Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.773
Filtrar
1.
Braz Oral Res ; 33: e021, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31508722

RESUMO

This study investigated the effectiveness of XP-Endo Finisher (XPF) associated with XP-Endo Shaper (XPS) or Reciproc Blue (RB) files in reducing bacterial load in oval-shaped root canals (RC) during chemomechanical preparation (CMP) using 0.9% saline solution (NaCl) or 2.5% sodium hypochlorite (NaOCl). Eighty mandibular incisors with single oval-shaped RC were contaminated with Enterococcus faecalis. The teeth were randomly assigned to eight experimental groups (n = 10) according to the CMP, as follows: G1: XPS, G2: XPS + XPF, G3: RB, and G4: RB + XPF. CMP was performed with NaCl or NaOCl. The reduction of bacterial load was assessed by colony-forming unit count before (S1) and after (S2) CMP. Data normality was verified by using Shapiro-Wilk test. ANOVA, Tukey's test, and Bonferroni post-hoc test were used at a 5% significance level. Culturable bacteria were present in all S1 samples (p>0.05). All instrumentation techniques were effective in reducing bacterial load, irrespective of the irrigating solution (p < 0.05). With the use of NaCl, RB was more effective than XPS (p = 0.035). With the use of NaOCl, XPS and RB presented similar effectiveness (p = 0.779). XPF enhanced the bacterial reduction of both systems tested (p < 0.05). The use of NaOCl improved the CMP, irrespective of the instrumentation technique used (p < 0.05). In conclusion, XPS and RB files are effective in reducing bacterial levels in oval-shaped RC. The use of XPF as a method of agitation of the irrigating solution improved the cleaning efficiency of both file systems tested. Mechanical preparation performed with saline solution decreased culturable bacteria from the root canal, but antimicrobial substances such as NaOCl should be used to achieve a significantly better disinfection.


Assuntos
Carga Bacteriana , Instrumentos Odontológicos , Cavidade Pulpar/anatomia & histologia , Preparo de Canal Radicular/instrumentação , Cavidade Pulpar/microbiologia , Desinfetantes/uso terapêutico , Enterococcus faecalis/isolamento & purificação , Infecções por Bactérias Gram-Positivas , Humanos , Incisivo , Teste de Materiais , Solução Salina/uso terapêutico , Hipoclorito de Sódio/uso terapêutico
2.
J Appl Oral Sci ; 27: e20180689, 2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31411264

RESUMO

OBJECTIVE: The aim of this study was to evaluate the root canal preparation and apical enlargement of molar root canals with rotary or reciprocating heat-treated nickel-titanium (NiTi) instruments, by using micro-computed tomography (micro-CT). METHODOLOGY: Mesial root canals (n=48) of mandibular molars, with a curvature between 20° and 40°, were prepared with ProDesign Logic (PDL) 25.01 and 25.06 in rotary motion, or ProDesign R (PDR) 25.06 in reciprocating motion (PDR). Apical enlargement was performed with PDL35.01 and PDL35.05 or PDR35.05. Scanning with 9 µm resolution was performed before and after preparation, and, after apical enlargement, by using micro-CT. The percentage of volume increase, debris and untouched root canal surface, transportation, centralization and preparation time were analyzed. ANOVA and Tukey or Kruskall-Wallis and Dunn statistical tests were conducted (α=.05). RESULTS: PDL promoted a higher apical percentage of volume increase, and lower percentage of debris and untouched root canal surface than PDR 25.06 preparation in entire canal and in all thirds (P<.05). Apical enlargement with PDL 35.05 and PDR 35.05 produced a higher percentage of volume increase in the apical region in relation to the initial preparation (P<.05). PDR 35.05 and PDL 35.05 showed similar results in relation to percentage of debris and untouched root canal surface in entire canal and in all thirds (P>.05). Centralization and transportation showed no difference (P>.05). PDR required less time to perform preparation and apical enlargement (P<.05). CONCLUSIONS: The apical enlargement 35.05 with CM heat-treatment instruments using reciprocating and rotary motion reduced the percentage of debris and untouched root canal surface, without causing deviations or procedural errors. The protocol of greater apical enlargement favors the cleaning of the root canals in both kinematics. Preparation by the reciprocating system was faster than by the rotary system.


