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1.
Oral Health Prev Dent ; 18(1): 881-887, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33215480

RESUMO

PURPOSE: To evaluate effects of the adjunctive subgingival application of sodium hypochlorite on clinical outcome following nonsurgical periodontal treatment. MATERIALS AND METHODS: A search protocol was developed to answer the following focused question: 'in patients with periodontitis, does adjunctive subgingival application of sodium hypochlorite have additional clinical benefits compared to subgingival debridement alone?' Randomised controlled clinical trials (RCTs) published up to January 30, 2020, with at least 6 months of follow-up, in which sodium hypochlorite was used as an adjunct in nonsurgical periodontitis treatment were included. The search was limited to the English language. RESULTS: Out of 355 studies retrieved, the search resulted in two publications that fulfilled the inclusion criteria. The adjunctive application of sodium hypochlorite did not provide additional beneficial effect in terms of changes in the evaluated clinical outcomes (i.e. probing depth values [PDs], clinical attachment level gain [CAL] and bleeding on probing [BOP]) when compared to mechanical instrumentation alone over the 12-month investigation period (p > 0.05). CONCLUSION: The available data have failed to show any additional clinical benefit following the use of sodium hypochlorite in conjunction with nonsurgical periodontal therapy.


Assuntos
Periodontite , Hipoclorito de Sódio , Raspagem Dentária , Humanos , Periodontite/tratamento farmacológico , Hipoclorito de Sódio/uso terapêutico
2.
J Endod ; 46(10): 1448-1454, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32681848

RESUMO

INTRODUCTION: This study evaluated the bacterial levels after regenerative endodontic procedures and their correlation with the treatment outcome using molecular microbiology methods. METHODS: Root canal samples of 15 necrotic immature teeth were analyzed by quantitative polymerase chain reaction. Bacteria were counted before treatment (S1), after irrigation with 6% sodium hypochlorite (S2), and after intracanal dressing (S3) using either triple antibiotic paste (n = 7) or calcium hydroxide with chlorhexidine (n = 8). The Wilcoxon test for related samples and the Mann-Whitney test were used for statistical analysis (P < .05). After a follow-up period of 12-48 months, clinical and radiographic findings were correlated with microbiological data using a linear regression model (P < .05). RESULTS: All S1 and S2 samples were positive for bacteria, but the number of positive S3 samples decreased to 53.3% (P = .001). Overall, there was a significant reduction of bacterial levels after each treatment step (S1-S2, P = .001; S2-S3, P = .02). In the triple antibiotic paste and chlorhexidine groups, 57.1% and 50% of S3 samples were positive with median numbers of 6.97 × 103 and 3.59 × 104 bacterial cells, respectively. No significant differences were found between the groups. Periapical healing occurred in all cases despite the presence of low levels of residual bacteria. However, the latter had a negative impact on the thickness of dentinal walls (R2 = 0.0043). CONCLUSIONS: Although the bacterial levels were drastically reduced after the regenerative endodontic procedures, the residual bacteria influenced the thickness of the dentinal walls.


Assuntos
Periodontite Periapical/terapia , Endodontia Regenerativa , Hidróxido de Cálcio/uso terapêutico , Cavidade Pulpar , Necrose da Polpa Dentária/terapia , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular , Tratamento do Canal Radicular , Hipoclorito de Sódio/uso terapêutico
3.
Medicine (Baltimore) ; 99(22): e20372, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481420

RESUMO

The present study investigated the effectiveness of a Carisolv III + 0.5% sodium hypochlorite (NaOCl)-based root canal irrigant for smear layer removal.Forty maxillary incisors were randomly divided into 4 groups (n = 10 per group). The canals in group A (experimental) were prepared with 0.5% NaOCl, and Carisolv III and 0.5% NaOCl was used for the final washing; groups B and C (positive controls) used 2% and 5.25% NaOCl, respectively; and group D (negative control) used phosphate-buffered saline (PBS). Ethylenediaminetetraacetic acid (EDTA) was used for all of the groups. A 5-point scoring scale and scanning electron microscopy were used to evaluate the effectiveness of the irrigants. The canals were consistently cleaner in the coronal and middle thirds than in the apical thirds (P < .05).For cleaning the root canals, 5.25% NaOCl was more effective than 2% NaOCl, 0.5% NaOCl + Carisolv III, and phosphate-buffered saline , respectively (P < .05). The 2% NaOCl solution showed similar results to 0.5% NaOCl + Carisolv III (P > .05). The combination of 5.25% NaOCl and 17% EDTA remains the most effective irrigant for removal of the root canal smear layer.A combination of Carisolv III + 0.5% NaOCl (with 17% EDTA) showed a cleaning ability similar to that of 2% NaOCl (with 17% EDTA).


