Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.122
Filtrar
1.
Pediatr Dent ; 43(5): 380-386, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34654500

RESUMO

Purpose: The purpose of this study was to investigate an association between treatments on the primary second molars (PSMs) under general anesthesia (GA) and odds of repeat GA. Methods: This was a retrospective study of children who received dental treatment under GA between the ages of 24 to 48 months. Descriptive statistics and logistic regression models (P<0.05) were used to test the association between the treatment of PSMs at the first dental GA visit (GA1) and the odds of receiving GA a second time (GA2) within the next 55 months post-GA1. Results: A total of 819 children (53 percent male) with a mean (±SD) age of 36 (±seven SD) months and 3,276 PSMs were included. Only three percent of children with all PSMs covered at GA1 received GA2. The odds of GA2 significantly increased for children with any uncovered PSMs. Among children with four uncovered PSMs, 19 percent (odds ratio [OR] equals 13; 95 percent confidence interval [95% CI] equals 5.8 to 33.5; P<0.001) and among those with unerupted PSMs at GA1, 51 percent received GA2 (OR equals 62.9; 95% CI equals 23.5 to 189.2; P<0.001). In the group that received GA2, 79.1 percent of uncovered PSMs at GA1 eventually received a stainless steel crown at GA2. Conclusions: Restorative treatments other than stainless steel crowns were associated with higher odds of repeat general anesthesia. These findings support the preferential use of full-coverage restorations for the treatment of carious primary molars in young children undergoing GA to minimize the risk of the need for repeat GA.


Assuntos
Coroas , Cárie Dentária , Anestesia Geral , Criança , Pré-Escolar , Cárie Dentária/terapia , Humanos , Masculino , Dente Molar/cirurgia , Estudos Retrospectivos , Dente Decíduo
2.
Niger J Clin Pract ; 24(10): 1450-1456, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34657009

RESUMO

Aim: The aim of this study was to determine the prognostic factors, such as the developmental stage of second permanent molar (SPM), the angulation of SPM, and presence/absence of the third molar associated with the spontaneous space closure after the mandibular first permanent molars (FPM) extraction. Material and Methods: A total of 177 mandibular SPMs were evaluated in this cross-sectional study. The prognostic factors determining successful space closure such as SPM developmental stage, SPM angulation, and presence/absence of the third molar were evaluated. Results: The mean age of the patients at the time of extraction of SPM was 9.4 years and post-extraction assessment at the time of the study was 12.7 years. Of the total 177 mandibular SPMs, 36 SPMs (20.3%) were at Demirjian stage D, 63 (35.6%) at stage E, 60 (34%) at stage F, 18 (10.1%) at stage G. 18 SPMs (10.1%) had distal angulation, 23 SPMs (13.0%) had mesial angulation and 136 SPMs (76.9%) had upright angulation. At the time of radiographic assessment, 79.1% of the mandibular quadrants showed evidence of third molar formation. Of the 177 mandibular SPMs, 93 (52.5%) exhibited successful space closure in the mandibular arch. Conclusions: There is no statistical significance between the chronological age and the developmental stage of the mandibular SPM with regard to the successful spontaneous space closure at the time of the dental extraction of FPMs. The presence of the mandibular third molar may be a consideration for spontaneous space closure in the mandibular arch.


Assuntos
Erupção Dentária , Extração Dentária , Criança , Estudos Transversais , Humanos , Mandíbula , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia
3.
Niger J Clin Pract ; 24(10): 1492-1498, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34657015

RESUMO

Background: Pulpal involvement, secondary to dental caries, is not uncommon and is a challenging task for pediatric dentists. Morphological differences in root canal of deciduous teeth increases the complexity of management. The aim of this study was to compare two rotary file systems and hand instrumentation for root canal preparation in regard to canal transportation, centering ability ratio, and dentin thickness using cone-beam computed tomography (CBCT). Methods: A total of 72 canals from 24 freshly extracted mandibular deciduous second molars were divided into a set of 8 teeth, then prepared using 2 rotary files systems: the Kedo-S pediatric file system (Group A) and Pro AF Baby Gold file system (Group B) were compared to hand instrumentation (Group C). CBCT scans before and after root canal preparation were used to evaluate tested parameters. Instrumentation time for all three techniques was also measured using a chronometer. Results: Although rotary file systems have shown superior results in root canal preparation as compared to hand instrumentation, no significant differences were observed between all the groups for canal transportation and dentin thickness at all three levels of prepared canals. A comparison of centering ability ratio between all the groups was found to be statistically significant only at the cervical level. A significant difference was observed between hand instrumentation using K-files (117.3 s) and both rotary systems (Kedo-S (81 s) and Pro AF Baby Gold (81.5 s)) in terms of canal preparation time (P < 0.001). Conclusions: Both tested rotary systems and hand instrumentation demonstrated comparable canal preparation results, with differences that were statistically non-significant in most tested parameters, without shaping errors. However, both the rotary systems were more efficient and faster than hand instrumentation.


