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1.
Stomatologija ; 21(1): 17-22, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32706342

RESUMO

The aim of this paper was to analyze the literature published in the research related to sodium hypochlorite induced injury. An internet search using search engines (Google, Researchgate and PubMed) was carried out. The keywords used for search were sodium hypochlorite, injury, cellulitis, apical extrusion, ulcer, endodontics. Full text articles of the articles were collected from the year 2007 to 2017. The data available from the clinical trials the journal articles were analyzed and presented in both tabular and descriptive patterns.


Assuntos
Endodontia , Hipoclorito de Sódio , Acidentes , Hipoclorito de Sódio/efeitos adversos
2.
Gen Dent ; 67(4): 63-66, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31355767

RESUMO

A 39-year-old woman sought specialized treatment complaining of a large, painful oral ulcer in the right buccal vestibule after receiving emergency endodontic treatment 3 days earlier. The patient reported that the tooth, the mandibular right first premolar, was not isolated with a rubber dam and that she felt the extrusion of a liquid in the buccal tissues. Clinically, a necrotic area with raised erythematous borders was observed in the mandibular right side. The clinical diagnosis was a chemically induced ulcer caused by a sodium hypochlorite accident. Dexamethasone and amoxicillin were prescribed to control pain and prevent secondary infection. The large size of the lesion was an indication for application of low-level laser therapy (LLLT), which was delivered at a wavelength of 685 nm (output power, 30 mW; power density, 0.5 mW/cm2 ; energy density, 6 J/cm2 ) every 2 days for a total of 6 sessions. The LLLT was applied to the necrotic area with a punctual mode (2 points) for 12 seconds per point. The patient reported a substantial reduction in pain after the second application, and the wound was completely healed after 6 sessions. The results observed in this patient suggest that LLLT could aid patients in recovering from NaOCl-related lesions.


Assuntos
Terapia com Luz de Baixa Intensidade , Úlceras Orais , Hipoclorito de Sódio/efeitos adversos , Acidentes , Adulto , Dente Pré-Molar , Feminino , Humanos , Úlceras Orais/etiologia , Úlceras Orais/terapia
3.
Rev. Odontol. Araçatuba (Impr.) ; 40(1): 25-28, jan.-abr. 2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-995151

RESUMO

O sucesso do tratamento endodôntico está diretamente ligado ao processo de limpeza e modelagem dos canais radiculares. E para se conseguir a limpeza e desinfecção são utilizadas substâncias químicas auxiliares como coadjuvantes ao preparo mecânico, pois são essenciais na redução de microrganismos presentes no sistema de canais radiculares. Dentre as principais substâncias químicas auxiliares empregadas, a que apresenta maior destaque é o Hipoclorito de Sódio. O objetivo do presente estudo é mostrar através de uma análise de prontuário, um relato de um acidente com hipoclorito de sódio durante um atendimento odontológico. Para isso, um prontuário foi selecionado, onde a paciente procurou a clínica do Curso de Odontologia do Centro Universitário da Serra Gaúcha para realizar tratamento endodôntico do dente 16. Durante este procedimento, ocorreu um extravasamento do hipoclorito de sódio aos tecidos periapicais, e partir deste fato foi possível relatar maneiras de como prevenir, tratar e evitar esse tipo situação(AU)


The success of endodontic treatment is directly related to the root canal cleaning and modeling process. In order to achieve cleaning and disinfection, auxiliary chemical substances are used as auxiliaries to the mechanical preparation, since they are essential in the reduction of microorganisms present in the root canal system. Among the main auxiliary chemical substances employed, the most prominent is Sodium Hypochlorite. The objective of the present study is to show through an analysis of medical records, an account of an accident with sodium hypochlorite during a dental care. For this, a chart was selected, where the patient sought the clinic of the Dentistry Course of the University Center of Serra Gaúcha to perform endodontic treatment of the tooth 16. During this procedure, an extravasation of the sodium hypochlorite occurred to the periapical tissues, and from this It was possible to report on ways to prevent, treat and avoid this type of situation(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Tecido Periapical/lesões , Hipoclorito de Sódio , Preparo de Canal Radicular , Hipoclorito de Sódio/efeitos adversos
4.
J Endod ; 45(2): 205-208, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30711179