Assuntos
Ácido Glutâmico/uso terapêutico , Leucina/uso terapêutico , Lisina/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Hipoclorito de Sódio/uso terapêutico , Adulto , Cavidade Pulpar/cirurgia , Feminino , Humanos , Técnicas In Vitro , Incisivo/cirurgia , Masculino , Pessoa de Meia-Idade
4.
J Endod ; 46(8): 1032-1041.e7, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32413440

RESUMO

INTRODUCTION: We aimed to compare the antimicrobial efficacy of chlorhexidine (CHX) and sodium hypochlorite (NaOCl), 2 irrigants routinely used in root canal therapy of permanent teeth. METHODS: Electronic databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, were searched for randomized controlled trials published until March 2020. The meta-analysis of relative risk (RR) and standardized mean difference (SMD) was performed using a random effects model with a 95% confidence interval (CI). Subgroup analysis was performed for culture and molecular methods of bacterial detection. RESULTS: The literature search yielded 2110 records without duplicates. Eight studies were eligible for a systematic review. No significant differences in the incidence of samples with positive bacterial growth after irrigation (RR = 1.003; 95% CI, 0.729-1.380; P = .987) and mean bacterial number changes (SMD = 0.311; 95% CI, -0.368 to 0.991; P = .369) were observed between CHX and NaOCl in the culture and molecular subgroups. Heterogeneity in RR (I2 = 0%, P = .673) was low among studies, whereas considerable heterogeneity was observed in the analysis of SMD (I2 = 76.336%, P = .005). CONCLUSIONS: Our findings suggest that both CHX and NaOCl can reduce bacterial infections after irrigation without any significant difference in antimicrobial efficacy between them. Although CHX and NaOCl showed similar efficacy, their molecular mechanisms were different. Therefore, they can be used as the main antibacterial root canal irrigants. However, our results were limited by inconsistencies among retrieved articles and a lack of clinically relevant outcomes. Further well-designed clinical studies are warranted to supplement our results.


Assuntos
Antibacterianos/uso terapêutico , Clorexidina/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Cavidade Pulpar , Enterococcus faecalis , Ensaios Clínicos Controlados Aleatórios como Assunto , Tratamento do Canal Radicular
5.
Rev. cuba. estomatol ; 57(1): e2872, ene.-mar. 2020. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126486

RESUMO

RESUMEN Introducción: La microfiltración es uno de los problemas principales de todas las obturaciones a base de resina. Muchos estudios buscan optimizar un buen sellado marginal utilizando diversos acondicionadores, como el hipoclorito de sodio, que permite que el adhesivo penetre bien, al generar desproteinización, y el ácido fosfórico que permite remover el barro dentinario, y así de esta manera formar una capa híbrida al colocar el adhesivo. Objetivo: Evaluar el grado de sellado marginal de la resina Bulk Fill aplicando gel de hipoclorito de sodio 10 por ciento comparado con el gel de ácido fosfórico al 37 por ciento en el acondicionamiento dental in vitro. Métodos: El universo fue de 72 dientes con cavidades clase I; se separaron en 4 grupos por muestra de 18 dientes cada uno; después de obturar se realizó el termociclaje a 500 ciclos entre 5 °C a 55 °C; luego se sumergieron en azul de metileno 2 por ciento, durante 12 h y 24 h a temperatura de 37 °C. Finalmente se evaluó el sellado marginal en el estereomicroscopio, según el ISO / TS 11405: 2015, con los criterios siguientes: grado 0 (sin microfiltración), grado 1 (microfiltración hasta esmalte), grado 2 (microfiltración hasta dentina) y grado 3 (microfiltración hasta piso pulpar). Resultados: El acondicionamiento con ácido fosfórico 37 por ciento a las 12 h presentó grado 0 (55,6 por ciento) y grado 1 (33,3 por ciento), y a las 24 h, grado 1 (55,6 por ciento). Con respecto al hipoclorito de sodio 10 por ciento a las 12 h, grado 0 (44.4 por ciento) y a las 24 h predominó grado 1 (55,6 por ciento). Para la contrastación de hipótesis en muestras relacionadas se obtuvo en ácido fosfórico 37 por ciento e hipoclorito de sodio al 10 por ciento a las 12 h y 24 h un p= 0,052 y p= 0,584, respectivamente. Para comparaciones entre muestras independientes a las 12 h y 24 h se obtuvo p= 0,462 y p= 0,406, respectivamente. Conclusiones: El gel de hipoclorito de sodio al 10 por ciento presenta similar eficacia en el sellado marginal respecto al gel de ácido fosfórico al 37 por ciento, al utilizarlo como acondicionador dental(AU)