Assuntos
Cárie Dentária , Criança , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/cirurgia , Desenho de Equipamento , Humanos , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Preparo de Canal Radicular , Dente Decíduo
4.
Niger J Clin Pract ; 24(10): 1511-1519, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34657018

RESUMO

Background and Aims: This study aimed to assess the outcomes of partial pulpotomy treatments using different biocompatible materials which were Biodentine®, mineral trioxide aggregate (MTA), and calcium hydroxide (CH) in cariously exposed pulp tissue in immature permanent molars. Materials and Methods: Fifty-four teeth of 50 patients, which had cariously pulp exposures were randomly divided into Biodentine®, MTA, and CH groups for partial pulpotomy treatments and finally restored with stainless steel crowns at the same appointment. Clinical and radiographical success was evaluated by the absence of any clinical and radiographical signs and symptoms for 12 months. Also, Image J was used for the quantitative assessment of length developments for mesial and distal roots. P value of less than 0.05 was considered statistically significant. Results: Partial pulpotomy treatments showed high overall success rate (87%). On the other hand, Biodentine and MTA showed higher success rates compared to CH without any statistical significance (P = 0.09). Besides, mesial and distal root lengths displayed a continuous and significant increase in each group at sixth month follow-up (P = 0.01; P = 0.03). Conclusions: Favorable results demonstrated that Biodentine, MTA, and CH might be recommended as suitable agents for partial pulpotomy treatment in cariously exposed immature molars with clinical diagnosis of normal pulp or reversible pulpitis.


Assuntos
Pulpite , Pulpotomia , Compostos de Alumínio , Materiais Biocompatíveis , Compostos de Cálcio , Hidróxido de Cálcio , Combinação de Medicamentos , Humanos , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Óxidos , Silicatos/uso terapêutico , Resultado do Tratamento
5.
Georgian Med News ; (318): 50-56, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628378

RESUMO

Objective - to evaluate clinical and radiographic changes of orthodontic intrusion of upper first molars with two mini-implants, using light intrusion forces, to create the space for prosthetic rehabilitation on the lower jaw. In 20 patients (aged between 26.8 and 45) with secondary deformities in the lateral region in the vertical direction, associated with partial absence of teeth in the lower jaw, and orthodontic preparation for subsequent prosthetics was performed. Each subject was missing 1-2 teeth in the lateral segment. All patients were divided into two groups: with intrusion mechanics with orthodontic implants (20 people) and intrusion with an orthodontic shape memory arch (20 people). The radiographic changes in male and female groups were assessed and compared based on the panoramic radiographs and CBCT data before and after intrusion. In the study 28 molars were fully intruded and their position was normalized with two mini-implants placed palatally and buccally. Mean extrusion time was 7.86±0.42 months (P<0.001), mean intrusion length was 2.97±0.15 mm (P<0.001), and mean change of mesial molar inclination was 2.02±0.44 degrees (P<0,005). The degree of root resorption was evaluated according to CBCT data in Multiplanar reconstruction (MPR); 50% of molars had grade 0 of resorption, 42.85% had grade 1, and 7.15% of molars had grade 2. There was no resorption in the trifurcation area. Intrusion of molars can be successfully accomplished with 2 mini-implants, placed palatally and buccally, with a light traction force (30-50 g) of an elastic chain.