RESUMO

INTRODUCTION: The aim of this study was to evaluate the effect of different temperatures of sodium hypochlorite (NaOCl) on the cyclic fatigue resistance of the heat-treated file systems. METHODS: The cyclic fatigue resistance of Reciproc 25 (VDW Dental, Munich, Germany), Reciproc Blue R25 (VDW), WaveOne Primary (Dentsply Maillefer, Ballaigues, Switzerland), WaveOne Gold Primary (Dentsply Maillefer), and One Shape (25.06; Micro Mega, Besançon, France) was tested in the following conditions: control (no immersion), immersion in distilled water (DW) at 37°C ± 1°C, immersion in DW at 60°C ± 1°C, immersion in NaOCl at 37°C ± 1°C, and immersion in NaOCl at 60°C ± 1°C. The immersion period was 5 minutes for all conditions. A stainless steel artificial canal with a curvature of 60° and a 5-mm radius was used. The time to failure and fragment lengths were recorded for each instrument, and data were subjected to statistical analysis. RESULTS: Reciproc Blue showed greater cyclic fatigue resistance in all conditions compared with the other systems (P < .05). Immersion in NaOCl at 60 °C negatively affected all instruments' cyclic fatigue resistance except Reciproc Blue. Immersion in DW at 60 °C increased the cyclic fatigue resistance of Reciproc Blue. Heat-treated files presented higher fatigue resistance than traditional files. CONCLUSIONS: A high temperature of NaOCl affected the cyclic fatigue life of the file systems. Instruments produced with heat treatment presented a longer fatigue life.


Assuntos
Instrumentos Odontológicos , Falha de Equipamento , Irrigantes do Canal Radicular , Tratamento do Canal Radicular/instrumentação , Hipoclorito de Sódio , Temperatura , Corrosão , Temperatura Alta , Irrigantes do Canal Radicular/efeitos adversos , Hipoclorito de Sódio/efeitos adversos
5.
Gen Dent ; 66(5): 69-72, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30188860

RESUMO

Accidental sodium hypochlorite extrusion can occur during endodontic irrigation procedures. The symptoms appear immediately and include severe pain, swelling, and probable tissue necrosis adjacent to the root of the treated tooth. Treatment of sodium hypochlorite extrusion involves immediate and copious saline irrigation to neutralize the area and prescription of analgesic, anti-inflammatory, and antibiotic medications. Low-level laser therapy (LLLT) might be useful as an adjuvant treatment for damaged soft tissues to improve healing. This case report describes the treatment of accidental extrusion of 1% sodium hypochlorite through a root canal perforation in a mandibular incisor during endodontic treatment. The extrusion caused minor swelling within the mentolabial sulcus and a large area of necrosis in the gingivolabial mucosa and right edentulous premolar area. Conventional treatment was performed in association with LLLT. Clinical and radiographic examinations after 6 months showed complete healing of the necrotic area without paresthesia and the repair of apical tissues.


Assuntos
Cavidade Pulpar/lesões , Gengiva/lesões , Terapia com Luz de Baixa Intensidade/métodos , Irrigantes do Canal Radicular/efeitos adversos , Preparo de Canal Radicular/efeitos adversos , Hipoclorito de Sódio/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade
6.
J Endod ; 44(11): 1714-1719, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30266468

RESUMO

INTRODUCTION: SmearOFF (Vista Dental Products, Racine, WI) is an irrigation solution containing chlorhexidine (CHX), EDTA, and a surfactant. This study examined the chemical interaction of SmearOFF with sodium hypochlorite (NaOCl) on the dentin surface, specifically the formation of precipitate and/or parachloroanaline (PCA). METHODS: Dentin blocks prepared from human maxillary molars were mounted in resin. Dentinal tubules were exposed in a perpendicular orientation using an ultracryomicrotome. The blocks were divided into 2 groups: the CHX group, irrigation with 6% NaOCl, 17% EDTA, 6% NaOCl, and 2% CHX, and the SmearOFF group, irrigation with 6% NaOCl and SmearOFF. The dentin surface was analyzed with time-of-flight secondary ion mass spectrometry and X-ray photoelectron spectroscopy to determine the formation of precipitate or/and PCA on the surface of dentin. RESULTS: Precipitation with PCA and occlusion of the dentinal tubules were noted on the dentin surface in the CHX group. No precipitate and no PCA were detected on the surface of dentin in the SmearOFF group. CONCLUSIONS: Interaction of SmearOFF with NaOCl on the dentin surface did not result in the formation of precipitate or PCA.