Assuntos
Instrumentos Odontológicos , Cavidade Pulpar/diagnóstico por imagem , Níquel , Preparo de Canal Radicular/instrumentação , Titânio , Análise de Variância , Cavidade Pulpar/anatomia & histologia , Desenho de Equipamento , Temperatura Alta , Humanos , Teste de Materiais , Valores de Referência , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Propriedades de Superfície , Microtomografia por Raio-X
3.
Braz Oral Res ; 33: e082, 2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31460608

RESUMO

The present study aimed to evaluate the internal configuration of the maxillary molars of a population from the Northeast region of Brazil. Cone-beam computed tomography (CBCT) exams from 512 patients (1501 teeth) were evaluated regarding the anatomical configuration of the root canal system, according to Vertucci's classification. The images were obtained using a Prexion 3D scanner operating at 90 kVp and 4 mA. The voxel size was 0.125 mm and the cut thickness was 1 mm. The images were then analyzed in the Prexion 3D Viewer software. The data were analyzed statistically by Pearson's chi-square test, with 5% of significance. The first and second molars presented three roots in 99.14% and 87.27% of the cases, respectively. In relation to the number of canals, the first and second molars had a significantly higher frequency of three and four root canals respectively, presenting a higher prevalence of types I and II (p < 0.001). The second mesiobuccal canal (MB2) was observed in 48.21% and 22.72% of the first and second molars, respectively (p < 0.001). The identification of the MB2 canal was greater in young and adult patients (p < 0.001), presenting a higher prevalence in male patients (p < 0.001). The internal configuration of the MB root was influenced by gender and by age, presenting a higher prevalence of the MB2 in male patients younger than 50 years of age.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Feminino , Humanos , Masculino , Maxila , Pessoa de Meia-Idade , Valores de Referência , Distribuição por Sexo , Fatores Sexuais , Adulto Jovem
4.
Microsc Res Tech ; 82(9): 1529-1534, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31184801

RESUMO

Electrochemical dissolution is a method in which fluoridated solution in direct contact with the fractured instrument receives an electrical current that speeds up fragment dissolution. The aim of this study was to assess the integrity of dentinal walls during the electrochemical dissolution of fractured rotary endodontic instruments in extracted human teeth. Forty-five human mandibular incisors subjected to the electrochemical dissolution process using fluoride solution with low NaCl concentration (LC group: NaF 12 g/L + NaCl 1 g/L, pH = 5.0), fluoride solution with saturating NaCl concentration (SC group: NaF 12 g/L + NaCl 180 g/L, pH = 5.0) and distilled water (control group) were evaluated. For each group, 15 incisors were submitted for the scanning electron microscopy (SEM) evaluation. The roots were sectioned longitudinally; each hemisection was analyzed (n = 30), and energy-dispersive spectroscopy (EDS) was performed. The amount of dentinal tubule openings was analyzed by SEM. Statistical analyses were performed. The test solutions did not alter the amount of dentinal tubule openings when compared with the control group. No Ni or Ti was impregnated into the dentinal tubules after electrochemical techniques. The dentinal structure remained unchanged following the electrochemical dissolution method.


Assuntos
Instrumentos Odontológicos , Cavidade Pulpar/efeitos dos fármacos , Dentina/efeitos dos fármacos , Técnicas Eletroquímicas/métodos , Falha de Equipamento , Propriedades de Superfície/efeitos dos fármacos , Ligas/isolamento & purificação , Cavidade Pulpar/anatomia & histologia , Dentina/anatomia & histologia , Humanos , Incisivo/anatomia & histologia , Microscopia Eletrônica de Varredura , Preparo de Canal Radicular/métodos , Espectrometria por Raios X
5.
J Appl Oral Sci ; 27: e20180700, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166415

RESUMO

INTRODUCTION: Alternatives for the treatment of caries disease, such as minimally invasive approaches, have been developed in recent years. OBJECTIVE: To carry out clinical and radiographic evaluations of three cavity liners after selective caries removal. METHODOLOGY: Thirty-six primary molars with deep occlusal caries lesions without pulp involvement (from children of both genders, aged between 5 and 8 years) were randomly divided into the following groups: calcium hydroxide cement (CHC) group; mineral trioxide aggregate (MTA) group and Portland cement with added zirconium oxide (PCZ) group. The following-up period was 6- and 12-month. The clinical and radiographic success rates were evaluated through chi-square test. The radiographic measurements were compared by ANOVA followed by Tukey's test (p<0.05). RESULTS: Thirty-six patients were included, but thirty-four returned for 12-month follow-up. The overall success rate of the therapy for the three groups was 94.11% and no statistically significant differences occurred in the comparison among groups (p>0.05). Nineteen radiographs were selected to measure the dentin barrier thickness. The intragroup comparison presented a statistically significant increase of the dentin barrier for all groups, at 12-month follow-up. However, the MTA group showed increase of the dentin barrier, over time, 6- to 12-month follow-up. The intergroup comparison revealed no statistically significant differences (p>0.05). CONCLUSION: The clinical and radiographic data showed that all cavity liners provided effective treatment of primary teeth after selective caries removal.


Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Cárie Dentária/terapia , Forramento da Cavidade Dentária/métodos , Óxidos/uso terapêutico , Silicatos/uso terapêutico , Zircônio/uso terapêutico , Análise de Variância , Criança , Pré-Escolar , Cárie Dentária/diagnóstico por imagem , Cimentos Dentários/uso terapêutico , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/efeitos dos fármacos , Restauração Dentária Permanente/métodos , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Radiografia Dentária , Fatores de Tempo , Dente Decíduo , Resultado do Tratamento
6.
J Endod ; 45(6): 724-728, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31056296

RESUMO

INTRODUCTION: The morphology of the palatal root of maxillary first and second molars was analyzed and compared using micro-computed tomographic scanning. METHODS: Forty-seven extracted maxillary molars were scanned with a micro-computed tomographic device to analyze the palatal radicular dentin dimensions, canal working width, root length, canal curvature, lateral canals, and apical constriction anatomy. Quantitative data were analyzed with mean and standard deviation for first and second molars, respectively. Comparison was made between first and second molars using an unpaired t test. RESULTS: The palatal root of maxillary first molars was found to have statistically significantly thinner dentin than second molars on the palatal aspect of the root 8-11 mm from the apex, correlating to the coronal and middle thirds of the root. First molar palatal roots also had a statistically significantly wider canal mesiodistally than second molars at 13-15 mm from the apex, correlating approximately to the level of the cementoenamel junction and pulpal floor. Significant canal curvature was present. These findings suggest the need for conservative coronal flaring and instrumentation. CONCLUSIONS: The absence of an apical constriction in 76.6% of the specimens highlights the importance of creating an apical seat through instrumentation to maintain obturation materials. A minimum master apical file size of 40 is recommended based on preoperative working widths in the apical 0.5-1.0 mm. A root-end resection of 3.5 mm would remove a greater majority of lateral canals.


Assuntos
Cavidade Pulpar , Dente Molar , Raiz Dentária , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Humanos , Maxila , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Microtomografia por Raio-X
7.
Surg Radiol Anat ; 41(7): 815-822, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30937566

RESUMO

PURPOSE: To investigate the prevalence of isthmi and middle mesial (MM) canals in the mesial roots of mandibular first molars (MFM) in a Mongoloid subpopulation and to evaluate their association with demographic and anatomic characteristics. METHODS: Cone-beam computed tomography (CBCT) images of 496 patients with 823 MFMs were selected and analyzed. The following data were collected: patient age and gender, side, presence and distribution of MM canal and isthmus, distance between mesiobuccal (MB) and mesiolingual (ML) orifices, and MB-ML root canal system (RCS) morphology. Logistic regression was used to determine the association between demographic and anatomic characteristics and the presence of isthmi in the apical third. RESULTS: The overall prevalence of isthmus and an MM canal in MFM was 64.6% and 10.8%, respectively. The highest prevalence of isthmi and MM canals was found in patients of ≤ 20 and of 41-60 years, respectively (p < 0.05). The prevalence of isthmi declines with age. A total of 41.3% of the MFMs had isthmi in the apical third of the mesial roots. Younger age, shorter MB-ML orifice distance, and Weine type II RCS increased the probability of the presence of an isthmus in the apical third (p < 0.05). CONCLUSION: The prevalence of isthmus in MFM is high in the subject population, but the prevalence of MM canals is not as high as previously reported. Demographic and anatomic characteristics could aid clinicians to better predict the presence of MM canal and an isthmus.


Assuntos
Variação Anatômica , Cavidade Pulpar/anatomia & histologia , Mandíbula/anatomia & histologia , Dente Molar/anatomia & histologia , Raiz Dentária/anatomia & histologia , Adolescente , Adulto , Fatores Etários , Idoso , Grupo com Ancestrais do Continente Asiático , Criança , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/diagnóstico por imagem , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Pessoa de Meia-Idade , Dente Molar/diagnóstico por imagem , Prevalência , Fatores Sexuais , Raiz Dentária/diagnóstico por imagem , Adulto Jovem
8.
Gen Dent ; 67(2): 73-75, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30875311

RESUMO

The aim of this study was to clinically assess the impact of a dental operating microscope (DOM) on the clinician's ability to locate a second canal in the mesiobuccal root (MB2), also known as the mesiolingual canal. An endodontic specialist treated 180 maxillary first molars using the same protocol for all teeth except for the use of the DOM (n = 90 per group). In the teeth treated without the use of a DOM, a mesiolingual canal was located in 26.67% of the cases; when a DOM was used, a mesiolingual canal was located in 77.78% of the cases. Analysis with the Fisher exact test revealed that the magnification provided by a DOM significantly (P < 0.05) improved the identification of MB2 canals in maxillary first molars.