Assuntos
Procedimentos de Ancoragem Ortodôntica , Adulto , Parafusos Ósseos , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Maxila/cirurgia , Pessoa de Meia-Idade , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Técnicas de Movimentação Dentária
6.
Chin J Dent Res ; 24(3): 199-202, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34491015

RESUMO

Gemination and fusion are developmental conditions affecting the shape of teeth in both primary and permanent dentition. A 12-year-old girl presented for clinical assessment and the examination revealed an unusually shaped mandibular right second molar with irreversible pulpitis. Correlation of the intraoral and radiological appearance of this tooth suggested a diagnosis of either double gemination or fusion. The favourable position of the developing third molar supported early extraction of the abnormal second molar. The present report documents the clinical and radiological presentation of a mandibular second molar with an unusual developmental alteration in shape. Well-timed extraction therapy and good communication may reduce the need for unnecessary, complex treatment.


Assuntos
Dentes Fusionados , Criança , Arco Dental , Dentição Permanente , Feminino , Dentes Fusionados/diagnóstico por imagem , Dentes Fusionados/cirurgia , Humanos , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia
7.
JNMA J Nepal Med Assoc ; 59(240): 795-798, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34508490

RESUMO

Intracanal separation of nickel titanium files hinders complete shaping, cleaning, and filling of the root canal system and ultimately influences the endodontic treatment outcome. In this case report, we presented a successful broken instrument retrieval from the middle third of the mesiobuccal root canal of tooth #30 with the assistance of cone-beam computed tomograpgy based preoperative computer-assisted simulation, micro-trepan bur and micro-tube from Micro-Retrieve & Repair system and dental operative microscope. The involved tooth was then successfully cleaned, shaped and obturated followed by coronal restoration. At the three-year follow-up, tooth #30 was asymptomatic and functioned well without radiographic changes. The present case provides an example to show the robustness of computer-assisted technology in dental procedures and to show how the combination of advanced techniques can facilitate root canal therapy.


Assuntos
Dente Molar , Preparo de Canal Radicular , Computadores , Humanos , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Tratamento do Canal Radicular , Tomografia
8.
Stomatologija ; 23(2): 51-55, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34528909

RESUMO

Iatrogenic perforation of the lingual cortical plate of the mandible is uncommon but it may result in injuries to various adjacent structures such as the lingual nerve, sublingual gland, submandibular duct, deep lobe of the submandibular gland, and branches of rich anastomosing plexus supplying the floor of the mouth (FOM). The aim of this article was to highlight an unusual case of protracted postoperative bleeding that was occurred due to a FOM injury during an attempt to extract a mandibular second molar. Various anatomical considerations with clinical relevance were summarized too. Even small and superficial injuries of FOM should be not misjudged but be carefully monitored, since there is a potential risk for significant haemorrhage and hematoma formation leading to airway obstruction.


Assuntos
Mandíbula , Soalho Bucal , Serviço Hospitalar de Emergência , Hematoma , Humanos , Doença Iatrogênica , Dente Molar/cirurgia
9.
Compend Contin Educ Dent ; 42(9): e1-e4, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34555918

RESUMO

The patient treatment described in this case report demonstrates management of a failing maxillary first molar utilizing an immediate loading approach. Following extraction, the site was successfully managed with socket grafting (ridge preservation) and allowed to heal prior to implant placement. A Straumann® TLX implant was placed using a guided approach and restored using CAD/CAM.


Assuntos
Implantes Dentários , Carga Imediata em Implante Dentário , Implantação Dentária Endo-Óssea , Humanos , Dente Molar/cirurgia , Extração Dentária , Alvéolo Dental/cirurgia
10.
BMJ Case Rep ; 14(8)2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344652

RESUMO

Patients with rapidly progressing periodontitis may require extractions of teeth with poor periodontal prognosis. Although replacement with a dental implant is a popular choice, teeth autotransplantation remains a viable option. Herein, we report a case of a 23-year-old patient with rapidly progressing periodontitis resulting in severe clinical attachment loss on the left maxillary first molar, which required extraction. The tooth was replaced by tooth autotransplantation of the unerupted immature left mandibular third molar, which was delivered carefully without compromising the periodontal ligament. Cone beam computed tomography and three-dimensional printing of the third molar donor tooth significantly aided the tooth autotransplantation procedure. Recovery was uneventful. At the 1-year follow-up, healthy periodontal parameters and radiographic features were noted, and the autotransplanted tooth remained vital. This case showed that tooth autotransplantation is a viable option for replacing tooth loss due to rapidly progressing periodontitis.