Assuntos
Clorexidina/química , Dentina/metabolismo , Dentina/patologia , Irrigantes do Canal Radicular/química , Hipoclorito de Sódio/química , Compostos de Anilina/metabolismo , Precipitação Química , Clorexidina/efeitos adversos , Interações Medicamentosas , Ácido Edético , Humanos , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular/efeitos adversos , Hipoclorito de Sódio/efeitos adversos , Espectrometria de Massa de Íon Secundário , Propriedades de Superfície , Tensoativos
7.
J Contemp Dent Pract ; 19(7): 768-772, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30066678

RESUMO

AIM: This study aimed to evaluate the fracture resistance of tooth crowns endodontically irrigated using different protocols. MATERIALS AND METHODS: A total of 76 bovine incisors were divided into four groups (n = 19): irrigation with distilled water (control; CON); conventional irrigation with positive apical pressure (PAP); passive ultrasonic irrigation using continuous flushing (PUI); and irrigation with PAP and heated sodium hypo-chlorite solution (PHS). The force required to fracture the crown was measured on a universal testing machine at an angle of 45°. RESULTS: The CON group had higher fracture resistance (351.71 ± 58.66 N) than the PAP and PUI groups (140.96 ± 37.26 N; 167.49 ± 40.08 N respectively). The PHS group had the lowest fracture resistance value (115.15 ± 41.07 N). Irrigation protocols had a significant effect on crown resistance (p < 0.01). CONCLUSION: Teeth subjected to irrigation with heated sodium hypochlorite showed decreased resistance to crown fracture. CLINICAL SIGNIFICANCE: The contact of the irrigating solution with the root canal walls potentially can cause their weakness, determining crown fracture.


Assuntos
Irrigantes do Canal Radicular/efeitos adversos , Hipoclorito de Sódio/efeitos adversos , Irrigação Terapêutica/efeitos adversos , Coroa do Dente , Fraturas dos Dentes/etiologia , Dente não Vital , Animais , Bovinos , Análise do Estresse Dentário , Incisivo , Preparo de Canal Radicular/métodos , Camada de Esfregaço , Soluções , Irrigação Terapêutica/métodos
8.
Acta Biomed ; 89(1): 104-108, 2018 03 27.
Artigo em Inglês | MEDLINE | ID: mdl-29633752

RESUMO

Endodontic therapy is a routinely practised clinical procedure with few reported complications but, as a bleaching agent, inadvertent spillage of sodium hypochlorite beyond the root canal system may result in extensive soft tissue or nerve damage, and even airway compromise. Although very rare, complications arising from hypochlorite extrusion beyond the root apex are described. NaOCl causes oxidation of protein and lipid membrane and causes necrosis, hemolysis and dermal ulcerations (2-4). Neurological complication are very rare. Paraesthesia and anaesthesia may affect the mental, inferior dental and infra-orbital branches of the trigeminal nerve and normal sensation may take many months to  completely resolve (6, 7). Nerve damage (the buccal branch) was described in 2005 by Witton et al. (8) and patients exhibited a loss of the naso-labial groove and a down turning of the angle of the mouth and the motor function was regained after several months. We present a case in which the extrusion of NaOCl solution during endodontic therapy led to important destructive effects on soft tissues and nerves. The arisen medico legal issues are discussed.


Assuntos
Extravasamento de Materiais Terapêuticos e Diagnósticos/complicações , Traumatismos do Nervo Facial/induzido quimicamente , Irrigantes do Canal Radicular/efeitos adversos , Hipoclorito de Sódio/efeitos adversos , Adulto , Blefarospasmo/induzido quimicamente , Doenças dos Nervos Cranianos/induzido quimicamente , Feminino , Humanos , Parestesia/induzido quimicamente
9.
J Endod ; 44(4): 559-564, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29459149