Assuntos
Cavidade Pulpar , Dente Molar/anatomia & histologia , Raiz Dentária , Cavidade Pulpar/anatomia & histologia , Humanos , Maxila , Microscopia , Preparo de Canal Radicular
9.
J Endod ; 45(5): 619-622, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30926161

RESUMO

INTRODUCTION: This study evaluated the accuracy and reliability of the tactile perception of the first apical binding file (FABF) and cone-beam computed tomographic (CBCT) imaging in estimating the canal diameter at the working length (WL). METHODS: Ten anterior mandible segments were obtained from cadavers maintained in formalin and scanned using CBCT and high-resolution micro-computed tomographic (micro-CT) imaging. Scans were used to measure the smallest canal diameter of 38 mandibular incisors at 1 mm short of the root apex. After coronal access preparation, the canals of these teeth were explored with a size 08 K-file up to the radiographic apex, and the WL was established 1 mm shorter. Larger K-files were passively introduced in the canal up to the WL until binding was felt and the next instrument size could not reach this point. This instrument was regarded as the FABF. The accuracy and level of agreement (reliability) of the FABF and CBCT imaging in determining the initial apical canal size were determined using the Pearson correlation coefficient and the intraclass correlation coefficient, respectively, considering the micro-CT measurements as the gold standard. RESULTS: The Pearson correlation coefficient and the intraclass correlation coefficient were statistically significant when CBCT imaging was compared with micro-CT imaging (P < .01), showing a moderate accuracy (r = 0.61) and good reliability (0.74). On the other hand, FABF was inaccurate and unreliable (P > .05). The means of the smallest root canal diameter obtained by micro-CT and CBCT imaging were 0.22 mm (range, 0.14-0.34 mm) and 0.23 mm (range, 0.13-0.37 mm), respectively. The mean of the FABF diameter was 0.15 mm (range, 0.08-0.30 mm). CONCLUSIONS: Although FABF did not accurately reflect the diameter of the apical canal at the WL, CBCT imaging showed good accuracy and reliability. Data from CBCT imaging regarding the initial apical canal size may be used to plan root canal enlargement.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Cadáver , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Humanos , Reprodutibilidade dos Testes , Microtomografia por Raio-X
10.
Clin Oral Investig ; 23(12): 4255-4262, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30834991

RESUMO

OBJECTIVES: This study compared canal transportation and centering ratio produced after instrumentation with a single heat-treated reciprocating system, WaveOne Gold (WOG; Dentsply Sirona, Tulsa, OK, USA) and a single heat-treated rotary instrument, XP-endo Shaper (XPS; FKG, La Chaux-de-Fonds, Switzerland), using micro-computed tomographic (micro-CT) imaging, and evaluated the ability of double-digital radiography (DDR) to detect canal transportation. MATERIALS AND METHODS: Mesial root canals of mandibular molars with severe curvature (25-70°) were randomly assigned to either WOG or XPS groups for preparation. Centering ratio was measured by micro-CT imaging, while canal transportation was measured by micro-CT and DDR methods at 3, 5, and 7 mm from the apex. Data were statistically compared between groups using the t test (α = 5%). RESULTS: The micro-CT method showed that XPS's shaping ability regarding the centering ability (P = 0.030) and canal transportation (P = 0.028) was significantly better than WOG only at the 7-mm level. The DDR technique detected no difference in canal transportation between groups at any level (P > 0.05); however, a significant difference between evaluation methods was detected at the 5-mm level in the WOG group (P = 0.023). CONCLUSIONS: Micro-CT technique revealed a significantly better centering ability and less canal transportation with XPS compared to WOG. The DDR technique was not capable of detecting the significant difference between the tested groups. CLINICAL RELEVANCE: Root canal curvatures may lead to procedural errors during endodontic treatment. Thus, differences on the shaping ability of single heat-treated reciprocating and rotary systems should be known.