Assuntos
Periodontite , Dente , Adulto , Humanos , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Periodontite/complicações , Periodontite/diagnóstico por imagem , Periodontite/cirurgia , Impressão Tridimensional , Transplante Autólogo , Adulto Jovem
11.
J Contemp Dent Pract ; 22(6): 680-685, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34393127

RESUMO

AIM: The aim of the study is (a) To use collagen as a pulpotomy material in comparison with the gold standard formocresol-based pulpotomy, (b) to assess the clinical and radiographic success rate of formocresol pulpotomy and collagen-based pulpotomy, and (c) to compare the success rate of formocresol-based pulpotomy and collagen-based pulpotomy over a definitive interval of time. MATERIALS AND METHODS: Totally 30 primary first or second molars indicated for pulpotomy after confirming with the operative diagnosis were taken as samples for this study. This split-mouth technique consists of two groups: Group 1-formocresol pulpotomy (n = 15), and group 2-collagen-based pulpotomy (n = 15). Both the procedures were done in the same patient on regular appointments. Pre- and postoperative radiographs were taken. The children were recalled for clinical and radiographic follow-up at 2, 4, and 6 months. The success of the procedure was assessed based on clinical signs (pain, tenderness to percussion, abscess, swelling, fistula, and pathologic mobility) and radiographic findings (radicular radiolucency, internal and external root resorption, periodontal ligament (PDL) space widening, and furcation radiolucency). The Chi-square test was used to compare the differences between the groups. RESULT: The overall success rate for formocresol pulpotomy (n = 15) was 14, 13, and 10 for the second-, fourth-, and sixth-month review period, respectively. For collagen pulpotomy group (n = 15), the overall success rate was 14, 14, and 14 for the second-, fourth-, and sixth-month review period, respectively. The obtained data from the overall success rate were subjected to statistical analysis, and chi-square test was used. The p-value less than 0.1 was considered a statistically significant result. The chi-square value for the fourth- and sixth-month review was 0.37 and 3.33, respectively. CONCLUSION: Statistically significant value was obtained from the sixth-month review period (p <0.1), which describes that the overall success rate was better for the collagen pulpotomy group when compared with the formocresol pulpotomy group. CLINICAL SIGNIFICANCE: Collagen had proven to be a very good alternative for formocresol, its biocompatibility, and regenerative efficiency and is a benchmark for a better clinical success rate in dentistry. However, its implication in pulpotomy should be subjected to further comparative research study on mineral trioxide aggregate (MTA), Biodentine, etc. Keywords: Collagen-based pulpotomy, Formocresol-based pulpotomy.


Assuntos
Formocresóis , Pulpotomia , Compostos de Alumínio , Compostos de Cálcio , Criança , Colágeno , Combinação de Medicamentos , Humanos , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Óxidos , Silicatos , Dente Decíduo
12.
Biomolecules ; 11(8)2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34439803

RESUMO

Developing multifunctional systems for the biomimetic remineralization of human enamel is a challenging task, since hydroxyapatite (HAP) rod structures of tooth enamel are difficult to replicate artificially. The paper presents the first report on the simultaneous use of chitosan (CS) and agarose (A) in a biopolymer-based hydrogel for the biomimetic remineralization of an acid-etched native enamel surface during 4-10-day immersion in artificial saliva with or without (control group) fluoride. Scanning electron microscopy coupled with energy-dispersive X-ray spectrometry, Fourier transform infrared and Raman spectroscopies, X-ray diffraction, and microhardness tests were applied to investigate the properties of the acid-etched and remineralized dental enamel layers under A and CS-A hydrogels. The results show that all biomimetic epitaxial reconstructed layers consist mostly of a similar hierarchical HAP structure to the native enamel from nano- to microscale. An analogous Ca/P ratio (1.64) to natural tooth enamel and microhardness recovery of 77.4% of the enamel-like layer are obtained by a 7-day remineralization process in artificial saliva under CS-A hydrogels. The CS component reduced carbonation and moderated the formation of HAP nanorods in addition to providing an extracellular matrix to support growing enamel-like structures. Such activity lacked in samples exposed to A-hydrogel only. These data suggest the potential of the CS-A hydrogel in guiding the formation of hard tissues as dental enamel.