ABSTRACT Introduction: Microfiltration is one of the main problems of all resin sealings. Many studies aim to optimize marginal sealing using a variety of conditioners, such as sodium hypochlorite, which allows good penetration of the adhesive by generating deproteinization, and phosphoric acid, which allows removal of the dental smear layer, thus creating a hybrid layer when the adhesive is placed. Objective: Evaluate the marginal sealing degree of Bulk Fill resin applying 10 percent sodium hypochlorite gel versus 37 percent phosphoric acid gel in in vitro dental conditioning. Methods: The study universe was 72 teeth with class I cavities, divided into four groups of 18 teeth. Upon sealing, thermal cycling was performed at 500 cycles from 5 ºC to 55 ºC. Next the teeth were submerged in 2 percent methylene blue for 12 h and 24 h at a temperature of 37 ºC. Finally marginal sealing was evaluated in the stereo microscope according to ISO / TS 11405: 2015, using the following scale: grade 0 (no microfiltration), grade 1 (microfiltration as far as the enamel), grade 2 (microfiltration as far as the dentin), and grade 3 (microfiltration as far as the pulp floor). Results: Conditioning with 37 percent phosphoric acid was grade 0 (55.6 percent) and grade 1 (33.3 percent) at 12 h, and grade 1 (55.6 percent) at 24 h, whereas conditioning with 10 percent sodium hypochlorite was grade 0 (44.4%) at 12 h, and predominantly grade 1 (55.6 percent) at 24 h. Hypothesis contrast in related samples yielded 37 percent phosphoric acid and 10 percent sodium hypochlorite at 12 h and 24 h, p= 0.052 and p= 0.584, respectively. Comparison between independent samples at 12 h and 24 h yielded p= 0.462 and p= 0.406, respectively. Conclusions: The 10 percent sodium hypochlorite gel has similar marginal sealing effectiveness as the 37 percent phosphoric acid gel when used as dental conditioners(AU)


Assuntos
Humanos , Ácidos Fosfóricos/efeitos adversos , Selantes de Fossas e Fissuras/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Micropeneiramento/métodos , Camada de Esfregaço/etiologia
6.
Adv Clin Exp Med ; 29(2): 209-213, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32101646

RESUMO

BACKGROUND: After the mechanical preparation of a root canal, the canal walls are covered with a smear layer. In order to deeply clean the dentinal tubules, removal of the smear layer is recommended. There is no consensus on the length of time of rinsing with chelating agents or irrigation with alternating chelating agents and sodium hypochlorite (NaOCl). OBJECTIVES: The aim of the study was to evaluate the effectiveness of smear layer removal using 4 irrigation protocols. MATERIAL AND METHODS: We prepared 42 straight root canals to size ISO40/04 and assigned them into 4 study groups (n = 10) and a control group (n = 2). The root canals were irrigated as follows: in the control group, 180 s with 5.25% NaOCl; in group 1, 60 s with 40% citric acid (CA) and 120 s with NaOCl; in group 2, 120 s with CA and 120 s with NaOCl; in group 3, 30 s CA, 30 s with NaOCl, 30 s CA and 120 s with NaOCl; and in group 4, 60 s with CA, 30 s with NaOCl, 60 s with CA, and 120 s with NaOCl. The roots were split longitudinally and the root canals were observed under ×200-500 magnification. The root canal walls were analyzed in areas 2 mm, 6 mm and 10 mm from the apex. RESULTS: In the apical and medial sections, the best effects were achieved in groups 3 and 4. In coronal sections, no significant differences between experimental groups were found. CONCLUSIONS: Within the limitations of this study, it can be concluded that irrigation with alternating NaOCl and CA was the most effective at smear layer removal, regardless of the irrigation time.


Assuntos
Quelantes/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular , Camada de Esfregaço , Hipoclorito de Sódio/uso terapêutico , Cavidade Pulpar , Humanos
7.
J Appl Oral Sci ; 28: e20190100, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31800872

RESUMO

OBJECTIVE: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. METHODOLOGY: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. RESULTS: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). CONCLUSION: Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar.