RESUMO

INTRODUCTION: The aim of this study was to assess the role of root canal irrigants and medicaments in endodontic injuries verified in Finland and to estimate the rate of such events over time. METHODS: The study material comprised all endodontic injuries verified by the Patient Insurance Centre in 2002 to 2006 (n = 521) and 2011 to 2013 (n = 449). The data, based on patient documents scrutinized by 2 specialists in endodontics, included patients' and dentists' sex and age and the service sector. We recorded the use of root canal irrigants and medicaments, each as a dichotomy. Furthermore, we dichotomized the injuries as those related to root canal irrigants/medicaments and any other injuries. The injuries were also dichotomized as avoidable (could have been avoided by following good clinical practice) or unavoidable (normal treatment-related risks). Statistical evaluation used chi-square tests and t tests; logistic regression produced odds ratios (ORs). RESULTS: The verified injuries (N = 970) comprised 635 (65%) avoidable and 335 (35%) unavoidable injuries. The number of irrigant-/medicament-related injuries was 69, accounting for 7.1% of all verified injuries; all resulted from sodium hypochlorite and calcium hydroxide, and 87% were avoidable. The overall rate of sodium hypochlorite/calcium hydroxide injuries was 4.3 cases per 100,000 endodontic patients per year. Compared with other injuries, sodium hypochlorite/calcium hydroxide injuries were more likely avoidable (OR = 3.8) and more than 5-fold likely in 2011 to 2013 than in 2002 to 2006 (OR = 5.6). CONCLUSIONS: Extreme care is needed when applying sodium hypochlorite and calcium hydroxide into root canals to avoid increasing harmful consequences.


Assuntos
Endodontia/legislação & jurisprudência , Imperícia/estatística & dados numéricos , Irrigantes do Canal Radicular/efeitos adversos , Adulto , Hidróxido de Cálcio/efeitos adversos , Cavidade Pulpar/lesões , Endodontia/normas , Feminino , Finlândia/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Hipoclorito de Sódio/efeitos adversos
10.
J Endod ; 44(4): 648-653, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29397218

RESUMO

INTRODUCTION: The purpose of this study was to assess the effects of sodium hypochlorite (NaOCl) immersion and sterilization on the cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) rotary instruments. METHODS: Two hundred ten new 25/.06 Twisted Files (TFs; SybronEndo, Orange, CA) and Hyflex CM (Coltene Whaledent, Cuyahoga Falls, OH) files were divided into 7 groups (n = 15) for each brand. Group 1 (control group) included new instruments that were not immersed in NaOCl or subjected to autoclave sterilization. Groups 2 and 3 were composed of instruments dynamically immersed for 3 minutes in 5% NaOCl solution 1 and 3 times, respectively. Groups 4 and 5 consisted of instruments only autoclaved 1 and 3 times, respectively. Groups 6 and 7 recruited instruments that received a cycle of both immersion in NaOCl and sterilization 1 and 3 times, respectively. Instruments were subsequently subjected to a fatigue test. The surface morphology of fractured instruments was studied by field-emission scanning electron microscopy and x-ray energy-dispersive spectrometric (EDS) analyses. The means and standard deviations of the number of cycles to failure (NCF) were calculated and statistically analyzed using 2-way analysis of variance (P < .05). RESULTS: Comparison among groups indicated no significant difference of NCF (P > .05) except for the groups of TFs sterilized 3 times without and with immersion in NaOCl (P < .05). HyFlex CM files exhibited higher cyclic fatigue resistance than TFs when files were sterilized 3 times, independently from immersion in NaOCl (P < .05). EDS analysis showed the presence of an oxide-rich layer on the Hyflex CM files' external surface. No morphologic or chemical differences were found between files of the same brand subjected to different treatments. CONCLUSIONS: Repeated cycles of sterilization did not influence the cyclic fatigue of NiTi files except for TFs, which showed a significant decrease of flexural resistance after 3 cycles of sterilization. Immersion in NaOCl did not reduce significantly the cyclic fatigue resistance of all heat-treated NiTi files tested.


Assuntos
Ligas , Instrumentos Odontológicos/efeitos adversos , Desinfetantes/efeitos adversos , Falha de Equipamento , Hipoclorito de Sódio/efeitos adversos , Temperatura Alta/efeitos adversos , Esterilização
11.
J Prosthodont ; 27(2): 169-176, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26999386