Assuntos
Materiais Biomiméticos/farmacologia , Quitosana/farmacologia , Esmalte Dentário/efeitos dos fármacos , Durapatita/química , Sefarose/farmacologia , Remineralização Dentária/métodos , Condicionamento Ácido do Dente/métodos , Materiais Biomiméticos/química , Tampões (Química) , Quitosana/química , Esmalte Dentário/fisiologia , Esmalte Dentário/ultraestrutura , Durapatita/metabolismo , Humanos , Hidrogéis/química , Hidrogéis/farmacologia , Teste de Materiais/métodos , Dente Molar/cirurgia , Saliva/química , Sefarose/química , Extração Dentária
13.
Biomolecules ; 11(8)2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34439823

RESUMO

Alveolar osteitis (AO) is a common complication following the extraction of the teeth, particularly the lower third molars. It starts within a few days after the extraction and manifests mainly as pain in the extraction site. Several strategies of treatment are available in order to relieve pain and heal the extraction wound. Recently, a novel medical device combining hyaluronic acid (HA) and octenidine (OCT) was introduced for the treatment of AO. This series of case reports aims to summarize the initial clinical experiences with this new device and to highlight factors possibly interfering with this treatment. The medical documentation of five patients with similar initial situations treated for AO with HA + OCT device was analyzed in detail. Smoking and previous treatment with Alveogyl (Septodont, Saint-Maur-des-Fossés, France) were identified as factors interfering with the AO treatment with the HA + OCT device. In three patients without these risk factors, the treatment led to recovery within two or three days. The patient pretreated with Alveogyl and the smoker required six and seven applications of the HA + OCT device, respectively. According to these initial observations, it seems smoking and previous treatment with Alveogyl prolong the treatment of AO using the HA + OCT device that, in turn, shows a rapid effect if these risk factors are not present.


Assuntos
Alvéolo Seco/tratamento farmacológico , Ácido Hialurônico/uso terapêutico , Iminas/uso terapêutico , Dor/tratamento farmacológico , Piridinas/uso terapêutico , Cicatrização/efeitos dos fármacos , Adolescente , Adulto , Creosoto/efeitos adversos , Combinação de Medicamentos , Alvéolo Seco/etiologia , Alvéolo Seco/fisiopatologia , Alvéolo Seco/cirurgia , Equipamentos e Provisões , Feminino , Humanos , Hidrocarbonetos Iodados/efeitos adversos , Pessoa de Meia-Idade , Dente Molar/cirurgia , Dor/etiologia , Dor/fisiopatologia , Dor/cirurgia , Fatores de Risco , Fumar/efeitos adversos , Timol/efeitos adversos , Extração Dentária/efeitos adversos , Resultado do Tratamento , Cicatrização/fisiologia
14.
Int Endod J ; 54(11): 1982-1992, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34347895

RESUMO

AIM: To establish the effects of submucosal tramadol, dexamethasone and articaine on the success of inferior alveolar nerve blocks (IANB) during root canal treatment of mandibular molars with symptomatic irreversible pulpitis (SIP). METHODOLOGY: In this randomized double-blind, controlled clinical trial, 120 patients with the diagnosis of SIP in their mandibular first or second molars were included and randomly divided into four groups (n = 30). The control group received normal saline and three experimental groups received a single dose of dexamethasone (8 mg/2 mL), or tramadol (100 mg/2 mL) or articaine (4% / 2 mL). The pre-operative pain levels of the patients were measured with the Heft-Parker visual analogue scale (HP VAS). All patients received standard IANB of 4% articaine with 1:200000 epinephrine. Following the observation of lip numbness, submucosal injections were administered into the mucobuccal fold adjacent to the mandibular molars. After 15 min, standard root canal treatment was initiated, and the pain intensity levels recorded from the access cavity preparation to pulp extirpation were measured with HP VAS. The duration of the anaesthesia was also evaluated. The experimental groups were compared using one-way ANOVA or Kruskal-Wallis H-test. The groups that were significantly different were compared pairwise using the Tukey Multiple Comparison test. The Chi-square test was used to compare the categorical variables. RESULTS: The submucosal administration of articaine significantly increased the success rate to 63% in comparison with the control group that received submucosal saline (p < .05). The success rate of pulpal anaesthesia was 37% in the control group, 57% in the tramadol group and 47% in the dexamethasone group, with no significant difference in the success rate among these groups. In the dexamethasone group, the duration of the anaesthetic effect of IANB was significantly longer than those in the other groups (p < .001). CONCLUSIONS: In patients with SIP, pre-operative submucosal administration of articaine increased the success rate of IANB, while administration of dexamethasone increased the duration of anaesthesia. These agents can be used in cases where effective anaesthesia cannot be obtained during root canal treatments.