Assuntos
Radiografia Dentária Digital/métodos , Preparo de Canal Radicular/instrumentação , Raiz Dentária/diagnóstico por imagem , Microtomografia por Raio-X/métodos , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Desenho de Equipamento , Humanos , Dente Molar/diagnóstico por imagem , Suíça
11.
J Endod ; 45(4): 372-386.e4, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30833097

RESUMO

INTRODUCTION: In the literature, several prevalence studies on root canal anatomy using cone-beam computed tomographic technology are currently available although their results remain disperse. This systematic review aimed to appraise and combine, under strict criteria conditions, selected prevalence studies in order to comprehend the distribution of root canal configuration types among different populations. METHODS: This systematic review was registered in PROSPERO. Six electronic databases were accessed, and the studies were selected according to a predefined inclusion/exclusion criteria. References of the collected studies and 3 peer-reviewed endodontic journals were hand searched. The authors of the selected studies were contacted for additional information. All eligible studies were submitted to a scientific merit evaluation by 2 evaluators independently, who also reached a final consensus for each study score using the Joanna Briggs Institute Critical Appraisal tool for prevalence studies. RESULTS: Fifty-two studies from 28 different countries including 102,610 teeth and presenting a Joanna Briggs Institute Critical Appraisal tool average score of 80.5% were included in this review. Overall, results showed a wide prevalence range of the second mesiobuccal canal in maxillary first and second molars but also a high prevalence of single-rooted configuration in maxillary first premolars and mandibular second molars and 3-rooted morphology in the mandibular first molar of Asian populations. CONCLUSIONS: The included studies showed a global tendency for a particular morphology in some groups of teeth, whereas others showed diversity in specific anatomic types among different populations.


Assuntos
Variação Anatômica , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Bases de Dados Bibliográficas , Humanos , Tratamento do Canal Radicular
12.
Braz Dent J ; 30(1): 3-11, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30864643

RESUMO

This study discusses a method to determine the root canal anatomic dimension by using e-Vol DX software. The methodology consists in initially establishes the correct positions which will be measured, define the point on the edge of the anatomical structure, and next adjust the intermediate position in the grayscale of CBCT image. Afterward, thin sections (0.10 mm) are obtained from 3D reconstructed slices in the filter for the measurements, in order to determine the edge of the anatomical surface in the axial plane. A replication of positions in 3D mode is done in multiplanar reconstruction (MPR) of CBCT images, where the correct position is established with the aid of a positioning guide. The 3D density is adjusted so that it is in the same dimension as the 2D image, and a dimension calibration occurs to the point where there is a coincidence between 3D and 2D. This calibration is done only at the beginning of the measurement. Next, the intermediate position of the division between the grayscale is verified in the CBCT scan. Once one side has been completed, it is moved to the other side and follows the same guidelines described above. When setting the position of the courses in the other margin, being that 2D mode is used as reference. Thus, one obtains the required measure, being checked in the two points. The creation of this filter in the e-Vol DX software for measurement, and its appropriate management, allows more effective applications when it is desired to obtain diameters of anatomical structures.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Imagem Tridimensional/métodos , Desenho de Programas de Computador , Humanos
13.
Braz Oral Res ; 33: e011, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30758408

RESUMO

To evaluate the influence of novel ultrasonic tips as an auxiliary method for the rotary preparation of flattened/oval-shaped canals. Forty-five mandibular incisors were selected and divided into one of three experimental groups (n = 15): Group PFCP - ProDesign Logic 25/.05 + Flatsonic + Clearsonic + Prodesign Logic 40/.01; Group FCP - Flatsonic + Clearsonic + ProDesign Logic 40/.01; and Group PP - Prodesign Logic 25/.05 + Prodesign Logic 40/.05. The teeth were scanned preoperatively and postoperatively using microcomputed tomography. The percentage values for increase in volume, non-instrumented surface area, dentin removal, degree of canal transportation, and centering ratio between the experimental groups were examined. Data were analyzed using the non-parametric Kruskal-Wallis and Dunn's tests (p < 0.05). Group PFCP showed the greatest volume increase in the total portion of the root canal and the lowest percentage of non-instrumented surface area. Regarding the degree of transportation in the buccolingual direction, statistically significant differences between groups PFCP and PP were observed at the coronal third of the canal. In the mesiodistal direction, no statistically significant differences were observed at the coronal, middle, and apical thirds. As for the centering ratio, statistically significant differences were found in the buccolingual direction. In the mesiodistal direction, no statistically significant differences were observed at the coronal, middle, and apical thirds. The use of novel ultrasonic tips combined with rotary instruments in group PFCP provided a significant increase in volume and reduced the percentage of non-instrumented areas during the preparation of flattened/oval-shaped canals.