Assuntos
Cavidade Pulpar/microbiologia , Periodontite Periapical/terapia , Tratamento do Canal Radicular/instrumentação , Terapia por Ultrassom/instrumentação , Adolescente , Adulto , Análise de Variância , Bactérias/isolamento & purificação , Carga Bacteriana , Contagem de Colônia Microbiana , Tomografia Computadorizada de Feixe Cônico , Sondas de DNA , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Irrigantes do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Hipoclorito de Sódio/uso terapêutico , Irrigação Terapêutica/instrumentação , Irrigação Terapêutica/métodos , Resultado do Tratamento , Terapia por Ultrassom/métodos , Adulto Jovem
8.
Clin Oral Investig ; 24(6): 1971-1979, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31432311

RESUMO

OBJECTIVE: To evaluate the effects of adjunctive delivery of a sodium hypochlorite gel in the treatment of peri-implant mucositis (PM). MATERIALS AND METHODS: Forty-six subjects with 68 implants diagnosed with PM were randomly assigned to two treatment groups. Prior to mechanical debridement, a sodium hypochlorite gel was delivered to the implants of the test group while implants of the control group received a placebo gel. Application of both test and placebo gels was repeated 5 times at baseline. The primary outcome variable was the change in pocket probing depth (PPD) between baseline and 6 months. RESULTS: After 6 months, the mean PPD decreased statistically significantly from 3.93 ± 1.09 mm to 3.04 ± 0.46 mm in the test (p = 0.0001) and from 3.68 ± 0.85 mm to 3.07 ± 0.58 mm in the control (p = 0.0001) group, respectively. No statistically significant difference (p = 0.53) was observed with respect to PPD changes from baseline to 6 months between test (0.88 ± 1.04 mm) and control group (0.61 ± 0.75 mm), respectively. The number of implants with bleeding on probing (BoP) decreased statistically significantly from 33 to 18 in the test group (p = 0.0001) and from 34 to 23 in the control group (p = 0.0001) after 6 months. CONCLUSIONS: In conclusion and within the limits of the present study, changes in PPD from baseline to 6 months were not statistically significantly different between groups. Complete resolution of mucosal inflammation was not achieved with either of the therapies. CLINICAL RELEVANCE: The present outcomes have showed that a complete resolution of peri-implant mucositis is not possible to obtain by means mechanical debridement with or without a sodium hypochlorite gel application.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Hipoclorito de Sódio , Estomatite , Géis , Humanos , Mucosite/tratamento farmacológico , Mucosite/etiologia , Peri-Implantite/complicações , Peri-Implantite/tratamento farmacológico , Índice Periodontal , Hipoclorito de Sódio/uso terapêutico , Estomatite/tratamento farmacológico , Resultado do Tratamento
9.
J. appl. oral sci ; 28: e20190100, 2020. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1056594

RESUMO

Abstract Objective: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. Methodology: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. Results: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). Conclusion: Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Periodontite Periapical/terapia , Tratamento do Canal Radicular/instrumentação , Terapia por Ultrassom/instrumentação , Cavidade Pulpar/microbiologia , Irrigantes do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Hipoclorito de Sódio/uso terapêutico , Bactérias/isolamento & purificação , Terapia por Ultrassom/métodos , Contagem de Colônia Microbiana , Sondas de DNA , Modelos Lineares , Análise de Variância , Resultado do Tratamento , Tomografia Computadorizada de Feixe Cônico , Carga Bacteriana , Irrigação Terapêutica/instrumentação , Irrigação Terapêutica/métodos
10.
J. appl. oral sci ; 28: e20190100, 2020. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1090785

RESUMO

Abstract Objective: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. Methodology: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. Results: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). Conclusion: Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Periodontite Periapical/terapia , Tratamento do Canal Radicular/instrumentação , Terapia por Ultrassom/instrumentação , Cavidade Pulpar/microbiologia , Irrigantes do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Hipoclorito de Sódio/uso terapêutico , Bactérias/isolamento & purificação , Terapia por Ultrassom/métodos , Contagem de Colônia Microbiana , Sondas de DNA , Modelos Lineares , Análise de Variância , Resultado do Tratamento , Tomografia Computadorizada de Feixe Cônico , Carga Bacteriana , Irrigação Terapêutica/instrumentação , Irrigação Terapêutica/métodos
11.
J Wound Care ; 28(11): 780-783, 2019 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-31721661