Assuntos
Anestesia Dentária , Bloqueio Nervoso , Pulpite , Tramadol , Anestésicos Locais , Carticaína , Dexametasona , Método Duplo-Cego , Humanos , Lidocaína , Nervo Mandibular , Dente Molar/cirurgia , Pulpite/cirurgia
15.
Int Endod J ; 54(11): 1993-2005, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34352123

RESUMO

AIM: To evaluate the effect of an enhanced infection control protocol on root canal treatment outcomes and on microbial load within root canals after chemomechanical preparation. METHODOLOGY: A total of 144 molar teeth from 139 healthy patients receiving primary root canal treatment were block randomized to a standard protocol (StP) or an enhanced infection control protocol (EnP). Both treatment arms adhered to current best practice recommendations, while the EnP comprised additional steps that included replacing rubber dams, gloves, files, all instruments and surface barriers at the time of canal filling to reduce the chances of iatrogenic contamination. Patients and radiographic examiners were blinded to the protocol used. Intracanal microbial samples were taken at baseline (S1) and after completion of chemomechanical preparation (S2). Microbial 16S rDNA copy numbers were enumerated by quantitative polymerase chain reaction (qPCR). Cone beam computed tomography (CBCT) scans were taken before treatment and at one-year follow-up. The outcome was assessed clinically and radiographically using CBCT by logistic regression modelling. RESULTS: At one-year follow-up, 115 teeth were analysed (54 in StP and 61 in EnP). The percentage of favourable outcomes assessed by CBCT was 85.2% in the EnP and 66.7% in the StP. The odds of 12-month success was three times higher in the EnP group compared with the StP group (OR=2.89; p=0.022, CI: 1.17 - 7.15). The median bacterial reads were reduced from 8.1×103 in S1 samples to 3.5×103 in the StP group and from 8.6×103 to 1.3×103 in the EnP group. The enhanced protocol significantly reduced bacterial counts in pre-canal filling samples when compared to the standard protocol (p=0.009). CONCLUSIONS: The implementation of a facile, enhanced infection control protocol in primary root canal treatment resulted in less detectable bacterial DNA before canal filling and significantly more successful outcomes at one year.


Assuntos
Cavidade Pulpar , Tratamento do Canal Radicular , Tomografia Computadorizada de Feixe Cônico , Humanos , Controle de Infecções , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Ensaios Clínicos Controlados Aleatórios como Assunto , Preparo de Canal Radicular , Resultado do Tratamento
16.
Int Endod J ; 54(11): 2006-2015, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34383325

RESUMO

AIM: To compare the effect of low-level laser therapy (LLLT) on postoperative pain after single-visit root canal retreatment on mandibular molars. METHODOLOGY: This randomized controlled clinical trial included 36 patients referred to the Department of Endodontics, Islamic Azad University, Tehran, Iran. Healthy patients who required root canal retreatment on symptomatic first or second mandibular molars, with a PAI index score of 2 or 3, preoperative tooth and percussion pain of <56 mm on a 170-mm visual analogue scale (VAS) were included. After local anaesthesia using inferior alveolar nerve block followed by rubber dam isolation and access cavity preparation, the D RaCe retreatment system was used to remove the existing root filling material, and after canal negotiation and gaining patency, working length was determined with an apex locator. Further canal enlargement was carried out with size 35, 0.04 taper, and size 40, 0.04 taper RaCe rotary instruments and then canals were filled using laterally compacted gutta-percha points and AH Plus sealer. The patients were randomly assigned to treatment groups: In the LLLT group, a 980-nm diode laser set at 6.89 W/cm2 energy density, 0.5 W power, and a tip diameter of 10 mm were activated from the buccal side on the mesial and distal root apices for 15 s. In the sham group, the laser handpiece was placed inside the patient's mouth at the same location, but the laser was not activated. Then patients were instructed to record their postoperative pain levels at 4, 8, 12 and 24 h and 2, 3 and 7 days after treatment on separate VAS scales. For data analysis, the independent sample t and the Mann-Whitney U tests were used. Nominal variables were analysed by using the chi-square test. RESULTS: In the LLLT group, the most intense pain was reported 24 and 48 h post-treatment [mean (SD) = 0.22 (0.54) for both], whereas in the sham group, the most intense pain level was observed 4 h post-treatment [mean (SD) = 0.78 (0.80)]. At the 4-h interval, pain intensity was significantly lower in the LLLT group (p = .016). CONCLUSIONS: Low-level laser therapy reduced postoperative pain after single-visit root canal retreatment of mandibular molars only four hours following the procedure.