Assuntos
Cavidade Pulpar/anatomia & histologia , Preparo de Canal Radicular/instrumentação , Terapia por Ultrassom/instrumentação , Instrumentos Odontológicos/normas , Dentina/cirurgia , Desenho de Equipamento , Humanos , Microscopia Eletrônica de Varredura , Valores de Referência , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Propriedades de Superfície , Resultado do Tratamento , Microtomografia por Raio-X/métodos
14.
PLoS One ; 14(2): e0211948, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30759126

RESUMO

INTRODUCTION: The study aimed to evaluate, through in vivo tomographic analysis, the prevalence of C-shaped canals in mandibular first and second molars of Brazilian individuals, analyzing its frequency by thirds of the roots, and in contralateral teeth. METHODS: Images of 801 mandibular molars (379 first molars and 422 second molars) from 334 Brazilian individuals (142 men and 192 women) were identified through 1544 cone beam computed tomography (CBCT) exams, obtained from a private oral radiologic clinic. The cross-sectional configurations were analyzed to determine the frequency of C-shaped canals at three different axial levels and classified in categories by three experienced endodontists independently. RESULTS: The incidence of C-shaped canals was 181 (23%). Considering the type of tooth, 91 (24.01%) were identified in the first molars, and 90 (21.32%) were found in the second molars. The incidence was significantly higher in female individuals (P < 0.05) for both first and second molars. The most common C-shaped canal configurations were: C1 (89.01% for first molars and 90% second molars), followed by C2 (8.79% for first molars and 6.66% for second molars) and C4 (2.19% for the first molars and 3.33% for the second molars). Bilateral C-shaped canals were significantly higher than unilateral for both first and second molars (P < 0.01). CONCLUSIONS: The prevalence of C-shaped canals in mandibular molars of the Brazilian individuals was higher than previously reported for both mandibular first (24.01%) and second molars (21.32%). The incidence was significantly higher in female individuals and the coronal portion of the roots. The classic C-shaped format "C1" was the most frequent anatomical configuration. Furthermore, the prevalence of bilateral C-shaped canals was higher for the first molar (61.70%) and lower for the second molar (38.29%).


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/anatomia & histologia , Mandíbula/anatomia & histologia , Dente Molar/anatomia & histologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Tomografia Computadorizada de Feixe Cônico/métodos , Estudos Transversais , Cavidade Pulpar/diagnóstico por imagem , Deformidades Dentofaciais/diagnóstico , Deformidades Dentofaciais/epidemiologia , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Pessoa de Meia-Idade , Dente Molar/diagnóstico por imagem , Prevalência , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Adulto Jovem
15.
J Endod ; 45(4): 406-413, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30770279

RESUMO

INTRODUCTION: The purpose of this study was firstly to compare the impact of radiographs, cone-beam computed tomographic (CBCT) imaging, and 3D Endo software (Dentsply Sirona, Ballaigues, Switzerland) on the assessment of root canal anatomy and radiographic quality of endodontic treatment and secondly to assess stress levels in the same cohort of residents performing endodontic treatment. METHODS: Sixty patients requiring primary molar endodontic treatment were allocated randomly into 3 groups: group 1 (n = 20), conventional radiographs (periapical radiography [PR]) only; group 2 (n = 20), PR and CBCT imaging; and group 3 (n = 20), PR, CBCT imaging, and 3D Endo software. All treatment was performed using a standardized protocol. Residents completed a questionnaire to assess their stress levels and usefulness of the imaging modality used. The radiographic quality of completed cases was assessed by 2 experienced endodontists who were not involved in the supervision of the cases being assessed. RESULTS: Groups 2 (CBCT imaging) and 3 (PR, CBCT imaging, and 3D Endo) proved significantly better than group 1 (PR) (P < .001) for assessing the number of root canals and anatomy and estimating the working lengths. Group 3 provided a significantly more accurate determination of the working level (P = .002). There were significantly more cases with obturation short of the apex (<2 mm) and voids in group 1 compared with group 3 (P < .05) and a significantly higher number of cases with voids in group 1 compared with group 3 (P < .01). Clinicians found treatment to be moderately or very stressful in 75%, 5%, and 0% in groups 1, 2, and 3, respectively. CONCLUSIONS: 3D Endo software followed by CBCT imaging were found to be more desirable for the evaluation of root canal anatomy and working lengths and reducing the residents' stress levels.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Endodontia/educação , Endodontistas/psicologia , Imagem Tridimensional , Internato e Residência , Dente Molar/cirurgia , Radiografia Dentária , Tratamento do Canal Radicular , Estresse Psicológico , Estudos de Coortes , Humanos , Software , Inquéritos e Questionários
16.
J Endod ; 45(4): 453-458, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30770281

RESUMO

Knowledge of the prevalent root canal anatomy and potential variations is necessary before the initiation of endodontic treatment. The purpose of this study was to aid in the detection and treatment of the Vertucci type V canal configuration when present in the distal root of the mandibular molars. This case series presents 3 radiographic indications of a type V configuration in the distal roots of the mandibular molars as revealed on conventional periapical radiographs: a "ghost" apex, a fast break canal, and eccentric canal tracing. Nonsurgical endodontic treatment was performed for 5 mandibular molars with the type V distal root canal. Four cases showed posttreatment resolution of symptoms and return of normal function. One case was classified as "failed" because of persistent symptoms and clinical signs. The tooth was surgically treated and subsequently healed. These case reports show the importance of visualizing and managing the anatomic variations of the canal system in distal roots of mandibular molars and incorporating these capabilities into clinical practice to enhance the occurrence of a successful outcome. Additionally, clinical guidelines are provided that can help clinicians overcome the challenges in diagnosing and treating such complex cases.


