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1.
Quintessence Int ; 51(5): 418-429, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32328595

RESUMO

OBJECTIVES: This paper is aimed at addressing the urgent need to develop a protocol that will address the operatory and clinical aspects of dental care during the Coronavirus disease 2019 (COVID-19) outbreak. DATA SOURCES: The epidemiology, clinical signs and symptoms, and modes of transmission of COVID-19 are presented. This protocol was established as an international collaboration of three dental universities: Hadassah School of Dental Medicine, Israel; University of Rochester Medical Center, USA; and the University of Pennsylvania, USA. This protocol is based on a detailed review of the existing English language literature as well on the logistic and clinical experience of each facility and the opinion of the authors. The protocol is designed for a hospital setting and includes considerations related to dental treatment in both healthy subjects and those suspected or diagnosed with COVID-19. The first part of this review discusses operatory considerations; the second part discusses general dental clinical aspects; the third part discusses endodontic considerations; and the fourth part discusses surgical aspects. This protocol may be applicable to other future similar pandemics. CONCLUSION: Logistic and clinical steps are required to provide dental care during the COVID-19 outbreak while preventing cross-contamination and protecting the dental team during the provision of care.


Assuntos
Infecções por Coronavirus , Coronavirus , Assistência Odontológica/tendências , Endodontia/tendências , Transmissão de Doença Infecciosa do Paciente para o Profissional , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Surtos de Doenças , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Israel , Pandemias , Pneumonia Viral
2.
Libyan J Med ; 15(1): 1688916, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31694490

RESUMO

The American Association of Endodontists (AAE) released a case difficulty assessment form to help general dentists and students treat cases within their expertise or refer advanced cases to reduce the risk of iatrogenic errors. The purpose of this study was to determine the incidence of iatrogenic complications after the use of the case difficulty assessment form. Arandom sample of 1000 cases that received root canal treatment in undergraduate clinics during the academicyear (2016-2017) was selected. Case difficulty assessment was made for each case before treatment onset. Once the case was approved for treatment in the undergraduate clinics, the endodontic treatments were performed following the standard procedure the endodontic department of the Dentistry School of King Abdulaziz University mandates. Digital radiographs were obtained during routine root canal treatment and were evaluated by four observers to detect any iatrogenic errors, after which the data were analyzed statistically. Iatrogenic errors were correlated significantly with case difficulty (p= 0.003), and were detected in 22.1% of all teeth treated in the undergraduate clinics. Underfilling accounted for the highestpercent of errors detected (8.4%), followed by ledge formation (4.2%). Molar teeth had the highest frequency of errors, and mesio-buccal roots of maxillary molars showed the highest percentage of errors. The AAE developed asignificantly useful tool to determine the difficulty of each case treated in undergraduate clinics, and following their recommendations will minimize the risk of iatrogenic errors.


Assuntos
Competência Clínica/normas , Endodontia/educação , Doença Iatrogênica/prevenção & controle , Tratamento do Canal Radicular/efeitos adversos , Estudantes de Odontologia/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Educação em Odontologia/métodos , Endodontia/tendências , Humanos , Doença Iatrogênica/epidemiologia , Incidência , Erros Médicos/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Retrospectivos , Tratamento do Canal Radicular/estatística & dados numéricos , Arábia Saudita/epidemiologia , Universidades
5.
Dent. press endod ; 8(3): 34-40, set.-dez. 2018. tab, graf
Artigo em Português | BBO - Odontologia | ID: biblio-948767

RESUMO

Introdução: diferentes irrigantes têm sido estudados, propostos e utilizados durante a terapia endodôntica. Objetivo: o objetivo deste estudo foi determinar as tendências atuais em irrigação, entre os endodontistas brasileiros. Métodos: um total de 398 endodontistas brasileiros respondeu a um questionário de pesquisa na internet, com 15 questões de múltipla escolha, seleções múltiplas e rankings numéricos, sobre sua seleção de irrigante, concentração, remoção da smear layer e uso de coadjuvantes para irrigação. Resultados: o hipoclorito de sódio foi o irrigante mais utilizado em uma concentração inferior a 5,0%. Clorexidina (CHX) foi o segundo irrigante primário mais utilizado, sendo a CHX 2% em gel a forma de apresentação mais prevalente. Em relação à remoção da smear layer, 88,4% dos entrevistados declararam realizar a remoção, onde o EDTA foi o irrigante mais utilizado (93,7%). Mais de 70% dos endodontistas utilizam um sistema coadjuvante durante a irrigação, dos quais 39,9% utilizam ativação ultrassônica; 24,4%, lima plástica e 1%, ativação sônica. O uso de EndoVac não foi relatado. Conclusões: a maioria dos entrevistados utiliza hipoclorito de sódio e remove rotineiramente a smear layer durante o tratamento endodôntico utilizando EDTA. Os endodontistas brasileiros utilizam técnicas coadjuvantes à irrigação. (AU)