RESUMO

OBJECTIVE: Acne vulgaris (acne) presents with increased oil-sebum secretion and subsequent formation of comedones, papules, pustules and nodules. Skin cleansing is part of the daily routine to improve skin condition. A monofilament debridement pad has shown to be effective when used for wound debridement and skin cleansing in dermatological conditions. The pad may offer benefits when used for acne affected skin. METHODS: The in vitro cleansing capacity of the monofilament fibre pad was analysed and compared with commercially available cosmetic pads. For this purpose, a sebum model consisting of glass plates coated with an oil-red-stained layer of artificial sebum was used. To gain clinical experience a case series evaluated cleansing efficacy of the monofilament debridement pad in combination with polyhexanide and sodium-hypochlorite based solutions. Over a period of four months, seven individuals suffering from retentive moderate facial acne who visited the dermatology clinic for their acne used the pad as necessary, ranging from twice weekly to daily, dependent on the sensitivity of the patient's skin condition. RESULTS: The in vitro study exhibited a significantly better cleansing efficacy of the monofilament debridement pad compared with the cosmetic pads. After single use of the pad subject scores on sebum reduction revealed excellent/very good in 42.9% and acceptable in 57.1% of cases. After repeated use of the monofilament pads scores on sebum reduction of excellent/very good were given in 85.7% and acceptable in 14.3% of cases. Subject scored handling of the pad and comfort during use also received favourable ratings. CONCLUSION: These initial results show the potential of the monofilament debridement pad for cleansing of acne-prone and acne affected skin. More robust studies are needed to confirm these results.


Assuntos
Acne Vulgar/terapia , Desbridamento/instrumentação , Face , Adolescente , Biguanidas/uso terapêutico , Desenho de Equipamento , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Hipoclorito de Sódio/uso terapêutico , Adulto Jovem
12.
Braz Oral Res ; 33: e021, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31508722

RESUMO

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


Assuntos
Carga Bacteriana , Instrumentos Odontológicos , Cavidade Pulpar/anatomia & histologia , Preparo de Canal Radicular/instrumentação , Cavidade Pulpar/microbiologia , Desinfetantes/uso terapêutico , Enterococcus faecalis/isolamento & purificação , Infecções por Bactérias Gram-Positivas , Humanos , Incisivo , Teste de Materiais , Solução Salina/uso terapêutico , Hipoclorito de Sódio/uso terapêutico
13.
J Biol Regul Homeost Agents ; 33(3 Suppl. 1): 1-9, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31538444

RESUMO

Blood contamination of the canal during preparation and obturation can be a problem in Endodontics; this may result in apical microleakage. The purpose of this investigation was to observe and evaluate the hemostatic properties of biofilm decontaminant material (sulfonic/sulphuric acid solution, HybenX, EPIEN Medical) used in teeth with necrotic pulp and unstoppable bleeding after root canal shaping. A prospective study was designed with 2 randomized parallel groups: decontaminant material (experimental group) and sodium hypochlorite 5% (control group). The analysis of the root canal bleeding was evaluated by the clinician before and after the application of the sulfonic/sulphuric solution or sodium hypochlorite 5%, by measuring the millimeters of blood on a sterile paper point introduced in the root canal. Sixty patients with necrotic pulp and unstoppable bleeding were enrolled in this study and randomly divided into 2 groups: decontaminant material in 30 patients (experimental group) or sodium hypochlorite 5% in 30 patients (control group). T-test showed that the percentage change in millimeters of blood detected in the root canal was statistically greater for experimental group [mean difference: 0.74 (IC: 0.66-0.82); p less than 0.0001]. The hemostatic properties were better in the experimental group than in the sodium hypochlorite 5% group (control). Further research may be needed to confirm the results of this study..


Assuntos
Cavidade Pulpar , Hemorragia/prevenção & controle , Hemostáticos/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Humanos , Estudos Prospectivos , Tratamento do Canal Radicular , Hipoclorito de Sódio/uso terapêutico
14.
Photodiagnosis Photodyn Ther ; 28: 253-255, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31518699

RESUMO

This article describes the use of Photodynamic Therapy (PDT) during the endodontic treatment of teeth with periapical lesion. Patients presented tooth 35 with diagnostic hypotheses of Periapical Cyst or Granuloma. The Crown-Down preparation was performed with the HyFlex CM system. In case I it was not possible to reach the working length, in case II the foraminal debridement was performed at the actual tooth length. In the final irrigation, the E1 - Irrisonic ultrasonic insert was used, promoting sequentially agitation of NaOCl 2.5%, EDTA 17% and NaOCl 2.5%. Then, PDT was applied with 0.005% methylene blue dye. Calcium Hydroxide with Parammonochlorophenol was used and after 15 days, the final irrigation protocol and PDT were performed again. After 90 days of case I and 1 year of case II, the total lesion regression was observed in both cases. It is concluded that the proposed treatment improved the microbial disinfection favoring the regression of the periapical alterations providing satisfactory clinical and radiographic results.