RESUMO

PURPOSE: Denture tooth debonding is a common complication for denture wearers; however, the effect of complete denture disinfection on bonding between denture teeth and acrylic resin remains unclear. The aim of this study was to evaluate the effect of disinfection methods on the bond strength between denture teeth and microwave-cured acrylic resin denture base. MATERIALS AND METHODS: Three commercial brands of denture teeth (Trilux, Biolux, Vipi Dent Plus) and one microwave-cured acrylic resin denture base were tested. Each brand of denture teeth was divided into seven groups (n = 6; estimated by partial Eta squared). The specimenss of groups H and Cl were immersed in 1% sodium hypochlorite and 4% chlorhexidine digluconate for 7 days, respectively. In group Br, the specimens were subjected to toothbrush simulation under 200 g of force for 20,000 cycles. In groups Br-H and Br-Cl, the specimens were brushed and further disinfected with 1% sodium hypochlorite and 4% chlorhexidine digluconate, respectively. In control groups 1 (Co1) and 2 (Co2), the specimens were stored in distilled water for 50 ± 2 hours and 7 days, respectively. Shear bond strength testing was performed at the resin/tooth interface in a universal testing machine at a 1 mm/min crosshead speed. The failure pattern was quantified and classified into adhesive, cohesive, or mixed. Data were analyzed using two-way ANOVA and Tukey HSD test (α = 0.05). RESULTS: Disinfection with 1% sodium hypochlorite (p = 0.031), brushing (p < 0.0001), and association of brushing with either 1% sodium hypochlorite (p < 0.0001) or 4% chlorhexidine digluconate (p = 0.01) reduced the bond strength between denture teeth and microwave-cured acrylic resin denture base. All commercial brands of denture teeth presented a similar bond strength (p > 0.05). The failure pattern was predominantly adhesive independent of the disinfection method and denture tooth brand. CONCLUSIONS: Disinfection with sodium hypochlorite, brushing, and the association of mechanical and chemical methods reduced the bond strength between denture tooth and microwave-cured acrylic resin denture base.


Assuntos
Resinas Acrílicas/uso terapêutico , Colagem Dentária , Bases de Dentadura , Dentaduras , Desinfetantes/efeitos adversos , Hipoclorito de Sódio/efeitos adversos , Resinas Acrílicas/efeitos adversos , Análise do Estresse Dentário , Desinfecção/métodos , Humanos , Micro-Ondas/uso terapêutico
12.
J Arthroplasty ; 33(3): 844-846, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29137898

RESUMO

BACKGROUND: Multiple antiseptics have been described for use in total joint arthroplasty infection, and the use of multiple antiseptic solutions during a single operation has been described. Our clinical experience is that chlorhexidine (CHX) and Dakin's solution (NaOCl) interact and form a precipitate. The purpose of this study is to determine whether this reaction could be replicated in a laboratory setting, and to determine if other commonly used antiseptics also visibly react when mixed. METHODS: Four percent chlorhexidine gluconate (CHX), 0.5% sodium hypochlorite (NaOCl), 3% hydrogen peroxide (H2O2), and 10% povidone-iodine (BTD) solutions were obtained and all possible combinations were mixed. Any visible reactions were noted and recorded, and a literature search was performed to characterize the reaction and products. RESULTS: CHX and NaOCl, CHX and H2O2, and CHX and BTD reacted instantly, forming a precipitate. NaOCl and H2O2 reacted to produce a gas. NaOCl and BTD reacted and produced a color change. The literature review revealed that at least 2 of the reactions tested (CHX + NaOCl and NaOCl + H2O2) could result in byproducts toxic to humans. CONCLUSION: Surgeons must be aware of these interactions when using antiseptic solutions during procedures. Caution should be used combining or mixing antiseptics, and we recommend against concomitant introduction in a surgical wound.


Assuntos
Anti-Infecciosos Locais/efeitos adversos , Anti-Infecciosos Locais/farmacologia , Artroplastia de Substituição/efeitos adversos , Interações Medicamentosas , Infecções/tratamento farmacológico , Clorexidina/efeitos adversos , Clorexidina/análogos & derivados , Clorexidina/farmacologia , Humanos , Peróxido de Hidrogênio/efeitos adversos , Peróxido de Hidrogênio/farmacologia , Povidona-Iodo/efeitos adversos , Povidona-Iodo/farmacologia , Hipoclorito de Sódio/efeitos adversos , Hipoclorito de Sódio/farmacologia
14.
Food Microbiol ; 65: 294-301, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28400016

RESUMO

The effect of sub-minimum inhibitory concentrations (sub-MICs) of three biocides (benzalkonium chloride [BZK], trisodium phosphate [TSP] and sodium hypochlorite [SHY]) upon the architecture and viability of the biofilms formed by a methicillin-resistant Staphylococcus aureus strain of food origin (MRSA 48a) was investigated. Images were examined through confocal laser scanning microscopy (CLSM) after staining with SYTO9 and propidium iodide. Sub-MICs of BZK or TSP reduced the ability of MRSA to produce biofilm. In contrast, the presence of sub-MICs of SHY enhanced the biofilm-forming ability of MRSA when cells had undergone previous adaptation to this compound (biovolume in the observation field was 137,785.31 ± 47,682.79 µm3 for biofilms formed in the presence of SHY, and 70,204.13 ± 31,603.98 µm3 in the absence of biocides; P < 0.05). The largest amount of live (green stained) cells (P < 0.05) was observed in biofilms grown in the presence of SHY relative to the other conditions tested (58,999.75 ± 55,312.37 µm3vs 31,976.29 ± 38,594.98 µm3). Findings from the present work constitute the first report of biofilm production by MRSA being induced by sub-inhibitory concentrations of SHY. The data suggest that repeated use of SHY at low concentrations could represent a public health risk.


Assuntos
Biofilmes/efeitos dos fármacos , Desinfetantes/farmacologia , Staphylococcus aureus Resistente à Meticilina/fisiologia , Viabilidade Microbiana/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Desinfetantes/efeitos adversos , Desinfetantes/química , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/ultraestrutura , Testes de Sensibilidade Microbiana , Microscopia Confocal , Hipoclorito de Sódio/efeitos adversos , Hipoclorito de Sódio/farmacologia
15.
J Contemp Dent Pract ; 18(4): 289-294, 2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-28349906

RESUMO

AIM: This study aimed to evaluate the push-out bond strength of NeoMTA Plus (NMTA), EndoSequence root repair material fast set putty (ERRMF), biodentine (BD), and ProRoot white mineral trioxide aggregate (PMTA) when used as perforation repair materials after exposure to 2.5% sodium hypochlorite (NaOCl) during the early setting phase. MATERIALS AND METHODS: Horizontal midroot sections were prepared from single-rooted human teeth. Sections (n = 144) were randomly divided into four groups: PMTA, BD, NMTA, and ERRMF. Materials were condensed and allowed to set for 10 minutes. The groups were further divided into two subgroups. The NaOCl group included specimens that were immersed in 2.5% NaOCl for 30 minutes, and the control group included specimens on which a wet cotton pellet was placed over the test material. After 48 hours, the highest force applied to the materials at the time of dislodgement was recorded. Slices were then examined under a digital microscope to evaluate the nature of the bond failure. The surfaces of two specimens from each subgroup were observed by scanning electron microscopy. Data were statistically analyzed with two-way and one-way analysis of variances, independent t-tests, and chi-square tests. The statistical significance was set at 0.05. RESULTS: In NaOCl-treated groups, PMTA showed a significantly higher push-out bond strength than the other three materials (p = 0.00). In the control groups, the bond strength of BD was significantly higher than that of PMTA, ERRMF, and NMTA (p < 0.05). Compared with the control group, NaOCl treatment significantly increased the push-out bond strength of PMTA (p = 0.00) and ERRMF (p = 0.00) and significantly reduced the bond strength of BD (p = 0.00) and NMTA (p = 0.03). None of the specimens showed an adhesive type of failure. The majority of the samples exhibited a cohesive failure type. Morphological observations revealed that the surfaces exhibited cubic crystals. In ERRMF, the crystals were few in number. Sodium hypochlorite enhanced the crystallization of NMTA. CONCLUSION: The push-out bond strengths of PMTA and ERRMF were significantly increased after exposure to 2.5% NaOCl in the early setting phase, and those of BD and NMTA were significantly decreased. CLINICAL SIGNIFICANCE: The results of the present study suggest that early exposure of NaOCl increase the push-out bond strength of PMTA and ERRMF. PMTA had the highest push-out values. Therefore, it would be a potentially useful perforation repair material for single visit endodontic treatment.


Assuntos
Compostos de Cálcio/uso terapêutico , Colagem Dentária , Dentina/lesões , Agentes de Capeamento da Polpa Dentária e Pulpectomia/uso terapêutico , Silicatos/uso terapêutico , Hipoclorito de Sódio/efeitos adversos , Compostos de Alumínio/uso terapêutico , Fosfatos de Cálcio/uso terapêutico , Análise do Estresse Dentário , Dentina/cirurgia , Combinação de Medicamentos , Humanos , Técnicas In Vitro , Óxidos/uso terapêutico
16.
J Endod ; 43(1): 16-24, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27986099

RESUMO

INTRODUCTION: Sodium hypochlorite (NaOCl) extrusion beyond the apex, also known as "a hypochlorite accident," is a well-known complication that seldom occurs during root canal therapy. These "accidents" have been the subject of several case reports published over the years. Until now, no publication has addressed the global synthesis of the general and clinical data related to NaOCl extrusion. The main purpose of this article was to conduct a systematic review of previously published case reports to identify, synthesize, and present a critical analysis of the available data. A second purpose was to propose a standardized presentation of reporting data concerning NaOCl extrusions to refine and develop guidelines that should be used in further case report series. METHODS: A review of clinical cases reporting NaOCl accidents was conducted in June 2016 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; it combined an electronic search of the PubMed database and an extensive manual search. RESULTS: Forty full-text articles corresponding to 52 case reports published between 1974 and 2015 were selected. Four main categories of data were highlighted: general and clinical information, clinical signs and symptoms of NaOCl extrusions, management of NaOCl extrusions, and healing and prognosis. Overall, up to now, clinical cases were reported in a very unsystematic manner, and some relevant information was missing. CONCLUSIONS: A better understanding of the potential causes, management, and prognosis of NaOCl accidents requires a standardization of reported data; this study proposes a template that can fulfill this objective.


Assuntos
Irrigantes do Canal Radicular/efeitos adversos , Preparo de Canal Radicular/efeitos adversos , Hipoclorito de Sódio/efeitos adversos , Humanos
17.
BMJ Case Rep ; 20162016 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-27769978

RESUMO

Sodium hypochlorite is a clear yellowish solution with a characteristic odour of chlorine and is commonly used as a disinfectant and a bleaching agent. It is used in various healthcare settings for its fast-acting and broad-spectrum antimicrobial activity. It is a known irritant and there are some reports that it can also cause allergic contact dermatitis of type IV hypersensitivity. We report a case of work-related type I hypersensitivity to sodium hypochlorite, presenting with recurrent urticarial rash and a positive prick test reaction to this chemical. He was subsequently excused from further exposure with no further recurrences of the urticarial rash. To the best of our knowledge, this is the first such reported case due to work in the healthcare setting.


Assuntos
Hipersensibilidade Imediata/etiologia , Exposição Ocupacional/efeitos adversos , Hipoclorito de Sódio/efeitos adversos , Humanos , Masculino , Auxiliares de Cirurgia , Recidiva , Testes Cutâneos , Soluções , Urticária/induzido quimicamente , Adulto Jovem
18.
J Endod ; 42(2): 284-8, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26723482

RESUMO

INTRODUCTION: The aim of this study was to evaluate the efficacy of sodium thiosulfate (Na2S2O3) for restoring adhesion to pulp chamber dentin treated with sodium hypochlorite (NaOCl) and EDTA. METHODS: Sixty-three crowns of bovine incisors were cut to expose the dentin pulp chamber. The specimens were polished and randomly distributed into 9 groups (n = 7) according to the following protocols used: 0.9% sodium chloride for 30 minutes (negative control), 5.25% NaOCl for 30 minutes, 17% EDTA for 3 minutes, and 5.25% NaOCl for 1 minute (positive control). The other groups, after treatments with NaOCl and EDTA, were immersed in 0.5% or 5% Na2S2O3 for 1, 5, and 10 minutes or just immersed in an inert solution for 10 minutes (0.9% sodium chloride). After drying the specimens, Scotchbond Multi-Purpose (3M ESPE, St Paul, MN) was applied to the pulp chamber dentin followed by Filtek Z250 composite (3M ESPE). Six rectangular slabs were obtained from each specimen, and the dentin/resin interface was tested by using a universal testing machine. The resulting data were submitted to 1-way analysis of variance and the Duncan test (P = .05). RESULTS: There was a significant decrease in bond strength regarding NaOCl and EDTA (P < .05). When 5% Na2S2O3 was used for 10 minutes, the bond strength was found to be statistically equal to the negative control and higher than the positive control (P < .05). CONCLUSIONS: The use of Na2S2O3 can significantly increase the bond strength of composite resin to NaOCl/EDTA-treated dentin, allowing adhesive restorations to be immediately applied after endodontic treatment.


Assuntos
Adesivos Dentinários/uso terapêutico , Dentina/efeitos dos fármacos , Hipoclorito de Sódio/efeitos adversos , Tiossulfatos/uso terapêutico , Condicionamento Ácido do Dente , Adesivos/química , Animais , Antioxidantes/farmacologia , Bovinos , Resinas Compostas/química , Colagem Dentária/métodos , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/efeitos dos fármacos , Cavidade Pulpar/ultraestrutura , Análise do Estresse Dentário , Dentina/diagnóstico por imagem , Dentina/ultraestrutura , Adesivos Dentinários/química , Adesivos Dentinários/farmacologia , Ácido Edético/administração & dosagem , Ácido Edético/efeitos adversos , Incisivo/diagnóstico por imagem , Incisivo/efeitos dos fármacos , Irrigantes do Canal Radicular/farmacologia , Hipoclorito de Sódio/administração & dosagem , Tiossulfatos/administração & dosagem , Tiossulfatos/farmacologia
19.
J Prosthet Dent ; 115(5): 606-10, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26775247

RESUMO

STATEMENT OF PROBLEM: Various Locator abutments and attachments are available commercially for use in overdenture patients. Patients are advised to use cleansing agents to keep their overdentures clean. The effect of different cleansing agents on attachments with different retention is not known. PURPOSE: The purpose of this in vitro study was to evaluate the retention of 3 Locator abutment attachments after they were soaked in 3 different cleansing solutions. MATERIAL AND METHODS: An implant analog with a diameter of 4.1 mm was embedded into acrylic resin, and 1 Locator abutment was placed onto the analog. Seven specimens of clear, pink, and blue Locator attachments (n=7) were soaked in 3 different denture-cleansing solutions (NaOCl, sodium perborate, sodium perborate-sodium bicarbonate) for a time simulating 6 months of clinical use. The control group was soaked in tap water. A testing machine was used to test the attachments' retention. The retention of the attachments after they were soaked in denture cleansers was compared among the groups with repeated-measures analysis of variance followed by the Tukey HSD test (α=.05). RESULTS: The retention of the clear attachments was significantly less after they had been soaked in sodium bicarbonate-containing denture cleanser (P=.001). The retention of the pink Locator attachments was no different after they had been soaked in the different solutions, and the retention of the blue Locator attachments decreased significantly after they had been soaked in the NaOCl and sodium bicarbonate cleansing agents (P=.002). CONCLUSIONS: Attachments of different colors and retention were affected differently by cleansing agents.


Assuntos
Higienizadores de Dentadura/efeitos adversos , Retenção de Dentadura , Revestimento de Dentadura , Boratos/efeitos adversos , Dente Suporte , Humanos , Técnicas In Vitro , Bicarbonato de Sódio/efeitos adversos , Hipoclorito de Sódio/efeitos adversos
20.
J Endod ; 42(1): 135-9, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26547720

RESUMO

INTRODUCTION: This study assessed apical extrusion during treatment with GentleWave (GW; Sonendo Inc, Laguna Hills, CA), a conventional open-ended 30-G needle (CN), or Endovac (EV; SybronEndo, Orange, CA) in root canals enlarged to different dimensions with and without apical constriction. METHODS: Sixteen mandibular molars were mounted in an in vitro apparatus. Roots were immersed in a pressure-regulated chamber containing distilled water with pressure kept at 5.88 ± 0.15 mm Hg to simulate periapical back pressure. Mesiobuccal (curved ≤30°) and distal (straight) canals were instrumented to the working length (WL) as follows: minimal instrumentation (MI, #15/.04), traditional instrumentation (#35/.06), or overinstrumentation (OI, #35/.06, to the WL + 1 mm). Canals were tested 5 times each with distilled water using GW, CN (at WL-3 mm), or EV and the mass (g) of extruded water recorded. Extrusion frequency and mean extruded mass were compared for each canal, irrigation group, and canal instrumentation mode (Wilcoxon t test, P < .05). RESULTS: No extrusion occurred with GW and EV, whereas the frequency of extrusion with CN was 33%. Mean extruded water mass using CN ranged in mesial canals from 0.000 ± 0.000 g (OI) to 0.047 ± 0.098 g (MI) and in distal canals from 0.123 ± 0.191 g (MI) to 0.505 ± 0.490 g (OI). With traditional instrumentation and OI instrumentation, extruded mass in distal canals was significantly higher than in mesial canals (P < .002) and distal canals with MI (P < .020). CONCLUSIONS: Within this study's limitations, root canal treatment with GW and irrigation with EV was not associated with extrusion. Extruded irrigation mass using the open-ended 30-G needle depended on the canal type and enlargement. These results have to be interpreted with caution, and further investigations are warranted to evaluate the possibility of extrusion using GW in different tooth types and clinical situations.


Assuntos
Cavidade Pulpar , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/instrumentação , Humanos , Dente Molar , Irrigantes do Canal Radicular/efeitos adversos , Preparo de Canal Radicular/métodos , Hipoclorito de Sódio/efeitos adversos , Hipoclorito de Sódio/uso terapêutico
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