Assuntos
Irrigantes do Canal Radicular , Preparo de Canal Radicular , Cavidade Pulpar , Endodontia/tendências
7.
Endodoncia (Madr.) ; 36(1): 22-35, ene.-abr. 2018. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-172441

RESUMO

Objetivo: El propósito de este estudio fue determinar la rugosidad superficial, al someter al agregado de trióxido mineral (MTA) y al cemento Pórtland (CP) a diferentes irrigantes utilizados en endodoncia. Material y Métodos: Se estudiaron un total de 210 muestras, 105 de cemento ProRoot MTA® blanco y 105 de CP blanco. Se seleccionaron los siguientes irrigantes: hipoclorito sódico al 2,5% y al 5%, ácido cítrico al 10% y al 20%, clorhexidina al 2%, EDTA al 17%, y suero fisiológico como control. Se expusieron 15 muestras de cada cemento por cada tipo de irrigante durante 15 minutos. El estudio de la rugosidad superficial se hizo con el microscopio Leica DCM 3D que permite una perfilometría con tecnología dual confocal e interferométrica. Se evaluó la rugosidad media (Ra), el valor cuadrático medio (RMS) y la profundidad de rugosidad máxima (PV) al inicio y a los 15 minutos de la inmersión de las muestras. Resultados: El CP aumentó significativamente la rugosidad en los parámetros Ra y RMS tras la irrigación con hipoclorito al 2,5%, ácido cítrico al 10% y al 20%, y suero fisiológico. En términos de PV el CP solo aumentó la rugosidad tras la irrigación con ácido cítrico al 20% y suero fisiológico. El MTA no mostró cambios significativos respecto a la rugosidad Ra, RMS y PV con ninguno de los irrigantes. Conclusiones: La rugosidad superficial del CP puede modificarse por la exposición a alguno de los irrigantes utilizados en endodoncia, mientras que la rugosidad del MTA no se modifica significativamente


Objectives: This study set out to determine changes to surface roughness when mineral trioxide aggregate (MTA) and Portland cement (PC) are exposed to the different irrigants used in endodontics. Material and Methods: The study included a total of 210 samples, 105 white ProRoot MTA® cement and 105 white PC cement. The following irrigants were tested: 2.5% and 5% sodium hypochlorite, 10% and 20% citric acid, 2% chlorhexidine, 17% ethylenediamine tetra-acetic acid (EDTA), and physiological serum as a control. Fifteen samples of each material were exposed to each irrigant for 15 minutes. Surface roughness evaluation was performed using a Leica DCM 3D microscope for dual system (confocal and interferometric) profilometry. Mean roughness (Ra), root mean square (RMS) and maximum roughness depth (PV) were evaluated before and after 15 minutes sample immersion in each irrigant. Results: PC significantly increased roughness for Ra and RMS parameters after irrigation with 2.5% sodium hypochlorite, 10% and 20% citric acid, and physiological serum. PC underwent an increase in the PV parameter after immersion in 20% citric acid and physiological serum. MTA did not show significant changes in Ra, RMS or PV with any of the irrigants. Significance. The surface roughness of PC may be modified by exposure to some of the irrigants used in endodontics, while the roughness of MTA is not modified significantly


Assuntos
Humanos , Masculino , Feminino , Cimentos Dentários/análise , Cimentos Dentários/química , Cimentos Dentários/uso terapêutico , Endodontia/tendências , Cimentos Dentários , Autocura de Resinas Dentárias , Autocura de Resinas Dentárias/instrumentação , Autocura de Resinas Dentárias/tendências
9.
Braz. j. oral sci ; 16: e17045, jan.-dez. 2017. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-883737

RESUMO

Aim: To determine the current trends in technological armamentarium and endodontic treatment among Brazilian endodontists. Methods: A total of 279 endodontists answered a web-based survey questionnaire about their region of activity in Brazil and years as a specialist, average number of endodontic cases treated per month, number of visits to complete the treatment, use of rubber dam for isolation, type of irrigant, obturation technique and device used for this purpose, temporary filling materials, and greater difficulty encountered during treatment and technological armamentarium. A descriptive analysis, expressed in terms of frequency and percentage, was performed and the data were correlated using the chi-square test (p<0.05). Results: Most of the respondents had up to 10 years as specialists. More than 50% of endodontists preferred to complete the endodontic treatment in a single visit. Ninety-nine percent of endodontists used rubber dam for isolation. NaOCl was the most widely used irrigant. Most of the respondents associated different techniques for root canal filling. Lateral condensation and Continuous wave of condensation were the isolated technique most reported. Filling devices (thermocompactors) were used by 53% of endodontists. Glass ionomer was the preferred temporary filling material. The answers for the use of technological armamentarium revealing that 94% of endodontists used an apex locator; 67.38% utilized magnification (loupe: 23.66%; microscope: 35.48%; microscope and loupe: 8.24%); 58% reported to digital radiography; and 47.31% used computed tomography as a complementary tool. About mechanized instrumentation, 44.44% endodontists employed rotary and reciprocating files. The difficulties encountered during endodontic treatment were classified as preparation > access > obturation > anesthesia > isolation. Conclusions: Most endodontists have implemented new technologies, such as mechanical instrumentation, apex locators, magnification, digital radiography, computed tomography, ultrasound, and obturation tools, in their clinical practice (AU)


Assuntos
Humanos , Masculino , Feminino , Endodontia/tendências , Endodontistas , Irrigantes do Canal Radicular , Obturação do Canal Radicular , Tratamento do Canal Radicular , Inquéritos e Questionários
11.
J Endod ; 43(9S): S95-S101, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28844309

RESUMO

Regenerative endodontic procedures (REPs) have been shown to promote the resolution of signs and symptoms of disease and increase survival compared with traditional treatment procedures. However, there is still variable predictability of continued root development and evidence that the tissues formed do not recapitulate the native pulp-dentin complex. There is growing evidence that the apical papilla is capable of surviving prolonged endodontic infection and apical periodontitis and that it represents a rich source of undifferentiated mesenchymal stem cells in REPs. The survival and proper differentiation of stem cells transferred into infected root canals are fraught with challenges. Residual antigens, such as lipopolysaccharides, have been shown to be present in dentin even after adequate chemomechanical debridement. These antigens have a profound effect on stem cell fate by modulating their proliferative capacity and postdifferentiation phenotype. Thus, root canals must be detoxified in addition to disinfection. There is a strong need for translational studies that incorporate all aspects of tissue engineering in endodontics in models that include an existing infection to promote further advancement of the field. This is particularly important to make REPs more predictable when treating immature teeth in young patients. Importantly, regenerative procedures could eventually promote tooth longevity in our aging population. Lessons learned from translational studies that best mimic the clinical challenges could be evaluated in pragmatic clinical trials to determine the effectiveness of these procedures to promote desirable patient-centered outcomes.


Assuntos
Polpa Dentária/fisiologia , Endodontia/métodos , Endodontia/tendências , Regeneração , Células-Tronco/microbiologia , Engenharia Tecidual , Previsões , Humanos
13.
Arch Oral Biol ; 81: 121-130, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28511093

RESUMO

The understanding of the cell biological processes underlying development and regeneration of oral tissues leads to novel regenerative approaches. Over the past years, knowledge on key roles of the hypoxia-based response has become more profound. Based on these findings, novel regenerative approaches for dentistry are emerging, which target cellular oxygen sensors. These approaches include hypoxia pre-conditioning and pharmacologically simulated hypoxia. The increase in studies on hypoxia and hypoxia-based strategies in regenerative dentistry highlights the growing attention to hypoxia's role in regeneration and its underlying biology, as well as its application in a therapeutic setting. In this narrative review, we present the current knowledge on the role of hypoxia in oral tissues and review the proposed hypoxia-based approaches in different fields of dentistry, including endodontics, orthodontics, periodontics, and oral surgery.


Assuntos
Odontologia/tendências , Hipóxia , Regeneração/fisiologia , Especialidades Odontológicas/tendências , Endodontia/tendências , Humanos , Ortodontia/tendências , Periodontia/tendências , Cirurgia Bucal/tendências
15.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 51(8): 460-4, 2016 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-27511034

RESUMO

The primary goal of modern endodontic therapy is to achieve the long-term retention of a functional tooth by preventing or treating pulpitis or apical periodontitis is. The long-term retention of endodontically treated tooth is correlated with the remaining amount of tooth tissue and the quality of the restoration after root canal filling. In recent years, there has been rapid progress and development in the basic research of endodontic biology, instrument and applied materials, making treatment procedures safer, more accurate, and more efficient. Thus, minimally invasive endodontics(MIE)has received increasing attention at present. MIE aims to preserve the maximum of tooth structure during root canal therapy, and the concept covers the whole process of diagnosis and treatment of teeth. This review article focuses on describing the minimally invasive concepts and operating essentials in endodontics, from diagnosis and treatment planning to the access opening, pulp cavity finishing, root canal cleaning and shaping, 3-dimensional root canal filling and restoration after root canal treatment.


Assuntos
Endodontia/métodos , Periodontite Periapical/terapia , Cavidade Pulpar , Endodontia/tendências , Humanos , Tratamentos com Preservação do Órgão/métodos , Periodontite Periapical/prevenção & controle , Obturação do Canal Radicular , Preparo de Canal Radicular , Tratamento do Canal Radicular/métodos , Dente não Vital
16.
Rev. ADM ; 73(4): 170-174, jul.-ago. 2016.
Artigo em Espanhol | LILACS | ID: biblio-835290

RESUMO

El éxito del tratamiento endodóntico depende de una serie de factores, entre ellos, el de conseguir un buen sellado marginal apical, preparar los conductos radiculares con instrumentos rotatorios de níquel-titanio, obteniéndose preparados con diferentes conicidades de aquellas conseguidas a través de la instrumentación manual. El sellado tridimensional de los conductos radiculares es de fundamental importancia, pues; al ocupar el espacio creado por la instrumentación, la obturación, evita la infiltración del exudado periapical para el interior del conducto radicular. Como consecuencia, inviabiliza la sobrevivencia de microorganismos residuales, ofreciendo condiciones para que ocurra la reparación, contribuyendo de manera decisiva para el éxito de la terapéutica endodóntica. La técnica de cono único es una técnica que utiliza apenas un cono principal o maestro que puede tener diferentes conicidades, y que a lo largo de los años fue retomando su popularidad debido a la capacidad de adaptarse mejor a la conformación de los sistemas rotatorios de níquel-titanio (Ni-Ti) sin la necesidad de usar conos accesorios, reduciendo así el tiempo de trabajo, permitiendo una obturación másfácil y rápida, disminuyendo tanto la fatiga del paciente como la deloperador. En relación con la calidad de la obturación, la microfiltración apical y la penetración de bacterias, esta técnica es semejante a las otras técnicas existentes. La finalidad de este trabajo fue realizar una revisión de literatura abordando las ventajas y desventajas de la técnica de cono único para obturar los conductos radiculares. Llegando a la conclusión que la técnica de cono único presenta las ventajas de la posibilidad deun tratamiento endodóntico más rápido y con mayor comodidad para el paciente y el clínico.


The success of any endodontic treatment depends on a range of factors, including achieving good apical sealing, preparing the rootcanal using rotary nickel-titanium instruments in order to obtain mechanical preparations with tapers unlike those achieved using manual instrumentation. Three-dimensional sealing of the root canal is of theutmost importance, given that proper fi lling of the space created bythe instrumentation prevents the microleakage of periapical exudateinto the root canal. This in turn hampers the survival of residual and resistant microorganisms, thus contributing to the healing process andthe success of the endodontic therapy. The single-cone technique isone that uses a single principal or master cone with diff erent tapers.It has become popular among endodontists over the years due to itsgreater adaptability to the characteristics of nickel-titanium (NiTi)rotary systems without the need for accessory cones, which reducesworking time and allows easier and faster fi lling, causing less fatiguefor both the patient and the operator. However, in terms of qualityof the obturation, apical microleakage, and bacterial penetration,this technique provides similar results to those achieved using othertechniques. This review article is an attempt to highlight the advantages and disadvantages of using the single-cone technique to sealthe root canal, considering the qualities of the endodontic sealerused. The single-cone technique has the advantage of saving timeduring root canal fi lling and being more comfortable for the patientand the physician alike.


Assuntos
Guta-Percha/química , Materiais Restauradores do Canal Radicular/classificação , Obturação do Canal Radicular/métodos , Endodontia/tendências
17.
J Am Dent Assoc ; 147(5): 372-80, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27017182

RESUMO

BACKGROUND AND OVERVIEW: Immature teeth are susceptible to infections due to trauma, anatomic anomalies, and caries. Traditional endodontic therapies for immature teeth, such as apexification procedures, promote resolution of the disease and prevent future infections. However, these procedures fail to promote continued root development, leaving teeth susceptible to fractures. Regenerative endodontic procedures (REPs) have evolved in the past decade, being incorporated into endodontic practice and becoming a viable treatment alternative for immature teeth. The authors have summarized the status of regenerative endodontics on the basis of the available published studies and provide insight into the different levels of clinical outcomes expected from these procedures. CONCLUSIONS: Substantial advances in regenerative endodontics are allowing a better understanding of a multitude of factors that govern stem cell-mediated regeneration and repair of the damaged pulp-dentin complex. REPs promote healing of apical periodontitis, continued radiographic root development, and, in certain cases, vitality responses. Despite the clinical success of these procedures, they appear to promote a guided endodontic repair process rather than a true regeneration of physiological-like tissue. PRACTICAL IMPLICATIONS: Immature teeth with pulpal necrosis with otherwise poor prognosis can be treated with REPs. These procedures do not preclude the possibility of apexification procedures if attempts are unsuccessful. Therefore, REPs may be considered first treatment options for immature teeth with pulpal necrosis.


Assuntos
Necrose da Polpa Dentária/terapia , Endodontia/tendências , Apexificação , Polpa Dentária , Humanos , Regeneração
18.
Endodoncia (Madr.) ; 34(1): 42-51, ene.-mar. 2016.
Artigo em Espanhol | IBECS | ID: ibc-156843

RESUMO

El objetivo del tratamiento de conductos es curar o prevenir la periodontitis apical. Para ello es necesario una correcta conformación y limpieza, que permitan obturar tridimensional el sistema de conductos. La irrigación supone una fase fundamental durante la terapia endodóntica y no debemos descuidarla. La eliminación completa de los restos pulpares vitales y/o necróticos es esencial para conseguir el éxito en el tratamiento de conductos. El irrigante gold estándar en endodoncia es el hipoclorito de sodio. Por sus características, no puede ser sustituido. Los principales inconvenientes son: la destrucción ósea en contacto con los tejidos periapicales, la no eliminación del barrillo dentinario y su alta tensión superficial. Los agentes tensoactivos en combinación con el hipoclorito de sodio se ha ido incorporando en los últimos años para reducir la tensión superficial, y así mejorar la penetración en el conducto principal. El objetivo de esta revisión bibliográfica es una puesta en día sobre qué dice la literatura al respecto en cuanto a disolución y capacidad antibacteriana de estas soluciones


The objective of root canal treatment is to heal or avoid apical periodontitis. This requires proper shaping and cleaning, enabling three-dimensional sealing root canal system. Irrigation is a critical phase during endodontic therapy and we should not neglect it. Complete removal of vital pulp remnants and/or necrotic allow a great success in the treatments. The gold standard endodontic irrigant is sodium hypochlorite. By their nature, it can not be replaced. The main drawbacks are: bone destruction in contact with the periapical tissues, no removal of smear and high surface tension. Surfactants in combination with sodium hypochlorite has been incorporated in recent years to reduce the surface tension, thereby improving penetration into the main duct. The aim of this review is a start-up on what the literature says to respect for dissolution and antibacterial ability of these solutions


Assuntos
Humanos , Endodontia/tendências , Tensoativos/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Desinfetantes/uso terapêutico , Irrigação Terapêutica
20.
Rev. Asoc. Odontol. Argent ; 103(4): 193-193, dic.2015. ilus
Artigo em Espanhol | LILACS | ID: lil-781820

RESUMO

La práctica endodóntica requiere el respaldo de imágenes de manera permanente, tanto para el diagnóstico como durante las distintas etapas del tratamiento. Desde siempre, estas imágenes han sido radiográficas. Con el advenimiento de las tomografías, se incluyó la visión de la tercera dimensión y se logró despejar interferencias gracias a la incorporación de cortes sectorizados. Sin embargo, estos estudios implican el uso de radiaciones ionizantes y de aparatología de alto costo. Con el tiempo, los estudios tomográficos han evolucionado; permiten obtener imágenes más fieles, isométricas, con mejor definición ymenos dosis de radiación para los pacientes. El presente trabajo tiene como objetivo brindar información clara a los colegas que deseen incorporar estas nuevas tecnologías en su práctica cotidiana. Para ello, se describen las diferencias entre los distintos sistemas, la manera en que deben ser evaluados por el profesional y los límites de su aplicación...


Assuntos
Humanos , Endodontia/tendências , Doenças da Polpa Dentária/diagnóstico , Doenças da Polpa Dentária , Tomografia Computadorizada de Feixe Cônico/métodos , Tomografia Computadorizada por Raios X/métodos , Desenho de Equipamento , Imageamento Tridimensional/métodos , Interpretação de Imagem Assistida por Computador/métodos , Tecnologia Odontológica
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