Assuntos
Necrose da Polpa Dentária/terapia , Fotoquimioterapia/métodos , Irrigantes do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Necrose da Polpa Dentária/diagnóstico por imagem , Desinfecção/métodos , Humanos , Materiais Restauradores do Canal Radicular/uso terapêutico , Hipoclorito de Sódio/uso terapêutico
15.
Microsc Res Tech ; 82(12): 1975-1981, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31444946

RESUMO

The purpose of this in vitro study was to investigate the effect of Trigonella foenum graecum seed extract (TFGSE) as a root canal irrigation agent on the surface of instrumented root canals and on changes in the mineral contents of the root dentin. A total of 90 extracted human mature maxillary central incisor teeth with a single root and without root resorption were selected. The specimens were subdivided into five groups according to irrigation protocol groups G0: distilled water (n = 15): G1: Sodium hypochlorite (5.25% NaOCl); G2: 1% TFGSE G3: NaOCl +17% EDTA (3 min); G4: NaOCl+1% TFGSE; G5: 1% TFGSE +17% EDTA. All the roots were sectioned longitudinally into two halves and examined under scanning electron microscope/energy dispersive X-ray analysis (SEM/EDX) to assess changes in the mineral content of the tooth. Smear layer removal from root canals was evaluated with scanning electron microscopy (SEM). A statistical analysis was performed using the Kruskal-Wallis test. The most effective irrigation protocols in removing smear layer occurred with TFGSE and NaOCl, both with rinsing with 17% EDTA. TFGSE was more effective than NaOCl for removing the smear layer. The results showed the ability of 1% TFGSE to remove the smear layer from the root canals. TFGSE is a promising alternative irrigation agent for root canals.


Assuntos
Cavidade Pulpar/efeitos dos fármacos , Extratos Vegetais/farmacologia , Irrigantes do Canal Radicular/farmacologia , Preparo de Canal Radicular/métodos , Trigonella/química , Ácido Edético/farmacologia , Humanos , Incisivo/efeitos dos fármacos , Microscopia Eletrônica de Varredura , Sementes/química , Hipoclorito de Sódio/uso terapêutico
16.
Photodiagnosis Photodyn Ther ; 27: 396-401, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31301436

RESUMO

This study aimed to determine the effects of photodynamic therapy (PDT) on postoperative pain after treatments of teeth with necrotic pulps. This randomized clinical trial consisted of 60 patients who presented for treatment of asymptomatic teeth. The patients were randomly assigned into the Control Group (CG) or the PDT Group (PG). The canals were instrumented with a reciprocating instrument (50.05) under 2.5% NaOCL irrigation. After instrumentation was completed, the canals were flooded with 1.56 µM/mL of methylene blue (MB), the optical fiber was inserted to the working length and applied for 3 min (P =100 mW, t =3 min, E = 18 J). The device emitted PDT only for the PG. The operator and the patient were both masked to the treatment protocol. After PDT, the root canal treatment was completed and the canals were filled. A card was given to the patients to document their pain perception through the 0-10 visual analogue scale (VAS) at 24 h, 72 h, and 1-week intervals. The Mann-Whitney and Fisher´s exact tests were used for statistical analysis (P < .05). The average pain level for the CG was 1.33 at 24 -hs and 0.50 at 72 -hs; for the PG, the average pain level was 0.37 at 24 -h and 0 at 72 -h (P < .05). After 1-week there was no report of pain. PDT had a significant effect in decreasing postoperative pain at 24- and 72 -h intervals in treatment of single-rooted teeth with necrotic pulps performed in one visit.


Assuntos
Azul de Metileno/administração & dosagem , Dor Pós-Operatória/prevenção & controle , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/administração & dosagem , Tratamento do Canal Radicular/métodos , Adulto , Idoso , Cavidade Pulpar/efeitos dos fármacos , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Irrigantes do Canal Radicular/uso terapêutico , Hipoclorito de Sódio/uso terapêutico
17.
Av. odontoestomatol ; 35(3): 114-119, mayo-jun. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-187645