Assuntos
Variação Anatômica , Mandíbula , Dente Molar , Radiografia Dentária , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Adolescente , Adulto , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tratamento do Canal Radicular
17.
J Endod ; 45(2): 129-135, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30711167

RESUMO

INTRODUCTION: Successful endodontic treatment vastly depends to a high degree on an accurate knowledge of root canal system morphology. It is a prerequisite to be aware of all possible reservoirs where bacteria and/or toxins can persist, compromising the surrounding tissues; such knowledge results in endodontic success. METHODS: The presence of interradicular canals and diverticula between the pulp chamber floor and the bifurcation area surface of 117 mandibular first molars was investigated. Access cavities were prepared, the teeth were embedded in plastic, and the pulp chambers were flooded with methylene blue and then centrifuged. An average of 4.2 (0.145 ± 0.03 mm thickness) slices per tooth were obtained by means of a diamond band saw. The presence of interradicular canals and diverticula was investigated using a light microscope (125×). RESULTS: Interradicular canals were observed in 9 teeth. Seven teeth had 1 interradicular canal, and 2 teeth had 2 interradicular canals. Diverticula (blind interradicular canals) were observed in 11 teeth originating either on the pulp chamber floor or the bifurcation side. The number of diverticula per tooth varied between 1 and 5 and originated in 3 teeth in the pulp chamber floor and 8 teeth in the bifurcation area. Two teeth had both 1 interradicular canal and 3 diverticula. Of the 117 mandibular molars investigated, 18 had either 1 or 2 interradicular canals, 1 to 5 diverticula, or an interradicular canal and 3 diverticula. CONCLUSIONS: Based on the results obtained with this ex vivo study and because of the difficulties involved in the clinical performance of mechanical cleaning of possibly existing interradicular canals, it is highly recommended to perform thorough chemical cleaning and disinfection of the pulp chamber floor area in order to enhance the sealing possibility of such structures and minimize treatment failure.


Assuntos
Cavidade Pulpar/anatomia & histologia , Mandíbula , Dente Molar/anatomia & histologia , Cavidade Pulpar/patologia , Cavidade Pulpar/ultraestrutura , Humanos , Microscopia , Tratamento do Canal Radicular/métodos
18.
Am J Phys Anthropol ; 168(3): 637-646, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30693948

RESUMO

OBJECTIVES: The aim of this study is to explore the root and root canal morphology of Homo fossil occupying China during the Middle Pleistocene period. Human occupation and evolutionary dynamics in East Asia during the Middle Pleistocene period is one of the most intriguing issues in paleoanthropology, with the coexistence of multiple lineages and regional morphs suggesting a complex population interaction scenario. Although premolar root and canal morphology has certain phylogenetic, taxonomic, and functional implications, its morphological diversity, possible evolutionary trend and characteristics regarding Middle Pleistocene hominins inhabiting East Asia are still insufficiently understood; where these populations fits within the Homo lineage (with respect to root and pulp canal structure) needs to be explored. MATERIALS AND METHODS: Using microtomography, we directly observed and assessed the nonmetric variability of root and canal forms in maxillary and mandibular premolars of Chinese Middle Pleistocene Homo (N = 19), and compared our observed variations with Eurasian Early Pleistocene specimens from the Asia continent (N = 1) and Java (N = 2), as well as with Neanderthals (N = 28) and recent modern humans (N = 67). RESULTS: A total number of nine types of root-canal forms were recorded. As a whole, the Chinese Middle Pleistocene record shows an evolutionary trend toward a modern human-like condition (a reduction of root/canal number and a simplification of root surface structure). We documented primitive signals like high percentage of Tomes' root in lower premolars. A considerable occurrence of incompletely separated root branches and bifid root and canal apices, representing evolutionary transformation from multi-root to single-root condition was also noticed. The results were compared with previous publications on Early and Middle Pleistocene Homo in East Africa, North Africa, and Eurasia. CONCLUSION: This work provides new original data, incorporates the latest human fossil discoveries and suggests that analyzing the variation of premolar root structural organization, notably integrating together root/canal form and number, could possibly contribute to taxonomic and phylogenetic assessments. The mid-Middle Pleistocene populations, or "classic" Homo erectus, in our study show closer affinity to Early and Middle Pleistocene hominins in Eurasia, than to East African early Homo, which supports the suggestion that at least some of the Early Pleistocene hominin groups in Eurasia contribute to the later population; on the other hand, it is still difficult to clearly trace the evolutionary fate of those late Middle Pleistocene populations (roughly assigned as archaic Homo sapiens through a craniodental perspective). More comparable materials from the Early to Middle Pleistocene period as well as precise chronological framework is needed to further explore the evolutionary trends of archaic hominins in the Asian continent before the arrival of modern humans.