Assuntos
Terapia com Luz de Baixa Intensidade , Cavidade Pulpar , Humanos , Irã (Geográfico) , Dente Molar/cirurgia , Dor Pós-Operatória , Retratamento , Preparo de Canal Radicular
17.
J Endod ; 47(9): 1496-1500, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34237385

RESUMO

INTRODUCTION: The aim of this study was to investigate the fracture resistance of endodontically treated and restored permanent mandibular molars with minimally invasive access cavities subjected to thermocycling and dynamic loading. METHODS: Forty first and second mandibular molars were randomly assigned to 4 groups (n = 10/group) as follows: group 1, control (intact teeth); group 2, traditional access cavity (TradAC); group 3, conservative access cavity (ConsAC); and group 4, truss access cavity (TrecAC). After endodontic treatment, teeth were restored with SDR core (Dentsply Caulk, Milford, DE) and subjected to thermocycling followed by dynamic and static loading with a multiaxial fatigue testing machine (Instron, Canton, MA). The maximum load to fracture and pattern of failure (restorable/unrestorable) were recorded. Data were evaluated with analysis of variance and the Tukey post hoc test for multiple comparisons. RESULTS: Fracture resistance of the samples in the control group were higher than those in the experimental groups (P < .005). TradAC exhibited the least resistance to fracture (P < .005). There was no statistically significant difference in the fracture resistance of ConsAC and TrecAC (P = .361) Unrestorable fractures were more frequent in the TradAC group compared with all other groups. CONCLUSIONS: Mandibular molars with ConsAC and TrecAC exhibited superior fracture resistance compared with TradAC. TradAC had the highest number of unrestorable fractures.


Assuntos
Cárie Dentária , Fraturas dos Dentes , Dente não Vital , Resinas Compostas , Análise do Estresse Dentário , Humanos , Mandíbula , Dente Molar/cirurgia
18.
J Contemp Dent Pract ; 22(3): 259-263, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210925

RESUMO

AIM AND OBJECTIVE: The aim of this study was to compare the formation of dentinal cracks with nickel-titanium (NiTi) instruments working in continuous rotation and reciprocating motion. MATERIALS AND METHODS: One hundred sixty extracted human mandibular first molars were selected for the study. The mesial roots were resected and mounted in resin blocks with simulated periodontal ligaments. Those teeth were randomly assigned to five groups (n = 32 teeth/group). The first one was treated with K-files and served as control group, and the remaining 128 teeth were divided into 4 groups depending on the root canal preparation technique. Group 2 samples were prepared by sequential ProTaper Universal (PTU), group 3 samples with rotary ProTaper Universal (RPTU), group 4 achieved by the One Shape (OS), and group 5 with the WaveOne (WO) primary files. Roots were then horizontally sectioned at 3, 6, and 9 mm from the apex, and the slices were then observed under a stereomicroscope at ×40 magnification to determine the presence of internal dentinal microcracks. The presence or absence of dentinal defaults was recorded and the statistical analysis was performed by Pearson Chi-square test. The significance level was set at p < 0.05. The study was made in the oral biology and biotechnology research laboratory of the faculty of medical dentistry of Rabat, Morocco. RESULTS: No dentinal defect was seen with the stainless steel hand file (group 1). The manual PTU (group 2), the RPTU (group 3), the OS (group 4), and the WO (group 5) in reciprocating motion caused cracks in 15.6%, 12.4%, 21.9%, and 6.2% of samples, respectively. The highest percentage of dentinal defect was showed in group 4 but without significant difference with the other group (p > 0.05). CONCLUSIONS: Dentinal cracks are produced indifferently of motion kinematics. Within the limits of this study and the current literature, such incidence is less with instruments working in reciprocating motion compared with those working in continuous rotation. Manual and rotary NiTi sequential systems showed fewer microcracks than the single file system working by continuous rotation motion.


Assuntos
Cavidade Pulpar , Dentina , Humanos , Dente Molar/cirurgia , Preparo de Canal Radicular , Raiz Dentária
19.
Mymensingh Med J ; 30(3): 840-845, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34226477

RESUMO

This in-vitro study was done to compare the sealing ability of Mineral trioxide aggregate (MTA), Biodentine, a mixture of MTA and Glass ionomer cement (GIC) in 2:1 and 1:1 ratio and MTA CEM, as furcation repair material using a dye extraction leakage model in the department of Conservative Dentistry and Endodontics from January 2020 to December 2020. Eighty five extracted molars with divergent and well formed roots were selected for study and were randomly divided according to the material used for perforation repair. Group A: MTA, Group B: Biodentine, Group C: MTA mixed with GIC in 2:1 ratio. Group D: MTA mixed with GIC in 1:1 ratio. Group E: MTA CEM and 2 control groups. All samples were subjected to orthograde and retrograde methylene blue dye challenge followed by dye extraction with 70 weight % nitric acid. Samples were then analyzed using Ultra violet (UV) Visible Spectrophotometer at 550nm wavelength. The data were subjected to statistical analysis One Way ANOVA (level of significance <0.05) and post-hoc tukey test. MTA, Biodentine, Mixture of MTA and GIC in 2:1 ratio and MTA CEM showed significant less dye absorbance than MTA and GIC in 1:1 ratio. Within the limitation of the study, the newer mixture of MTA and GIC in 2:1 ratio showed promising sealing ability and was comparable to MTA, Biodentine and MTA CEM.


Assuntos
Dente Molar , Humanos , Dente Molar/cirurgia
20.
Int Endod J ; 54(10): 1738-1753, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34291470

RESUMO

AIM: This retrospective observational study investigated the survival rate of teeth with radicular cracks that were restored using composite materials. METHODOLOGY: The study was approved by the Ethical Committee of Sistema Sanitario Nazionale (prot. N°2370CELazio1), Clinicaltrials.gov identifier: NCT04430205. Between 1991 and 2019, 87 teeth with radicular cracks (87 patients [46 men, 41 women, mean age 50.2 years]) were treated with adhesive composite restorations. Forty-five cracks were observed in the maxillary posterior teeth (molars and premolars), 40 in the mandibular posterior teeth and only two cracks in the anterior teeth, both in maxilla. Based on the depth of the crack, teeth were categorized as proximal radicular cracked teeth (PRCT), in which the fracture line was restricted within the pulpal floor or the coronal one-third of the root and deep radicular cracked teeth (DRCT), in which the fracture line extended to the middle and apical thirds of the root canal up to the apex. Bone loss/recovery was evaluated radiographically at 1-year follow-up. All patients were treated using surgical microscopy by the same operator. Logistic regression analysis was performed to determine independent predictors of extraction. Kaplan-Meier survival curves were used to analyse PRCT and DRCT. RESULTS: Among 87 cracked teeth, 66 were molars, 19 premolars and 2 incisors. Fifty-two were DRCT, 35 were PRCT, 46 had a periodontal probing defect. Patients were followed up for a mean of 66.9 months (standard deviation 44.6, min 1 to max 172). Lack of probing depth was a significant protective factor against extraction (odds ratio [OR] 0.027, 95% confidence interval [CI] 0.003-0.27, p < .05), whereas further bone loss (OR 10.63, 95% CI 2.08-54.36, p < .05) was a risk factor for extraction. More than 50% of teeth treated with the adhesive protocol were functional (46 of 87 teeth [χ2 test], p < .05) at 5-year follow-up. Among the PRCT group, a 78% survival rate at 5 years was found, while among the DRCT group, a 58% survival rate was found. CONCLUSION: Composite resin restorations resulted in tooth survival in >50% of patients; 85.4% of PRCT and 61.5% of DRCT were functional after 5 years of follow-up.


Assuntos
Síndrome de Dente Quebrado , Dente Pré-Molar , Resinas Compostas , Síndrome de Dente Quebrado/etiologia , Síndrome de Dente Quebrado/terapia , Coroas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dente Molar/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...