RESUMO

Introducción: Una de las propiedades del hipoclorito de sodio (NaOCl) es la disolución de tejido pulpar remanente después de la instrumentación. Los sistemas de activación del irrigante pretenden mejorar esta propiedad. Este trabajo tiene como objetivo determinar la capacidad de disolución de tejido de NaOCl con y sin activación sónica o ultrasónica en diferentes concentraciones. Metodología: 300 muestras de tejido conectivo de paladar de cerdo de 4,5 * 2 mm obtenidos 1 día antes del estudio, congelado a-15°C en 100% de humedad, fueron pesados en una balanza analítica y sometidos a la acción de NaOCl 1%, 3% y 5% con y sin activación durante 45 minutos, cambiando la solución cada 10 minutos. Se secaron en papel filtro y se pesaron nuevamente. Los datos se analizaron mediante tests Kolmogorov-Smirnov; Kruskal-Wallis y Mann-Whitney. Resultados y Discusión: NaOCl 1% tiene menor capacidad de disolución que mejora levemente al activarlo. NaOCl 3% tiene mejor capacidad de disolución que NaOCl 1%, pero la activación no la mejora significativamente. NaOCl 5% tiene mayor capacidad de disolución, que aumenta con la activación, sin significancia entre activación sónica y ultrasónica, lo que se debería a que la mucosa palatina porcina requiere más tiempo para su disolución completa, y a que el volumen de tejido utilizado es mayor que una pulpa dental. Conclusiones: Bajo las condiciones de este estudio, sólo NaOCl 5% mostró mayor capacidad de disolución con la activación. NaOCl 1% y 3% no mejoraron significativamente con la activación


Introduction: One of the properties of sodium hypochlorite (NaOCl) is dissolution of pulp tissue remaining after instrumentation. Irrigant activation systems aim to improve this property. The objective of this work is to determine tissue dissolution capacity of NaOCl with and without sonic or ultrasonic activation in different concentrations. Methodology: 300 pork palate connective tissue samples of 4.5 * 2 mm obtained 1 day before the study, frozen at-15 ° C in 100% humidity, weighed on an analytical balance and subjected to the action of NaOCl 1%, 3% and 5% with and without activation for 45 minutes, changing the solution every 10 minutes. They were dried on filter paper and weighed again. The data were analyzed by Kolmogorov-Smirnov tests; Kruskal-Wallis and Mann-Whitney. Results and Discussion: NaOCl 1% has a lower dissolution capacity that improves slightly when activated. NaOCl 3% has better dissolution capacity than NaOCl 1%, but the activation does not significantly improve it. NaOCl 5% has greater dissolution capacity, which increases with activation, without significance between sonic and ultrasonic activation, which is due to the fact that the porcine palatine mucosa requires more time for its complete dissolution, since the volume of tissue used is greater than a dental Pulp. Conclusions: Under the conditions of this study, only NaOCl 5% showed greater dissolution capacity with activation. NaOCl 1% and 3% did not improve significantly with activation


Assuntos
Animais , Hipoclorito de Sódio/uso terapêutico , Cavidade Pulpar/efeitos dos fármacos , Polpa Dentária/efeitos dos fármacos , Palato/efeitos dos fármacos , Técnicas In Vitro , Suínos , Preparo de Canal Radicular/métodos , Tecido Conjuntivo/efeitos dos fármacos
18.
J Endod ; 45(6): 736-741, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30981431

RESUMO

INTRODUCTION: This ex vivo study evaluated the intracanal bacterial reduction promoted by chemomechanical preparation using a single-file technique varying the volume, concentration, and retention time of sodium hypochlorite (NaOCl) irrigation in comparison with a multifile system. METHODS: Palatal roots from extracted maxillary first molars were selected and anatomically matched based on microcomputed tomographic analysis for group distribution. The canals were contaminated with a fresh mixed bacterial culture grown in anaerobiosis and recently obtained from a tooth with apical periodontitis. Specimens were divided into 4 groups of 24 each according to the following preparation protocols: REC-6LOW (Reciproc R50 instrument [VDW, Munich, Germany], 6% NaOCl, low irrigant volume), REC-2.5LOW (R50, 2.5% NaOCl, low irrigant volume), REC-2.5HI (R50, 2.5% NaOCl, high irrigant volume), and BR-2.5HI (BioRaCe [FKG Dentaire, LaChaux-de-Fonds, Switzerland], 2.5% NaOCl, high irrigant volume). The total time of preparation was recorded. Intracanal bacteriologic samples were taken before and after preparation; DNA was extracted and subjected to quantitative polymerase chain reaction. RESULTS: Bacteria were detected in 22 initial samples from the REC-2.5LOW group and in 23 from the other groups. Intragroup analysis showed that all tested preparation protocols were highly effective in significantly reducing the intracanal bacterial counts (P < .001). Intergroup comparison of bacterial reduction levels revealed a statistically significant difference between BR-2.5HI and REC-2.5LOW (P < .05). Counts of bacteria were 2.5 times significantly higher in REC-2.5LOW compared with BR-2.5HI. No other significant differences were found in quantitative findings (P > .05). CONCLUSIONS: The concerted effects of multiple instruments, the high volume of irrigation, and the long retention time of NaOCl irrigant had a positive influence on intracanal disinfection during chemomechanical preparation.


Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Hipoclorito de Sódio , Desinfecção , Alemanha , Humanos , Irrigantes do Canal Radicular , Hipoclorito de Sódio/uso terapêutico
19.
Niger J Clin Pract ; 22(3): 305-312, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30837416

RESUMO

Objective: To evaluate the clinical and radiographical success of primary molar pulpotomies which used 15.5% ferric sulfate (FS) or 1.25% sodium hypochlorite (NaOCl) for hemostasis and zinc oxide-eugenol (ZOE) and calcium hydroxide (CH) pastes as base materials. Methods: In 29 healthy children, 80 primary molars were randomly allocated to one of the study groups: Group 1: FS-ZOE, Group 2: FS-CH, Group 3: NaOCl-ZOE, and Group 4: NaOCl-CH. After hemostasis with the respective solutions, pulp stumps and floor of the pulp chambers were covered with either ZOE or CH pastes. All teeth were restored with stainless steel crowns. Follow-up examinations were carried out at 1, 3, 6, and 12 months. Results: One tooth in Group 1 and two teeth in Group 4 were extracted because of pain and periapial pathosis at sixth month. After 12 months, clinical success rates of pulpotomies in Groups 1-4 were 95%, 100%, 100%, and 89.5%, respectively. The differences were not significant (P = 0.548). Radiographic success rates for Groups 1-4 were 80%, 88.9%, 78.9%, and 84.2%, respectively. No statistically significant difference was found (P = 0.968). Pain on percussion was the most observed clinical finding. However, internal root resorption was the most common radiological finding and it was observed significantly more in mandibular primary molars (P < 0.05). Conclusion: Both ZOE and CH can be preferred as base materials after hemostasis achieved by the use of 15.5% FS or 1.25% NaOCl in primary tooth pulpotomy.


Assuntos
Hidróxido de Cálcio/uso terapêutico , Polpa Dentária/diagnóstico por imagem , Compostos Férricos/uso terapêutico , Hemostáticos , Pulpotomia/métodos , Irrigantes do Canal Radicular/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Dente Decíduo/diagnóstico por imagem , Cimentos para Ossos , Criança , Pré-Escolar , Cárie Dentária/terapia , Feminino , Seguimentos , Humanos , Masculino , Radiografia Dentária , Reabsorção da Raiz , Reabsorção de Dente/etiologia , Dente Decíduo/cirurgia , Resultado do Tratamento , Cimento de Óxido de Zinco e Eugenol/uso terapêutico
20.
J Am Anim Hosp Assoc ; 55(3): 117-123, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30870602

RESUMO

The emergence of methicillin-resistant Staphylococcus pseudintermedius has increased the interest in topical therapy for treating canine pyoderma. Shampooing with chlorhexidine followed by dilute bleach rinses are often recommended, but household bleach can dry the skin and is unpleasant to use. A shampoo formulated with sodium hypochlorite and salicylic acid was evaluated as sole therapy for dogs with superficial pyoderma associated with S. pseudintermedius, including methicillin-resistant strains. Client-owned dogs were recruited based on positive culture for methicillin-resistant staphylococci or prior failure of pyoderma to respond to antibiotics. This prospective, open-label pilot study assessed the efficacy of the shampoo when used three times weekly for 4 wk. Dogs were evaluated at baseline and at 2 and 4 wk by cytology, clinical examination, and owner assessment. Digital images were also obtained. Baseline bacterial counts, clinical assessments and owner scores were significantly improved at 2 and 4 wk. Clients completing the study reported excellent lathering and dispersion, reduction in odor, and brightening of white and light coats. No owners reported skin dryness or other adverse events during the study. We conclude that this shampoo containing sodium hypochlorite in a vehicle that avoids skin drying is an effective treatment for canine pyoderma.


Assuntos
Doenças do Cão/tratamento farmacológico , Resistência a Meticilina , Ácido Salicílico/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Infecções Cutâneas Estafilocócicas/veterinária , Staphylococcus/efeitos dos fármacos , Animais , Anti-Infecciosos/uso terapêutico , Cães , Formas de Dosagem , Feminino , Masculino , Meticilina/farmacologia , Projetos Piloto , Ácido Salicílico/administração & dosagem , Hipoclorito de Sódio/administração & dosagem , Infecções Cutâneas Estafilocócicas/tratamento farmacológico
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