Assuntos
Dente Pré-Molar/anatomia & histologia , Cavidade Pulpar/anatomia & histologia , Hominidae/anatomia & histologia , Raiz Dentária/anatomia & histologia , Animais , Antropologia Física , China , Europa (Continente) , Fósseis , Humanos , Homem de Neandertal/anatomia & histologia , Microtomografia por Raio-X
19.
Int Endod J ; 52(1): 86-93, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29858500

RESUMO

AIM: To evaluate and compare the canal shaping ability of BioRace, ProTaper NEXT and Genius engine-driven nickel-titanium (NiTi) file systems in extracted mandibular first molars using micro-computed tomography (MCT). METHODOLOGY: Sixty mesial root canals of mandibular first molars were randomly divided into three equal groups, according to the instrument system used for root canal preparation (n = 20): BioRace (BR), ProTaper NEXT (PTN) or Genius (GN). Root canals were prepared to the full WL using a crown-down technique up to size 35, .04 taper instruments for BR and GN groups and size 30, .07 taper instruments for the PTN group. MCT was used to scan the specimens before and after canal instrumentation. Changes in dentine volume, the percentage of uninstrumented canal surface and degree of canal transportation were evaluated in the coronal, middle and apical thirds of canals. Data were analysed statistically using one-way analysis of variance and Tuckey's post hoc tests with the significance level set at 5%. RESULTS: There were no significant differences between the three groups in the terms of dentine removed after preparation and determination of the root canal volume, or percentage of uninstrumented canal surface (P > 0.05). No significant differences were found between the systems for canal transportation in any canal third (P > 0.05). CONCLUSIONS: The shaping ability of the BR, PTN and GN NiTi file systems was equally effective. All instrumentation systems prepared curved root canal systems with no evidence of undesirable changes in 3D parameters or significant shaping errors.


Assuntos
Ligas Dentárias/química , Níquel/química , Preparo de Canal Radicular/instrumentação , Titânio/química , Microtomografia por Raio-X/métodos , Análise de Variância , Instrumentos Odontológicos , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Dentina/anatomia & histologia , Dentina/patologia , Desenho de Equipamento , Humanos , Processamento de Imagem Assistida por Computador/métodos , Técnicas In Vitro , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Preparo de Canal Radicular/métodos , Propriedades de Superfície
20.
Lasers Med Sci ; 34(5): 973-980, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30426356

RESUMO

The aim of this study was to evaluate the ability of spectral-domain optical coherence tomography (SD-OCT) to display the roof of the pulp chamber and to estimate the residual dentin thickness (RDT) of the pulp complex. The roots of 20 extracted human molars were embedded in epoxy resin, and crowns were longitudinally sectioned in the mesial-distal direction, exposing the pulp chamber. The coronal part of the crown was removed up to an RDT to the pulp chamber roof of 2 mm. Samples were imaged by SD-OCT from coronal view and by light microscopy (LM) in the sagittal plane. Using a microtome, dentin was subsequently removed in four levels from the occlusal aspect in steps of 250 µm. At each level, RDT was documented and measured by both methods. The data were compared (Spearman's rho correlation coefficient, Wilcoxon signed-rank test). Using OCT, the roof of the pulp chamber was first displayed at a maximum RDT of 1.94 mm. The minimal RDT that could be imaged by OCT was 0.06 mm. Values from both methods were strongly correlated (r, 0.83-0.95; pi ≤ 0.05) and differed significantly for large RDTs (dentin levels 1, 2; pi < 0.05) but not for small RDTs (levels 3, 4; pi ≥ 0.226). The roof of the dental pulp chamber could be already visualized by SD-OCT with a RDT of 1.94 mm. Therefore, the method could be a useful diagnostic tool during the preparation of deep dentin cavities and might help to preserve the integrity of the pulp chamber.


Assuntos
Cavidade Pulpar/anatomia & histologia , Dentina/anatomia & histologia , Tomografia de Coerência Óptica/métodos , Estudos Transversais , Cavidade Pulpar/ultraestrutura , Dentina/ultraestrutura , Humanos , Dente Molar/anatomia & histologia , Estatísticas não Paramétricas
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA