the guide being placed on top of the teeth. The aim of this case report was to present a novel guided endodontics technique using a sleeveless 3-dimensional-printed guide. This design can reduce vertical space, allowing an open view of the tooth and irrigation during drilling. A 46-year-old female patient consulted the endodontic department with intermittent pain around tooth #5. Tooth #5 presented pain upon percussion and responded negative to a cold test. The initial periapical radiograph revealed an apical radiolucency with pulp canal obliteration. Clinically, there was no sinus tract. The tooth was diagnosed with pulp necrosis and symptomatic apical periodontitis. Guided endodontic treatment was performed with a sleeveless 3-dimensional-printed guide and long neck carbide bur with a head diameter of 1 mm to drill a minimally invasive access cavity up to the root canal. A completely healed apical area of tooth #5 was visible after 1 year on periapical radiographs. This technique seems to be a promising alternative in comparison with the conventional guided endodontic guide design for the negotiation of pulp canal obliteration in cases in which vertical space is limited.


Assuntos
Endodontia , Periodontite Periapical , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/cirurgia , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Periodontite Periapical/diagnóstico por imagem , Periodontite Periapical/cirurgia , Tratamento do Canal Radicular
12.
J Endod ; 47(1): 39-43, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33045268

RESUMO

INTRODUCTION: The aim of this cone-beam computed tomographic study was to evaluate the association between the mesiobuccal root canal configuration (RCC), interorifice distance (IOD), and the corresponding root length of a permanent maxillary first molar tooth. METHODS: One hundred cone-beam computed tomographic scans obtained from the computerized data bank of the institute were studied. The IOD between the first mesiobuccal and second mesiobuccal canal was measured in the axial section where the second mesiobuccal canal was first visualized. The root length was measured from the cementoenamel junction to the root apex in the coronal and sagittal section. The associations of these parameters with the RCC (based on Vertucci's classification) were evaluated. RESULTS: The predominant RCC was observed to be Vertucci type II (89%). The mean root length with this configuration was 11.19 ± 1.35 mm. In type IV RCC, the mean root length was 9.13 ± 0.52 mm. A statistically significant association was established between the root length and RCC (P < .05). In roots with type II and type IV RCC, the mean IOD was 2.58 ± 0.04 mm and 2.62 ± 0.1 mm, respectively. No statistically significant relation was established between the IOD and the type of RCC (P > .05). CONCLUSIONS: The length of the mesiobuccal root is an important anatomic parameter for predicting the type of RCC in the permanent maxillary first molar tooth.


Assuntos
Cavidade Pulpar , Maxila , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/diagnóstico por imagem , Maxila/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
13.
J Endod ; 47(1): 105-111, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33045271

RESUMO

INTRODUCTION: The purpose of this study was to evaluate the cleanliness of root canal walls and dentinal tubules after attempting to remove the calcium hydroxide dressing with different irrigant solutions and the use of nonactivated irrigation or passive ultrasonic irrigation (PUI). METHODS: After root canal instrumentation, 80 single-rooted teeth were filled with calcium hydroxide mixed with propylene glycol and 0.1% rhodamine B dye and inserted into canals with a Lentulo spiral. The calcium hydroxide dressing was initially removed with 10 mL saline solution and reinstrumentation with the master apical file. Then, the samples were randomly assigned into 8 experimental groups (n = 10) according to the irrigant solution with or without PUI: 2.5% sodium hypochlorite, 17% ethylenediaminetetraacetic acid + 1.25% sodium lauryl ether sulfate (EDTA-T), 37% phosphoric acid, or 70% ethanol. A final flush with 5 mL saline solution was performed. The percentage of clean root canal walls and the depth of clean dentinal tubules were measured with images of confocal laser scanning microscopy. The groups were compared using the 2-way analysis of variance test with the Bonferroni post hoc test for depth analysis and the Kruskal-Wallis with Dunn post hoc test for the perimeter analysis. RESULTS: Irrigation with 70% ethanol presented a significantly higher percentage of clean root canal walls and a higher depth of clean dentinal tubules when compared with irrigation with 2.5% sodium hypochlorite and 17% EDTA-T for both irrigation methods (P < .05). No differences were observed between nonactivated irrigation or PUI protocols (P > .05). CONCLUSIONS: Seventy percent ethanol enhanced calcium hydroxide removal from the apical root third compared with 2.5% sodium hypochlorite or 17% EDTA-T.


Assuntos
Hidróxido de Cálcio , Irrigantes do Canal Radicular , Cavidade Pulpar , Ácido Edético , Etanol , Microscopia Eletrônica de Varredura , Preparo de Canal Radicular , Hipoclorito de Sódio , Irrigação Terapêutica
14.
J Endod ; 47(1): 69-77, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33058937

RESUMO

INTRODUCTION: This study evaluated photodynamic therapy (PDT) and photobiomodulation therapy (PBM) as adjuncts to pulp revascularization using cultures of apical papilla cells (APCs) and endothelial cells (HUVECs). METHODS: The root canal and apical foramen of 2 mandibular first premolars were enlarged to simulate immature teeth. The canal of 1 tooth was filled with 1 mL 0.005% methylene blue (MB). After that, the canals of both teeth were irrigated with 20 mL 1.5% sodium hypochlorite (NaOCl) and 20 mL 17% EDTA. The resulting solutions were diluted in cell culture media at a concentration of 0.5% (0.5% MB + NaOCl + EDTA and 0.5% NaOCl + EDTA). After PDT (0.5% MB + NaOCl + EDTA + PDT) and PBM (0.5% NaOCl + EDTA + PBM) applications, the effects were evaluated to determine cytotoxicity, polarity index, APC migration, and HUVEC sprouting, and results were compared with those of their controls (solutions without laser application). Cell culture media (CT) was also used as a control. Data were analyzed using 1-way analysis of variance and the Tukey post hoc test (P ≤ .05). RESULTS: PDT and PBM promoted greater APC viability than their controls, and PDT had greater cell viability than CT (P < .05). All protocols reduced APC migration when compared with CT (P < .05). HUVEC sprouts grown out of spheroids in PBM had a greater ratio area than their control (P ≤ .01), and the PDT ratio of the spheroid area was similar to that of its control (P > .05). CONCLUSIONS: PBM and PDT seem to be potentially effective adjuncts to revascularization in nonvital immature teeth.


Assuntos
Fotoquimioterapia , Cavidade Pulpar , Ácido Edético , Células Endoteliais , Fármacos Fotossensibilizantes/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular , Hipoclorito de Sódio/farmacologia
15.
Clin Oral Investig ; 25(1): 231-236, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32474809

RESUMO

OBJECTIVES: To evaluate ex vivo the efficacy of the integrated motor Tri Auto ZX2 in controlling the apical extent of preparation compared to conventional visual control (CVC) of the working length (WL). MATERIALS AND METHODS: Eighty standardized mandibular premolars were divided into five groups (n = 16). In the CVC group, instruments were used in continuous rotation (CR) and visual control performed by means of rubber stoppers. For each of the remaining groups, it was assigned a combination of a motion (CR or optimal torque reverse (OTR)), and an apical function (Auto Apical Reverse (AAR) or Optimum Apical Stop (OAS)). Root canals were prepared using the apical functions at 0.5 mark using an alginate model. Difference between the final WL and the actual length post-instrumentation was calculated. Data were analyzed statistically with the significance set at 5% (ANOVA, Tukey HSD). RESULTS: There was no difference in the mean WL among the groups, except between the CR combined to OAS compared to CVC (P > 0.05). Although CVC resulted in two cases beyond the foramen, no significant difference was found among the groups when comparing the distributions of measurements (P > 0.05). CONCLUSIONS: All combinations of motion and apical control functions of Tri Auto ZX2 provided an adequate apical limit ex vivo, similar to the visual control using rubber stoppers. CLINICAL RELEVANCE: TriAuto ZX2 was efficient to control the apical extent of preparation dispensing the need for calibrating the files, regardless of the different settings. This motor might potentially prevent over-instrumentation by continuously monitoring the apical limit.


Assuntos
Instrumentos Odontológicos , Preparo de Canal Radicular , Cavidade Pulpar , Eletrônica , Desenho de Equipamento , Odontometria , Ápice Dentário
16.
Clin Oral Investig ; 25(1): 237-245, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32500405

RESUMO

OBJECTIVES: To evaluate the efficacy of a stepwise intraoperative activation (SIA) of irrigants during and after the instrumentation compared with that of a conventional activation (CA) performed only after the instrumentation to remove smear layer and debris using different activation devices. MATERIALS AND METHODS: A total of 70 single-rooted teeth were divided into a control group (no activation, n = 10) and two different experimental groups according to the irrigant activation protocol used: group 1 (CA), in which sodium hypochlorite was activated only after the use of the last mechanical file, and group 2 (SIA), in which activation was performed during and after the instrumentation. The two groups were divided into 3 subgroups according to the activation device used (n = 10): passive ultrasonic irrigation (PUI, subgroup a), EndoActivator (EA, subgroup b), and EDDY (subgroup c). The roots were split longitudinally and observed using scanning electron microscopy (SEM) to evaluate the presence of debris and smear layer, and the results were statistically analyzed. RESULTS: All activation protocols and devices were more effective than control group in removing smear layer and debris from all root canal thirds (P < 0.05), except for CA-EA (group 1b) in the apical third. In the apical third, SIA was found to be more effective than CA (P < 0.05) to remove smear layer and residual debris when PUI was used, to remove the smear layer when EA was used (P < 0.05), and to remove residual debris when EDDY was used (P < 0.05). PUI and EDDY removed statistically more smear layer and debris than EA in the apical third (P < 0.05). CONCLUSIONS: The SIA technique improved the smear layer and debris removal from the apical third and debris removal from the coronal third, and PUI and EDDY were more effective than EA in the apical third. CLINICAL RELEVANCE: The stepwise intraoperative activation (SIA) technique may increase smear layer and debris removal.


Assuntos
Camada de Esfregaço , Cavidade Pulpar , Ácido Edético , Humanos , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Hipoclorito de Sódio , Irrigação Terapêutica
17.
Clin Oral Investig ; 25(1): 211-218, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32519236

RESUMO

OBJECTIVES: To evaluate via scanning electron microscopy the amount of smear layer generated during the use of sonic and ultrasonic activation systems with standardized short-term intentional contacts with the canal walls. METHODOLOGY: Seventy single-root human teeth were randomly assigned to 2 control (n = 5 each): NC (negative control), PC (positive control) and four experimental groups (n = 15 each): NC (negative control), PC (positive control), G1 (passive ultrasonic irrigation with Irrisafe), G2 (ultrasonic irrigation with EndoUltra), G3 (sonic irrigation with Endoactivator), G4 (sonic irrigation with Eddy). Samples were instrumented with ProTaper Next®. An irrigation protocol with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) was followed for both PC and the experimental groups. Standardized intentional contacts were made in the mesial walls during 5 s at WL - 2 mm in all experimental groups. Two calibrated evaluators scored the smear layer generated with an ordinal scale by scanning electron microscopy. The weighted kappa coefficient (Kw) was calculated to determine the inter-observer agreement. Post-consensus ordinal data were analyzed using the ordinal (linear) chi-square test. RESULTS: When the agitation file is in contact with dentine walls, Irrisafe® significantly generated the least amount of smear layer in the coronal third (p < 0.05). Both in the middle and apical third, activation with Irrisafe® also showed statistically significant better results than Eddy™ and EndoUltra®. Endoactivator® showed significant better results than EndoUltra® and Eddy™ in the apical third (p < 0.05). CONCLUSIONS: Irrisafe generated the least amount of smear layer in the entire canal and similar to Endoactivator in the apical third when the agitation file is in contact with dentine walls. CLINICAL RELEVANCE: The smear layer is generated during activation. It is common to apply irrigation protocols where after the removal of the smear layer using chelants, a final rinse and activation is carried out but there are no previous studies analyzing the possible creation of a new smear layer with this final activation.


Assuntos
Camada de Esfregaço , Cavidade Pulpar , Dentina , Ácido Edético , Humanos , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Hipoclorito de Sódio
18.
J Endod ; 47(1): 94-99, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33002538

RESUMO

INTRODUCTION: This study aimed to analyze torque/force generation and transportation in double-curved canals instrumented with 3 types of glide path files using optimum glide path (OGP) motion in comparison with continuous rotation. METHODS: Sixty simulated double-curved canals were prepared with #10/0.05 or #15/0.03 HyFlex EDM Glidepath files (Coltene/Whaledent, Altstätten, Switzerland) or a #13/0.04 prototype MANI Glidepath file (Tochigi, Japan) using OGP motion or continuous rotation (n = 10 each). Canals were sequentially prepared to 20 mm and 22 mm (full working length) using automated root canal instrumentation and a torque/force analyzing device. Transportation was calculated at 1-9 mm from the apex. Data were compared using 2-way analysis of variance followed by a post hoc simple main effect test with Bonferroni correction and a Kruskal-Wallis test (α = 5%). RESULTS: All #10/0.05 instruments fractured. In the 22-mm preparation, the OGP motion resulted in lower clockwise torque and screw-in force than did continuous rotation (P < .05). In the 20-mm preparation, #15/0.03 instruments recorded a lower screw-in force for OGP motion than for continuous rotation (P < .05). Comparing the 2 preparation phases, OGP motion generated no significant differences; however, continuous rotation developed higher clockwise torque and screw-in force in the 22-mm preparation than in the 20-mm preparation (P < .05). There was no significant difference among the tested groups for transportation values. CONCLUSIONS: Compared with continuous rotation, OGP motion generated less screw-in force, lower clockwise torque, and similar transportation. The #15/0.03 HyFlex EDM instrument and the #13/0.04 prototype MANI instrument performed similarly well.


Assuntos
Parafusos Ósseos , Preparo de Canal Radicular , Instrumentos Odontológicos , Cavidade Pulpar , Desenho de Equipamento , Rotação , Titânio , Torque
19.
Clin Oral Investig ; 25(1): 363-370, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33184717

RESUMO

PURPOSE: Postoperative pain following root canal treatment is a concern for pediatric patients and pediatric dentists. The purpose of this study was to evaluate the effect of using sonic activation (SA) on postoperative pain levels after root canal therapy of primary molars. METHODS: A total of 110 patients aged 5-9 years with symptomatic irreversible pulpitis involving primary molars were included in the study and were randomly divided into two groups according to agitation methods: SA and no sonic activation (NSA). Root canal treatments were completed, and the teeth were restored permanently. Postoperative pain levels were evaluated using the five-face scale at 8, 24, 48, and 72 h and 1 week after treatment. Pain levels and frequency of analgesic intake were recorded and analyzed. RESULTS: Postoperative pain values were lower in the SA group than in the NSA group at 8, 24, and 48 h after treatment (p < 0.05). No significant difference was observed between the groups in terms of postoperative pain values at 72 h and 1 week after treatment (p > 0.05). CONCLUSIONS: It was determined that the use of SA reduces postoperative pain level significantly after root canal treatment in primary molar teeth. CLINICAL RELEVANCE: The use of SA can be recommended to clinicians since it is effective in the successful management of postoperative pain of root canal treatment in primary molar teeth. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT04197531.


Assuntos
Cavidade Pulpar , Pulpite , Criança , Pré-Escolar , Humanos , Dente Molar/cirurgia , Dor Pós-Operatória , Pulpite/terapia , Preparo de Canal Radicular , Tratamento do Canal Radicular
20.
J Oral Sci ; 63(1): 65-69, 2020 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-33298628

RESUMO

The purpose of this study was to examine the effect of heating on the physical properties of four types of premixed calcium silicate-based root canal sealers. Endoseal MTA, Well-Root ST, EndoSequence BC Sealer, EndoSequence BC Sealer HiFlow, and AH Plus (epoxy resin root canal sealer) were heated at 100°C for 1 min, and changes in setting time, flow, and film thickness were evaluated in accordance with ISO 6876:2012 standards. In addition, pH measurement and scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) analyses of the set materials were performed. All root canal sealers heated at 100°C showed significant decreases in setting time and flow, particularly Endoseal MTA. In addition, the film thickness of Endoseal MTA increased significantly after heating at 100°C. The pH and SEM/EDS results were not affected by heating. Heating calcium silicate-based root canal sealers accelerated setting time, decreased flow, and increased film thickness. However, the degree of these changes varied among the products. The present findings indicate that heat-induced changes in the physical properties of calcium silicate-based root canal sealers could adversely affect the quality of warm vertical condensation technique.


Assuntos
Materiais Restauradores do Canal Radicular , Compostos de Cálcio , Cavidade Pulpar , Resinas Epóxi , Guta-Percha , Calefação , Teste de Materiais , Silicatos
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